Journal of Pediatric Perspectives
Year:2018 | Volume:6 | Issue:7 (55)|Papers Count:15

Succinic semialdehyde dehydrogenase (SSADH) deficiency or 4-Hydroxybutyric Aciduria is an autosomal recessive inherited disorder of amma-aminobutyric acid (GABA) degradation. It is characterized by developmental delay, infantile-onset hypotonia, cognitive impairment language deficit, and ataxia. Epilepsy, aggression, Hyperkinetic behavior, hallucinations, and sleep disturbances have been described in about half of the patients, more frequently in older individuals. Its management is largely symptomatic, conducted at the treatment of seizures and neurobehavioral disorder. We present two girls with chief complaint of hypotonia and developmental delay how referred to department of Pediatrics (Ghaem hospital), Mashhad, Iran.

Dear Editor-in-Chief, Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly of the diaphragm with an incidence of 1: 2, 000-5, 000 of live births (1). The diaphragmatic defect is located on the left side in 85% of cases, whereas right-sided CDH occurs in 15% of cases (2). Right CDH is associated with higher mortality, and morbidity as compared to left CDH (3-5). This study retrospectively evaluated patients who had been operated on for CDH at our department of Pediatric Surgery between January 2013 and December 2016. The Demographic Data and outcomes of right CDH cases (Group 1) were compared with left CDH cases (Group 2). During the 5-year period, 35 neonates were operated on for CDH. Of these, six cases were right CDH with 29 left CDH cases. Twenty-two patients (63%) were male, and 37% were female. Antenatal diagnosis was performed in only 20% of the cases (n=7)...

Background: One of the painful procedures in the Neonatal Intensive Care Unit (NICU) is phlebotomy. However, the use of non-pharmacological approaches could be helpful in reducing the pain. This study aimed to determine the effect of Quran recitation on the physiological parameters of premature infants during and after phlebotomy. Materials and Methods This randomized, double-blind clinical trial was performed on premature infants admitted to the NICU at Dr. Ganjavian hospital in Dezful, Iran. The infants were randomly divided in two equal groups (n=28). A Quran recitation was started five minutes before blood sampling in the case group and it continued to play for another 20 minutes. The physiological symptoms were documented in both groups starting 10 minutes before blood sampling and continued until 20 minutes after it. The data was analyzed using SPSS software (version18. 0). Results: The primary outcomes of this study were the measurement of the heart rate, respiratory rate, and oxygen saturation. The results showed that the heart rate slowed significantly in the intervention group (p<0. 05). There was a significant difference in the oxygen saturation between the groups (p<0. 05). The respiratory rate showed a significant difference between the groups (p=0. 039) only 20 minutes after blood sampling. Conclusion The findings indicated that Quran recitation can help improve physiological parameters and can be used as a routine standard method in NICU.

Background Methylphenidate (MPH) is commonly prescribed for children who have been diagnosed with attention deficit hyperactivity disorder (ADHD); however, the action mechanisms of methylphenidate have not been fully elucidated. Studies have shown a relationship between apoptosis signaling pathways and psychiatric disorders, as well as therapeutic targets for such disorders. So, we examined the effects of chronic methylphenidate administration on the brain of mice. Materials and Methods Animals were administered MPH at doses of 2, 5 and 10 mg/kg for 60 days. At the age of three months and in estrous phase, brian tissues were removed and washed in cold phosphate-buffered saline and some of them were frozen at-80oC for Western blot analysis. We measured the levels of pro-apoptotic protein, Bax and anti-apoptoticprotein, Bcl-2, in the brain of neonate female Balb/c mice. The rest of the brains were fixed in formalin (10% phosphate-buffered, pH = 7. 4). Then samples were embedded in paraffin according to routine histologic procedures. Results: Our results showed that MPH with a dose of 10 mg/kg causes a considerable increase in the level of the Bax protein as compared with other groups. In contrast, in the partial cortex of female mice under treatment with high dose of MPH (10 mg/kg) could less Bcl2 levels as compared with 5 mg/kg MPH. However, 5 mg/kg MPH have a significant effect on Bcl2 levels compare with each of mentioned doses (P<0. 05). Conclusion Our results suggest that long-term administration of MPH in the mouse brain had influence on the cascade of apoptosis and its effects, depends on dose rate.

