International Journal of Pediatrics
Volume:9 Issue: 95, Nov 2021

Menstrual hygiene is a complex phenomenon which is affected by various factors especially cultural factors, and poor menstrual hygiene can be a major cause for infertility and other problems. This study aimed at developing and psychometrically evaluating a cultural instrument for comprehensive measurement of menstrual hygiene.

This study was performed in two phases based on the PEN3 cultural model. The first phase was a qualitative study and literature review for the initial development of the instrument. The second phase was to determine the validity and reliability of the instrument. In order to determine the validity, we used the expert panel, impact score, Content Validity Ratio (CVR), and Content Validity Index (CVI); to determine the reliability, we used the test-retest method and Cronbach's alpha coefficient.

The instrument (questionnaire) has two parts; the first part consisted of 10 demographic questions and the second part was constructed based on PEN3 cultural model structures. After measuring the validity, Score Impact results suggested that all Items had a score of 1.5 or above. In the content validity index, we omitted 2 Items with CVI lower than 0.79 and 11 Items with CVR lower than 0.49. As for the reliability of the questionnaire (Cronbach's alpha), the items with the reliability coefficient higher than 0.7 were confirmed. So the reliability of the Acknowledge section was 0.87, Attitude 0.92, Practice 0.90, and the score for Enablers was 0.87.

This study presents a reliable and valid cultural instrument for comprehensive measurement of menstrual hygiene. Thus, it can be used to assess needs or investigate the effects of executive and educational interventions.
Key Words: Cultural instrument, Instrument development, Menstrual hygiene, Psychometrics.

Congenital hypothyroidism (CH) is the most common curable cause of mental retardation. The aim of this study was to compare the intelligence quotient (IQ) of congenital hypothyroid patients with that of healthy children.
This case-control cross-sectional study was performed on 30 permanent CH children within the age range of 6-12 years referring to the Endocrine Clinic of Imam Reza Hospital, Mashhad, Iran between April 2017-2019. In addition, 32 healthy children of the same age and gender from the family members of the patients were chosen as the control group. The intelligence test was performed using the revised version of the Wechsler Intelligence Scale for Children and the mean verbal, performance, and total IQ were compared between case and control groups.
There was no significant difference between the two groups in terms of age and gender. The mean verbal, performance, and total IQ in the case group were obtained as 104.33±13.30, 93.13±7.42, and 98.03±7.94, respectively. With regard to the healthy group, these mean values were, respectively, estimated at 121.34±16.74, 99.65±11.92, and 110.71±14.15 (the normal range of IQ was 90-109).
Accordingly, the results revealed a significant difference between the two groups in terms of verbal (P=0.000), performance (P=0.013), and total (P=0.000) IQ. Furthermore, a relationship was found between early treatment initiation and higher verbal IQ (r=0.521; P=0.032), as well as between lower thyroid-stimulating hormone and higher performance IQ (r=0.559; P=0.020).
The permanent CH children that had received timely treatment had normal levels of IQ based on the Wechsler Intelligence test. However, it was significantly lower in the CH children than that in healthy children of the same age, gender, and socioeconomic status.

Urinary tract obstruction is defined as any disorder in the normal urinary flow tract in the pediatric group. In the field of urology, urine stasis and urinary obstructions play an important role in renal complications. Every obstruction in the urinary tract can lead to hydronephrosis, atrophy and even full destruction of renal function. In addition, tract obstruction can result in a urinary infection which exacerbates the destruction per se. The present study was a descriptive-analytical study of 25 one-month-old to one-year-old children. In this study, one urine sample was collected the day before surgery, another urinary sample was taken from the affected pelvis during surgery, and the other urine sample was collected at the time of double J exertion and stored at a suitable temperature (minus 70. C). The EGF factor was measured in the collected samples, by the use of ELISA method. The findings revealed that the urinary level of EGF was significantly reduced after surgery, so that the average level of this marker before surgery for the study population was 40.12±12.55, while this amount after surgery equaled 37.32±11.51 mg/dL. The analysis of the data by the T test showed a significant relationship between EGF level and the time of measurement (P=0.0001). The results of the above study show that obstruction of the urinary tract can increase the urinary level of EGF; and with increasing age, the amount of this marker increases in children who have obstruction of the urinary tract.

