Journal of Comprehensive Pediatrics
Volume:6 Issue: 2, May 2015

Exchange transfusion is commonly used in newborns for immediate treatment of severe hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus.. This study aimed to determine etiology and complications in newborns who received exchange transfusion for severe hyperbilirubinemia over the last five years..Patients and A retrospective study was performed on 28 days old infants who received exchange transfusion due to severe hyperbilirubinemia for a period of five years (from October 1st, 2006 through September 30th, 2011) in two neonatal units at Besat and Fatemieh hospitals in Hamadan, Iran. All data about patients’ demographic characteristics, causes of hyperbilirubinemia, frequency, and complications of exchange transfusion were collected from medical records and analyzed using SPSS Version 12.0).. Exchange transfusion was performed in 148 neonates. Eighteen patients (12.2%) received exchange transfusion twice and seventeen patients (11.4%) three times or more. Among 118 neonates 80 (54.9%) were female and the mean gestational age and birth weight were 37.2 ± 2.5 weeks and 2847 ± 699 grams, respectively. The mean maximum total serum bilirubin levels were 27. 7.6 ± 7.28 mg/dL. Hemolytic disease was found in 72 (48.6%) of newborns. The most common cause of hemolysis was ABO incompatibility in 54 (36.5%). The etiologic factors were unidentified in 61 (41.2%) neonates. Complications occurred in 57 (38.5%) neonates and the most common complications were thrombocytopenia in 26 (17.6%) and hypocalcaemia in 17 (11.5%) neonates. Mortality was found in one (0.7%) neonate.. The etiology of exchange transfusion was unidentified in most cases; however, ABO incompatibility was the most prevalent cause of hyperbilirubinemia. Complications were common after exchange transfusion and should be considered carefully..

Cold may aggravate urge symptoms in patients with frequency/urgency syndromes.. This paper attempts to establish the correlation between the changes in three variables, namely the changes of ambient temperature, age and weight of conscious infants and their micturition rate.. The time interval between the napkin removal and micturition was recorded, in order to establish the relationship between environmental temperature changes and urination.. Micturition occurred in response to decreased skin temperature of the lower trunk, during the first minute interval of napkin removal, in 287 of the infants (35.9%). Totally, 428 infants (53.5%) voided in a 5 minute interval. The younger infants urinated more frequently and also faster, in relation to ambient temperature changes.. We concluded that the occurrence of urination, as a response to cooling stimulation of the lower trunk, is correlated with infants’ age and amount of environmental temperature degree..

Constipation is a common symptom in children and can cause significant distress to parents.. The aim of this study was to investigate the response and recurrence rate after treatment with polyethylene glycol alone versus polyethylene glycol plus lactulose in children with chronic functional constipation..Patients and In this randomized controlled trial study, 200 patients aged 1 to 12 years with functional constipation based on the ROME III criteria, were divided into two identical therapeutic groups; group I received polyethylene glycol (PEG) alone and group II received PEG and lactulose. Participants were treated for one month and responsive patients were followed prospectively at 3, 6 and 12 months to assess the recurrence.. The response rate to treatment was 70% in group I and 87% in group II (P value 0.003). Recurrence rate was 15.9% in group I and 10.3% in group II (P value 0.3). Factors such as positive family history, sex, age onset of constipation, low fiber diet, toileting and fecal incontinence did not significantly contribute to success rate of treatment or recurrence rate in the both groups.. There was no significant lower recurrence rate of constipation with PEG and lactulose combination therapy over PEG alone. Therefore, changing treatment from lactulose plus PEG to PEG alone would result in better compliance of patients for long-term therapy and would be cost effective..

In the United States, 17% of children are considered obese, and the economic burden of obesity and related conditions are concerning. Healthy Caregivers-Healthy Children (HC2) is an early childcare center-based obesity prevention trial among ethnically diverse children and families.. To better understand the economic impact of early childhood obesity prevention efforts, this study conducted a cost analysis of the HC2 intervention and estimated the potential lifetime cost-savings of HC2 from reducing childhood obesity..Patients and Economic analyses estimated the direct intervention costs and the projected lifetime medical cost savings from preventing childhood obesity. Cost data were collected using detailed staffing and financial records, from the HC2 study investigators. Resources were organized into four main categories: personnel costs, contractors, supplies and equipment, and miscellaneous expenditures. Costs were estimated separately for the two phases of the intervention: Year 1 and Years 2 ‒ 3.. The total cost of HC2 intervention was 206319 $. The average cost per child in Year 1 was 113.90 $. The average cost per child for the booster sessions, in Years 2 and 3 was 29.02 $ per year. Average cost per child throughout the intervention was 172 $. If HC2 generates just a 1% reduction in obesity, lifetime savings would be of approximately 228000 $, with net savings of 21681 $, over the three years of the intervention. The average (per child) net savings across all HC2 participants range from 18 $, if 1% of participants avoid obesity, to 1728 $, if 10% avoid obesity.. The HC2 intervention shows potential for generating cost savings. Cost analyses of programs of this type are helpful to policymakers and program planners to allocate resources for obesity prevention programs in school and childcare settings..

Parents’ psychological health is one of the most important factors to obtain health in children with chronic disease.. In this paper, we intended to evaluate and compare psychological health in parents of type 1 diabetes mellitus (T1DM) and Leukemic children with control group and estimate the effect of the type of disease on parents’ psychological health and if possible recommend means to improve it..Patients and Three groups of mothers (30 people per group) were evaluated. T1DM children’s mothers, Leukemic children’s mothers and control group were chosen from mothers of children who came to Hazrat Aliasghar Emergency Room without any underlying diseases. The samples were asked to fill SCL-90-R and FBIS questionnaires. In addition, other forms were filled for their demographic characteristics.. The abbreviation (GSI) score in Leukemic children’s mothers was higher than T1DM children’s mothers and both groups had higher GSI compared with the control group.. Parental functioning and wellbeing are important aspects of a family adaptation to chronic pediatric conditions. Moreover, psychological interventions were recommended to patients..