Journal of Pediatric Perspectives
Year:2016 | Volume:4 | Issue:6 (30)|Papers Count:24

Dear editor-in-chief, A secular milestone is approached by the world in line of reaching Millennium Development Goals (MDGs). After December 2015, a new of flexible and global Sustainable Development Goals (SDGs) were set, replace MDGs by SDGs. Infant mortality rate (IMR) is a pivotal indicator of development in a given country that embedded in Millennium Development Goal (MDG). After that in manner of strong clinical reasons, IMR has been replaced by the neonatal mortality rate (NMR); here, we were interested to write a concise chronological fantastic story about what had happened on IMR’ s life span in Iran. First in other regions, although inequality between countries is considerable for mortality rate in children, so that six countries account for 50% of worldwide deaths in children under 5 years (1), but totally child mortality is decreasing worldwide (2). The fourth Millennium Development Goal (MDG) was the reduction of child mortality by two-thirds between 1990 and 2015 (3). In fact, IMR is one of the most important indices that for determine the level of economic status, culture, society, as well as the public health of countries (4). Also child’ s mortality is the symbol of development and have important role in population growth (5). From 1970 to 2010 worldwide neonatal and post-neonatal mortality rates have decreases by 2. 1% and 2. 2% per year respectively (6). The annually rates of change from 1990 to 2013 ranged from − 6. 8% to 0. 1%. For 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000– 2013 than during 1990– 2000 (2). Nearly half of all under-five deaths are associated with under nutrition (7). Neonatal mortality (NM) is more associated with biological factors such as congenital anomalies and sensitive to proximal determinants (maternal factors, nutrient deficiency, infections and injuries) while Post-neonatal mortality (PNM) is more influenced by distal determinants (education, employment, national income and income distribution) (8). Results of a study showed that Total fertility rate (TFR), GDP per capita (current US$), public health expenditure as % of total health expenditure were identified as the main factors affecting on infant mortality in Petroleum Exporting Countries (OPEC) over the ten years (2004-2013) (9). Because of heterogeneity in determinants the 1 to 50 months mortality should be analyzed in two age groups including post neonatal deaths (1-11 months) and childhood deaths (1– 4 years) (3). Second in Iran, trend of child mortality and IMR statistics are presented in (Table. 1) and illustrated in (Figure. 1). Iran has made notable progress towards reaching the MDGs by child mortality rate from 57. 5 to 15. 5. The Average Annual Percent Change (AAPC) for IMR and child mortality showed that they have a decreasing trend so that are reached to-5 and-5. 4 in 2015 respectively (Table. 1). Conclusion: Looking ahead, the good experience in child mortality and IMR reflects concerns that Iran will have to confront in the post-2015 period to achieve a Better, more inclusive and sustainable rates in neonatal mortality rate and even other SDGs.

Background Rhabdomyolysis is considered a rare medical condition in pediatric population. Case Report We report our experience on a one year old girl referred to Shiraz Nemazee Hospital, Southern Iran with rhabdomyolysis due to severe hypernatremia, secondary to gastroenteritis. Discussion Rhabdomyolysis should be taken in to consideration in hypernatremic states, as it may lead to severe consequences. Treatment of underlying cause and proper management of hypernatremia could be helpful while handling this complicated situation.

