Child

In diagnosing and tracking fecal impaction in children with functional constipation, a variety of methods such as history taking, physical examination, digital rectal examination (DRE), and, if needed, imaging-based methods are used. However, the most effective method for tracking this condition remains unclear. Our objective was to evaluate the agreement of medical history and DRE with trans-abdominal radiography as the gold standard for diagnosing childhood fecal impaction. In this cross-sectional study, two subgroups of children aged 4 to 10 years with and without fecal impaction were included and evaluated through physical examination, DRE, and trans-abdominal radiography (as the standard), along with a detailed medical history.  The positive abdominal examination in the groups with and without fecal impaction was 33.5% and 7.9%, respectively, indicating a significant difference (p < 0.001). In the groups with and without fecal impaction, positive medical history related to functional constipation was revealed in 85.3% and 4.2%, respectively, indicating a significant difference (p <0.001). Also, in the DRE method, compared to abdominal radiography, fecal impaction was positive in 85.9% of patients with fecal impact. In comparison, only 8.5% of the control group indicated a significant difference (p < 0.001). A combination of history taking, DRE, and, if necessary, abdominal radiography should be considered to diagnose fecal impaction in children with functional constipation.

Otitis media with effusion (OME) is a widespread condition affecting children globally. This study aimed to assess the relationship between obesity in pediatric populations and the risk of developing OME.This retrospective observational study was performed in 2020 at Khalili and Dastgheib hospitals, affiliated with Shiraz University of Medical Sciences in Shiraz, Iran. The study included all children aged 2 to 15 years with a confirmed OME diagnosis. Participants in the non-OME group were chosen from children who did not have OME.A total of 148 healthy individuals were included in the non-OME group, while the OME group comprised 110 patients. Statistical analysis revealed that the mean age (p=0.040), weight (p<0.001), height (p=0.024), BMI (p=0.023), and BMI percentile (p=0.023) were significantly greater in the OME group compared to the non-OME group. Additionally, there was a higher proportion of males in the OME group (63.6%) compared to the non-OME group (44.0%), with this difference being statistically significant (p=0.001). Logistic regression analysis indicated that factors such as older age (p=0.023), male gender (p=0.001), and elevated BMI percentile (p=0.004) were significantly associated with the presence of OME.This research indicates that there is a correlation between obesity and a heightened risk of OME.

Approximately a quarter-million Iranian newborns receive the Bacille Calmette-Guérin (BCG) vaccine annually. However, in immunodeficient infants, this vaccine can lead to disseminated BCG disease (DBD).

This study aims to determine the clinical presentation, comorbidities, underlying immunodeficiency, and prognosis of DBD in a group of Iranian children.

In a longitudinal case-series study, data were collected from the files of infants and children diagnosed with DBD from 2005 to 2017. Immunodeficiency screening was conducted for each patient. For children with normal immunodeficiency screening results, further testing for Mendelian susceptibility to mycobacterial diseases (MSMD) was performed. Detection of DBD in children was achieved by evaluating gastric lavage and bone marrow aspiration samples for mycobacterium.

Most of the 22 patients were immunocompromised, with the following distribution: 31.8% had severe combined immunodeficiency (SCID), 45.5% had MSMD (specifically IL-12Rβ1 deficiency), one patient (4.5%) had Wiskott-Aldrich syndrome (WAS), and the remaining 18.1% had unknown immunodeficiency types. Most patients with MSMD were successfully treated and did not show relapse during the follow-up period, even after discontinuing anti-tuberculosis (TB) medications.

Due to the similarity of its manifestations to sepsis, diagnosing systemic infections caused by the BCG vaccine in children requires a high level of clinical suspicion and appropriate diagnostic measures, such as mycobacterial culture, biochemical speciation, or polymerase chain reaction (PCR). These diagnostic steps should be taken promptly in cases of DBD, with concurrent treatment using anti-tuberculosis drugs and, if possible, targeted therapies for underlying immunodeficiency.

Cancer in children, due to its unpredictable and progressive nature, causes a psychological burden and reduces the quality of life for mothers. The present study aimed to examine the effect of quality-of-life therapy (QOLT) training on the psychological burden of mothers of children with cancer.

