فهرست مطالب

Pediatrics - Volume:7 Issue:64, 2019
  • Volume:7 Issue:64, 2019
  • تاریخ انتشار: 1397/11/08
  • تعداد عناوین: 15
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  • Nader Saki, Sahar Bahmani , Mohammad Ghasem Hanafi * Pages 9207-9213
    Background
    Cochlear implant surgery is an invasive procedure for patients with bilateral Sensorineural hearing loss and may cause some risks such as cochlear damage. We aimed to evaluate the effectiveness of cochlear measures obtained by computed tomography (CT) scan in predicting depth of cochlear implant insertion.
    Materials and Methods
    This study was conducted in a retrospective and cross-sectional study on 39 patients undergoing cochlear implantation with MED-EL Device. High-resolution radiographs provided preoperative by CT-Scan were used to determine electrode array insertion depth and diameter of the cochlea’s basal turn. The insertion was considered deep when the electrode was placed at least 22 mm into the cochlea. Demographic data, CT-Scan results and cochlear implantation outcomes (deep or shallow) were evaluated. Data were analyzed by SPSS22 software and the significance level was less than 0.05.
    Results
    The mean age of patients was 8.026±1.77 years. The depth of insertion of the electrode in 34 (87.18%) patients was deep and in 5 (12.82%) patients was shallow that the difference was statistically significant (P<0.05). Mean size of cochlear in deep group was significantly higher than shallow group (5.89±0.39 vs. 5.2±0.25 mm respectively). There was a significant relationship between age and gender of patients in deep group, which females and patients with lower age reported a higher level of shallow insertion.
    Conclusion
    The results of present study showed the efficacy of using CT-Scan before surgery to predict the depth of implant placement and help it to select the appropriate prosthesis
    Keywords: Children, Cochlear Implant, CT-Scan, Electrode, Hearing Loss
  • Saptadi Yuliarto*, Kurniawan Kadafi, Dessy Anitasari Pages 9215-9224
     
    Background
    Fluid resuscitation is the mainstay of treatment to counteract massive plasma leakage in dengue shock syndrome. We aimed to determine the differences in clinical outcomes and hemodynamic parameters of children with dengue shock syndrome post restrictive and liberal fluid resuscitation.
    Materials and Methods
    A retrospective observational study of pediatric patients who were between one month to 18 years old, presented with clinical criteria for dengue hemorrhagic fever (DHF) grade III and IV based on WHO classification of dengue fever in 2011, and admitted to the Saiful Anwar General Hospital, Malang- Indonesia, from January 2016 to December 2016. Patients were divided in two groups: resuscitated with either 40ml/kg BW (liberal group) solutions; then we analyzed the clinical outcomes and hemodynamic parameters between two groups.
    Results
    Among 100 patients, 92 patients were classified as DHF grade III and 8 patients were DHF grade IV. 74 patients were in the restrictive group and 24 patients were in the liberal group. Median age at diagnosis was 6 years old, and 56% of patients were female. No significant differences were observed between length of stay in pediatric intensive care unit (P=0.09), and duration of ventilator use (P=0.68). The restrictive group had 53% lower mortality compared to the liberal group (P=0.18). This study also showed that there were no significant differences in hemodynamic parameters between two groups based on measurement with USCOM which were preload component (SVV) (P=0.89), inotropy components (SMII) (P=0.07), SVRI (P=0.85) as well as the cardiac index (P=0.66).
    Conclusion
    This study showed that there is no difference in clinical outcomes (length of mechanical ventilation and length of PICU stay), and hemodynamic parameters (preload, inotropy, afterload, and cardiac index) in Dengue Shock Syndrome patients who receive restrictive or liberal fluid resuscitation
    Keywords: Children, Dengue Shock Syndrome, Liberal, Fluid resuscitation, Restrictive
  • Sahar Fallahi, Azam Shirinabadi Farahani *, Maryam Rasouli, Reyhane Sefidkar, Leila Khanali Pages 9225-9235
    Background
    Diabetes is a stressful condition, which affects identity and psychosocial dimensions in adolescent then they need to be adapted. This study was conducted to investigate the effect of spiritual care on adolescents' adjustment with Type 1 diabetes.
    Materials and Methods
    This randomized controlled clinical trial study was performed on 52 adolescents with Type 1 diabetes mellitus members of Sanandaj Diabetes Association (Sannadaj city, Kurdistan province, Iran), who were selected through convenience sampling and randomly divided into two groups (26 in each group). Spiritual care in the intervention group was performed in group form and daily for 6 sessions. Data were collected using "Baseline Characteristics Questionnaire", and "Lazarus and Folkman Coping Strategies Questionnaire" before and after the intervention and three weeks later. Data were analyzed using SPSS software version 19.0.
    Results
    Chi-square test indicated the difference between the groups according to the level of education (p=0.048). Therefore, the effect of this variable was moderated. The mean of overall adjustment score in control group before and after providing intervention in the intervention group and during the follow-up period was 94.92±13.04, 90.12±10.96, and 92.08±13.34, respectively. The mean of overall adjustment scores in the intervention group before and after intervention and during the follow-up period were 104.08±23.35, 112.46±17.09, and 117.35±16.05, respectively; also t-test result showed a significant effect of intervention type (p<0.001).
    Conclusion
    The results indicate the positive effect of spiritual care on adolescents' adjustment with Type 1 diabetes after the intervention and three weeks later in intervention group, but the increase of adjustment was not rational reasonable in control group.
    Keywords: Adaptive behavior, Adolescent, Care, Diabetes Mellitus, Spirituality
  • Masoumeh Abbasi, Shavazi, Sedigheh Safari hajataghaiee* , Hosseinali Sadeghian , Mahmood Noori Shadkam, Mohsen Askarishahi Pages 9237-9248
     