Background Chest physiotherapy has been used to clear secretions in pediatrics for many respiratory problems. The aim of this study was to investigate the effect of chest physical therapy on full term neonates with primary pneumonia. Materials and Methods Sixty full term neonates admitted to neonatal intensive care unit (NICU), Minia University, Egypt, during the period from September 2016 to September, 2017 divided into two equal groups: group I included 30 patients received routine medical treatment according to American Academy of Pediatrics (AAP) recommendations and group II included another 30 patients received routine medical treatment plus chest physical therapy modalities in the form of positioning, postural drainage, percussion and vibration. We compared between the two groups as regards the duration for mechanical ventilation and/or oxygen therapy, clinical improvement, oral feeding and duration of hospitalization. Results There was significant differences between group I, neonates who received routine medical treatment) and group II, neonates who received routine medical treatment plus chest physical therapy regarding the duration needed for mechanical ventilation and/or oxygen (p<0. 045), the duration needed for clinical improvement (p<0. 042), the duration needed for oral feeding (p<0. 035) and the duration of hospitalization (p<0. 031). Conclusion According the results, chest physical therapy has a positive supportive effect on full term neonates with primary pneumonia regarding the duration needed for mechanical ventilation and/or oxygen therapy, the duration needed for clinical improvement and the duration of hospitalization.

In 2010, there were estimated 219 million cases of malaria resulting in 666, 000 deaths and two-thirds were children. Children are more vulnerable than adults to malaria parasites. In sub-Saharan African countries, maternal malaria is associated with up to 200, 000 estimated infant deaths yearly. Malaria is caused by five Plasmodium parasites namely: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi. Of these, Plasmodium falciparum accounts for the majority of the burden of malaria infection in sub-Sahara African countries and is associated with most severe disease. Plasmodium vivax accounts for half of the malarial burden infection in South and East Asia and > 80% of the malarial infections in the America. The artemisinins are very potent and fast-acting antimalarials, inducing more rapid parasite clearance and fever resolution than any other currently used of antimalarial drugs. They are particularly well suited for the treatment of severe Plasmodium falciparum malaria. The standard treatment of malaria infection employs artemisinin-based combination therapy. This antimalarial drug increases treatment efficacy and reduces selection pressure for the emergence of drug resistance. Artemisinins cause a significant reduction of the parasite burden, with a reduction in the parasite population. Only three to four cycles (6 to 8 days) of treatment are required to remove all parasites from the blood. Artemisinins are formulated for oral, intramuscular, intravenous, and rectal routs. Bioavailability after oral dosing is ≤ 30%. The aim of this study is to review the published data on the clinical pharmacology of artemisinins in children.

Background Childbirth affects the quality of mother– neonate attachment after delivery. The aim of this study was to compare the quality of mother– infant attachment in physiological delivery with non-physiological delivery after birth. Materials and Methods A case-control study was conducted on 60 women (n = 30 non-physiological delivery, 30 physiological delivery) referred to Shahid YahyaNejad Hospital (Babol city, Iran) durring 2015 to 2016. Subjects in the physiological delivery group received special care from the midwife or significant other, labor mobility, spontaneous progress of labor, and non-pharmacological methods. Subjects in the non-physiological delivery group received medical interventions including birth aids, use of analgesics, and local anesthesia. Quality of mother-infant attachment after delivery was assessed with a valid Persian version of Avant’ s mother-infant attachment. Multivariate analysis of variance (MANCOVA) was also used to assess the differences in two groups. Results The mean of mother– infant attachment scores in the physiological delivery compared with non-physiological delivery group were as follows: emotional behavior (2. 29 ± 38. 7 vs. 1. 56 ± 27. 23), proximity behavior (1. 82 ± 27. 30 vs. 1. 49 ± 20. 70), caring behavior (1. 17 ± 15. 77 vs. 1. 13 ± 10. 80), and total score (4. 58 ± 81. 72 vs. 3. 66 ± 58. 73). Results showed that in all three dimensions of attachment (emotional, caring, and proximity behavior), physiological delivery showed higher scores than did non-physiological delivery (P < 0. 05). Conclusion The quality of mother– infant attachment (emotional, proximity, and caring behaviors) was higher in women with physiological birth than non-physiological birth.

Background Recently, there has been a fast growth in the use of different kind of media especially in adolescents. Media literacy education is supported by numerous national organizations and institute as a potential tool to decrease negative media effects and to increase desirable use of media. However, there are little documents about their effects. This study was conducted to investigate the effect of educational intervention on media literacy among high school female students. Materials and Methods This quasi-experimental study was complete on 100 female students in Semirom city, Isfahan province, the central of Iran, in 2017. Eligible students were selected and randomly assigned as intervention and control groups. Then, a media literacy intervention (7 sessions of 40-55 minute) was delivered by skilled and trained educators in field of media as facilitators only in the intervention group. The media literacy measure was administered at pre-intervention, post-intervention. Data were analyzed by SPSS software (version 20. 0). Results Based on results independent t-test, demographic variables in students of intervention and control groups were similar as well the mean of media literacy scores before intervention, but 2 months after the intervention the differences were statistically significant between the intervention and control groups in all media literacy domains (P≤ 0. 001) except the creators of media message domain (P=0. 27), and the selective uses of media messages (p=0. 21). Conclusion The present study recommends media literacy education can be practicably included into schools as a method to promoting critical analysis of media products.

