International Journal of Pediatrics
Volume:10 Issue: 106, Oct 2022

Previous studies have shown that parental socioeconomic status directly affects the participation of children in physical activities and consequently the improvement in their motor competencies. Nevertheless, this issue has been less studied in children with ADHD. Therefore, the present study was designed to investigate the associations between parental socioeconomic status and motor competence considering physical activity as a mediator.
The present study followed a descriptive-correlational approach using structural equation modeling (SEM). The statistical population of the study included 86 male students diagnosed with ADHD (mean age of 8.36±1.07) who attended in a special school in Tehran. Short-Form Bruininks-Oseretsky Battery, Parental Socioeconomic Status Scale, and Physical Activity Questionnaire for Children were used for data collection. Pearson correlation test and structural equation modelling were used for investigating the relationships between the research variables.
The mean BMI of the participants was 16.9±1.84, placing the BMI-for-age at the 70-percentile indicating that they have healthy weights. Children in this study were in the lower-average level of motor competence (e.g., balance, upper limb coordination, and strength), their parents were mostly at medium level of socioeconomic status, and the physical activity level of the children was lower than average (M=2.23). In addition, parental socioeconomic status positively affected motor competence (T=6.862) and physical activity (T=5.151), and physical activity positively impacted motor competence (T=5.593).
Low amounts of physical activity in our sample make it necessary to find out appropriate factors and strategies to enhance it in children with ADHD. According to our findings, education and income of parents along with the children’s participation in physical activity may be critical concerns for their health.

Melatonin is effective as a treatment option for sleep disorders in children. Parents can develop positive sleep habits in children through behavior therapy. This study aimed to evaluate the effects of melatonin on children undergoing behavioral therapy.
The present study was performed on 60 children (1–3-year-old, male and female). Thirty children were randomly selected as the treatment group, treated with melatonin. All of the participants in both treatment and control groups and their parents were taught how to observe sleep hygiene and behavior therapy through a graduated extinction method. The Pediatric Sleep Clinic Questionnaire Background Information (for 1–3-year-old children) was used in this research. Parents in both groups were educated on sleep hygiene and behavioral therapy. The data was analyzed through paired t-test and chi-square (p < 0.05) using SPSS 18 software program.
Mean ± SD (standard deviation) of age was 27.33 ± 8.99 months in the behavior therapy/melatonin-treated group, while it was 23.10 ± 10.76 months in the behavior therapy/non-melatonin-treated group. There was a significant difference between the two groups regarding breastfeeding (p <0.05). Moreover, significant differences were observed between the two groups in terms of the average number of waking ups during the night, the length of wakefulness of a child at night (in minutes), the time of waking up in the morning, the average sleep time at night (in hours), and the relationship between sleeping in parents’ bed and parents staying in the child’s room after the lights were switched off (p <0.05).
The quality of night sleep in the melatonin-treated group was better than that in the group that did not receive melatonin. Therefore, proper medical treatment along with psychological and behavioral therapies can be helpful for treating sleep disorders

Traumatic Brain Injury (TBI) in children is one of the most common causes of death and disability in children. Cardiac arrhythmias can be cited as one of the main factors influencing the mortality and morbidity of these children. The purpose of this study was to investigate the frequency and types of cardiac arrhythmias in children with TBI in the Intensive Care Unit (ICU) of Bahonar Hospital in Kerman.
This study is a cross-sectional descriptive-analytical study examining patients under 18 years of age who were admitted to the ICU with TBI during 2018-2019 for cardiac arrhythmias. Data were collected using a checklist, including demographic characteristics and other variables in the patient’s file. Finally, the data were analyzed using SPSS version 22.
Forty-six of the 240 traumatized patients admitted to the ICU developed cardiac arrhythmias, the most common of which was sinus tachycardia. The incidence of arrhythmias was significantly higher in patients with subarachnoid hemorrhage (SAH), cerebral contusion, and intracerebral hemorrhage (ICH) than in those with other brain lesions. Most bradycardia was seen in mixed lesions. Dangerous arrhythmias, such as bradycardia and ventricular tachycardia (VT), were also significantly more common in the severe trauma group.
It seems that in children with a head injury, the incidence of cardiac arrhythmias is significantly associated with the Glasgow Coma Scale (GCS) and some lesions due to brain trauma such as SAH, ICH, and brain contusion.

