Caspian Journal of Pediatrics
Volume:7 Issue: 1, Mar 2021

Viral myocarditis (VMC) is one of the common heart diseases to endanger human health in different age groups, especially children. The aim of this study was to diagnose VMC in children with clinical suspicion of myocarditis (MCI) using multiplex real-time PCR in Birjand Vali-Asr Hospital.

This cross-sectional study was conducted on 19 patients with clinical suspicion of MCI, who had evidence of infections in the recent weeks. Routine electrocardiogram and dynamic electrocardiogram (ECG) examinations, auxiliary laboratory testing and echocardiographic evaluation were performed. Multiplex real-time PCR was used for detection of viral agents in blood or pericardial fluid samples.

The results indicated that 4 out of 19 (21.05%) MCI patients were virus-positive. The spectrum of viral agents included human herpesvirus 6, 7 (HHV), parvovirus B-19 (PVB19), Epstein–Barr virus (EBV), varicella zoster virus (VZV) and adenoviruses. A co-infection of HHV-6, 7 and PVB19 was found in one patient. The ECG findings such as sinus tachycardia with ST-T changes, premature ventricular contraction and complete heart block were observed in VMC patients. The predominant echocardiographic features in VMC patients were low ejection fraction, mitral regurgitation and severe pericardial effusion with hypotension. Aspartate aminotransferase (AST) and lactic dehydrogenase (LDH) had abnormal increase in some patients.

Our findings highlight the importance of identification of VMC in children with clinical suspicion of MCI. The present study emphasizes the importance of PCR-based assays for detection of viral agents in MCI patients with symptoms of virus infection.

Play therapy provides an opportunity for children with disabilities to experience and learn new skills. The aim of this study was to evaluate the effectiveness of play therapy in improving the adaptive skills of children with physical-motor disability (PMD).

The method of the present study was quasi-experimental using pre-test and post-test design with control group. The statistical population of this study included all 6-8-year-old PMD children referred to Behesht Occupational Therapy Clinic in Isfahan in the first half of 2020. According to the inclusion criteria, 30 children were selected through convenience method and randomly divided into two groups of 15 ones as the experimental and control groups. The Lambert Adaptive Behavior Scale was used to collect the data. Finally, the data were analyzed by one-way covariance test using SPSS 21.

These findings showed that there was a significant difference between the pre-test and post-test in adaptive skills in the experimental group (F=72.8; P=0.01). This difference was not found in control group (170.7±10.06; 171.3±10.6; P>0.05).

According to the results, play therapy helps the children to learn the adaptive skills; therefore, it is suggested that the play therapy, in addition to conventional treatment methods, could be used for these children in rehabilitation centers to establish a happy and creative environment.

Elective cesarean section (ECS) increases neonatal respiratory complications like transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). This pilot study examined the effect of antenatal steroids on the prevention of respiratory problems in full-term neonates born via ECS.

This experimental study was carried out on full-term neonates (39-42 weeks) born by ECS to the mothers admitted to Babol Clinic Hospital, northern, Iran in 2016. The intervention group received betamethasone (12 mg, intramuscular, once a day) for 2 days before ECS plus conventional care, but the control group received only conventional care. The rate of respiratory complication and the admission rate of the newborn ward and neonatal intensive care unit (NICU) were compared between two groups.

Overall, 200 full-term neonates (100 neonates in the experimental group and 100 neonates in the control group) were enrolled. Nine neonates (9%) in the experimental group and 8 neonates (8%) in the control group had TTN (P=0. 64), and one (1%) neonate in the experimental group and one neonate (1%) in the control group had RDS (P=1).

Antenatal corticosteroid administration to the mothers before ECS with gestational ages of 39-42 weeks does not reduce the incidence of respiratory complications.  Thus, further studies are needed to determined its effects in gestational age group more than 39 weeks.

Neonatal jaundice is a common condition among neonates in the first few days of life and is a leading cause of admission among neonates. The aim of this study was to investigate the most common risk factors associated with severe neonatal hyperbilirubinemia (NNH) and short-term complications of the exchange transfusion (ET).

