Journal of Pediatric Perspectives
Year:2017 | Volume:5 | Issue:1 (37)|Papers Count:15

Background Management and control of adolescence aggression improves constructive relationships, quality of life, and academic achievement. This research aimed to study the impact of educational intervention on reduction of aggression among male high school students in Ilam city, Iran. Materials and Methods This quasi-experimental intervention study using the pretest-posttest method was conducted on 70 aggressive male high school students in Ilam who were selected using the convenience sampling method. First, students were asked to fill out the Buss-Perry Aggression Questionnaire (BPAQ)and 70 of them with the highest score of aggression were selected as the sample. They received educational intervention for eight 90-minute sessions during one month. Then post-test data were collected and follow-up at three months after the intervention and statistically analyzed using SPSS-20. Results The mean age of subjects was 15. 81± 1. 24 years old. 83% belonged to the urban community and 12. 5% belonged to the rural community. The results showed that the educational intervention was effective in reduction of aggression levels and its four subscales (P<0. 05). The results of the within-subject ANOVA indicated that the mean score of overall aggression, verbal aggression, physical aggression, anger, and hostility, follows a linear and descending trend from the posttest to the follow-up (P<0. 05). Conclusion: The study findings suggest that development of educational interventions can lead to improved management of aggression and mental health of students.

Familial adenomatous polyposis (FAP) is a hereditary autosomal dominant cancer syndrome, results from germ line mutation or deletion of the Adenomatous Polyposis Coli (APC) gene on chromosome 5q21. Patients with FAP suffer from multiple polyps mainly at the colorectal region as well as other parts of the gastrointestinal tract, which has propensity to transform into carcinoma. FAP has also been well described in association with various syndromic extra-gastrointestinal manifestations. Less commonly, patients with FAP present with varying degrees of cognitive dysfunction and developmental delay, though the reason for the association is unclear. Herein, we report the case of a male patient born with an interstitial deletion of chromosome 5q, 46, XY, del(5) (q14q23), presenting with familial adenomatous polyposis (FAP), profound developmental delay, cognitive dysfunction, and multiple congenital anomalies including talipes equinovarus, agenesis of the corpus callosum, and dysmorphic facial features.

Background: The present study assesses independent predictors of clinically important traumatic brain injury (ciTBI) in order to design a prognostic rule for identification of high risk children with mild head injury. Materials and Methods: In a retrospective cross-sectional study, 3, 199 children with mild traumatic brain injury (TBI) brought to emergency ward of three hospitals in Tehran, Iran were gathered, from April 2014 to April 2016. The associations between probable predictors of ciTBI in children with mild TBI were assessed and a prediction rule for identification of high risk children in need of computed tomography (CT) scan was designed based on a stepwise multivariate logistic regression. Results: 592 (18. 5%) children had ciTBI. History of loss of conciseness (odds ratio [OR]=3. 0; p<0. 0001), underlying disease (OR=3. 6; p=0. 002), Glasgow coma scale (GCS) score equal to 14 (OR=40. 6; p<0. 0001), altered mental status (OR=19. 1; p<0. 0001), need for intubation (OR=27. 4; p<0. 0001), presence of vomiting (OR=7. 3; p=0. 001), and sign of basilar skull fracture (OR=25. 9; p=0. 007), were the most important prognostic factors of ciTBI in children. Pediatric traumatic brain injury prognostic rule (PTBI prognostic rule) was designed based on these predictors. PTBI prognostic rule had an area under the curve of 0. 93, a sensitivity of 100. 0%, a specificity of 73. 0% and a proper calibration (slope=0. 97 and intercept=0. 006) in identification of ciTBI. Conclusion: The present study showed that a few of children with mild TBI have ciTBI. Therefore, CT scans are not necessary in all of these children. Using PTBI prognostic rule can reduce the number of unnecessary CT scans.