The assisted reproductive technology (ART) is an important option for fertility in infertile couples. The aim of infertility treatment is not only pregnancy, but also healthy children. However, there are challenges to the development of children born following ART. The present study aimed to compare the developmental status of children born following ART and spontaneous pregnancy.

The study was a retrospective cohort study that investigated 84 children born following ART and 168 children born following spontaneous pregnancy at the same age. They had referred to comprehensive health centers of Isfahan in 2019.
The cases were selected through systematic random sampling. Data collection tools included the researcher-made demographic information questionnaire, and the standard Ages and Stages Questionnaire (ASQ). We evaluated the children's development in five developmental domains, namely communication, gross motor, fine motor, problem-solving, and personal-social domains. The data was analyzed using descriptive and analytical statistics in SPSS version 21 at a significance level of <0.05.

Analysis of covariance after adjusting the demographic variables indicated that the developmental domains were not significantly different in children born following ART and spontaneous pregnancy (P>0.05). Pearson correlation coefficient test showed gross motor had a statistically significant association with the child's age (p =0.24, r = 0.075), birth weight (p =0.47, r = 0.045), current weight (p =0.34, r = 0.061), and current height (p =0.30, r = 0.066).

There was no statistically significant difference in the development of children born following ART and Spontaneous pregnancy. The gross motor had a statistically significant association with some demographic information of children.

Antimicrobial resistance is an important public health issue worldwide, which is prevalent in developing countries such as Iran. The present study aimed to assess the bacterial sepsis and patterns of antimicrobial susceptibility in neonatal sepsis. This cross-sectional study was conducted on 430 neonates with the clinical suspicion of septicemia, who were admitted to the neonatal intensive care unit (NICU) of Beasat Teaching and Referral Hospital in Sanandaj, Kurdistan, and west of Iran from May 2018 to April 2019. Data analysis was performed using the WHONET software version 5.6, and the research units were described based on frequencies and proportions. From a total of 430 neonates, 41 blood cultures were positive. Early onset sepsis (EOS) and late onset sepsis (LOS) were detected in 17(41.5%) and 24 (58.5%) cases, respectively. Coagulase-negative Staphylococci (CONS) and Acinetobacter spp. were identified in 18/41 (43.9%) and 7/41(17%) isolates as the most predominant species. CONS and Acinetobacter spp. had the highest resistance against ampicillin (13; 72.2% and 5; 71.4% respectively). In addition, Gram-negative and Gram-positive bacteria both showed resistance to third-generation cephalosporins, while multidrug resistance was observed in 22 isolates (53.7%). On the other hand, the isolates of Gram-positive bacteria exhibited more efficient susceptibility patterns against third-generation antibiotics, such as clindamycin, vancomycin, and ciprofloxacin. According to the results, neonatal sepsis was primarily caused by CONS and Acinetobacter spp. as they showed high resistance to first- and second-generation antibiotics at the NICU. Therefore, it is recommended that proper policies be adopted to restrict antibiotic use without prescription in the community.

One of the factors reducing the satisfaction and quality of life in thalassemia is the injection of iron-depleting drugs that always cause complications in these people. But with the advent of oral detoxification drugs, it can be predicted that this problem will be solved to some extent. Given that Sistan province is one of the regions with the highest prevalence of thalassemia in Iran, we aimed to compare the quality of life in major thalassemia patients receiving oral and injectable iron depleting drugs.

This cross-sectional descriptive-analytic (Prospective) study was performed during a one-year period (2017-2018) in Ali Asghar Hospital of Zahedan University of Medical Sciences. Demographic information of patients was extracted and recorded through history as well as the information in their files. EQ5D questionnaire was used to assess the quality of life. Data were analyzed using SPSS 18 software.

the quality of life score is significantly higher in Patients receiving oral treatment than injecting patients (p= 0.02). The issue is also true in terms of the health degree of the patients in both groups (p=0.03). Furthermore, comparing the quality of life score and health status of patients between the two groups receiving injectable and oral iron deprivation showed that in females, under 15 years of age and the patients with poor acceptance, the degree of health in the group receiving oral decontamination was higher than injectable decontamination.

