Journal of Pediatric Perspectives
Year:2016 | Volume:4 | Issue:3|Papers Count:10

Background: Medication errors (MEs) are the most common types of medical errors which effecting on pediatric safety. For decrease MEs, we should to have information about difference aspects of MEs. We have no study which assessed the frequency, types and causes of MEs made by pediatric nurses, in Iran.Material and Methods: This was a cross-sectional study, which performed on 53 Pediatric Nurses. Data were collected by a self-structured questionnaire for assessment of MEs contained 3 parts: 1- one question about the fact that, do you had MEs in past 3 months; 2- types of MEs occurred (12 items); 3- causes of MEs from nurses’ perspective (20 items). The MEs in past 3 months gathered through pediatric nurses’ self-report. Descriptive statistics and Chi-square test were used for analysis. Data were analyzed using the SPSS.Results: The majority of participants were female (77.3%), and initial (novice) nurses (33.9%). The results showed that, 31 (58.4%) of nurses were reported at least one MEs history and totally, 131 MEs were occurred in past 3 months. Most prevalent of MEs types were reported: wrong dose (36.6%) and wrong drug preparation (14.5%). Also, most prevalent of MEs causes from Nurses’ perspective were reported: poor medication knowledge (96.2%) and poor calculation skills (73.5%).Conclusion: With using of this study results, we can program for prevention/decrease MEs and enhancing pediatric safety. On the basis of this study, actually we should enhancing level of nurses knowledge by education and to carry out special courses for pediatric nurses.

Background: Mothers’ empowerment in breast-feeding is a key motivational and psychological factor for continuous breast-feeding. Therefore, this study was designed to examine the effects of family-centered educational-supportive program on mothers’ empowerment in breastfeeding.Materials and Methods: In this random clinical trial, pregnant women who met inclusion criteria were gradually selected and randomly put into a control and an intervention group. For the intervention group, two 2-hour educational breastfeeding sessions were held for each pregnant woman along with her key family members and breastfeeding training manual and software were given to them; then mothers and family members attended a breastfeeding counseling session one week after delivery. The control group received routine education. Mothers’ empowerment was assessed by a researcher-made questionnaire two weeks after delivery.Results: Thirty-five mothers were in the intervention group and 35 were in the control group. The mean of the total score of breast-feeding empowerment and its seven areas in the intervention group was significantly higher than that of the control group. Moreover, exclusive breast-feeding was also significantly higher in the intervention group (P<0.05).Conclusion: Results showed that family- centered education during pregnancy and post-delivery counseling and support could promote mothers’ empowerment in breast-feeding and exclusive breast-feeding. It is therefore necessary for breast-feeding promotion to begin training of mothers and their families during pregnancy period while focusing on the importance of breast-feeding and to teach breast-feeding skills and family support after delivery and resolve related problems in collaboration with key family members.

Background: The learning environment dramatically affects the learning outcomes of students. Noise, inappropriate temperature, insufficient light, overcrowded classes, misplaced boards and inappropriate classroom layout all make up factors that could be confounding variables distracting students in class. This study was conducted to examine the effect of noise in educational institutions on the academic achievement of elementary school students in the academic year 2015-2016 in Ahvaz.Materials and Methods: This study is applied and it is survey in terms of the nature of study. The population of the study included all male elementary school students in Ahvaz, of whom 210 students were selected randomly as the sample of the study. Cluster sampling was done by appropriate allocation. Questionnaires were randomly distributed among students. Data collection tools included Hermance’s achievement motivation questionnaire and the researcher-constructed questionnaire (observation checklist to examine the physical parameters of noise in educational institutions) and interviews with students. Validity of questionnaires was confirmed by content and construct validity, and the reliability of study was confirmed by Cronbach's alpha. The data of the study were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (factor analysis, t-test, Kolmogorov - Smirnov test and one-way ANOVA analysis) in SPSS-21.Results: The results showed that noise in educational institutions has a negative impact on learning and academic achievement of elementary school students in Ahvaz (P<0.05).Conclusion: Educational managers are recommended to reduce or remove the educational environment noises.