Background Osteoporosis is one of the most important health problems and it is of great importance to prevent this disease. This study aimed to evaluate the nutritional preventive behavior of osteoporosis using health belief model in female students in Qom city, Iran. Materials and Methods This cross-sectional descriptive analytical study was conducted on 265 tenth to twelfth grade female students in Qom city. The subjects were selected via multistage sampling method. To collect data, we used a standard questionnaire based on health belief model. Data were analyzed by SPSS version 20. 0 using independent t-test, Pearson correlation coefficient, and ANOVA. Results Knowledge and perceived self-efficacy had a positive and significant relationship with nutritional preventive behavior of osteoporosis (P=0. 04, r=0. 12 and P=0. 004, r=0. 18, respectively). However, perceived susceptibility and perceived barriers had a negative and significant relationship with nutritional preventive behavior of osteoporosis (P=0. 02, r=-0. 14 and P<0. 001, r=-0. 27, respectively). Perceived severity and perceived benefits had no significant relationship with nutritional preventive behavior of osteoporosis (P=0. 08, r=0. 11 and P=0. 22, r=0. 07, respectively). Conclusion Health Belief Model is a helpful and efficient model for preventive behaviors. This method can be also utilized to design intervention programs to change osteoporosis preventive nutritional behaviors.

Background: Due to lack of detailed standards of sexual maturity in individuals with Intellectual, sensory and motor disability in Iran and the importance of timing of onset of puberty in these individuals, a study is necessary. By knowing the onset of puberty, physiologic and behavioral changes can be traced in these people, as well as the potential impact of the puberty on the underlying disease can be considered. The aim of the study was to investigate of sexual maturation among boys of special schools of Tehran. Materials and Methods: Cross-sectional study was performed on children and adolescents male students in special school in Tehran at 2013. A random, multistage sample 0f 895 boy students of special schools was taken from 25 special schools in five districts of Tehran city. In this study, symptoms and stages of puberty were identified. Pubertal stages were assessed by visual inspection and palpation based on the rating scales of Tanner. In addition, demographic data such as age, height, weight were collected. Then the data were analyzed and mean age of onset of puberty was determined. Results: The mean age of onset of puberty in boys (Genitalia stage 2) was 13. 12 ± 1. 84 years and sexual maturation was completed at 16. 57 ± 1. 34 years. The average height at the onset of puberty (Genitalia stage 2) was 151. 1 ± 9. 91 cm and the average weight was 48. 47 ± 10. 14kg. The mean BMI for puberty onset was 20. 89 ± 5. 43. Conclusion: In our study, the mean age of puberty onset in boys with disabilities was 13. 12 ± 1. 84 years. Compared to the data from healthy boys, our findings indicate that the mean age of pubertal onset in boys with disabilities in special school is higher than that of their healthy counterparts.

Background: Infant's transition is a challenge for parents and the health system that requires ongoing assessment and management to improve each newborn`s growth and development. The purpose of this study was to explore the management of infant` transition from neonatal intensive care unit (NICU) to home. Materials and Methods: We used a grounded theory study to explore and describe the management of infants’ transition from the NICU to the home. Interviews were conducted with 31 professionals and 20 family members, and participant observations were made in hospitals, clinics, and one physician office. MAXQDA was utilized for coding and categorizing data. Results: The theory illustrated six phenomena: An unexpected separation; A crisis situation; Mother-infant rebonding; Protection of the infant’ s health; Promotion of growth and development; and Inadequate management causing disability. Together, these formed a three-phase process consisting of: A threat to the infant's life, Efforts to save the infant's life, and Continuation of life. Conclusion: Development of the theory of infants transition provides a three phases process ( A threat to the infant’ s life, Efforts to save the infant’ s life, and Continuation of life), that can yield guidelines to manage the infant` transition in prevent mother– infant separation, support parents in their role as primary caregivers, and follow up with individual home visits by nurses.

