فهرست مطالب

Pediatrics - Volume:5 Issue:38, 2017
  • Volume:5 Issue:38, 2017
  • تاریخ انتشار: 1395/10/20
  • تعداد عناوین: 17
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  • Masoud Karimi, Mohammad Hossein Kaveh, Mohammad Ali Morowatisharifabad, Ali Dehghani, Ghasem Dastjerdi Pages 4263-4274
    Background
    Several environmental and psychosocial risk factors are known for adolescent smoking as the single cause of preventable diseases and premature death. This cross-sectional study aimed to determine the prevalence of cigarette smoking, socio-demographic factors associated with cigarette smoking (age, education level, parents’ job, and family’s socioeconomic statues), and the role of family and friends in cigarette smoking by high school students.
    Materials And Methods
    In this cross-sectional study which was conducted in Shiraz, Iran, 900 high school boy students (grades 9-11) were selected through multistage random cluster sampling. They responded a researcher designed anonymous questionnaire about smoking experiences of themselves- and their friends and family members. Chi-square and Mann-Whitney U test and Binary logistic regression analysis were used to analysis of the data, using the SPSS version 17.0.
    Results
    The mean age of the participants was 16.11 (1.16) years and 19.7% of the students were ever smokers. Students’ higher educational grade (P=0.001), fathers’ lower education level (P=0.03), live with one parent or people other than parents (P=0.024), father’s, siblings’, and friends’ smoking, and family members’ cigarette smoking at home (P
    Conclusion
    Cigarette smoking is a public health concern in all families from different socio-economic status. Special attention to orphans and children of divorce, setting rules about cigarette smoking in families, monitoring and being aware of offspring’s and their friends’ behavior can be recommended.
    Keywords: Adolescent, Environmental, Smoking, Socioeconomic, Student Risk Factor
  • Shirin Hasani Ranjbar, Akbar Soltani, Marzieh Hadavi, Hanieh Sadat Ejtahed, Mahsa Mohammad, Amoli, Amir Reza Radmard Pages 4275-7284
    Background
    Congenital generalized lipodystrophy (CGL) is a rare disease. It is associated with near total fat loss, severe insulin resistance and hypoleptinemia leading to metabolic derangements.
    Case Presentation
    We report a 25- year- old female with 1-Acylglycerol-3-phosphate-O-acyltransferase 2 (APGAT2) mutation, and both sclerotic and lytic bone lesions together for the first time. Bone cyst is one of the manifestations of CGL with AGPAT2 mutation. Patients usually have sclerotic bone lesions before and lytic bone lesions after puberty. Our patient had lytic bone lesions in (femur) long bones and also sclerotic lesions in the pelvic which was related to AGPAT2 mutation.
    Conclusion
    The young female hadacral enlargement, hepatomegaly and both sclerotic and cystic bone lesions with AGPAT2 mutation.
    Keywords: AGPAT2 mutation, Congenital generalized lipodystrophy, Cystic bone lesions
  • Maryam Mohammadian Dameski, Mohammadreza Mehri, Zohre Feyzabadi Pages 4285-4293
    Colic is a common and annoying problem in infancy whose etiology is not well understood. Traditional Iranian Medicine (TIM) scientists know flatulent food effective in creating this disorder. Since the reduction or withdrawal of this kind of food in mother’s and infant’s nutrition can be effective in preventing flatulence, this study aims to study and identify flatulent foods and the mechanism of flatulence in traditional and modern medicine. The search was conducted using the following keywords: "flatulent", "flatulence", "colic" and "bowel sound (Gharagher)" in six pharmacopeias of Traditional Iranian Medicine.
    Then, the scientific name of foodstuff was determined and the materias were scored based on the repetition in one or more traditional medicine book. Finally, by searching electronic resources, etiology and the mechanism of flatulence were evaluated for some of these materias. A total of 90 flatulent materias were found. Apples, cucumbers, pears, wheat, turnips and rice are the most flatulent plant materias. Etiology of flatulence in modern medicine is the gas production caused by the fermentation of the remaining food and carbohydrates by colon bacteria while in traditional medicine texts, flatulence occurs due to dysfunction in digestion performance which may be due to the type of the food.