    Background
    Kangaroo Mother Care (KMC) is an easy and emotional care that can reduce the mortality and morbidity in premature infants, but often the relationship between mother and her newborn is delayed due to some barriers. The aim of this study was to investigate perceived benefits and barriers of mothers in this regard.
    Materials and Methods
    In this descriptive cross-sectional study, 121 mothers with premature infants admitted to the Neonatal Intensive Care Unit (NICU) of Yazd Shahid Sadoughi Hospital, Iran, studied using convenience sampling method in 2018. Data gathering accomplished by interviewing mothers using researcher-made questionnaire included baseline characteristics of parents and their infant and items measuring perceived benefits and barriers of mothers to KMC. The data were analyzed using SPSS software version 22.0
    Results
    Strengthening of the emotional relationship between mother and infant and a greater sense of confidence were the main perceived benefits of mothers. Not being in good physical and mental condition, lack of relevant knowledge and fear of performing KMC were the most important perceived barriers of mothers to KMC. The perceived benefits differed only in mother's ethnicity and father's occupation (P<0.05). The perceived barriers did not differ by any of demographic variables of parents and infants (P>0.05).
    Conclusion
    According to the results though the high perceived benefits of mothers in performing KMC, it seems that planning for improving mothers mental condition, providing mothers with necessary knowledge and reducing fear of caring can effectively promote doing KMC by mothers
    Keywords: Barrier, Benefit, Infant, Kangaroo mother care, Premature
  • Kumars Pourrostami, Mostafa Qorbani*, Ramin Heshmat, Fatemeh Mohammadi, Nasrabadi, Shirin Djalalinia, Ali Sheidaei, Mohammad Esmaeil Motlagh, Gelayol Ardalan, Armita Mahdavi, Gorabi, Morteza Mansourian, Roya Kelishadi Pages 9249-9263
    Background
    Nutritional habits and its determinants, especially in children and adolescents have recently turned into the one of the major concerns of health researches. We examine the diet contribution inequality in according to socio-demographic factors, age, gender, physical activity and body image to alleviate this gap in Iranian children and adolescents.
    Materials and Methods
    Study sample was comprised of 14,880 students aged 6-18 years who selected from urban and rural districts of 30 provinces of Iran via stratified multi-stage sampling method. A short food frequency questionnaire was used for estimating the food group consumption. The Blinder-Oaxaca method was applied to investigate the inequality in the prevalence of healthy and junk foods consumption between the first and fifth socio-economic status (SES) quintiles.
    Results
    The frequency of healthy and junk foods consumption showed considerable differences between the SES quintiles. The highest differences were found in the frequency of fresh fruit (25.38%), vegetable (12.92%), and milk (10.74%) consumption, respectively. The daily consumption of vegetables, and fresh and dried fruits increased linearly by increasing the SES quintiles. The highest absolute difference was seen in the frequency of fresh fruit consumption between the bottom and top of the socioeconomic groups (SII value=-32%). The estimated SII was statistically significant for the consumption of all healthy and junk foods except for fast foods and milk consumption. The estimated C index for consumption of healthy and junk foods was positive and negative, respectively.
    Conclusion
    This study provides the considerable information on the consumption of healthy and junk foods and its determinants among Iranian children and adolescents for better programming, developing health policies, and future complementary analyses.
    Keywords: Adolescents, Children, Inequality, Healthy foods, Junk foods
  • Ashraf Abou, Taleb*, Wafaa Abdelhameed, Ahmed Ahmed, Ahmed El, Hennawy Pages 9265-9279
    Background
    Cholestatic jaundice in infancy is always pathologic and mainly caused by biliary atresia (BA), and neonatal hepatitis (NH). The early discrimination of both conditions is critical for the outcome of BA. We aimed to assess different non-invasive diagnostic tools in differentiating BA from NH.
    Materials and Methods
    Forty infants (25 boys, 15 girls) with cholestatic jaundice and final diagnosis of BA (n=17), and NH (n=23) were studied retrospectively from January 2015 to December 2017. All patients were subjected to thorough history and complete physical examination. Liver function tests, abdominal ultrasonography, hepatobiliary scintigraphy using (hepatobiliary iminodiacetic acid [HIDA]), and percutaneous liver biopsy were performed for all patients. Finally the accuracy of HIDA scan and liver function tests for differentiating BA from NH, in comparison with histopathological diagnosis, was evaluated.
    Results
    Acholic stool, absence of gall bladder visualization by ultrasonography and high level of serum gamma-glutamyl transpeptidase (GGT), and positive HIDA scan findings were strong indicators of BA. The accuracy of GGT > 250 IU/L for diagnosis of BA was 92.7 % and that of positive HIDA scan findings was 82.7 %. The diagnostic accuracy for using both parameters was 98.1% (95% CI: 94.9 - 100.0%, p<0.001).
    Conclusion
    According to the results, BA can be differentiated from NH by non-invasive methods as presence of acholic stool, absent gall bladder by ultrasonography, elevated GGT, positive HIDA scan findings. GGT > 250 IU/L and positive HIDA scan had high accuracy to differentiate BA from NH and combination of both parameters has increased the accuracy to 98.1%.
    Keywords: Biliary atresia, Egypt, hepatobiliary scintigraphy, neonatal hepatitis
  • Parvin Abbasi, Marziyeh Kaboudi, Arash Ziapour, Fateme Dehghan*, Vahid Yazdani Pages 9277-9284
     
