فهرست مطالب

Comprehensive Pediatrics - Volume:9 Issue:2, 2018
  • Volume:9 Issue:2, 2018
  • تاریخ انتشار: 1397/04/30
  • تعداد عناوین: 9
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  • Arash Bordbar, Parisa Mohagheghi, Ladan Yoonesi, Majid Kalani, Mandana Kashaki, Ali Ghassemian, Sarah Farhadi, Somayeh Farhadi * Page 1
    Background
    Developmental dislocation of the hip joint is among joint abnormalities and lack of its early diagnosis leads to irreversible complications and disabilities.
    Methods
    The current cross sectional study was conducted on 210 eighteen - month - old premature infants. Premature infants at term gestational age were examined by a neonatologist and underwent a sonographic scanning by a skilled radiologist. The results of the physical examination and ultrasound reports were collected and analyzed.
    Results
    In the clinical assessment, hip joint examination was diagnosed abnormal in 22 cases (10.4%) and joint dislocation was diagnosed by ultrasonographic examination in 17 patients (8.1%). In one high - risk case, despite normal clinical examination (0.48%), the dislocation was diagnosed by ultrasonographic evaluation. There was a significant relationship between hip dislocation rate, and reduced mean gestational age and birth weight (P 0.05). In diagnosis of joint dislocation, clinical examination (the results of the Ortolani and the Barlow tests) had sensitivity of 94% and specificity of 97% compared with sonography; the positive and negative predictive values were 73% and 99%, respectively.
    Conclusions
    Clinical examination has high sensitivity and specificity for early diagnosis of developmental hip dislocation. If there are risk factors, ultrasonographic scanning is recommended despite normal physical examination, and ultrasound is not necessary in case of normal physical examination and the absence of risk factors.
    Keywords: Premature Infant, Dislocation, Hip, Clinical Examination, Ultrasonography
  • Fatemeh Fatan, Mahnaz Haghighi * Page 2
    Background
    The vital role of sleep and sleep disorders in children has been proven. Children, who suffer from sleep disorders, experience more behavioral problems, depression, and anxiety in childhood, learning disabilities, and emotional development impairment. The aim of this study was to evaluate sleep habits of primary school students in Shiraz and its relationship with demographic factors.
    Methods
    This cross-sectional study was conducted on 200 students (100 female students and 100 male students) aged 8 to 12 selected from four (one to four) different educational districts of Shiraz during the academic year 2016 - 2017. The data were collected using the CRSP questionnaire. The sleep questionnaire and a demographic questionnaire were filled out by asking children to answer the questions. Descriptive statistics, T-test, Spearman correlation coefficient, and other statistical methods were used in this study. Data were analyzed using SPSS ver.24 software and the significance level was less than 0.5.
    Results
    The results of the study indicated that children sleep duration varied from six to 13 hours with an average of 9.18 ± 1.5 hours. 50% of children had less than nine hours of sleep and only 40.5% of them had nine to 11 hours of proper sleep. The median of bedtime was 10:00 p.m. and a significant percentage of children (25%) went to bed after 11:00 p.m. There was a significant relationship between age, bedtime, and sleep duration. Furthermore, boys displayed significantly longer sleep duration in comparison with girls.
    Conclusions
    According to the results of the study, a significant percentage of children did not have adequate sleep at night. As a result, it is necessary to pay more attention to children’s sleep habits and sleep patterns. It is suggested providing parents and children with adequate information about sleep patterns, sleep health, and sleep disorders and even giving them appropriate strategies.
    Keywords: Sleep, Child, Sleep Disorders
  • Milad Borji, Mohsen Moradi, Masoumeh Otaghi *, Asma Tartjoman Page 3
    Background
    Healthy nutrition in the early years of life has utmost importance and can significantly influence the health status of individuals in the forthcoming years; thus, one of the most important health - related goals in the early years of a child’s life is proper nutrition.
    Objectives
    Accordingly, the current study aimed at determining the relationship between nutritional status, food insecurity, and causes of hospitalization in children with infectious diseases admitted to a hospital in Ilam, Iran.
    Methods
    In the current cross sectional study, 580 children hospitalized in the ward of Pediatric Infectious Diseases at Imam Khomeini Hospital were recruited through the census method. To collect the relevant data, a demographic information questionnaire, the household food security survey module (HFSSM), and tools such as a tape measure and a weighing scale were used. Within these indices, weight - for - age indicated being underweight, weight - to - height represented thinness, and height - for - age showed short stature. The data, in terms of descriptive and inferential statistical tests were analyzed with SPSS version 16.
    Results
    The results revealed that out of the 580 children examined, 192 (33.1%) were moderately underweight, 166 (28.6%) had moderate thinness, and 167 (28.8%) had a moderate short stature. In total, 453 (78.1%) children had food security. Furthermore, a statistically significant relationship was observed between the causes of hospitalization and being underweight, short stature, and thin with food insecurity (P
    Conclusions
    Given the statistically significant relationship between nutritional status, food insecurity, and causes of hospitalization in children, it is necessary to take appropriate interventions to promote nutritional status in children and improve household food security to reduce pediatric hospitalization.