Background Neonatal sepsis is a type of neonatal infection and specifically refers to the presence in a newborn baby of a bacterial blood stream infection (BSI) in the setting of fever. This study aimed to evaluate the prevalence, pathogen distribution, antibiotic resistance pattern and the most common clinical features in infants with suspected sepsis admitted to teaching hospitals of Ilam, Iran. Materials and Methods This retrospective study was conducted in two teaching hospitals of Ilam city, Iran, during 2012-2017. After calculating sample size, simple random sampling was started in a total of 166 infants; of these, 22 infants were excluded from the study. The data collection method for each record was reviewed by two researchers and finally, the accuracy of the data extracted was examined by the third researcher. Required data were extracted based on the prepared checklist. Results The prevalence of neonatal sepsis was estimated to be 10. 4%. The most common pathogens were Escherichia coli (46. 7%), and Staphylococcus epidermidis (20%). Prematurity (46. 7%) and low birth weight (35. 4%) were the most common risk factors for sepsis. The most common clinical features in neonatal sepsis were lethargy (53. 3%), jaundice (46. 7%), and respiratory distress (40%), respectively. Neonatal sepsis was not significantly correlated with mother's age, gestational age, infant's age, infant's weight, gender, and normal vaginal delivery (p>0. 05). Conclusion The results of the study showed that prevalence of neonatal sepsis was 10. 4% and the most common pathogen was Escherichia coli. Lethargy, jaundice and respiratory distress, were the most common clinical features in neonatal sepsis.

Background Because of severe adverse effects of hyperbilirubinemia on newborns central nervous system diagnosis of its risk factors before delivery can prevent these effects. This study aimed to determine the relationship between types of delivery with jaundice during the first week of life in Term neonates. Materials and Methods In this retrospective study, all term neonates born in Amiralmoemenin Hospital, Semnan, Iran, in 2016 were included into the study. Required data were collected including age, weight, type of delivery, gender, incidence of non-pathological jaundice and type of anesthesia in cesarean delivery using data recorded in the labor ward, hospital archives, and medical records of infants and recorded in a researcher made questionnaire. Results: Mean age of neonates was 40 ± 2 weeks and their mean weight was 3100 ± 200 grams. Among them, 48. 8% of neonates with normal delivery and 49. 1% of neonates with cesarean delivery were girls. Both groups did not have a significant difference in term of age, weight and gender (P > 0. 05). In girls, there was no significant difference between type of delivery and hospitalization due to icterus (P=0. 56). As the same in boys there was no significant difference between type of delivery and hospitalization due to icterus (P=0. 059). Also, there was no difference in all neonates regardless of their sexuality, between type of delivery and hospitalization due to icterus (P=0. 078). In cesarean delivery there was no significant difference in icterus severity between general and epidural anesthesia (P= 0. 21). Conclusion The results indicate that cesarean delivery was not a risk factor for hospitalization due to icterus during first week after delivery. Further studies are recommended to confirm our results.

Background: One of the most important managerial resources in the health system is the existence of efficient, competent and strong human resources in an organization. In this regard, it is essential to strengthen and educate the human resources and develop a curriculum that meets the needs of society. This study aimed to determine the educational needs of midwifery students. Materials and Methods: This study reviewed the national and international databases including MEDLINE, Scopus, ProQuest and Ovid and the Cochrane Central Register of Controlled Trials. In addition, SID, Iran Medex, Magiran, Medlib, Iran doc, and Google Scholar were searched from inception 1950 to 2018 to find equivalent keywords in Persian, using keywords such as: "Educational Needs, Midwifery, Needs Assessment, and "Curriculum". Results: Eight studies were included in this systematic review. According to the findings, education needs to develop midwifery curriculum can be divided into three categories: clinical education, public course and specific course. In term of public course, English classes, Information technology lasses and research methodology; regarding specific course, non-pharmacological treatment for menopause complaints, abnormal uterine bleeding, hypertensive disorders, common gynecological infections, common neonatal diseases and infant mortality in crisis situations; in term of clinical education, revising training program in clinical, improving instructor function in clinical practice (skills), the empowerment instructor in appropriate monitoring and evaluating of students, and including of puberty counseling education as component of the maternal and child health internship in the field of midwifery students, should be considered. Conclusion: Midwifery curriculum should be developed to be in according to midwifery educational needs, and also to support the learner’ s personal development by contributing to enhancing their self-respect and confidence, motivation and aspirations.

