Aims: We evaluated the efficacy of active video games as weight reduction intervention among obese children and adolescents by synthesizing available published evidence.

Materials and methods: A meta-analysis was performed using nine RCTs based on the PRISMA guidelines. Children less than 18 years of age who are Obese I and Obese II and underwent active video games intervention or standard weight management programs were included. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, Cochrane, and HERDIN databases from inception to September 2024 databases using the MeSH and key words: (“video games” or “digital games” or “console games” or “electronic games”) AND (“weight loss” or BMI or obesity) AND (children OR pediatric OR adolescents) AND (RCT OR trials OR “randomized controlled trial). Pooled mean difference was used to determine effectiveness on reducing weight and BMI.

Results: The pooled mean difference showed significantly lower post-intervention weight (in kg) (MD=-2.97, 95%CI=-5.15 to -0.78, p=0.008) and significantly lower post-intervention BMI z-score (MD=-0.12, 95%CI=-0.13 to -0.10, p<0.000001) on children with AVG intervention. There was also lower post-intervention BMI on children with AVG intervention (MD=-1.27, 95%CI=-2.93 to 0.38). However, the difference was not statistically significant (p=0.13).

Conclusion:Active video games showed a significant benefit in weight reduction among obese children. Usual lifestyle modification interventions may be challenging due to lack of motivation and poor adherence among younger demographics. AVGs present a novel approach by integrating entertainment with physical activity, thereby addressing these barriers.

Human ; Male ; Female ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Randomized Controlled Trial ; Adolescent ; Meta-analysis ; Video Games ; Life Style ; Exercise ; Electronics

OBJECTIVES: This study aims to compare the effectiveness of rice-based ORS as compared with glucose-based ORS in the treatment of acute watery diarrhea among children. Specifically, it aims to review and analyze the effectiveness of rice-based ORS as compared to glucose-based ORS as to stool output, duration of diarrhea and effect of osmolarity on treatment of diarrhea and to determine associated adverse events associated with rice-based ORS and glucose-based ORS. METHOD: This study used systemic review and meta-analysis of randomized trials. Primary outcomes were computed with 95% confidence intervals to determine the effectiveness of ricebased ORS. Adverse event was expressed as risk ratios with 95% confidence intervals. RESULTS: Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60). CONCLUSION Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60).

BACKGROUND: The dengue vaccine controversy in the Philippines caused significant public anxiety affecting childhood vaccines, as well as other healthcare programs. An assessment of parental perception and attitude on childhood immunization and other government healthcare programs after the dengue vaccine controversy is lacking

OBJECTIVE: To determine the perception and attitude of parents on childhood immunization and other government health care programs after the dengue vaccine controversy at a tertiary pediatric hospital.

METHODOLOGY: A hospital-based cross-sectional survey was done at a tertiary pediatric hospital. A total of 96 subjects participated in the study. Parents with children ages 9 to 18 years old whose child was either vaccinated or non-vaccinated with dengue vaccine seen in the dengue clinic, outpatient department and private clinics were invited to answer the structured questionnaire. Proportional stratified sampling was employed. Mann Whitney U-test compared the perception and attitude scores between parents of children who were recipients and non-recipients of dengue vaccine. A p-value of

RESULTS: The overall perception and attitude of parents on childhood immunization, deworming and vitamin A supplementation did not differ significantly between parents of non-dengue vaccinated children and dengue-vaccinated children. Sociodemographic factors such as gender, marital status, educational attainment, employment, and economic status did not differ significantly in their perception and attitude in terms of childhood immunization, deworming and vitamin A supplementation.

CONCLUSIONS: The overall perception and attitude of parents in both groups showed no significant difference toward childhood immunization, deworming and vitamin A supplementation. There is no association with the overall perception and attitude of parents on childhood immunization, deworming and vitamin A supplementation and their sociodemographic factors. RECOMMENDATIONS: Future similar studies may be conducted in other regions to determine parental perception and attitude towards the government's immunization program and other health care programs.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Dengue Vaccines ; Immunization

BACKGROUND: Increasing incidence of natural and man-made disasters emphasize the need to assess home disaster preparedness of pediatricians.

OBJECTIVES: To determine degree of family disaster preparedness and association of demographic characteristics of active consultants of a tertiary hospital for children in Quezon City.

METHODS: Cross-sectional study where participants were selected using purposive type of sampling. Fifty-eight active consultants for children answered a self-administered questionnaire on home disaster preparedness. Data was analyzed using SPSS version 24.0.

RESULTS: Total of 36 (62.06%) participants scored 70 and above, indicating family disaster preparedness. A total of 22 (37.94%) participants scored below 70, indicating lack of home disaster preparedness. The age of participants 35 to 40 (OR 108.57), 41 to 45 (OR 36.01), 51 to 55 (OR 11.4) and 56 to 60 (OR 17.93) are more likely to be family disaster ready (p value <0.05). Male participants were 7 times more likely to have higher overall family disaster preparedness.

