Journal of Pediatric Perspectives
Year:2016 | Volume:4 | Issue:7 (31)|Papers Count:27

Background Autism spectrum disorder (ASD) is a intricate childhood neuropsychiatric disorder that is described by deficits in communication of verbal and non-verbal, reciprocal social interactions, stereotypic behaviors, interests, and activities. The studies of post-mortem neuro-anatomical anomalies have indicated that migration alterations could occur early during development (first trimester) in autistic brain. Since the Reelin gene, plays a crucial role in these migratory processes, it is subsequently considered as a potential candidate gene for autism. Materials and Methods In this case-control study, we recruited 74 patients with ASD and 88 healthy controls from Iranian-Azeri Population. Genomic DNA isolated from blood leukocytes of cases and control individuals by the proteinase K and using salt-out method. Single nucleotide polymorphisms (SNP) genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Results The allele and genotype frequencies did not show significant difference between autistic and control groups (P>0. 05). No significant relationship was observed between the genders and genotypes in autism group (P>0. 05). Conclusion The current study showed that the SNPs rs362691 could not be used as a useful molecular biomarker to predict genetic susceptibility for ASD among Iranian-Azeri patients.

Background This study aimed to assess the effects of maternal self-efficacy and oral health-related knowledge on pre-school children oral hygiene behavior. Materials and Methods This cross-sectional study was conducted on 301 mothers with children aged 2– 6 years old randomly selection from health centers of Tabriz, Iran. Data were collected using self-report questionnaires including demographic characteristics, maternal self-efficacy, oral health-related knowledge, and children’ s oral hygiene behavior. Data were analyzed using SPSS 16 using one-way ANOVA, Independent samples t-test, and multiple linear regressions at 95% significant level. Results The mean age of children was 4. 1(standard deviation [SD] =1. 4; range: 2– 6 years). The mean score (SD) of children oral hygiene behavior was 5. 4 (1. 9). The mean score (SD) of mothers knowledge and self-efficacy were 4. 9 (1. 8) and 46. 6 (14. 8), respectively. 44. 2% (133/301) of mothers had low self-efficacy and 55. 8% (168/301) high self-efficacy. The children oral hygiene behavior was significantly and positively associated with maternal self-efficacy (r = 0. 517, P < 0. 001) and oral health-related knowledge (r = 0. 363, P < 0. 001). Conclusion According to the results of this study, mothers’ self-efficacy and knowledge was the strongest predicator of children oral hygiene behavior. So, educational interventions to improve maternal self-efficacy and knowledge may be beneficial for children oral health habits.

Background Febrile seizure is one of the most prevalent childhood convulsions. There are controversy about possible relation between febrile seizure and Attention Deficit Hyperactivity Disorder (ADHD). The aim of this study was to find the effect of simple febrile seizure on ADHD in children. Materials and Methods In a case-control study all children of 3-12 years old with febrile seizure referring Amir-Kabir hospital, Arak-Iran. Among these children, 103 of them with no corporeal or psychiatric disorders were compared to 103 children of the same age and gender admitted due to disease other than febrile seizure utilizing DSM-IV criteria for ADHD. Data were analyzed using SPSS 16. Results This study shows that the hyperactivity disorder in the same order were 34. 3% and 16. 7%, respectively, which also denotes a significant relation between simple febrile seizure and hyperactivity(P<0. 05). The frequency of consanguineous marriages was 26. 2% in parents of children with simple febrile seizure, and 9. 7% in the control group (P<0. 05). Conclusion A significant relationship observed between FS with HI and CT of ADHD among children. In addition, hyperactivity has a significant relation with febrile seizure in male gender, making further investigation in these children prudent for early diagnosis and management.