Background The Neonatal period is one of the most dangerous and vulnerable stages of life. The importance of neonates' mortality has led to national and international efforts, notably as research and scientific studies. However, different aspects and patterns of the scientific productivity in the field have not yet been studied. The present study aimed to investigate the scientific production in the field of "Neonates’ health" in Scopus. Materials and Methods Using a scientometric method, the present study tries to identify and analyze a sample of 2, 842 neonates’-health-related items indexed by Scopus during 1914 to 2014. After some preparation and refinement, the data were analyzed by Excel 2010, using descriptive and analytical statistics including frequency, percentile, and regression models (P <0. 01). Results The Neonates’ Health field showed to be growing on an exponential basis. Its authorship pattern adheres to Lotka's law in that the number of authors decreases as their publications increase on a power basis. The field is revealed to be globally distributed, within a wide language variation and a wide range of countries. USA is the most prolific country in Neonates’ Health. "The Pediatrics" journal ranks first among the fields’ core journals. Research articles are the dominant document type, implying the field’ s research-oriented nature. Conclusion The field’ s exponential growth model and its adherence to Lotka’ s law mark its similarity to established science systems implying it to be establishing and sustaining its research realm. The language and geographical diversity of the Neonates’ Health signifies the world's concerns for research in the field, though at a very low and unbalanced level. Consequently, the Neonates’ Health seems to get progressively developed throughout the world. This promises an improvement in neonatal health and well-being in a not-far future.

Background: Acute respiratory distress (ARD) is a critical respiratory failure due to lung injury of neonates leading to the clinical appearance of poor lung compliance. The aimed of the study was to evaluate the diagnostic values in differentiating respiratory from heart diseases with using of N-terminal pro brain natriuretic peptide (NT-pro BNP) and Atrial natriuretic peptide (ANP) in neonates. Material and Methods: Ninety neonates randomly collected from those who hospitalized in the neonate ward of the Ali Ebne abitalib Hospital, Zahedan, Iran. After taking blood samples ANP and NT pro Brian Natriuretic peptide using ELISA kit were measured. The separated serum was kept in-20 ° C until BNP measurement. 250 μ l of the patients’ serum was isolated to assess pro BNP level using ELISA kit (USA). Data were analyzed using SPSS-20 with considering of P< 0. 05. Results: NT pro-BNP level had the highest in cardiac patients and followed by respiratory. The level of NT pro-BNP for control neonates had the lowest. These levels had significant variation (P<0. 05). The level of ANP had the lowest for the cardiac patients. ANP level had the lowest for the acyanotic. NT pro-BNP had the highest concentration in acyanotic patients and and had the second highest concentration in cyanotic. Respiratory diseases ranked in the third levels in concentration of pro-BNP. The level of NT pro-BNP had the lowest for controls. The analysis showed a significant difference in the level of NT pro-BNP (P<0. 05). Conclusion: Many studies revealed that NT pro-BNP cannot be used as a tool for differentiation between cardiac and respiratory as a cause of respiratory distress during neonate, but the results of the present study showed that it would be good biomarker.

Dear editor-in-chief, Alkaptonuria is a rare autosomal recessive metabolic disease, with a prevalence of 1: 250, 000 to 1: 1, 000, 000 (1). Alkaptonuria occurs mostly in adults aged over thirty years (2). The disease is caused due to total inhibition of homogentisic acid oxidase enzyme, which catalyzes the conversion of homogentisic acid (HGA) to maleyl acetoacetate, fumaric acid and acetoacetic acid (3). It is usually deposited in outer ear cartilage, sclera, eyelid, cornea, conjunctiva, eyelids, mucous, skin, bone and internal cardiac structures (mitral valve, aorta and coronary arteries), as well as secreted in urine and sweat (2). The most common presentation in children is darkening of the urine exposed to air, while osteoarthritis followed by changes in eyes, ears, skin and cardiovascular is the most common symptom in adults (4). Alkaptonuria is a still frequently sub diagnosed and rare disease. We present here a child with the final diagnosis of alkaptonuria...

Background Carrying heavy backpacks by school students at growth age can cause irreversible physical harms. This study aimed to investigate the relationship between backpack weight and the incidence of lordosis, kyphosis, scoliosis, and dropped shoulders in elementary school students. Materials and Methods This descriptive-analytical study was conducted in 2015 in Abadan, Iran, and 383 elementary school students were selected and enrolled using the cluster sampling method. Data was collected through the grid method and a demographic questionnaire. The weights of students’ backpacks were recorded, and it was determined whether they were standard or not. Statistical analysis was conducted using SPSS version 22, descriptive statistics, and the Chi-square test. Results Findings showed that 36. 9% of public school students’ backpacks and 55. 1% of private school students’ backpacks were non-standard with respect to weight. A significant relationship was also found between non-standard backpack weight and prevalence of dropped shoulders, kyphosis and lordosis (P<0. 05) among students. Conclusion Findings showed that non-standard backpack weight increases the prevalence of dropped shoulders, kyphosis and lordosis in elementary school students that can endanger the physical health of the future society; therefore, parents, teachers and health workers must give needed training to students about carrying the bags and backpacks.

