International Journal of Pediatrics
Volume:10 Issue: 98, Feb 2022

Quality of school life is defined as the overall student satisfaction with their experiences of school activities. This study is aimed at investigating the structural relationships between academic procrastination and quality of school life with the mediating role of difficulty in emotional regulation.
This correlational study adopts the structural equations method. The statistical population consists of 4734 female high school students in the city of Kerman, in 2018-2019. A sample of 353 subjects was selected through Cochran's formula using the random cluster sampling method. To collect data, Ainley and Burke's Quality of School Life Scale, Solomon and Rothblum's Procrastination Assessment Scale for Students (PASS) and Graz and Roemer's Difficulty in Emotion Regulation Scale (DERS) were used. The validity and reliability of the questionnaires was confirmed through factor analysis and Cronbach's alpha, respectively. Research data were analyzed through inferential statistics. SEM and confirmatory factor analysis were applied using SPSS and AMOS.
The results showed that the variable of academic procrastination has a negative and significant effect on the quality of the students’ school life with a negative coefficient (β = -0.722) and a significance equal to 0.000. Academic procrastination has a significant and direct effect on the difficulty of emotional regulation according to the positive coefficient (β = 0.528), and a significance equal to 0.000.
According to the results, the variable of academic procrastination has a negative and significant effect on the quality of school life among the students. The academic procrastination variable has a significant and direct effect on the difficulty of emotional regulation

Considering the importance of proper infant nutrition, especially in the first two years of life, and also the effect of cultural issues on the type of infant's nutrition, this study aimed to investigate the type of nutrition and anthropometric indices of infants during the first year of birth in Bushehr, Iran.
This cross-sectional study carried out on 546 delivered mothers. The data of mothers and their children were collected through Integrated Health System (SIB). Five centers of comprehensive health care centers were randomly selected. Required information included maternal demographic characteristics and anthropometric indices of infants at birth, 6 and 12 months. The collected data were analyzed using SPSS 19 with appropriate statistical tests at a significance level of p<0.05.  
The frequency of exclusive breastfeeding, formula feeding and also both feeding methods (combined) were 56.8%, 25.1%, and 18.1%, respectively. The results showed that the 6-month weight gain compared to birth time was not different among the three groups. The increase in height and head circumference in the first six months in the formula feeding group was less than the exclusive breastfeeding group and the combined group (P<0.05). In the second six months, weight gain and height in the formula feeding group were less than the other two groups (P <0.01).
This study showed that the prevalence of exclusive breastfeeding in Bushehr is desirable. The growth trend in breastfed infants is either similar or better than formula-fed infants. Using formula with breast milk compared to formula alone has better growth outcomes.

Lipoblastoma is one of the rare masses in childhood and its diagnosis is very uncommon in the perinatal period, so we reported a case with a diagnosis of this mass during pregnancy.

In a routine third-trimester ultrasound at 28 weeks, a hyperechoic mass in the size of 27*30mm was detected in between labia majora. However, no abnormal findings were found in perinatal care before this gestational age. Finally, after the birth, at 40 weeks of gestation, the mass was resected and now the baby is in good condition and no recurrence has occurred. There was also an anorectal anomaly associated with this mass in our patient who underwent Anorectoplasty surgery.

Due to the rarity of these tumors, it is important to diagnose them in the perinatal period and to investigate other associated anomalies.