CONCLUSIONS: This study has shown that 36 consultants in a tertiary hospital for children in Quezon City are prepared for home disasters. Males and younger population are the demographic characteristics associated with an increased degree of family disaster preparedness.

RECOMMENDATIONS: Basics of home disaster management should be included in continuing medical education of the hospital staff. Health education management system should encourage participation of hospital staff in disaster management programs. Bigger sample size of the pediatric society is recommended. Determine association of other demographic variables on home disaster preparedness. Address issues to overcome response bias.

Human ; Male ; Female ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Person 19-44 Years Of Age) ; Health Education ; Disaster Planning

BACKGROUND: Hearing impairment has a great impact on the functional, social and emotional aspects of a child. Thus, early detection and management is crucial for optimal development of the child. The Newborn Hearing Screening Act was approved in the Philippines to ―institutionalize measures for prevention and early diagnosis of congenital hearing loss among newborns‖. A simple, accurate and readily available hearing screening tool is necessary in less privileged communities. OBJECTIVES: To determine the accuracy of Pen Click Test as compared to otoacoustic emission test as a hearing screening tool among newborns seen in two tertiary government hospitals. The accuracy of Pen Click Test was measured for its sensitivity, specificity, positive and negative predictive value. METHODS: The study is an experimental design consisting of three phases: Phase I is a randomized complete block design; Phase II involves inter-rater and intra-rater variability randomized block design and Phase III is a cross sectional design. The study was done in two government tertiary hospitals. The subjects are term newborns with both ears analyzed independently from each other. RESULTS: Phase I of the study identified Acroball retractable pen as the study stimulus based on its accessibility and its capability to produce high decibel. In phase II, all health workers produced a sound stimulus of more than 70 decibels. Majority of the health workers had no significant difference among each other which means there is minimal deviation from the mean. Phase III showed that pen click test has a high specificity of 98% and a sensitivity of 43%. Based on disease prevalence, the test showed a positive predictive value of 77% and negative predictive value of 93%. Kappa agreement showed moderate result with a Kappa coefficient of 0.54. CONCLUSION The study showed high specificity in identifying hearing impairment and a positive association of Pen Click test to the standard hearing audiometer. The application of this test in the community may be done as a hearing screening tool. This study provides an accessible, easily reproducible and accurate tool for hearing screening that may be applied in communities without facilities.

BACKGROUND: Timely initiation of therapy for neonatal hyperbilirubinemia is routinely made based on total serum bilirubin levels. However, serial samplings by invasive needle pricks are needed for laboratory analyses. Studies comparing the correlation between serum bilirubin and transcutaneous bilirubin have yielded diverse results. A meta- analysis was done to find out the relationship between transcutaneous bilirubin measurements and serum bilirubin values. OBJECTIVE: This study aims to analyze scientific articles regarding the accuracy of transcutaneous bilirubin measurements among healthy neonates as an alternative screening for hyperbilirubinemia. STUDY DESIGN: Diagnostic Accuracy meta- analysis. METHODS: Studies on the accuracy of transcutaneous bilirubin measurements were identified through intensive literature search. Local studies were confirmed thru personal communication. RESULTS: Three hundred eighteen studies were identified through literature search. Ten studies met the eligibility criteria. Eight of the ten studies reported results as correlation coefficients. The pooled estimates of correlation coefficients is high at r = 0.85 (95% CI = 0.84 to 0.857). Five studies reported results with data for diagnostic accuracy. The pooled analysis for sensitivity and specificity are high at 0.84 (95% CI 0.8-0.88) and 0.79 (95% CI 0.77-0.81) respectively. The pooled likelihood ratio has a significant difference with a pooled positive LR of 4.19 (95% CI 2.98-5.9, P<0.01) while the negative likelihood ratio is 0.23 (95% CI: 0.17 to 0.29). The AUC for transcutaneous bilirubinometry is 0.89. CONCLUSIONS Transcutaneous bilirubin measurement can be an alternative in monitoring the risk of healthy neonates for hyperbilirubinemia based on the pooled analysis of correlation coefficient and diagnostic accuracy.

OBJECTIVES: The study aims to determine and compare the anxiety of children with acute lymphoblastic leukemia (ALL) and their well siblings based on Child drawing: Hospital manual and to identify factors associated with the level of anxiety. METHODS: A prospective cross-sectional study was done in tertiary pediatric hospitals which included children aged five to eleven years old diagnosed with ALL and their well siblings. RESULTS: A total of forty dyads of participants were studied. ALL patients presented higher anxiety scores than their siblings, but this was not statistically significant. There is a weak direct correlation between overall anxiety scores of ALL patients and their siblings (p = 0.017). There is insufficient evidence for an association between select clinical factors with anxiety scores. The linear regression model explained 49.77% in the variation of the anxiety scores but was not statistically significant. CONCLUSIONS: There is a direct correlation between overall anxiety scores of ALL patients and their siblings. There is also a positive association with larger family size and child‘s response to sibling‘s illness. Larger families are likelier to have a healthier environment. The study also showed low to average anxiety levels among participants which may be related to quality of care and support given by the institution and inherent resiliency of the family. RECOMMENDATIONS Future research should aim to develop programs in partnership with families and other social support groups and explore the effectiveness of these interventions. Further studies should examine other possible cultural and psychodynamic factors prevalent in Filipino Family.
Anxiety ; Siblings