    Keywords: Nutritional Status, Food Insecurity, Children, Infectious Diseases
  • Reza Amir Askari, Seyed Abolfazl Afjeh, Naeeme Taslimi Taleghani, Mohammad Kazemian, Sara Sanii *, Minoo Fallahi Page 4
    Background And Objectives
    Non-invasive ventilation (NIV) has brought about significant changes in care and treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) neonates. The present study was designed and conducted to evaluate different strategies of initial respiratory support (IRS) in VLBW neonates, who were hospitalized in the neonatal intensive care unit (NICU).
    Methods
    This prospective study was conducted from 21st of March, 2015 to 20th of March, 2016 at the NICU division of Mahdieh Maternity hospital. Each eligible VLBW infant with diagnosis of RDS, received a specific IRS, including nasal continuous positive airway pressure (NCPAP) or nasal intermittent mandatory ventilation (NIMV). All infants with mild to moderate RDS, weighing less than 1500 g, were enrolled in NCPAP and NIMV groups in a randomized manner and their clinical course were evaluated by the neonatologists or the neonatology fellows. The information of medical files was recorded in a data form designed to include all prenatal and post-natal information in accordance with the objectives of the study. The obtained data were then statistically analyzed.
    Results
    Of 76 infants, who met the criteria to enter the study, 28 cases (36.8%) were males and 48 cases (63.2%) were females. Twenty-two infants (28.9%) were included in the NCPAP group and 54 infants (71.1%) in the NIMV group. The mean gestational age was 29.2 weeks. The mean birth weight was 1148 g (birth weight range between 550 and 1500 g). Intubation was performed in 8 of 22 infants (36.4%) in the NCPAP group and 32 of 54 (59.3%) newborns in the NIMV group. Surfactant was administered in 4 of 22 (18.2%) newborns in the NCPAP group and 31 of 54 (57.4%) newborns in the NIMV group. Pneumothorax did not occur in the 22 infants, who were under NCPAP, yet did occur in 4 of 54 (7.4%) infants in the NIMV group. Intra ventricular hemorrhage was reported in 2 of 22 (9.1%) newborns in the NCPAP group and 6 of 54 (13%) newborns in the NIMV group. Furthermore, BPD was reported in none of the 22 infants, who were under NCPAP, while it occurred in 2 newborns (3.7%) in the NIMV group.
    Conclusions
    Although NIMV improves minute ventilation and tidal volume through increasing the air flow and theoretically improves respiratory condition by reducing dead space, its effectiveness as the first step respiratory support in very premature infants is under question. The other problem with NIMV is the necessity of ventilator usage and its higher expenses in comparison to NCPAP. It seems that as the first step of respiratory support; NCPAP is still the preferred method in very premature infants.
    Keywords: Premature Infant, NCPAP, NIMV, VLBW, RDS
  • Mansour Sadeghzadeh, Parisa Khoshnevisasl, Mina Shabani, Parisa Bahmani * Page 5
    Background
    Iron deficiency is one of the most common nutrient defeciencies in the world. Iron plays an important role in the central nervous system. The aim of this study was to identify the association of iron deficiency with IQ level of students.
    Methods
    In this case control study, 289 randomly selected students aged eight to eleven years old were tested for iron, TIBC, Hb, and RBC indices. Iron deficient patients were referred to a psychologist to determine their IQ level with the Raven test. The IQ level of children with Iron deficiency was compared with a normal student randomly chosen and matched by age, gender, and socioeconomic status.
    Results
    Sixty patients had a Fe/TIBC ratio of less than 15%. The frequency of iron deficiency was 20.7%. There was no significant differences in the frequency of iron deficiency between males and females. A significant difference was not found in the IQ level between cases and controls.
    Conclusions
    The IQ of cases and controls did not differ significantly. It seems that there was still controversies regarding the effects of IQ and iron deficiency.
    Keywords: Intelligence, Iron, Iron Deficiency
  • Parsa Yousefichaijan, Masoud Rezagholizamenjany *, Fatemeh Safi, Ali Arjmand, Hassan Taherahmadi, Seyede Behnaz Shirnejad Page 6
    Background
    In vesicoureteral reflux urine passage from bladder into kidney and induce hydronephrosis. Current diagnostic methods are voiding cystourethrography and cystogram radionuclide. Dimercaptosuccinic acid scan is not routinely used in vesicoureteral reflux disease.
    Objectives
    So the aim of this study was evaluation diagnostic efficacy of dimercaptosuccinic acid scan as a alternative dignostic approach for vesicoureteral reflux diagnosis.
