Journal of Pediatric Perspectives
Year:2019 | Volume:7 | Issue:6 (66)|Papers Count:14

The menstrual hygiene education is a process for strengthening skills and empowering women, especially young girls. The aim of this systematic review was to investigate the efficacy of menstrual health education on young girls’ knowledge, attitude and practice in Iran. Materials and Methods The searching procedure was systematically fulfilled on databases of Medline (via PubMed), Scopus and Cochrane library with no time restriction from inception to November 2018. Also, equivalent Persian keywords were searched in Iranian databases such as Irandoc, Magiran, Medlib, SID, and Barakatkns. The quality of enrolled trials was assessed using the Jadad scale. Random effect instead of fixed effect model was used if heterogeneity existed across different studies. Results Four studies were included in the meta-analysis. Level of practice improved significantly in intervention group than control group (standardized mean difference [SMD]: 0. 458; p=0. 006 (95% confidence interval [CI]: 0. 132 to 0. 783). Pooled data of two studies showed that attitude score increased significantly in intervention group when compared to control group (SMD: 0. 599 (95%CI: 0. 032 to 1. 167; random effect model; two trials). The mean score of knowledge was significantly higher in educational intervention group compared to control group (SMD: 0. 831; p=0. 023 [95%CI: 0. 117 to 1. 546 random effect model; three trials) Conclusion The current meta-analysis confirmed that educational approach such as peer education and role playing can be more effective than classic method (booklet and lecture) on girl’ s level of knowledge, attitude and practice.

Atopic dermatitis (AD) is detrimental to the infants' and their families' quality of life. We aimed to study the disease effects on Iranian infants and their families applying the infants’ dermatitis quality of life index (IDQOL), and the dermatitis family impact questionnaires (DFI). Materials and Methods Questionnaires (DFI and IDQOL) were translated into Persian and retranslated into English. Three experts assessed the content validity of the questionnaires by evaluating the relevance and transparency of the tools. Test-re-test was used to evaluate the questionnaires reliability. The reliability and internal consistency of the IDQOL and DFI were accessed by Cronbach’ s alpha coefficient which was 0. 74. The construct validity of the questionnaires was assessed using the Pearson correlation index to evaluate convergent and divergent validity. 50 Infants with AD fulfilling the criteria as well as their parents entered the study in Mashhad, Iran, in 2017. An independent-sample t-test was used to compare mean scores and one-way ANOVA was used to analyze other data. Results Intense itching (64%), taking one to more than two hours to get the child to sleep (52%), and three to more than five hours of infant sleep disturbance (34%) were significant. Family expenses (70%), and emotional stress (68%) affected the families' quality of life prominently. There were significant differences between the average DFI scores and other allergic diseases, both among infants suffering from AD (p = 0. 04), and their families (p = 0. 03(. Conclusion The Persian versions of the questionnaires (DFI and IDQOL) have validly and reliably measured both groups' quality of life. They experienced remarkable disturbances in their quality of life.

Background: The Neonatal Abstinence Syndrome (NAS) has been treated so far by various drugs, such as opioids and non-opioids. There is some concern about NAS babies who receive chemical drug treatment. Some researchers mentioned that shorter pharmacological treatment and less lengthy hospitalization are associated with several secondary advantages. The aim of this study was to assess safety, tolerability, and efficacy of acupuncture in management of Neonatal Abstinence Syndrome in infants. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: Five studies were included in the systematic review. Auricular acupuncture when implemented as adjunct pulse non pharmacologic in management of NAS is safe, feasible, and acceptable. However, Auricular acupressure did not show any significant effect on pharmacological therapy, length of hospital stay and average NAS scores. Treatment with Laser acupuncture as adjunct in management of infants with NAS were associated with several advantages. These include improvement in feeling (better relaxation and higher calorie intake), decreased Finnegan scores, shorter duration of treatment with morphine, and shorter duration of hospitalization. In terms of safety, treatment with laser acupuncture as adjunctive were well-tolerated. Conclusion: The findings of this systematic review showed that infants with NAS secondary to maternal opiate usage may receive more benefits of treatment with acupuncture in combination with pharmacologic therapy compared to pharmacologic therapy alone. In these findings should be interpreted in light of mentioned limitation.