Trauma is an important cause of disability and death in young people.  This study aimed to investigate the association between serum lactate level and in-hospital mortality in multi-traumatic children.

In this cross-sectional study, all children with multi-trauma admitted to the emergency department in Shohada and Imam Reza hospitals of Tabriz/Iran were evaluated from 2018 to 2020. At the time of admission to the emergency department, serum lactate, PRISM (Pediatric risk of mortality) score, and other findings as well as outcome were checked and correlated with the outcomes for all patients. Patients were classified into two groups (based on outcome) and six groups (based on lactate levels) to evaluate associations between results. The Chi-square test, independent samples t-test, ANOVA, and multivariate logistic regression test were performed in SPSS.22. P-value<0.05 and OR with 95% confidence interval were considered statistically significant.

Out of 110 admitted children, 10 (9%) died in hospital. Mean lactate level was 3.2 mmol/l and 85 patients (77.2%) had lactate level>2 mmol/l (millimoles). The initial blood lactate level was directly correlated with mortality.  This relationship was confirmed even after adjusting for variables such as the PRISM score (OR = 1.27; 95% CI, 1.19-1.35; P <0.001). Multiple regression study showed that a high lactate level (OR =1.17; 95% CI, 1.07-1.29; P=0.001), high PRISM score (OR = 1.15; 95% CI, 1.11-1.20; P<0.001), and low albumin level (OR =0.92; 95% CI, 0.88-0.96; P<0.001) were independent risk factors for mortality.

High blood lactate level was an independent factor in the increase of mortality rate in the emergency department.

This study aimed to assess the symptoms and clinical laboratory data of pregnant women with COVID-19 in their second or third trimester of pregnancy as well as their maternal and neonatal outcomes.
This retrospective observational study was conducted on 177 pregnant women with COVID-19 who were admitted to Yas hospital (affiliated with Tehran University of Medical Sciences), and Ali-ibn-Abi-Talib hospital (affiliated with Zahedan University of Medical Sciences).
There was significant higher complaints including fever (p-value=0.015), cough (p-value=0.028), fatigue (p-value=0.002), dyspnea (p-value=0.022), and lower hemoglobin level (p-value=0.009) in patients who were in their third trimester compared to those who were in their second trimester. 9.6% (n=17) of the patients had severe disease and needed ICU admission. There was a significant variation regarding gestational age (p-value=0.022) in pregnant women admitted to ICU compared to the other ones. During the study, delivery happened in 108 (61%) pregnant women. Fetal distress following meconium deification (p-value=0.041), need to MGSO4 (p-value=0.001), IUFD (p-value=0.006), need for blood transfusion (p-value=0.004), and neonatal death (p-value<0.001) were significantly higher in patients who needed ICU admission.
Higher gestational weeks are the main risk factor for severe COVID-19 disease. Although vertical transmission is rare; due to the higher risk of perinatal outcomes, the delivery should be done in a center with a NICU department.

Urinary tract infection (UTI) in children is a serious condition that should be treated promptly and properly to prevent further complications. The most common causative agent of UTI is Escherichia coli (E.coli). This study aims to investigate the resistance profile of E.coli in pediatric cases of UTI.
In this cross-sectional study, the positive cultures for E.coli in patients admitted in Dr. Sheikh Children Hospital of Mashhad, Iran, in Feb 2020 to Feb 2021 were assessed. The demographic factors including age and sex were excluded. Urinalysis was conducted to assess the number of bacteria (categorized as mild, moderate, and many) and the WBC count (categorized as > 5/hpf, > 10/hpf, and > 15/hpf). Furthermore, the antibiogram was consulted to assess the sensitivity and resistance to different antibiotics. Data was analyzed using SPSS software.
In 160 children (20 males and 140 females) with the mean age of 24.00 ± 26.06 months, urinalysis showed that 22.5% were in the mild bacteriuria category, 21.3% in moderate bacteriuria, and 56.3% in the many bacteriuria category. For WBC count in urine, 12.5% had more than 5/hpf WBC, 11.9% had more than 10/hpf WBC, and 75.6% more than 15/hpf WBC. Regarding resistance, 4.5% of the patients were resistant to Amikacin, 6.5% to Nitrofurantoin, 20% to Ofloxacin, 35.1% to Ciprofloxacin, 50% to Gentamicin, 52.6% to Cefixime, 59.5% to Cefazolin, and 76.1% to Trimethoprim. The mean age and also the frequency of sex showed no significant difference between different severities of bacteriuria and WBC count in urine analysis (P > 0.05).
The highest E.coli resistance was to Trimethoprim, Cefazolin, Cefixime, Gentamicin, and Ciprofloxacin. The lowest resistance was to aAmikacin and Nitrofurantoin.

