فهرست مطالب

International Journal of Pediatrics
Volume:6 Issue: 51, Mar 2018

  • تاریخ انتشار: 1396/12/28
  • تعداد عناوین: 16
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  • Nazish Baig, Manoochehr Karjoo *, Mirza B. Beg, Sara Karjoo Pages 7271-7273
    A digital rectal examination is a highly important procedure carried out on infants and children during visits to the gastroenterology clinic, but is often accompanied with physiologic and psychologic trauma in patients, along with being diagnostically inaccurate in the results obtained from it. In order to avoid causing discomfort to the patients, and to improve the accuracy of the results obtained from a DRE, we have articulated a much safer and more precise method of conducting the examination. The use of a 16 French Foley Catheter in the collection of stool samples during a DRE has proved to be an innovative technique, which eliminates discomfort in patients, provides a less stressful environment for both the physician and the family of the patient, along with providing unambiguous results for the FOBT. The use of this technique will not only produce accurate results, but will also eliminate reasons to avoid such an important examination due to the uncomfortable situation a normal DRE would cause.
    Keywords: Children, Digital Rectal Examination, Gastrointestinal Bleeding, Infants
  • Yamna Waseem *, Muhammad Naseeb, Mohammad Hamza Pages 7275-7276
    Sleep disturbance is a very common finding in patients with persistent cough1. This is especially apparent in infants with common cold or influenza and the continuous crying can lead to considerable distress for the parents. Cough syrups which are easily available as over the counter medications can induce sleep, and many parents turn to this medication when their infant is suffering from persistent cough.
    Keywords: flu, Children, medicine, sleep, antitussive
  • Hamid Reza Kianifar, Atefeh Ezzati, Seyed Ali Jafari, Mohammad Ali Kiani, Hamid Ahanchian, Hasan Karami, Ezzat Khodashenas *, Arezoo Jahanbin Pages 7277-7284
    Background
    Dermatoglyphics could assist in the diagnosis of congenital abnormalities. The aim of this study was to identify the dermatoglyphic patterns (finger print pattern type, total ridge count of each finger, a-b ridge count, and articulotrochanteric distance [ATD angles]) in the parents of cystic fibrosis children.
    Materials And Methods
    We recruited 75 parents of children with cystic fibrosis for the study group and 341 parents for the control group. We recorded finger print pattern type, total ridge count (TRC), a-b ridge count, and ATD angles of all participants. Then we identified any asymmetry between the right and left hands of each person and characteristics of parents in two genders. Chi-square analysis, Mann-Whitney U test, and Fisher's exact test were used for data analysis.
    Results
    We observed significant differences in a-b ridge count on the right hand (P=0.02), and mean total ridge count on the right digit I (P=0.05), right digit IV (P=0.03), and right digit V in the fathers of children with cystic fibrosis compared to the control group(P=0.02).
    Conclusion
    According to the results, we suggest that the dermatoglyphic traits of parents could be used as a simple, appropriate, and supplementary screening method in the diagnosis of children with CF. Nevertheless, we need lager studies to precisely confirm that dermatoglyphics is a reliable method in the diagnosis of CF.
    Keywords: Dermatglyphics, Cystic Fibrosis, Palm patterns, Asymmetry a, b ridge count, ATD angel
  • Ali Khani Jeihooni, Shideh Arameshfard, Mahmood Hatami, Morteza Mansourian, Seyyed Hannan Kashfi, Babak Rastegarimehr, Omid Safari, Mehdi Amirkhani Pages 7285-7296
    Background
    Considering the importance of learning health knowledge and the need to promote appropriate health attitudes, beliefs and behaviors regarding Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) among school-age people, the aim of this study was to investigate the effect of an educational program based on Health Belief Model (HBM) about HIV/AIDS.
    Materials And Methods
    This quasi-experimental study was performed on 100 male high school students in Fasa, Iran. A sample size of 100 was determined based on the examination of similar literature with 95% confidence interval and 80% test capability. The subjects were divided into two groups of 50 subjects. After administering a pre-test to both groups, only the experimental group was trained based on the HBM constructs on the HIV/AIDS preventive behaviors. Then intervention was followed by group discussion (10-person groups) in 8 sessions each 55-60 minutes. In order to collect information based on Health Belief Model, a questionnaire consisting of 41 questions in three sections was used. Data were analyzed using SPSS version 22.0 software.