Vitamin B12 (cobalamin) is an essential coenzyme for nucleic acid synthesis. Animal protein is the major dietary source of vitamin B12. Deficiency of vitamin B12 leads to megaloblastic anemia, degeneration of the brain, spinal cord, peripheral nerves, and abnormalities of epithelial tissues. Two factors are necessary for the cure of megaloblastic anemia: one in food (extrinsic factor) and one in gastric juice (intrinsic factor). The extrinsic factor is vitamin B12. Intrinsic factor (a glycoprotein secreted by gastric parietal cells) ensures cobalamin absorption by receptors in the terminal ileum. Vitamin B12 is actively transported across the placenta. Neonates have high serum levels and significant liver stores of vitamin B12. The neonates born to mothers with deficiency of vitamin B12 have deficiency of this vitamin. Pregnant women in resource-poor areas have low vitamin B12 status which is associated with adverse pregnancy outcomes, including anemia, low birth weight, and intrauterine growth retardation. Supplementation of vitamin B12 had significantly higher plasma of vitamin B12 in mothers and neonates. A single intramuscularly injection of vitamin B12 of between 250 μ g and 1mg and a dietary intake of 1 μ g/kg per day vitamin B12 is sufficient to combat vitamin B12 deficiency. Mean DNA damage scores in infants with vitamin B12 deficiency and their mothers were significantly higher before than after supplementation with vitamin B12. There were correlations between the infants' and their mothers' DNA damage scores. The aim of this study is the review of the effects of vitamin B12 in neonates and young infants.

Background Autistic Spectrum Disorder (ASD) is a neurodevelopmental disorder. There is a large quantity of evidence which point towards a positive correlation between Autism and Mitochondrial disorders (MD). In addition to that, several published reports, indicate that people with neurological disorders exhibit pathological signs of mitochondrial disorders and vice versa. Screening for underlying MD is essential in ASD as the children (clinically) appear and behave the same way in the both instances; however, their management is very different. Materials and Methods The current study examined biochemical, neuroimaging and genotyping technique in ASD patients to see which technique would be easier to interpret and indicate underlying MD. The analysis of the screening was based on several objectives like clinical, histological, biochemical, molecular, neuroimaging and enzymatic findings. Results We found out that pathogenetic analysis based on clinical and genotyping gives spontaneous results to analyse the possibility of MD in ASD patients. Conclusion It does not necessarily require blood samples from ASD patients to accomplish this type of analysis.

Background Home care is an acceptable strategy for the relationship between family and healthcare team and implementation of healthcare interventions, and infants’ nurses could play an important role in enhancing the capability of families and promoting child health in this area. This study examined challenges facing infants’ home care from nurses’ viewpoints in Iranian culture. Materials and Methods A qualitative design was used to explain challenges facing infants’ home care from nurses’ viewpoints. Participants included 20 nurses’ working in the neonatal units of University hospitals in Isfahan, Iran in 2015. Data collection was done by interviewing nurses working in neonatal units of Shahid Beheshti and Alzahra hospitals. All the data were analyzed by qualitative content analysis. Results Four main categories of "The need to warn the community", "Culture", “ Need for security" and "legal support" were extracted from the participants' explanations, indicating the dimensions of challenges for infants’ home care. Conclusion Nursing policy makers and managers are able to help to facilitate home care and improve the infants’ health through correcting the infrastructure and eliminating current obstacles.