Background: The accidents are the leading cause of morbidity and mortality among children in in the world. The aim of this study was to determine the effect of Educational intervention on promotion of prevention behaviors of home accidents in mothers with children less than 5-year based on protection motivation theory (PMT) in 2015. Materials and Methods: In this controlled interventional study 190 mothers with children less than 5 years were participated (95 in intervention group and 95 in control group). The data collection tool was researcher made questionnaire based on the structures of PMT. After done pre-test and the results obtained from it, appropriate educational intervention designed and was conducted only in intervention group. Then two months after the educational intervention, evaluation was done and data analysis was using SPSS-20. Results: Statistically significant difference was found between mean scores of all structures of PMT in intervention and control groups after the educational intervention (P<0. 05). There was a significant difference between the mean scores of all structures of PMT in intervention group in before and after the educational intervention (P<0. 05); whereas no significant difference was seen between mean scores of all structures in control group in before and after the educational intervention (P>0. 05). Conclusion: The results of this study showed that PMT can be used as a framework in designing educational programs in order to promotion of prevention behaviors of home accidents in mothers with children less than 5-year.

Background Breast milk is the best and most effective food for infants and their survival and health. Promotion of breastfeeding self-efficacy is a goal of breastfeeding education. The purpose of this research was to teach breastfeeding through role-playing and explore its effects on breastfeeding self-efficacy among pregnant women referring to healthcare centers of Isfahan, Iran. Materials and Methods This study was carried out in 2014 on 74 pregnant women who referring in two healthcare centers of Isfahan. Data collection tool was Denis and Fox’ s breastfeeding self-efficacy questionnaire. The intervention group was trained at the 36th week of pregnancy while the control group received routine care. Questionnaires were administered before the intervention and then one week and one month after delivery. Data were analyzed using SPSS-18. Results The mean score of self-efficacy, one month after delivery, was significantly higher in the intervention group (P<0. 05). Also, the frequency distribution of breastfeeding self-efficacy differed significantly between the control and the intervention groups (P<0. 05) and exclusive breastfeeding was higher in the intervention group (P<0. 05). Conclusion Since role-playing method of teaching is directly related to breastfeeding self-efficacy it seems that laying the grounds for providing pregnant women with breastfeeding education could offer a solution for promoting self-efficacy and ultimately exclusive breastfeeding.

Background: The mean of DMFT (D=decayed teeth or untreated caries, M=missing teeth, F=filled teeth and T=permanent teeth) has been increasing from 1957 to 2015 years in Iran. The current survey aimed to test the power of health promotion model for predicting the oral health behavior among high-school students. Materials and Methods: A cross-sectional study was conducted on 482 high school students in Gorgan city, Iran. Multi-cluster sampling was used to recruit the samples. A researcher-made questionnaire based on HPM was implemented to collect data. To analyze, SPSS-18 and statistical tests, including t-test, Pearson correlation coefficient and univariate and multivariate regression models were used. Results: A total of 482 high-school students including 255 (52. 9%) male and 227 (47. 1%) with mean age of 16. 02 ± 0. 5 were investigated. The highest and lowest prevalent positive oral health behavior were tooth brushing (73%) and using fluidized oral irrigator (3. 6%), respectively. Except for perceived barriers (with negative correlation), all constructs of HBM were positively related to oral health behaviors. Self-efficacy was the strongest predictor of oral health behavior (β =0. 653) (r=0. 541, P<0. 05). Conclusion: HPM seems likely beneficial to design and develop oral health behaviors among students. Self-efficacy and perceived benefits should also be noticed to promote students oral health behaviors.

