فهرست مطالب

Comprehensive Pediatrics - Volume:9 Issue:3, 2018
  • Volume:9 Issue:3, 2018
  • تاریخ انتشار: 1397/05/30
  • تعداد عناوین: 9
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  • Zahra Meidani, Ehsan Nabovati *, Shirin Gohari, Sara Chopannejad Page 1
    Context: This systematic review was conducted to investigate the role of phones (telephone and mobile phone) in interventions designed to control obesity in children under age six and to determine the features and effects of these interventions.
    Evidence Acquisition: A systematic search was conducted of the electronic databases (until November 2016). Randomized controlled trials that assessed the effects of phone-based interventions to control obesity in children under age six were included.
    Results
    Of the 1920 papers accessed, 38 were relevant based on title and abstract. After review of the full texts, five studies were deemed eligible for inclusion. The results showed that in two studies phone-based interventions succeeded in improving the children's weight and BMI while in three other studies they were not. Among the functionalities of a telephone and mobile phone (e.g. text messaging and smartphone applications), only phone calls were used to communicate with participants. Only one of the included studies had used the phone as its main intervention, in the other studies the phone was used as part of a multicomponent intervention. Most of the included studies used phone calls to encourage and remind the participants about their children’s nutritional status and physical activity.
    Conclusions
    Although the numerous functions of phones can be used independently or in combination with other interventions for controlling obesity, so far, only the phone call function has been used for children under age six. Moreover, there is still no strong evidence on their positive effects on obesity control in children under age six.
    Keywords: Pediatric Obesity, Overweight, Child, Mobile Phone, Systematic Review
  • Behrang Kazeminezhad, Hamid Taghinejad, Milad Borji *, Reza Seymohammadi Page 2
    Background
    Febrile seizure is the most common seizure disorder during childhood. Although its prognosis is appropriate, it may indicate a serious infection. Therefore, the present study aimed to investigate the prevalence of urinary tract infection (UTI) in children with febrile seizure.
    Methods
    This is a prospective cross-sectional descriptive study conducted in 2017 in 238 children from Ilam. Data were collected using a demographic questionnaire answered by the children. The patients’ records and diagnostic test results were used in a survey on disease history, considering the description of febrile seizure, the cause of referral, the necessary tests performed, body temperature measured using the axillary method, and seizure days. Data were analyzed by the SPSS version 18 software using descriptive and analytical statistics.
    Results
    The findings showed that from among the 238 children studied, 143 (60.1%) were girls, 132 (55.5%) were aged 13 to 24 months, 145 (60.9%) had the first seizure on the first day of admission, and 92 (38.7%) had a fever with a body temperature between 37°C and 38°C. In addition, the findings showed that 28 (11.28%) children had UTI and 210 (88.2%) had no UTI. No correlation was found between UTI and seizure (P > 0.05).
    Conclusions
    No correlation was found between UTI and seizure. Other studies among other children with febrile seizure should be performed.
    Keywords: Prevalence, Urinary Tract Infection, Febrile Seizure
  • Mohammad Reza Mirzaaghayan, Leili Koochakzade, Aalie Safari, Mohammad Taghi Majnoon, Ali-Asghar Zeinaloo, Chehreh Mahdavi, Azin Ghamari, Ehsan Aghaei Moghadam *, Armen Kocharian, Farzad Kompani, Maryam Nikoufar Page 3
    Background
    Despite high effectiveness of Anthracycline as a potent antineoplastic agent, its-related cardiothoxicity is the most notorious complication. The purpose of our study was to assess the value of using different methods (LVEF, E, E’, A and Tei index versus global longitudinal strain) for detection of early cardiac changes by measuring them before and one month after the Anthracycline administration in a cross-sectional cohort study.
    Methods
    This cross-sectional study was performed on 22 new diagnosed cancer patients aged 18 years or younger who referred to the children Medical center in Tehran in 2016 as the cases and also 22 age-matched healthy children who referred to the center because of any non-cardiac reasons as the control. All participants were assessed to determine the left ventricular functional indices before and also one month after starting the therapeutic regimen containing Anthracycline.
    Results
    Among all parameters assessed by echocardiography, only the mitral annular peak systolic velocity (Sm) significantly reduced after administrating Anthracycline compared to before that. Data for patients and the control group showed no statistical significant differences before the therapy as well.
    Conclusions
    Our findings show that evaluating Sm is most useful for early detection of cardiac changes. This may be due to our limitation of small cohort studies and also the short interval after the drug administration; although this was related to the main goal of our study.