    As a conclusion, almost all foods that were introduced as flatulent in traditional medicine are known as flatulence generators in modern medicine resources, as well. Identification of these foods can help to reduce infantile colic.
    Keywords: Infantile colic, Flatulence, Flatulent, Traditional Iranian Medicine, Medicinal plants
  • Parisa Dehkordian, Najmeh Hamid, Kumars Beshlideh, Mahnaz Mehrabizade Honarmand Pages 4295-4302
    Background
    Quality of life (QOL), is the most important goal of treatment. The aim of this study was to compare the effectiveness of mindful parenting, social thinking and exercise on quality of life in ADHD children.
    Materials And Methods
    An experimental design was used. Samples consist of 60 students 8-12 years with the DSM-5 classification ADHD that were engaging in education in 2015-2016 in Abadan, Iran. 60 children according to criteria inclusion were randomly placed in 4 groups: mindful parenting (17 mothers of ADHD children), social thinking (n=15), exercise (n=13), and control group (n=15). Measure tools consist of Conner’s Parent Rating Scale (CPRS) and Pediatric quality of life (pedQOL) questionnaire. Interventions were: mindful parenting (9-session), social thinking (8 sessions) and exercise (8-session).
    Results
    The results showed significant change in QOL of experimental group compared with the control group (P
    Conclusion
    Considering the effective role of mindful parenting and exercise in improving QOL, can be told mindful parenting intervention and exercise can be applied in clinical field, particularly for improving ADHD children's QOL.
    Keywords: ADHD, Children, Mindful Parenting, Social thinking, Quality of life
  • Fereshteh Ghaljaei, Hamideh Goli, Alia Jalalodini, Nasrin Mahmoodi Pages 4303-4308
    Background
    Rickets is a disorder due to impaired metabolism of bone mineralization which caused by low concentrations of extra-cellular calcium or phosphate. In children, hypophosphatemic rickets (HR) happen malabsorption of phosphate and increasing of renal tubular loss.
    Case Presentation
    We present the case of a 4-year-old girl who had medical history of HR with failure to thrive (FTT). Child hospitalized several times due to osteomalacia and leg fractures. In physical examinations, there were obvious signs of rickets such as bow legs and hands, deviations of the wrist and chest pigeon. The results of blood tests showed low level of Phosphorus; but the level of calcium was normal. Radiography showed deformity of wrists and hands.
    Conclusion
    HR should be considered as one of the childhood disorders which impairs metabolism of bone mineralization and cause osteomalacia and bones fractures. If HR undiagnosed and remedies poor during childhood, in older ages would reveal automatic fractures and mineralization defects.
    Keywords: child, Hypophosphatemia, Hypophosphatemic rickets, FTT
  • Zaher Khazaei, Elham Goodarzi, Ebrahim Ghaderi, Salman Khazaei, Alireza Alikhani, Saeeid Ghavi, Kamyar Mansori, Erfan Ayubi, Behzad Gholamaliee, Reza Beiranvand, Seyedeh Leila Dehghani, Nahid Ghotbi, Sairan Nili Pages 4309-4318
    Background
    Congenital hypothyroidism (CH) is the most common endocrine diseases and one of the major causes of preventable mental retardation. This study was conducted to investigate the prevalence of transient and permanent congenital hypothyroidism in Kurdistan province, Iran.
    Materials And Methods
    In this cross-sectional study, all registered congenital hypothyroidism neonate of health centers of cities covered by Kurdistan University of Medical Sciences during 2006 to 2014 entered to study. Demographic and laboratory information of CH neonates was collected and entered into the Stata-12 and was analyzed using student t-test and Chi-square statistic and P- value less than 0.05 was considered.
    Results
    Overall incidence rate during 2006 to 2014 for province was 1.8, 2.3, 3.2, 4.3, 3.3, 4.0, 3.6, 4.6 and 2.7, respectively per 1000 neonates in this period. The number of diagnosed patients was 855 cases including 519 (60.7%) boys and 336 (39.3%) girls who 516 (60.4%) cases were from urban areas. Of the total patients, 202 (22.6%) were permanent. There was no significant difference between gender, location, type of childbirth, and season of birth with transient and permanent types of disease (P˃0.05); while, there was a significant statistical relationship between consanguineous marriages and congenital hypothyroidism (P
    Conclusion
    The prevalence of congenital hypothyroidism in Kurdistan province is significantly higher than the global and country levels that emphasize the continuation and reinforcement of screening program of infants. Therefore, complementary studies are research priorities of the health system in Kurdistan province in order to clarify the environmental and genetic factors related.
