Journal of Comprehensive Pediatrics
Volume:11 Issue: 3, Agu 2020

Since the outbreak of COVID-19, global concern emerged inspiring scientists to dedicate more attention to this pandemic. The disease caused by a novel coronavirus requires urgent striking action to probe the disease phases and find a proper cure. In this regard, the necessity of brief and thorough explanations comes into view. In this study, we gathered useful information about the virology, pathogenesis, epidemiology, manifestations, diagnosis, and treatment with special consideration of pediatric patients. This review article helps medical caregivers to receive a quick and effective approach to deal with this disease in their practice.

Congenital CMV infection is the most prevalent congenital infection in the world, and perinatal Listeria infection is an important cause of neonatal sepsis. The identification of these two infections is hard. The PCR technique is a sensitive method, which is not simply available in Iran.

This study investigated the prevalence of CMV and Listeria in 100 urine samples from under 21-day-old neonates with positive risk factors by PCR electrophoresis and fluorescent end-point detection (FEP) PCR in Tehran referral hospitals.

We used 100 urine samples from neonates admitted to 11 medical centers in Tehran with positive selected clinical symptoms compatible with these infections. Electrophoresis and FEP PCR for CMV and Listeria were performed on all urine samples. For the data analysis, SPSS version 21 software was used, and p values of less than 0.05 were considered significant.

We collected 100 urine samples from 100 under 21-day-old neonates, referring to Tehran hospitals. Seven cases were positive for Listeria, and 58 cases were positive for CMV by electrophoresis and FEP PCR. Respiratory distress was the most common clinical finding in both groups. The Mc-Nemar test revealed a statistical agreement between calcification and CMV and meningitis and Listeria (P = 0.18 and 0.07, respectively). There was a positive relationship between the neonates’ age and CMV-positive condition (P = 0.001). This result was not significant among Listeria-positive cases.

Screening for CMV and Listeria infections in neonates with clinical features compatible with these intrauterine infections may give important information for their treatment and follow-up.

Neonatal jaundice is one of the most common neonatal problems. About 60% of term and 80% of preterm neonates have jaundice.

Due to the high prevalence of early neonatal jaundice, which can lead to mothers’ concerns and even hospitalization of neonates, we decided to study the frequency and risk factors of breast feeding jaundice to determine the role of gynecologists and nurses in the development of this type of jaundice.

This study was a cross-sectional descriptive study. The sampling method was by convenience. Study populations included one hundred terms, exclusively breastfed neonates aged equal or less than seven days with jaundice who were admitted in Golestan and Khanevadeh hospitals Tehran, Iran from July 2019 to January 2020.

The percentage of causes of jaundice in the study population was 65% non-breastfeeding jaundice (29 male, 36 female), including 36% blood group incompatibility, 19% Rh incompatibility and 10% G6PD deficiency. The amount of breast feeding jaundice was 35% (18 male, 17 female). The most significant factors in breastfeeding jaundice were: use of water or sugar water, depressed nipple, mother’s unwillingness to breastfeed; inappropriate breastfeeding technique, and birth weight < 2500 g.

The high prevalence of breastfeeding jaundice indicates that policies of breastfeeding education need to be revised. Breastfeeding education before delivery, attention of gynecologists to breast problems of mothers during pregnancy, professional coordination of nurses and physicians for effective breastfeeding training, and early mothers’ revisit after the initial discharge of neonates can reduce the frequency of breastfeeding jaundice and readmission of neonates.

Congenital anomalies are a physical impairment that occurring to baby at birth. About 10% of anomalies are caused by teratogenic effect, including chemicals, viruses, physical agents, and medications.

This study was conducted to determine the risk factors of congenital anomalies in newborns.

332 infants with congenital anomalies (case group) and 332 healthy infants (control group) were compared in this case-control study, which was conducted in Akbar Abadi Hospital from April 2016 to April 2017, on infants who are diagnosed with congenital anomalies, based on a first pediatric examination. The data obtained from these infants were analyzed, based on questionnaires and clinical records.

The adjusted odds ratio (OR) estimate of congenital anomalies were 1.045 for increasing maternal age, 2.47 for consanguineous parents, 4.42 for positive maternal disease (hypertension, Diabetes, hyperthyroidism and hypothyroidism) compared to negative maternal disease, 1.92 for cesarean section compared to natural vaginal delivery, 3.02 for positive history of abortion compared to negative history of abortion, 1.136 for father’s age, 2.47 for smoking mothers compared to non-smoking mothers, 3.27 for mothers with the history of having child with abnormality compared to mothers who did not have child with abnormality, and 0.91for gestational age.

maternal disease, the history of having child with abnormality, and the history of abortion were the most effective factors in anomalies. In the next step, the consanguineous parents, smoking, the type of delivery, and father’s age were important risk factors. Finally, maternal age and gestational age had significant effect on anomaly.

Although living in a children’s home provides physical security, nutrition, and shelter, it may lack psychological security. Therefore, attention needs to be focused on the quality of life of children and adolescents living in children’s homes. This descriptive-analytic study was conducted from April to January 2015 to compare the quality of life and happiness in adolescents and children in residential care and those in parental care in Ahvaz. This study, using an available multi-stage random sampling method, was performed on 150 children and adolescents aged 18 - 8 years old, the information of 75 children available in residential care, and 75 children and adolescents in parental care were gathered. The result showed the mean quality of life scores and happiness in children and adolescents in residential care (80.8 ± 9.08, 67.05 ± 13.59) was significantly lower than the mean score quality of life and the happiness of children and adolescents in parental care (103.61 ± 8.88, 83.24 ± 15.92) (P < 0.0001). Children and adolescents in residential care had a lower quality of life and happiness than children and adolescents in parental care.

