parsa yousefi

Urinary control disorder is one of the most common disorders in children, which has important psychological consequences such as reducing self-confidence, anxiety, etc. This research was conducted with the aim of evaluating aggression in children with daily urinary disorders.

This case-control study was conducted on 200 children aged 5 to 12 years in two groups (50 girls and 50 boys) and control (50 girls and 50 boys) who referred to the pediatric clinic of Amirkabir Arak Hospital in 1401 and with random sampling. Easy randomization and using Shahim's aggression questionnaire, the level of aggression was measured in two groups of cases and controls, and the data were analyzed using SPSS version 23 software.

In this study, 200 children, including 100 in the case group and 100 in the control group, with an average age of 7.17 years (±2.17) participated. No significant relationship was found between the two groups in terms of parents' education, place of residence, socio-economic status, number of children in the family, and history of mental illnesses in the parents. (P>0.05). The mean total score of aggression in the case group (±8.18) was 34.41 and in the control group (±5.17) it was 27.80. The total score of aggression and the mean score of reactive-overactive aggression and Physical aggression and relational aggression were significantly higher in the case group than in the control group (P<0.05).

In this study, children with daily urinary disorders were more aggressive than non-diseased children. Therefore, screening children with urinary disorders and, if necessary, psychiatric interventions such as teaching anger management methods are very important.

Infantile colic is a painful condition in the first months of infancy. This study was carried out with the aim of testing the hypothesis that massage treatment has a clinically relevant effect on this condition.
This randomized clinical trial was conducted among 100 infants of Significant differences were not observed in infant and mother demographic information. Before intervention, the mean of total number, length, and severity of crying were 6.12 (1.76) time/day, 4.97 (1.37) hour/day, and 6.60 (1.54) in the massage group and 6.96 (2.9) time/day, 3 (1.31) hour/day, and 5.98 (2.22) in the rocking group, respectively. After 1 week of intervention, the mean difference of total number, length, and severity of crying were 4.08 (1.83) time/day, 2.81 (1.77) hour/day, and 2.9 (2.37) in the massage group and 0.56 (2.28) time/day, 0.27 (1.09) hour/day, and 0.02 (1.64) in the rocking group, respectively.
This trial of massage treatment for infantile colic showed statistically significant or clinically relevant effect in comparison with the rocking group.

Diurnal voiding dysfunction is one of the most common causes of pediatric urology clinic admissions. It can cause behavioral problems for children and their parents. We lunch this study to compare the parents’ function and children’s behavior problem in pediatric patients suffering from diurnal voiding dysfunction referring Arak Amir Kabir hospital. To perform this case-control study, we recruit 116 children with diurnal voiding dysfunction and compared them with other 116 children non-affected children aged between 5 to 16 years old. The child behavior checklist (CBCL4/18) for children behavior assessment and Global Assessment of Functioning (GAF) for the evaluation of their parent’s behavior were completed by the parents. Data was analyzed using ANOVA, qualitative variables and X2 formula. Among 116 patient with voiding dysfunction, 10 case (8.6%) showed behavioral problem while this figure was 3 case (2.6%) in the control group, denoting a significant difference (p=0.04). Moreover 20 children (17.2%) in the case group and 9 children (7.8%) in the control group had internalizing problem (p=0.02). Twenty two children (19%) with voiding dysfunction and 8 children (6.9%) in the healthy group had externalizing problem which was also a significant difference (p=0.01).As a significant difference (0.01), the parent’s average stress and behavior scores in case and control group were 3.65 and 3.76, respectively. The higher prevalence of behavioral problem in the children suffering from diurnal voiding dysfunction and their parent’s functional impairment highlights the importance of early parent’s intervention for early treatment and subsequently prevention of future behavioral problem in their sibling.

Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province. In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012،127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH≥5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment. From127112 screened neonates، 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was. Recall rate was 4. 8%. In 94. 4% of patients، treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program. Recall rate and the incidence of CH were higher than those in other studies، both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.

