Journal of Pediatric Perspectives
Year:2013 | Volume:1 | Issue:1|Papers Count:8

Introduction: Hyperbilirubinemia is a relatively common disorder among infants in Iran. Bacterial infection and jaundice may be associated with higher morbidity. Previous studies have reported that jaundice may be one of the signs of infection. The aim of this study was to determine the incidence rate, presentation time, severity of jaundice, signs and complications of infection within neonatal hyperbilirubinemia.Materials and Methods: This cross sectional study was conducted between 2003 and 2011, at Ghaem Hospital, Mashhad- Iran. We prospectively evaluated 1763 jaundiced newborns. We finally found 434 neonates who were categorized into two groups.131 neonates as case group (Blood or/and Urine culture positive or sign of pneumonia) and 303 neonates with idiopathic jaundice as control group. Demographic data including prenatal, intrapartum, postnatal events and risk factors were collected by questionnaire. Biochemical markers including bilirubin level, urine and blood cultures were determined at the request of the clinicians.Results: Jaundice presentation time, age on admission, serum bilirubin value and hospitalization period were reported significantly higher among case group in comparison with control group (p<0.0001). Urinary tract infection (UTI), sepsis and pneumonia were detected in 102 (8%), 22 (1.7%) and 7 (0.03%) cases, respectively.Conclusion: We concluded that bacterial infection was a significant cause of unexplained Hyperbilirubinemia among jaundice newborns (10%). Therefore, we advise performing screening test for UTI as part of the evaluation in asymptomatic jaundice infants presenting after five days of life and sepsis workup should be request in symptomatic infant especially in the first week of life.

Introduction: Vitamin deficiency and iron deficiency anemia are common nutritional problems, at least in children under 5. These materials shortage, especially in the first two years of life, impair physical and brain growth, reduces the child's learning ability, reduces body resistance against infections, behavioral changes, apathy and finally social and economic adverse consequences would be followed. This study aimed to determine the supplements used in children under two years and its Association with Growth rate in Mashhad City.Materials and Methods: In this cross-sectional descriptive study, 300 children 6 to 24 months were recruited in health centers in Mashhad, Data was collected from mother and and children’ records and valid and reliable questionnaire was used to collect data. The data was analyzed by statistical tests and SPSS 11.5 and P<0.05 was considered significant.Results: Results showed that 13.7 percent of families were with low income, 82.7 percent middle income and 3.7 percent well income. In growth chart, 86.7 percent of children showed appropriate growth, 10.3 percent had delayed growth and 3 percent had horizontal growth curve. In 80.7 percent of families, maternal multivitamin and iron drops have been used to their children regularly, 1.7 percent did not believe in these supplements and 17.7 percent of mothers sometimes used these supplements for their children. Results also showed statistical correlation significant variables of parental education, family income, mothers referred to health centers for monitoring the growth and get face to face training of personnel center drops of multivitamin with iron and growth status of children variable is available, so children who regularly have used supplements and income level and above are literate parents have grown more favorable than the other kids (P<0.05).Conclusion: Regarding the importance of iron and multivitamin use in children under two years, necessary training must be provided to mothers in this field by health centers personnel. Meanwhile, it is recommended that the authorities must distribute periodical and enough drops to health centers.

Introduction: To define the clinical features, biochemical and histological findings and outcome of three forms of autoimmune hepatitis.Materials and Methods: In a cross sectional study between November 2001 to January 2008 in Tehran and Mashhad university of medical sciences, 61 children who diagnosed as AIH (40 girls and 21 boys) have been analyzed for their clinical, serological, and histological data. Variables analyzed included age, sex, clinical presentation, hepatic function, immunoglobulins, autoimmunity markers, histology and clinical evolution. According to the auto-antibodies profile, AIH patients were classified as type I AIH (ANA or smooth-muscle antibodies or both positive), type II (anti-LKM-1 positive) and type III (antibody negative).Results: We analyzed data of 61 children with AIH. 51 patients (median age: 10 (0.7-14) years had anti-nuclear and/or smooth muscle antibody (ANA/ASMA or both), 5 (median age: 7 (2-8) years) had liver/kidney microsomal antibody (LKM-1). 5 patients had no detectable autoantibody. At presentation: 60% had jaundice or symptoms of acute hepatitis; LKM-1 positive were younger. Interface hepatitis was seen in 100% and fibrosis+/- cirrhosis were found in 70%. Frequency of AIH was 2:1 in girls. Type 1 was the most frequent diagnosis (83%) and was more frequent in older children. Relapse and treatment failure were common in type II.Conclusion: AIH may have different clinical presentation in children. Althout most of cases may have high inflammatory activity or cirrhosis, good response to treatment and remission may accur.