This quasi-experimental study was conducted with mothers of children with cancer who visited the chemotherapy departments of Ali Ibn Abi Talib Hospital in Zahedan in 2023. The sample consisted of 80 participants who were randomly divided into two groups: An intervention group and a control group, each containing 40 members. The mothers in the intervention group attended eight group counseling sessions based on QOLT every other day. Data were collected before the intervention and eight weeks after the intervention using the Zarit Burden interview (ZBI). The collected data were analyzed using SPSS-27 software with independent samples t -tests, paired samples t-tests, chi-square tests, Fisher’s exact tests, and analysis of covariance (ANCOVA). A significance level of less than 0.05 (P < 0.05) was set for data analysis.

There was no significant difference between the two groups in terms of the mean psychological burden score before the intervention (P = 0.97). However, the results of the ANCOVA, controlling for the variables of mothers' age, number of children, duration of illness, and pre-test scores, showed that the mean psychological burden score for mothers in the intervention group (27.22 ± 12.82) was significantly lower than that of mothers in the control group (41.20 ± 11.50) after the QOLT training intervention (P < 0.001).

The QOLT intervention in this study had a positive and significant effect on reducing the psychological burden of mothers of children with cancer. Therefore, healthcare providers and medical staff are encouraged to utilize this counseling technique to enhance the well-being and psychological health of mothers and to promote the quality of life for both mothers and their children.

Few studies have compared the concentration of trace elements and antioxidants in the serum of depressed and non-depressed as well as children on dialysis with and without anxiety.

 A prospective cross-sectional research was conducted. Forty children undergoing dialysis were assessed to define the correlation between mean serum levels of Selenium, Zinc, Copper, Manganese, vitamin C, and vitamin E and their deficient levels with mood disorders. The Child Depression Inventory (CDI) and Depression Anxiety Stress Scale (DASS) scorings were applied. According to Scorings, patients were divided into no depression and depression and no anxiety and anxiety disorders groups.

Eighteen hemodialysis and 22 peritoneal dialysis patients were enrolled. The median of age was 11 years. Twenty-two patients (55%) were males. Selenium, copper, and vitamin C deficiencies were found in 32.5%, 15%, and 2.5% of patients, respectively. Anxiety and depression disorders were diagnosed in 82.5% and 67.5% of patients, respectively. No relationship between gender, modality of dialysis, duration from onset of dialysis, serum levels of hemoglobin, blood urea nitrogen, albumin, Zinc, Copper, Selenium, manganese, and vitamin C with anxiety and depression disorders (p > 0.05 for all). The severity of depression was higher in hemodialysis versus peritoneal dialysis patients (P < 0.001). The Serum level of Vitamin E significantly was higher in depressed in comparison with non-depressed cases (P=0.02).

There was no relationship between trace elements and vitamin C serum level and depression or anxiety disorders. An unreported finding was significantly higher level of vitamin E in depressed patients in comparison to those without it.

Despite the decrease in prevalence from 18.5% in 2013 to 12.3% in 2018, diarrhea presents a major public health challenge in Indonesia which leads to significant mortality. This study investigated factors influencing diarrhea among children under five years of age in underdeveloped regions of Indonesia, where disparities from other regions are significant.

 A cross-sectional study.

This study obtained data from National Basic Health Research conducted in 2018. Sixty underdeveloped regions of Indonesia, with a total of 9243 children aged 0-59 months, were included. Chi-square, bivariate, and multivariate analyses were conducted to determine factors influencing the prevalence of diarrhea in children under 5 years of age.

Multivariate analysis revealed that the age categories of 12-23 months (OR: 1.73; 95% CI: 1.48, 2.02) and 24-35 months (OR: 1.31; 95% CI: 1.11, 1.53), awareness of a nearby hospital (OR: 0.74; 95% CI: 0.63, 0.86), and history of acute respiratory infection (ARI) in the past month (OR: 1.99; 95% CI: 1.66, 2.40) were associated with diarrhea in children under the age of five in underdeveloped regions of Indonesia. In contrast, the environmental factors analyzed further in the study were not significantly associated with the prevalence of diarrhea in children under five years of age in underdeveloped regions of Indonesia.