Chylothorax is defined as abnormal accumulation of lymphatic fluid in the pleural space secondary to leakage from thoracic duct or one of its main tributaries. Congenital idiopathic chylothorax is the most common form of pleural effusion in neonates. Conservative therapy is the mainstay of treatment. An alternative therapy is Octreotide, which is a long-acting somatostatin analog that can reduce lymphatic fluid production. It has been used for the treatment of chylothorx in children, but it is used as a new strategy for the treatment of chylothorax in neonates. Case Report We herein report a case of idiopathic unilateral chylothorax in a 3-day-old Iranian male neonate who was treated successfully with conservative therapy, octreotide and regimen therapy with medium-chain triglyceride (MCT)-enriched formula. Conclusion Chylothorax may be suspected in patients with pleural effusions. Pleural fluid triglyceride measurement remains the recommended diagnostic method in chylothorax.

Background Parental caregiver burden is an important priority in children's oncology researches. The present study aimed to determine care burden among parents of children with leukemia. Materials and Methods This cross-sectional study was conducted among a total of 209 parents of children with leukemia who referred to Dr. Mohammad Kermanshahi Hospital, Kermanshah city, in the West of Iran, in 2018. Parents were surveyed with the caregiver burden scale and baseline characteristics items based on interview. Pearson correlation, t-test, and ANOVA analysis at 95% significant level were used in data analysis with SPSS software version16. 0. Results The mean of care burden score was 56. 43+9. 32 and ranged from 0 to 88. 10. 7%, 79. 7%, and 9. 6% of parents had low, moderate and high care burden, respectively. The higher care burden score was associated with the lower age of parents (r=-0. 255, P < 0. 001), higher educational level (P=0. 028), and better economic status (P=0. 001). Conclusion Our findings indicated that most of the parents of children with leukemia had moderate-to-high levels of care burden. Thus, health care providers are expected to be more available to respond to their requests and pay more attention to planning educational programs.

Effective basic newborn resuscitation is an important strategy to reduce the incidence of birth asphyxia and associated newborn morbidity and mortality. There is presently no valid and reliable tool to evaluate clinical midwives confidence to apply required skills of basic newborn resuscitation. This study was undertaken to develop and psychometrically test an instrument to measure basic newborn resuscitation skills among clinical midwives. Materials and Methods The multi-dimensional nature of the tool was confirmed, with four core factors being identified. A total of 118 midwives who attended the birth and performed basic newborn resuscitation were observed by a trained researcher to fill the required performed skills. The skills ranged from not performed to appropriately performed and met standard sequence. Results Content validity indices, CVI and CVR, for MSNRQ were 0. 712 and 0. 94, respectively. Reliability was confirmed in internal consistency (α = 0. 851). Construct validity was confirmed using the generalized factor analysis. Conclusion The instrument was successfully tested and modified, and factorial validity was subsequently confirmed. There was strong evidence of internal consistency, reliability, content, and convergent validity of the basic newborn resuscitation skill instrument.

Background: Leisure time activities might be associated with school performance. This study aimed to investigate the association between leisure time variables, including television and computer using time, homework time and cell phone using time, with children’ s school performance in a nationally representative sample of Iranian children and adolescents. Materials and Methods: In this analytical cross-sectional study as the fifth survey of a national school-based surveillance program in Iran, participants were selected by multi-stage sampling approach among 7-18-year-old students from urban and rural areas. In addition to filling questionnaires obtained from World Health Organization Global School Health Survey and conducting physical examinations, the averages of school grades were categorized into "very good" (grade 17-20 out of 20), and "not very good" (under 17 out of 20) as school performance according to qualitative evaluation scales established recently in Iranian schools. Results: The participation rate was 99%, 14, 274 students completed the study. Urban students spent more time doing homework and using screen media, and they had better school performance than rural students (P < 0. 001). Girls had higher homework time and better school performance than boys (P < 0. 001). Prolonged screen time, including watching television and computer use increased the odds of lower school performance (Odds ratio = 1. 11). No other media type times or homework time had a significant association with school performance. Conclusion: In this study, prolonged screen time represents an inverse association with school performance. Television viewing time, computer and cell phone using time and homework time might have no separate significant effects on school performance.