    Keywords: Congenital hypothyroidism, hypothyroidism, Neonate, Iran
  • Moradali Zareipour, Ali Sadaghianifar, Rohollah Valizadeh, Mahin Alinejad, Simin Noorani, Mousa Ghelichi Ghojogh Pages 4319-4327
    Background
    Investing in the health of children in learning situation is one of the most important health interventions. The aim of this study was to determine the effect of health promoting schools in improving the health status of schools in Urmia, North West of Iran.
    Methods and materials: This interventional study was conducted on 155 schools executing the health promoting schools program that were included by census. Data collection instrument was standard checklist of health promoting schools approved by Ministry of health and Ministry of education. Data were collected in two-stage before and after intervention during 12 months. Data were analyzed using the software SPSS 16.0 and descriptive statistics and Paired t- test were used.
    Results
    There were 217 schools in Urmia in primary, Middle and High school. A total of 155 schools surveyed in the study, 77 schools (49.7%) were primary school, 68 schools (43.9%) junior schools, and 10 schools (6.5%) were high school. Mean score of rates was 59.35 13.22 before the intervention and 63.94 12.1 after intervention and this difference was statistically significant (P
    Conclusion
    The results showed that health promoting schools program was effective in improving schools in terms of health promotion. It is recommended that families, organizations, and policy makers to be involved in the implementation of this program.
    Keywords: Health promotion, Iran, Schools, students
  • Leila Valizadeh, Vahid Zamanzadeh, Akram Ghahramanian, Parvaneh Aghajari Pages 4329-4341
    Background
    One of the essential aspects of the provision of care is cultural issues. Cultural sensitivity is the key for cultural care. The aim of this study was to explore culturally sensitive care in pediatric nursing care in Iran.
    Materials And Methods
    This study was a conventional content analysis. Participants were consisted of 25 nurses and 9 parents selected through purposive sampling from three pediatric referral centers in Tabriz and Tehran, Iran. Data was collected using semi-structured interviews and field notes and were concurrently analyzed by using Graneheim and Lundman (2004) method. Data was transcribed verbatim, words, sentences, and phrases were considered meaning units, abstracted, labeled and compared for developing categories.
    Results
    Culturally sensitive care of a sick child was consisted of three themes: ‘cultural exposure’, ‘intercultural communication’ and ‘the reconciliation of cultural conflict in families/care’. During the ‘cultural exposure’ nurses were informed of the cultural manifestations, strived to identify and understand patients/families with cultural diversities and respect their cultural beliefs. The nurse used the native language in ‘intercultural communication’ or a combination of verbal and nonverbal communication methods to reach a common understanding. Finally, a nurse in the conflict between the culture of child/family and care took actions for making decisions to develop a compliance between care and the family culture and amended parents’ harmful desires through negotiation and appropriate care.
    Conclusion
    Understanding the concept of culturally sensitive care, can help with resolving the problems of cultural exchanges in Pediatric wards. Providing cultural facilities and interpreters to communicate with patients/family increase their satisfaction.
    Keywords: child, Cultural diversity, Culturally sensitive care, nurses, Qualitative research
  • Ali Ramezankhani, Elahe Tavassoli, Akbar Babaei Heydarabadi, Mahnoush Reisi Pages 4343-4351
    Background
    Changes in the nutritional behaviors from consumption of traditional nutriments to intakes of high energy, concerned in powering the increasing problem in adolescents and children's obesity. The current study intended to evaluate Proper consumption of sugary drinks and its association with adolescent girls’ knowledge and skill in Shahr-e-kord city, Iran.
    Materials And Methods
    This was a cross-sectional study carried out on girl's students in Shahr-e-kord city. Using random sampling method and based on sampling size formula, a total of 308 of the girls students were randomly selected from the schools and were registered into the study. Then they received a research-made questionnaire containing questions about the knowledge, skill and Food Frequency Questionnaire (FFQ). The collected data were analyzed using SPSS version 18.0 by ANOVA, and Pearson correlation coefficient.