Background: The breakfast is the most important meal of the day that its regular consumption is effective on individuals' physical, psychological and social health. Given the high prevalence of irregular consumption of breakfast among students, this study aimed to investigate breakfast consumption behavior and self-efficacy, outcome expectations, evaluation and knowledge in elementary students. Materials and Methods: This cross-sectional study was carried out on 360 (52. 3%) female primary school students and 154 (47. 7%) male students of Isfahan-Iran using cluster-random sampling. The data were collected in a self-reporting form by researcher made questionnaire. The data were analyzed using SPSS 18. 0 with independent t-test, ANOVA, Pearson correlation coefficient, and multiple regression. Results: The mean breakfast consumption (in a week) score of 2. 4 with a standard deviation of 1. 7. 10. 5% of students were eating breakfast daily. There was a significant relationship between breakfast consumption and self-efficacy, outcome expectation and outcome evaluation (P<0. 001). There was an inverse relationship between students' age, economic situation and breakfast consumption (P=0. 01 and r=-0. 143). Multiple regression analysis showed there was a significant relationship between self-efficacy (Beta [standardized regression coefficients] =0. 145), type of school (Beta =0. 631), and student age (Beta =0. 402) and having breakfast and it predicted 24. 3% of breakfast consumption variance. Conclusion: Results showed that eating breakfast is not desirable in students. Self-efficacy is a predictor of breakfast consumption. Therefore, some interventions such as regular psychological counseling to increase the self-efficacy of students and educational programs to increase the knowledge of students are necessary to increase breakfast consumption rate.

Background For using of complementary and alternative medicine methods (CAM) in the leukemia pediatrics than other types of cancer, we have two great challenges; first challenge is their safety and risks and second challenge is study gaps in this field. Regarding to these challenges, this study is a narrative review of some CAM methods in the leukemia pediatrics from the perspective of their safety, risks and study gaps. Materials and Methods In this narrative review study searched both international electronic databases including ISI Web of science, PubMed, PsycINFO, CINAHL, ISC, Embase, Scopus, Google Scholar and also, Iranian electronic databases including Magiran, Medlib and SID. Also, searches were performed separately in the specialized journals in the field of leukemia pediatrics and complementary and alternative medicine research. Results Music therapy, gentle yoga movements, gentle massage types are quite safe for leukemia pediatrics. But, use of heavy yoga movements, massages with deep pressure, acupressure and acupuncture can be dangerous for leukemia pediatrics (risks of bleeding and or infection). Also, this study showed that, the number of investigations about the use of CAM in the leukemia pediatrics is very limited; especially in the field of yoga and acupuncture. Conclusion The results of this study can be a basis both for chose of safe CAM method in these children and a basis for future studies on the basis of identified study gaps in this review study.

Background: Previous studies have shown that meconium staining of the amniotic fluid may affect maternal and neonatal outcomes. In this study, we aimed to investigate the relationship between birth weight and meconium passage and its related factors in pregnant women. Materials and Methods: This matched case control study was conducted on a total of 200 newborns (100 as cases and 100 as controls) in Imam Reza and Valiasr hospitals in Qom city-Iran in 2014 and 2015. A questionnaire was used to collect required data including the passage or non-passage of meconium, newborn's birth weight, gestational age, maternal age, newborn gender, maternal weight, comorbidities, type of delivery, and history of abortion or stillbirth. Data were analyzed by SPSS using independent t-test, Fisher exact test, and Chi-square test. Results: Based on the results of this study, there was a significant difference between the two groups in terms of birth weight (P=0. 001). So, the birth weight was higher in the cases than in the controls. There was also a significant differences between the two groups in terms of the relationship between newborns gender and meconium passage (P=0. 04). In addition, there was a significant difference between the two groups in terms of gestational age (P=0. 035). Moreover, a significant difference was observed between the two groups in terms of birth height (P=0. 003). Conclusion: The newborns birth weight associated meconium passage. Therefore, meconium passage must be monitored and controlled through examination and screening during the period of pregnancy.

