International Journal of Pediatrics
Volume:10 Issue: 102, Jun 2022

Cystic fibrosis (CF) is an inherited disease which involves multiple organs including respiratory tract. It results in chronic respiratory signs and symptoms which exacerbate with frequent lung infections. The majority of exacerbations require hospitalization and intravenous antibiotic therapy as part of the management. The aim of this survey was to study the effectiveness of outpatient management of pulmonary exacerbations on pulmonary function tests. This randomized clinical trial included all CF patients older than 6 years old who presented with a pulmonary exacerbation and were able to perform Spirometric tests. All eligible CF patients first referred to pulmonary function tests center to determine forced expiratory volume in the first second (FEV1), residual volume (RV), total lung capacity (TLC) and airway specific resistance (SRaw). Then, they were treated outpatiently for 2 to 4 weeks and after that, they underwent all the tests again; and the participants’ improvements in pulmonary function tests after outpatient treatment were investigated. In this study, 32 patients were enrolled including 13 women (40.6%) and 19 men (59.4%). Mean and standard deviation (SD) of pulmonary variable, before and after the treatment were investigated. All of them were statistically significant. Sub-analysis of data based on gender was also performed showing that outpatient treatment led to significant improvements in all of the variables except for the percentage of RV in females (p value = 0.08). The findings revealed that outpatient management of CF exacerbations effectively improved values of FEV1, SRaw and TLC along with reducing RV values and air trapping. Thus, applying this method on appropriately selected CF patients, may prevent unnecessary hospitalization and subsequent disadvantages.

The emotional bonds that develop between the coach-athlete and the athlete-athlete in team sports, such as loving each other, mutual trust, respect and appreciation, are effective in the success of the team. The individual's feeling of commitment to the team ensures that coaches and athletes maintain a good relationship. In order to increase the performance of the athlete, it is necessary to work together in a harmonious and motivated way. The aim of this study is to examine whether the group cohesion of adolescents who play team sports is related to social connectedness and general belonging variables and whether it is predicted by these variables. This research is a relational study aiming to reveal whether group cohesion is predicted by general belonging and social connectedness levels in adolescents participating in team sports. A total of 344 athletes, 115 (33.4%) girls and 229 (66.6%) boys, from sports clubs competing in football, basketball and volleyball branches in Istanbul in the 2020-2021season participated voluntarily. Social Connectedness Scale-Revised (SCS-R), General Belongingness Scale and Group Environment Questionnaire were used in the study. Multiple linear regression was used in data analysis. When the results of the regression analysis are examined, it is seen that the general belonging and social connectedness variables are significant predictors of group cohesion in terms of their contribution to the variance. It is seen that the variables of general belonging and social connectedness explain 22% of the total variance. The variable that contributes the most to the model is the social connectedness variable. The increase in the level of general belonging and social connectedness in adolescent individuals participating in team sports increases the group cohesion of individuals

A number of researches have discussed the overlap of symptoms or the simultaneous occurrence of allergic proctocolitis due to consuming cow's milk allergy and gastroesophageal reflux in infants. The present study aimed to assess the relationship between gastroesophageal reflux disease and allergic proctocolitis (eosinophilic) in one- to six- month-old infants. This case-control study was performed on one- to six-month-old infants referred to the Pediatric Gastroenterology Clinic for whom gastroesophageal reflux disease was diagnosed as the case group (n=95); and the same number of age-matched infants without gastrointestinal problems referred for periodic care were included as the controls.  (n = 95). The diagnosis of allergic proctocolitis was made for subjects whose WBC and RBC were found to be higher than the normal range in their stool samples. The prevalence of allergic proctocolitis in the two groups with and without reflux was 36.8% and 5.3%, respectively, indicating a significant difference (P < 0.001). According to the multiple logistic regression model, the chance of developing allergic proctocolitis in the case group with gastroesophageal reflux was 12.2 times higher than the control group (OR = 12.2, P< 0.001). Boys were also 2.6 times more likely to be affected by proctocolitis than girls (OR = 2.6, P = 0.025). Developing gastroesophageal reflux, especially in boys, will be associated with an increased risk of developing allergic proctocolitis.

Cystic fibrosis is a multisystemic disorder. It is the most common autosomal recessive disorder in whites that causes complications such as changes in bone density. Therefore, evaluating bone densitometry and serum levels of vitamin D in children with cystic fibrosis is the aim of our study.
This study was performed on 54 children with cystic fibrosis. After recording demographic information, bone densitometry and serum levels of vitamin D were recorded. Chi-square and Pearson correlation tests were used to compare data.
Based on our study 53.7% of patients with CF had vitamin D less than 20 nmol / l. It was also found that based on lumbar BMD, 20.3% had a BMD less than 2.5 - Based on femoral BMD, 18.5% had a BMD less than -2.5. And our results demonstrated that there is no relation between BMD with vitamin D, calcium and phosphorus but it is significantly correlated with age, height, weight, and BMI.
Decreased BMD is high in patients with CF; on the other hand there is a deficiency of vitamin D in more than 50% of these patients to whom vitamin D supplements should be prescribed along with the standard treatments. Further studies are also required to investigate the effect of other factors on BMD.

