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Prevalence of Celiac Disease, Helicobacter pylori and Gastroesophageal Reflux in Patients with Refractory Iron Deficiency Anemia
Objective: The aim of this article is to determine the prevalence of celiac disease (CD), Helicobacter pylori (H. pylori) and gastroesophageal reflux (GER) in patients with resistant iron deficiency anemia (IDA). Patients: The study included 25 patients 2 years and it was statistically significant (p = 0.05*). Also patients with H. pylori had age of presentation ≤4 years in five patients (41.7%) and the remaining seven patients (81.8%) had age of presentation >4 years and it was statistically significant (p = 0.03*). Logistic regression analysis demonstrated that the risk factors for severity of anemia were age of patients and duration of anemia. On the other hand, other parameters have no significant influence on the severity of anemia. Also risk factors of short stature were age of presentation of anemia, degree of anemia and H. pylori infection. AGA had the highest sensitivity (100%) followed by antiendomysium antibody (81.8%) while the tTG antibody had the highest specificity (85.7%) for diagnosis of CD. UBT and histopathology had the highest sensitivity (100%) for diagnosis of H. pylori while rapid urease test, culture, H. pylori stool antigen and anti-H. pylori IgG antibody had the highest specificity (100%). In conclusion, refractory IDA may be due to clinically unapparent H. pylori gastritis and CD. CD is one of the most common causes of intestinal malabsorption during childhood which leads to impairment of iron absorption. Apart from offering them gluten-free diet rich in iron, early detection and treatment of IDA and prophylactic iron and folic acid supplementation will go a long way to optimize their mental and psychological functions. Eradication of H. pylori infection with concomitant iron therapy should correct the anemia.

Pain Reduction of Heel Stick in Neonates: Yakson Compared to Non-nutritive Sucking
The purpose of this study was to test the effect of Yakson (i.e. a traditional Korean touching method) and non-nutritive sucking (NNS) on reducing the pain that neonates experience when undergoing the heel stick procedure for blood testing. Ninety-nine healthy neonates were recruited and assigned into three groups: Yakson (n = 33), NNS (n = 33), and control group (n = 33). Each intervention was provided to the Yakson and NNS groups from 1 min before heel stick until the completion of the heel stick. For the Yakson group, a researcher caressed the belly of a neonate with one hand while supporting the back with the other hand. For the NNS group, a pacifier packed with sterile gauze was put in the neonate’s mouth. The oxygen saturation levels in the Yakson and NNS group neonates were maintained significantly better than in the control group neonates. There was no significant difference between the groups with regard to heart rate and neonatal infant pain, measured using the Neonatal Infant Pain Scale. Findings indicate that Yakson can be used during heel stick to help neonates maintain their oxygen saturation level following the procedure.

Medicare Online Search and Information Resource - Medicare - Medicare Part A
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