internal carotid intima thickness has been identified as a predictor of atherosclerosis. Patients with type 1 diabetes are at risk for macrovascular complications. Atherosclerosis is 2 to 4 times more common in patients with diabetes, which exposes them to mortality and morbidity. The aim of this study was to determine the thickness of internal carotid intima thickness in children and adolescents with type 1 diabetes and its relationship with cardiovascular risk factors in Iranian children and adolescents with type 1 diabetes.
The present study is a cross-sectional study that was performed in Mofid and Imam Hossein hospitals in Tehran from 2020 to 2021. A total of 91 patients with type 1 diabetes in the age range of 6-18 years, who have been diagnosed with diabetes for at least three years, were included in the study as a diabetic group.
In total, 91 children and adolescents with type 1 diabetes were included in this study, of which 44 (48.4%) were boys and 47 (51.6%) were girls. The mean age of patients was 12.24 ± 3.17 and ranged from 6 to 18 years. The mean age of the patients at the time of diagnosis was 5.86 ± 2.98. In this study, blood pressure of 6 patients (6.6%) was abnormal and the rest had normal blood pressure. In addition, the mean duration of disease in this study was 6.3 ± 2.57 years. The insulin of most patients (93.2%) was Analogue and only 8.8% of patients used Neutral Protamine Hagedorn (NPH) and Regular. The thickness of the intima of the right internal carotid artery is 0.54 ± 0.05 and the thickness of the intima of the left internal carotid artery is 0.48 ± 0.07.
According to the results of this study, none of the factors of disease duration, age of onset, blood pressure, cholesterol, triglycerides, LDL (Low-Density Lipoprotein), HDL (High-Density Lipoprotein), HbA1C (Hemoglobin A1c), history of CHD (Coronary Heart Disease) and hyperlipidemia were significantly associated with the thickness of the intima of internal carotid artery. However, body mass index showed a significant relationship with the thickness of the left internal carotid intima.

Writing disorders have an adverse effect on students' academic achievement in school. These children need to learn new concepts or skills that they have not learned in the usual way through new methods such as multisensory teaching. Therefore, the aim of the present study was to compare the effectiveness of Fernald’s and Rossner’s multisensory teaching methods on reducing the spelling disorder of elementary school students in Tehran.
Using a multi-stage cluster sampling method, 120 research samples were selected from third and fourth grade elementary school students in districts 6 and 11 of Tehran in the academic year of 2018-2019 and randomly divided into two experimental groups (15 students each) and one control group (15 students). Research instruments included Fallah Chai Spelling Test (1974), the Wechsler Intelligence Test for Children, and Fernald’s and Rossner’s Multisensory Teaching Protocols.
Fernald's multisensory teaching method was found to be more effective than Rossner in reducing the post-test spelling disorders of the students. Furthermore, the students in Rossner's multisensory teaching group showed more reduction in spelling disorders in the post-test than those in the control group. Overall, the effectiveness of Fernald's sensory method was greater than that of Rossner's sensory training method.
The results showed that Fernald’s and Rossner's multisensory teaching methods are both effective on students with spelling disorders. However, Fernand's sensory method is more effective than Rossner's in reducing spelling disorders.