In this retrospective study, the medical records of newborns <28 days with severe hyperbilirubinemia who underwent ET during 2015-2018 were analyzed. Medical records and files were searched using the keyword “exchange transfusion”. The clinical and demographic characteristics of the study population as well as the short-term complications of ET were descriptively analyzed.

Totally, 74 newborns with the mean age of 5.6 ± 3.4 days were included in the current study. The baseline mean peak total serum bilirubin (TSB) was 25.8 ± 5.7 mg/dl.  In neonates, the ABO incompatibility was the most frequent cause of severe hyperbilirubinemia requiring ET (54.1%), followed by sepsis (39.2%). Moreover, 57.7% of neonates developed complications secondary to ET. The most common complication was hyperglycemia (71.6%), followed by thrombocytopenia (48.6%).

Hemolysis and sepsis are common causes of NNH; therefore, the extensive screening and identification of the at-risk population can help decrease the incidence of severe NNH. Frequent monitoring of blood sugar and screening of thrombocytopenia before and after ET procedures are necessary to reduce adverse events.

Anxiety disorders are among the most common mental health disorders in children with disabilities. Children with abnormal anxiety may have difficulty with verbal tasks. The present study aimed to investigate the effectiveness of painting therapy on anxiety in children with specific learning disabilities in Kermanshah city in 2019.

The research method was quasi-experimental with a pre-test, post-test, and follow-up design and a control group. The statistical population included all female students with learning disabilities in Kermanshah, Iran in 2019. The sample consisted of 30 children with specific learning disabilities selected by convenience sampling and divided into experimental and control groups (n=15 per group). The research instrument included the Spence Childrenchr('39')s Anxiety Scale (SCAS). First, both experimental and control groups completed the pre-test questionnaires. Then, the children of the experimental groups received painting therapy for eight sessions (two 45-minute sessions per weak). The follow-up was performed after 45 days. Data analysis was done using SPSS version 21.

The mean±SD of the anxiety in the experimental group in pre-test and post-test phases was 142.26±10.95 and 97.26±10.95, respectively, while the anxiety score of the control group in the pre-test and test phases was 138.60±11.10 and 143.93±10.55, respectively (p<0.01). Besides, the post-test scores had no significant difference in the follow-up scores.

Based on the results, painting therapy reduced anxiety in children with disabilities. Therefore, it can be concluded that painting therapy can decrease anxiety in children with disabilities. These results were true until the follow-up phase.

Retinopathy of prematurity (ROP) is a progressive neovascular retinal disorder in neonates. This study investigated the possible correlation of hematological and biochemical laboratory indexes with the plus disease and the neovascularization of the iris (NVI) statuses in stage III ROP patients.

This case-control study was performed on 124 stages III ROP patients [(a) 58 cases with plus disease and 66 cases without plus disease, (b) 7 cases with NVI and 117 cases without NVI] in the Ophthalmology center of Ayatollah Rouhani Hospital, Babol, Iran. All ophthalmologic examinations were performed according to the international classification of retinopathy of prematurity (ICROP) criteria. The hematopoietic/biochemical parameters were evaluated based on standard protocols.

The mean corpuscular volume (MCV) in patients with the plus disease was 84.88±22.274 fl/cell, while it was 94.12±14.419 fl/cell in ROP patients without the plus disease (p =0.012). Also, the mean corpuscular hemoglobin (MCH) in patients with the plus disease was 30.12±3.649 pg/cell, while it was 31.99±5.149 pg/cell in ROP patients without the plus disease (p =0.033). Our results showed that CRP is higher in patients with plus disease (16.11±29.403 mg/L) than patients without plus disease (3.25±2.633 mg/dl) (p=0.033). Also, SpO2 was significantly higher in stage III ROP patients with NVI (64.00±13.730 %) compared to non-NVI patients (75.58±16.135 %) (p=0.043).