It is critical to identify the factors that influence mothers' decision to discontinue breastfeeding and use formula. The purpose of this study is to compare the characteristics of breast-fed and formula-fed subgroups in order to identify the factors influencing the discontinuation of exclusive breastfeeding in a group of Iranian infants.

The data of the two groups of women who fed their infants with breast milk (n = 275) or formula (n = 275) were gathered by the use of a questionnaire including questions regarding maternal demographics, breastfeeding-related problems, infant disorders, and factors that influence formula preference. Face-to-face interviews with the mothers of the children were used to obtain the questionnaire data by a trained interviewer. In SPSS version 22, descriptive and inferential statistics were used to analyze the data.

Lack of weight gain (32.8 %), inadequate breast milk (51.3 %), return to work (9.1%), teething (0.7%), mothers' disorders (3.6 %), and infants' disorders (2.5 %) were the most common reasons for starting formula feeding. Physicians (34.5 % versus 21.5 %), health providers (26.5 % versus 30.5 %), health assistants (26.9% versus 26.7 %), and books (12.0 % versus 16.7%) are the main sources of information about the types of infantile feeding in the groups of mothers who use formula or breast-feeding, indicating a significant difference between the sources used by the two groups (p = 0.001).

Formula use is primarily motivated by two factors: apprehension over the insufficiency of breastfeeding and a lack of time to do so. As a result, comprehensive education for mothers about the necessary cases of formula feeding is critical

The aim of this study was to investigate the effects of instructional and motivational self-talk on learning a dart throwing skill in children with mild mental retardation.
The subjects included 45 children with mild mental retardation who were equally divided into three groups of instructional self-talk, motivational self-talk, and control. The motor task included darts throwing skill in which children’s darts throwing scores as well as self-efficacy were measured as dependent variables. The Participants performed pre-test (including 15 throws), acquisition phase (including five 5-minute practice blocks), and retention test (including 15 throws). The participants in the instructional self-talk group were asked to repeat the “Center-Target” phase before each attempt during the training phase and then throw the dart. Those in the motivational self-talk group were asked to use a motivational phrase “I Can" before the throw. The children in the control group followed a similar protocol but were not given any self-talk instructions.
The results showed that mentally retarded children who practiced instructional self-talk had better performance than those who used motivational self-talk and the control group in throwing darts in the retention test (P=0.000). Moreover, the motivational self-talk group performed better than the control group in dart throwing in the retention test (P=0.000). Finally, the results showed that children in the instructional and motivational self-talk groups reported higher self-efficacy scores than those in the control group in the retention test (P=0.000), while no significant difference was observed between the instructional and motivational self-talk groups. (P=0.527)
The results of this study show that children with mild mental retardation are able to learn motor skills through self-talk.

Due to COVID-19 disease, children of all ages seem susceptible to COVID-19; thus, preventing children from COVID-19 disease is a serious duty. One of the preventive strategies in children is the behavior of mask-wearing. Recently, many parents have stated concerns to doctors and social media about whether masks may be harmful for their children. Incorrect news about the negative effects of face masks has also been increasing. Therefore, this letter aims at answering the most common and most important parents' worries about children’s wearing face masks

The associations between the epidemiological, clinical, and serological features of coronavirus disease 2019 (COVID-19) and the nasopharyngeal viral load have not, yet, been understood completely.
This cross-sectional single center study of outpatient children and adolescents was conducted between January and March 2021. Reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal swab specimens was positive for SARS-CoV-2. Nasopharyngeal Cycle threshold (Ct) values were measured for all patients considering different clinical features, age, and sex, in presence of covid-19 specific serum antibody.
The data of 70 individuals with confirmed COVID-19 were analyzed (mean (range) age: 9.6 (5-14) years; 29 females (41%)). Sixty-four children (91.4%) were symptomatic at the time of sampling (mean time of symptom onset, 3.9 days). There were no differences in mean Ct values between the symptomatic and asymptomatic patients (31.4 vs 28.8, p=0.247). Ct values were significantly lower in cases with diarrhea (p=0.044) and younger children (p=0.003). No correlation was found between Ct values and gender (p=0.415). Serum antibody was measured in 25 (36%) patients. Presence of antibody was not associated with Ct values (p=0.121). Fifty-nine cases (84.3%) reported exposure to a SARS-CoV-2 positive household.
Higher nasopharyngeal Ct values, suggesting lower virus load, are related to older age, but there is no difference in Ct values between genders. Considering that diarrhea may predict lower Ct values in the respiratory system, the importance of early quarantine of children with atypical symptoms (such as gastrointestinal symptoms) or children in contact with a confirmed COVID-19 family member is highlighted

