فهرست مطالب

  • Volume:9 Issue:4, 2018
  • تاریخ انتشار: 1397/09/06
  • تعداد عناوین: 10
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  • Rahim Khodayari Zarnaq , Mohammad Saadati , Ramin Rezapour , *, Hamed Baghaie Page 1
    Background
    Childhood injuries are among the main reasons of children referring to hospital’s emergency department and were introduced as the most common cause of child disability and death. The aim of this study was to investigate the epidemiology of injuries in younger than five years old children, admitted to Tabriz Shohada Hospital emergency ward, since year 2015.
    Methods
    In a cross-sectional study, all children under five years old, admitted to Tabriz Shohada Hospital emergency department, due to trauma, since 2015, were selected, as the study population (n = 1376). Required data included gender, age, length of hospital stay, type of accidents, injury type, the injured body part, and type of insurance. Data were gathered using hospital information systems as well as medical records, through a researcher-made goal driven form. Data were analyzed using the SPSS 24 software, and Pearson Chi-square test and Phi and Cramer's V.
    Results
    The highest number of accidents was related to males (59.4%), and child at age four (41.1%). Most common type of insurance was social security insurance (50.3%). Falling, with a frequency of 44.3%, was the most prevalent accident and the most frequent injuries were fractures (66.9%). Forearm was the most injured anatomic part of the body (22.7%). There was a significant relationship between children’s age and season of the accidents, and also between the child’s gender and injury types (P < 0.05).
    Conclusions
    Mothers should be trained on fall prevention strategies, especially when the child starts to walk and play. Moreover, safety rules must be employed in settings used by children, such as playgrounds and parks
    Keywords: Children, Injury, Accident, Epidemiology
  • Mahdieh Momayyezi , Hossein Fallahzadeh , * , Fatemeh Farzaneh , Mohammad Momayyezi , Soheila Bazm Page 2
    Background
    Children and adolescents with cancer experience some complications such as pain, depression, and fatigue that impact the quality of life. Fatigue is one of the most common cancer treatment problems in most children with cancer.
    Objectives
    The purpose of this study was to construct a comprehensive instrument to examine fatigue in patients with cancer (4 - 18 years).
    Methods
    This descriptive study was conducted on 101 children with cancer. A questionnaire was designed to examine fatigue in patients with cancer (4 - 18 years) using similar studies. The questionnaire reliability was determined using the Cronbach’s alpha and test-retest method. Face validity of the questionnaire was assessed by professionals. To determine the construct validity, factor analysis was run. Data were analyzed using SPSS (version 16).
    Results
    The mean age of the patients was 9.54 ± 3.97 years and the mean duration of the cancer 12.82 ± 2.66 months. Cronbach’s alpha for whole scale and for all dimensions was 0.93 and more than 0.8 (excellent score). Intraclass correlation coefficient (ICC) for whole scale and for all dimensions of questionnaire was 0.92 and more than 0.8, respectively. According to factor analysis method, three extracted dimensions of the questionnaire were: daily activities and general problems (11 items), sleep problems (9 items), as well as mental states and emotions (5 items).
    Conclusions
    This study showed that validity and reliability of the cancer-related fatigue questionnaire for patients with cancer (4 - 18 years) are acceptable and suitable for Iranian culture.
    Keywords: Child, Epidemiologic Study, Fatigue, Reproducibility of Results, Sensitivity, Specificity, Logic
  • Mahin Ahmadi Pishkuhi , , Mahdieh Ahmadi , Hamidreza Shoraka , Maryam Chegeni , , * Page 3
    Background
    Diagnostician of cancer in children can influence their parents’ life due to the fact that the disease may threaten the patient’s life. It can also put a great burden of care on their parents.
    Objectives
    In this study, we tried to clear the feelings of parents who experience the phenomenon of caring a child with cancer.
    Methods
    The present study has been conducted as a qualitative research with phenomenological approach. Participants were selected with purposeful sampling among 13 parents with an average age of 33.2 and we continued sampling until data saturation. Information was collected by in-depth interviews. The process of interviews was valid and acceptable. Finally, data were categorized as content frameworks (themes) and analyzed with the Colizzi method.
    Results
    The extracted content is consisted of eight main subheadings that include the parents anxiety of the death of their children, parents inability to respond to the questions of their children, parents inability to have an appropriate behavior while confronting the children angry, parents suffering of treatment side effects in their children, the pressure of economic, social, and psychological burden on family, lack of time, experienced the impact of spiritual support, and influence on the relationship between parents and 18 subthemes.
    Conclusions
    Taking care of a child with cancer may have an influence on the parents’ life in different aspects and on their quality of life. Regarding the severity of this experiment on the life of parents and due to the sensitivity of this issue, it seems necessary that the results of this study be considered by the country’s health policy makers.
