International Journal of Pediatrics
Volume:2 Issue: 5, Aug 2014

Many healthy individuals may have celiac disease but they are not aware of it, or may have a disease situation that may be related to celiac disease. Celiac disease also known as gluten-sensitive enteropathy is characterized by intestinal mucosal damage and malabsorption from dietary intake of wheat, rye or barley. Symptoms may appear with introduction of cereal in the first 3 years of life. A second peak in symptoms occurs in adults during the third or forth decade and even as late as eight decade of life. The prevalence of this disease is approximately 1 in 250 adults. The disease is more prevalent in Ireland as high as 1 in 120 adults. The disorder occurs in Arab, Hispanics, Israeli Jews, Iranian and European but is rare in Chinese and African American.To have celiac disease the patient should have the celiac disease genetic markers as human leukocyte antigen (HLA) DQ 2 and (HLA) DQ 8. Patient with celiac disease may have 95 per cent for DQ 2 and the rest is by DQ 8. Someone may have the genetic marker and never develops the disease. In general 50 percent with markers may develop celiac disease. To develop the disease the gene needs to become activated. This may happen with a viral or bacterial infection, a surgery, delivery, accident, or psychological stress. After activation of gene cause the tight junction to opens with the release of Zonulin. This results in passage of gluten through the tight junction and formation of multiple antibodies and autoimmune disease. This also allows entrance of other proteins and development of multiple food allergies. As a result is shortening, flattening of intestinal villi resulting in food, vitamins and minerals malabsorption.

Helicobacter pylori (H.pylori) infection has an important role in promoting gastrointestinal disease in human. It may be acquired early in life, particularly in developing countries. The aim of this study is to evaluate the association between H.pylori infection and clinical manifestations in Iranian children. In this retrospective, cross-sectional study, H. pylori status was assessed by pathological examination of gastric biopsy in symptomatic children. A total of 266 patients were diagnosed as infected by H. pylori, compared with 268 uninfected patients matched by age and sex. Reported symptoms, endoscopic and pathological findings in the two groups were analyzed using chi-square test. The limit of statistical significance was set at (P<0.05). The prevalence of H. pylori infection in children suffering from gastrointestinal symptoms was 9% and rised with age (54.9% of infected children were older than 8 years old). Recurrent abdominal pain was the most common symptom in 62.5% of infected children. With regard to gastric endoscopy, a statistically significant correlation was observed between antral nodularity and H. pylori Infection (P=0.000). Gastritis was the most common seen pathology (91.5%) with mostly mild (30.9%) or moderate (34.9%) inactive inflammation. This study demonstrated that emphasis on clinical manifestations rather than paraclinical testing is not suitable to predict H. pylori infection. However, existence of antral nodularity can be assigned as an endoscopic sign of infection in children.

Today we are witnessed a growing number of minimally invasive surgical techniques for different diseases. Laparoscopic colon surgery as a minimally invasive surgery is currently growing in treatment of malignancies after proving his place in the treatment of benign diseases. We compare in this study results of laparoscopic colorectal surgery with open surgery.36 laparoscopic colon resections performed for benign disease were compared to 36 open colon resections with respect to operating times, length of hospital stay, estimated blood loss, days until first postoperative bowel movement, and complications. The laparoscopic colon resection group had decreased length of stay, less blood loss, earlier return of bowel function, and an equivalent number of complication. Duration of surgery was higher in the laparoscopic group.The use of laparoscopic colon surgery for benign disease not only affords the patient the advantage of the laparoscopic approach, but also allows the surgeon to gain experience for laparoscopic colon surgery in malignant disease.