Background The spectrum of foreign bodies is various based on specific environment and eating habits in each area. This study was designed to identify the type of foreign bodies, associated symptoms and management of children with ingestion or aspiration of objects. Materials and Methods This descriptive retrospective study reviewed the medical charts of all children under 18 years of age with suspected foreign body aspiration or ingestion who were admitted to Namazee Hospital affiliated to Shiraz University of Medical Sciences over a 5-year period from 2013 to 2018. The data recorded in the checklists were analyzed using SPSS software version 22. 0. Results Over the five-year study period, 369 children in the age range of 28 days to 18 years with FB ingestion or aspiration were included in this study. Of 264 patients (43. 9% girls, 56. 1% boys) with a mean age of 3. 73± 3. 30 years who had referred with foreign body ingestion, an identifiable object was recognized in 245 (92. 8%) patients. The most common ingested object was coin (40. 9%) followed by disc batteries (15. 9%). Foreign bodies had been aspirated in 105 patients (32% girls, 68% boys) with a mean age of 3. 1± 2. 8 years. The majority of the aspirated objects were seeds (28. 6%). Conclusion This study showed the most common ingested FBs were coin and is more commonly located in the esophagus; however, the common aspirated FBs were seeds and lodged preferentially in the right bronchial tree.

Background Rectal biopsy and its histopathological study with hematoxylin and eosin (HE) is the gold standard for Hirschsprung's disease (HD) diagnosis. However, there are some limitations in the diagnosis of ganglion cells in HE approach. Recently, it was reported that the utility of Calretinin is a reliable ancillary immunohistochemistry (IHC) test for HD diagnosis. We aimed to investigated Calretinin and S100 IHC staining as ancillary methods to diagnose HD. Materials and Methods: In this cross sectional study, 36 rectal biopsies taken from suspected HD patients were evaluated in pathology department of Mofid children’ s Hospital. Patients ranged from 1 day to 60 months. Data were collected in a 2-year period from 2014 to 2016 in Mofid Children Hospital, Tehran, Iran. The histological study was done observing HE stained tissue sections by two pathologists and diagnoses were: twenty-four HD (aganglionic), and twelve non-Hirschsprung's (NHD) (normoganglionic) patients. Then Calretinin and S100 IHC were performed on the slides. The IHC slides were evaluated by two pathologists and the diagnostic value of Calretinin and S100 was determined in comparison with gold standard which is the presence or absence of ganglion cells in serial HE stained sections of rectal biopsies. Results The results in this study demonstrated that sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for S100 were 61. 9%, 93%, 93%, and 62%, respectively. Also, sensitivity, specificity, NPV, and PPV for Calretinin were all 100%. Conclusion Based on the findings it may be concluded that Calretinin Immunohistochemistry had good diagnostic value and S100 Immunohistochemistry had intermediate level diagnostic value for Hirschsprung's disease.

Background Cutaneous leishmaniasis (CL) is a common parasitic infectious disease which is distributed worldwide. Despite low morbidity rate, the disorder negatively impacts on psychological well-being and social life of patients. We aimed to evaluate the frequency of psychiatric morbidity including depression and anxiety levels as well as quality of life (QOL) in children with CL. Materials and Methods In this cross-sectional study, 42 children with CL who referred to the Leishmaniasis clinic of Mashhad University of Medical Sciences, Mashhad, Iran, were enrolled by the convenience sampling method. Levels of depression and anxiety were assessed with the Child Depression Inventory (CDI), and the State-Trait Anxiety Inventory for Children (STAIC), respectively. QOL was evaluated by means of Children's Dermatology Life Quality Index (CDLQI). Questionnaires were filled by parents according to the children’ s answers. Results Forty-two patients including 29 girls (69. 04%), and 13 boys (30. 95%) with mean age of 9. 10 ± 1. 87 years were studied. According to the CDI scores, 13 patients (30. 95%) had depression disorder. Girls showed significantly more depression compared to boys (p = 0. 021). According to the STAIC scores, 9 patients (21. 42%) had anxiety state, and 6 patients (14. 28%) had anxiety trait. Non-acceptable QOL was detected in 24 patients (57. 14%). Significant lower QOL was detected in patients with divorced parents (p = 0. 038), and those who had lesions on head and neck compared to other parts of the body (p = 0. 023). Conclusion Based on the results, CL in children leads to disturbed QOL and mental health including depression and anxiety among affected patients. Psychological survey of children with CL should be considered through interdisciplinary scrutiny that combines dermatological and psychiatric evaluations.