Epidemiological information on childhood masturbation and its associated factors have received little attention in Iran.

The present study aimed to investigate the prevalence of pathological childhood masturbation in children as an outpatient child and adolescent psychiatric clinic in Ahvaz.

This cross-sectional study was conducted from 2015 to 2017on all children (age range of 2 - 12 years) with pathological masturbation who were referred to a child and adolescent psychiatric clinic in Ahvaz. A clinical psychologist and a child and adolescent psychiatrist diagnosed masturbation after taking the history of the child or his/her parent and watching a video of the behavior. The data were collected via clinical interview and demographic form and analyzed via SPSS16.

Among 600 children, 65 (10.8%) had pathological masturbation. The most common behavior during masturbation was genital stimulation with hand and rubbing of the genitalia against other objects. The most common emotional states in which they masturbated were boredom (23.07%) and agitation (12.3%). Toilet was the most common location for masturbation (6.15%). The pathological masturbation co-occurred in 76.88% of children with other psychiatric disorders. The most prevalent psychiatric disorders in children with masturbatory behavior were Attention Deficit Hyperactivity Disorder (ADHD) with a comorbid psychiatric disorder.

Knowing this problem, its behavioral patterns, situations in which masturbation occurs, and its comorbid disorders facilitate diagnosis and prevent unnecessary tests and treatments.

Constipation and Urinary Tract Infection (UTI) are common problems in children. The gastrointestinal tract and the urinary system are related together anatomically and functionally. Constipation is one of the possible causes of UTI and its recurrence.

The purpose of this study was to evaluate the association between the duration of constipation and the frequency of upper and lower UTI in children in Sanandaj.

A descriptive-analytical study was performed on children with chronic constipation aged less than 12 years, referring to the Pediatric Gastroenterology Clinic of Besat Hospital in Sanandaj in 2018-2019. Urine analysis and culture were performed for all the patients. Data were recorded in separate questionnaires.

There were 220 children in this study. Most cases of constipation and UTI belonged to the group of 3-6 years. Constipation was more common in boys and UTI in girls. Lower UTI was more common than upper UTI. Besides, 45% of the patients had constipation for less than a year. There was no significant relationship between the duration of constipation and the prevalence and type of UTI (upper or lower) (P = 0.405, P = 0.911).

Urinary tract infection was common in children with chronic constipation. There was no relationship between the duration of constipation and the frequency and type of UTI.

Middle ear inflammation and fluid accumulation are one of the most common childhood diseases. Untreated or chronic ear inflammation can lead to more serious complications, including hearing loss, eardrum rupture, adhesive otitis media, tympanosclerosis, temporal bone necrosis, and cholesteatoma. Ventilation tube insertion is one of the best treatments to cure these diseases.

This aimed to observe children suffering from ear inflammation who were candidates for VT insertion surgery and study surgical complications.

A historical cohort study was performed, and 205 VT surgeries were studied. Demographic information of children (like age, sex, and family medical history) was gathered through their medical records and probable complications, including otorrhea, tympanosclerosis, atrophy, and eardrum rupture were noticed through medical examinations and interviews. Data were analyzed using descriptive statistics, chi-square test, independent t-test, Fisher’s exact, and Mann-Whitney U-test.

The results showed that 57% of surgery cases were boys, and 43% were girls, both having no family medical history. Serous otitis with tonsillar hypertrophy was reported in 200 cases (97.6%), which had concurrent adenoidectomy or adenotonsillectomy. The frequency of otorrhea, tympanosclerosis, atrophy, perforation, and serous otitis recurrence was 2%, 12.2%, 6.8%, 1.5%, and 14.1%, respectively. Serous otitis recurrence was reported in 3.9% of cases with T-tube insertion.

The findings of this study show no significant difference in surgical complications between the two groups of girls and boys. But studying the relationship between the age of patients and the timing of surgery shows that the mean age of girls is significantly higher.

Patient safety is the first step to improve the quality of care.

Therefore, the present study aimed to examine the risk assessment of processes in a pediatric surgery department using the Health Failure Mode and Effect Analysis (HFMEA) in 2017 - 2018.

In this research, a mixed-method design (qualitative action and quantitative descriptive cross-sectional study) was used to analyze failure mode and their effects. The nursing errors in the clinical management model were used to classify failure modes, and the theory of inventive problem solving was used to determine a solution for improvement.

According to the five procedures selected by the voting method and their rating, 25 processes, 48 sub-processes, and 218 failure modes were identified with HEMEA. Eight risk modes (3.6%) were found as non-acceptable risks and were transferred to the decision tree. The main root causes (hazard score ≥ 4) were as follows: Technical-related factors (14.34%), organizational-related factors (31.9%), human-related factors (45.3%), and other factors (7.6%).

The HFMEAmethod is very effective in identifying the possible failure of treatment procedures, determining the cause of each failure mode, and proposing improvement strategies.