Positive social climate can influence academic performance, satisfactory cognitive and emotional results, and higher sport commitment. However, the social climate within the physical education class has rarely been investigated. The aim of this study was, therefore, to investigate the impact of social climate within the physical education class on the participation of children in physical activities, considering the mediating role of perceived relatedness.
This study followed a descriptive-correlational method. 384 children (192 girls) attending regular primary schools participated voluntarily in this study. Mean age of participants was 10.37 ± 1.07 years-old. Standard questionnaires were used to measure the research variables. Data was analyzed by the use of Pearson correlation test, independent t-test, and structural equation modeling.
Level of physical activity among children was almost low (2.10±1.09). In addition, boys had significantly higher amounts of physical activity than girls (t=-5.167, P<0.001). Social climate in the physical education class had significant effects on the participation of children in physical activity (T=6.366). Also, perceived relatedness support was revealed to significantly affect physical activity (T=5.947). In addition, perceived relatedness support significantly mediated the association between social climate and physical activity (P<0.001).
Social climate, relatedness support, and physical activity are critical concerns for children. Thus, there is a need to make a social and supportive climate in the physical education class. This can be achieved by increasing the quality of contacts and friendship among students.

Many parents are concerned about their child's final height with the onset of the larche. We decided to investigate the height potential in different stages of puberty.

731 healthy girls who had not yet completed puberty were studied. Bone age and predicted final height were assessed. The correlation of height potential with various indices has been investigated.

The Mean age was 9.88±1.3 years. The girls have a mean height potential of 28.90, 25.64, 20.89, and 13.76 cm in thelarche stages of 1, 2, 3, and 4, respectively (p =0.001), and a mean height
potential of 27.19, 21.46, 15.51 and 11.02 cm in pubarche stages of 1, 2, 3 and 4, respectively (p
=0.001). Height potential was inversely related to pubarche stage (p-value =0.004) , chronological age (r = 0.74, p-value =0.001), bone age (p-value <0.001) and Height Standard Deviation score (SDS) (p
<0.001). It was not related to the thelarche stage, target height, or BMI SDS. Linear regression showed that the height potential has a significant relationship with pubarche stage (P=0.004) but not with the thelarche stage ((P=0.267).

This study found that potential height has no significant relationship with the thelarche stage. On the other hand, pubarche is associated with advanced bone age and lower height potential.

Coronavirus, a common infectious disease in the 21st century, has not been studied enough in children. Therefore, this study aimed to investigate the clinical manifestations, laboratory findings, and outcomes of children with Covid-19 admitted to Shahid Beheshti Hospital in Kashan during 2020-2022.

In this retrospective cohort study, the medical records of children with covid-19 referred to Shahid Beheshti hospital in Kashan between February 2020 and March 2022 were reviewed. The information extracted from the patient's medical records included demographic variables, clinical characteristics, laboratory findings, and the outcome of covid-19. The collected data were analyzed through SPSS 16, using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (chi-square test and ANOVA).

The findings of 271 children (159 boys; 52% of the age group≤5 years) showed that fever (57.6%), cough (39.9%), nausea-vomiting (31.7%), and diarrhea were the most common clinical symptoms. Also, the majority of patients were in the abnormal range in terms of Monocyte (89.3%), PTT (84.7%), Lymphocyte (83.6%), Neutrophil (80.4%), and LDH (74.5%). Pulmonary involvement was present in 12.5% of children. Finally, four children (1.5%) died.

Severity of lung involvement and the outcome of the covid-19 disease (admission to the ICU and death) among children were at a low level, and in fact, it shows the better condition of children than adults in relation to this disease.

Story therapy can be used as an effective method in cognitive-behavioral therapy for children. The main purpose of this study was to investigate the effectiveness of tranquillisation stories on children's psychological well-being and aggression.
This study was quasi-experimental (controlled pretest-posttest). The population of this study included preschool children with 6-7 years of age, who were registered in preschool centers in the 2nd and 3th districts of Eslamshahr in 2018-2019. The sample size included 30 individuals (15 in the experimental group and 15 in the control group) who were selected by random sampling method.  Rutter's behavioral disturbances (teacher's form), Reef's psychological well-being questionnaire (1980) and storytelling method were used.
The study included children with a mean age of 5.67, among whom 60% were girls and 40% boys. The results approved the significant effects of tranquillisation stories on psychological well-being (F=3.7, p=0.031) and aggression (F=39.47, p=0.018) of the studied children (p <0.005).
Storytelling as a non-drug method is a good way to reduce aggression and increase psychological well-being among 6-7 preschool children in Tonekabon. Therefore, it is recommended that preschool teachers use this method to help children with aggression and mental health problems.

