Journal of Pediatric Perspectives
Year:2018 | Volume:6 | Issue:11 (59)|Papers Count:15

Background Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) including Ibuprofen is one of the most currently used drugs in all age groups and finding the relation between upper gastrointestinal bleeding and Helicobacter pylori (H. pylori) in children who used Ibuprofen, is our topic of research. Materials and Methods During the two years of the study, ten children with upper GI bleeding after Ibuprofen were selected as case group and twenty children with upper GI bleeding without history of drug usage were the control group. Their histories were obtained and compared. Helicobacter pylori (H. pylori) infection prevalence and other factors were compared by means of SPSS software, T independent test and chi square, P value less than 0. 05 was significant. Results H. pylori was detected in 40% of case group and 8% of control group (P= 0. 1) haemoglobin (mean ± standard deviation) in case group was lower than control group 10. 5± 2. 1 vs 11. 9 ± 1. 2 g/dl (P= 0. 08). This level (Hb) in H pylori infected was 8. 3± 1. 3 vs. 12 ± 0. 5 (P= 0. 0001) in non-infected children. Conclusion Upper GI bleeding following Ibuprofen prescription is a complex matter in children. H pylori infection is more common in bleeding episodes following Ibuprofen users which show lower haemoglobin levels compared to non-infected patients.

Background: The current study aimed to develop a tool to assess the performance skills of Iranian children aged 5 to 7 years in order to evaluate their school competency based on the occupational therapy practice framework and to determine its validity. Materials and Methods: Performance skills are the cornerstone of the tool. The eight-step design process of Devellis was used to develop the tool. To analyze the content validity, the content validity index, and the content validity ratio were used. Following administration of the tool in 100 children (5 to 7 years) in the pilot study, the items were analyzed. After applying the tool to 400 children aged 5 to 7 years, the construct validity of the tool was determined with confirmatory and exploratory factor analysis and differential, convergent, and divergent validity. Results: The primary item pool included 212 items which was reduced to 112 items after administrating content validity and item analysis. Based on exploratory factor analyses, Kaiser-Meyer-Olkin (KMO) index was (0. 890), and five factors indicating 55. 02% of the total variance were obtained. The confirmatory factor analysis confirmed the results. The discriminant validity between the age groups was statistically significant (P < 0. 001); r ranged from 0. 447 to 0. 867 for convergent validity and 0. 073 to 0. 597 for divergent validity. Conclusion: The results indicated the excellent validity of the SICPSBS to assess the performance skills of 5 to7 year-old Iranian children in terms of school competency. The test evaluates all sensory-perceptual, motor-praxis, visual-perception, cognitive, social interaction, and process domains for each child.

Background: Considering the religious and legal structures in Iran, the occurrence of euthanasia seems to be impossible; however, the attitude of nurses towards euthanasia and its related factors may also affect creating moral distress conditions for nurses. Therefore, this study aimed to investigate of the moral distress and attitude of Adult and Neonatal Intensive Care Units (AICU/ NICU) nurses toward euthanasia. Materials and Methods: In this descriptive-analytical study, all the nurses working in intensive care units of Educational Hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences (Ahvaz city, Iran) were selected by census. Data were collected using Corley's Moral Distress Scale and Holloway’ s Euthanasia Attitude Scale. Single-variable and multivariate linear regression tests were used to analyze the data and to determine the relationships between independent and dependent variables. Analyses were done using SPSS software (version 22). Results: The attitude of all nurses towards euthanasia was negative (min score=20, max score=73, mean score= 43. 78± 7. 99). The mean Moral distress frequency and Moral distress intensify were 47. 01± 12. 90 and 48. 42± 11. 62, respectively (indicates moderate ethical distress). In AICU nurses, there was a significant relationship between the frequency of moral distress and the nurses’ attitudes. However, there was no significant relationship between the intensity of moral distress and the nurses’ attitudes. In NICU nurses, there was no significant relationship between the frequency of moral distress and intensity of moral distress with nurses’ attitude toward euthanasia. Conclusion: The religious and cultural conditions of the country have caused all nurses did not consider euthanasia to be acceptable under any circumstances. Further studies are needed to better understand the attitude of nurses towards euthanasia, especially with regard to the culture of Iranian society.