    Background
    According to the results of epidemiological studies, human beings from various races, colors, cultural, educational and economic backgrounds are affected by cancer worldwide, thereby encouraging researchers to conduct extensive studies in this regard. We aimed to compare the components of quality of life and adjustment in both cancer-stricken and healthy children.
    Materials and Methods
    In this descriptive-comparative study, the statistical population consisted of two groups: 10-19-year-old children, diagnosed with leukemia, who were referred to Kermanshahi Children’s Hospital based in Kermanshah, Iran, and healthy students in elementary, secondary and high schools in Kermanshah. As for the sample population, 80 subjects were selected from each group through convenience sampling. As for data collection, the World Health Organization Quality of Life (WHOQOL) scale, and the Adjustment Inventory for School Students (AISS) scale were employed.
    Results
    Mean of quality of life in healthy female subjects measured 105.93±10.70, which exceeded that of subjects with cancer. In contrast, the mean of adjustment of girls in the normal group was 19±5.12, which was better than that of subjects with cancer. Furthermore, in terms of the components of adjustment, the male subjects in the cancer group had the highest mean and standard deviation (12.20±1.37), which was an indication of their lack of compatibility. Besides, the results of MANOV revealed that there were significant differences between the two groups in terms of the components of quality of life and adjustment at the significance level of P<0.001.
    Conclusion
    According to the findings, children with cancer had significantly lower levels of quality of life and adjustment in comparison with healthy children.
    Keywords: Adjustment, Cancer, Children, Iran, Quality of life
  • Hassan Mozaffari Khosravi, Mohammad Ali Hojjati Kermaniorcid , Maryam Hassanzad*, Mansour Rezaie, Sabereh Tashayoie, Nejad, Seyed Javad Sayedi, Ali Akbar Velayati Pages 9285-9294
     