    Keywords: Qualitative Studies, Pediatrics, Cancer
  • Shahnaz Pourarian , Saeed Fotouhikia , Forough Saki , * Page 4
    ackground: Resistin is an adipocyte-secreted hormone with critical roles in energy, lipids, and glucose homeostasis. However, its specific role during fetal and neonatal period remains poorly understood.
    Methods
    This cross sectional study included 160 neonates in four groups of term-AGA, term-SGA, preterm-AGA, and preterm-SGA. Body measurements, blood sugar, and cord blood resistin were evaluated.
    Results
    In SGA-preterm neonates: Resistin had reverse correlation with birth weight (P = 0.006) and positive correlation with gestational age (P = 0.002). In SGA-term ones resistin had positive correlation with gestational age (P = 0.041).
    Conclusions
    Cord blood resistin has a positive correlation with gestational age and a reverse association with neonatal birth weight. We suggest that these two different associations might be the cause of conflicting results in previous reports.
    Keywords: Cord Blood, Resistin, Birth Weight, Gestational Age
  • Seyed, Reza Raeeskarami , , Fatemeh Tahghighi , Amir Hossien Ziaee Bigdeli , Raheleh Assari , Vahid Ziaee Array , Yahya Aghighi , , Payman Sadeghi , , * Page 5
    Background
    Coronary complications are common in children with Kawasaki disease (KD). Administration of intravenous immunoglobulin (IVIG) during the first 10 days will result in lower coronary complications. It is useful to predict if a patient will develop coronary complications or not.
    Objectives
    We designed this study to evaluate the role of Kobayashi risk scoring for determining refractory KD.
    Methods
    Medical records of all cases with KD were reviewed and demographic data, previous history, coronary artery involvement, laboratory findings, and days with fever were extracted for all cases. Kobayashi score was calculated.
    Results
    A total of 168 cases enrolled. There was no significant difference regarding Kobayashi score in different groups regarding coronary involvement. In cases without coronary involvement, 93.5% were classified as low risk, in one and two vessels involvement groups, all were categorized as low risk, and among three vessels involvement cases, 75% were known as low risk.
    Conclusions
    Kobayashi score is not useful for predicting severity of coronary involvement in Kawasaki disease
    Keywords: Kobayashi, Kawasaki, Iran
  • Parsa Yousefichaijan , Masoud Rezagholizamenjany , * , Fatemeh Rafiei , Ali Arjmand , Sima Tayebi Page 6
    Background
    Nephrotic syndrome (NS) as a glomerular basal membrane disease has different outcomes. The current study aimed at evaluating epidemiologic status in NS and its correlation with the outcome in children.
    Methods
    The current hospital based study evaluated the patients of pediatric clinic at Amir-Kabir hospital. Demographic information was obtained by interviewing both the physicians and patients. Also, to determine the sesitivityto steroid drugs, children were given prednisolone (2 mg/kg/day with maximum dose of 60 mg/day) for four weeks and syndromes were determined based on children responses to the drug. Patients were divided into four groups of 25. At the end, data were transfered to SPSS program and the correlations between epidemiological information and different types of NS were investigated
    Results
    Results of the current study showed that steroid responded children with frequent relapse as well as steroid dependent children had better epidemiological and socioeconomic status compared with the steroid resistance ones (P < 0.05).
    Conclusions
    Prognosis of NS or medication responses was related to epidemiological status of children.
    Keywords: Nephrotic Syndrome, Epidemiology, Children
  • Parsa Yousefichaijan , Masoud Rezagholi Zamnjany , * , Parvin Soltani , Yazdan Ghandi , Mohammad Rafiei , Somayeh Bayat Page 7
     
    Background
    Enuresis has been defined as bed voiding at least twice a week for more than 3 consecutive months in individuals older than 5 years of age. Increased nocturnal enuresis could be possibly associated with dysfunction of autonomic nervous system. To observe autonomic nervous system function in enuretic children, the current study performed management of blood pressure.
    Methods
    In this study, primary non-monosymptomatic nocturnal enuresis and healthy children were enrolled and blood pressure was measured twice, in the morning and afternoon. Urinalysis, urine culture, and urinary system ultrasound were carried out for the patients. A diary on the daily fluid intake and volume of daily urine was required.
    Results
    The researchers observed that there was a significant difference between age variation (P value = 0.001) gender variation (P value = 0.030), educational level of patients’ mothers and fathers (P value = 0.001) and record of hypertension in the family (P value = 0.001) between case and control groups.