    Keywords: Chemotherapy, Echocardiography, Ventricular Function, Strain, Anthracycline
  • Shabnam Jalilolghadr *, Amir Pakpour-Hajiagha, Masoud Heidaralifard, Reza Pakzad Page 4
    Background
    Children sleep disorder (CSD) is one of the most common disorders in children with a high prevalence shown by some studies.
    Objectives
    We aimed to determine sleep patterns and factors affecting CSD among 7-12-year-old children.
    Methods
    In this cross-sectional study, 20 elementary schools for boys and girls were selected using stratified-clustering sampling, and 661 students were invited to participate in the study. Children’s sleep habits questionnaire (CSHQ) was used to investigate sleep patterns among the children. A multiple linear regression with backward approach and correlation coefficients were used to determine the factors affecting children’s sleep and inter-correlation between subscales, respectively.
    Results
    511 students took part in the study (participation rate: 77.30%). CSD prevalence was 89.6 percent (95% confidence interval: 86.65 - 92.13). Based on the results of multiple linear regression, school grade was inversely related to bedtime resistance, sleep anxiety, and sleep-disordered breathing (b: -0.233, P: 0.003, b: -0.252, P: 0.001, and b: -0.051, P: 0.049, respectively). The female gender had a direct significant relationship with sleep onset delay (b: 0.135, P: 0.036). School grade (b: -0.080, P: 0.020) and father’s education (b: -0.100, P: 0.002) had significant inverse relationships with sleepwalking. School grade (b: -0.157, P: 0.022) and father’s education (b: -0.209, P: 0.005) had significant inverse relationships with parasomnias. The female gender (b: 7.172, P
    Conclusions
    Given the high CSD prevalence and its impact on children’s behavioral disorders, it is recommended carrying out further studies to understand the etiology and formulating plans to increase the awareness of CSD among parents.
    Keywords: Sleep Disorders, Children's Sleep Habits Questionnaire, Elementary School
  • Parsa Yousefichaijan, Aziz Eghbali, Ali Khosrobeigi *, Hasan Taherahmadi, Mohammad Rafiei, Sima Tayebi, Ali Arjmand Page 5
    Background
    Children with nephrotic syndrome (NS) are treated for 12 weeks with prednisolone regarding the damage to the bones. Deficiency in the level of vitamin D damages the bones. Assessment of vitamin D status in children with NS is based on serum 25OHD3 level taking into consideration the type of steroid susceptible (SS), steroid dependent (SD), and steroid resistance (SR) nephrotic syndrome (NS).
    Methods
    This study was a prospective study on children with the first visit of NS before treatment with prednisolone. The glomerular filtration rate (GFR) was calculated with Schwartz formula, and only sick people with normal GFR were included in the study. Analysis of 218 children aged 1-13 years, median 9.5 [108 with SSNS, 64 with SDNS, and 46 with SRNS] was performed. Serum concentrations of 1,25(OH)2 D3, calcium, phosphorus, and creatinine were measured. The correlation of 25OHD3 with the type of nephrotic syndrome, seasons, gender, and age was investigated.
    Results
    A total of 218 children were examined. Vitamin D level was deficient (
    Conclusions
    Our results suggest the necessity of developing new strategies in vitamin D supplementation in children with INS.
    Keywords: Vitamin D Level, Nephrotic Syndrome, Prognostic Biomarker, Steroid Resistance
  • Zahra Chavoshzadeh *, Azadeh Zeinab Mirzaee, Mehrnaz Mesdaghi, Sepideh Darougar, Mahboubeh Mansouri, Delara Babaie Page 6
    Background
    Primary immunodeficiency disorders are a diverse group of rare genetic diseases that are often under-recognized. Therefore, significant morbidities and mortalities ensue due to diagnosis delay. This is an evaluation of clinical presentations and laboratory data of children referred to Mofid University Hospital during a 10-year period. The aim of this study is to provide epidemiologic data for early diagnosis and proper management of these patients.
    Methods
    A total of 80 children referred to Mofid’s Children Hospital suspected to primary immunodeficiencies (PIDs) were evaluated clinically. The demographic, clinical, and laboratory data were collected in detail and were analyzed as a cross-sectional study. Missing data were completed in follow-up visits.