    Results
    The mean age of the participating adolescent girls was 13.86 ± 1.3 years old. The mean score for knowledge was 36.53 ± 21.87 and the mean score for the skill of preparing and consumption of sugar free drinks was 35.77 ± 24.67. The average amount of daily consumption of sugary drinks among studied adolescent girls was 2.95 glasses.There was a direct significant association between students’ knowledge and skill (P = 0.002, r = 0.182), There was also a significant reverse association between adolescents’ skill(P = 0. 006 r = -0.228) and knowledge (P = 0. 05 r = -0.322) with consumption of sugary drinks.
    Conclusion
    According to the findings of this study, to increase the consumption of valuable foods and improving adolescents’ nutritional habits, more attention should be paid to the health education and promotion and by using effective relevant patterns and theories.
    Keywords: Adolescent, Behavior, knowledge, skill
  • Mahsa Behdarvandi, Mehrdad Azarbarzin, Shahram Baraz Pages 4353-4360
    Background
    It is not clearly specified that which of the components of body mass index (BMI) affect body image and which of them do not. Given that having information in this regard is of special importance as a basis for future planning for adolescents, the present research aimed to compare body image in female and male adolescents and study its relationship with body mass index in high school students of Ahwaz, Khuzestan Province in the academic year 2015-2016.
    Materials And Methods
    In this descriptive-analytic study, 200 high school students were selected as the sample using the random cluster sampling method. The required data were collected using demographic questionnaire, anthropometric data checklist (height and weight), and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). All descriptive and inferential statistics tests were performed using SPSS-17 at a confidence level of 95%.
    Results
    The students ranged from 15 to 18 years old. Equal distribution was employed among all four grades of high school. Body mass index (BMI) in male students showed a significant inverse relationship only with appearance orientation (P
    Conclusion
    Overweight and obesity are considered important factors affecting the physical and mental health, including satisfaction with body image, among adolescent girls. Women’s extreme attention to their body leaves a negative impact on their attitude toward their body and body value. Therefore, promotion of a healthy body image should be integrated across all interventions aimed to address obesity and other health-related concerns among adolescents.
    Keywords: Adolescent, Body Image, Body mass index, students
  • Azam Fathi, Gholamreza Sharifirad, Zabihollah Gharlipour, Javad Hakimelahi, Siamak Mohebi Pages 4361-4370
    Background
    Malnutrition can threaten mental and physical development of children while healthy nutrition can improve mental and physical status of children. To select the best foods, children need nutrition education. This study aimed to determine the effect of nutrition education on reducing the consumption of unhealthy snacks in female primary school students in Qom- Iran.
    Materials And Methods
    This interventional study was conducted on 88 students in intervention and control groups who were selected via multistage random sampling method. The data was collected using a valid and reliable researcher-made questionnaire which was designed based on the health belief model (HBM). First four training sessions were held for the intervention group; two months later, data were collected again from both groups of students (intervention and control group). The collected data were analyzed by SPSS version 16.0 using descriptive statistics and independent and paired t-test.
    Results
    The mean score of knowledge and performance of the intervention group, were 96.12 and 18.61 before the intervention which changed to 110.00 and 68.22 after the intervention. The results showed that before the intervention there was no statistically significant difference between the two groups in terms of mean scores of knowledge, and the constructs of the health belief model (P>0.05). After the intervention, the scores of all variables and the behavior of unhealthy snacks consumption were significantly increased in the intervention group (P
    Conclusion
    This study showed that the nutrition education program (designed based on the HBM) was effective in reducing the consumption of unhealthy snacks as it increased the scores of the Health Belief Model constructs and decreased the score of perceived barriers.
    Keywords: Health belief model, Iran, students, Unhealthy snacks
  • Abdel Azeem El Mazary, Reem Abdel Aziz, Madiha Sayed, Ramadan Mahmoud, Ahmed Saedii Pages 4371-4383
    Background
    Many studies reported that copper, zinc and magnesium play important roles in the pathogenesis and development of neonatal hyperbilirubinemia. Exchange transfusion and intensive phototherapy are known two modalities of therapy for severe neonatal hyper bilirubinemia, but the effect of them on those trace elements is unknown.