    Conclusions
    In children affected by primary non-monosymptomatic nocturnal enuresis, nighttime Systolic Blood Pressure (SBP) were significantly higher, than healthy children. These circadian blood pressure provisions may reflect pathogenesis of primary non-monosymptomatic nocturnal enuresis and autonomic nervous system dysfunction
    Keywords: Children, Enuresis, Blood Pressure, Autonomic Dysfunction
  • Kourosh Goudarzi Pour , Peyman Eshghi , Mohammad Naderisorki , * Page 8

    To Cite: Goudarzi Pour K, Eshghi P, Naderisorki M. A Comparison of Two Chemotherapeutic Regimes in Children with B-Cell Acute Lymphoblastic Leukemia, J Compr Ped. Online ahead of Print ; 9(4):e64153. doi: 10.5812/compreped.64153.
    Abstract
    Background
    Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood, and B-cell is the most common type of ALL. In childhood ALL, the most important prognostic factor is treatment and without effective treatment, ALL is a fatal illness. So far, different treatment protocols are employed for ALL chemotherapy. Each of these treatment protocols has different side effects and prognosis.
    Methods
    In the current study, the children oncology group (COG) protocol was compared with the modified protocols, based on the Berlin-Frankfurt-Munster (BFM) protocol, called the Mofid Children’s Hospital protocol (MCHP). The current study was conducted on 108 patients; 51 patients with COG protocol and 57 with MCHP; 61.1% of patients had pre B-cell ALL type and 38.9% had early pre B-cell ALL type.
    Results
    Induction failures in the COG and MCHP groups were 5.9% and 10.5%, respectively (P = 0.390). In the two groups, the most common recurrence sites were bone marrow (BM) and central nervous system (CNS). Moreover, the incidence of recurrence was significantly higher in the MCHP group than the COG (P = 0.262). In terms of complications, bleeding was significantly higher in the COG group than the MCHPs (P = 0.016). There was no significant difference in mortality rate between the two groups (P = 0.489).
    Conclusions
    Comparison between treatment results of these two protocols can lead to finding a better treatment protocol to treat ALL
    Keywords: Childhood, Acute Lymphoblastic Leukemia, Protocol, Induction Failure, Relapse, Overall Survival
  • Soheila Siroosbakht, Bijan Rezakhaniha * Page 9
    Background
    Primary nocturnal enuresis is the most common type of enuresis and has profound detrimental effects on quality-of-life and sleep patterns, and increased morbidity. The purpose of this study was to determine the frequency of urinary tract abnormalities found in ultrasound of children with monosymptomatic primary nocturnal enuresis (MPNE) and to compare with ultrasound findings of children without MPNE to determine whether performing ultrasound in these children is necessary.
    Methods
    One hundred and two children aged three to 13 years with MPNE at Golestan Hospital affiliated to the Military University of Medical Sciences of Tehran, Iran from 2016 to 2017, were enrolled in this case-control study. The control group included 59 children with no history of voiding dysfunction, who had abdominal ultrasoud for other than urinary system-related causes. The ultrasound findings were compared between the MPNE and control group.
    Results
    Urinary tract abnormality, detected by ultrasound, was found in 15 children (14.7%) in the MPNE group and one child (1.69%) of the control group, with a statistically significant difference (P < 0.05). Findings of the nocturnal enuresis group were mild unilateral or bilateral kidney fullness in three children (20%), kidney simple cysts in one child (6.66%), hydrocele in three children (20 %), increased thickness or irregularity in the bladder wall of eight children (53.33%), and increased bladder wall thickness in one child of the control group.
    Conclusions
    Urinary abnormalities discovered by ultrasonography in MPNE were not clinically significant and did not require any other diagnostic tests. It may only be of concern to parents and cause unnecessary diagnostic procedures by the physician. This study showed that ultrasound should be done for patients with resistant or inappropriate clinical response during treatments.
    Keywords: Enuresis, Pediatrics, Nocturia, Ultrasonography, Urinary Tract Anomaly
  • Abdolreza Malek, Mohammad Saeed Sasan , Forough Rakhshanizadeh* Page 10
    Brucella endocarditis occurs in less than 2% of patients with brucellosis, it is the most common reason of death among these patients. Considering the difficulty in the diagnosis of endocarditis and its dangerous side effects, knowledge and awareness about this disease seems to be necessary. This case report introduces an eight-year-old girl who has referred to the Emam Reza Hospital, Pediatric ward, Mashhad, Iran, with complaints of fever, body pain, and skin rash. In our investigations, Brucella endocarditis, along with leukocytoclastic vasculitis was determined. According to our best of knowledge, similar case of Brucella endocarditis and leukocytoclastic vasculitis, simultaneously, has not been reported in childhood.
    Keywords: Endocarditis, Leukocytoclastic Vasculitis, Pediatrics, Brucellosis