    Results
    Educational intervention based on Health Belief Model resulted in meaningful enhancement of the subjects’ knowledge, perceived susceptibility, perceived severity, perceived benefits, and perceived self-efficacy (P
    Conclusion
    According to the results, educational intervention has increased the HIV/AIDS prevention behavior based on Health Belief Model. Therefore, the results of this study can be used in the theory-based intervention strategies to create and modify health behaviors.
    Keywords: Education, Health Belief Model, HIV, AIDS, Iran, Students
  • Mohammad-Taghi Talebian, Shahram Bagheri-Hariri * Pages 7297-7298
    There are considerable rates of pediatrics trauma referring emergency department following a traumatic event. The worried parents are requesting for the most sensitive diagnostic test, so emergency physicians ask them to underwent brain computed tomography (CT) scan. Lower threshold of decision making regarding use of brain CT scan results in huge number of normal imaging. On the other hand, radiation exposer of the child may accompanied with lots of side effects in future. It may highlight a question that “how to reduce the numbers of unnecessary brain CT scan of traumatic pediatric patients?”
    Keywords: Closed Head Injuries, pediatrics, X-ray Computed Tomography
  • Marziyeh Kaboudi, Parvin Abbasi, Parisa Heidarisharaf, Fateme Dehghan *, Arash Ziapour Pages 7299-7310
    Background
    Diagnosis of cancer in children has an adverse effect on the family. Resilience refers to the ability of humans to adapt to diseases, the pain and suffering caused by parental stresses and stressful factors in the life. The aim of this study was to investigate the effect of resilience training on the styles of coping status and parental stress of mothers whose children had leukemia.
    Materials And Methods
    At a case- control study, 60 mothers of children with leukemia were selected by available sampling method in Mohammad Kermanshahi Hospital in Kermanshah city, Iran. They were randomly assigned into two experimental groups (n=30), and control group (n=30). Connor-Davidson Resiliency Questionnaire, coping styles and parental stress form were used for data collection. The experimental group was trained nine sessions of resilience training weekly and the control group did not receive any training.
    Results
    The mean score of mother's style of coping after the training intervention in the experimental were increased (101.93±31.42 versus 89.20 23.84), and this difference was statistically significant (P
    Conclusion
    The results of this study showed that mothers who were trained under resilience skills, had significant progress in increasing the style of coping and reducing parental stress in comparison with mothers in control group.
    Keywords: Children, Leukemia, Parental Stress, Resilience, Style of Coping
  • Gian Maria Pacifici * Pages 7311-7343
    Malaria is an infection sustained by three parasites namely: Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale. Plasmodium falciparum is the most common and virulent parasite. These parasites are present in different areas of the sub-Saharan African countries and Asia. In 2010, there were an estimated 219 million cases of malaria resulting in 660,000 deaths and, approximately, two-thirds were children. In sub-Saharan African countries, maternal malaria is associated with up to 200,000 estimated infant deaths yearly. Chloroquine was the world's widely used antimalarial drug, but Plasmodium falciparum is now increasingly resistant. However, Plasmodium ovale and Plasmodium vivax are sensitive to chloroquine. Pregnancy makes women vulnerable to malarial parasites and the risks of anemia, miscarriage, stillbirth and prematurity increase. Resistance to chloroquine is a major concern for treatment of malaria and alternative drugs are needed. Proguanil is safe, being very rarely associated with severe adverse reactions. Chloroquine, mefloquine, sulfadoxine-pyrimethamine, and amodiaquine have been found to be active against Plasmodium falciparum in-vitro. In the Cameroons, chloroquine was initially replaced by amodiaquine and artemisinin-lumefantrine was gradually introduced in 2004. Tanzania replaced chloroquine with sulphadoxine-pyrimethamine, and in 2006 artemisinin was introduced in the therapy. Pyrimethamine-sulfadoxine should be reserved as a second-line-treatment. Mefloquine may provoke severe neuropsychiatric reactions. In the treatment of Plasmodium malaria, which has a high mortality rate if untreated, a greater risk of adverse reactions to malarial drugs is acceptable. The aim of the present study is to review the published data on the treatment of malaria in infants and their mothers.
    Keywords: Antimalarials, Infants, Malaria, Mothers, Pregnant, women, Resistance
  • Yazdan Ghandi, Mehrzad Sharifi *, Danial Habibi, Saeed Alinejad, Ali Arjmand, Sara Nikdel Pages 7345-7351
    Background
    We designed a cross-sectional study to determine electrocardiographic disorders in Down syndrome patients with congenitally normal hearts in a bid to predict fatal cardiac arrhythmia in the future.