These findings suggest that the child’s age, the child’s history of ARI, and household awareness of nearby hospitals are critical factors associated with the child’s diarrhea in underdeveloped regions of Indonesia.

Oral health poses significant challenges, particularly among preschool children, emphasizing the critical role of mothers in preventive care. Self-efficacy, as a determinant of behavior, holds promise in shaping oral health practices.

The present study was conducted to determine the effect of Bandura's self-efficacy strategies on the fluoride varnish therapy behavior of mothers of preschool children.

This intervention study, conducted from 2021 to 2023, involved 88 mothers with children aged 3 to 6 years. Participants were randomly divided into intervention and control groups. Data collection included a demographic questionnaire, a researcher-developed self-efficacy assessment tool, and an observational checklist of mothers' fluoride varnish therapy behavior. The intervention comprised educational sessions focusing on self-efficacy strategies. Data were analyzed with descriptive and inferential statistics in SPSS software version 20.

Before the intervention, there were no significant differences in self-efficacy scores between the intervention and control groups (Cohen's d = 0.18). Similarly, there were no significant differences between the two groups in the varnish therapy behavior score of the mother before the intervention (Cohen's d = 0.05). However, two months later, significant improvements were observed in both self-efficacy scores (Cohen's d = 2.28) and fluoride varnish therapy behavior (Cohen's d = 3/32) among mothers in the intervention group compared to controls.

This study underscores the pivotal role of self-efficacy strategies in empowering mothers to effectively engage in fluoride varnish therapy behavior, and highlights the significant improvements observed in both self-efficacy and varnish therapy behavior that emphasize the educational interventions aimed at enhancing mothers' self-efficacy, ultimately contributing to improved oral health outcomes for children.

Body posture in children has been a focus of research for decades. Posture refers to the way the human body is positioned against the force of gravity. When musculoskeletal structures are still developing during childhood, establishing good postural habits is crucial for long-term health [1]. Studies have shown that good posture is associated with appropriate physical performance in children. For example, research indicates a correlation between good posture and improved athletic performance.

Understanding the care needs of parents with epileptic children is crucial, as they experience unique challenges affecting their mental and physical health. 

This study aims to investigate the needs of parents caring for children with epilepsy.

This is a systematic review study. A search was conducted in databases such as PubMed, Web of Science, and Scopus for related articles published from 1975 to 2023, using keywords “epilepsy”, “children”, “parents”, “caregivers”, “care needs”, and “unmet needs”. The review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Finally, 30 articles were selected for review after quality appraisal using the critical appraisal skills program (CASP) and strengthening the reporting of observational studies in epidemiology (STROBE) checklists.

The care needs were identified as psychological, educational, supportive, economic, social, and unmet needs. Parents expressed their supportive, economic, and social needs to reduce the burden of caregiving; their educational needs to cope with epilepsy; their psychological needs to reduce stress and anxiety; and their unmet needs to reduce emotional distress.

To improve the health status of children with epilepsy, their parents' care needs should first be considered. The healthcare providers should provide health care services to the parents of epileptic children tailored to the identified needs.

Despite remarkable advancements in the use of embryo donation, concerns havearisen regarding its potential effects on the psychological well-being of children conceivedthrough this assisted reproductive technology and their parent-child relationships.   In a cross-sectional analytical study, the psychological adjustment of 31 children aged3 to 7 born through embryo donation was assessed and compared to 30 age-matched childrenfrom families who conceived naturally using the Strengths and Difficulties Questionnaire.Parenting styles within these families were also evaluated using the Baumrind Parenting StylesInventory through clinical interviews.   Although 8 out of 31 children born through embryo donation (25.8%) and 3 out of 30children from natural conception families exhibited psychological maladjustment, this differencewas not statistically significant. Furthermore, parenting styles did not significantly differbetween the two groups. The absence of genetic parent-child relationships does not appear to be a dominantfactor influencing the psychological adjustment of children or parenting styles.

