International Journal of Pediatrics
Volume:6 Issue: 58, Oct 2018

Despite the positive and remarkable effects of baby massage on both mothers and infants, mothers are less likely to use this health behavior. This study was designed to evaluate the impact of baby massage training on awareness, perceived stress and breastfeeding self-efficacy of mothers with hospitalized neonate.
This study, as a quasi-experimental design, was carried out on 120 mothers with hospitalized neonates (60 in the experimental group, 60 in the control group). Data were collected using a valid and reliable four -part instrument including Social-demographic information, Awareness’s scale about baby massage, Cohen’s Perceived Stress Questionnaire (PSS), and the Breastfeeding self-efficacy scale (BSES). Baby massage training was conducted on the intervention group for 3 days by a trained midwife, and changes were compared in two groups using suitable statistical tests three days after educational intervention.
Before education, the mean score of awareness, perceived stress, and breastfeeding self-efficacy of intervention group were 6.47±2.23, 33.42±6.85, 131.50±19.34, respectively. After education, the mean scores of the above variables were orderly changed into 8.33±1.28, 27.10±1.85, 145.77±15.80, and these changes were statistically significant (P 0.05). In addition, there was a significant difference between groups (p The results of the study indicated that baby massage training (BMT) is effective in increasing the mothers’ awareness, breastfeeding self-efficacy, and in decreasing their perceived stress. Therefore, applying this approach to improve mothers’ stress and breastfeeding self-efficacy was recommended and emphasized.

Today, lifestyle changes have led to increasing fast food consumption. Regarding importance of nutrition in adolescence, the present study aimed to identify determinants of fast food consumption using theory of planned behavior among students of guidance schools in Tehran, Iran.
This cross-sectional study (descriptive-analytical) was carried out using self-administered questionnaire among 768 (384 boys and 384 girls) students of grades 1, 2 and 3 in regions 2, 9 and 18 of Tehran. Sampling method in this study was randomized and multi-stage.Finally, participants were selected from 10 schools. Data was gathered using scales based on constructs of Theory of Planned Behavior. Obtained data was analyzed using SPSS software (version 16.0). Participation of students in this study was voluntary and with informed consent.
Logistic regression confirmed the predictability of perceived behavioral control for students’ intention to fast food consumption (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01, 1.04). In addition, perceived subjective norms (OR: 1.01, 95%CI: 1.001, 1.02) and behavioral intention (OR: 1.9, 95% CI: 1.64, 2.2) predict significantly fast food consumption behavior.
Based on results, perceived behavioral control, subjective norms and intention were reported as predictors of fast food consumption, thus these constructs should be addressed in designing fast food-related educational interventions among study population.

Several agents have been used for the treatment of neonatal hyperbilirubinemia, but the effect of oral fenofibrate on serum bilirubin level was not evaluated so much. The aim of this study was to assess the effect of oral fenofibrate on a total serum bilirubin (TSB) in term neonates with hyperbilirubinemia.
This clinical trial was done on 80 term neonate with a TSB higher than 15 mg/dl in two equal groups of control and intervention. Both groups received conventional phototherapy with the same condition. The intervention group received a single dose of oral Fenofibrate (Sobhan- Darou Company, Iran) 10 mg/kg. The TSB was measured in both groups, at admission, second day, and third day and also at the time of discharge. The serum bilirubin level, the duration of phototherapy and need to exchange transfusion were compared in two groups.
Results showed that of 80 neonates studied, the TSB at the second day of hospitalization in the intervention group was 13.29 ±1. 64 mg/dl and in control group 14.06±1.78 mg/dl (p=0.04), and at the third day in intervention group it was decreased to 9.99± 1.53 (p=0.04), and in control group to 11.01±1.68 mg/dl, (p=0.006). The duration of phototherapy in the intervention group was 2.5±0.71 days and in control group 3.35±0.97 days (p=0.003).
According to the result of this study administration of oral Fenofibrte in a term neonate with hyperbilirubinemia under the phototherapy lead to faster decline in serum bilirubin levels, shorten the duration of hospital stay and earlier discharge from hospital.