Background: On tuberculosis control standpoint, the treatment of children with TB is not considered a priority as they rarely transmit the disease and contribute little to the maintenance of the tuberculosis epidemic. Therefor this study conducted to describe pediatric TB cases, and to identify pattern of risk factors in non-endemic communities Materials and Methods: The present cross-sectional study conducted on 139 children under-five years of old with TB in Tehran province from March 2006 to March 2015. Data were extracted from TB registry system. Data were analyzed using Stata software version, 12. Results: Overall, records on 139 children with TB had been evaluated. Most of under-five TB cases were boys (58%) and urban dwellers (88%), roughly half of the sample (54%) was diagnosed as extra-pulmonary TB, while most of them (66%) had been reported through public health networks. Treatment success rate were nearly 85%, and 11% of them had been deceased. There was a significant relationship between household contacts and type of TB (P <0. 05). Conclusion: We found that most of pediatric TB cases in central part of Iran were males, urban dwellers, and extra pulmonary type. Despite the fact that Afghans refugees make up a small percentage of the population of Tehran province but more than 25 % of TB cases attributable to them. Given that Pediatric TB is a direct consequence of adult TB and is a good marker of current transmission in the community, therefore necessary health strategies should be taken to control TB in this high-risk group.

Background: Sunlight is the main source of vitamin D; therefore, environmental factors might have an important role in the high prevalence of hypovitaminosis D in children. This study aimed to assess the vitamin D status according to the climate of the living area in a nationally representative sample of Iranian adolescents. Material and Methods: This nationwide cross-sectional survey was performed among a representative sample of 1, 095adolescents aged 10-18 years, selected by multistage cluster sampling method from 27 provinces of Iran. Serum 25-hydroxyvitamin D [25(OH) D] concentrations was compared in inhabitants of humid-rainy, cold-mountainous, and sunny regions. Results: Vitamin D deficiency was documented in 40% of participants including 40. 70% of boys and 39. 30% of girls. We found significant difference in 25(OH) D concentrations among participants living in the three different climates of the living area (P<0. 05). The median inter-quartile range (IQR) level for 25(OH)D was lower in humid-rainy climate: 11. 40 (18. 64). Hypovitaminosis D was more frequent in humid-rainy climate (42. 30%), compared to other climates; this difference was more prominent in urban areas (P<0. 05). Boys living in various climates had significantly different levels of 25(OH) D(P<0. 05), however this figure was not significantly different for girls (P>0. 05). The highest frequency of hypovitaminosis D (45. 2%) was documented among boys living in humid-rainy regions. Conclusion: The high prevalence of hypovitaminosis D, notably among inhabitants of humid-rainy region underscores the necessity of implementing national preventive strategies. This is of great importance especially in regions with lower exposure to sunlight.

Background Apnea is one of the most common problems in preterm neonates. This study aimed to evaluate the effectiveness of aromatherapy on the reduction of apnea, bradycardia, and Pulse Oximetry (SPO2) in premature infants. Materials and Methods In a clinical trial study, 60 preterm neonates randomly divided in two groups and exposed to aromatherapy with Rosa damascenes distillate or distilled water beside the routine treatment. In experimental group, two drops of 10% Rosa damascenes distillate was dropped on the pad eye in second day of birth at 6 Am. The intervention was repeated in 9 AM, 12 Am, 15 PM and 18 PM hours. A same condition applied for control group and distilled water was dropped on the pad eye. The number of apnea attacks, bradycardia and decrease in SpO2 compared between two groups using chi-square test, independent t-test and repeated measure test. Results The overall apnea attacks, bradycardia, and SPO2 in tree studied days were lower in intervention group than control group (0. 47± 0. 13 vs. 2. 6± 0. 41, 0. 47± 0. 13 vs. 2. 56± 0. 41 and 0. 70± 0. 17 vs. 2. 77± 0. 21, respectively). In addition, the repeated measurement test showed that the mean number of apnea attacks, decrease in heart pulse rate, and decrease in SpO2 was statistically lower in intervention group with aromatherapy than controls in first, second, third and sum of three days (P< 0. 05). Conclusion Aromatherapy with Rosa damascenes distillate can reduce more and speedy the occurrence of apnea attacks, bradycardia and SPO2 in premature infants, along with other routine treatment.