Background Neonatology has evolved with respect to the needs of premature infants for special care. One of the major problems in premature infants is that their lungs are not developed adequately to fulfill newborns’ needs. There is a broad spectrum of strategies for management of respiratory problems in premature infants. In this study, we aimed to determine the best Strategies against Respiratory Problems in Extremely Low Birth Weight Infants. Materials and Methods In this analytical, prospective study, we recruited 79 newborns with birth weight of less than 1000 g, who were born in Mahdieh Hospital in Tehran-Iran, during September 2011-March 2013. The newborns were divided into three groups of Supportive care (n=10), the INSURE strategy (n=17), and Mechanical ventilation (n=52) based on their needs. Survival rate and complications were evaluated among these groups. Results Gestational age ranged between 23 and 34 weeks, and birth weight ranged between 420g and 1000 g. Survival rates in the supportive care, INSURE, mechanical ventilation groups were 90%, 47. 1%, and 17. 3%, respectively. Gestational age and birth weight in the three groups were significantly different (P<0. 05). Complications were not significantly different between the groups except for pulmonary hemorrhage, which was significantly higher in the mechanical ventilation group, compared to the other groups (P<0. 05). Conclusion However weight and gestational age are significantly different in all three groups, but only pulmonary hemorrhage as biomedical variable was higher in mechanical ventilation group. The best strategy according to different conditions for challenging babies is intervention only when it would be necessary and not rushing in INSURE and mechanical ventilation.

Background: Obesity has a growing global epidemic with several risk factors including lifestyle habits, physical activity, and prolonged screen time. This study aimed to compare the dietary habits and self-reported health behaviors in a nationally representative sample of Iranian children and adolescents. Materials and Methods: This cross sectional nationwide study was conducted in the framework of the fourth survey of a national school-based surveillance program, entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-IV) Study. Participants were 14, 880 students aged 6-18 years from 30 provinces in Iran. The World Health Organization-Global Student Health Survey questionnaire was utilized to assess their relationship with peers, body image, dietary, life-style and smoking habits, physical activity, and violence behaviors. Apart from the questionnaire, additional information on dietary habits was obtained as well. The Chi-square test and the student t-test were used to compare the groups. Results: Boys had higher proportions of obesity (P<0. 05). The prevalence of overweight and obesity decreased with age. Intake of refined bread (NS), non-hydrogenated oils (P<0. 001), and low fat dairies (P<0. 05) predominated in all three BMI categories. Meal skipping was less prevalent compared to planned meals, but there was an increasing trend according to BMI. All three BMI categories, were watching TV more than 2 hours per day (P<0. 05). Depression and fighting were more prevalent in overweight and obese individuals, respectively. Conclusion: Unhealthy food intake and dietary habits were prevalent in all BMI categories, while poor health related behaviors were more seen in children with higher weight.

Background In Iran, Brucellosis mainly is transmitted from animals to humans of non-occupational ways, thus its prevalence in children is equal to adults or higher than them, thus in view of etiology and public health studying the epidemiological pattern of Brucellosis in children is important. Present study aimed to investigate the epidemiologic characteristics of brucellosis in children under 15 years old in Hamadan province. Materials and Methods This cross – sectional study was carried out on children under 15 years old in Hamadan province during 2012-2014. 460 patients in this period were investigated. Data were analyzed using by descriptive statistics and incidence rate as an analytic statistics with Stata software version 12. P-value≤ 0. 05 considered as statistically significant. Results Overall 460 Brucellosis cases were detected in children during the studied period, among them N (%) of boys and reside in rural area were 317 (68. 9) and 404 (87. 8) respectively. Incidence rate of brucellosis was 41. 4 per 100, 000 populations. 103 cases (22. 4%) had a history of consumption of raw or unpasteurized milk products and 170 (37%) had direct contact with domestic animals. Conclusion Age and gender pattern of transmission of brucellosis in children in Hamadan province was similar to the pattern of endemic countries and prevalence in children was comparable with adults.

Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 – 2014. Children (186 boys, 186 girls) with Stage 3 to 5 CKDs, defined as a glomerular filtration rate below 60 ml/min per 1. 73 m2body surface area, were identified. Results Etiology was congenital anomalies of the kidney and urinary tract in 125 (33. 60%), cystic/ hereditary/ congenital diseases in 91 (24. 46%), glomerulopathy in 73(19. 62%), and cause unknown in 71 (19. 09%) patients. Forty-eight (13. 22%) were on conservative treatment, 174(47. 93%) had end-stage renal disease (ESRD) with chronic hemodialysis, 24 (6. 61%) were on continuous ambulatory peritoneal dialysis. Sixty-eight (18. 74%) underwent on renal transplant which was successful in 52 (14. 33%) patients but was associated with abnormal renal function in 16(4. 41%) children. Finally, 49 (13. 50%) patients died. Conclusion A large number of children developed CKD secondary to congenital anomalies of the kidney and urinary tract. Planning for screening, early detection and instituting timely treatment of preventable causes could lead to a lower incidence of CKD in this group of children.