Background: Acute appendicitis is one of the common and urgent illnesses among children. Children usually are unable to help the physicians completely due to weakness in describing the medical history. Moreover, acute appendicitis overlaps with conditions of other diseases in terms of Symptoms and signs in the first hours of presentation. These conditions lead to unwanted biases as well as errors for diagnosis of acute appendicitis and increase the medical costs for hospitals and patients. The purpose of this study is to develop a computer based model in the diagnosis of Acute appendicitis specially at pediatrics field.Materials and Methods: Fuzzy-rule based systems are popular methods widely used in the Clinical Decision Support Systems (CDSSs). In this article, a hybrid Fuzzy rule based system as a CDSS was compared with the Alvarado method for diagnosis of appendicitis in children. In this system an evolutionary algorithm was also developed to create and optimize the Fuzzy rules for diagnosis of pediatrics. To find the performance of the proposed model, a dataset was created from children with abdominal pain who referred to the teaching general hospitals in Ahvaz, Iran in 2013 to 2014 years. In this process, the results achieved from the developed model were compared with the Alvarado scoring system used for children with abdominal pain in the previous studies.Results: The experimental results showed that the developed model has a proper performance to detect the patients with acute appendicitis from others techniques and models such as the Alvarado scoring system.Conclusion: The developed model can be used as an assistant for physicians in the diagnosis of acute appendicitis, especially in the field of pediatrics.

Fluconazole is commonly used both to prevent and to treat invasive neonatal Candida albicans infection. This drug is a potent, selective, triazole inhibitor of the fungal enzymes involved in ergosterol synthesis. It is largely excreted unchanged in the urine. In infants with a birth weight<1, 500 grams, fungal infection is approximately 3% to 4%. Up to 30% of infants with invasive candidiasis die. Penetration into the cerebral spinal is good. While high-dose systemic exposure of 400 mg/day in the first trimester of pregnancy can produce serious fetal abnormalities a single dose of 150 mg of fluconazole does not produce fetal abnormalities. The fluconazole exposure target AUC of ≥400 mg.h/ml should be reached and a dosage of 12 mg/kg/day is recommended. However, to reach the desired fluconazole concentration a loading dose of 25 mg/kg of fluconazole is used in patients with candidiasis on the first day of therapy. The half-life of fluconazole ranges from 25.5 to 88.6 hours while adults it is 32 hours. In prematures, the half-life of fluconazole is 88.6, 67.5 and 55.2 hours, in the first day, in the first week and in the second week of life, respectively. The clearance of fluconazole ranges from 0.27 to 0.52 ml/min/kg and the adults it is 0.27 ml/min/kg. The distribution volume of fluconazole ranges from 1.1 to 2.4 l/kg and in adults it is 0.60 l/kg. The aim of this study is to review the effects and pharmacokinetics of fluconazole in neonates.

Aim: This study aimed to assess the relationship of screen time and metabolic syndrome (MetS) among Iranian adolescents.Materials and Methods: In this nationwide study, the propensity score (PS) was used in a matched case-control study design. The data was obtained from 5, 625 students aged 10-18 years, who participated in a national school-based surveillance program. MetS was defined according to the criteria of the International Diabetes Federation (IDF). In addition, the continuous MetS score (cMetS) was calculated and the best cutpoint for cMetS was selected based on the receiver operator characteristic (ROC) curve estimate of sensibility and specificity. Data analysis was performed by a conditional logistic regression in 2014.Results: Screen time increased the risk of MetS by 44% with a near significant P- value (P=0.052). The time spent on computer during leisure time was significantly associated with MetS and waist circumference (P<0.05). Moreover, the time spent on watching TV had significant relationship with elevated serum triglyceride levels (P<0.05).Conclusion: The current findings serve as confirmatory evidence on the adverse health effects of prolonged ST, including the association of leisure time computer use with increase in the risk of MetS and excess weight, as well as the relationship of the time spent on watching TV with serum triglycerides levels. Reducing sedentary leisure time activity, notably ST, should be considered as a health priority for the pediatric age group.