Background: Chemotherapy is the main component of systemic cancer treatment; however, the effective application is restricted due to nausea and vomiting. We aimed to assess the effect of acupressure on nausea and vomiting in children undergoing chemotherapy. Materials and Methods: An extensive search was done in databases of Medline, Embase, Scopus, Cochrane, and Web of Science until February 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: Four studies were included in the systematic review (including 223 children and adolescents aged 5 to 19 years). The first study assessed the effect of acupressure wrist bands and placebo bands; the results showed the feasibility of well tolerated acupressure, but not more effective than placebo. In the second study, researchers concluded that the acupressure bands compared to sham bands could not improve nausea and vomiting, neither in the acute nor the delayed phase. In addition, daily vomiting was not improved via acupressure bands in either the acute, or the delayed phases in chemotherapy. In the third study, a significant difference was observed between the two groups auricular acupressure intervention+ standard care (AAP), and auricular acupressure using sham auricular points (SAP) + standard care regarding occurrence, and severity of both nausea and vomiting. The results of fourth study showed that acupressure has a significant role in the reduction of nausea, vomiting and retching associated with chemotherapy among adolescents with cancer. Conclusion: The patients considered the acupressure as a safe, effective and well-received strategy though objective criteria exhibited no statistically significant improvements compared to conventional care.

Human rights are rights inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion, or any other status. Human rights include the right to life and liberty, freedom from slavery and torture, freedom of opinion and expression, the right to work and education, and many more. Everyone is entitled to these rights, without discrimination. The right to health is the economic, social, and cultural right to a universal minimum standard of health to which all individuals are entitled. The concept of a right to health has been enumerated in international agreements which include the Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, and the Convention on the Rights of Persons with Disabilities. There is some debate on the interpretation and application of the right to health due to considerations such as how health is defined, what minimum entitlements are encompassed in a right to health, and which institutions are responsible for ensuring a right to health.

Background Life skills are the strategies that enable people to live a successful life in different environments. Life skills training promotes self-esteem. Self-esteem, as one of the most fundamental factors in the optimal growth of personality in teenagers, is a crucial factor. Considering the role of life skills in gaining self-esteem, we aimed to study the status of life skills and self-esteem as well as the association between life skills and self-esteem among Iranian teenage girls. Materials and Methods This correlational cross-sectional study was conducted on 364 teenage girls in the age range of 12-14 years in Birjand city, 2018. The data were collected using a three-part questionnaire; baseline characteristics, Life Skills questionnaire, and Rosenberg Self-esteem Questionnaire. Data were analyzed using SPSS software version 22. 0. Results The highest mean score of life skills was related to the "interpersonal relationships" dimension (15. 07 ± 2. 99); whereas, the lowest mean score was related to the "problem-solving" dimension (12. 09 ± 3. 53). The total mean score of life skills was 138. 23 ± 26. 80 and the mean score of self-esteem was 4. 98 ± 4. 41. There was a significant association between life skills and self-esteem (p<0. 05). Conclusion According to the significant association between life skills and self-esteem, we can improve adolescents' self-esteem by conducting appropriate educational courses about life skills.

Background Congenital hypothyroidism (CH) may cause alterations in the child's global development. The current study aimed to screen the global development of children with and without congenital hypothyroidism, focusing on communication, and cognitive abilities and to investigate the influence of illness severity, clinical history, and treatment factors in the evaluated results. Materials and Methods A case control study was conducted on 20 children with early-treated congenital hypothyroidism (CH), and controls without CH (n=100), both groups were matched for age and sex. Patients were subjected to a protocol of assessment applied in Pediatric and Phoniatrics Unit Sohag, Egypt. Assessments included detailed history and medical data, language development testing, intelligence quotient (IQ). According to TSH and T4 levels, case group was divided into controlled group and uncontrolled group. 99m pertechnetate scintigraphy of thyroid (Tc-99m TS) was recommended for all CH children. Results Children’ s ages ranged between 3-7 years with a mean age of (4. 6 ± 1. 9year). There were statistically significant differences between study and control group in presence of middle ear effusion, delayed language development, IQ scores (p<0. 001). Interestingly, there was a negative correlation between IQ test and total language age with TSH level (r =-0. 06, p= 0. 004; r =-0. 4, p=0. 06), respectively. Tc-99m pertechnetate scintigraphy of thyroid confirmed transient CH diagnosis in three cases. Conclusion Despite early treatment in the studied CH children, language and cognitive skills impairments were detected. The magnitude of these impairments related significantly to TSH values and regularity of hormone replacement therapy. TS confirmed transient CH diagnosis in three cases, replacement therapy stopped in those children.