Quality of life in patients with thalassemia treated with oral iron depletion is higher than patients receiving injectable iron depletion treatment, and in under 15-year-old females and patients with poor acceptance, this difference is significant.

Pregnant women experience significant anxiety and stress, even under normal conditions, and anxiety is the most common psychological disorder during pregnancy. As different mental aspects of the COVID-19 pandemic breakout and its psychological consequences at the individual and social levels are neglected, the present study presents a systematic review of pregnant women's anxiety level during the event.

The present study was conducted in the time range of 01/09/2019-01/06/2020. The study involved searching the MEDLINE in PubMed, SCOPUS, PubPsych, and google scholar databases. Two researchers independently searched the databases and screened the data, and evaluated their quality. After final screening and eliminating the duplicate and irrelevant items, twelve cross-sectional articles were finally included in the study.

The participants were divided into two groups of COVID-19 positive and negative patients. The available information and guides in parallel to reassurance through social media, healthcare professionals, and primary care were the reasons that led to low anxiety scores. The second group's higher anxiety score referred to concerns about the transfer of the disease, house quarantine, inadequate pregnancy care, first delivery, age, low weight during pregnancy, low income, living space, and public use places and transportation.

Increasing mothers’ awareness about Coronavirus transmission, risk factors and providing online advice on prenatal care via mobile phones and the internet can reduce their anxiety and stress. It is also suggested that the medical team reassure mothers, provide the child delivery services, and the subsequent care services in the houses wherever these services are required

Emergency care of traumatic children is an important health subject. The aim of this study was to evaluate the accessibility of emergency care for traumatic children in terms of management equipment, cause defects, and familiarity of medical staff with training programs.

This descriptive-analytical study evaluated the emergency departments of all general hospitals in East Azerbaijan province during 2018, based on a checklist with 4 sections and 20 items, rated according to Likert scale from very high (scored 3) to very low (scored 0). For a score less than 3, defect causes were explained in 7 categories. The staff training certificates were considered for early and advanced pediatric life support in an emergency situation.  The staff’s training certificates in terms of early and advanced resuscitation of children were also surveyed. Data was analyzed by SPSS 21.

From among 20 emergency hospitals, more than 50% were equipped with adequate airway instruments. All of the emergency departments were provided with oxygen therapy equipment, but more than 70% had no chest tube and ventilator fit for children. More than 70% of them had cardiac monitoring and a sphygmomanometer for pediatric patients; however, less than 50% had a blood transfusion set and a urinary catheter. Only two hospitals had held early and advanced pediatric resuscitation workshops for their staff.

This study showed that 19 (95%) of emergency departments had the potential for early diagnosis and treatment of traumatic children. However, only 2 (10%) of the emergency staff had enough work experience in this issue. It is necessary to implement training programs for the familiarity of medical staff with pediatric early and advanced life support in emergency departments

This study aimed to determine factors affecting compliance with Hand Hygiene (HH) from the perspective of the health care team working in the pediatric intensive care unit of a children's tertiary center, Ali -Asghar hospital, in Tehran, Iran.

we recruited 35 Pediatric ICU health care workers, including nurses, attending physicians and medical students, selected by purposive sampling between February to November 2020. Data were collected using deep semi-structured interviews, and analyzed through Graneheim and Lundman’s (2004) qualitative conventional content analysis method. All interviews were recorded and typed in the MAXQDA software and then analyzed in eight steps including writing interviews, determining the semantic units, text coding, matching codes with text, categorizing and developing categories, reviewing the categories, identifying the sub themes and reporting the findings.

68.5% of the participants were female, with an average age of 32.7 years and work experience of 8.6 years. After reviewing all codes obtained, 4 main categories were finally extracted. (I) Meta-organizational factors including two subcategories of macro-health policy, sanctions and economic problems, (II) Organizational factors including three subcategories of incoherence in observing the rules, monitoring and evaluation, and the prevailing attitude of the organization, (III) Individual factors including three subcategories of attitude of the health care team towards patients, skin reactions to hand sanitizers, concerns about their own health and health of their family, (IV) Characteristics of the clinical environment including three subcategories of professional relationships, special conditions governing the pediatric ICU, and care facilities.