    Methods
    This is a case series study that was conducted on children who were under the age of 6 with varying degrees of vesicoureteral reflux or by vesicoureteral reflux indication review and referring to Amir Kabir hospital. Vesicoureteral reflux was diagnosed by voiding cystourethrograms and pediatrician confirmation, in following what dimercaptosuccinic acid scans has done for renal parenchyma evaluation. At the end, grade of vesicoureteral reflux in voiding cystourethrograms was campared to dimercaptosuccinic acid scan results.
    Results
    Dimercaptosuccinic acid scan and voiding cystourethrograms were correlated in high grades of vesicoureteral reflux (P = 0.0001). However, in low grade, there is no significant correlation between two tests (P = 0.4).
    Conclusions
    Dimercaptosuccinic acid scan is an appropriate dignostic approach with lower complications in the diagnosis of high graded vesicoureteral reflux, renal scar, and pyolonephrit.
    Keywords: Vesicoureteral Reflux, Diagnosis, Dimercaptosuccinic Acid Scan
  • Behrang Kazeminezhad, Hamid Taghinejad, Milad Borji *, Asma Tarjoman Page 7
    Background
    Type 1 diabetes is a chronic condition that causes many problems for adolescents and their families. Given the increasing prevalence of diabetes and the numerous complications of the disease that require long-term treatment and the need for daily blood glucose control, lifestyle modification and knowledge acquisition regarding self-care behaviors are essential throughout life.
    Objectives
    Considering the increasing prevalence of diabetes, this study evaluated the effect of self-care education on glycosylated Hemoglobin (HbA1c) level and blood glucose control in adolescents with diabetes in Ilam, Iran.
    Methods
    A randomized clinical trial was conducted on patients with type 1 diabetes in Ilam. Patients were assigned randomly to experimental (n = 21) and control (n = 24) groups. A total of seven self-care group training sessions were arranged by the researcher; each session lasted 90 minutes and each group included five people. Patient fasting blood sugar (FBS) and HbA1c levels were measured before and three months after the intervention and analyzed using the SPSS 16.0 software, including descriptive statistics and chi-square, Mann-Whitney, independent t, and paired t-tests.
    Results
    The findings of this study showed that there was no significant difference between the control and experimental groups regarding FBS and HbA1c findings before the intervention. However, compared to the levels before the intervention, the difference was significant in the experimental group yet insignificant in the control group.
    Conclusions
    These findings suggest that nurses should provide patients with this type of training to improve the health of patients with type1 diabetes.
    Keywords: Self Care, Diabetes Mellitus, Type 1, Adolescents
  • Shahin Abbaszadeh, Ehsan Shahverdi *, Fatemeh Beiraghdar, Fatemeh Heydari, Mohammad Ali Najafizadeh, Mohammad Amin Konjedi, Fatemeh Shafizadeh Barmi, Yasaman Vakiloroaya Page 8
    Background
    Due to high prevalence of vitamin D insufficiency in Iranian children, researchers found a low level of vitamin D among patients with nephrolithiasis.
    Objectives
    Since previous studies showed hyper-vitaminosis D in patients with renal stone, the current study aimed to clarify this paradox.
    Materials And Methods
    In this cross-sectional study, 100 pediatric patients with renal stone referred to Pediatric Urology and Nephrology Clinic of Baqiyatallah Hospital in Tehran, Iran, in 2014 were selected using a simple sampling method. The serum level of vitamin D3 was measured in a laboratory and the correlation between vitamin D3 and other variables were evaluated.
    Results
    One-hundred pediatric patients, 64% male and 36% female, with renal stone were evaluated. The serum level of vitamin D and calcium had no significant difference between male and female patients. Four patients had vitamin D deficiency, 31 patients had vitamin D insufficiency and others had sufficient levels of vitamin D. There was a direct significant correlation between the level of vitamin D and calcium serum level. Family history of renal colic did not affect the serum levels of vitamin D and calcium. The serum level of vitamin D was significantly higher in patients with bilateral renal stone compared to patients with unilateral renal stone.
    Conclusions
    Serum levels of vitamin D in children with urinary stones were low. The level of vitamin D deficiency was significantly correlated with disease severity and serum level of calcium.
    Keywords: Renal Stone, Vitamin D, Calcium, Pediatric
  • Mastaneh Moghtaderi *, Aliasghar Abedzadeh, Mahmmad Vasei Page 9
    The patient was a 10-year-old male that was transplanted six months prior to this study. He was admitted because of epididymo-orchitis, pyuria, glucosuria, and rising blood urea nitrogen (BUN) and creatinine (Cr). BK viruria copy number was 50,000,000. In renal biopsy examination, acute cellular rejection was reported. The diagnosis was BK virus epididymo orchitis with BK allograft nephropathy. His treatment was started by discontinuation of tacrolimus and mycophenolate and starting of leflunomide and low dose prednisolone. After improvement of renal dysfunction and BK load, the treatment regimen was changed to cyclosporine and sirolimus. Renal function after the one-year follow up did not change and remained in a good condition.
    Keywords: BK Nephropathy, Renal Transplant, BK Virus