International Journal of Pediatrics
Volume:3 Issue: 18, Jun 2015

There has been a dramatic rise in the use of Assisted Reproductive Technologies (ART), including In Vitro Fertilization (IVF) throughout the world over the past three decades. Because they represent >1% of the birth cohorts in many developed countries, much attention is being paid to the health and well-being of ART children. Children born after assisted reproductive techniques (ART) have an increased risk of several adverse perinatal outcomes compared with their naturally conceived peers. Morbidity in this particular group of neonates pertains mostly to multiple gestation and prematurity. Morbidities more specific to ART/IVF have however been noted such as elevated risks of congenital malformations and imprinting disorders. Since many factors can potentially influence the neonatal outcome such as risks associated with the ART procedures themselves, advanced parental age, higher incidence of maternal nulliparity and underlying cause of parental subfertility among others, the exact pathological role played by ARTs in the occurrence of congenital malformations and genetic disorders is still unclear. In this review we aim to discuss the important epidemiological aspects of ART/IVF and the neonatal outcomes of IVF-conceived offspring.

Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis. Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization. Of the 3 types of wild poliovirus (type 1, type 2 and type 3), type 2 wild poliovirus transmission has been successfully stopped (since 1999). Today, despite a concerted global eradication campaign, poliovirus continues to affect children and adults in Afghanistan, Pakistan and some African countries (Nigeria). In Iran, the last laboratory-confirmed indigenous polio case was reported in 1997. Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially in the ''poliovirus importation belt'' of countries from west Africa to the Horn of Africa.

Pediatric neurological disorders including muscular dystrophy, cerebral palsy, and spinal cord injury are defined as a heterogenous group of diseases, of which some are known to be genetic. The two significant features represented for stem cells, leading to distinguish them from other cell types are addressed as below: they can renew themselves besides the ability to differentiate into cells with special function as their potency. Researches about the role of stem cells in repair of damaged tissues in different organs like myocardium, lung, wound healing, and others are developing. In addition, the use of stem cells in the treatment and improving symptoms of neurological diseases such as autism are known. Many epigenetic and immunological studies on effects of stem cells have been performed. The action of stem cells in tissue repair is a need for further studies. The role of these cells in the secretion of hormones and growth factors in the niche, induction of cell division and differentiation in local cells and differentiation of stem cells in damaged tissue is the samples of effects of tissue repair by stem cells.Cognitive disorders, epilepsy, speech and language disorders, primary sensory dysfunction, and behavioral challenges are symptoms of non-neuromotor dysfunction in half of pediatrics with CP. Occupational therapy, oral medications, and orthopedic surgery for supportive and rehabilitative approaches are part of Conventional remedy for cerebral palsy. This paper summarizes the clinical world wide experience about stem cell based therapeutic procedures for pediatric neurological disorders.

Congenital esophageal atresia needs to be surgically corrected as soon as possible. Some will present with post surgical stricture that needs to be dilated by a balloon dilator. This procedure is difficult in premature born due to infant esophageal size and availability of equipments. We herby report the first case in a premature infant with post surgical esophageal stricture of esophageal atresia by the use of biliary duct balloon dilator.

Hyperplastic polyps of the esophago-gastric junction are seen during endoscopic evaluation of upper gastrointestinal tract. They are usually asymptomatic and discovered accidentally during endoscopic evaluation for other problems. These protrusions are mucosal regenerative response to surrounding mucosal injury. Case: Here we present a 9-year-old boy presenting with abdominal pain and vomiting since about one year ago. Recently, he was suffering from retrosternal chest pain. So after thorough clinical and paraclinical evaluations, upper endoscopy was done and, a small polypoid lesion in esophago-gastric junction was seen. Its surface seems normal and the polyp has no true stalk. Polypectomy was performed without any complication. These lesions usually are regenerative response to surrounding mucosal injury. So, a thorough clinical evaluation and obtaining the sufficient biopsy specimen of the nonpolypoid mucosa are necessary for determining the clinicopathologic context in which the polyps have developed.