Considering the importance of preventing smoking hookah in adolescents and the lack of a standard questionnaire in this field, this study aimed to develop and validate a Persian Preventing Hookah Smoking (PHS) Questionnaire in adolescents based on the Protection Motivation Theory.
After conducting focus groups discussion, reviewing the literature and scientific resources, an initial self-administered questionnaire including 68 questions was designed and then validated. For face validity, the questionnaires were evaluated by 10 experts considering difficulty, inappropriateness, and ambiguity of the phrases. Both quality and quantity methods were used to evaluate the content validity. The content validity ratio (CVR) and the content validity index (CVI) were determined by a group of experts (10 people). Its internal consistency was estimated and its reliability was determined by the test-retest method. Confirmatory Factor Analysis (CFA) was done using Amos 21.0.
From 68 questions in the initial questionnaire, eventually 64 questions remained in the final questionnaire. The CVR value for most questions, except for 3 questions, was above 0.79 and the CVI value of all questions was above 0.79. The Cronbach’s alpha coefficient was 0.79-0.91 and the test-retest coefficient was 0.81-0.91. The results of CFA showed the following values, Chi-square (x2): 1254.712, degree of freedom (df): 3.456, adjusted goodness of fit index (AGFI): 0.964, the root mean square error of approximation (RMSEA): 0.072 which indicates the appropriateness of the tool among Iranian adolescents.
The results of this study showed that this Persian questionnaire about preventing hookah smoking in adolescents based on the Protection Motivation Theory has a good validity and reliability and can be used in investigating about prevention of hookah smoking in adolescents.

Infant respiratory distress syndrome (IRDS) is one of the main causes of serious complications and death in preterm infants. Both Nasal Continuous Positive Airway Pressure (NCPAP) and Nasal Intermittent Positive Pressure Ventilation (NIPPV) are known as the most common treatment strategies for IRDS. The present study intended to compare NCPAP and NIPPV in the treatment of preterm infants with respiratory distress syndrome.
To this double blind clinical trial study during a one-year period (2016 to 2017) in Fatemieh Hospital in Hamadan city (Iran), about 60 preterm RDS infants were randomly assigned into two treatment groups; the NIPPV group received the PIP (14–20 cmH2O), RR: 30-50/min, PEEP (5–6 cmH2O), FiO2 up to 60%. The NCPAP group received PEEP (5-6 cmH2o), Flow: 6-7 L/min, and FiO2 up to 60%
There was not any significant difference in the mean values of gestational age (30.07±1.50 vs. 30.07±2.05; P>0.05), birth weight (1259±263 vs. 1235±285; P>0.05), and 1-minute Apgar score (5.53±1.13 vs. 5.33±1.34; P>0.05) between NIPPV and NCPAP treatment groups. Besides, the rate of recovery, mortality and disease complications was not significantly different between both groups. However, the duration of respiratory support was less in NIPPV than NCPAP (34.9±33.8 vs. 68.4±32 h; P=0.001).
According to the results, there was not significant advantage between the NIPPV vs. NCPAP methods in the treatment of RDS in preterm infants with very low birth weight.

Pregnant women’s health is a major health priority in all countries. Teenage pregnancies can be high-risk. This study was conducted to determine the effect of counseling on hemoglobin, hematocrit and weight gain in teenage pregnant women.
This randomized, controlled, clinical trial was conducted on 120 teenage women with a gestational age of 20 to 24 months presenting to medical centers in Ardabil, Iran, in 2016 to 2017. The participants were assigned to a counseling (n=60) and a control (n=60) group through randomized blocked sampling. The intervention group received counseling on self-care, symptoms and risks of teenage pregnancy and methods for its prevention in five 60-minute sessions and booklets were distributed among them, too. Each woman and her husband received private counseling in the last session based on their questions and problems. The control group received routine care. Hemoglobin and hematocrit levels and weight at the beginning of pregnancy and before delivery were evaluated. The independent t-test and ANCOVA with adjusted baseline values were used to analyze the data.
The two groups did not differ significantly in terms of demographic details, except the mother’s age and baseline hemoglobin and hematocrit levels (P>0.05). There were no significant differences between the two groups after the intervention (with adjusted baseline values) in terms of hemoglobin (adjusted mean difference: -0.07, 95% confidence Interval: 0.31 to -0.46, P=0.710), hematocrit (-0.14, 0.76 to -1.05, P=0.747), and pregnancy weight gain (0.07,1.80 to -1.65, P=0.931).
The results showed that providing counseling to teenage women during pregnancy does not affect their hemoglobin and hematocrit levels and pregnancy weight gain.

Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment.
A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics.
Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole.
MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.