Background Life expectancy has increased in congenital heart diseases (CHD) patients and the interest has risen considering the quality of life (QOL). The study aimed to compare patients and proxy-parents reports on CHD children' QOL. Materials and Methods This cross-sectional study performed on 165 CHD patients aged 2-18 years during 2016 using Pediatric Quality of Life 3. 0 (PedsQL™ 3. 0) inventory. PedsQL™ 3. 0 has same dimensions with different question for various age groups. The internal consistency of the inventory scales and subscales was assessed by means of Cronbach’ s alpha. Scales with reliability ≥ 0. 70 were recommended. Results The overall mean score of QOL was significantly higher in parents’ perceived (51. 78± 10. 87) compared to children’ s perceived (48. 61± 11. 25) (t=-2. 615, P=0. 009). The anxiety was significantly higher (56. 23 ± 17. 93 vs. 47. 31± 17. 96) in parents’ perceived compared to children (t=-2. 281, P=0. 025). The cognition has been perceived significantly better by children than parents’ (51. 22± 15. 76 vs. 41. 53± 13. 15). Children with simple diseases had higher score of quality of life (53. 09± 13. 44) compared with those children with complex diseases (42. 73± 18. 23) (t=2. 786, P=0. 007) for 2-4 years age in parents' perceived. The mean scores in heart problem scale were 46. 74± 13. 64 and 61. 14± 18. 17 and for the communication scale were 28. 49± 13. 87 and 41. 77± 20. 23 for pre and post operated children respectively for the age group of 5-7 years in parents' perceived. Conclusion Resulted no impacts by two clinical (types of diseases and operation) factors on CHD patients' Health-related quality of life (HRQOL). Therefore should be considered more clinical factors to detect the gap in QOL in CHDs.

Background Bronchiolitis is the commonest cause of lower respiratory tract infection in infant. Respiratory syncytial virus is the commonest cause of bronchiolitis. This study aimed to assess the efficacy of nebulized 3% hypertonic saline and salbutamol in the treatment of acute bronchiolitis in comparison with nebulized 0. 9% saline and salbutamol. Materials and Methods A prospective case second multicenter study was done at two pediatric tertiary centers at the period from 1st of December 2014 to 31 of March 2015. A total of 100 previously well infant and children of age 1-24 months with clinical diagnoses of bronchiolitis who were admitted to the hospital were included. They were divided into two groups, the study group received 4 ml of nebulized hypertonic 3% saline (for 14 days), and second group received 4 ml of nebulized normal 0. 9% saline (for 14 days), each co-administer with 0. 5 ml salbutamol. Results All patients with acute bronchiolitis having similar baseline characteristic, mean age 4. 9 + Standard deviation (SD) months, male gender constitutes 68% of the patients and the majority (67%) of the cases were below 6 months. The mean of clinical severity score at admission was 6. 4 for normal saline (NS) group and 6. 6 for hypertonic 3% saline (HS) group. The mean length of hospital stay of normal saline group = 4. 3 + Standard deviation (SD) day and for hypertonic saline group was = 4. 7 + Standard deviation (SD) day. Conclusion We didn’ t find any advantage of hypertonic 3% saline over 0. 9% normal saline in terms of length of hospital stay and clinical severity score.

Background: Nasal continuous positive airway pressure (NCPAP) is an effective method of ventilation in newborns with respiratory distress syndrome (RDS). Using an appropriate nasal skin care protocol is identical to prevention or reduction of nasal skin breakdown in those who receive NCPAP. This study aimed to investigate the effectiveness of an evidence-based clinical care protocol on nasal skin integrity in preterm newborns who receive NCPAP. Materials and Methods: A Randomized Controlled Trial was used to conduct the study. A cohort of 110 preterm newborns with a gestational age (GA) of 25 to 36 weeks, receiving nasal continuous positive airway pressure (NCPAP) for RDS in the neonatal intensive care unit of a university teaching hospital were selected to perform the study. They were randomly assigned to a protocolized nasal skin care (group A) or to a group receiving the routine care (group B). Nasal skin integrity of the preterm neonates, were measured on a daily basis for 10 days using the Neonatal Skin Condition Scale (NSCS) 24 hours after placement of NCPAPs in both groups. Results: Each intervention and control group included 55 neonates. 65. 50% of neonates in the control group and 47. 30% of neonates in the intervention group were male. Repeated measures analysis showed that NSCS scores were significantly lower in intervention group receiving nasal skin care in accordance with the protocol than the control group receiving the routine nasal skin care (P=0. 000). Conclusion: In this study, the protocolized care reduced nasal skin breakdown in the preterm newborns receiving NCPAP. Therefore, it can be used as an effective method in nasal skin care in neonates who are treated by NCPAP.