Constipation as a common disease in children can cause significant complications for this age group, so that one third of children have chronic symptoms which may continue into adulthood. The causes of chronic functional constipation are largely unknown; and it may be a multifactorial disorder. Gallbladder dysfunction in chronic idiopathic constipation may be an underlying cause of idiopathic constipation. Hence, this study aimed to evaluate the gallbladder mobility ultrasound in children with chronic functional constipation in Imam Khomeini Hospital of Ahvaz. Children between the ages of 3 to 13 years in Imam Khomeini Hospital of Ahvaz, who suffered from functional constipation, were visited by a pediatric digestive and liver subspecialty physician after referring to the pediatric gastroenterology clinic of the hospital and were referred to us for conducting gallbladder ultrasound. In this study, 50 patients with chronic functional constipation and 50 healthy individuals (control group) were studied. The mean age of the participants in this study was 6.96 with a standard deviation of 2.44 years. In this study, 40 patients (40%) were boys and 60 patients (60%) were girls. The mean volume of gallbladder in fasting mode (preprandial) and after meal (postprandial) in individuals of the case group were 5.66 and 4.17 cm3 with standard deviations of 0.80 and 0.64, respectively, and in the control group were 6.08 and 3.06 cm3 with standard deviations of 0.97 and 0.75, respectively. The thickness of the gallbladder wall in the fasting mode (preprandial) and after meal (postprandial) in the case group was 1.50 and 1.67 mm with standard deviations of 0.24 and 0.29 mm, respectively, and in the control group, it is equal to 1.39 and 1.69 with standard deviations of 0.22 and 0.28, respectively.A significant relationship was observed between case and control groups (P <0.05) in terms of gallbladder volume after meals, but no significant relationship was found between gallbladder volume and the gallbladder wall thickness in the fasting mode and after meal in neither of the case and control groups (P> 0.05). Due to the slow mobility of the gallbladder in patients with chronic functional constipation, it can be concluded that gallbladder dysfunction can be a cause of chronic functional constipation.

Herbal remedies have been implicated as adjunctive therapies in the treatment of neonatal jaundice over the years. The aim of this review was to investigate the therapeutic effects of herbal medicines on neonatal jaundice. In this systematic review, a search process was performed in online databases of Scopus, Medline, Web of Science and Cochrane Library based on PRISMA guidelines. Components for searching were “neonatal jaundice” and “herbal medicine”. Relevant articles in English published between January 1900 and October 2020 were extracted. The quality of the articles was assessed by the CONSORT checklist. Finally, according to the inclusion criteria, 9 studies with a total of 1323 neonates were selected.  The herbal remedies used by the researchers for treatment of neonatal jaundice included Bilineaster drop, alhagi pseudoalhagi, and zizyphus jujuba were used in 8 of the 9 studies. In 5 of these 8 studies the Bilineaster (Purgative manna extract) had significantly reduced serum bilirubin levels of the infants. Based on the results, the herbal remedies (especially bilineaster) are probability effective as adjuvant therapies along with standard therapies in the treatment of neonatal jaundice. These can reduce the bilirubin level – hospitalization days and re-hospitalization.

Pregnancy is one of the most crucial and stressful periods in the life of the women, influenced by physiological and psychological changes during pregnancy that affect mother-fetus attachment during pregnancy. The present study aimed to determine the effects of mindfulness training on emotion control of primiparous pregnant women and to investigate its impacts on the formation of secure attachment style in infants.
This pretest posttest control group single blind study was done on pregnant women who were chosen from the healthcare centers of Tehran, Iran. From among 150 women screened for eligibility to participate in the study, 38 Primiparous Pregnant women met the inclusion criteria and were randomly assigned into the study groups. The intervention group received seven weekly mindfulness training sessions. The control group received the prenatal routine care. The participants answered the Motion Control Scale at the pretest and posttest. Data were collected using the strange situation in the two groups and analyzed by statistical tests, eight weeks after the intervention.
According to the findings, the average age of the sample is in the range of 23 to 39 years. The pregnancy week of the subjects was between 15 months and 41 months. After the intervention, the mean maternal emotion control score was significantly higher in the intervention group than the control group (F=15.894; P=0.001). Moreover, the Chi Square test revealed that in terms of infant’s safe attachment style (P=0.570; χ2= 7,644a), there is no difference between the mothers in the studied groups.
The results showed that Mindfulness was effective in the formation of secure attachment style in infants and in promoting maternal-infant attachment. Therefore, it was recommended that such interventions be integrated in the prenatal care programs of pregnant women to improve the secure attachment of infants.