Background Stevens-Johnson syndrome (SJS) is one of potentially fatal disorders that often occur after taking certain types of medication. There are reports of this disease after some infections. This paper presents the case of a young boy with idiopathic Stevens-Johnson syndrome. Case Report A six-year-old male patient with complaint of fever and skin lesions was transferred to emergency department of Bu-Ali Sina hospital (Center of Mazandaran province, Iran). After further evaluations (Physical examination and laboratory reports), the patient did not show any common causes of Stevens-Johnson syndrome. Fortunately he was discharged in a good condition after duration of treatment. Conclusion Further studies need to be done in the field of risk factors of Stevens-Johnson syndrome.

Background Nutrition support and noticing the required goal calories in patients having critical conditions are essential aspects of medical care in preventing malnutrition in these patients. Materials and Methods This research is a clinical trial which was done on 60 children aging between 5 to 17 years old hospitalized in Intensive Care Unit (ICU) of Shiraz’ s Namazee hospital, South West of Iran, during April to September 2015. Patients were separated randomly into two groups. Enteral nutrition was done with infusion pump for one of the groups and intermittently for the other one. The data was collected for 7 days by a check list regarding enteral nutrition method, complications and the time needed to reach goal calories. Data analysis was done using SPSS-18 software through Chi-square and t-student test. Results The results of this study showed that there was a significant difference of the mean time needed to reach target goal calorie between the continuous and intermittent nutrition methods (P<0. 05), so the time was less in continuous infusion method. Results showed that there was no significant difference between the GI complications of the two groups (P>0. 05). Conclusion This study showed that continuous enteral nutrition method has better outcomes in children hospitalized in ICU than intermittent method.

Background: Studies report inappropriate snack and junk food consumption patterns in children and young adults in Iran. The current survey was aimed to explore fast food consumption behaviors in high-school students based on the Theory of Planned Behavior. Materials and Methods: A cross-sectional study was done among 500 high-school students. Samples were selected based on cluster sampling method at first and simple random at second. Data were collected using a researcher-made questionnaire. To analyze, SPSS-16 and tests, including t-test, Chi-square, correlation coefficient and multiple regressions were used. Results: The monthly frequency of fast food consumption was 4. 01. The TPB explained fast food use behaviors with R2 of 0. 6, effectively. Results also represented that frequency of fast food consumption was meaningfully in line with behavioral intention (β = 0. 60, P < 0. 05) and subjective norms (β = 0. 17, P < 0. 05). Conclusion: It seems likely beneficial to consider important subjective norms (especially friends) that may strongly effect on high-school student intention to use fast food. Also students perceived behavioral control must be increased.

Background The prevalence of celiac disease (CD) is remarkably varied in Down syndrome (DS) patients compared with other diseases. This study aimed to assess celiac disease prevalence in Down syndrome children with and without congenital heart defects (CHD) and its comparison with controls. Materials and Methods This case-control study was performed at a single center on 132 participants in three groups. Clinical and genetic tests were performed on all patients suspected with Down syndrome to confirm their diseases. After that in patients with confirmed Down syndrome echocardiography was carried out to diagnosis of CHD. Healthy children selected randomly among those who referred to the center for annual check-up. Statistical evaluation was done using SPSS-16. Results For the factors of age, weight, height and Body Mass Index (BMI) not observed significant differences between three groups of participants, but it would be observed statistically differences for the variable of tTG-IgA. For variables of weight, tTG-IgA and BMI was observed statistically different in the case and controls. The status of tTG-IgA (normal or <= 20 and abnormal or >20) had significant correlation with three groups of controls, Down syndrome with and without CHD. The status of tTG-IgA also had significant correlation with groups of case and controls. In comparison of tTG-IgA in DS patients with and without CHD, no significant differences were observed. Conclusion The prevalence of CD in DS patients was higher compared the controls population; and in DS patients with CHD was higher compared the DS patients without CHD.