Late onset sepsis is a frequent complication of prematurity, associated with increased mortality and morbidity. Probiotics may prevent late onset sepsis in premature infants. The aim of this study was to determine prophylactic effect of oral probiotics in prevention of late onset sepsis of very preterm infants.
This study was a randomized, double blinded, placebo controlled trial. Eighty preterm infants born at Cause of hospitalization in all patients was respiratory distress and prematurity. The incidence of late sepsis and death in the intervention group was lower than the control group, which was significant. The mean time to establish full enteral feeding in the probiotic group was lower than the control group. No case of necrotizing enterocolitis was observed. There was no difference in terms of days of hospitalization among two groups (P>0.05).
According to the results, usage of prophylactic probiotics can reduce the incidence of late onset sepsis and its mortality. By consuming probiotics preterm infants could reach the full enteral feeding in a shorter period of time, but the duration of hospitalization not reduced.

Klinefelter syndrome is characterised by advancing testicular function deterioration causing aspermatogenesis and androgen deficiency. Klinefelter patients characteristically have complete male sex differentiation, and genital anomalies are infrequently associated.
Penoscrotal malformations at birth are very rare in this syndrome. Nonetheless, it is important to know the association, as one of the causes of abnormal genitalia at birth. Understanding of the indications of karyotyping can help early detection of these cases. We report a boy who had Klinefelter syndrome with penoscrotal transposition (PST), hypospadias and inguinal hernia.

Childhood obesity has reached epidemic proportions and become one the most important public health issues globally. One of the significant determinants of childhood obesity-related behaviors such as poor dietary habits relates to role of friends and peers. This study aimed toexplore the role of interaction within the social network of friends on unhealthy eating behaviors of overweight and obese adolescents.
This qualitative study was conducted between 2016 and 2017 in Mashhad and Isfahan, two large cities of Iran. Ten parents and 52 overweight and obese adolescents were selected through purposeful sampling. To obtain perceptions and experiences regarding the role of adolescent friendships on unhealthy eating behaviors, in-depth semi-structured interviews and focus group discussions were conducted. Data were analyzed based on conventional content analysis.
Six themes which contributed to following unhealthy dietary habits when adolescents are in the friend networks were identified: "Eating in the peer networks as a usual way for social interaction", "Peers’ pressure to have unhealthy dietary habits", "High availability and accessibility to unhealthy foods", "Lack of nutritional knowledge", "Neglectful parenting style", and "Passive interaction in the friendship networks".
Our findings indicate that peer support along with appropriate parenting style are necessary to affect adolescent eating behaviors when they are in the friend social networks, but are not sufficient per se. Being a confident, decisive and self-determined adolescent and owing a high level of behavioral confidence and self-esteem might reduce the impact of friends for adhering to unhealthy dietary habits in youth.

Violence against women is a social, legal and health problem that poses a threat to mother and child in pregnancy. The present overview was conducted to review of Meta-analysis that assessed the line between the abuse on mother during pregnancy and pregnancy outcomes.
This study reviewed all published articles from January 1996 to March 2018 by searching International databases such as Scopus, EMBASE, Medline (via PubMed), Google Scholar, Web of Sciences, and Cochrane library for related Meta-analysis. Also, along with international databases, national databases such as SID, Magiran, Medlib and Irandoc were searched. Two independent researchers screened articles and in the next step, full texts of probably relevant articles were read and summarized. There was not any language limitation.
Data from 5 Meta- were entered. A significant relationship was found between abuse during pregnancy and Low birth weight (LBW) (odds ratios [OR] ranged from 2.11 to 1.18; five Meta-analysis), and preterm birth (PTB) (OR ranged from 1.21 to 1.91). According to one Meta-analysis, intimate partner violence (IPV)was statistically marginally associated with small-for-gestational-age (SGA) infants (OR: 1.37, 95% confidence interval [CI]: 1.02 to 1.84; Heterogeneity I2: 84%; I2: 32%), but there was not any relationship between IPV with Intrauterine growth restriction (IUGR) (P>0.05).
Our overview showed that the pregnant women who expose to domestic violence are at increased risk of an adverse pregnancy outcomes such as preterm birth', low birth weight' and small for gestational age' infants. So, intervention such as screening and counseling for violence is needed for all pregnancy women especially previous victims of violence.