Adenoidal hypertrophy is a common condition of childhood، when abstructive sleep apnea ocurs adenoidectomy is indicated. In less sever cases، non surgical interventions maybe considered، however few medical altematives are currently available. Intranasal steroids used to reduce nasal airway obstruction To assesthe effectiveness of intranasal corticosteroids for improving nasal airway obstruction and in children with adenoid hypertrophy. 77 children 1-12 years exhibiting adenoid hypertrophy symptom and confirmed with radiologic imaging and without tonsilar hypertropy that not inclined to surgery were included and divided two groups in one group were treatend with intranasal betanethason 3 times daily for 3 weeks and and second group treatend with intranasal NACL as placebo. The subjects were assessed for airway obstruction symptoms including، snoring mounth breathing and prulaunt rhinorea، via questionarre ear examination، first month and third month of treatment. Intranasal betanethasone improved airway obstruction symptoms especially night snoring but hadn’t effective on other symptoms and infection complications including rhinorea. Intranasal betanethasone can be used as alterative treatrnent for adenoidal hypertroply because its effect on airway obstruction symptoms due to probably reduction adenoideal size.

Long QT is a cardiac electrical disorder. One of the symptoms of long QT caused by fatal ventricular arrhythmia is seizure. In some studies it was indicated that up to 35% of seizures induced by long QT may be misdiagnosed as other causes of seizure. In a case-control study, patients experiencing primary seizure with unknown etiology and referring for clinical diagnosis were selected as the case group. The control group consisted of patients hospitalized for other reasons except seizure. Corrected QT Interval (QTc) was measured for each patient on an electrocardiogram, and the two groups were compared. Long QT was defined as a QT more than 0.46 seconds. Among 508 subjects who were recruited in this study 254 children were in the case group and 254 were in the control group. There were 66 children experiencing seizure and long QT in the case group. In the control group, 48 children with long QT were observed; the difference was statistically significant (P = 0.02). Syncope and sudden death were not significantly different between the two groups. The present study showed that children with unknown causes of seizure have more frequently long QTc, which implies the possibility of an arrhythmic origin of some seizures. Therefore, it is advised to get an electrocardiography for patients with unknown causes of seizure.

Acute gastroenteritis in pediatric patients entails high rates of morbidity and mortality. One of its complications is dehydration، which should be managed carefully. We evaluated the efficacy of metoclopramide in the control of vomiting in children with acute viral gastroenteritis and moderate dehydration. In this single-blind randomized clinical trial، we randomly assigned children aged 1-7 years with vomiting due to acute viral gastroenteritis to two groups of serum therapy (control) and metoclopramide (intervention). The control group received 5% dextrose water solution along with electrolyte management while the intervention group، in addition to the standard treatment، received 0. 1 mg/kg metoclopramide intravenously. Patients were followed for 4 days for the number of vomiting episodes. 240 children were studied in intervention and control groups (120 in each group). The mean number of vomiting episodes was significantly lower in metoclopramide-assigned patients in all 4 days of the follow up period (P = 0. 021، P = 0. 007، P = 0. 002، and P = 0. 001، respectively for day 1 to 4). Although metoclopramide have shown effectiveness in the treatment of vomiting due to acute gastroenteritis، it is suggested performing multicenter studies comparing this drug with other common anti-emetics to allow for a better judgment.

Transient hip tenosynovitis is one of the common causes of pain and limping in children and includes 0.4% to 0.9% of admissions in emergency wards. The aim of this study is to evaluate this disease in terms of clinical presentations, age and sex distribution, and six-month recurrence. In this cross-sectional study, 51 children with diagnosis of transient hip tenosynovitis were investigated. Inclusion criteria were physician's clinical suspicion of acute tenosynovitis according to clinical presentations, physical exam, and age range of 3 to 8 years. Among the 51 children with tenosynovitis, 34 patients were male with age of 61.70±19.1 months and 17 patients were female with mean age of 48.35±20.49 months that presented a significant statistical difference (p=0.026). The most common complaint was hip pain and the most commonly involved joint was the hip. Also, most of the patients had the history of viral diseases. Transient hip tenosynovitis is more common in boys. The right hip is the most involved joint and the majority of patients have the history of recent viral diseases.

Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age and has a high prevalence in school aged children. In primary enuresis (PE) children have never gained control over urination or has been dry for<6months. While in secondary enuresis children have developed incontinence after a period of at least 6 months of urinary control. The aim of this study was to investigate a possible relation between PE and sacral ratio (SR) in 5-9 aged children. 118 children with aged 5-9 year were enrolled in this case-control study. All them were divided into two aliquots groups of 59 patients. The case study (children with PE) and the control (children without PE) groups were matched in age and sex. SR based on antero-posterior plain radiograms of pelvis was calculated. Results were then analyzed using Chi square and student t-test as appropriate. There were no significant differences between the two groups regarding age and gender. Mean SR in case and control group was 0.89 and 0.90, respectively. Moreover, there was no significant difference between the two groups (p=0.82). Only 1 child (1.6%) in case group showed abnormal SR while this was 7 children (11.9%) in the control group This study showed that, there was no significant difference between children with PE and those without PE in terms of SR. However, multicenter and larger sample size is recommended for definite decision of this finding.

Attention deficit hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder which affects 5-10% of children in school age. It seems that the disorder is more common among children with enuresis. The aim of this study was to investigate ADHD in children with enuresis and compare it with a control group in patients referring to Amir Kabir Hospital (Arak, Iran). This case-control study was performed on 100 children with enuresis and 100 children without enuresis in the age bracket of 5-16 years old. In all patients, Conners questionnaire [based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV)] and a demographic checklist about age, gender, history of maternal disease during pregnancy, birth weight, and head trauma were filled. The subjects were interviewed by a psychiatrist to confirm the diagnoses. The data was analyzed using descriptive and analytical statistics in SPSS15. Attention deficit was observed in 16 cases (16%) with enuresis and 5 controls (5%) (P = 0.01). Moreover, while 25 children with enuresis (25%) were affected by hyperactivity/impulsive behavior, only 16 controls (16%) were affected by this behavior. However, this important difference was not significant between the 2 groups (P = 0.08). ADHD in children with enuresis is significantly more common than non-enuretic children. The observed correlation between ADHD and enuresis makes psychological counseling mandatory in children with enuresis.

This study assessed the possible effect of hydrochlorothiazide (HCT) on soothing recurrent abdominal pain (RAP). A hundred girls with RAP and IH were randomly assigned into two groups of experiment (treated with hydrochlorothiazide 1mg/kg/day) and control and all patients were followed for 3 months. In the experiment group, the mean of painful attacks in the first, second and third month were 0.38, 0.4 and 0.26, respectively which were far less than their counterparts in the control group. Single daily dose of HCT is a safe and effective therapeutic option in the treatment of RAP in children with IH.

Urinary tract infection (UTI) is the most common disease of urinary tract. This disease lacks characteristic signs and symptoms and occasionally occurs with atypical presentations such as weight loss, anorexia, and growth failure. Zinc improves host immune-system response to many infections and has a significant role in immune system integrity. The aim of this was to study of zinc supplementation on treatment of UTI in children. In this clinical trial study, 200 children with UTI who were admitted to Amir Kabir hospital (Arak, Iran) were randomly divided into two control and case groups. Two groups were matched in age, gender, urine laboratory profiles, and clinical signs and symptoms such as fever, dysuria and frequency. The control group received only routine treatment of UTI. The case group, in addition to routine treatment of UTI, received oral zinc sulfate syrup. Findings showed that dysuria and frequency in zinc-supplemented subjects recovered significantly sooner than control subjects, while the abdominal pain persisted longer. There were no significant differences in onset of fever remission and negative urine culture time 48h and 7-10 days after treatment between two groups. Zinc supplementation has a significant effect in ameliorating severe dysuria and frequency of urinary in UTI. When the abdominal pain is present, usage of this drug is not recommended.