Overall, 234 codes were extracted from the interviews and after the integration of similarities, four key themes including Meta-organizational factors, Organizational factors, Individual factors and Characteristics of the clinical environment were obtained indicating factors affecting hand hygiene performance of  the PICU health care team.

Anxiety disorders are the most common disorders in children that affect the psychological and social functioning of the child. Recently, researchers have used the coping cat programs (CCP) as a way to reduce anxiety disorders. Therefore the current study aimed to investigate the effectiveness of a coping cat program on symptoms of anxiety disorders in primary schools. This study was performed in a pre-test-post-test control group design. The statistical population included all children aged 8 to 11 years with anxiety disorders in five state primary schools in the second district of Bandar Abbas, Iran, in 2019. Using a questionnaire (SCAS), 32 children with anxiety disorders were selected from schools and randomly divided into control (n=16), and experimental (n=16) groups. CCP) training intervention was performed for the experimental group (for 16 sessions, twice a week for 45-minute). The control group did not receive any intervention. The participants’ anxiety was assessed in both groups, one week after the intervention by Spence Children's Anxiety Scale (SCAS). Data were analyzed through SPSS version 23. The experimental and control groups were homogeneous before intervention. The mean anxiety score in the intervention group after the coping cat program including the Separation anxiety disorder (‎3.56±2.09)‎, Panic disorder (‎‎2.12±2.15), Obsessive-compulsive (3.81±2.007)‏‎, physical injury fears (4.06±3.08‏‎) was significantly lower than that in the control group (9.81±3.54), (7±3.07), (9.43±3.28), and (7.37±3.36) respectively (P <0.05). The results revealed that through a 16-session intervention of recognizing the symptoms of unwanted anxiety in children and using these symptoms to apply anxiety management strategies, CCP leads to a reduction of anxiety disorders in children.

Oral health is one of the most important dimensions of individual health, so in order to assess the status of oral health in a community, it is necessary to conduct various epidemiological studies at different stages to determine the effectiveness of prevention and oral health programs in a community. The aim of this study was to determine some of the factors associated with dental caries in primary school students in Hamadan in 2019.

In this case-control study, information about students with dental caries and controls was extracted by referring to schools in the four education districts of Hamadan (A girls' school and a boys' school were selected from each district). The total sample size was 980 people and 30 cases and 90 controls were selected from each school. For determining dental caries status a final year dental student examined the students. Logistic regression model was used to evaluate the risk factors for the disease. All analyses of this study were analyzed using Stata software, version 14.

A total of 240 cases and 740 controls were studied in this study. The mean dmft in primary school students in Hamadan was 1.86 ± 2.92. Among them, the first and second grade students had the highest caries rate. The results of the logistic regression model showed that the risk of tooth decay in people with severe toothache is almost twice as high as that in people who do not have toothache. This rate is more than 1.5 times higher for students whose fathers are workers than for those whose fathers are self-employed. Also, as the number of family members increased, the chances of developing tooth decay increased linearly. The odds of tooth decay in people who do not brush and floss are 2.84 and 2.13, respectively, more than people who brush and floss three times a day.

In our study, having severe toothache, lack of parental supervision over the children's oral health, employment and education of parents, family dimension, not using toothbrush, flossing and mouthwash, excessive consumption of sweets, lack of regular visits to the dentist, and low dairy consumption were associated with tooth decay.