    Background
    Cystic Fibrosis (CF) is a hereditary autosomal recessive genetic disorder that can affect many organs including the lungs and the digestive system. We aimed to assess the effects of coenzyme Q10 level on clinical parameters in cystic fibrosis patients.
    Materials and Methods
    This cross-sectional study was performed on 40 patients (13 females and 19 males) with cystic fibrosis who were admitted in Masih Daneshvari Hospital in Tehran- Iran, in 2017. A researcher-made questionnaire was distributed among them, and then the height, weight and arm circumference of the patients were measured and also their serum Q10 levels were evaluated. Then, the pulmonary function was evaluated using a 6-minute respiration test and a spirometry test. Finally, their total scores were calculated based on Shwachman score.
    Results
    The age range of participants was from 6 to 27 years old. Anthropometric indices such as weight (p=0.02, r=-0.408), age (p=0.016, r=-0.422), height (p=0.002, r=-0.520), birth weight (p=0.0113, R=-0.286), and height at birth (p=0.037, r=-0.37) had a significant negative relationship with coenzyme Q10. There was relationship between anthropometric indices and spirometry tests, including the association of FEV1 (act) with weight (p=0.00), and arm circumference (p=0.00) which were determined.
    Conclusion
    According to the results, there was no direct relationship between muscle mass and Q10. Besides, the mean age of Q10 was greater than that of in age group of 9-16 years old, which can be considered for nutrition or childhood reserves for coenzyme Q10 production, which is decreased due to increasing age and lack of intake or loss of body power for the production of coenzyme Q10.
    Keywords: Anthropometry, Coenzyme Q10, Cystic fibrosis, Respiratory System
  • Sarah ghahremani, Hosseyn Arian, Somayeh Ghahremani, Forough Rakhshanizadeh, Rahele Rahimi, Masumeh Ghazanfarpour* Pages 9295-9303
     
    Background
    Postpartum Bonding Questionnaire (PBQ) is a remarkable tool to assess impairments in the mother-infant bonding. The purpose of the present study was to review the factorial structure of the PBQ cross different versions.
    Materials and Methods
    The search strategy was implemented on databases of Medline (via PubMed), Scopus, Cochran library and Web of Science through electronic databases. The quality assessment was fulfilled by COSMIN checklist.
    Results
    The four factors were identified in original English version of PBQ. Theses consisted of "impaired bounding", "rejection and anger", "anxiety about care of the baby", and "risk of abuse". Three-factor-solution was confirmed by other English versions. In the Italian version of PBQ, three factors emerged including "annoyance and anger toward the infant", "detachment and rejection" and "anxiety about infant care". In the Spanish version of the PBQ, four factors including "impaired bonding", "anxiety about care", "lack of enjoyment and affection for the baby", and "rejection and risk of abuse". Three studies assessed factorial structure of Japanese version of PBQ. In the first Japanese version, four factors with 14 items were emerged including "impaired bonding ", "rejection and anger" and "anxiety about care", and "lack of affection". In second adapted Japanese version, exploratory factor analysis (EFA) identified a three factor solution: "mother's annoyance with anger toward their baby", "lack of affection" and" rejection and fear". The third version identified one-single solution. In the German version, one single factor emerged that explained 31 of the total variance.
    Conclusion
    Original English version of PBQ was not confirmed in Japanese, Italian, Spanish and other English versions.
    Keywords: Factor Analysis, Postpartum Bonding Questionnaire, Systematic review
  • Ashraf Abou, Taleb *, Ahmed Ahmed, Ahmed El, Hennawy Pages 9305-9315