Components of self-determination theory work very well in physical education settings. However, very few studies in Iran focused on this issue which might be due to the lack of validated questionnaires. The present study aimed to investigate the psychometric properties of a Persian questionnaire derived and translated from four scales assessing the self-determination components of physical activity/education in adolescent students.
This study used an exploratory-confirmatory method. The participants were 400 high-school students (16-18 years old) studying in Aliabad Katoul, Golestan, Iran, during 2019. The items of the English standard questionnaires were converted into Persian using the translation-retranslation method. Subsequently, nine experts confirmed the validity of the final Persian questionnaire. The questionnaires included Needs Support in Physical Education Questionnaire which is used to measure autonomy support; Sport Climate in Physical Education Questionnaire which is used for measuring needs satisfaction; Intrinsic Motivation Scale which is used to measure intrinsic motivation for having physical education in the leisure-time; and Intention to Physical Activity used to measure intention to perform physical activities outside the school. We employed factor analysis and structural equation modeling to examine the validity of the questionnaire.
The descriptive statistics showed that all boys and girls were in almost identical ages. Exploratory and confirmatory factor analysis indicated that the Persian version of the questionnaires had relatively high powers for assessing self-determination components in physical education (GoF=0.729). Moreover, perceived autonomy support positively affected the needs satisfaction and intrinsic motivation in physical education. Moreover, intrinsic motivation in physical education was transferred into intrinsic motivation outside school and subsequently affected intention to do physical activities (all T>1.96).
The Persian questionnaire validated in this study enjoys a relatively high power for assessing the self-determination components in physical education. Moreover, autonomy support plays an important role in motivating students to be physically active.

Malnutrition is one of public health concerns among children leading to high morbidity and mortality. The present study aimed to determine the prevalence and the determinants of malnutrition among under-five-year-old children in Zahedan, Iran. This cross-sectional study included under-five children and their mothers who attended Zahedan comprehensive urban health centers. The participants were recruited from a quota sampling. Data on the characteristics of children and mothers were obtained from the child care records, and maternal reporting when necessary. Weight and height of children were measured according to the standard protocol by a trained person. Malnutrition was measured in terms of underweight, stunting and wasting. Multivariable logistic regression analysis and the area under the curve (AUC) were used to identify determinants of malnutrition. A total of 825 mother-child pairs were included. Prevalence of underweight, stunting and wasting was 7.6%, 20.6% and 5.8%, respectively. The results of multivariable analysis revealed that underweight may be predicted by mother’s education, low birth weight (LBW), birth interval, nutrition style, age of introduction of complementary feeding (AUC=0.75); stunting by sex, age, maternal age, father’s education, family size, LBW, birth order and nutrition style (AUC=0.67) and wasting by sex, age, mother’s education, LBW and nutrition style (AUC=0.72). LBW was a significant shared determinant in the nomograms with an odds ratio of over 2.00. Our findings demonstrate a moderate to high prevalence of malnutrition and identify a combination of parent's educational attainment, LBW, birth order, birth interval and nutritional practice as determinants of malnutrition among children under five years of age, in Zahedan.

There is a wide variety of sociocultural and environmental background characteristics in different geographical places of Iran. The aim of this study was to investigate the rates of developmental delay in Tehran in comparison to the norm of Iran, using the Bayley III measure.

This cross sectional study was a part of a national study conducted in Iran, between 2014 and 2016. During the study period, five hundred fifty Persian speaking children in Tehran were included. The sampling was in proportion to the population of children covered in each region. First, the differences between the scaled scores, based on the norms of Tehran and Iran were calculated and then, a one sample Multivariate Analysis of Variance (MANOVA) was used, which showed a significant difference between the scaled scores. Next, we used a univariate analysis to find which scales these significant differences were generated from. Finally, the rate of children with low scores (<-1SD, and <-2 SD) were compared by means of the McNemar analyses.

The numbers of male participants were 310 (54.5%). The mothers in the sample of Tehran had higher educational levels in comparison to those in the sample of Iran (P= 0.001). Considering Iran’s norm compared to Tehran’s norm leads to significantly fewer rates of delay, on cognition scale (<-1SD; 11.6% to 19.8%) and fine motor scale (<-1SD; 15.1% to 21.1%)(<-2SD; 1.6% to 3.3%) respectively (p <0.01). The differences in estimation rate were somewhat age-dependent. The greatest difference between the norm of Tehran and Iran was in the age group of “25 months 16 days to 42 months 15 days”.