Preterm premature rupture of membranes (PPROM) is spontaneous rupture of fetal membranes before 37 weeks of gestation. PPROM cases that are clinically stable with no sign or symptom of intrauterine infection and normal fetal assessment are usually managed expectantly in hospital settings or at home. This study aimed at comparing the inpatient and outpatient management among women with uncomplicated PPROM. This non-randomized clinical trial was performed in an academic hospital, Mashhad University of Medical Sciences in 2017-2018. Women with confirmed PPROM who received initial treatments during the primary 72 hours of hospitalization were assigned into inpatient (n=45) or outpatient (n=35) management groups according to the patient's decision. The obstetrical, maternal and neonatal outcomes under the focus of this study included latency period, gestational age at delivery, delivery route, delivery reason, WBC and neutrophil count, neonates’ weight, Apgar score, NICU admission, and death in the first 28 days after delivery. Data were analyzed by Statistical Package for Social Science (IBM SPSS) version 23. P<0.05 was considered statistically significant. Among 120 patients assessed for eligibility criteria, 80 patients were enrolled and the data of 68 participants was analyzed. Women in outpatient group had significantly longer latency period than women in inpatient group (18.7±12.9 vs.7.1±5.8days, p<0.001). The rate of vaginal delivery was 77.5% (n=31) in inpatients group vs.57.1% (n=16) in the outpatient group (p=0.1), no significant difference was found regarding cesarean indications, pregnancy termination indication, GA at delivery and WBC or neutrophil count (p>0.05). Neonatal Apgar score, death, and NICU admission rate or period were not significantly different between the two groups (p>0.05). Homecare for the selected PPROM women could be a suitable expectant strategy without compromising neonatal or maternal outcomes.

Ductus arteriosus (DA) is a vascular structure that makes a link between the proximal descending aorta and main pulmonary artery near the origin of the left pulmonary artery. The present study aimed to assess the changes of LA/Ao ratio after PDA closure in children. This cross-sectional study was performed on 635 children with PDA in the Ali Asghar clinic, Zahedan, Iran, from 2003 to 2019. The participants were followed for at least one year after discharge from the hospital after intervention. PDA diagnosis was conducted in accordance with the echocardiography performed by a pediatric cardiologist using Mylab 60 and challenged 7000 made in Italy.  The analyses were performed by SPSS 20.00, considering 0.05 as the significant error. As compared to the baseline measures before the interventions, the growth rates of LA/Ao ratio decreased by 24% and 10% in the first and second 6 months after the intervention. During the first 6 months after the intervention, the percentages of LA/Ao ratio reduction were 23%, 25% and 22% in small, medium and large PDA while these percentages were 7%, 13% and 16%   during the second 6 months after the intervention, respectively. Regarding the intervention, the percentages were 25%, 24%, 24% and 24% in PDAs that were, respectively, closed by medication, surgery, occlusion device and VATS in the first six months after the intervention. The percentages were, respectively, 9%, 10%, 11% and 9% for the second 6 months after the intervention. The percentages were, respectively, 24%, 24% and 21% in those PDAs with residuals, no complication and PH in the first six months after the intervention. This pattern was, respectively, 8%, 9% and 16.6% for the second 6 months after the intervention. It was concluded that LA/AO ratio had the highest decrease during the first six months after the intervention, so that PDAs with moderate sizes or those who had medication as intervention or those with residual complications had the highest percentages of reduction.

The rate of neonatal mortality is one of the main indices of health, treatment, and development in societies. It reflects the quality of nutrition and life of mothers as well as the rate of healthcare services that mothers and children are provided with by societies. This study aimed to identify the factors affecting neonatal mortality by using a bagging neural network in Rapidminer Software.
The study was conducted on 8053 births (including 1605 death cases and 6448 control cases) all over Iran in 2015. Factors such as maternal risk factors, mother’s age, gestational age, child gender, birth weight, birth order, and congenital anomalies were utilized as the predictor variables of the bagging neural network. Some criteria, including the area under the ROC curve, as well as the property and sensitivity of the bagging neural network, were compared with the neural network model. The bagging neural network with 99.24% precision rate enjoyed better results in predicting the factors affecting neonatal mortality.
Our suggested method revealed that gestational age is the most significant predictor factor of a neonate's status at birth time. Besides, 1-minute Apgar, need for resuscitation, 5-minute Apgar, birth weight, congenital anomalies, and birth order, as well as diabetes and preeclampsia in mothers were identified as the most significant predicting factors after the gestational age.
Factors discovered in this study can be considered to decrease neonatal mortality. This can help the health of mothers’ community, optimize healthcare services, and development of societies.