This study aimed to explore the mechanisms of prioritizing risk factors of coffee consumption in kindergarten children based on parental perceived changeability and importance. It was conducted in a local Chinese kindergarten, with study participants involving 40 parents.

Qualitative data were generated by conducting semi-structured interviews and analyzed employing a thematic inductive analysis approach.

Multiple risk factors related to high doses of coffee consumption in children were identified. Notably, children’s mobile phone use and sleep behavior were considered relatively more changeable and more important risk factors, which should be addressed in intervention development. Moreover, other identified risk factors, including later diner times, physical activity participation, parental coffee consumption before sleep, and parental perceived benefits and barriers of coffee consumption, require further contextual investigation.

Future intervention development should target parental influences on children’s coffee consumption and sleep health. The aim should be to promote awareness of sleep hygiene behaviors in both children and parents as a starting point. The intervention development process could be an iterative and back casting approach, necessitating extensive information gathering and in-depth consideration of critically revisiting the existing data to enhance the potential success and effectiveness of the intervention.

Children under five are dependent on caregiver's hand washing and their health literacy for their health and well-being attention to which was reinforced during COVID-19. A caregiver's hands can act as primordial prevention for children under five. The current study aimed to assess caregiver's health literacy and WHO-five moments of hand hygiene in a uni-center of a developing country. To explore the practice and attitude of WHO-Five Moments of hand washing and caregiver's health literacy using the Maternal Health Literacy (MaHeLi) survey a cross-sectional study was conducted at a single centre at a developing country among 418 caregivers of children under five. The analysis and reporting of variables utilized descriptive, univariate, paired t-test, and multivariate analysis methods. Caregivers' handwashing practices were significantly associated with education level and socioeconomic status (P-value ≤ 0.001). A positive correlation (P-value = 0.003) was observed between health literacy and handwashing practices, with caregivers demonstrating better hygiene practices after caregiving activities than before (P-value ≤ 0.001). Although most participants reported moderate levels of handwashing, only a small percentage practices optimum handwashing before or after child care. Caregivers with lower health literacy were less likely to perform adequate hand hygiene. Our study suggests that caregivers with higher health literacy demonstrated better hand hygiene practices. Enhancing health literacy and promoting handwashing education, especially in paediatric care settings and at community, could help improve hygiene practices among caregivers. These findings reflects the need for healthcare providers and policymakers to consider targeted interventions on developing health literacy and hand hygiene practices to reduce infections in children under five.

Autologous fat grafting in pediatric patients is limited due to restricted fat tissue reserves. Preadipocytes, derived from adipose tissue, offer a promising alternative for soft tissue augmentation in children.

This study aims to compare the effectiveness of preadipocyte fat grafting with conventional adipose grafting, particularly in cases where adipose tissue availability is limited.

In this experimental study, 28 male Wistar albino rats were used. Fat was harvested from periepididymal fat pads to prepare preadipocyte and adipocyte suspensions. These suspensions were injected subcutaneously into the right and left scapular areas, respectively. The rats were divided into four groups based on post-injection excision timing. Volumes of excised tissue were calculated using a hemi-ellipse formula. Histopathological examinations were conducted, comparing necrosis, fibrosis, vascularity changes, cyst formation, and inflammatory cell density.

Statistical analysis was performed using GraphPad Instat 3.0 and SPSS 17.0 software. Histopathologically, preadipocyte grafts showed better scores for necrosis, fibrosis, cyst formation, vascularity, and inflammation across all groups. Although no significant volumetric differences were observed in the other groups, in the fourth group (22 weeks), volumetric loss of adipocyte grafts was significantly greater than that of the preadipocyte grafts (0.09 ± 0.01 vs. 0.05 ± 0.02, P < 0.05).