    Materials And Methods
    Copper, Zinc and Magnesium serum levels were measured before and after treatment with intensive phototherapy and exchange transfusion in full term neonates with indirect hyperbilirubinemia admitted to neonatal intensive care unit (NICU) of Minia and Sohag University hospitals, Egypt, during 2014-2016 and comparison with normal healthy neonates was done.
    Results
    There were significant higher copper and magnesium and lower zinc serum levels in neonates with indirect hyperbilirubinemia than controls before and after intensive phototherapy. These levels were significantly changed after exchange transfusion to be comparable with controls. Significant positive correlations between the total bilirubin levels and hemoglobin, copper, and magnesium serum levels and significant negative correlations with serum zinc levels were present. There were no significant correlations between maternal and neonatal copper, zinc or magnesium serum levels.
    Conclusion
    Neonates with indirect hyperbilirubinemia had significant higher copper and magnesium and lower zinc serum levels than healthy neonates which were not related to their maternal serum levels. Intensive phototherapy had no effect on their levels while exchange transfusion changed these levels to be comparable with that of normal healthy neonates.
    Keywords: Copper, Hyperbilirubinemia, Magnesium, Neonates, Phototherapy, Zinc
  • Hengameh Khajavikia, Leila Valizadeh, Soheila Zarei, Nemat Bilan, Negar Taleschian Tabrizi Pages 4385-4393
    Background
    Asthma is the most common chronic disease of childhood and adolescents worldwide that can result in variable restriction in the physical, emotional and social aspects of the patient’s life.The purpose of this study was to assess the effect of asthma stimulants modifying education program on the attitude of adolescents with asthma.
    Materials And Methods
    This study was based on pretest-posttest control group design. A sample of 60 adolescents from 12 to 18 years of age participated in the study. Groups were assigned randomly to intervention and control groups. Measurement of child’s attitude toward illness scale (Austin and Huberty,1993) was collected prior to intervention and five weeks post intervention in both groups. The intervention group received the asthma stimulants education program and followed up by telephone. Data Analysis was conducted with SPSS 13.0. Descriptive analysis (i.e. Chi-square and t-tests) were used.
    Results
    The difference in scores of pre and post changes of the child’s attitude toward illness between the two groups showed statistically significant differences (P
    Conclusion
    This type of educational intervention to adjust stimulants has the potential to improve the attitude toward illness in adolescents with asthma. Promoted attitude by educating adolescents about modifying asthma triggers can empower them to control the disease and reduce the participation of parents.
    Keywords: Adolescent, Asthma stimulant, attitude, education
  • Manoochehr Karami, Bahram Haghighi, Alireza Soltanian, Ardashir Khosravi Pages 4395-4405
    Background
    Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) is a leading cause of bacterial pneumonia, meningitis, and sepsis in children under 5-year of age. This study aims to estimate potentially preventable number of cases and deaths caused by Hib and pneumococcal in Iran.
    Materials And Methods
    We used the burden of diseases model estimates of the World Health Organization (WHO) to calculate the number of cases and deaths caused by Streptococcus pneumoniae and Haemophilus influenzae in children less than 5 years old. Efficacy of Hib and pneumococcal vaccine was obtained from literature. Vaccine coverage was cited of published report from Ministry of Health and Medical Education Iran (National Committee on Immunization). Hib and Streptococcus pneumoniae diseases burden was obtained from the WHO global burden of disease project.
    Results
    We found that the number of potentially preventable cases and deaths from meningitis caused by Hib among under five years old children in 2013 were 5,414 (95% confidence intervals [CI]: 2838, 11630), and 61 (95% CI: 31, 93), respectively. Estimated number of Streptococcus pneumoniae related pneumonia cases in 2010 and 2013 were 37,732 (95% CI: 22,183, 58,334), and 30,728 (95% CI: 17,023, 50,412), respectively. The corresponding values for pneumonia related deaths from Streptococcus pneumonia were 438 (95% CI: 257, 677), in 2010 and 356 (95% CI: 197, 586), in 2013.