The aim of this study was to evaluate the effectiveness of teaching neuro-verbal planning strategies and cognitive-behavioral approach on reducing students' anxiety, depression, and stress. This quasi-experimental study is a pre-test-post-test with a control group and the study population includes all adolescent girls and boys 15 to 18 who were studying in the secondary schools of Kerman in the academic year of 1999-2010. And were randomly replaced in three groups of 15 people. Experimental group 1 underwent strategic training of neuro-verbal planning for 18 minutes in each session for 18 minutes and experimental group 2 underwent aphthous-behavioral therapy in 6 sessions once a week for 60 minutes. They did not receive any special training or treatment. The instruments used in this study included the Depression, Anxiety, Stress Scale (DASS-21). Findings showed that teaching neuro-verbal programming strategies as well as cognitive-behavioral therapy on reducing depression (=2 = 0.883, P <0.05), anxiety (=2 = 0.846, P <0.05) and stress (=2 = 0.863, P <0.05) had a significant effect on students. On the other hand, the effect of teaching neuro-verbal planning strategies and cognitive-behavioral approach on reducing students' depression, anxiety and stress was not significantly different (p> 0.05). Based on the results, it can be said that teaching neuro-verbal planning strategies and cognitive-behavioral approach reduces depression, anxiety and stress in adolescents. And the effect of teaching neuro-verbal planning strategies and cognitive-behavioral approach on reducing depression, anxiety and stress in adolescents has been the same.

GnRH agonists are the standard treatment for precocious puberty. Studies on the side effects of these drugs in adults have shown that these drugs may cause changes in ECG and some cardiovascular effects; however, few studies have evaluated these effects in children. This study aims to investigate the effect of these drugs on ECG intervals in children with precocious puberty.

In this study with a pre-post design 50 children with precocious puberty referred to the endocrinology clinic of Tabriz Children's Hospital in 2019 for receiving GnRH agonists were included. From all patients, ECGs were obtained before starting the treatment and then 6, 12, and 18 weeks later and PR, QRS, and QTc intervals were extracted from ECG records.

The mean age of the participants was 91±9 months including 48 (96%) girls and 2 (4%) boys. Triptorelin (GnRH agonist) was administered for all patients with the standard protocol. Comparison of pre- and post-treatment ECG intervals showed that the drug did not cause a significant change in PR (p = 0.535) and QTc (p = 0.250) intervals, whilst there was a significant increase in QRS interval after the treatment (p = 0.001).

The use of GnRH agonists in children can lead to some changes in ECG records by increasing in QRS intervals; and ECG could be used as a tool to detect these changes. Further studies are also needed to identify ECG changes in larger sample sizes and longer intervals.

Anxiety and specific learning disorders (SLDs) are two problems faced by some elementary-school students, resolving of which is a challenge for elementary teachers. The present study aimed to investigate the effectiveness of play therapy on anxiety and specific learning disorders of elementary-school students.
The research method was quasi-experimental with pre-test post-test design and control group. The statistical population comprised of all the male elementary-school students aged 9-10 years in Isfahan, Iran, in 2020. Using convenience sampling, we selected 30 students and randomly divided them into experimental and control groups (n= 15 per group). The experimental group underwent nine sessions of play therapy (two 30-minute sessions per week), while the control group received no intervention. The research instruments included Spence Children's Anxiety Scale (SCAS) and the Colorado Learning Difficulties Questionnaire (CLDQ). First, both groups completed the pre-test questionnaires, and the intervention program was evaluated in the last training session. As the children could not complete the questionnaires, their parents were asked to collaborate with the research. Analysis of covariance (ANCOVA) was performed in SPSS software version 22.0 to analyze the data.
The mean ± standard deviation (SD) of the post-test scores of anxiety and specific learning disorders were 64.73±1.30 and 41.73±3.06 in the experimental group and 71.64±1.80 and 49.73±3.33 in the control groups. The results showed that play therapy was effective in reducing the anxiety of elementary-school students in Isfahan. It was also highly effective in alleviating their SLD-related problems (P= 0.001).
Based on the results, the play therapy intervention can reduce anxiety and ameliorate the SLD problems of elementary-school students.