Urine tract infection (UTI) is the most prevalent bacterial infection and the second prevalent infection after viral flu among children. With respect to the importance of urine culturing, we decided to assess the effect of ablution the genital area on the result of urine culturing among 3-12 years old girls referring to Amir Kabir hospital, Arak, Iran.Patients and This randomized clinical trial was achieved on 620 girls referring to our hospital. Children were randomly assigned in two groups, with and without ablution. In ablution group, the appropriate technique of genital area ablution with water and soap was trained as well as how to collect middle-urine sampling, however, the other group received recommendations on how to appropriately collect middle-urine sample. Of 310 children of the ablution-trained group, UTI was reported in 11 (3.5%), contamination in 3 (1%) while 296 children were normal (95.3%). However, these figures were 14 (4.7%), 6 (2%) and 290 (93.3%) in the other group, respectively. Contamination rate did not differ significantly between the 2 groups (P=0.49). Genital area ablution is not associated with a significant decrease in rate of urine culture contamination, hence, it should not be routinely recommended for children.

Urine culture has an important role in diagnosing and tracking down urine tract infection (UTI) in pediatrics. Sampling methods also have a great effect on patients’ treatment procedure. Hence, this study was conducted to determine the effect of genital area ablution on urine culture test results in 3-12 year old girls referring to Amir Kabir Hospital of Arak. In a case-control study, 620 3-12 year old girls, referring to Amir Kabir Hospital in 2006, for whom urine culture test had been prescribed with suspicion of UTI, were evaluated. The population under investigation did not have a history of using catheter, genital anomaly, inflammation, genital discharge, and taking antibiotics up to seven days prior to the investigation. The patients were randomly divided into two groups of 310 each: Ablution and no-ablution. After data collection, the data were analyzed by t-test. In the ablution group, 3.7% of patients were reported with UTI, 1% with contamination, and 95.3% with normal conditions. In the non-ablution group, 4.7% of patients were reported with UTI, 2% with contamination, and 93.3% with normal conditions. Contamination rate in ablution and non-ablution groups were 1% and 2%, respectively. This difference, however, was not significant (p=0.491). The relationship between genital area ablution and reduction of contamination in urine culture was not significant; therefore, genital area ablution does not have an important effect on decreasing the contamination of urine culture.

Noticing the sensitivity and restlessness of medical centers, aggression in the workplace as an agitating factor is one of the dangers of medical profession that is threatening to the health and hygiene of the society. The aim of this study was to determine the types and contributing factors of aggression toward physicians and students of medicine in hospitals of Arak in 2009.

This descriptive-cross-sectional study was conducted on 400 of accessible physicians and students of medicine working in hospitals of Arak in 2009. A self-made questionnaire, containing 14 questions which surveyed the status of aggressions, was used.

On the whole, 205 individuals returned the forms. Most of them (71.7%) had faced a form of oral, physical, or sexual aggression and had been violated by a male companion of patients. They also viewed the use of drugs or alcohol by patients or their companions, lack of security facilities, patients’ death, and lack of educational possibilities for the prevention, as influential factors in the occurrence of aggression. The majority of participants saw increasing the security personnel, presence of psychological counselors and psychologists of the ward, increasing the rest hours, decreasing the work hours of the physicians, and having a codified program for the prevention of aggression, as anti-aggression factors.

Oral and then physical aggression toward physicians are quite prevalent. Hence, taking immediate actions and providing useful instructions for prevention are of priority in designing effective programs.

Developmental anomalies in sacral bone have been recognized as one of the causes of urinary incontinence. Sacral ration was suggested as a valuable scale in determining the sacral bone health. According to insufficient studies in this field and variation in results, a determination of relationship between sacral ratio (SR) with primary enuresis were seemed imperative. In a cross sectional-analytic study, two groups (n=59) of 5-9 year-old children who admitted in pediatric and urology clinics of Amir Kabir hospital in one year were determined. Primary enuresis group with normal urine-analysis and ultrasonography, no history of dysuria, frequency, and urgency and control group without primary enuresis were selected. The mean ratio between the greatest widths of the sacral bone to its greatest length in the AP radiogram was compared between both groups. In case group, 98.3% had normal SR. The mean ratio of greatest width to length was 0.89. There were not a significant relationship between gender and normal or abnormal SR. In control group, 88.1% had normal SR. The mean ratio of greatest width to length was 0.91. Girls more than boys had normal SR. Significant difference between mean ratio of SR and greatest width to length in both groups were not seen. Significant relationship between SR with primary enuresis in 5-9 year-old children was not seen.