Background Bronchopulmonary dysplasia (BPD) is one of the most common serious squeal of preterm infants. It involves approximately one quarter of infants with birth weight less than 1500 grams and 30% of less than 1000 grams. Vitamin A has been shown to reduce BPD rate. We compared efficacy of low and high doses of vitamin A for prevention of BPD in very low birth weight preterm infants. Materials and Methods In a randomized clinical trial, 120 preterm infants with gestation age 32 weeks or less and birth weight less than 1, 500 grams were enrolled in the study. Group A (n=60) received 1, 500 IU vitamin A intramuscularly three times per week and group B (n=60) received 5, 000 IU vitamin A intramuscularly 3 times/week. Vitamin A was continued for 4 weeks in all patients. Oxygen dependency at age 28 days after birth and at 36 weeks’ postmenstrual age was determined in all studied infants. Results The mean gestation age and birth weight in group A was 29. 2 ± 2. 1 weeks and 1095 ± 211 gr and in group B 28. 7 ± 2. 1week and 1147 ± 218 grams (P>0. 05). Moderate to severe bronchopulmonary dysplasia was detected in 6 (10%) neonates in group A and 13(21. 6%) infants in group B, P= 0. 09. Mortality rate was 4 (6. 6%) infants in group A and 3 (5%) patients in group B (P>0. 05). Conclusion In our study, high and low doses of vitamin A were similar with respect to the BPD, intra-ventricular hemorrhage, and retinopathy of prematurity and total number of days for hospital stay in very low birth weight preterm infants.

Background: The children’ s body composition status is an important indicator of health condition evaluated through their body mass index (BMI). We aimed to provide standardized percentile curves of BMI in a population of Iranian children and adolescents. We assessed the nationally representative of sample populations from Tehran. Materials and Methods: A total sample of 14, 865 children aged 7-18 years was gathered. The Lambda-Mu-Sigma method was used to derive sex-specific smoothed centiles for age via the Lambda-Mu-Sigma Chart Maker Program. Finally, the prevalence of overweight and obesity with 95% confidence interval (CI) was calculated. Results: BMI percentiles obtained from Tehran’ s population, except for the 10th percentile, seem to be very slightly greater than the urban boys from all over Iran. BMI percentiles have an increasing trend by age that is S-shaped with a slight slope. Only in the 90th and 97th percentiles of BMI for girls, this rising trend seems to stop. Boys generally have higher BMIs than girls. The exceptions are younger ages of 90th and 97th percentiles and older ages of 3rd and 10th percentiles. A total number of 1, 008 (13. 20%; 95% CI: 12. 46-13. 98) boys and 603 (8. 34%; 95% CI: 7. 72-9. 00) girls were categorized as overweight and obese. Obesity were observed in 402 (5. 27%; 95% CI: 4. 79-5. 79) boys and 274 (3. 76%; 95% CI: 3. 35-4. 22) girls. Conclusion: We construct BMI percentile curves by age and gender for 7 to 18 years Iranian children and adolescents. It can be concluded that sample populations from Tehran are nationally representative.