Mild symptoms of COVID-19 in children may lead to delayed or misdiagnosis. Reverse transcription polymerase chain reaction (RT-PCR) is an approved laboratory method for detecting COVID-19 virus. Given that COVID-19 is considered an emerging disease, its diagnostic methods in children have not yet been well compared. Therefore, this study was designed to compare RT-PCR, lung CT scan, and anti-COVID-19 antibody results in hospitalized children suspected for COVID-19. This cross-sectional study was conducted on patients less than 18 years of age, suspected fot COVID-19, and admitted to Shahid Sadoughi Hospital in Yazd, Iran, from February 2020 to February 2021. All hospitalized children who had suspected COVID-19 based on their initial clinical symptoms or signs, and had undergone RT-PCR were included in the study. Demographic data such as age, sex, contact history with COVID-19 patients, clinical manifestations, outcome, comorbidities, and information on other paraclinical procedures were collected by checklist. In total, 53.3% of the patients were male, and 59% were under five years old. The most common symptom was fever (81%), followed by respiratory distress (34.3%) and diarrhea (26.7%), and cough (19%). Additionally, a significant relationship was observed between respiratory symptoms and a positive PCR test (P = 0.020) and positive lung CT findings (P = 0.017). This study failed to find a significant association between PCR, chest CT scan, and anti-COVID-19 antibody results with ICU admission, endotracheal intubation, and death (P>0.05). Our findings showed a significant association between respiratory symptoms, positive RT- PCR, and positive CT findings. But ICU admission, endotracheal intubation, and death were not significantly correlated with PCR, chest CT scan, and anti-COVID-19 antibodies

The increase of ADHD affects family relations and the mental health of family members as well as the child himself. The main purpose of this study was to determine the effectiveness of swimming training on reducing coping behaviors, cognitive problems and inattention of Elementary School female students with hyperactivity disorder.

The present applied research follows a descriptive-analytical method and a pre-post test experimental-control design. The participants included children with signs of hyperactivity (age=7.2±1.6 years) from welfare centers of Tabriz. The participants were randomly assigned to two experimental (n=15) and control (n=15) groups. Before the initiation of the training program, the Conners questionnaire (parent form) was completed by the parents. The training was held every week in two 45-minute sessions for 2 months. At the end of the training, a practical test was performed according to the standards of the province sports board, and the scores were recorded on special sheets. After completing the exercises and testing, the Conners questionnaire for parents was again distributed among the parents. T tests were used for analyzing the data.

The results showed that swimming had a significant positive effect on reducing coping behaviors, cognitive problems and inattention of elementary school hyperactive girls.

Exercise strengthens the primary atrial nervous system and promotes superior brain functions such as motor skills and integration in action, which can reduce social maladaptation by creating a conducive environment for increased self-confidence and empowerment

Cystic fibrosis (CF) is an autosomal recessive disorder caused by a mutation in CF transmembrane conductance regulator gene (CFTR). Clinical manifestations of the disease and their severity have considerable variations in patients having similar mutations in CFTR gene. This can be due to different polymorphisms, epigenetic changes and microRNAs (miRNAs) as gene modifiers. Considering the proven roles of miR-301b and miR-302b on infection and inflammation, expression of these miRNAs might change in CF patients.

In this study, 30 CF patients (homozygous for ΔF508 mutation) and 30 healthy individuals were participated and their demographic data were recorded. The whole RNA was extracted from serum samples and cDNA was synthesized. Using Real-Time PCR, expression levels of miR-301b and miR-302b were measured between the patient and normal groups. Patient classification was carried out based on Shwachman-Kulczycki score, and expression levels of these miRNAs were determined in these classifications. All statistical analyses were performed using IBM SPSS software, version 21.

Statistical analyses of qRT-PCR results showed a significant increase in serum levels of miR-301b and miR-302b expression (p-Values of 0.02 and 0.03; fold changes of 3.73 and 1.95, respectively) in CF patients compared to healthy controls. A significant increase (p<0.05) in miR-301b expression level was observed in severe, moderate and mild groups, while miR-302b expression level was increased in CF patients of severe and moderate groups according to Shwachman-Kulczycki score.

Expression levels of miR-301b and miR-302b are different based on the clinical scoring system. This data suggests that expressions of these two miRNAs are influenced by infection and inflammation of CF patients. Further studies can lead to the development of innovative treatment strategies.