    Conclusions
    Findings favor the effects of both Hib and Pneumococcal conjugate vaccine (PCV) in reducing the burden of disease and death in Iran. Policy makers are advised to introduce PCV to National immunization program.
    Keywords: Children, Iran, Haemophilus influenzae type b, Immunization, Streptococcus pneumoniae
  • Gian Maria Pacifici, Giovanna Marchini Pages 4407-4428
    Amikacin is a bactericidal aminoglycoside. Aminoglycosides inhibit bacterial protein synthesis. The antibacterial spectrum of amikacin is the broadest of aminoglycosides. Because of its resistance to many of the aminoglycosides-inactivating enzymes, it has a special role in hospitals where gentamicin- and tobramycin-resistant microorganisms are prevalent. Amikacin is active against the majority of aerobic gram-negative bacilli in the community and in the hospitals. This includes most strains of Serratia, Proteus, Enterobacter, and Escherichia coli that are resistant to gentamicin and tobramycin. Amikacin is active against Mycobacterium tuberculosis (99% of strains are inhibited by 4 μg/ml amikacin), including streptomycin-resistant strains atypical mycobacteria. The gastrointestinal absorption of amikacin is minimal and is largely excreted through the renal glomerulus. In neonates, the dose of amikacin is 15 mg/kg. In the first week of life, a loading dose of 10 mg/kg followed by a maintenance regimen of 7.5 mg/kg has been suggested. After the first week of life, the corresponding doses are 17 mg/kg (loading dose) and 15 mg/kg (maintenance dose). The peak and trough doses of amikacin should be 20-30 μg/ml and
    Keywords: Amikacin, Effects, Neonate, Pharmacokinetics
  • Bahare Fallah Tafti, Naiire Salmani, Sara Afshari Pages 4429-4437
    Background
    One of the most common symptoms of diseases in infancy period is fever, and the concerns occurred could lead to encouraging parents to control fever as soon as possible. This study has been conducted to explore experiences of mothers caring children with fever.
    Materials And Methods
    This qualitative study was conducted using conventional content analysis. The data were collected through 14 unstructured individual interviews with a purposive sampling among the mothers having children with fever admitted to pediatric ward of Shahid Sadoughi hospital, Yazd-Iran. Data analysis was performed on a continuous and consistent comparisons basis.
    Results
    The mean and standard deviation of variables of mothers’ age (year), length of hospitalization of children (day), and age of children with fever (year) were 5.17 ± 28.25, 2.7 ± 4.2, and 2.3 ± 1.7, respectively. The experiences of participants were revealed in three themes of "concern penetration", "in search of fever control", and "discomfort".
    Conclusion
    Since the occurrence of fever is associated with concerns of parents and self-medication to control fever and discomfort of mothers, it is essential for the health care providers to design and implement the appropriate family-centered interventions to improve awareness and the performance of parents.
    Keywords: child, Experience, Fever, Iran, Mother, Qualitative research
  • Zahra Hosseini, Zabihollah Gharlipour, Siamak Mohebi, Gholamreza Sharifirad, Abolfazl Mohammadbeigi, Zohreh Kazazloo Pages 4439-4448
    Background
    Among various food products, milk and dairy products are among the most basic nutrient foods. The consumption of milk and dairy products in Iran is much lower than the global rate of per capita consumption. This study used Health Belief Model to determine associated factors of milk consumption among 7-9th students.
    Materials And Methods
    This cross-sectional descriptive analytical study was conducted on seventh to ninth grade students in the city of Qom. Using multistage cluster sampling method, a total of 390 students were enrolled onto the study. In order to collect data in this study, we used a researcher made questionnaire which was designed based on health belief model. Using SPSS version 20.0 software, the collected data was analyzed via descriptive statistics and independent t-test and Chi-square test.
    Results
    Of all the participants, 41% consumed milk daily and 59% did not consume milk. The perceived benefits (P=0.007), perceived barriers (P
    Conclusion
    The daily milk consumption associated with perceived benefits, perceived barriers and perceived self-efficacy. Therefore, there is a need to utilize educational programs based on health belief model for increasing of milk consumption.
    Keywords: Health belief model, Iran, Milk consumption, students