Background: Exact determination between children's sleep habits and their growth could help us to prevent this risk factor of children's growth disorders. Thus this research was performed to investigate the correlation between sleep habits and growth of preschool children in Ahvaz-Iran. Materials and Methods: In this cross-sectional study, the data was obtained by using available sampling from 208 children of 3-6 years old that came to a private pediatric clinic in Ahvaz, South West of Iran in 2015 without regard to their gender. Measurement of height and weight of all patients with the meter and scale was performed. After measuring height and weight, stature-for-age and weight-for-age percentiles was calculated using child growth chart calculator of CDC for each child. Information on the onset time of night sleep, time to wake up in the morning and nap duration of children were gathered using researcher made questionnaire. Data analysis was performed with descriptive statistic and Kendall's tau-b statistical test using SPSS-19. Results: Results of this study showed of the 208 children that were evaluated, 32 of them (15. 38%) was stunted, underweight, or both and 176 (84. 6%) of them hadn`t any growth disorder. Results of Kendall's tau test showed that there is no significant relationship between the onset time of night sleep, waking up time in the morning, nap duration and neither height-for-age percentile nor weight-for-age percentile of preschool children (P>0. 05). Conclusion The results of this study showed that children sleep habits does not affect their stature and weight-percentile. But this isn`t mean that going to sleep late has no effect on children's health, since the establishment of a normal sleep-wake rhythm is essential for both physical and mental development in children, so it is necessary to educate parents regarding the importance of children's sleep.

Background Infantile colic is a painful phase in the first months of infancy but no safe and effective conventional treatment exists. Massage is used in traditional medicine as a control and treatment method for infantile colic. The aim of this study is to evaluate the efficacy and safety of massage in the control and treatment of infantile colic. Materials and Methods We searched international database such as PubMed, EMBASE, Cochrane library, and Iranian databases such as SID, Magiran, Iranmedex using a searching strategy with key words "Infantile colic", "Massage", "Complementary of Alternative Medicine" during 2000 to 2015. Analysis of data extraction and quality evaluation of the literature were performed independently by two investigators. Results Most articles provides the strongest evidence for benefits of massage in stress, anxiety reduction, pain control, cancer, skin disease, weight gain, sleep, promote growth, development in premature infants, neuromuscular and gastrointestinal disease such as infantile colic. The infantile colic massage helps relax the gastrointestinal tract and good digestion. Conclusion Our findings demonstrated that pediatric massage therapy is effective in the treatment of infantile colic. Compared to other possible treatments for colic, massage is a safe and enjoyable procedure; the risk of serious adverse effects is low. The pediatrician should feel comfortable discussing massage therapy with patients and be able to refer patients to a qualified massage therapist as appropriate.

Background: Patients with transfusional iron overload have depended on iron chelation therapy and improving chelation regimens have been of the highest priority. The aim of this study was to compare effect of combined versus monotherapy with Deferoxamine (DFO) and Deferiprone (DFP) in iron overloaded beta thalassemia (BT) major patients Materials and Methods We studied 36 BT major patients (mean age 7. 6± 4. 6; range 3– 16 years) attending the Ormieh Motahari hospital for regular transfusional support. Patients were randomly allocated to receive one of the following two treatments: DFO in combination with DFP (n=12), DFO alone (n=12) and DFP alone (n=12). Serum ferritin level, liver enzymes, blood urea nitrogen, and creatinine and side effects were monitored over a 12 months period. Results: After one year, serum ferritin decreased more significantly in patients on DFO+DFP therapy compared to patients who only received DFO or DFP alone (P<0. 01). Side effects of DFP, including gastrointestinal upset (nausea, vomiting and abdominal pain) and mild agranulocytosis occurred in five (41. 7%) and two (8. 3%) patients, respectively but none led to discontinuation of the treatment. Conclusion: In comparison to the standard chelation monotherapy of DFO, combination treatment with additional DFP reduced serum ferritin and is effective procedure in clinical management of iron overload in patients with BT major.

Background This retrospective study aimed to determine the epidemiologic characteristics and risk factors of chronic kidney diseases (CKD) in patients < 18 years old at a single referral center. Materials and Methods In a hospital-based case control study, 66 CKD patients less than 18 years old were compared to 81 control patients (also under 18) without CKD. A patient was defined as a CKD case with renal injury and/or had a glomerular filtration rate (GFR) of <60 ml/min/1. 73 m2 for more than 3 months. Required information for the study was collected using a questionnaire and conducting clinical tests. Data analysis was performed by using univariate and multivariate logistic regression, as well as a Chi-square test. Results Fever, chills, and urinary tract infections were the most common clinical signs in the referred patients. Urinary tract infection (39. 5%) and growth failure (12. 9%) were the most important causes in referred pediatric CKD. After controlling the effect of confounding variables, household income, using packed water for drinking, percentile of body mass index (BMI), and gestational age were the significant predictors of pediatric CKD (P<0. 05). Conclusion The most common presentations of the disease were Urinary Tract Infection (UTI) and fever. Reflux nephropathy was the leading cause of CKD in children. Therefore, more attention to children with these signs is essential for early diagnosis. High household income and preterm delivery were the risk factors for CKD in children.