    Materials And Methods
    We investigated 60 children with DS without congenital abnormal hearts. Sixty healthy juveniles were also included in the study as a control group. Physical examination, electrocardiography, and echocardiography were performed in all subjects. Corrected QT interval (QTc) was measured according to Bazett’s formula.
    Results
    Patients with DS consisted of 32 males (53.33%), and 28 females (46.66%), aged 6–13 (9.21 ± 6.24) years old. Healthy subjects comprised 31 males (51.66%), and 29 females (48.33%) with a mean age of 9.15 ± 5.01. The two groups were significantly different in terms of heart rate (P=0.006), maximum P-wave duration (P=0.001), and P-wave dispersion (PWd, P=0.0001). There was no statistically significant difference regarding minimum P-wave duration (P=0.176). The patients with DS had a greater maximum QTc interval, QT dispersion, and corrected QT interval dispersion (QTc-d) than the healthy control subjects (P=0.001). However, there was no difference in maximum QT interval and minimum QTc interval between the two groups (P=0.67 and P=0.553, respectively). A positive correlation was found between age, heart rate, and all electrocardiographic variables.
    Conclusion
    All DS patients, even in the absence of concomitant congenital heart disease should be followed up carefully by electrocardiography, looking for increased PWd and QTc-d to detect predisposed cases to arrhythmia.
    Keywords: Cardiovascular Abnormalities, Children, Down syndrome, Congenital Heart Defects
  • Fatemeh Bastami, Fereshteh Zamani-Alavijeh, Firoozeh Mostafavi *, Mohammad Almasian, Mohammad Hydari Pages 7353-7367
    Background
    The elimination of breakfast and the high consumption of low-value snacks are becoming more frequent and common among adolescents. Nutrition is a complex behavioral phenomenon that is associated with the specific cultural and environmental issues of each society as well as psychological features.This qualitative research was conducted to identify factors affecting breakfast consumption behavior in adolescents using the social marketing framework.
    Materials And Methods
    A qualitative research based on the social marketing framework was conducted through directed content analysis in the high schools of Isfahan and Khorramabad, Iran, in 2016. Data were collected through seven focus group discussions and 33 in-depth, semi-structured; interviews conducted in person with both male and female students, the parents, and the teachers and were analyzed simultaneously in three phases, namely preparation, organization and reporting.
    Results
    The results obtained in the present study within the social marketing framework were coded into the four categories of product, place, price and promotion. The product category had four subcategories, including favorite taste sought in breakfast, breakfast preparation, breakfast serving style, variety and the healthful features of breakfast. The price category had four subcategories, including time, psychological, social and financial prices. The promotion category had three subcategories, including official channels, unofficial channels, and educational materials and equipment. The place category had two subcategories, including having breakfast at school or having breakfast in an outdoor space.
    Conclusion
    The promotion of healthy breakfast as a product, requires that first its important features be considered, including the favorite taste sought in breakfast, second that it be promoted through channels most popular with students, and most importantly, that its price be reduced by using incentives such as serving breakfast at school as an attractive place for students.
    Keywords: Adolescents, Breakfast, Snack foods, Social marketing, Students
  • Hayet Zitouni, Hamdi Louati *, Manel Belhajmansour, Mohamed Jallouli, Riadh Mhiri Pages 7369-7370
    The clinical presentation of appendicitis in the newborn is nonspecific. The diagnosis was always made after surgical exploration for acute abdominal findings mimicking necrotizing enterocolitis. We report the case of acute appendicitis in a newborn diagnosed intraoperatively after neonatal occlusion symptoms.
    Keywords: Neonatal, Appendicitis, enterocolitis
  • Firoozeh Sajedi, Elham Habibi *, Soheila Shahshahanipour, Nikta Hatamizadeh, Hosein Malek Afzali Pages 7371-7382
    Background
    According to the World Health Organization (WHO), parents need to be informed about Early Childhood Development (ECD). Different methods of parents’ education include group-based, face-to-face, book, booklet, web-based, technology-based, and mobile learning using laptops, tablets, and cell phones. Paying attention to caregiver's attitudes is the first step to their education. The objectives of this study were to determine parental education requirements and the best approach towards promoting caregivers` knowledge about ECD, from the perspective of the Iranian main child caregivers.
    Materials And Methods
    A qualitative approach with directional content analysis method was used. Participants were selected through purposive sampling. Thirty-one child-caregivers participated in 5 individual interviews and 5 focus group discussions (FGDs). Participants were parents and grandparents that had less than the 36-month child (grandchild), and kindergarten staffs. Four criteria namely: validity, transferability, reliability and verifiability were used to validate data.