    Chronic liver diseases (CLD) in children represent a growing health problem with significant morbidity and mortality. This study aimed to define the clinicopathological pattern of pediatric CLD in Sohag University Hospital, Sohag,Upper Egypt.
    Materials and Methods
    A total of 151children with CLD were included in a prospective hospital-based study from June 2014 to May 2018. Cases of acute liver illness or hepatic focal lesions were excluded. All patients were subjected to detailed history and thorough physical examination. Abdominal ultrasonography, CBC, liver function tests, viral serology, evaluation of autoantibodies for autoimmune hepatitis, and liver core biopsies were performed for all children.
    Results
    Pediatric CLD comprised 1.6% of total admissions in pediatric department. Neonatal cholestasis disorders (NCD), and metabolic liver disorders (MLD) were the leading causes of CLD (41.05% and 35.1%, respectively). NCD comprised neonatal hepatitis (25.1%), extrahepatic biliary atresia (13.2%), and paucity of interlobular bile ducts (2.7%). MLD included glycogen storage disease (26.5%), undetermined inborn error of metabolism (5.3%), Gaucher's disease (2.0%), and Niemann Pick disease (1.3%). Other causes of CLD comprised autoimmune hepatitis (8.6%), congenital hepatic fibrosis (5.9%), non-alcoholic fatty liver disease (4.0%), chronic hepatitis C infection (2.7%), and Budd Chiari disease (0.6%). On follow-up of 89 cases, stationary clinical course, clinical improvement, and clinical deterioration were seen in 52.8%, 34.8%, and 12.3% of them, respectively.
    Conclusion
    The rate of CLD is growing in Upper Egypt and is mainly caused by neonatal cholestasis and metabolic liver disorders. In general, the outcome of children is favorable and comparable to other countries
    Keywords: Children, Chronic liver diseases, cholestasis, Egypt, metabolic liver disorders
  • Jafar Hassanzadeh, Fatemeh Rezaei *, Zaher Khazaei, Mehdi Noroozi, Leila Jahangiry Pages 9317-9325
     
    Background
    Mental health problems are common among adolescents. Proper screening and rehabilitation could improve adolescents’ function at the present time and in the future. This study aimed to assess the prevalence of psychiatric disorders and the associated familial factors among high school students.
    Materials and Methods
    The present cross-sectional study was conducted on 630 high school students (315 boys and 315 girls) aged 13-17 years in Jahrom, Iran. The participants were selected using random cluster sampling. The data were collected using the self-report version of strength and difficulties questionnaire (SDQ), and were analyzed using the SPSS statistical software, version 16.0.
    Results
    The results showed that 22.38% of the students had total difficulty (14.9% of boys, and 29.8% of girls). The highest prevalence was related to peer relationship problems (23%) followed by conduct problems (18.1%), hyperactivity (11.1%), pro-social behaviors (6.3%), and emotional problems (5.7%). The results of multivariate logistic regression analysis revealed that female gender (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.68-3.66) increased the odds; while grade 9 (OR=0.52, 95% CI: 0.32-0.83), and number of siblings (OR: 0.88, 95% CI: 0.78-0.99) decreased the odds of mental health problems (p<0.05).
    Conclusion
    According to the results, the prevalence of behavioral disorders was relatively high among the students. The number of sibling, being girl and being in nine grade significantly contributed to the prevalence of behavioral disorders. In order to reduce these disorders, familial intervention and educational programs are recommended to be designed and implemented to prevent and treat behavioral disorders among students.
    Keywords: Adolescent, Iran, Mental health, Prevalence, SDQ, Students
  • Maryam Abolhasani, Mohammad Vasei, Moeinadin Safavi * Pages 9327-9332

    De novo duplication of 2q is very rare. Most cases of 2q duplications result from familial translocations, and are associated with simultaneous monosomy of another chromosome segment. To our knowledge and search in English literature there are less than 20 reported cases of isolated 2q duplication. Hereby we introduce a 4.5-year-old Iranian boy of a non-consanguineous marriage who was referred for cytogenetic study due to developmental delay and intellectual disability.
    He also had short stature and dysmorphic facial features. He had depressed broad nasal bridge and broad nasal tip, long philtrum and thin upper lip. His hands were edematous and the first phalanxes were broad and the thumbs were larger than normal. The chromosomal analysis revealed isolated 2q31.3q36.3 duplication, and array comparative genomic hybridisation (CGH) confirmed the diagnosis. After six months follow- up, could not walk or speak despite occupational therapy. We also, describe the common morphological characteristics of isolated 2q duplication.
    Keywords: Array CGH, Karyotype, Developmental delay, 2q duplication
  • Mohsen Reisi, Mahdiyeh Behnam, Seyed Javad Sayedi, Farzaneh Salimi, Pegah Kargar, Mansoor Salehi, Hossein Saneian*, Iman Kashani, Roya Kelishadi Pages 9333-9339
     