Background: Nutritional health and adequate physical activity (PA), especially in childhood and grow periods, have a substantial role in health. This study assessed the association of dietary behaviors (main courses and snacks intake) with PA in children and adolescents.Materials and Methods: Using multistage random cluster sampling method, a representative sample of 14, 880 school students were selected from urban and rural areas of 30 provinces of Iran. Through a validated questionnaire, daily consumption of main course (breakfast, lunch, and dinner) as well as daily consumption of different snacks and health foods (fast foods, milk, vegetables, dry fruits, fresh fruits, sweetened beverages, salty snacks and sweets) were recorded for every participants. Information of past week weekly frequency of leisure time PA was collected.Results: Overall, 13, 486 out of 14, 880 students (response rate: 90.6%) participated in this survey. Participants consisted of 6, 640 (49.2%) girls and 75.6% urban residents; their mean and standard deviation (SD) age was 12.47 (3.36) years. Daily consumption of fresh fruits (odds ratio [OR]: 1.35, 95%confidence interval [CI]: 1.20-1.52), dried fruits (OR: 1.21; 95%CI: 1.06-1.40), vegetable (OR: 1.39; 95% CI: 1.24-1.56), and milk (OR: 1.35; 95% CI: 1.21-1.52) increased the odds of high PA compare to low PA in adjusted model. Skipping the breakfast, lunch and dinner decreased the odds of moderate and high PA compare to low PA (P<0.05).Conclusion: Present study showed that dietary behaviors are associated with PA level in Iranian adolescents. Findings should be used for better evidence based planning of health promotional programs in these age groups.

Background: Thalassemia is the most common single-gene disorder that carries along many difficulties and effects such as oral and dental problems in patients. This study aimed to determine DMFT indicator and its correlation with the amount of serum ferritin and hemoglobin in patients with thalassemia major.Materials and Methods: This cross-sectional study has been conducted by descriptive-analytical method, in 2015 with the participation of 50 patients with thalassemia major referring to Shafa hospital in Ahvaz and 50 healthy samples who were demographically similar to patients. Then, DMFT indicator was investigated in both groups; the amount of hemoglobin and serum ferritin was considered in patients, too.Results: In the patient group, the average of DMFT indicator was 4.94 with a standard deviation of 1.5 and in control group 5.8 with a standard deviation of 2.04 (P<0.05). There was a significant difference between the averages of the filled teeth in two groups (P<0.05); but there was not any significant relationship between the amounts of hemoglobin and serum ferritin on the one hand and DMFT indicator on the other (P<0.05).Conclusion: Considering that the results showed that thalassemic patients are not in appropriate condition regarding the oral and dental hygiene and dental health and referring to dentist. Educational these patients and their families about the increasing use of dental care and oral hygiene and treatment are recommended.

Liver or hepatic transplantation (LT) is the replacement of a diseased liver with part or whole healthy liver from another person (allograft). Human liver transplants were first performed by Thomas Starzl in the United States and Roy Calne in Cambridge, England in 1963 and 1967, respectively. Liver transplantation is a viable treatment option for end-stage liver disease and acute liver failure. Pediatric patients account for about 12.5% of liver transplant recipients. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic location as the original liver. Cirrhosis, or liver injury, is a common reason why adults need liver transplants and children with bile duct disease issues are often the candidates. Survival statistics depend greatly on the age of donor, age of recipient, skill of the transplant center, compliance of the recipient, whether the organ came from a living or cadaveric donor and overall health of the recipient. Survival rates improve almost yearly, due to improved techniques and medications.

A 7 year-old male presented with recurrent fever, cough and respiratory distress for over last 2 years. Based on extremely high eosinophil count, high Immunoglobulin E, increase in eosinophilic precursors in bone marrow, and positive antigen test for Wuchereria bancrofti, a diagnosis of Tropical Pulmonary Eosinophilia with Eosinophilic Leukemoid Reaction was made. Complete recovery was achieved with Diethylcarbamazine for 3 weeks. We are reporting this case as the first case of Tropical pulmonary eosinophilia with eosinophilic leukemoid reaction in a child.