Valproic acid (VPA, Valproate) is an eight-branch fatty acid and varies from other antiepileptic drugs. VPA use might lead to mild to severe hepatotoxicity. The aim of this study was to investigate valproic acid impact on liver transaminases at the beginning of VPA treatment and after three and six months of it. This study was designed as a cross sectional project in Pediatrics Neurology ward of a Tertiary Academic Hospital (Ghaem Hospital, Mashhad-Northeastern Iran). All children who needed valproic acid therapy alone were selected for study. Liver function test was performed for them at the beginning of VPA administration, three and six months after VPA, respectively. Data was analyzed by SPSS version 16. 60 children with mean age of 49±28.6 months were entered the study. 37 of them were male and 23 were female. 5% (3 children) were mental retard and 11.7% (7 patients) had neurologic or developmental deficit. Mean value of Aspartate Aminotransferase (AST), Alanine Transferase (ALT) and Alkaline phosphatase (ALP) were 27, 30.8 and 30.4 and 17.4, 20.7 and 22.8 and 425, 426 and 441 at the beginning of VPA administration, three and six months after VPA, respectively. In six months of our follow up, only one child (1.7%) had elevated liver transaminases. Regard to our findings and its agreement with previous researches, it is important to control adverse drug events by measuring liver transaminases during antiepilepsy treatment.

Vitamin D has an important role in maintaining human health. The main source of vitamin D production is skin exposure to sunlight. Accordingly with the spread of apartment life culture, growth of industrial cities and the increase of air pollution; vitamin D deficiency and its implications is an important factor in the appearance of debilitating diseases in different age categories (especially for children, adults and elderly people). A retrospective cross-sectional study based on an objective was conducted on 1,110 patients who were selected randomly. These patients have been referred to “center of education culture and research” laboratories (2 laboratories) and 8 specialized laboratories for vitamin D test in the city of Mashhad. And after conducting the study, the collected data was analyzed using SPSS 13 software. The prevalence of vitamin D deficiency in the population under study was 68.8%. Vitamin D levels were significantly lower in males in comparison with females (P <0.05). And the statistical correlation between age and vitamin D deficiency was also significant (P <0.05). The results showed a significantly positive correlation between age and vitamin D deficiency (r = 0.187 and P = 0.000), consequently vitamin D deficiency in 40-59 age group was more prevalent. The prevalence of vitamin D deficiency in the residents of the city of Mashhad is higher in men in comparison with women. And vitamin D deficiency has increased considerably in this city in comparison with the past years.

Factors influencing the choice of the subject could strengthen the knowledge and motivation to enter the field to promote the health of society. This study explores factors influencing specialty choice of Ahvaz Jundishapur University of Medical Sciences pediatric department residents In this cross-sectional study all 38 pediatric residents were was undertaken using a questionnaire designed to assess their reasons with regard to pediatric course choice. The nameless questionnaire with sixteen questions was completed separately. The reliability and validity of the questionnaires were verified by experts and Cronbach''s alpha 0. 810. From 38 pediatric residents, including 26 female (71%) and 12 male (29%), twenty six (70. 3%) were married. Mean age was 33. 1±4. 2 years. participating in the study mentioned factors such as «helping patients», «raising knowledge and skills» and «the ability to do a better service» with the average of 4. 32, 4. 26 and 4. 18 respectively as high priority; and factors such as «lack of heavy duty,» «comfortable and effortless» and «lack of urgency», respectively, with an average of 2. 18, 2. 24 and 2. 37 had a low priority in choosing pediatric specialty course. According to the t-test, statistically significant differences were observed between gender, marital status and factors influence specialty choice of pediatric course (P)

Mechanical ventilation may be lifesaving intervention,It can be associated with complications,Thus,successful weaning is constitutive.One of the factors which is important in successful weaning is method of weaning. It is shown that weaning is conducted successfully by using Spontaneous Breathing Trial (SBT) through T-piece and pressure support (PS) ventilation.But few studies have not accepted it.In this study,we evaluated the role of SBT in extubation of patients in pediatric intensive care. In a cross sectional and analytical study, three hundred sixty patients with adequate gas exchange (indicated by PaO2 higher than 60 mm/Hg while FIO2 of 0.40 or less (or PaO2 ∕ FIO2ratio> 300) were enrolled. Patients underwent a 2-hours trial of spontaneous breathing with pressure support ventilation.They were monitored during the test for 2 hours and were classified as failing the test if at any time in the 2-hours period, there was tachypnea, excessive work of breathing,Tachycardia and SPO2<90%.Extubation failure was defind as needing reintubation within 72 hours of extubation. 240 patients(66%) of 360 patients successfully underwent SBT and were immediately extubated.In 120 patients(33%), the trial of spontaneous breathing was stopped.(trial failure;33% vs. 66% P=0.04). Of the 240 patients with successful SBT,29 patients were re-intubated (extubation failure) and 211 patients had successful extubation.(12% vs. 88% p=o.oo2).For patients experienced successful extubation, the mortality rate was 5% While the rate of mortality was 27% in patients with needing re-intubation.(5% vs. 27% p= o.oo3) The spontaneous breathing trial with pressure support prior to elective extubation may predict successful extubation in ventilated children.