Background: Normal standard references of blood pressure (BP) for children and adolescents have been suggested to be constructed based on anthropometric indices. Accordingly, we aimed to develop first BP reference percentiles by weight and age for Iranian children aged 3-18 years old. Materials and Methods: A total of 16, 246 children and adolescents aged 3-18 years were included from 3 cross-sectional studies conducted in Tehran-Iran. Data on demographic characteristics, anthropometric indices and BP values of these subjects were gathered. Quantile regression model was used to assess the need for weight adjustment in different percentiles of systolic and diastolic BPs with age, gender, and the corresponding weight percentiles. Then, Age-and sex-specific BP nomograms were developed according to weight. Results: All the regression coefficients for weight percentiles were statistically significant in quantile regression of BPs, which confirms the positive effect of adjustment for weight (P<0. 05). The BP percentiles by age and weight are presented for each gender. All the BP percentiles rose steadily in all the weight percentiles with minor discrepancies between the two genders. Based on the weight-adjusted BP curves, lean subjects are estimated to have a higher prevalence of hypertension while this figure is lower among the overweight and obese children. Conclusion: This study presents the first Iranian BP references by age and weight for 3 to 18 year old children and adolescents. BMI-adjusted BP curves were found to be a better tool for assessing the prevalence of hypertension in children and adolescents, on the basis of which a more reliable classification standard for hypertension could be obtained.

Dear Editor-in-chief: Vaccination considered as one of the most cost-effective health interventions worldwide through prevention and control of many serious childhood diseases (1). It is estimated global coverage of Dose 3 of Diphtheria, Tetanus, and Pertussis (DTP3) among children one year old has been 86% in 2014 (by range from 77% to 96% in African Region and Western Pacific Region; respectively) (2). Globally in 2014, it is estimated about 18. 7 million infants were not receive routine immunization services such as DTP3 vaccine. More than 60% of these children were living in 10 undeveloped countries (3). Coverage rate the third dose of DTP vaccine (DTP3) in at the age of 12 months is a key indicator of National Immunization Programme (NIP) performance; because it reflects completion of the basic infant immunization schedule and coverage with other vaccines (2). In this study we aimed to examine status of immunization coverage in Iran compared to other countries in the world during 1980-2015.

Background Motor intervention plays an important role in reducing the disabilities of Down syndrome (DS). A lack of balance and postural control has created motor problems in DS patients. Therefore, the aim of this study was to examine the effect of backward walking on postural stability of DS patients. Materials and Methods Sixteen DS children with 8-10 age range were selected by convenience sampling method and assigned to control and experimental groups. The experimental group performed backward walking training for 8 weeks (2 sessions per week, each session for 25 min). The dynamic postural stability of both groups was examined by Biodex stability system (general balance, medial collateral and anterior-posterior balance indexes) before, during and after the training (pretest, 4th week, 8th week and 18th week). To analyze the data and test the hypotheses, independent t test was used. Results The results of this study showed that the three balance indexes in the experimental group was drastically lower than the control group after 8 weeks of backward walking training (P˂ 0. 01). In addition, significant differences could be observed in balance indexes even 10 weeks after the last session of the backward walking training (P˂ 0. 05). Conclusion It seems that the findings of this study have confirmed the effect of backward walking training on the improvement of postural stability and Syndrome children with 8-10 age range can benefit from this method.