    Results
    The prevalence of antibody deficiencies, phagocytic defects, and combined immunodeficiencies in 80 children with primary immunodeficiency syndromes were respectively 36.25%, 32.5%, and 31.25%. Common variable immunodeficiency (13.75%) and severe combined immunodeficiency (12.5%) had the highest prevalence among these disorders and the lowest prevalence were reported for cyclic neutropenia (5%), ataxia-telangiectasia (5%), and transient hypogammaglobulinemia of infancy (3.75%). The most common mode of inheritance detected was an autosomal recessive pattern. Pneumonia, otitis media, and diarrhea were the most common complications in the course of these disorders, which were seen respectively in 30%, 18.8%, and 15% of the patients.
    Conclusions
    Issues regarding clinical presentation and management of primary immunodeficiencies continue to puzzle the clinical practitioner. Epidemiological data are needed to increase the awareness of the physicians regarding primary immunodeficiency disorders and to support the benefits of early diagnosis and treatment. Diagnosis delay is associated with increased morbidities and even mortalities.
    Keywords: Primary Immunodeficiency, Delayed Diagnosis, Morbidity
  • Maliheh Kadivar, Ziba Mosayebi, Razieh Sangsari *, Hamid Soltan Alian, Saeid Jedari Attari Page 7
    Reducing infant mortality in recent years is due to advances in care of neonates in the intensive care units (NICU), including the design of new ventilator devices in neonatal care. The application of mechanical ventilation devices is always associated with complications in all age groups including newborns. Several factors are involved in the development of pulmonary injuries and complications in neonates treated with mechanical ventilation. One of the most important factors involved in pulmonary injury is asynchrony during mechanical ventilation; the higher the asynchrony, the more the lung damage and the longer the mechanical ventilation time. Researchers always seek to use devices that have a greater synchrony, which quickly receive the infants` respiratory efforts and deliver the appropriate respiratory help at the same time that the patient breathes. Recently, using diaphragmatic electrodes, the activity of the diaphragmatic signal is transmitted to the ventilator. Then, a respiration is sent to the patient. By this mode- neurally adjusted ventilatory assist (NAVA) more synchrony respiratory support with the spontaneous efforts of patient are provided. In the current study, this mode was discussed in a few infants. It was tried to study the duration of hospitalization, the duration of oxygen therapy, the effects of oxygen therapy, and the complications of the respiratory system in this mode. It was concluded that NAVA provides more convenient ventilation with good results for neonates.
    Keywords: Diaphragm, Neonates, Lung Injury
  • Esra Caliskan * Page 10
    Introduction
    Tracheal agenesis (TA) is a rare congenital anomaly presenting at birth with respiratory distress and difficult airway management. Polyhydramnios and premature labor are often pathologies associated with these pregnancies, which makes patient management more difficult. TA is often associated with other organ system anomalies (such as cardiovascular, renal and limb anomalies). Hereby, we report a case of tracheal agenesis who is presenting to our pediatric surgery and anesthesiology clinics.
    Case Presentation
    An 30 weeks’ premature infant was transferred to our neonatal intensive care unit, with the diagnosis of tracheal agenesis. He had failed attempts at intubations because of failing to visualize the vocal cords. It was learned that immediately, his respiratory tract was secured via cervical oesophagostomy using long tracheostomy cannula and the infant was subsequently stabilized by gently ventilated. The diagnosis was confirmed on CT scan. It was performed distal oesophageal banding at the upper gastroesophageal junction with gastrostomy. On postoperative day 12 in intensive care unit, the baby further got complicated with a developing cyanosis and circulatory insufficiency. Cardiorespiratory arrest was developed and the infant died after 40 minutes after resuscitation.
    Conclusions
    Successful approach at tracheal agenesis depends on, either prenatal diagnosis or recognition of this situation immediately after birth. In recent years, long time survival has been reported in tracheal agenesis through various surgical approaches. Therefore, it should be remembered that early esophageal ventilation is a life-saving alternative.
    Keywords: Pediatric, Tracheal Agenesis, Anesthetic Management, Intubation
  • Ozkan Onal *, Irem Gumus, Emine Aslanlar, Mehmet Sari, Jale Bengi Celik Page 11
    The development of pseudocyst in patients to whom ventriculoperitoneal shunt was placed for hydrocephalus is a rare condition. Depending on the size of pseudocyst and the intracranial effects of hydrocephalus, difficulties and complications may be encountered in the induction and management of anesthesia. The aim of this case report was to draw attention to hemodynamic changes and anesthesia management during operation in patients with hydrocephalus and intrabdominal space-occupying lesions.
    Keywords: Ventriculoperitoneal Shunt, Anesthesia, Hydrocephalus, Pseudocyst, Airway Management