Journal of Pediatric Perspectives
Year:2020 | Volume:8 | Issue:6 (78)|Papers Count:14

Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing pregnancy complications including gestational diabetes and preeclampsia. This study was performed with the aim of examining the impact of metformin on incidence of gestational diabetes and preeclampsia in pregnant women with PCOS. Materials and Methods: In this clinical trial, 88 pregnant women with PCOS with a history of taking metformin referring to Fatemieh hospital in Hamedan, Iran in 2017-18 were randomly assigned into two groups: metformin consumption (1000-2000 mg/day) continuing throughout the pregnancy and control (stopping metformin consumption immediately after detection of pregnancy). The pregnancy and fetal consequences and complications were compared in both groups. The data were analyzed by STATA software version 14. 0. Results: In both groups, no significant difference was observed in terms of mean age, duration of infertility, body mass index, and baseline variables (p>0. 05). The relative risk (RR) of incidence of gestational diabetes (RR: 1. 97, 95% CI: 1. 63-2. 39), preeclampsia (RR: 2. 65, 95% CI: 1. 95-3. 59), and abortion (RR: 2. 33, 95% CI: 1. 69-3. 22) was higher in the control group who did not continue metformin consumption throughout the pregnancy (p<0. 05). The frequency of C-section was lower in the intervention group than in the control group (p<0. 05). Conclusion: Based on the results of the present study, continuation of metformin consumption in women with PCOS during pregnancy may be associated with decreased adverse consequences of pregnancy including gestational diabetes and preeclampsia.

Background: Early Childhood Caries (ECC) is considered as the most prevalent childhood disease. Numerous factors have been mentioned for the formation of ECC. This study evaluated the relationship of parental dental anxiety and ECC in Iranian Children. Materials and Methods: In this cross-sectional study, 340 parent-child dyads were divided into two groups: the first group consisted of 170 parents and their 3-6-year-old child with ECC (the case group), and the second group consisted of 170 parents and their 3-6-year-old child without ECC (the control group). Samples were selected using cluster random sampling from the kindergartens of Zahedan, Iran in 2019. A questionnaire containing parent's information (age, education level, occupation and monthly income), and Corah Dental Anxiety Scale (CDAS) were used in this study. Data were analyzed using SPSS software version 20. Results: The anxiety level of mothers and fathers of the case group was similar to the control group (P= 0. 284 and P= 0. 114, respectively). There was no statistically significant difference between the level of parental anxiety (mother and father), and dmft index in the case group (P= 0. 154 and P= 0. 255, respectively). Also, mothers who were equal or less than 30 years-old were more anxious than mothers with more than 30 years-old (P= 0. 034). Conclusion: Based on the results, there were no significant differences in the groups based on parental dental anxiety. In other words, parental dental anxiety cannot lead to ECC in children.

Background: The most common sites affected in pediatric osteomyelitis are long bones of lower extremities such as femur and tibia but isolated fibular osteomyelitis has rarely been reported in children. Here, we present a case of isolated chronic osteomyelitis of fibula in a 2. 5-year-old girl. To our knowledge, this is the youngest patient reported with isolated chronic fibular osteomyelitis in literature. Case Presentation: A 2. 5-years-old Iraqi girl was referred to our center with pain and swelling of the right lower leg. Her vital signs were stable and she had partial weight bearing on her right foot. She had been partially treated for acute osteomyelitis 4 months before. She was diagnosed with isolated chronic osteomyelitis of the right fibula and undergone surgical debridement. There was no bacterial growth on blood and bone tissue cultures and the patient was empirically treated with IV cloxacillin and ceftriaxone, followed by oral clindamycin for at least 3 months. At a 6-month follow-up, she was symptom-free and showed complete recovery. Conclusion: We present a rare case of isolated chronic fibular osteomyelitis in a child, emphasizing the importance of appropriate empiric antibiotic therapy compatible with the patient's age and suspected organism in case of negative cultures.