Excessive consumption of Sugar-Sweetened Beverages (SSBs) is a health problem in most societies today, which has adverse consequences in health, social and economic areas. The aim of this study was to investigate the effect of the application of social cognitive theory (SCT) in the design and evaluation of an educational intervention in order to adopt behaviors to prevent excessive consumption of SSBs in students.
The current research was a quasi-experimental study. Using multistage sampling, 100 Junior High-school students in Urmia, Iran in 2021 were selected and assigned to two groups, namely intervention (n=100) and control (n=100). To collect the study data, the researchers utilized a researcher-made questionnaire including items about demographic information and SCT constructs such as awareness, outcome expectations, self-regulation, self-efficacy, social support , barriers and Preventive behaviors, which was completed in two stages before and three months after the last training session; the data were analyzed using the SPSS software version 25.0.
The mean age of the participants in the intervention and control groups was 13.71 ± 0.71 and 13.84 ± 0.81, respectively. Before the intervention, the mean scores of social cognitive theory structures and desired behavior were not significantly different between the two groups. But three months after the intervention, the mean scores of knowledge constructs, outcome expectations, self-regulation, self-efficacy, social support, perceived barriers, and desirable student behavior showed a significant difference between the two groups (P<0.001).
The results of the study revealed that social cognitive theory can be used as a theoretical basis for designing and evaluating interventions to encourage people to follow a proper diet and reduce the consumption of SSBs.

This study aims to compare the COVID-related anxiety and depression between Midwives and nurses working in pediatric wars and the other clinical settings during the COVID-19 outbreak.

Random sampling method was implemented for sample selection. Modified Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression related to COVID-19; and the data was analyzed through linear regression.

In this study, 88.6% of the participants were female and the mean age of nurses was 30.41 ± 6.59 years. 36.4% of the nurses were midwives, 35% were pediatric nurses and the rest were other nurses. The mean and standard deviation of anxiety and depression scores were 12.76 ± 7.75 and 1.78 ± 2.27, respectively. 92.9% of the participants were anxious and 11.4% were depressed. The variables of marital status and sports activity had a significant effect on nurses' depression scores.

Anxiety and depression scores were not significantly different among the treatment staff. The prevalence of COVID-19 anxiety was high among hospital staff in Iran and the prevalence of depression was moderate, which can have detrimental effects on the quality of care provided by nurses and midwives to the patient.

More than 20 years after the introduction of the mumps vaccine in the Iranian national vaccination program, there are concerns about meningitis induced by the Measles, Mumps, and Rubella (MMR) vaccine. The aim of this study is to virologically determine the incidence of MMR-induced meningitis in Mashhad, Iran.

This is an observational prospective study during which all children who were admitted (in all hospitals of Mashhad) under the clinical suspicion of meningitis and had a history of MMR vaccination during the past 45 days were included. A polymerase chain reaction (PCR) test for mumps virus and enterovirus (EV) was done on cerebrospinal fluid (CSF) samples with pleocytosis.

During 13 months of study, 55 children were hospitalized for suspicion of meningitis and had a history of recent MMR shots (94% presented with a febrile seizure). Meningitis was confirmed by CSF pleocytosis in 23 (2 bacterial and 21 aseptic) cases (44.2%). All incidents of meningitis had occurred after the first MMR. The incidence of any kind of aseptic meningitis, EV meningitis, and mumps meningitis during 45 days after the first MMR was, respectively, 19.9, 5.71, and 1.9 per 100,000 cases. The number of meningitis cases during the first 3 months after MMR was, respectively, 4.5 and 2 times more than the cases that occurred during the 3 months before and 3-6 months after MMR.

Around 40% of all cases of meningitis (between 4 and 43 months of age) occur during the first 3 months after the first MMR vaccination (12-15 months). The disproportionate increase of aseptic meningitis after the first MMR is strong epidemiologic evidence in favor of mumps vaccine induced meningitis.

