International Journal of Pediatrics
Volume:2 Issue: 1, Jan 2014

Antibiotic- associated diarrhea is a common problem in pediatric population. There is growing interest in probiotics, probiotics and synbiotics for prevention of this complication because of their worldwide availability as dietary supplements. The aim of this study was to assess the efficacy of a synbiotic mixture in prevention of antibiotic- associated diarrhea. In this randomized controlled trial, 218 patients (111 in the synbiotic and 107 in the placebo group) aged 6 months to 14 years with respiratory tract infection and/ or otitis media who needed antibiotic treatment in outpatient setting, were enrolled. They received 1 billion Colony Forming Unit of seven probiotics species plus Fructooligosaccharide in form of powder or placebo (matched for size, shape, and volume) for 7 days. Amoxicillin, Amoxicillin-clavalanic acid, cefixim and Azithromicin were the most common drugs used by physcicians Mothers recorded stool frequency and consistency daily for 7 days. We found no significant difference (P>0.05) in occurrence of diarrhea between synbiotic and placebo groups. This synbiotic mixture did not appear to reduce antibiotic- associated diarrhea in children. Further studies are needed to investigate the potential benefits of Synbiotics in prevention of this disease.

Breast milk is a complete food for growing children until 6 months of age, and mothers, as the most important child health care, play a decisive role in their growth. So promoting their attitude toward the benefits of breastfeeding ensures guarantee child health in the future. This study aimed to assess maternal knowledge and attitude of Mashhad toward exclusive BMF in the first 6 months of infant life. This cross-sectional descriptive-analytic study was conducted on 126 mothers who referring to Mashhad health-care centers for monitoring their 6-24 month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic tests and using SPSS 11.5. Mean score of maternal attitude toward exclusive BMF was 14.32±5.28 (out of 28) and maternal knowledge score toward advantages of breast milk was 19.59±4.80 (out of 28). The incidence of exclusive BMF in the first 6 months of life study was 73.8%. Child growth was as follows: excellent growth (5.6%) and good growth (42.1%). ANOVA showed a significant difference between parent's education and maternal attitude towards exclusive BMF; whatever higher education of parents, more positive maternal attitude towards exclusive BMF (P<0.05). There was a significant direct relationship between knowledge and attitude (Spearman test, P-value= 0.000& r= 0.4). Maternal attitude towards exclusive BMF was moderate. It is essential to plan for mothers by officials in order to promote breast-feeding in the first 6 months of baby's life to enhance positive maternal attitude in this regard.

Chronic liver diseases consist of wide spectrum disorders that may be complicated by cirrhosis and therefore need to transplantation. The pediatric end-stage liver disease (PELD) score and model of endstage liver disease (MELD) score has been used as predictors of mortality chronic liver diseases listed for liver transplantation. The aim of this study is evaluation of relation between PELD\MELD score and evidence of cirrhosis in children with choronic liver disease. This cross-sectional study conducted on 106 patients of chronic liver disease referred to Ghaem haspital, Mashhad university of medical science, Iran during 24 months period (2010-2013). PELD and MELD score were calculated for all patients. Clincal and patholoogical findings of cirrhosis were recorded. Mean age of patients was 68/3 ± 41.8 months. Mean PELD\MELD score was -1/59± 9/64. There was significant correlation between PELD\MELD score and clinical icter, spelenomegaly, evidence of hepatopulminary syndrome, esophageal varices, evidence of cirrhosis in tissue specimences. PELD\MELD score appear to be benefit for detection of cirrhotic children among paients with choronic liver disease.

Premature neonates admitted in NICU besides being separated from their mothers are prone to inevitably painful and stressful situations. Kangaroo care is the most effective method to get rid of this separation and its negative consequences. This study was performed to determine the experiences of mothers having premature neonates concerning Kangaroo care. The present study is a qualitative research in which focus group discussion method is used for data collection. Research society consisted of mothers having premature neonates Research group reread and categorized the qualitative findings. Contents of interviews were analyzed using the conventional interpretation approach introduced by Dicklman Method. Through content analysis of information emerged two major categories including mothers’ experiences about advantages of kangaroo care in interaction with neonate, and, feeling of physical-mental healthiness of neonate. Executive obstacles of kangaroo care from mothers’ standpoint were also discussed, which will be subsequently presented. According to the obtained results, it seems vital to highlight kangaroo care as a safe and effective clinical care-taking treatment in nursery of premature neonates in all hospitals. Nurses shall provide all mothers with the needed instructions for holding the premature and lower-weight neonate properly on their chests and shall promote their knowledge level concerning positive effects of kangaroo care including induction of tranquil sleep, optimization of physiological conditions of neonate, and removal of suckling obstacles.