    Results
    According to the perspective of participants, two main themes were requirements for parent education (educators, educational content, time, place), and approach to educate child caregivers (mobile learning, group and face-to-face education, electronic learning, media, physical resources), totally 98 sub-themes. Finally the best approach to educate child caregivers was a multi-model approach includes group or face-to-face education with mobile learning.
    Conclusion
    Participants suggested a multi-model approach based on traditional and modern technological methods, especially mobile learning (smartphone). They believed that the educational approach should be flexible and selectable, so caregivers can choose an appropriate individual method.
    Keywords: Caregivers, Child development, Educational Model, Knowledge, Qualitative Study
  • Eslam Moradiasl *, Shahram Habibzadeh, Javad Rafinejad, Malek Abazari, Saeid Sadeghieh Ahari, Abedin Saghafipour, Mohammad Mehrtak, Hassan Edalatkhah Pages 7383-7392
    Background
    Head louse (Pediculus humanus capitis) is one of the common health problems of the children in elementary schools. The aim of this study was to determine risk factors associated with head lice (Pediculosis) infestation among elementary school students in Meshkinshahr County, Northwestern Iran.
    Materials And Methods
    This descriptive-analytic study is done over 1,950 students (1,055 girls and 895 boys) in Meshkinshahr County, North West of Iran that were selected two-stage cluster. Data collection was conducted using researcher-made questionnaire. In addition, the suspected cases were confirmed via physical examination for the presence of adult lice, and eggs. Head examinations were done by general physicians and medical entomologist experts. For data analysis, Chi-square and Regression Logistics tests were used.
    Results
    In total, out of 1,950 students of primary schools, 200 students (10.25%) were infested with pediculosis. A total of 131 (12.42%) of girls, and 69 (7.71%) of boys were head lice infested. Most of head lice infested students 145 (72.5%) were in the classrooms with capacity of more than 20 students. Also, one hundred sixty-one (80.5%) of the cases were in the schools with capacity of more than 100 students. This study revealed significant differences among student’s family size, students and their parent's history of infestation, type of bathrooms, history of use shared hygiene items and head lice infestation (P
    Conclusion
    The prevalence of head lice infestation in Meshkinshahr County was relatively high in comparison to other studied areas of Iran. It seems family size, students and their parent's history of infestation, type of bathrooms, and history of use shared hygiene items were probably risk factors associated with head lice infestation among students of primary schools.
    Keywords: Head lice, Elementary students, Iran, Pediculosis
  • Silva Hovsepian, Mostafa Qorbani *, Mohammad Esmaeil Motlagh, Mojgan Asadi, Armita Mahdavi Gorabi, Sahar Alirezayi, Hamid Asayesh, Neda Hani Tabaei Zavareh, Roya Kelishadi Pages 7393-7404
    Background
    This study investigates the association of perceived weight status and health-related quality of life (HRQOL) in a representative sample of Iranian children and adolescents.
    Materials And Methods
    In this study, 6-18-year-old students were selected from 30 provinces of Iran. Weight status and perceived weight status of students were determined by physical examination and using the validated questionnaire of the World Health Organization-Global school-based student health survey, respectively. The students’ HRQL was evaluated by the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0TM 4.0) Generic Core Scales.
    Results
    The participants consisted of 23,043 students with mean (standard deviation [SD]) age of 12.55(3.31) years. Underweight was significantly less prevalent than perceived underweight (30.8%vs 10.0%, respectively, P0.05). After adjustment for age, gender, region, socio-economic status, physical activity, screen time, and body mass index (BMI), significant negative association was documented between perceived overweight and total score of HRQOL. School functioning was negatively associated with perceived overweight. Positive significant association existed between perceived overweight and psychosocial functioning.
    Conclusion
    Our findings indicated that weight underestimation is the most common form of weight misperception in Iranian children and adolescents, which could be a cause of concern especially for obesity treatment and prevention programs. Furthermore, considering the negative association between weight overestimation and total HRQOL and school functioning, it is suggested that social standards and norms impacts on weight perception and consequently HRQOL in children and adolescents.
    Keywords: Health related quality of life, Children, Iran, Weight
  • Majid Khademian, Mohammad Ali Kiani *, Seyed Ali Jafari, Hamid Ahanchian, Niloofar Sedghi, Fatemeh Behmanesh, Ali Khakshour, Hamidreza Kianifar Pages 7405-7412
    Background
    The popularity of probiotics is on the rise. Despite the beneficial effects of antibiotics, gastrointestinal health is at risk of diarrhea. This study aimed to investigate whether probiotic yogurt is of capability to prevent the incidence of diarrhea versus conventional yogurt.