Background: Thalassemia is the most common genetic disorder in Iran. High treatment costs, the use of iron chelators, comorbidities and periodic visits affect the quality of life in these patients. The present study was conducted to assess the quality of life, according to the Short healthy survey (SF-36), in Iranian patients with thalassemia major. Materials and Methods: In this meta-analysis, search was done in national and international databases, including SID, MagIran, Google Scholar, Web of Science, Medline (via PubMed), and Scopus until March 2018. The searched papers were screened and summarized by two independent reviewers. Based on the heterogeneity among the studies, the data were analyzed using the random effects model. Data were analyzed using STATA version 14. 0. Results: Data from 18 studies, including 2, 897 patients (age group 12-45 years old); were entered in the final analysis. The mean mental component scale in patients with thalassemia major (57. 30; 95% confidence interval: 50. 31-64. 30) was lower than the mean physical component scale (62. 77, 95% CI: 52. 63-70. 91). The mental component scale increased significantly between 2009 and 2017 (as the year of publication increased) (P = 0. 043). The highest (74. 77), and lowest (60. 94) subscale scores of quality of life were related to physical functioning and general health, respectively. Conclusion Patients with thalassemia major have a relatively low quality of life. Providing strategies for improving the quality of life in this group of patients (particularly in terms of mental components) seems necessary.

Background There are controversial views on the advantages and disadvantages of swaddling. Perhaps an explaination on how to swaddle according to the teachings of traditional Persian Medicine will make it easier to have a better judgment of this kind of treatment. Materials and Methods This study was based on the books of famous Persian Traditional Medical scholars as well as modern medical literature, published or in databases. Results The study showed that nowadays, the Sudden Infant Death Syndrome (SIDS), and hip joint dislocation were considered as the disadvantages of swaddling while baby's' better sleep was believed to be its advantage. However, in Persian traditional medicine, swaddling was known as a treatment for joint dislocation during labor or a means of preventing the dislocations which might occur while carrying the infant. Based on this aim, a careful method for swaddling was proposed which not only diminished the above mentioned disadvantages but also, provided positive side effects like better sleep and preserved body temperature for the newborn baby. Conclusion There is a big difference between the ideas of traditional medical scholars and those of people on swaddling. Therefore, by reviewing the works of Iranian scholars and combining modern medical findings and Iranian experience, we can provide a different definition of swaddling. By teaching it to physicians, nurses and mothers, it can be considered as a treatment in the neonatal complications of childbirth. It is used during childbirth, and taking advantage of other benefits of this practice, also prevents its harm.

Background We aimed to compare the efficacy of nebulized hypertonic (3%, 5% and 7%) saline with normal saline in hospitalized infants with acute bronchiolitis. Materials and Methods In this triple-blinded randomized clinical trial, 120 children with moderate to severe bronchiolitis randomly assigned into four groups to receive nebulized normal saline (group A), saline 3% (group B), saline 5% (group C), and saline 7% (group D). The length of hospital stay (LOS) as primary outcome and the use of oxygen, temperature, oxygen saturation (SPO2), pulse rate (PR), respiratory rate (RR), and bronchiolitis severity score were measured in the beginning of the study and during hospitalization. Results The mean age of patients was 5 + 0. 423 months and 79 of them (65%) were male. The length of hospital stay (LOS), and use of oxygen supplementation was not different between group A and B (P=0. 36), but significantly lower than group C and D (P<0. 001). Vital signs, improvement in severity score and oxygen saturation were similar between groups. Conclusion Our study demonstrated that nebulization with 3% hypertonic saline and 0. 9% saline can significantly reduce hospitalization rate compared nebulization with 5% and 7% hypertonic saline.

Background: Nowadays, backpack is the best and most commonly used tool for carrying books and stationery by students. There are huge evidences which confirmed that carrying method of school backpack influences on the students’ health status. The aim of this study was to determine of features of backpack carrying methods by schoolchildren. Materials and Methods: A cross-sectional study was conducted on 650 primary schoolchildren in Gonabad city (Iran) in 2017. Using both a made researcher’ s questionnaire and observation, we collected the required data. The gathered data were analyzed using SPSS software (version 22. 0). Results: The results showed that 85. 87% of student carried their backpacks in the incorrect way. Although 83. 13% of the students used both straps of his/her backpacks, there was a backpack between the two scapulae in only 55% of the students. Besides, just 31. 3% of their backpacks were attached to back of the respondents. In terms of appropriateness of the size between students and backpacks, only 40. 1% of the students used a suitably sized backpack with their own body structure. The results of multiple logistic regression analysis showed that there were significant association between backpack carrying methods of the students and their age, gender, school grade type of school (governmental, non-governmental) (P<0. 001). Conclusion: Findings of the study showed that most of the students do not carry their backpack by proper method. Therefore, educational and executive interventions are necessary in order to prevent future musculoskeletal disorders in students.