Children with reflux who fail prophylaxis management or reflux which do not resolve spontaneously are candidates for sugery. Delay in surgery increases the development of new renal scars. Finding a modal factor for prediction of reflux resolution likelihood can decrease complications of treatments. Regarding that sacral bone anomalies have a direct influence on the final function of urinary and bowel systems, this study is done to investigate the relationship between sacral ratio and reflux. This is a case-control study. The case group included 76 children less than 9 years old refered to Vali-e-Asr and Amir Kabir hospital clinics with urinary tract infection and according to voiding cystouretrograply (VCUG) results, children with III, IV and V grade vesicoureteral reflux (VUR) entered the study. The control group included 76 children with previous urinary tract infection and normal VCUG. Sacral ratio in the two groups was measured and was compared by student t, Chi square and Mann Whitney tests. The case group included 24 males and 52 females with average age of 2.7 years old and the control group included 23 males and 53 females with the average age of 3 years. The percent of sacral ratio abnormality were 40% and 23.7% in the case and control groups respectively, which was significantly different (p=0.001). The difference between the mean sacral ratio in case group with the value of 80% and the control group with the value of 84% was not different. The ratio distribution pattern in the two groups was not different. The percent of sacral ratio abnormality in children with vesicoureteral reflux were more than children without reflux.

Chronic and relapsing abdominal pain is one of the most common reasons that bring children to pediatric clinics. About 20% of these children are suffering from idiopathic hypercalciuria. Since Hydrochlorothiazide is effective in relieving hypercalciuria, we assessed its effects on reducing these relapsing pains in girls with idiopathic hypercalciuria. In this single blind clinical trial study, 100 girls, aged 5-12 years old, with chronic relapsing abdominal pain and hypercalciuria were divided to two groups by random block design. All children and their parents were trained about consuming plenty of liquids and decreasing salt in foods. In addition to these measures, Hydrochlorothiazide (1 mg/kg/day) was also administered to children in the case group. The control group was assessed for the number of abdominal pain episodes for 3 months following the commencement of the diet and the case group for 3 months after becoming normocaciuric. The results were analyzed by T-test. The mean number of pain episodes in Hydrochlorothiazide group in the first, second, and third months were 0.38, 0.4, and 0.26 respectively much lower than the corresponding months in the control group which were 1.60,1.94, and 1.84 in that order (p<0.001). It seems that single dose daily Hydrochlorothiazide is a safe and effective drug in the treatment of chronic relapsing abdominal pain in children with idiopathic hypercalciuria.

Hydronephrosis in infancy and childhood is a frequent urinary malformation. We were unable to find any reports concerning rate and causes of hydronephrosis in Iranian children therefore, we decided to evaluate it, in under 12 years old children. This was a descriptive study done in a 9-month period starting from Novemger 2004. All children under 12 years old who had visited Amir Kabir hospital of Arak for UTI or FTT were enlisted and an ultrasonography was requested. If hydronephrosis was detected, then a VCUG was performed. For those with normal VCUG results, if hydronephrosis persisted in the follow up sonography, the next step was an IVP or DTPA scan. 65 patients (39 girls and 26 boys) were evaluated for hydronephrosis. 18.5% presented with FTT, 75.4% with UTI and 6.1% with FTT+UTI. The most prevalent causes of hydronephrosis were VUR (40%) and UPJO (23.5%). Grade I hydronephrosis was the most prevalent form (65%), however when VUR was present, it was mostly grades III or IV (27% and 19% respectively). 70% of girls and 31% of boys had VUR and the average age at the time of diagnosis was 2-3 years. Vesicouretero reflux and UPJO are the most prevalent causes of hydronephrosis and must be evaluated in children with hydronephrosis.