Dear Editor-in-chief, Measles is a highly contagious disease. By the end of 2013, 84% of children had received at least a single dose of measles vaccine by their second birthday, and 148 countries had included a second dose as part of routine immunization. In 2002, the Iranian Ministry of Health and Medical Education developed a comprehensive strategy to eliminate Measles including mass immunization campaign for people aged 5-25 years (1). Suburban areas where residents usually are nomads or migrants with low socio-economic status (SES), pose a serious threat to the success of any prevention program(2). There are a huge yet unknown number of Iranian immigrants and illegal refugees living in suburbs of large cities in Iran, where low participation of families in vaccination services might be a challenge (3). In this report, we try to highlight the importance of migrants and immigrants on the success of Measles vaccination programs. Briefly, after Measles and Rubella mass vaccination campaign on 2002 in all around Iran, reports demonstrated satisfactory coverage in vaccination status of migrants and slum residents living in suburbs of big cities (3). Accordingly, mortality rate for Measles had been sharply declined between 2002 and 2003, and been plateau afterwards as shown in (Figure. 1).

Background: The incidence of animal bite is increasing in Iran and there is lack of knowledge about animal bite in children. Hence, the aim of this study was to describe the characteristics of animal bite in children and also evaluate delayed time of post exposure prophylaxis (PEP) in children. Materials and Methods: This cross-sectional study was conducted on 172 children cases of animal bites in Isfahan province in 2015. We used registered data from Rabies Treatment Center (RTC) of counties using the census method. Descriptive statistics were used to describe demographic and clinical status of bitten children. The Chi-square test was used to identify factors affecting on delayed time in PEP using Stata 12, software. Results: Of 172 cases, 66. 8% were boy, and 68. 0% lived in urban area. The cases were mainly bitten by cats (47. 7%), and the most common sites of the animal bite were hands (55. 8%). The bite incidents were happened more frequently in spring (32. 0%). Overall, 30. 8% of the cases received PEP by more than 48 hours after exposure. Conclusion: The results of this study showed that the pattern of animal bites is different in children compared with adults. More bites caused by cats, especially in the upper limbs. Delay in PEP in children is more common; therefore, it is necessary for parents to be sensitive in this regard.

Background: Ninety-five percent of low birth weight infants are born in developing countries. This study was aimed to assess the predictors of low birth in East Azerbaijan, North-west province of Iran. Materials and Methods: The study was conducted through a hospital based case– control design involving 49 women delivering low birth weight infants and 98 delivering normal weight infants. The data analysis was using SPSS-13 software with bivariate and multivariate methods. Results: There was a significant positive association between maternal chronological and marriage ages with low birth weight infants (P <0. 05). Additionally, there was negative association between maternal weight prior to pregnancy and low birth weight (P <0. 05). Interestingly, larger families of more than four members had higher probability for low birth weight infants in comparison to the families with less than four members (OR = 2. 86, 95% CI: 1. 09-7. 47; P-value: 0. 032). According to the multivariate logistic regression independent factors associated with low birth weight include higher maternal chronological age (OR = 1. 88, 95% CI: 1. 29-2. 75; P-value: 0. 001) and marriage age (OR = 4. 97, 95% CI: 1. 97-12. 50; P-value: 0. 001) and increase in maternal weight prior to pregnancy (OR = 0. 60, 95% CI: 0. 42-0. 86; P-value: 0. 006). Conclusion: Major risk predictors of low birth weight in the Iranian female population were maternal age other than 25-30 at delivery, young maternal marriage age and lower maternal weight before pregnancy.

