International Journal of Pediatrics
Volume:2 Issue: 4, July 2014

The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15) and control group (15). The experimental group was undergone eight 2-hour sessions of cognitive-behavioral training. Before and after the intervention, the Multidimensional Anxiety Scale for Children, which included four components of social anxiety, physical symptoms, harm avoidance, and separation anxiety, and Children Depression Inventory was administrated in both groups. The findings from the covariance analysis test revealed that depression and anxiety and glycemic control in experimental group was controlled at post-test and depression score in experimental group compared to the control group at post-test was decreased. The findings from the multivariate covariance analysis test between components of, physical symptoms, harm avoidance, separation anxiety, and social anxiety revealed meaningful differences between the two groups in social anxiety post-test score. According to the article, cognitive behavior therapy can be effective for depression, anxiety, and blood sugar control in children.

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 Breast Milk Feeding (BMF) in the first 6 months of infant life. This cross-sectional descriptive-analytic study was conducted on 190 mothers who referring to Yazd 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 10.14±2.00 (out of 14) and maternal knowledge score toward advantages of breast milk was 10.12±2.015 (out of 14). The incidence of exclusive BMF in the first 6 months of life study was 72.9%. Child growth was as follows: excellent growth (24.5%) and good growth (55.3%). ANOVA showed a significant difference between parent's education and maternal attitude and maternal knowledge towards exclusive BMF; whatever higher education of parents, more positive knowledge and 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 knowledge and 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.

Iron Deficiency (ID) is the most prevalent nutritional disorder in the world. The prevalence of Iron Deficiency Anemia (IDA) is about 9% in toddlers, 9-11% in adolescent girls and less than 1% in teenage boys. IDA presents when there is not sufficient iron for haemoglobin synthesis. In particular it has negative effects on the behavior, cognitive performance, immune system and physical growth of infants, preschool and school age children. Blood samples of 337 randomly selected children (6-59 months) living in the Ahwaz, Khuzestan province-Iran, were taken. Serum ferritin, Complete Blood Cell (CBC) and hematological indices were measured In this study (61.1%) of the children had serum ferritin less than 12mcg/dl. Prevalence of IDA were (29.1 %). The results showed that most children with IDA were at (12-23) months. Families with more than 6 children had (4.49) times greater chance of IDA. The mean of breast-feeding in non-IDA children was higher than IDA children (17.6 and 16.3 months respectively, P>0.05). In this study families who gave tea to their children for (1-11) months had the highest prevalence of IDA. There are several main risk factors for ID & IDA in the children. Parent's illiteracy, family income and using cow's milk before 12 months are among most important risk factors for iron deficiency for children.

Constipation is one of the most common complaints of individuals, which may present with complication like hemorrhoid and fissure. Hirschsprung is a disease presenting with chronic constipation and its diagnosis may be delayed until adulthood. It is diagnosed by biopsies from anorectal transitional zone. This study aimed to evaluate the association between Hirschsprung and anorectal problems. Sixty three patients with anorectal problems who underwent surgery enrolled in this study. Some consecutive biopsies were obtained from anal canal at 2, 4 and 6 cm above the dentate line. Biopsies were assessed for ganglion cells changes. Patient's data and biopsies results were analyzed with SPSS version18. Out of 63 patients 29 (46%) patients were female and 34 (54%) were male with the mean of 32.65±13.73 years. Fifty six (73%) patients complained from constipation with the mean time of 57.65±45.21 months. Aganglionic zones were reported in six patients with the mean length of 43.33 mm. There was not any relation between anal ganglion cells pathology and constipation (P=0.363), but there was a significant relation between duration of constipation and pathologic changes (P=0.001). The ratio of constipation duration to age was related to anal ganglion cell pathology (P=0.001). Hemorrhoid degree was also affected anal ganglion cells pathology (P=0.037). The relation between Hirschsprung's disease and anorectal problems in adults were significant. The pathologic findings were more presented in younger patients, and those with longer history of constipation and lower degree hemorrhoids.