The findings suggest that preadipocyte grafting holds promising potential for soft tissue augmentation, particularly in pediatric cases where limited fat tissue availability presents challenges. Preadipocytes' inherent characteristics, including resistance to hypoxia and enhanced promotion of angiogenesis, may contribute to their sustained volume retention and improved histopathological outcomes. The significant reduction in adipocyte graft volumes may be attributed to their susceptibility to hypoxia and graft resorption. The ability of preadipocytes to withstand ischemic conditions and promote angiogenesis could contribute to their enhanced viability. Further research and clinical investigations are warranted to establish preadipocyte grafting as a viable solution for soft tissue augmentation, especially in pediatric patients with limited adipose tissue availability. A comprehensive assessment of volumetric changes and histopathological outcomes provides deeper insight into the potential benefits of preadipocyte grafting in pediatric healthcare.

To evaluate the risk factors associated with asthma in children hospitalized at Hospital Belen de Trujillo.

An analytical study of retrospective cases and controls was carried out in which 258 clinical histories of children between 5 to 14 years of age who were hospitalized in the Hospital Belen de Trujillo (HBT) during the period 2015-2019 were included, which were grouped into 129 histories of children who had been hospitalized for asthma (cases) and 129 histories of children hospitalized for a different cause (controls). The frequency distribution will be calculated, the Chi-square statistical test will be used, the odds ratio will be obtained and the 95% confidence interval will be calculated; finally, a multivariate analysis will be performed by means of logistic regression to determine whether the influence of other variables generates a greater risk of developing asthma in children.

The multivariate analysis showed that the factors: cesarean delivery, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age together predict 92. 0% of the cases of asthma; however, taking the influence of all the factors at the same time, it was found that the cesarean delivery route, non-exclusive breastfeeding, obesity and maternal age are significant for the regression (p<0.05), while the factor history of bronchiolitis is not significant (p>0.05). Likewise, when the bivariate analysis of the five variables studied was performed and the Chi-square test was applied, it was found that all five factors were significant (p<0.05) for asthma in children at Hospital Belen de Trujillo.

The factors cesarean delivery route, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age are associated with asthma in children hospitalized at HBT.

This article explores my personal experiences as a veterinary student diagnosed with attention deficit hyperactivity disorder (ADHD), focusing on how ChatGPT has figsignificantly helped me manage my symptoms and improve concentration, particularly during preparation for the IELTS exam. Despite my high cognitive abilities and early literacy, ADHD has posed challenges in sustaining focus during intensive study periods. As a high-functioning individual with ADHD, incorporating ChatGPT into my study routine has been instrumental in enhancing both focus and productivity. This study underscores the positive impact of ChatGPT as a digital tool for improving concentration and managing ADHD symptoms, demonstrating its potential as an effective supplement to traditional interventions.

Ganglioneuromas (GNs) are benign tumors composed of gangliocytes and mature stroma which is usually asymptomatic. The GNs are differentiated neuronal tumors without immature elements and can arise from peripheral autonomic ganglion sites. The main treatment for that is complete surgical excision. In the case of tumor resection, chemotherapy and radiotherapy are not indicated.

The 12-year-old boy was referred to Abouzar Hospital in Ahvaz with complaints of cough, cold, and shortness of breath. Based on abdominal and pelvic CT scans, a heterogeneous hypodense mass (135 × 105 mm) was observed in the left upper region. The pathology of it was ganglioneuroma. Then the patient underwent surgery with a midline incision extending to the 6 - 7 intercostal space. Finally, the patient was discharged with good general condition.

The most effective treatment for ganglioneuroma is complete surgical removal of the mass. This study highlights the importance of imaging in diagnosing ganglioneuroma as a tumor located in the posterior mediastinum.

Music can serve as a passive distraction to reduce pain and anxiety. Due to the limited number of studies in this field, a study was designed and implemented to determine the effect of music therapy on the pain level of 3 - 6-year-old children undergoing wound repair by suturing and their parents' anxiety in the emergency department.

This study aimed to examine the effect of music therapy on the pain level of 3 to 6-year-old children undergoing wound repair by suturing and their parents' anxiety in the emergency department.