Introduction: Mild intermittent asthma is common in children and viral infections are responsible for the majority of exacerbations. As leukotrienes are potent inflammatory mediators, some studies have shown that Montelukast, a leukotriene receptor antagonist, may be effective on reduction of asthma symptom. To determine whether a short course of Montelukast in asthmatic children with common cold would modify the severity of an asthma episode.Materials and Methods: Children, aged 6-12 years with intermittent asthma participated in this randomized, double-blind, placebo-controlled clinical trial. Treatment with Montelukast or placebo was initiated at the onset of viral upper respiratory tract infection and continued for 7 days. Primary outcomes included the clinical manifestation: duration of episodes, daily symptom, nights symptoms and activity limitation. Secondary outcomes included the need for beta agonist usage, oral prednisolone, physician visit, hospital admission and school absence.Results: A total of 187 children with intermittent asthma were randomized, 93 to Montelukast group and 94 to placebo group. Montelukast significantly decreased the cough by 17.3% (P<0.001), nighttime awakenings by 5.4% (P=0.01), interference with normal activity by 6% (P<0.01), time off from school by 6% (P<0.01), b-agonist usage by 17.2% (P<0.001) and doctor visits by 12.2% (P<0.01) compared to placebo. Whereas there was a non significant reduction in wheezing, tachypnea, respiratory distress, asthma exacerbation, oral prednisolone and hospitalization (P=0.8).Conclusion: A short course of Montelukast, introduced at the first sign of a viral infection, results in a reduction in cough, β-agonist use and nights awakened, time off from school and limitation of activity. More studies are needed to evaluate the optimal dose and duration of treatment.

Introduction: Increasing number of working mothers and changes in viewpoints on fathers’ roles in families has increased fathers’ participations. Fathers’ participation is his broad, positive and active participation in different stages of children’s life. Women possess the main role in enhancing and limiting father’s participation. Fathers and couples require training to define father’s role in infant care and the significance of his role in infant’s health and foundation of family. Therefore, the present study is done to determine the impact of training couples and fathers how to take care of infants on the rate of father’s participation to take care of infants after birth.Materials and Methods: The study was done as a clinical trial in three groups, on 150 people who refered to health clinical centers of Medical University of Mashhad. Fathers of training group and couples of training group took part in two training sessions of infant care in weeks 35 to 37 of pregnancy. The questionnaires of role of father’s training in infant care were filled by mothers in three groups and were analyzed by SPSS18 software and ANOVA with repeated measure, Bonferroni tests.Results: Role of fathers’ participation in infants care in father’s training group and couple training group than control group increased significantly (P=0.003).Conclusion: Training fathers and couples before birth will enhance rate of their participation in infant care.

Introduction: The autism spectrum disorders (ASD) are amongst the most heritable complex disorders. Although there have been many efforts to locate the genes associated with ASD risk, many has been remained to be disclosed about the genetics of ASD. Scrutiny's have only disclosed a small number of de novo and inherited variants significantly associated with susceptibility to ASD. These only comprise a small number of total genetic risk factors. Some studies confirm the contribution of mitochondrial genome mutations to the pathophysiology of the autism, but some other studies rejected such a contribution. In the current study we tried to scrutinize the association between mitochondrial tRNA genes mutations and the risk of Autism.Materials and Methods: DNA was extracted from the blood of 24 patients with ASD and 40 age-matched healthy controls from Special Medical Center in Tehran. 22 tRNA genes of mitochondrial genome were PCR amplified using 12 primer pairs and sequenced. Sequencing results were searched for mutations using clustalW Progran and then the association of mutations with the autism risk was assessed by statistical analysis using SPSS version 15.Results: Many of the observed mutations were sporadic mutations without any significant relationship with the risk of autism, and the other mutations including those of high frequency showed no significant relationship with the risk of disease as well (P>0.05) except mutations 16126T>C (P=0.01), 14569G>A(P=0.02) and 1811A>G(P=0.04). These three mutations were in the noncoding regions of the mitochondrial genome near tRNA genes. The mutation 16126T>C was in the mtDNA control region.Conclusion: Our study showed a significant relationship between the point mutations 16126T>C, 14569G>A and 1811A>G of the mitochondrial genome and the risk of autism.

Introduction: Beta-thalassemia is the most common hereditary disease in Iran. More than two million carriers of beta-thalassemia live in Iran. Since the Iranian population is a mixture of different ethnic groups, it is necessary to determine the frequency in the different parts of the country.Materials and Methods: This descriptive study is a cross sectional study with helping by professional groups fighting diseases in Khorasan Razavi province.Results: In Iran, according to World Health Organization, about 4 percent of the population, are carriers of the thalassemia gene. In other words, about 2-3 million people are suffering from thalassemia minor.Now, more than 18 thousand cases of thalassemia are scattered across the country in different provinces, are different. Mazandaran, Gilan, Hormozgan, Khuzestan, kohgiloyeh, Fars, Bushehr, Sistan and Baluchestan, Kerman and Isfahan, are 10 provinces with high prevalence in our country. We have 342 cases of thalassemia major in Khorasan Razavi province.Conclusion: Prevalence of thalassemia in our country is 3.6% and Iran is located on the belt of thalassemia and due to a history of consanguinity, this disease has a prevalence of 0.6% among in the provinces of Khorasan Razavi.

Kawasaki disease is a systemic vasculitis of children. Among gastrointestinal symptoms of this disease jaundice occurs uncommonly. We present a 23 month boy with icter and clinical hepatitis and final diagnosis of kawasaki disease.