    Background
    Cystic fibrosis (CF) is the most common lethal genetic disorder of Cystic Fibrosis Trans-membrane Conductance (CFTR) Regulator gene mutations. We aimed to investigate common mutations in CF patients and to assess its possible relationship with clinical presentations.
    Materials and Methods
    This cross sectional study was conducted on 36 CF patients who were referred to a tertiary pediatric hospital in Isfahan, Iran. They were evaluated for 34 common mutations in CFTR gene by using reverse dot blot strip assay. Other parameters such as the age of diagnosis, the sweat chloride level, and clinical manifestations due to lung involvement and pancreatic insufficiency were also assessed. According to genotype mutations, children were divided in three groups: ΔF508 mutation (group 1), non-ΔF508 mutation (group 2), without current mutations (group 3). Finally, genotype, and phenotype relationship were reported.
    Results
    The mean age of patients was 8.1+2.3 months, and 23 of them (63%) were male. CFTR mutations were found in fourteen patients (38.8%). ΔF508 mutation has the highest prevalence in the studied samples with allele frequency of 15.27%, and c. 2183 AA>G was in the second standing. Furthermore, p.R553X, p.G542X, C.1766+1, p.N1303K mutated alleles also were obtained in lower level. Mean age at the diagnosis time of CF, sweat chloride level and pancreatic insufficiency were not different between groups but lung complications were significant in children with common mutations.
    Conclusion
    Our findings showed that commercial kit designed to identify 34 common CFTR mutations failed to detect 61.2% of alleles of our patients. This necessitates designing local diagnostic kits for proper diagnosis of CF in Iranian children
    Keywords: Children, Cystic fibrosis, mutations, Prevalence, sweat test
  • Shereen Hamadneh *, Manar Alazzam, Manal Kassab , Sirhan Barahmeh Pages 9341-9347

    The present study reviewed the literature about intervention programs for Autism Spectrum Disorder (ASD) among children. ASD is a long-term neurodevelopment disorder that is identified as impairment in the context of social communication and interaction, and the predominance of restricted and repetitive patterns of behavior, interests or activities. Intervention programs have objectives such as to help individuals with ASD, particularly at the early developmental stage. Another objective is to involve the parents of the children with ASD to improve the effectiveness of implementing these interventions. Reviewing the literature showed that the involvement of parents reduced their stress level.
    Keywords: Autism, Autism spectrum disorders, Children, intervention
  • Mohammad Ali Kiani, Masumeh Ghazanfarpour, Masumeh Saeidi* Pages 9349-9354

    Dear Editor-in-Chief,
    Influenza, commonly known as the flu, is an infectious disease caused by an influenza virus (1). Symptoms can be mild to severe (2). The most common symptoms include: high fever, runny nose, sore throat, muscle pains, headache, coughing, sneezing, and feeling tired (1). Three of the four types of influenza viruses affect people, Type A, Type B, and Type C (3, 4). Type D has not been known to infect people, but is believed to have the potential to do so (4, 5). Usually, the virus is spread through the air from coughs or sneezes (1). Influenza spreads around the world in yearly outbreaks, resulting in about three to five million cases of severe illness and about 250,000 to 500,000 deaths (1). About 20% of unvaccinated children, and 10% of unvaccinated adults are infected each year (6). In the northern and southern parts of the world, outbreaks occur mainly in the winter, while around the Equator, outbreaks may occur at any time of the year (1). Death occurs mostly in the young, the old, and those with other health problems (1). Larger outbreaks known as pandemics are less frequent (3). In the 20th century, three influenza pandemics occurred: Spanish influenzain 1918 (~50 million deaths), Asian influenza in 1957 (two million deaths), and Hong Kong influenza in 1968 (one million deaths) (7). The World Health Organization (WHO) declared an outbreak of a new type of influenza A (H1N1) to be a pandemic in June 2009 (8).
    Keywords: Children, death, Influenza, Pregnant Women, Vaccine, World