Background Although following a suitable sports program with mild intensity promoted the health of mother's who had healthy pregnancy and caused no harm to the growing fetus; pregnant women usually choose to live a sedentary life. This study was conducted to determine the psychological factors related to physical activity in pregnant women. Materials and Methods This descriptive, correlational and cross-sectional study was conducted on 201 pregnant women who referred to Isfahan health center, Iran. Data gathering tools included a questionnaire on physical activity during pregnancy and a questionnaire to evaluate variables related to social cognitive theory. The validity of socio-cognitive questionnaires was approved by expert professors and their reliability was approved using internal consistency and Cronbach's alpha (above 0. 6). Data were analyzed using SPSS software (version 16. 0) through descriptive statistics, correlation coefficient test and linear regression. Results: The greatest amount of physical activity was related to activities in a moderate level. The results showed that there was a significant relationship between three variables of socio-cognitive theory and several levels of physical activity. There was also a significant relationship between variable of observational learning and physical activity in a moderate level and total activity (P<0. 05) and a significant relationship between variable of social norms with all three levels of physical activity and total activity. Furthermore, there was a significant relationship between outcome expectations and inactivity (P<0. 05) Conclusion: Among the variables related to social cognitive theory, social norms as one of the environmental factors in interaction of the individual, the behavior and environment could be used to analyze the physical activity during pregnancy. Suitable interference focusing on social norms to promote physical activity in pregnant women should be considered.

Background: The decrease in physical activities following increased usage of computer and digital games has led to serious health consequences in children. This study investigates the prevalence of obesity, cellphone and computer usage and physical activity levels and their relationship with spirometry indicators in Iranian children. Materials and Methods: This is a cross-sectional study during 2013 to 2014 on high-school students in Isfahan, Iran. Sample size determined 1, 690 students and sampling performed from 10 girls and 10 boy's high schools, based on multi-staged cluster randomized scheme. A research-made questionnaire was developed to complete by students interview and also contact with teachers and parents and measuring height and weight by researchers. If the asthma was probable (based symptoms and examined by physician) the spirometry was performed. Results: Overall 1, 622 high-school students with the average age of 12. 9 (+ 1. 1) years were recruited. Prevalence of obesity and overweight were significantly higher in boys (P<0. 05). The prevalence of obesity was 9. 5% in boys and 5. 3% in girls, and sever underweight was 4. 2% and 2. 5%, respectively. Cell phone, computer, and digital game usage were significantly higher for boys (P<0. 05); while watching television (TV) was not (P=0. 400). Of total, 423 students (26. 1%) witch asthma was probable and the average of FVC and FEV1 was significantly higher in boys than girls (P=0. 001). Conclusion: The overall prevalence of obesity in 12 to 14-year-old students was more than 7% and its prevalence was influenced by physical activity. Spirometry indicators were correlated with physical activity and lifestyle.

Background The maternal attitude toward infant feeding is one of the strong predictors of the start and continuation of exclusive breastfeeding. According to the validity and reliability assessment of Iowa Infant Feeding Attitude Scale (IIFAS) in many countries, the purpose of this study was to examine psychometric properties of an Iranian version of this scale. Materials and Methods: The present study was a cross-sectional and performed on 280-breastfeeding mothers in the first 48 hours after delivery. After translation with forward-Backward technique, in order to assess the structure validity, the confirmatory factor analysis (CFA) was conducted and the goodness of fit indices were calculated. Reliability of the tool was measured with the use of Cronbach’ s Alpha coefficient for the measurement of internal consistency and the intra-class correlation coefficient (ICC) to assess the stability through test-retest method. Results: In the first phase of CFA, from 17 questions of the original version of the scale, six questions included 1, 4, 5, 8, 10, and 17 were removed due to the loading factor of less than 0. 3. In the second phase of CFA, validity of the 11-question version with two-factor structure confirmed. The ratio of Chi-square to the degree of freedom was 2. 44 that along with other goodness of fit indices of the model showed the two-factor model has excellent fit. The Cronbach’ s alpha and ICC were 0. 856 and 0. 885, respectively; that represented the good reliability of the scale. Conclusion Overall, the results showed that the 11-question version of (IIFAS) is a valid, reliable, acceptable and repeatable tool for measuring infant feeding attitude in Iranian mothers.