Background It is remain a main concern that pediatric chest radiographies contribute to the significant radiation exposure to the thyroid gland as a more susceptible organ to radiation induced cancer. The aim of this study was to evaluate the entrance surface dose (ESD) of pediatric chest radiography compared to the diagnostic reference levels (DRL) and evaluation the efficacy of the lead (Pb) shield in radiation dose reduction to the thyroid gland. Materials and Methods After assessing each patient against specific inclusion-exclusion criteria, 40 pediatric patients who were undergoing anterior-posterior (AP) projection of the chest x-ray were considered eligible for this study. The ESD of the chest and also ESD of thyroid gland with and without a 1 mm butterfly-shaped lead shield which placed on the thyroid gland were measured using high sensitive thermo luminescent dosimeters (TLD-GR 200). Results The average of ESD for chest radiography was 0. 068+ 0. 006 mGy (0. 021-0. 232 mGy). The unshielded average thyroid ESD was 0. 065 + 0. 003 mGy compared to the shielded average thyroid ESD of 0. 001 + 0. 0005 mGy. The use of Pb-shield produced a statistically significant decrease in the average thyroid dose by about 97% (P< 0. 001). Conclusion The use of Pb-thyroid shield in the AP projection of pediatric chest radiography has potential to reduced radiation dose without compromising image quality.

Background Existence the children with blood diseases in family could cause lots of stress and anxiety for parents, this stress among parents would negative effects on children's disease process and his response to treatment. Materials and Methods This is a descriptive-analytical study which carried out on 480 parents with children affected to blood disease referring to Shafa hospital of Ahvaz, Iran. The parents’ level of anxiety was evaluated using the Hospital Scale for Anxiety and Depression. In this study Sample size by using statistical formulas was selected 480 persons by available sampling. Data were analyzed using SPSS-16 software. Results Results showed that in 20. 4% (98 cases) of parents level of anxiety was intense, in 50. 7% (243 cases) level of anxiety was middle, in 15. 6% (75 cases) level of anxiety was low and 13. 3% (64 cases) of parents were lack of anxiety. Additionally the results of level depression study showed that 8. 6% (41cases) of parents had severe depression, 35. 7% (171 cases) moderate depression, 15. 7% (76 cases) low depression and 40% (192 cases) no depression. According to the results of this study, there was a significant difference between level of anxiety and depression of parents and the duration of child's hospitalization (P<0. 05). Conclusion According to the results, high prevalence of anxiety and depression was among parents; so with treatment and management of anxiety and stress in parents of children; it can be achieved to better treatment in children with blood disease.

Background Adolescents’ perception of their weight is a strong factor in shaping dietary habits and weight control and management. Among non-overweight and overweight adolescents, both overestimation and underestimation of weight status are associated with harmful effects. This study aimed to examine the relationship between perceived weight and attitude toward eating disorders among adolescent girls living in Karaj, Iran. Materials and Methods Involving a two-stage random sampling, this cross-sectional study was conducted on a total of 537 high school girls 14-18 years of age living in Karaj. The Eating Attitudes Test (EAT-26) was employed to screen for attitude toward eating disorders. Also, anthropometric measurements (weight and height), perceived and the ideal weights of the participants were assessed. Results The average age of girls participating in the study was 16. 12± 1. 20. According to the results, 70% of girls had normal body mass index. It was found that the ideal weight of 55% of the girls in the normal body mass index group fell under the lower than normal boundary. Moreover, the prevalence of eating disorders was estimated to be 23. 6%. The attitude toward eating disorder was significantly correlated with body mass index of participants and their self-concept (P<0. 05). Conclusion The results showed that girl’ s adolescent with normal BMI have tendency to the lower weight. Their opinion about ideal weight fall them to the underweight group. Concerns about lean and bony body require desirable planning and weight management for adolescent girls.