In some developmental domains, the norm of Iran in comparison to that of Tehran indicates a lower rate of children with developmental delay.

The individuals' physical, behavioral, and emotional growth is most significant during childhood and adolescence. The purpose of this study was to determine the effectiveness of play therapy with clay and cognitive-behavioral therapy on children's behavioral-emotional disorders.

The study was a quasi-experimental design with a pre-test and post-test. The participants were selected by simple random sampling and divided into an experimental (n= 15) and a control (n = 15) group. The statistical population consisted of all children aged 7 to 9 years, living in Mobarakeh, Iran, during 2017-18.  The intervention of play therapy with clay and cognitive-behavioral therapy was conducted in ten 45-minute sessions; the participants were assessed by the Child Behavior Checklist and finally both prior to and one month after the intervention. Data was analyzed by the use of SPSS software version 23.0.

The results of data analysis, on the 30 male participants with a mean age of 8.1 years, showed that after the therapeutic intervention, there was a significant decrease in the scores of behavioral-emotional problems (p <0.05) of the participants in the experimental group compared to the control group.

According to the results, psychotherapeutic interventions of play therapy with clay and cognitive-behavioral therapy can help decrease the behavioral-emotional problems among 7-9-year-old children.

This study aimed to determine the effect of selected motor games on executive functions of children with developmental coordination disorders.
This was an experimental study with pretest-posttest design conducted in Tehran, Iran. The participants were 30 children who were identified and selected based on diagnostic criteria in two stages and were randomly divided into experimental and control groups. The experimental group performed motor games for 24 sessions during eight weeks, three sessions per week, every other day, and each session for 45 to 60 minutes. In the pretest and posttest, the Coolidge Executive Functioning scale (2002) was used to measure the Executive Functions of the subjects. Disorder Levels were measured using the data analyzed through SPSS software version 22.
The results showed that after controlling the pretest levels, organizing, inhibition,  decision making-planning, and the overall score of executive functions in the experimental group were significantly lower than the control group, in the posttest (p <0.05).
Based on the results, the motor games intervention for eight weeks effectively improved the executive functions of children with developmental coordination disorders and can be used as an appropriate intervention.

Critical congenital heart diseases (CCHDs) are the most common group of congenital malformations in newborns, the mortality and morbidity of which may be prevented by early diagnosis. As a simple and noninvasive technique in detecting hypoxemia, pulse oximetry can help us in the early diagnosis of complex congenital heart diseases. This study aims to provide information for future clinical and health policy decisions for making a Uniform Screening Panel in the early detection of CCHDs in newborns. In this study, we determine the prevalence of congenital heart disease in newborns with Oxygen Saturation in the Maternity ward of Imam-Reza Hospital in Mashhad, Iran. This is a prospective clinical study which was conducted in the Maternity ward of Imam-Reza hospital between March 2018 and March 2019. We recorded Spo2 of the newborns between 4 to 24 hours after delivery by a trained general practitioner using RS232C/NOVAMETRIX Pulse Oximetry device. The newborn also underwent a comprehensive clinical examination by a neonatologist, and further cardiological evaluation was performed afterward. A pediatric cardiologist performed Echocardiography for the final diagnosis if there was no evidence of other non-cardiac pathologies. Statistical analysis of data was done by SPSS version 24. Out of a total of 418 newborns screened by a pulse oximetry device, four newborns were screen-positive, and had pulse oximetry tests with Spo2 results. Two of these patients were reported to have complex congenital heart diseases, subsequently. The remaining two newborns with positive screening tests had no congenital heart disease in echocardiography evaluation. This study revealed that a pulse oximetry screening test could be beneficial for detecting many of the newborns with CCHDs before hospital discharge. However, further research studies with larger sample sizes are necessary for a definitive result.

Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder among children, which several studies have indicated the role of genetic factors in its development. Dopamine transporter gene (DAT1) is one of the candidate genes and a 40-bp variable number of tandem repeat (VNTR) in 3'-UTR of the gene is reported to have a role in ADHD. Here we examined the association between DAT1 VNTR and ADHD susceptibility among Iranian Azeri Turkish children.
The study included 202 patients and 143 controls aged 6-12 years. ADHD children were diagnosed according to DSM-IV and "conners scale" and DAT1 3'-UTR VNTR was genotyped by PCR technique.
The genotypes and allelic distribution of the DAT1 3'-UTR VNTR were not significantly different between the case and control groups (p>0.05) but a significant difference was found in allelic frequencies when the analysis was confined to females (p=0.029).
Our results do not support the role of 10 or 9-repeat alleles as risk alleles in the studied subjects but an association was found between 11-repeat allele and the susceptibility to ADHD in females.

This study examines the effects of adopting external and internal focus of attention on learning a static balance skill in children with mild mental retardation. The participants included 45 children with mild mental retardation in three groups: external focus, internal focus, and control. Motor tasks were used for the static balance, and the time children performed the skills without error was considered as the dependent variable. The students performed the pretest, the acquisition phase (including five 3-minute practice blocks), and posttest. In each exercise block, the children in the external focus group were instructed to focus on a red marker on the ground, while children in the internal focus group focused on their feet. Descriptive findings showed that the age means of the participants in external focus, internal focus, and control groups were 14.29, 14.62, and 13.84 years, respectively. And the means of their BMI were 21.27, 23.52, and 23.51 kg/m2, respectively. The results showed that external focus could improve motor learning. However, there was no significant difference between mean scores of the internal focus and control groups. Furthermore, children in the external focus group reported that they focused more on the external sign (red marker) rather than the internal sign (body part) when performing the skills, while the opposite was true for those in the internal focus group. The results show that children with mental retardation benefited from adopting an external focus of attention to learn a static balance. This finding may indicate that these children have mechanisms such as goal-action coupling, which are needed to learn new motor skills through external focus of attention.

This study examined the diagnostic accuracy of the children's communication checklist-Persian version (CCC-Persian) in differentiating children with autism spectrum disorders (ASD) from typically developing (TD) children.
The parents of 47 children with ASD and the parents of 104 TD children completed the CCC-Persian. The children were monolingual Persian-speakers between 5 and 11 years of age. The sensitivity, specificity, likelihood ratios, and cut-off score of the CCC-Persian were calculated in identifying children with ASD.
The mean pragmatic composite score (PCS) of the CCC-Persian was significantly lower in children with ASD than in the TD children (P>0.05). Corresponding cut-off score, sensitivity, and specificity were 107, 86%, and 97%, respectively. The positive and negative likelihood ratios were obtained as about 30 and 0.14, respectively.
The CCC-Persian has the potential to be used as a valid clinical tool for diagnosing pragmatic language impairment or screening ASD in Persian-speaking children.

Congenital chylothorax is a rare cause of respiratory distress in the newborns. It has a high mortality rate and its prognosis depends on the time of the diagnosis, etiology and therapy.The chromosomal gain, duplication of 28 Mb, including more than 200 genes, in the long arm of chromosome 7 (seq [GRCh37] 7q21.13q31.31, chr7:g.89783721_117877082dup) is very rare and is established as the likely etiology in this clinical case.Phenotypic reports of chromosomal imbalances are an important source for genetic counseling.

Local anesthesia injection is one of the painful and stressful experiences in children during dental procedures. Distraction is one of the non-pharmacological methods for controlling pain during treatments. Using video games is one of the distraction methods. The aim of the present study was to determine the effect of video game distraction on pain control during the inferior alveolar nerve block administration in 6-9-year-old children.
This is a randomized controlled clinical trial, in which 33 girls and 27 boys were divided into control and experimental groups. The experimental group was provided with a video game prior to the anesthesia injection, but the control group only had the parents by their side. Children's behavioral response during anesthesia injection was measured by the face, legs, activity, cry and consolability (FLACC) scale and the Wong Baker Faces Pain Self-Rating Scale. The obtained results were analyzed using independent t-test, chi square, Mann-Whitney and Kruskal-Wallis tests in SPSS ver. 16.
FLACC scale showed a statistically significant difference between the control and experimental groups (P = 0.013). That is the mean pain score in the experimental group (1.1 ± 10.18) is lower than the control group (2.2 ± 86.24). Also, Wong Baker scale also showed a statistically significant difference between the control and experimental groups in terms of the mean pain self-assessment score (P <0.0001). That is, the mean pain score in the experimental group (1.1 ± 67.82) was lower than that in the control group (4.2 ±62.82).
The results of the present study showed that video games have a positive and significant effect on pain control during the inferior alveolar nerve block among 6-9-year-old children.