Background: Green tea and salt had been known for a long time as an effective home remedy for common cold and flu. We aimed to evaluate the effect of gargling with warm salty green tea on signs and symptoms of acute upper respiratory tract infection (AURTI) among children. Materials and Methods: A two group, quasi-experimental research design was adopted. Tools: (1) structured interview to collect socio-demographic data of children, and history of the child's disease (2) signs and symptoms of AURTI inventory. Samples: A purposive sample of 200 school age children who attended the outpatient clinics in Cairo University Specialized Pediatric Hospital (CUSPH), Cairo, Egypt. 200 cases were assigned randomly as follows: 100 children as controls for whom analgesics were prescribed, and 100 children as intervention group, who were given salty green tea gargling in addition to analgesics; data of signs and symptom severity were collected on daily basis for three consecutive days. Results: There was a highly significant difference between controls and intervention group regarding total mean score of signs and symptoms (p-value<0. 01). In addition, there was a highly significant positive correlation between children’ s age, sex, residence, presence of a smoking family member and presence of another family member with similar condition and the total mean signs and symptoms score in control and intervention groups. Conclusion: Children with AURTI in intervention group showed less total mean signs and symptoms scores than those in the control group. Recommendations: Experimental studies on larger random samples need to be conducted to explore the effect of gargling with salty warm green tea on the signs and symptoms of AURTI.

Varicella is a common and worldwide disease in childhood. It causes primary (chickenpox) and latent infection that may lead to a reactivation disease called zoster (shingles). Zoster or shingles is caused by reactivation of the virus that has been latent in the spinal dorsal ganglion and may occur even in immunocompetent hosts. Although zoster is rare in children, it may happen sometimes latter. The contemporaneous occurrence varicella and zoster are very rare. We present an immunocompetent 4 years old boy presented by simultaneous varicella and zoster after a household contact. In this case, the virus appeared both neurotropic and dermotropic characteristics simultaneously. This study may enhance the awareness about this rare presentation and obviate the need for unnecessary treatments and investigations for both clinicians and patients.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus. A pneumonia of unknown cause detected in Wuhan, China was first reported to the WHO Country Office in China on 31 December 2019. The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020. On 11 February 2020, WHO announced a name for the new coronavirus disease: COVID-19. The Middle East is one of the areas where the virus has become widespread and has caused many deaths. The severity of the COVID-19 disease varies from country to country, with the highest rates of infection in Iran, Turkey and Egypt. Compared to other countries involved, Iran has the most recovery, too. It is worth noting that these countries have been the target of unfair US sanctions for many years, and the import of drugs and medical equipment is associated with many problems. By maintaining personal hygiene and keeping a distance from anyone who is coughing or sneezing, also stopping the civil and foreign wars, lifting the sanctions and paying special attention to the health of all people, especially the weak and sensitive, there is hope that the disease may be defeated.

Background: Women with unplanned pregnancy experienced a number of psychological problems. Thus, the present study aimed to examine the effectiveness of midwifery counseling based on cognitive approach in improvement of adaptation to pregnancy, mother-fetal attachment and quality of life among unplanned pregnant women. Materials and Methods: This pre-test posttest control group single blind study was done on pregnant women who were chosen from the healthcare centers of Zanjan city, Iran. Of 187 women screened for eligibility to participate in the study, 54 unplanned pregnant women met inclusion criteria and were randomly assigned into intervention group or control group. The intervention group received eight weekly group cognitive therapy sessions. The control group received prenatal routine care. The participants answered WHO Quality of Life Questionnaire, Maternal-Fetal Attachment Scale, and Lederman Prenatal Self-evaluation Questionnaire at pretest, posttest, and one-month follow-up periods. Results: The two groups were not different in terms of age (p = 0. 89), educational status (p = 0. 56), and job status (p = 0. 31). In addition, they were not different regarding pre-test scores of Lederman Prenatal Self-evaluation Questionnaire (p = 0. 27), Maternal-Fetal Attachment Scale (p = 0. 22), and WHO Quality of Life Questionnaire (p = 0. 37). At posttest and one-month follow-up, the intervention group showed significant improvement in adaptation to pregnancy (p < 0. 0001), Maternal-fetal attachment (p < 0. 0001), and quality of life (p < 0. 0001) than the control group. Conclusion: Midwifery counseling based on cognitive approach could be an effective approach to improve adaption to pregnancy, maternal-fetal attachment, and quality of life among women who became pregnant unintentionally.