Dextro-transposition of the great arteries (d-TGA) is the one most common cyanotic congenital heart disease in neonates. The discordant ventriculoarterial arrangement results in parallel circulation, it so is vital to understand the management. We report a rare interesting but critical case of 33-day-old boy who developed cyanosis and had transposition of great arteries combined with interrupted aortic arch (IAA), diagnosed as d-TGA, and describe the entire interventional management. The patient underwent surgical correction of the transfection and defects.

The attitude towards lactation is one of the best predictors of breastfeeding. Iowa Infant Feeding Attitudes Scale (IIFAS) is used to measure the attitude toward lactation. IIFAS is a valid and reliable tool but factorial structure of this tool was reported various in different studies. The aim of this study is to assess factorial structure of IIFAS.
An extensive search was done in databases of databases of Medline, EMBASE, Web of Science, Scopus, Cochrane Library, and CINAHL until May 2018. Two independent researchers screened articles and in the next step, full texts of probably relevant articles were read and summarized. The quality of studies was performed by COSMIN checklist. The following keywords were used: (Iowa Infant Feeding Attitude Scale OR IIFAS) AND (Factor Analysis OR exploratory factor analysis OR confirmatory factor analysis OR Validity OR psychometric).
Six studies were assessed in systematic review. In Spanish version, single- factor solutions with 9 items in sample of 1,294 pregnancy women was tested and showed a satisfactory fit to the data. In Japanese version, authors provided single-factor- model with 16 items. Factors loading were ranged from -0.06 to 0.68. Arabic version, EFA identified 6 factors with eigenvalues more than 1 explained 61% of total variance. However, scree plot suggested unidimensional structure. In Chinese version, EFA extracted four factors and labeled "Favorable to breastfeeding", "Favorable to formula-feeding", "Convenience" and "Sociological influences". In Canadian and Singapore version, the most sense model based on EFA was a three –factors model and labeled "Favorable to breast feeding", "Convenience" and "Favorable to formula feeding".
Four-factor model and three- factor model can be used in clinical practices and research. There is a need to further test single-factor model.

Children undergo painful procedures during care and treatment. This study aimed to determine the effect of distractionon the intensityof pain in children aged 6 to 12 years old.
This clinical trial was conducted on the school-age children, who referred to Imam Hossein Hospital, Iran, Heris city, East Azarbaijan province (Iran) in 2017. In total 48 patients were selected through convenience sampling technique and were randomly divided into three groups of 16 cases. In all three groups, pain was measured using the Oucher self-report scale, 3 minute before and after the venipuncture. One minute before venipuncture, in the "deep breathing with blowing paper whirligigs" groups after spinning the paper whirligigs and exhalation, in the "deep breathing" groups after exhalation, numbers were counted up to 10 spins or 10 breaths. In the control group, no intervention was performed. The data analysis was performed in the SPSS software (version 13.0).
The results showed that "deep breathing with blowing paper whirligigs" (Mean standard deviation [SD]: 2.69±0.79) and "deep breathing" (Mean SD: 2.63±1.31) reported less pain intensity than the control group (Mean SD: 5.25±1.00), and the "deep breathing with blowing paper whirligigs" method had the least pain intensity. The results of ANOVA test showed that there was a significant difference among the groups in terms of pain intensity after intervention (P ≥0.001).
The findings showed that both methods of distraction in this study (deep breathing with blowing paper whirligigs and deep breathing) can effectively decrease the venipuncture pain.

The prevalence of high-risk behaviors in adolescents is one of the most important concerns of the community; this study aimed to determine the effectiveness of life skills training on decreasing high risk behaviors among high school boy students.
In a quasi-experimental study, the statistical population included Mullah Sadra boy high school students in the academic year of 2017-2018. In this research, the sampling was done in two stages; first, to identify the individuals with high-risk behavior questionnaire, was used and 30 students who have high-risk behavior and willing to participate were selected and randomly assigned to intervention group (n=15) and control group (n=15). The educational intervention consisted of 12 sessions (each session was 60-120 minutes). The Life Skillsquestionnaire was completed by two groups before, after and one month after intervention; and data were analyzed using SPSS software version 23.0.
The mean of pre-test, post-test and follow-up scores in the intervention group for variances of substance abuse, violence, insecure sexual behavior and high-risk behaviors were lower than the control group. But the mean score of life skills in the intervention group was higher than the control group. The results of the analysis of variance showed that the post-test difference of the studied groups (intervention and control) in the components of high risk behaviors in the health area, substance abuse and violence was significant (P According the results, Educational intervention had a positive impact on reducing of high-risk behaviors in boy high school students.