Background Complementary Feeding between 6 and 24 months of age underlies nutritional habits in adulthood which can be formed by mothers through these habits. This study was conducted in Kerman aiming to apply the social cognitive theory (SCT) in feeding practices of mothers for their children aged 6 to 24 months. Materials and Methods This quasi-experimental study, controlled before and after, was conducted in Kerman health centers on 170 mothers with children aged 6 to 24 months, who were selected by multistage random sampling. The data collection tool was a valid and reliable questionnaire which was completed by mothers before and one month after the intervention. Interventions were implemented for 45 days through four sessions. In the intervention program; presentations, booklets, pamphlets, focus group discussions, role playing, demonstrations, and self-control cards were used. Also, bean sprouts were given to mothers and individual counseling was provided. The data were analyzed using SPSS software version 22. 0. Results: Social cognitive theory constructs including knowledge, outcome expectations, outcome expectancies, situational perception, the environment, self-efficacy and self-control could have significant effect on feeding practices of mothers for children (P <0. 05). The intervention caused significant changes in the SCT constructs and feeding practices particularly, changes in environment and situational perception had the greatest impact on behavior change (P <0. 05). Conclusion Use of the SCT theory for community-based interventions in the studied population programs or regions with similar cultural backgrounds is effective.

Background Maple Syrup Urine Disease (MSUD) is a rare autosomal recessive metabolic error, characterized by Branched Chain α-Keto-acid Dehydrogenase Complex (BCKDC) deficiency. Mutations in 3 genes can lead to abnormal metabolism and accumulation of leucine, isoleucine, valine and corresponding keto-acids. MSUD affects 1 in 185, 000 infants globally. Seizure is a common presentation among neonates. However, in intermediate MSUD, seizures have a delayed and insidious onset, along with developmental Case Report We report a case of grand mal seizures in a patient with intermediate MSUD, presenting with multiple episodes of seizure, dystonia, spastic quadriplegia, involuntary micturition and oculogyric crisis. Seizures were managed successfully with intravenous lorazepam and other supportive measures. The patient was advised to strictly adhere to branched chain amino acid restricted diet. Conclusion This case report emphasizes on the importance of medication adherence and dietary restrictions to prevent permanent psychomotor damage or death.

Background: Osteoporosis is a common increasing disease on which the lifestyle has an important role. This study aimed to examine the two educational methods (lecture and texting) using the theory of planned behavior on improving the osteoporosis preventive nutritional behaviors in high school students. Materials and Methods: This semi-experimental study conducted on 138 female students in who were randomly assigned to three groups (intervention group (Lecture), intervention group (mobile phone short message service [SMS]), and control group, with equal group of 46 people. The data collection tool was a researcher made questionnaire consisting of three parts; part A consists of demographic questions, part B consists of questions based on the theory of planned behavior, and part C was the Food frequency questionnaire (FFQ). The questionnaire was completed by students three times of before, immediately after, and two months after the intervention. Results: There was no statistically significant difference in the mean of preventive nutritional behavior scores between the three groups before the intervention. But immediately after the intervention, and two months after that, a significant difference was observed between the mean scores of the preventive nutritional behaviors in the intervention and control groups (P<0. 05). Also, the mean scores of preventive nutritional behavior in the two intervention groups, significantly increased in the three steps (P<0. 05). Conclusion: The text message method (mobile phone SMS) had a better impact on the improvement of the osteoporosis preventive nutritional behavior than the lecturing method. So considering the new generation tends to the use of today’ s technology as well as principles of education based on the use of innovative methods, is more effective and affordable.

Background H syndrome is an autosomal recessive genodermatosis with a low prevalence which is caused by a mutation in SLC29A3 gene. This disorder is characterized by sclerotic, hyperpigmented, hypertrichotic cutaneous plaques with systemic involvement including: hepatosplenomegaly, heart anomalies, hearing loss, hypogonadism, low height, and hyperglycemia. Case Presentation Here we have presented two cases of H syndrome that have been misdiagnosed and mismanaged as rheumatologic disease. The first case had been represented with sclerotic skin lesions and diagnosed as morphea, and second one with chronic and recalcitrant to treatment arthritis as juvenile idiopathic arthritis. Conclusion H syndrome is an autosomal recessive genodermatosis that has been recently recognized with a variety of manifestations and overlapping features with other diseases. Increase the knowledge of physicians for wide spectrum manifestations of this syndrome along with reporting the misdiagnosis of this condition can increase the accuracy of physicians for its better identification. This time our cases masquerade as rheumatologic diseases.