Background: COVID-19, novel coronavirus, has been identified by the World Health Organization as a pandemic that causes highly transmittable respiratory disease. Lack of awareness about COVID-19 preventive measures represents a global threat. The aim of the current study was to evaluate the effect of nursing instructions about COVID-19 preventive measures on knowledge and reported practice of hospitalized school age children. Materials and Methods: One group pre-posttest quasi-experimental design was utilized to carry out the current study. Setting: The study was conducted in the medical wards at Cairo University Specialized Pediatric Hospital (CUSPH). Sample: A purposive sample of 100 hospitalized school age children was included in the study. Data Collection Tool: Structured interview questionnaire designed by the researcher contained seventy-eight questions related to children's demographic data, general knowledge about COVID-19, symptoms, modes of transmission, treatment and prevention was used. Results: More than half of the children's ages ranged from 10 to 12 years, they were males and ranked as first child. The results of the current study revealed that there were statistically significant differences in total mean score of children's knowledge before and after receiving nursing instructions and total mean score of children reported-practices Conclusion: School age children had insufficient knowledge about novel COVID-19; along with low standards of reported-practices. After nursing instructions, higher total mean scores were detected regarding their knowledge and reported-practices. Recommendations: Pediatric nurses must provide awareness and public knowledge regarding the novel COVID-19 with simple Arabic illustrative educational booklets and posters about COVID-19 for all children in all health care settings to prevent the spread of this pandemic disease.

Background Hypertrophic pyloric stenosis (HPS) is a common surgical condition in infancy, and typically presents at 2-4 weeks of age. Case Presentation A full term male neonate in Zeinabieh hospital, Shiraz, Iran was presented with oral feeding intolerance from birth, bile-stained output of nasogastric tube, and a double bubble sign on abdominal radiography suspected to duodenal atresia. However subsequent laparotomy on 3 day of life revealed HPS. rd Conclusion HPS should be considered as part of a rare differential diagnosis of newborn with sign of obstruction at birth.

Background: Oral health is one of the key elements of quality of life and welfare. The aim of this study was to investigate the role of the Theory of Planned Behavior (TPB) as predictors of dental brushing behavior among Iranian adolescents. Materials and Methods: This cross-sectional study was carried out on 791 students in Guilan province, Iran, during the year 2018. The participants were selected through the multi-stage random sampling method. The data collection tool was a self-administered questionnaire designed based on TPB. The validity and reliability of the scale were assessed and confirmed. The data were analyzed using linear and logistic regression models in SPSS software version 21. 0. Results: Nearly half of the assessed students were girls (49. 6%, n=392/791). In total, 363 students (45. 9%) brushed their teeth once or more daily. The TPB constructs accounted for 28% of the variance of intention to teeth brushing. Multiple logistic regression showed that one-point increase in scores of attitude, perceived behavioral control (PBC), and subjective norms, led to 10%, 12%, and 3% increase in the odds of daily teeth brushing respectively. Moreover, one-point increase in behavioral intention increased the odds of daily teeth brushing 2. 24 fold. Conclusion: Based on the results, the level of oral health practice was unfavorable among most of Guilan high school students compared to similar studies in the world. It seems designing and implementing educational interventions based on TPB constructs especially variables of perceived behavioral control and attitude, could result in optimal activities regarding oral health care among students.

Background: Cerebral hydatid cyst is a rare condition even in endemic parts of the world, which usually happens in children. Huge cysts are usually presented with neurological deficits and symptoms of increased intracranial pressure. Here, we present the case of a five-year-old child with solitary huge cerebral cyst. Case Presentation: A five-year old girl presented with symptoms of headache, nausea, and vomiting in the emergency department of Ninth of Dey Hospital, Torbat Heydariyeh, Iran. She had referred to several doctors and received symptomatic treatments. In the initial impression, the patient had no neurological deficit but a suture splitting in physical examination and laboratory findings showed no eosinophilia. The brain computed tomography (CT) scan showed a huge cystic lesion suggestive for hydatid cyst. The cyst was removed intact and postoperative treatment with albendazole was initiated. The patient was discharged in good condition with no recurrences in a six-month follow-up. Conclusion: Huge cerebral hydatid cyst is a very rare condition, usually occurring in solitary form and in children. Surgical removal and postoperative medical treatment should be considered in these cases.

