International Journal of Pediatrics
Volume:3 Issue: 13, Jan 2015

Child abuse is a recognized public health and social problem worldwide. According to the World Health Organization (WHO), child abuse includes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect and negligent treatment and exploitation. Child maltreatment is a global problem with serious life-long consequences. In spite of recent national surveys in several low- and middle-income countries, data from many countries are still lacking. Estimates of child maltreatment indicate that nearly a quarter of adults (22.6%) worldwide suffered physical abuse as a child, 36.3% experienced emotional abuse and 16.3% experienced physical neglect, with no significant differences between boys and girls. However, the lifetime prevalence rate of childhood sexual abuse indicates more marked differences by sex – 18% for girls and 7.6% for boys. The lifelong consequences of child maltreatment include impaired physical and mental health, poorer school performance, and job and relationship difficulties. Ultimately, child maltreatment can contribute to slowing a country's economic and social development. We conclude that child maltreatment is a widespread, global phenomenon affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nation's Convention on the Rights of the Child.

Recording nursing reports is considered as a quality assurance tool for patients and nurses. Nowadays, the presence of electronic health record systems is an indicator of development. Studies on advantages and disadvantages of the electronic and manual recording methods have shown different results. In this study, electronic and manual recording of nursing reports were compared from the perspective of nurses. Methods and Materials: This descriptive-comparative study included all nurses in Neonatal Intensive Care Units (NICUs) of two health care centers equipped and non-equipped with electronic nursing records. A researcher-made questionnaire was used to evaluate and compare the viewpoints of nurses from four dimensions of accuracy and quality, time, health care information exchange, and control and management of nursing reports, after determining its validity and reliability. The data were analyzed with SPSS software version 16. Comparison of the survey’s subscales showed a significant relationship between the two subscales of time and control and management of nursing reports between the two centers(P<0.05). Nurses working in the center with manual system spent more time for writing nursing activities and there was a better control in the electronic system than the manual system. According to the results, despite many positive aspects, the electronic recording systems have still some defects which resolution is a responsibility of the designers of these systems. To this end, feedbacks of nurses as the users of these systems can be used to tailor them with nursing needs and activities, to improve their performance, and to increase care quality. Keywords:

Infant Mortality Rate (IMR) is one of the main indicators of the general level of health status as well as well-being. The aim of this study was to investigate the main components of IMR in Iran from 1967 to 2012 years. Methods and Materials: Using time series data of national level (1967 to 2012 years), we explored the association between Total Fertility Rate (TFR), Gross Domestic Product (GDP) per capita, number of physician per 1000 populations, female labor force participation rate, percentage of people living in rural regions and mean years schooling for each people with infant mortality rate of Iran. These data were obtained from Central Bank of Islamic Republic of Iran (CBI) data bank and Iranian statistical center. Time series analysis was done for this purpose. This study showed that there are positive relationships between total fertility rate, percentage of people living in rural regions with mortality rate of infant. In addition, IMR had inverse relationships with number of physicians and mean years of schooling. The per capita GDP and female labor force participation rate had not significant correlation with IMR. Many predictors of infant mortality were identified. The total fertility rate, number of physician per 1000 populations, percentage of people living in rural regions and mean years schooling of each people were strongly associated with infant mortality. These findings may be very useful for policy makers that how death of infant can be decreased.

The frequency of pediatric and adolescent oral and maxillofacial lesions is various in different societies. The present study was aimed at investigating the frequency of oral and maxillofacial pediatric and adolescent biopsies in Zahedan, Southeastern Iran, and compare the results with other epidemiologic studies. Methods and Materials: This retrospective study reviewed oral and maxillofacial lesions in patients aged 0-18 years old referring to the treatment centers of Zahedan University of Medical Sciences, during 12-years period. Patients’ demographic information including age, gender and location of the lesion were collected and statistically analyzed with SPSS software, version 19. In general, among 1112 oral and maxillofacial lesions, 154 (13.9%) cases were related to children and adolescents younger than 18 years old. The average age of patients was 11.4 ± 4.9, 53.2% and 46.8% of them were boys and girls, respectively. The most frequent sites of lesions were the gingiva and lip. The most prevalent lesions included inflammatory/reactive, cystic and neoplastic lesions, respectively. Benign and malignant tumors comprised 12.3% and 4.5% of cases. Moreover, pyogenic granuloma and Peripheral Giant Cell Granuloma (PGCG) were the most frequent lesions. The most prevalent oral and maxillofacial lesions in patients under 18 years old were inflammatory/reactive lesions in gingiva and in the 13-18 age range. Determining the characteristics of these lesions in the children and adolescents population provides a firm groundwork for proper diagnosis and treatment.