Background Injuries and accidents are the first cause of death in the first 5 years of children life in the world; the present study was conducted to investigate the extent and distribution of accidents in the infants under one year in Hamadan Province, Iran. Materials and Methods: This cross-sectional descriptive-analytic study was carried out using of data of injuries and accidents related to children under one year for Hamadan province in seven years period from March 2009 to March 2016. In this study we used data according national injuries and accidents recorded program. The data were analyzed using descriptive statistics as well as analytical statistics including the Chi-square test. Data were analyzed using Stata software version 12. Results: In this 7 year periods, 3, 200 accidents were registered among children under one year. The highest occurrence of accidents was in the spring 1, 029 (31. 15% of cases). 1, 890 (59. 1%) of accidents occurred in the urban area and only 429 (13. 4%) of them were in rural area. In total, car accidents (53. 4%), trauma (12. 6%) and fall from altitude (8. 8%) had most frequency from all accidents. There was a significant difference between gender and place of accident with type of accident (P <0. 001). Conclusion Car accident, trauma and fall were most common types of accident among under one year children. Accident among children can be controlled by improvement in planning and design results in safer homes, leisure areas and motor vehicles as well as increasing the awareness of parents for the risk of accidents in a variety of settings.

Background This study aimed to evaluate the effectiveness of Intravenous immunoglobulin (IVIg) and combination of IVIg and Methylprednisolone for childhood Idiopathic (autoimmune) Thrombocytopenia (ITP) treatment; in addition investigate the related factors to develop chronic form of under 15 years ITP. Materials and Methods This retrospective study conducted on 88 ITP patients that treated with IVIg or combination of IVIg and Methylpredinosolon. Children were treated with IVIg 2 mg/kg/d or combination of IVIg 2 mg/kg/d and Methylpredinosolon 20 mg/kg/d for maximum 5 days. The numbers of patients with a platelet count > 50, 000/μ l, after treatment initiation, were the primary outcome. Odds Ratio (OR) as well as 95% Bayesian Credible interval (Crl), were estimated using a Bayesian Logistic regression model. Results The median age of subjects was 3. 5+ 4. 42 years (Interquartile: 2 8. 5). About 13% of patients were discharged from hospitalization in day 2 and day 3. The ITP of 23% of children were progressed to chronic form. The following factors were significantly associated with the development of chronic ITP, combination of IVIg and Methylprednisolone [OR: 3. 24, 95% Crl: [1. 06 11. 11]), and day 2 and 3 of discharge from hospitalization (OR: 7. 72, 95% Crl: (1. 14 67. 16)]. Conclusion The current results, suggest that the both IVIg and combination of IVIg are equally effective in providing a platelet level > 50, 000/μ l early. In addition patients how received combination drug were more likely to develop to chronic ITP. Therefore, we suggest that this route must be preferentially used in decision making for treatment childhood ITP.

Background Malaria is one of tropical and semi-tropical and vector-borne parasitic diseases produced by the protozoan parasites of the genus and species Plasmodium. The aim of this study was to assess the epidemiology and the factors associated with the malaria in children in Sistan and Baluchistan province in 2013-2016. Materials and Methods This cross-sectional study was conducted between March 2013 to March 2016 on 247 child cases of malaria in Sistan and Baluchistan province. Descriptive statistics were used to describe demographic and clinical status of malaria in children. The Chi-square test and Fisher's exact test were used to identify factors affecting malaria in children using SPSS 18, software. Results: Of 247 cases, 51. 8% were boys, 70. 9% were in rural areas and 64. 4 % were Iranian. Plasmodium Vivax with 83. 8 % of cases was the most common species of the plasmodium. The relationship between parasite species and treatment failure, illness severity and type of treatment were statistically significant as (P<0. 05). Conclusion Children are at high risk for malaria in Sistan and Baluchestan province; therefore, it is necessary that the primary and second level of prevention programs be done with more emphasis; as a result, prevent the occurrence or at least reduce the number of disease cases.

Parents who have a baby with infantile colic experienced a different thought and emotions such as hopelessness, fatigue and impasses. In this study, our living experience as a professional nursing parents' are represented with new relieving modality for infantile colic. Herein, we report a new relieving dietary protocol for a colicky infant with non-Immunoglobulin E – mediated protein induced cow's milk protein allergy. In this dietary protocol, we used a new and forgotten traditional dietary regime with specific restriction protocol on some allergic food concomitant with improving bowel microbiota and dysmotility with pro biotic drops and vitamin D3. Use of the mentioned dietary protocol decreases typical cow's milk protein allergic symptoms in this case's.

