Journal of Pediatric Perspectives
Volume:13 Issue: 134, Feb 2025

The work environment of nurses is a critical factor that not only has substantial physical and psychological effects on the nurses themselves but can also have adverse consequences for their families, especially their children. The complex interplay between nurses' job duties and their ability to care for their families has significant social and emotional repercussions on their work-life balance, a topic that may have received less attention until now. Nurses often work in high-stress environments, which can lead to mental health issues. The nature of their work exposes them to challenging situations, life-saving decisions, and emotional interactions with patients and their families. The way they cope with such problems has consequences that extend beyond the workplace and can negatively impact the family dynamics of nurses. They constantly grapple with their emotional states at home and are never truly separate from their work lives. Psychologists emphasize that job-related stress in nurses may result in increased irritability, emotional unavailability, and difficulties in interacting with their children. Ultimately, it can be said that the families of nurses, particularly their children, are indirectly affected by the challenging working conditions of nursing, a topic that has perhaps received less attention until now. The environment in which nurses operate impacts not only their own health but also the emotional and psychological well-being of their children. Addressing these issues is essential not only for improving the lives of nurses but also for nurturing resilient and emotionally healthy children who thrive in supportive family systems.

Matrix metalloproteinases (MMPs) include a group of factors responsible for cell proliferation, apoptosis, and angiogenesis. Changes in the level of this family are associated with the pathology of structural disorders such as Congenital Heart Disease (CHD). This systematic study assessed previous research to determine the therapeutic potential of MMPs in congenital heart disorders.

This systematic review was written based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and the principle of nonbias was respected. All the articles from 2014-2024 were extracted from the Web of Science, PubMed and Scopus databases. The study investigated the role of MMPs in the pathology of cardiovascular structural disorders, as well as therapeutic and diagnostic effects of MMP and Tissue inhibitors of metalloproteinases (TIMP) levels.

A total of studies15 were included in our analysis. MMP-1, MMP-2, MMP-3, MMP-8, MMP-10, MMP-13, TIMP-1, and TIMP-4 were found to be significantly elevated in patients with higher degrees of myocardial fibrosis and diastolic heart failure. MMP-2 and MMP-9 levels were significantly increased in hypertensive male patients with bicuspid aortic valve (BAV) and may be associated with an aneurysmal cellular phenotype. MMP-15 plays a critical role in the formation of endocardial cushions, while MMP-1 may serve as a biomarker for ventricular remodeling in patients who have undergone surgery for tetralogy of Fallot (TOF). Elevated levels of TIMP-1, MMP-7 and MMP-12 in patients with postoperative hypoxemia put these children at a higher risk for difficulty weaning off the mechanical ventilator.

Regulating of MMP levels during fetal and postnatal periods could lead to the prevention and treatment of CHD. MMP/TIMP homeostasis is considered the key to CHD treatment and is even an important diagnostic tool.

The rate of postural abnormalities, particularly in young individuals, is increasing. Therefore, the present study focused on examining the extent of postural structure abnormalities among sixth-grade students in Yazd province and the factors associated with it. This descriptive correlational study was conducted through a field approach. A total of 2001 sixth-grade students from Yazd province (1000 boys and 1001 girls) were randomly selected using cluster sampling, following the Morgan table. To conduct the study, the necessary data were collected through a questionnaire to gather anthropometric information about the subjects, such as age, height, weight, gender, and the prevalence of postural abnormalities, including forward head, kyphosis, lordosis, neck tilt, knock knees, bowlegs, flat feet, hallux valgus, asymmetric pelvis, scoliosis, drooping shoulders, raised shoulders, and inward rotated shoulders. The questionnaire also assessed the participants' consent to participate in the study and included the inclusion and exclusion criteria. A form was used to record measurements (sample questionnaires are provided in the appendix). The results of this study showed a positive correlation between weight and winged scapula, bowlegs, and inward rotated shoulders. On the other hand, there was a negative correlation between weight and knock knees, flat feet, and lumbar lordosis (p < 0.01). A positive correlation was observed between height and winged scapula, sway back (p < 0.01), and inward rotated shoulders (p < 0.05). Moreover, a negative correlation was found between the level of physical activity and winged scapula, knock knees, bowlegs, flat feet, inward rotated shoulders, and lumbar lordosis (p < 0.01). Schools should increase the amount of structured physical activity during the school day. This could include exercises aimed at strengthening core muscles, improving flexibility, and promoting proper posture. By incorporating daily physical education classes, schools can help students build the muscle strength necessary to maintain proper posture.