OBJECTIVES: The study aims to determine and compare the anxiety of children with acute lymphoblastic leukemia and their well siblings based on Child drawing: Hospital manual and to identify factors associated with the level of anxiety. METHODS: A prospective cross-sectional study was done in the hematology-oncology outpatient clinic and private clinics of hema-oncology specialist in tertiary pediatric hospitals. The study included children five to eleven years old diagnosed with Acute Lymphoblastic Leukemia (ALL) and their well siblings. RESULTS: A total of forty dyads of participants were included in the study. ALL patients presented higher anxiety scores than their siblings. However, this was not statistically significant. There is a weak direct correlation between overall anxiety scores of ALL patients and their siblings (p = 0.017). There is insufficient evidence to demonstrate an association between select clinical factors with anxiety scores. The linear regression model showed 49.77% in the variation of the anxiety scores. CONCLUSIONS: There is a direct correlation between overall anxiety scores of ALL patients and their siblings. There is a positive association with larger family size and child’s response to sibling’s illness. A larger families are likely to have a healthier environment. The study showed low to average anxiety levels among participants which may be related to quality of care and support given by the institution and inherent resiliency of the family. RECOMMENDATIONS Future research should aim to develop psychological, emotional and behavioral programs in partnerships with families and other social support groups. Future studies should examine other possible cultural and psychodynamic factors prevalent in Filipino Family.
Human ; Anxiety ; Precursor Cell Lymphoblastic Leukemia-lymphoma

BACKGROUND: Nutritional status is crucial in neonatal survival, especially among the Very Low Birthweight (VLBW) preterm infants. They have low nutrient reserves with increased metabolic needs and immature gut system. Several studies have proven the efficacy of medium-chain triglycerides (MCT) as a good source of calories among pre-term infants. However, such is not commercially available. Virgin coconut oil (VCO) has the most concentrated content of MCT's, hence a possible source of MCT.

OBJECTIVES: This review aims to determine the efficacy of VCO-supplementation to milk feeding in augmenting weight gain among very low birth weight preterm infants.

METHODS: Pubmed (1975-September 2016), Cochrane Central Register of Controlled Trials (The Cochrane Library, September 2016), HERDIN (1966 -September 2016), Google Scholar (September 2016), and https://clinicaltrials.gov (last searched September 2016) were thoroughly searched. Manual search in reference and citation lists of the eligible studies and list of abstracts from the Philippine Pediatric Society was also reviewed. Only randomized controlled trials comparing VCO-supplemented milk versus standard care in weight gain among very low birth weight preterm infants were included. The author reviewed each study's quality and extracted data on weight gain. Weighted mean differences with 95% confidence intervals were reported. Risk of biases among studies were also evaluated.

RESULTS: Three randomized controlled trials involving 290 infants were included. All trials were of good quality with relatively low heterogeneity (39%), and low risk of biases. Overall, infants receiving VCO-supplemented milk feeding had statistically significant weight gain compared to those given non-fortified milk (mean difference 5.31, 95% CI: 3.83 to 11.93).

CONCLUSION: Virgin coconut oil is effective in augmenting weight gain among very low birth weight preterm infants.

RECOMMENDATIONS: Small trials were used in this review, and a single multicenter randomized controlled trial would be ideal to further establish these findings.

Human ; Coconut Oil ; Triglycerides ; Infant, Low Birth Weight ; Weight Gain ; Meta-analysis ; Philippines

INTRODUCTION: This study compared the effectiveness and safety of neem (Azadirachta indica) seed oil methanolic extract shampoo against permethrin shampoo in reducing head lice infestation among children. METHODS: A single-blind, non-inferiority, randomized clinical trial was conducted on children aged 6-14 years with pediculosis. Using block randomization, the participants were assigned to receive either 10% neem seed oil methanolic shampoo, 1% permethrin shampoo, or pure shampoo for three treatment applications at 10-day intervals. The presence of head lice after each application was determined by standard quadrant counting and compared with the baseline count within and among treatment groups. RESULTS: There was a statistically significant difference in lice count after treatment for both neem and permethrin, with mean reductions of 17.8 ± 23.97 (p = 0.043) and 22.5 ± 23.47 (p = 0.014), respectively. Repeated Measures ANOVA showed a summary p-value of 0.041 for neem, 0.013 for permethrin, and 0.193 for the shampoo alone with a linear trend indicating a significant decrease in the lice counts from the baseline to the third application of neem and permethrin shampoo, but not in the shampoo group. There was no significant difference in the mean decrease in lice count from baseline to the third application between the neem and permethrin shampoo groups. CONCLUSION Neem seed oil methanolic extract shampoo is non-inferior and comparable to permethrin in the reduction of head lice count. There were no reported dermatologic adverse effects such as burning sensations, redness, skin irritation, and allergic reactions.