Background Because of some special and privileged attractions of dentistry discipline, the first choice of volunteers who want to enter university is dentistry. The students usually choose it regardless to their interests and talents. Therefore, this study aimed to investigate Iranian and Foreign student’ s motivations to choose dentistry field of study. Materials and Methods We searched international databases such as PubMed, Scopus, EMBASE, Cochrane Library, and Iranian databases such as SID, Magiran, Iranmedex using a searching strategy during 2000 to 2015 years. Database without language restriction, since 2000 sources, with the MeSH term "Choose dentistry field" AND "Students". At first, in the initial search, 152 articles were found, and finally, 51 of them which were related to the subject of this research were used. Results In general, the motivation of students to choose field of study in Iranain and Foreign students include the following: : an independent office or job independence, high economic income, appropriate social status, job attractiveness of dentistry, appropriate job position, individual longing, help others, top rank of student in the university entrance exam, continue to study at specialized PhD in one of dentistry trends, successful marriage nd interest in the field of dentistry. Conclusion It seems that with regard to the high unemployment rate of university graduates in Iran, the most important incentives of applicants who want to enter the dentistry discipline are high income and particular social prestige at this major. Moreover, high income and independent job situations are the most important factors in Foreign students for choosing this filed of study in the overseas studies.

Background Malnutrition and infections are widespread in almost all developing countries. The aim of this study was to investigating prevalence and some of the determinants of malnutrition and intestinal parasitic infections among preschool children in Shahroud, Iran. Materials and Methods At a cross-sectional study, the all preschool children (1, 850 cases), in Shahroud city as simple census, were selected. General information was collected using questionnaires and face-to-face interviews with the children’ s parent. Stool specimens, collected fresh in paper cups, were examined by formalin-ether concentration. Also, the adhesive cellophane tape method was used to diagnose oxyuriasis. The nutritional status of the children’ s was determined based on anthropometrics. Data were analyzed using the SPSS. Results The prevalence of malnutrition, based on weight-for-age, height-for-age, and weight-for-height was 6. 7, 5. 8 and 7. 7%, respectively. A third of children (35. 1%) had parasites infections, including 22. 8% pathogenic parasites and 26. 4% non-pathogenic and 35. 5% of children were infected to oxyuris. The prevalence of parasite infection in the boys (51. 1%) was significantly higher than the girls (42. 3%)). Also, a significant relationship was found between malnutrition (height-for-age) and parasitic infections (P<0. 05). Conclusion The results of this study showed that about a third of children’ kindergarten of Shahroud infected to at least one intestinal parasitic infection and these infections can cause malnutrition in children's preschool.

Background Anxiety is one of the most common childhood disorders, so it is necessary to explore extend and its related factors in the students. This study was conducted to determine the prevalence of anxiety and the related factors of anxiety among the children aged 9-12 years. Materials and Methods At a descriptive-analytic study 623 children aged 9-12 year-old who were studying in the fourth to sixth grade of elementary school in Dezful city, were selected through multistage random sampling. The data were collected using demographic profile questionnaire and School Anxiety Scale (SAS) using SPSS-16. Results Of total 623 students, 36. 3% were girls. 232 (37. 2%) students had mild anxiety, 304 students (48. 8%) had moderate anxiety and 87 students (14%) had severe anxiety. There was a significant relationship between the mean score of children anxiety and the number of children in family (P<0. 05). There was a significant relationship between the mean score of children anxiety and the history of hereditary disease (P<. 05) and the between the mean score of children anxiety and educational level was not significantly (P>0. 0. 5). Conclusion This study showed that the prevalence of anxiety was higher in boyes, children who were single children, children who had a family history of hereditary disease, and children who experienced corporal punishment at home. It is recommended arranging programs including training, counseling, and psychotherapy ones for these children and their families.