It has been shown that social support is an essential factor for participation of children in physical activity. However, this issue among children with ADHD has been rarely investigated. Therefore, the aim of the present study was to examine the effects of social support on participation of children with ADHD in physical activity with considering the emotional wellbeing as a mediator.
This study followed a descriptive-correlational method. Totally, 103 children with ADHD aged 10 to 12 years attended in the special school for children with ADHD participated in this study. Social support, physical activity, and emotional wellbeing were measured by the use of standard questionnaires. Data was analyzed through Structural Equation Modeling (SEM).
Descriptive data showed that our sample had relatively low amounts of physical activity, besides moderate levels of perceived social support and emotional well-being. Social support positively affected physical activity (T=6.954) and emotional wellbeing (T=6.954). Moreover, emotional wellbeing positively affected physical activity (T=6.954). Finally, emotional wellbeing significantly mediated the association between social support and physical activity (P<0.001).
The results of the present study indicate that urgent strategies should be adopted for children with ADHD, as they had small amounts of physical activity. Moreover, social support can be considered as a vital factor in the participation of children with ADHD in physical activities. Finally, we can consider emotional wellbeing as a moderating factor in the effectiveness of social support on the amount of physical activity among children with ADHD.

The purpose of the present study was to systematically review all published studies investigating the effects of only vestibular interventions on neurodevelopment, growth and vital signs in preterm infants (PIs).

PubMed, SCOPUS, Web of Science, CINAHL and EMBASE databases were searched to find relevant studies published from 1980 and June 2022. In addition, reference lists of the articles were also checked.

Twenty articles met the inclusion criteria. Fifteen of these articles reported studies conducted on stable preterm infants and five on unstable ones. Waterbed, rocking, hammock, air mattress and Vestibu_Guide stimulations were applied in eight, four, six, one, and one study, respectively. Twelve studies evaluated neurobehavioral development, five studies assessed neuromotor development, five studies evaluated the growth and fifteen studies assessed the vital signs in preterm infants using vestibular stimulations.

The results indicate that vestibular stimulations may improve neurodevelopment, growth and vital signs in premature infants, but there are still some disagreements among researchers, and further research is recommended.

Patients with Severe Combined Immunodeficiency are at high risk of Transfusion Associated Graft Versus Host Disease (TAGVHD) if they receive a non-radiated blood product that has a high mortality rate. This Case study reports on the case of a premature baby who had anemia of prematurity with a normal level of WBC. He received packed red blood cells, but after a while, he developed severe nausea and skin lesions. Endoscopy was done and the biopsy from the gastrointestinal lesions as well as the biopsy from the skin lesions showed graft versus host disease when he was 6 months old. However, he has received Hematopoietic Stem Cell Transplantation and is well now after about 4 months from his transplant.

Wiedemann-Steiner syndrome (WDSTS) is an exceptionally rare genetic syndrome characterized by postnatal growth retardation, facial dysmorphism, hairy elbow, and short stature. It is known that the occurrence of WDSTS is due to mutations in KMT2A gene. It is noteworthy that not a great number of WDSTS have been identified yet; thereby, new phenotypes and features continue to be added. In this report, we describe a 5-year-old male patient presented with developmental delay, hypothyroidism, facial dysmorphism, and behavioral signs such as autistic spectrum features. By Whole Exome Sequencing (WES), a new mutation in KMT2A was found and WDSTS was diagnosed genetically. According to a genetic test, a variant in exon 27 of the KMT2A gene c.6647delT (p.Pro2215fs) was found. This mutation was not reported previously, also this case was the first WDSTS diagnosed in Iran. This syndrome is a rare genetic disorder representing a broad range of phenotypes. The mentioned low frequency emphasizes the importance of a phenotype-genotype correlation to be established. The phenotype comparison between our case and previously reported patient did not reveal any difference related to age or sex in patients with WDSTS