    Materials And Methods
    This controlled, randomized, double-blind trial was designed to recruit 48 hospitalized children, whose treatments included different types of antibiotics. They were subsequently assigned into a 1:1 ratio into groups A and B at random. The first group was instructed to consume probiotic yogurt (Bifidobacterium strains and Lactobacillus acidophilus), while the second were on conventional yogurt (placebo containing Streptococcus thermophiles and Lactobacillus bulgaricus) at least for 7 days. The incidence of diarrhea, its onset and duration were compared between the two groups.
    Results
    The findings indicated that there was no statistically significant difference between the experimental and control groups (p > 0.05). No significant decrease was observed in the incidence of diarrhea between the groups following adjustment for negative C-reactive protein (CRP) (p > 0.05).
    Conclusion
    According to the results, the consumption of yogurt, either probiotic or conventional, reduced the incidence, duration, and onset of antibiotic-associated diarrhea in pediatric population. This study showed no significantly better performance for probiotic yogurt than conventional yogurt.
    Keywords: Diarrhea, pediatrics, Probiotics, Yogurt consumption
  • Shahrbanoo Moslemi, Saber Mohammadi, Mahin Hosseininejad, Sima Mohtasham, Elaheh Kabir-Mokamelkhah * Pages 7413-7419
    Background
    Postural structure abnormalities have been highly prevalent among children in primary school children.The present study aimed to assess the relationship between the backpacks weight and method of carrying with postural structure disturbances in primary school children.
    Materials And Methods
    This cross-sectional study was performed on 472 primary school children in Karaj-Iran. Study investigators, assessed stature structure disturbances of head, neck, and spinal cord based on the New York scoring protocol. Ergonomic data of backpacks such as type of bag, weight of student's bags, the method of carrying bag, feeling pain when carrying the backpack, the mean time for carrying the backpack from school to home, was evaluated
    Results
    In this study 97.2% of students carried backpacks as the school bags and only 1.9% carried their bags correctly. The mean time for carrying backpacks was associated with the increased risk for posture disorder including forward head (p
    Conclusion
    According to the results the postural structure disturbances was partially high among primary school children and were closely associated with some ergonomic parameters such as weight and type of backpack.
    Keywords: Iran, Musculoskeletal abnormality, Spinal Curvatures, Student
  • Gohar Eslami, Azade Panji, Hosein Firoozi, Fatima Hosseinzadeh, Siavash Moradi, Ali Mohammadpour Mir, Mohammad Sadegh Rezai * Pages 7421-7432
    Background
    Pleural empyema is a collection of purulent exudate between the lungs and the chest wall. Despite the importance of the disease in children, no study has investigated it in Mazandaran province, Iran. The aim of this study was to evaluate the prevalence, clinical manifestations, diagnosis, treatment and its outcome in children referring to hospitals of Mazandaran during 12 years.
    Materials And Methods
    In this cross-sectional study, medical records of all children aged 0 to 18 years admitted to 5 educational hospitals of Mazandaran province, Iran, with Tenth Revision, Clinical Modification (ICD-10-CM) codes confirming pleural empyema or effusion from March 2004 to 2016 were identified retrospectively. The clinical records were reviewed for demographic information, hospitalization information, medications, symptoms; laboratory and medical imaging results and the patient's condition on discharge were recorded. Statistical analysis was performed by SPSS version 20.0 software.
    Results
    Of 50 patients with the mean age of 7.08±5.6 years, 31(62%) were boys and empyema incidence was higher (58%) in 5-18 year-old children.The mortality rate was 12% (6 patients).The most common microorganisms were Escherichia coliand Klebsiella (33.3%). In 17(34%) patients, antipyretics were prescribed prior to admission and pre-admission treatment regimen included beta-lactams with or without macrolides.The most commonly prescribed drug regimens were vancomycin and beta-lactam (50%), and the most common drug resistance of microorganisms was to ampicillin, cephalexin and ceftazidime.
    Conclusion
    Since most of the gram-negative organisms in Mazandaran hospitals were Extended-Spectrum Beta-Lactamases (ESBL), and all the microorganisms of this study were susceptible to gentamicin, it is suggested to consider it in empiric therapy of pediatric pleural empyemain Mazandaran province. Also, lower rate of surgical intervention in children who received pre-admission antibiotics highlights the importance of antibiotic intervention before admission.
    Keywords: Anti, Bacterial Agents, Children, Empyema, Chest tubes, Pleural, Pediatrics