Due to the correlation of CRP, MCV, and MCH with the severity of neovascularization, the long-term management of arterial oxygen may be effective in managing the severity of neovascularization in stage III ROP patients.

The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16% of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis.

This cross-sectional study included 100 neonates in two groups of case and control. The PCT level of umbilical cord blood was measured by immunoluminoassay method and PCT=2-10 ng/ml,./5-2ng/ml and >10ng/ml were considered positive, weak positive and strong positive respectively. Sepsis screening tests and culture from blood or other sterile fluids were studied in the case group.

The PCT mean was 1.39±1.52 in the case group (sepsis) and 0.17±0.05ng/ml in the control group and finally, the PCT level was significantly higher in all cases in the proven sepsis group so that it was between 2-10 ng/ml in most cases.

The result of our study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher than the other two groups of sepsis in the group with proven sepsis (positive culture).

Physical abnormalities in patients with beta-thalassemia major might potentially have a negative impact on the patients’ body image (BI). The aim of the current study was to evaluate the BI of thalassemic adolescents in Southeast Iran in comparison with healthy peers.

This cross-sectional study was performed on 94 individuals in Ali Asghar Hospital in Zahedan in 2020. A total of 46 teenagers with beta-thalassemia major and 48 healthy individuals, both groups in a range of 11-18 years of age, were entered into the study. Evaluation of the BI was performed by using the Multidimensional Body-Self Relations Questionnaire. All statistical analyses were performed by SPSS software. Obtained data were displayed by using descriptive statistical methods. Independent t-test and ANOVA were applied to compare the scores of different groups. The P values less than 0.05 were considered statistically significant.

The statistical analyses revealed a significant difference in the Appearance Evaluation, Fitness Evaluation, Fitness Orientation, and Body Areas Satisfaction scales, with a higher score of the thalassemic group in the first three items. (p<0.05). The difference between the two groups was not significant in Appearance Orientation and Subjective Weight scales (P>0.05).

An unfavorable BI in adolescents with thalassemia, as a kind of psychiatric disorder, emphasizes the need for emotional and social supports by family, medical staff and peers.

Fetal macrosomia increases the risk of perinatal mortality and morbidity. The aim of this study was to determine the prevalence of macrosomia and its relationship with related factors in neonates born in the hospitals affiliated to Mashhad University of Medical Sciences.

This cross-sectional study was performed on 97569 neonates using the data obtained from the neonateschr('39') screening program in Mashhad. Their information was extracted from Sina electronics system (electronic medical records software) and analyzed using SPSS 16. The prevalence of macrosomia and its related factors are revealed by tables.

In this study, the prevalence of macrosomia was estimated at 6.6 % which was higher in male neonates than females. The mean birth weight was higher in male infants than female ones. It occurred 8.25 times higher in singletons than multiplets. The prevalence of macrosomia was increased by maternal age. Most of the neonates were born by cesarean section, and in most of them, the parents were not relatives. The prevalence of macrosomia gradually increased in parents living in densely populated cities and its trend gently decreased from the beginning to the end of the year.

The prevalence of macrosomia in infants in Mashhad was 6.6% and was correlated with maternal age during pregnancy, infantchr('39')s gender, number of fetuses, mode of delivery, parental consanguinity, parental residence places and birth season.

Spontaneous pneumomediastinium (SPM) can be due to increased intrathoracic pressure. Pneumomediastinium (PM) with Diabetic Ketoacidosis (DKA) is a very rare complication that can be caused by severe vomiting or Kussmaul breathing.

Case Report:

 The patient is a 15-year-old girl with a history of type 1 diabetes mellitus (T1DM) who has been hospitalized due to nausea, severe vomiting, abdominal pain, chest pain and dyspnea. Based on physical examination and imaging (CXR and chest CT scan), PM was diagnosed. The patient underwent conservative treatment for PM and treatment for DKA and was discharged after 5 days in good general condition.

SPM with DKA is a rare complication with a benign process that usually has a good prognosis if diagnosed and treated timely.