The present study is a parallel, controlled, randomized clinical trial. Sixty children aged 3 to 6 years referred to the emergency room for sutures were included in the study. In the test group, music was played on a mobile phone from the time the child entered the outpatient operating room until the end of the procedure and discharge. In the control group, children were sutured as usual. The behavioral reactions of both groups were assessed using Wong-Baker's pain scale before washing the wound, immediately after the injection of lidocaine, and at the end of the suture. The abbreviated Spielberger Situational Anxiety Questionnaire was used to measure parents' anxiety before washing the wound and at the end of the suture. These measures were recorded by the researcher.

Comparing the mean (standard deviation) of pain before washing the wound in the test group (9.90 ± 0.44) and the control group (9.97 ± 0.258) showed no statistically significant difference (P = 0.311). Using the GEE model, the average pain score immediately after lidocaine injection and at the end of the suture decreased by 1.77 and 4.9 units, respectively, compared to the phase before washing the wound (P < 0.001). The average anxiety of parents before washing the wound was 21.05 ± 2.59 in the test group and 21.05 ± 2.09 in the control group, showing no statistically significant difference (P = 0.801).

Based on the results of this study, there was no statistically significant difference between the two groups in terms of children's pain and parents' anxiety. However, clinically, the average levels of children's pain and parents' anxiety in the intervention group decreased at all three times. Music therapy seems to be effective in the emergency department during painful procedures.

The COVID-19 crisis has confronted parents with significant challenges in the field of child and adolescent psychiatry that must be addressed.

The current study aimed to evaluate the burden of the pandemic on families with children and adolescents diagnosed with psychiatric disorders.

This descriptive study used a cross-sectional design. A total of 92 children and adolescents (age range: 2 - 18 years; mean age: 9.49 ± 4.72) diagnosed with psychiatric disorders participated in the study. The parents (father or mother) of the children were asked to complete an informed consent form, a questionnaire to obtain demographic data, and a questionnaire to gather information about the difficulties parents faced with their children and adolescents during the COVID-19 pandemic. Data were analyzed using descriptive statistics, chi-squared tests, and Fisher's exact test.

The most common challenges parents faced included sleep problems (disruption of the sleep-wake cycle; 58.7%), excessive use of media (54.3%), and significant challenges with eLearning (53.33%). Inactivity (41.3%), difficulty accessing a psychiatrist (32.6%), difficulty accessing other therapists (23.9%), and worsening symptoms (23.9%) were the next most prevalent issues. The results also showed that 80.8% of parents of children with sleep-wake cycle disruptions, 83.5% of parents of children with excessive social media use, and 79.3% of parents of children with educational problems reported conflict with their children; the intensity of the conflict was moderate in most cases. A history of psychiatric disorders in parents did not predict parent-child conflict over the children’s problems during the quarantine (all P > 0.05).

Attention to the impact of the pandemic on these patients should guide the care provided by clinicians.

Ifosfamide is a crucial element in various chemotherapy protocols for the treatment of diverse solid tumors in both children and adults. Despite its efficacy, ifosfamide is associated with a rare yet severe adverse effect known as ifosfamide-induced encephalopathy (IIE), with a spectrum of signs and symptoms spanning from mild lethargy to coma or death. While approximately 13% of pediatric patients undergoing ifosfamide treatment experience IIE, consensus regarding its management remains controversial.

We present the case of a 4-year-old girl with stage 4 Wilms tumor and lung metastases who underwent radical nephrectomy followed by UH-1 chemotherapy. Imaging post-chemotherapy initially showed tumor clearance but later revealed relapse and lung metastasis. Following the initiation of the adjusted ICE protocol (ifosfamide, etoposide), the patient developed IIE, which was successfully treated with methylene blue.

We strongly advise pediatric oncologists and hematologists to proactively consider the potential occurrence of IIE. Before starting ifosfamide therapy, patients should be assessed for possible risk factors associated with IIE. Considering methylene blue as a prophylactic measure is recommended for patients with significant risk factors. In cases where IIE manifests, using Methylene Blue to alleviate and reverse its signs and symptoms should be considered. Moreover, we highly encourage further research endeavors to validate methylene blue's effectiveness and determine its optimal dosage range, especially concerning pediatric patients.