Transient hyperglycemia is a condition that happens during acute physiologic stress in children. The aim of this study is to determine if there is any relation between stress hyperglycemia and diabetes mellitus and metabolic syndrome in pediatric patients. The study was performed on children hospitalized in Amirkola pediatric hospital, North of Iran, between February 2011 to January 2013. Children with a history of stress hyperglycemia were studied for the presence of metabolic syndrome or Anti GAD65 Autoantibodies. A total of 50 patients were studied. None of our patients had developed type 1 diabetes. OGTT was normal in all patients. Metabolic syndrome was present in 2 cases (4%). The prevalence of insulin resistance was 16%. The most common metabolic abnormality noted was hypertriglyciredemia and one patient was positive for GAD 65 autoantibody. According to our data children with stress hyperglycemia do not appear to be at increased risk of developing type 1 diabetes but insulin resistance is relatively common in these patients.

Constipation in children is a common health problem affecting 0.7% to 29.6% children across the world. Exact etiology for developing symptoms is not clear in children and the majority is considered to have functional constipation. Alteration of rectal and pelvic floor function through the brain-gut axis seems to play a crucial role in the etiology. The diagnosis is often a symptom-based clinical process. Recently developed Rome III diagnostic criteria looks promising, both in clinical and research fields. Laboratory investigations such as barium enema, colonoscopy, anorectal manometry and colonic transit studies are rarely indicated except in those who do not respond to standard management. Treatment of childhood constipation involves several facets including education and demystification, toilet training, rational use of laxatives for disimpaction and maintenance and regular follow-up. Surgical options should be considered only when medical therapy fails in long standing constipation.. Complementary and alternative medical therapies and practices are widely employed in the treatment of the children Constipation. This article aims to be a practical guide for paediatricians and primary care physicians, to outline the current etiology an TIM for the medical management of constipation in children.

Biotinidase deficiency is a life threatening inborn error of metabolism specially when delayed in diagnosis.We report a 2-month-old male infant that presented with refractory infantile spasm, alopecia and seborrheic dermatitis. With a high suspicion of the biotinidase deficiency we started biotin 10 mg daily orally before definite diagnosis was made. Rapid treatment was life-saving and all complications disappeared rapidly. With this report we tried to explain the clinical manifestations of biotinidase deficiency and show the importance of early diagnosis and treatment in resolving the complications.

Glutaric academia type I is a metabolic disorder that is caused due to deficiency of glutaryl-CoA dehydrogenase. Macrocephaly is a common sign in GA1, although many infants usually appear healthy at birth.Case Report: A 5.5 year old boy with GA1 was admitted to NICU. Chief compliance of patient for hospitalization was pneumonia and sepsis and he was intubated and mechanically ventilated. This disease was diagnosed with signs of set developmental delay at 8 months old and during these years; he was under control for nutritional counseling with a nutritionist and pediatrician. Nutritional support for this patient was in NICU. Medical treatment combined with nutritional support in GA1 management signs of serious illness; also dietary treatment may control progression of the neurological damage.

Vitamin D deficiency and rickets continue to be health problems in developing countries and most of the infants with congenital rickets may present with hypocalcemic seizure.Case Report: In this article, the report on four infants who presented with hypocalcemic seizures but subsequently were found to have congenital rickets is presented. All of them had hypocalcaemia and low level of serum 25- hydroxy vitamin D. Their mothers had not received vitamin D supplementation during pregnancy and so evidence of vitamin D deficiency was presented. Although current vitamin D supplementation guidelines for infants was effective in prevention of rickets in Iranian children, it is necessary to evaluate women before pregnancy to prevent this entity. Also infants without vitamin D supplementation therapy who present with seizures during the first 6 months of age should undergo biochemical and other investigations for rickets.