Nosocomial infections are an important cause of mortality in neonatal intensive care units (NICUs). Therefore, in this study, the incidence and prevalence of nosocomial infections were determined in NICUs of the three largest neonatal centers in northwest Iran, and the causative bacteria were identified in order to provide potential solutions to control the infections in these hospitals. This is a descriptive-prospective study in which the cases of nosocomial infections were examined in the three largest hospitals in Tabriz city in northwest Iran, during one year (from June 2012 to May 2013) based on clinical findings, medical and nursing reports of patients, and laboratory results. Of the 3129 patients hospitalized in NICUs of the three hospitals, 208 patients were diagnosed with nosocomial infections. The incidence rate of nosocomial infections was 11.34% (per 100 patient-days) with: 52.4% bacteremia, 32.69% pneumonia, 5.77% urinary tract infections, 5.29% wound infections, and 3.85% necrotizing enterocolitis. There was a statistically significant relationship between invasive procedures (such as umbilical catheters, central venous catheters, surgery, and TPN) and sepsis (P=0.001).The relationships between urinary tract infection and urinary catheter (P=0.000), and aggressive procedures (such as suctioning and intubation) and pneumonia (P=0.001) were also statistically significant. Incidence of nosocomial infections in premature and low birth weight newborns is considered as a health threat. The findings of this research reiterate the importance of giving further attention to prevention and control of nosocomial infections in the NICU.

Patient satisfaction is the main indicator of the quality of healthcare systems. Usually in pediatric works parents are questioned due to lack of appropriate scale. Therefore, this study was done to assess the children’s satisfaction themselves by drawing which is an applicable scale for them. This study was done with 20 hospitalized children aged 6-12 years in medical and surgical wards of Dr. Sheikh Pediatrics Hospital in Mashhad, who were hospitalized at least for 2 days in order to gathering data a blank A4 size paper and 12 color pencils was given to participants and asked them to draw what they’ve been thinking about nursing and their interventions. Each drawing was analyzed based on Plander scale. Most of participants were boys (65%), and hospitalized in medical wards (60%).In patient’s room no entertainment tools, toys or even readings were drawn. In all drawings the child was happy and in most was resting on a bed instead of playing or sitting (80%, 20%, and 0.0%, respectively). Drawing is a good and reliable source for assessing the quality of pediatric nursing care. So, suggested its usage in order of assessing children’s opinions in different matters relating to their care.

Pleural effusion is the accumulation of excess fluid in the pleural cavity. Most information available about pleural effusion is obtained from studies on adults and little evidence is available in children. Therefore, it is necessary to identify the existing status and explain the disease process, signs, treatment, and prognosis. In this descriptive research, children with pleural effusion who were admitted and undergone thoracocentesis in the children’s university hospital during the last ten years were studied. The data obtained from in vitro experiments and the information questionnaire was analyzed using SPSS18 through descriptive statistics of frequency, percent, and mean. Ninety-four children with pleural effusion were admitted during 10 years. Pleural effusion was exudate in 56.38% and transudate in 43.61% of children. The most common symptoms were tachypnea, fever, and cough. Antibiotic administration was the most performed therapeutic action. The mode of addressing pleural effusion in this research was similar to other studies. Considering the results, better planning can be performed regarding preventing this disease or improving its prognosis.

The purpose of this study is to evaluate the effect of Acceptance and Commitment Therapy for Children with Chronic Pain (CHACT) on quality of life of 7 to 12 year-old children. Thus, the basic problem of the current study is whether CHACT can increase the quality of life on 7 to 12 year-old children with chronic pain? According to the criteria of chronic pain, a number of children suffering from 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 were prepared to participate in this study and met the inclusion criteria, were selected and were placed in the experimental group (n=10), and the control group (n=10). The KID Screen was administered in both groups at the pre-test, post-test, first and second follow-up. The results showed that the experimental group compared with the control group showed significant change in quality of life in multiple stages(P<0.05). These changes continued after the treatment, first and secondary follow-up. Regarding the used protocol in this study on the quality of life of the children, it can be said that this protocol can be applied in the clinical fields, especially in relation to improving children's quality of life.

Electronic education is there to enhance knowledge of patients especially mothers during postpartum and can provide an efficient way to enhance personnel-patient interaction. So, this study was conducted to define the effect of electronic education on the awareness of women about post partum breast feeding education. This is a quasi- experimental study conducted on 72 primiparous women during postpartum period referring to Shahid Beheshti Hospital in 2013. In order to educate the subjects through electronic and paper based methods, the subjects were selected through random allocation. A pre- test before and a post- test after education were conducted with a 15 item questionnaire to measure women’s awareness about breast feeding. The data were analyzed by descriptive statistical tests, and t-test and paired t- test through SPSS11.5. Significance level was considrred (P<0.05). Mean scores of awareness about postpartum breast feeding after intervention in electronic education and control (paper based) groups were 9.22+0.43 and 13.12+1.2 respectively, which showed a significant difference (P=0.002). Levels of increase of awareness in electronic education and control groups were 128% and 68% respectively. As electronic education method had a higher effect on level of awareness about postpartum breast feeding among mothers compared to paper based method, health providers are suggested to apply this method to increase mothers’ knowledge and to provide them with care.