Background: The relationship between anthropometrical and physiological parameters with jumping and throwing distance is important. We aimed to investigate the relationship between anthropometrical and physiological parameters with jumping and throwing distance of young elite female jumpers and throwers for talent identification and performance predicting. Materials and Methods: In this cross sectional study, subjects were selected from 122 elite girl runners, 14-16 years old, who participated in the 2019 national championship selection of the country in Ardabil, Iran. All anthropometrical and physiological parameters were measured with appropriate and reliable tools. Limbs’ circumference, trunk flexibility and dynamic balance were measured using a China rubber band meter. Limbs’ length was measured with China VERINER caliper. Subcutaneous fat and hands and legs strength were measured with Iran Pouya Caliper (Reliability 99. 32% and validity 99. 8 %), and the dynamometer (the Grip Dynamometr-Blue model (0-130 Kg), American model), respectively. Static balance was measured with timer (KhosRo1 / 100SECSW50). Pearson correlation coefficient was used to examine the relationships between variables. Results: There was a significant negative relationship between hand action and reaction time (r=0. 545, P=0. 009) with high jump distance (n=22). There was a significant negative relationship between palm width (r=-0. 011, P=0. 002) and hand action and reaction time (r=-0. 458, P=0. 028) with javelin throw distance (n=23). In contrast, there was no significant relationship between anthropometrical and physiological parameters with triple jump distance, weight throw, and discus throw. Conclusion: Based on the results, there was a significant negative relationship between hand action and reaction time with high jump distance, between palm width and hand action and reaction time with javelin throw distance.

Background: Diabetes Mellitus is the fourth leading cause of death worldwide, bringing enormous costs to communities and the health care system. Self-care behavior has a major influence on type 1 diabetes (T1D) health outcomes, and with successful management, children and adolescents with T1D can lead long and healthy lives. This study aimed to investigate the predictors of self-care behavior in adolescents with T1D based on social cognitive theory (SCT). Materials and Methods: This study is a descriptive-analytical cross-sectional study in adolescents with diabetes mellitus type 1. A self-administered questionnaire based on SCT and self-care behavior was completed by 200 girls and boys, aged between 14 and 19 years old in Isfahan Endocrinology and Metabolism Research Center, Iran. The data were analyzed by descriptive statistics and hierarchical multiple regression analysis in SPSS software version 23. 0. Results: The mean age of the participants was (16. 61+2. 67 years). The majority of participants were woman (n=123) and single (n=152). The results of regression analysis showed that SCT constructs (self-efficacy, outcome expectations and self-regulation) were able to explain self-care behavior significantly (R =0. 4, p<0. 001), and the self-regulation was the strongest predictor of self-care behavior (β =0. 5, p <0. 001). 2 Conclusion: Considering the explanation of self-care behavior by SCT constructs in the present study, and the effective role of self-regulation in explaining self-care behavior in adolescents with diabetes mellitus type 1, it is recommended to consider strategies for improving the self-regulation in these adolescents in future interventions.

Background: The COVID-19 infection, which has been a pandemic since early 2020, can occur in pregnant women and transmit to the baby after birth. There are few reports of this transmission in newborns. Regarding the effect of multiple causes of respiratory symptoms in a neonate, it is difficult to diagnose COVID19 infection in the newborn. In this regard, the evaluation of antibodies in the blood umbilical cord may be an option. We studied the COVID-19 infection in newborns. Materials and Methods: In this longitudinal follow-up study, pregnant mothers who had suspicious symptoms of coronavirus infection before or after childbirth were consulted by the medical team for neonatal infection. Newborns were evaluated for respiratory symptoms. PCR test for coronavirus was performed on a pharyngeal swab or tracheal tube sample of the newborns. Results: Twenty-five pregnant women with symptoms of suspicious coronavirus infections were consulted by a team of specialists from March 15 to April 15, 2020. After delivery, their babies were carefully examined and followed up. Four neonates had coronavirus confirmed by the PCR test. Conclusion: Our study shows that neonates can become infected with Covid-19. This issue should be considered among various differential diagnoses of neonatal respiratory diseases.