Background: This study aimed to assess the relationship between meal frequency with mental distress and violent behavior among a nationally representative sample of Iranian children and adolescents. Materials and Methods: The participants of this national study were 14, 880 Iranian students with 6 to 18 years of age. They were selected from urban and rural regions of Iran by multi-stage cluster sampling method. The data were obtained about demographic information, mental distress, violent behaviors and meal frequency by the questionnaire of the World Health Organization-Global School-based Student Health Survey (WHO-GSHS). Results: The response rate was 90. 6%. The participants who were categorized as the group eating 3 meals per week significantly experienced less mental distress than those who were categorized as consuming 2 meals and one/no meal per week (P-value < 0. 05). The min rate of violent behaviors was observed among participants who were classified as consuming 3 meals group and the max rate in one/no meal group. Participants who were categorized as consuming one/ no meal and 2 meals per week had higher risk of mental distress and violent behaviors compared with those whom consumed 3 meals per week. Conclusions: Meal skipping was significantly associated with mental problems and violent behaviors among Iranian children and adolescents and this association was independent of known confounders.

Iron is essential to erythrocyte oxygen transport and is a catalyst for oxidative metabolism in all cells. Iron is absorbed by the duodenum and requires an acidic environment for optimal absorption. Iron is found for 70% in erythrocytes, and 30% in storage, and a small amount in myoglobin and cytochromes. Iron supplementation reduces anemia in breastfed infants and increases in significant dose-dependent effects hemoglobin and ferritin levels, transferrin saturation, mean cell volume, and transferrin receptor levels. The prevalence of iron deficiency at 6 months of age is 36% in the placebo, 8. 2% after 1 mg/kg per day, and 3. 8% after 2 mg/kg per day iron (P<0. 05). The prevalence rates of iron deficiency anemia is 9. 9%, and 2. 7%, respectively (P<0. 05). Iron supplements are well tolerated. Infants with iron-deficiency anemia test lower in mental and motor development assessment. Low-birth-weight (2, 000 to 2, 500 grams) infants received 0, 1, or 2 mg/kg iron per day from 6 weeks to 6 months of age. The prevalence of child with Child Behavior Checklist scores were 12. 7%, 2. 9% and 2. 7% in the placebo, 1 mg and 2 mg iron supplementation, respectively (P<0. 05). Infants lacking iron supplements respond less positively to the physical and social environment and have growth and development retardation. Prenatal alcohol exposure causes an increase in the incidence of iron-deficiency anemia. Iron is used to combat iron deficient anemia in infants. The aim of this study was to review the effects of iron in infants.

Background Children that living with addicted parents are at risk for intentionally and unintentionally poisoning. Present study aimed to evaluate the effect of parental addiction on unintentional childhood poisoning. Materials and Methods: Totally, 140 admitted children with poisoning in Loghman hospital, Tehran-Iran, as referral center were recruited from March 2013 to July 2014. Cases were matched with 280 controls by age (within a caliper of six months), gender, and date of hospital attendance in Tehran, Iran. Parents were interviewed using an objective checklist about the risk factors of childhood poisoning. Conditional logistic regression with within-group varying weights was used to adjust for measured confounders. Vary weights within the matched set was defined by inverse probability weighting (IPW). Results: Sixty-two of cases (74. 7%) were poisoned with Methadone. The odds ratio [OR] 95% confidence interval [CI] of having addicted parents in poisoned children compared to the controls in three scenarios of ordinary, un-stabilized weighted and stabilized weighted conditional regression logistic ORs (95% CI) were 17. 3 (8. 7, 34. 6), 2. 6 (1. 9, 3. 3) and 3. 6 (2. 9, 4. 3) respectively. Conclusion The results indicate that child abuse and neglect have been linked to parental substance abuse. Education on preventive interventions such as safe storage of methadone and store poisoning product out of reach and sight of children are necessary in substance abusing families.