Upload poisoning is one of the most dangerous and common poisoning in iranian children. Depression of the respiratory and central nervous systems may lead to significant toxicity. Even low doses of uploads are dangerous in pediatrics under 6 years old. Methadone is the most toxic of the uploads; small doses as low as a single tablet can lead to death. According to this information we decided to evaluate methadone poisoning in hospitalized children.

Acupuncture is increasingly used in children; however, the safety of pediatric acupuncture has yet to be reported from systematic review. Acupuncture has become a dominant complementary and alternative modality in clinical practice today but its associated risk has been questioned. The National Institutes of Health Consensus Statement states “one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same conditions.

We encountered a patient with methylmalonic aciduria associated with skin lesions resembling acrodermatitis enteropathica. This child was being fed with a low-protein diet when the skin disorder developed. A deficiency in plasma levels isoleucine, was confirmed. Supplementation of a high-caloric, protein-rich diet led to a prompt improvement of skin lesions. We assume that in our patient the skin lesions were the result of malnutrition, rather than being primarily associated with the underlying metabolic disease. To our knowledge, few reports are so far available concerning methylmalonic aciduria complicated by skin eruptions.

The risk of life-threatening complications during induction of anesthesia in patients with anterior mediastinal mass is well recognized. Maintenance of spontaneous ventilation during anesthesia is an accepted standard goal in all published reports. However, the decision to paralyze the patient, which is really needed in most surgical procedures, is still a challenging event. In this study, “manually ventilating test” as a predictive test was assessed to make the decision to paralyze children with massive anterior mediastinal masses who needed tracheal intubation.. It seems that manually ventilating test may at least be a simple and reliable test to identify cases that could be paralyzed successfully.

Pediatric intensive care unit (PICU) has a specific location for management of children with serious and severe diseases. This is a crass-sectional and analytical study was performed on all children admitted in PICU of Boali Hospital from March 2010 to March 2012. Out of 490 patient admitted in PICU, 35 was died (7.14%), but this was 6/04 % (27/447 patients) in march 2011 to march 2012. Overall, 62 cases were died (6/6%) in two years [male =30 (3.2%), female =32 (3.4%)]. Mortality rate is similar with other developed countries or higher level of medical care.

Fruits are one of the oldest forms of food known to man. There are many references to fruits in ancient literature. According to Quran, the fruits like grape, date, fig, olive and pomegranate are gifts and heavenly fruits of God. Fresh and dry fruits are the natural staple food of man. They contain substantial quantities of essential nutrients in a rational proportion. Persons subsisting on this natural diet will always enjoy good health. Moreover, fresh and dry fruits are thus not only a good food but also a good medicine. Holy Quran is one of the reference books describing the importance of plants used for different ailments in various verses. There are several verses in Quran talking about the fruits in Paradise, including; date, olive, pomegranate, grape, banana and fig. What has been mentioned in the Quran is what scientists have achieved over the time, since the Quran is governed by logic. Although we do not know the reasons for many things in the Quran, we consider it as the foundation.

Human rights are the basic standards that people need to live in dignity. In addition to the rights that are available to all people, there are rights that apply only to children. Children need special rights because of their unique needs; they need additional protection that adults don’t. The United Nations Convention on the Rights of the Child is an international document that sets out all of the rights that children have – a child is defined in the Convention as any person under the age of 18. On the other hand Islam recognises family as a basic social unit. Along with the husband-wife relationship the Parent-child relationship is the most important one. To maintain any social relationship both parties must have some clear-cut Rights as well as obligations. The relationships are reciprocal. Duties of one side are the Rights of the other side. So in Parent-child relationship the Rights of parents are the obligations (duties) of the children and vice versa, the Rights of children are obligations (duties) of parents. Islam clearly defines the Rights of Parents (which mean duties of children) and obligations of parents (which means Rights of children).