The rare form of skeletal dysplasia is thanatophoric dysplasia. The meaning for thanatophoric dysplasia is death bearing which is derived from Greek word. It occurs 1in 20, 000 to 50, 000. It is mainly due to mutations in the fibroblast growth factor receptor 3gene. Features of thanatophoric dysplasia are frontal bossing, prominent eyes, narrow thorax, protruded abdomen and bowed legs. The knowledge about this condition is useful in the fields of Anatomy, Paediatrics, Obstetrics and Gynaecology, Ultrasonagraphy and Genetics, for future research purpose.

Background: Helicobacter pylori (H. pylori) is a common bacterial infection, with considerably high morbidity and mortality worldwide. This bacterium represents a key factor in the etiology of various chronic infections ranging from gastritis, peptic ulcer disease to gastric cancer; but the prevalence has large variations in different communities. The aim of this study was to estimate the prevalence H. pylori infection in a nationally representative sample of Iranian adolescents. Materials and Methods: In this cross-sectional study, serum samples of 882 Iranian adolescents, aged 10-18 years, were examined for seroprevalence of H. pylori. They were randomly selected from the samples obtained in the third survey of a national surveillance program (the CASPIAN III study). Seroprevalence of H. pylori was examined by detection of H. pylori immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) in sera by using Enzyme Linked Immunosorbant Assay (ELISA). Results: The study participants had a mean age of 14. 82 + 2. 77 years. Overall, 51. 7% of students were boys and 61. 52% were urban residents. The H. pylori IGM and IGA seropositivity had no significant association with demographic characteristics (p>0. 05). The H. pylori IgG seropositivity were significantly different in boys and girls (69. 7%, 95% confidence interval [CI] = 66. 7-72. 7 vs. 76. 3%, 95%CI= 73. 5-79. 1, respectively, P=0. 03). Conclusion: The seroprevalence of H. pylori IgG in Iranian adolescents is high, and girls had greater risk of H. pylori IgG seropositivity compared to boys. Preventive strategies and health education are recommended to reduce the prevalence of this infection in Iranian adolescent.

Background Acute otitis media (AOM) is very common in children. In spite of spontaneously relief, some cases suffer from the recurrence and other complications occurring after AOM. Animal studies have proved that persistence of leukotrienes in the middle ear may play a role in the development of AOM. Based on this statement, treatment with leukotriene modifiers may be effective in the treatment of OM. The aim of this study was to examine the effect of adjunction of montelukast to antibacterial agents in treatment of AOM. Materials and Methods One hundred patients aged 2-6 years were randomly divided into two groups. One of the groups (53%) were treated with "amoxicillin alone", 80-90 mg/kg amoxicillin for 10 days, and the other group (47%), received "amoxicillin and montelukast" 5 mg per day orally for 10 days. Patients were evaluated for resolution and complications of AOM at 2 post enrollment visits (days 2-4 and 10-14). Results The patient followed-up for one month and results showed that, treatment with montelukast had beneficial effects on resolution of AOM. In monotherapy (amoxicillin alone) group, 66% of patients and in the montelukast (amoxicillin and montelukast) group, 85. 1% were treated. Conclusion In this study, the montelukast receiving group showed a better response to treatment. Based on this and previous studies, it is recommended to consider the role of inflammatory mediators in AOM. Prescribing montelukast and other leukotriene receptor antagonists may have benefits for the patients.