Type 1 Diabetes Mellitus (T1DM) is a chronic disorder that can cause microvascular and macrovascular damages in the long term as well as higher rates of mortality and morbidity in infectious diseases such as Covid-19. It has been discovered that the homeostasis of trace electrolytes like magnesium plays a crucial role in the pathogenesis of diabetes and its related complications. We aimed to determine serum magnesium levels in children with T1DM in northwest Iran and to evaluate the relationship between serum magnesium levels and glycemic control while also assessing several anthropometric and birth-time-related factors. This cross-sectional study gathered data from 50 patients with T1DM and 50 other healthy subjects matched for age and gender living in the northwest area of Iran. These children were tested during their visits to the children’s hospital of Tabriz. Magnesium levels and environmental factors were measured in all study subjects. We found magnesium levels to be significantly lower in children with T1DM (p < 0.001). Hypomagnesemia was also seen in 58% of the case group, which was significantly more prevalent than the 6% in the control group (p <.001). We observed a negative correlation between serum magnesium and HbA1c levels in the diabetic group (r = -0.882, p <.001). No significant correlation was found between magnesium levels and duration of diabetes, age, and gender. We concluded that total serum magnesium is lower in children with T1DM, which correlates with glycemic control. Further and more extended studies should be conducted to assess the effect of correction of serum magnesium in diabetic children with hypomagnesemia on glycemic control and the risk of diabetic complications.

Undoubtedly, playgrounds should be safe and secure environments for children so that children can play in them, enjoy the game and gain different experiences. Despite the above, the statistics regarding the playground environmental incidents in urban areas indicate a lack of proper attention to the safety of playgrounds. The purpose of this study is to evaluate the safety of children’s playgrounds from the perspective of parents in district 3 of Tehran. The sample of the present study included 295 children from district 3 of Tehran, Iran. The data was collected by the use of standard questionnaires. Also, in order to organize, summarize and describe the data, descriptive statistics (frequency, percentage, mean and standard deviation) were implemented, and in order to test statistical assumptions and prioritization with the normally distributed data, T-Hotelling test and Friedman test were performed. It should be noted that in this study, SPSS software version 23 was used to analyze the data, also the level of reliability of the scale used in this study is 95%. The results of the t-hotelling test showed that the safety of design, the safety of the equipment and the safety of the environmental features in children's playgrounds were in good condition in Tehran's third district. The differences and priorities among these components are also identified

This case report describes a 30-month-old child with primary pulmonary rhabdomyosarcoma with a congenital cystic adenomatoid malformation (CCAM). In the current literature, primary pulmonary neoplasms have been reported for similar cases. The tumor was located in the anterior-basal segment of the left lower lobe with a thin-walled cystic appearance and lobulated margins. A histology examination showed rhabdomyosarcoma origin with an embryonal subtype. Postoperative systemic chemotherapy was carried out. After a 6-month follow-up, the patient had no residual or recurrent disease.

We report the case of a 14-year-old girl with huge cervical intramedullary lipoma, who presented with spastic quadriparesis. Her MRI revealed an intramedullary lipoma extending from the craniovertebral junction to the sixth cervical vertebra. There was no spinal dysraphism. Subtotal excision of tumor with primary dural closure and laminoplasty was performed from C3 to C6, which produced an improvement in the patient’s function.

Cesarean section plays an important role in reducing mortality and complications for the mother and fetus, in high-risk childbirths. But the problem with modern midwifery is the high prevalence of cesarean sections. The aim of this study was to investigate the prevalence and causes of cesarean sections in primiparous women.

In the present descriptive cross-sectional study, all pregnant women referring to Ali-Ibn-Abitaleb Hospital in Zahedan, Iran, for cesarean section during a year from April 2018 to March 2019 were enrolled. The data including the participants’ demographic information and reasons for the cesarean sections were extracted from the patients' files and recorded in a pre-designed form. Data were analyzed using SPSS statistical software, V. 21.

Out of 174 cases, 44.2% of them ended to cesarean section because of maternal causes, among which 27.5% had delivery arrest, 2.5% preeclampsia, 4.6% chorioamnionitis, 3.5% Placental abruption and HELLP syndrome, and CPD was 4.3%. The fetal causes with a prevalence of 55.8% included fetal distress with 19%, placental abruption with 12%, multiple births with 11%, placental and umbilical prolapse with 9.2%, and macrosomia with 4.6%, respectively.

Lack of progression in labor and then fetal distress were, respectively, the most important causes of cesarean delivery in primiparity women. The other maternal reasons comprised the third leading cause of cesarean sections in these women

This study reports the case of an infant patient with organized vitreous hemorrhage (VH) due to hemi-central retinal vein occlusion (Hemi-CRVO) secondary to thrombocytosis.

A twenty-seven-day-old female infant with the gestational age of 30 weeks and 2040 grams weight at the time of birth and the history of a twenty-five-day admission in a neonatal intensive care unit (NICU) due to idiopathic hydrops was referred to the retinopathy of prematurity (ROP) clinic of the Khatam-al-Anbia Eye Hospital, for usual ROP screening. We found an organized VH in her left eye; so, we vitrectomized her eye. With the diagnosis of hemi-CRVO due to thrombocytosis, she is under observation.

In this report, thrombocytosis showed to be a cause of hemi-CRVO; and the patient’s laboratory test review is important in such cases