Hydrops Fetalis is a serious condition in fetal period, characterized by the presence of serous fluid accumulation in at least two potential spaces in fetus including pleural effusion, pericardial effusion, and ascites. The incidence of hydrops fetalis is one per 2500-3000 pregnancies. This condition is followed by different diseases. Fetal hemolytic anemia and its hypoxemia due to hydrops fetalis are potentially life or function threatening. Mortality rate is 50-90%; this poor prognosis is improving with advances in prenatal and medical treatment. Methods and Materials: This study performed on patients’ records with hydrops fetalis diagnosis in one of the neonatal referral and academic center, Vali-e-Asr Hospital Tehran, the capital of Iran from 2003 to 2010. Etiology, prognosis, and frequency of Hydrops fetalis in newborns were evaluated. Out of 10878 cases, 0.35% was born with hydrops fetalis:18.42% immune [Rh incompatibility (%85.71), Kell antigen system(%14.29)] and 81.58% non-immune. The rate of hydrops due to Rh incompatibility is significant in our center (85.71%), however, it is unusual in most of medical centers all over the world.

Although there is a consensus that the economic burden of burn injury is high, but few studies have conducted about cost of burns injury among pediatric in developing countries. We explored the main factors influencing on hospital costs and length of stay (LOS) associated with pediatric burns injury in Kermanshah, Iran. Methods and Material: We performed a review of medical records from 105 pediatric burn (16 years and younger) admitted to burn center at Imam Khomeini Hospital in Kermanshah, Iran. Univariate and logistic regressions were employed to identify the main factors affecting hospital costs and LOS associated with pediatric burn injury. Also, the data analysis was done by Stata statistical software. The results showed the overall mean hospital costs and LOS was 9,853,758 IRR and 7.5 days, respectively. Also, the LOS, gender and Burn Body Surface (BBS) were identified as the main independent predictor of costs and the cause of burn, BBS and age were the main factors affecting LOS. This study highlights that the independent predictors affecting hospital costs and LOS associated with pediatric burn injury in Kermanshah. Also, our study indicates the BBS was the main factors affecting hospital costs and LOS for the study population.

Developmental delay occurs when children do not reach their developmental milestones at the expected time. The main causes of developmental delay are often unknown. Investigation of the prevalence of developmental delay and its effective factors in children from 4 to 12 months old in Pakdasht County was the aim of this study. Methods and Materials: This cross-sectional study was carried out among 210 children from 4 to 12 months old in Pakdasht County in 2014. For collecting the survey data, the Questionnaires of demographic and Ages and Stages (ASQ) have been used. Collected data were analyzed with descriptive statistics, chi-square test and independent t-test by SPSS18 software. The study participants in the study consisted 97 girl (46.2%) and 113 boy (53.8%). The average age of children was 7.96 ± 2.83 months. There were significant relations between developmental delay with child nutrition and the mother's education level (P <0.001). According to the findings, further studies are necessary to understand the factors influencing children's developmental delays.

Ventilator - Associated Pneumonia (VAP), as defined by the Centers for Disease Control and prevention (CDC), is a pneumonia that occurs in a patient receiving mechanical ventilation that develops 48 hours or more after initiation of ventilation. Re-intubation which occur within 72 hours of planned extubation may be effective in VAP incidence. The aim of this study was to determine VAP incidence in re-intubated patients in comparison to patients underwent intubation without re-intubation to highlight re-intubation as a risk factor for VAP. Methods and Materials: A total of 1230 intubated patients, admitted to Pediatric Intensive Care Unit (PICU) department were enrolled in this cohort observational study consecutively from May 2010 to May 2014. VAP was clinically suggested and confirmed by chest X-ray. Patients demographic data, underlying disease, duration of mechanical ventilation length of PICU stay and re-intubations were recorded prospectively. In this study 336 intubated patients out of 1230 patients admitted to PICU department developed VAP (27%) with higher incidence in re-intubated patients (30% vs. 12%). VAP developed in nearly one third of intubated patients in our study. Re-intubation was significant risk factor for development of VAP.

Annular pancreas (AP) is a rare congenital malformation resulting from failure of pancreas ventral anlage rotation with the duodenum. This leads to a ring of pancreatic tissue that envelops the duodenum. Clinical manifestations of AP most commonly develop in infancy or early childhood but can present at any age. The diagnosis of AP, usually suggested by an upper Gastrointestinal (GI) series or abdominal Computerized Tomography (CT) scan, but surgery is considered the gold standard diagnostic method. Surgical bypass of the annulus in all patients with symptomatic AP is recommended. We report a 1 year old girl who presented with intermittent, non projectile, non bilious vomiting that occurred 1h to 2h after feeding since neonatal period. Upper GI contrast study demonstrates, a dilated duodenal bulb associated with narrowing of post bulbar area. The patient underwent surgical correction of the obstruction. A bypass of the ectopic pancreas tissue was performed by duodenoduodenostomy. Considering the rarity of this congenital abnormality, presenting with chronic partial duodenal obstruction, and its successful correction by surgical means have prompted us to report the case.