The aim of this study is to evaluate the effect of Acceptance and Commitment Therapy for Children with Chronic Pain on the function of 7 to 12 year-old children. Thus, the basic problem of the current study is whether CHACT can improve the function level of 7 to 12 year-old children with chronic pain? According to the criteria of chronic pain, a number of children with chronic pain were selected by available sampling method from specialty and subspecialty pediatric hospitals of Tehran. Then, among the children, 20 children who according to their parents prepared to participate in this study and met the inclusion criteria, were selected. They were placed in the experimental group (n=10) and control group (n=10). The child and parents versions of Function Disability Inventory (FDI) were answered by children and parents in both groups at the pre-test, post-test, first and second follow-up. The result showed that the experimental group compared with the control group showed significant change in function in multiple stages (P<0.05(. These changes continued after the treatment, first and secondary follow-up. Regarding the impact of CHACT on the function of children with chronic pain, it can be said that this protocol can be used in clinical fields, especially in the area of improving the function that appears that is one of the most vulnerable areas that children with chronic pain are faced with it.

Hypothermia is an important complication during surgery, especially in children, and is highly associated with serious adverse outcomes. One of the preventive methods is the intraoperative administration of amino acids, which can be effective through increasing thermogenesis and stimulating energy consumption. No studies have been conducted in this regard on children; therefore, we evaluated the preventive effect of intraoperative administration of amino acid on hypothermia in children. Forty children, aged 2 to 6 years, who were candidates for hypospadias surgery in Dr. Sheikh Hospital, Mashhad-Iran, were divided into two groups. In the case group, 10% amino acid (2 cc/kg/h) was administered two hours before the operation, and in the control group, normal saline was given as required. All patients underwent a similar method of anesthesia. body temperature was recorded before the anesthesia, immediately after it, and every ten minutes. The mean age and weight had no difference between the groups. Duration of patient's awakening time was (13.60 ± 4.91 min), which in the case and control groups was reported as (11.90 ± 5.27) and (15.30 ± 3.96 min), respectively (P<0.05).The patients’ body temperature was higher in the case group. It was not significantly different between the groups before, and until 20 min after the start of the surgery. In the next measurements, the temperature was significantly different among the groups; the difference became more prominent as the time passed. Perioperative administration of 10% amino acid causes an increase in children’s body temperature, leading to faster awakening time of the patients.

Spinal muscular atrophy (SMA) is a genetic disorder which affect nervous system and is characterized with progressive distal motor neuron weakness. The Survival motor neuron (SMN) protein level reduces in patients with SMA. Two different genes code survival motor neuron protein in human genome. Skeletal and intercostal muscles denervation lead to weakness, hypotony, hyporeflexia, respiratory failure, symmetric muscle atrophy and paralysis in patients with SMA. Manifestations are prominent in proximal muscle of lower extremities. There is no curative treatment for spinal muscular atrophy, and supportive treatment should be considered to improve patients’ quality of life and independency. New treatment strategies focus on gene therapy or invent method to increase survival motor neuron protein level. The aim of this study is to review spinal muscular atrophy clinical and molecular manifestations.

Primitive neuroectodermal tumours (PNET) are malignant small cells neoplasm mainly occurring in children but can occur at any age. Extensive bleeding into the pleural cavity is rare in children. Hemothorax would be compatible with a variety of congenital anomalies including sequestration, patent ductus artreiosus, and pulmonary arteriovenous malformation.Case Report: A 2.5-year old girl who was known a case of PNET with dyspnea and tachypnea referred to our hospital. The chest X-ray revealed bilateral opacity. After consulting the general surgeon, the bilateral chest-tubes inserted and 200cc blood drained. The diagnosis of a hemothorax can be made only by thoracentesis. The symptomatology of the peripheral primitive neuroectodermal tumors is related to size and their location. We did not find any residue of cancer as a cause of hemothorax, and the hemothorax was not related to side effects of chemotherapy, infection and trauma. Therefore, PNET should be included as a cause of children hemothorax.