The quality of life disruption in children with irritable bowel syndrome (IBS) has not been thoroughly studied. We aim to evaluate the quality of life (QoL) of children with irritable bowel syndrome and investigate the underlying factors related to the occurrence of these disorders. We examined seventy-one children suspected of suffering from IBS. We used the Pediatric Quality of Life inventory (PedsQL) to assess their QoL. The patients' QoL scores in the field of physical performance were 48.59 ± 5.42, in emotional state it was 57.95 ± 11.07, in social function it was 58.59 ± 12.16, and in educational performance it was 56.76 ± 12.13. The mental status of girls was more affected than that of boys, while the academic performance of boys was more affected than that of girls. Younger children had more defects in academic performance, while mental disorders were evident at older ages. Patients with abdominal pain had lower physical performance, those with diarrhea had lower social performance, and the incidence of loss of appetite had an inverse relationship with social performance score. The type of medication for IBS did not have a noticeable effect on QoL. In Iranian children with IBS, various dimensions of QoL are severely disturbed. Gender, age and clinical manifestations are determinants of impaired QoL. However, routine treatments to control IBS may not be effective in improving or reducing the severity of quality of life.

Pain is an unpleasant sensory and psychological experience. Invasive procedures such as Intravenous (IV) line placement and blood sampling are a major source of pain and fear in hospitalized children. Pain control is one of the important nursing measures. The present study aimed to determine the effect of setting up an IV Access team on reducing pain intensity in children with cancer aged 5 to 7 years.

This descriptive study was conducted on children hospitalized in the hematology department of Dr. Sheikh Children's Hospital in Iran from 21 July to 21 September 2024. 67 children were selected using a census and purposive sampling method. The data collection tool was the FLACC Pain Scale.

A total of 67 IV line placements were performed in 53 patients. 40 were boys (75.47%) and 13 were girls (24.52%). The number of IV line placements performed by the IV access team was significantly higher in boys (47 cases) than in girls (20 cases). The results of the severity of children's behavioral reactions to pain showed that 7% experienced mild pain, 12% had moderate pain, 37% showed severe pain, 29% reflected very severe pain, and 15% exhibited the worst pain.

Despite the implementation of the IV Access team, no significant reduction in pain severity was observed, suggesting the need for further investigation into alternative pain management strategies.

Werner syndrome (WS) is a rare autosomal recessive disorder characterized by premature aging and various metabolic complications. Non-Alcoholic Fatty Liver Disease (NAFLD) is primarily associated with metabolic syndrome, but its occurrence in young patients with WS is rarely reported. We describe the case of a 17-year-old male diagnosed with Werner syndrome who presented with grade 2 NAFLD and elevated liver function tests (LFTs).

A 17-year-old male, born to consanguineous parents, presented with clinical features suggestive of premature aging. Genetic testing confirmed a mutation in the WRN gene, establishing a diagnosis of Werner syndrome. Liver ultrasound revealed grade 2 fatty liver, and liver biopsy confirmed moderate steatohepatitis (activity grade 6, stage 2). Elevated liver enzymes were observed, although other metabolic parameters were within normal limits.

This case highlights the importance of recognizing liver involvement in patients with Werner syndrome and underscores the need for routine monitoring and a multidisciplinary approach to management. Genetic counseling is essential for families with consanguineous backgrounds to reduce the risk of autosomal recessive conditions like WS.