It has been reported that the incidence of cow's milk protein allergy (CMPA) has increased in recent years, especially among infants in the first year of life. It is thought that the use of antibiotics may trigger the development of CMPA by causing intestinal dysbiosis and altering immune response, and thus, it may be a factor responsible for the supposed increase. The relationship between antibiotic use and the development of CMPA has been evaluated in very few studies in the literature. Our aim is to evaluate whether CMPA development is associated with antibiotic use during pregnancy or neonatal period. The development of CMPA within the first year of life among infants hospitalized and followed up in the Neonatal Intensive Care Unit (NICU) of Karabuk University Faculty of Medicine, Training and Research Hospital, between January 1, 2017 and October 30, 2020, was evaluated. During the study period, 1120 babies were followed up in our NICU. When the data of 975 babies who met the inclusion criteria were evaluated, it was found that the use of antenatal and conclusion postnatal antibiotics did not increase the development of CMPA. The data of our study contradicts the two study of which previously associated maternal and infant antibiotic use with the development of CMPA.This contradiction suggests that the aetiology of CMPA is multifactorial and more studies are needed to elucidate the antibiotic-CMPA relationship.

The prevalence of eosinophilic esophagitis (EoE) has increased in recent decades. Recent studies have found that the prevalence of EoE in patients with celiac disease (CD) is much higher compared with the general population. In this study, the prevalence of EoE in children with CD was calculated and their clinical symptoms, endoscopic and histopathological findings were compared.
This was a retrospective study conducted on the data records of the patients diagnosed with celiac disease during 2012-2020, and registered at Imam Hossein Children’s Hospital and the Institute of the Celiac Association in Isfahan, Iran. Clinical findings, endoscopic reports, serological and histopathological data of the patients were recorded and analyzed.
A total of 80 children with CD were included in the study. The mean age of the patients with CD and EoE (n=8) was 7.75± 3.99 years, and in children with CD alone (n=72), the mean age was 7.85± 3.83. The most common clinical findings were abdominal pain, anorexia, diarrhea and constipation. There were no significant differences in the symptoms of either group. The most common endoscopic view was duodenal scalloping and esophagitis; and 50% of EoE patients had a normal endoscopic view of the esophagus. With regards to serological findings, the level of TTG-IgA (U/ml) in the CD and EoE group was higher than the CD group (183.73 ± 101.54 vs. 117.07 ± 95.34 U/ml); however, no statistically significant difference was observed.
Our study found that the prevalence of EoE in children with CD appears to be higher than in previous studies.  We have also shown that the presence of EoE cannot be detected solely based on clinical and even endoscopic results.  Therefore, an esophageal biopsy is recommended in celiac patients.

Proper management of the Corona pandemic is one of the most critical issues causing a serious crisis for the health care system in all countries. This management includes the prevention, treatment and control of complications. Due to the large number of cases in the recent pandemic and the limited health facilities in the hospitals, the use of more cost-effective solutions, especially home care and the use of telemedicine in the management of coronavirus is increasing day by day.
Candidates for home treatment must meet certain requirements, including the stability in the patient’s general condition, the possibility of care taking at home by other family members or health care staff, access to personal protective equipment (at least gloves and masks), and not having people with heart, lung or kidney disease among the people living at home. It is also necessary to monitor the person's symptoms regularly. If the patient's symptoms worsen, especially in cases of shortness of breath, worsening of the coughs, decreased level of consciousness or fever for more than 5 days, there is a need to contact the medical system. Providing home care treatment solutions can be considered as a part of Transformation management in the recent Corona epidemic.
There is still a lot unknown about how to manage the Covid 19 patients and information in this field is rapidly increasing