Background Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and characterized by a wide range of clinical manifestations. The study aimed to compare Doppler tissue echocardiography findings between children with celiac disease and healthy children. Materials and Methods This case-control study was performed on 186 celiac and healthy children aged 6-19 years. Celiac diagnosed by clinical findings and laboratory's tests (tTGIgA) confirmed by intestinal biopsy. Controls consisted of voluntary individuals free of any diseases. Echocardiography performed on participants. Data analyzed utilizing SPSS software version 20. 0. Results Left Peak A, left S', right ICT', right IRT', right S', EF, FS, left ET', left IRT', right E'/A' left S' were higher in case when Right ET was lower. Patients with left S' < 8 were lower in left A', higher in right ICT', lower level in right S', higher in left E/E'. Patients with Left E/E' ≥ 9, were higher in Left Peak E velocity, lower in IVSD, higher in right E/E’ , lower in left S' and lower in left E’ (P<0. 05). Conclusion Almost all heart findings were higher in celiac patients except a few. Patients with left S' <8 were in lower level of left A' and right S', and in higher level of right ICT', left E/E'. Patients with Left E/E' ≥ 9, were higher in Left Peak E velocity and E/E', lower in IVSD, left and left S'.

Background Neonatal sepsis is one of the most critical illness in neonates that is responsible for a great proportion of morbidity and mortality in neonates so early diagnosis and identification of high risk cases is a challenging aim of our study. The purpose of this study was to investigate the prognostic value of red cell distribution width (RDW), in neonatal sepsis at the time of admission to neonatal intensive care unit (NICU). Materials and Methods This prospective case control study included 3 groups divided into Group 1: Neonates with sepsis (78 neonates), Group 2: Neonates with severe sepsis (42 neonates) Group 3: Neonates as a control group (60 neonates) were gender, gestational and postnatal ages matched. Red cell distribution width was determined for all included neonates. The score for neonatal acute physiology (SNAP II) was determined within 12 hours of admission to the NICU. Results One hundred and two sepsis newborns (85%), including 66 (64. 7%) cases from sepsis group and 36 (35. 3%) cases from severe sepsis group, the mortalities were 15. 4% (n= 12), and 71. 4% (n= 30) for group 1 and 2, respectively. The incidence of RDW increase in survivors group (45. 7%) was significantly lower than in the non-survivors group (92. 9%, n=39). The score for neonatal acute physiology (SNAP II) was positively correlated with RDW increase in newborns (r= 0. 735 and p<0. 05), and the mortality was positively correlated with RDW increase (r= 0. 598 and P<0. 05). Conclusion In our study RDW is a helpful prognostic marker for early diagnosis of neonatal sepsis and identification of high risk cases.

Background Prevalence of hypertension has a relatively high prevalence especially in developing countries. In order to prevent and control the disease, it is important to know the extent of the complications. The aim of this study was to investigate the relationship between pregnancy-induced hypertension with neonatal and maternal complications. Materials and Methods This prospective, descriptive study was conducted on 230 overweight women, with hypertension (n=115) and normal blood pressure (n=115) during pregnancy, referring to Hamedan hospitals. Researcher-made questionnaire including demographic characteristics and maternal and neonatal complications were used to collect required data. Data analysis was performed using Chi-square, t-test and ANOVA based on the difference between the data at a level of error less than 5%. Results: There was no significant difference between the two groups in terms of demographic characteristics, smoking history, and mean weight, number of pregnancies, number of births, history of abortion and the reception of care during pregnancy (P > 0. 05). Significant relationship was observed between pregnancy and maternal outcomes, such as cesarean section, infection, bleeding, hydramnios, diabetes, proteinuria, edema, headache and hospitalization time, as well as neonatal outcomes such as low birth weight, preterm delivery, Apgar, and longer hospitalization (P <0. 05). Conclusion Regarding the proved significant relationship between pregnancy and maternal hypertension, it is highly recommended to prevent these complications by controlling the blood pressure and providing necessary measures during pregnancy.

Background Progress in medical science and success in increasing the survival rate of vulnerable infants have raised the issue of future development in these children. This study aimed to investigate the relationship between small for gestational age (SGA) status at birth and developmental delay in children aged 4 to 60 months. Materials and Methods This study was a correlation descriptive through a multistage sampling method on 419 Iranian children aged 4 to 60 months who attended healthcare centers affiliated to Isfahan University of Medical Sciences and Healthcare Services, Iran. Data collection tools included a data collection checklist and the Ages and Stages Questionnaires (ASG). The data obtained were analyzed using the SPSS software (version 18. 0(. Results The results showed that 83 (19. 8%) of 419 children in the study, had developmental delay and 336 (80. 2%) had normal development. Comparison of developmental domains between the two groups of children based on birth weight, showed that there was a significant relationship between the birth weight of children and developmental delay in the domain of fine movements (p = 0. 02, r=0. 81), problem solving (p = 0. 02, r= 0. 73), and the total score (p =0. 02, r= 0. 87). In addition, the Chi-square test showed a significant relationship between small for gestational age (SGA) status at birth and developmental delay in children (p = 0. 001). Conclusion Given the relationship between birth weight and developmental disorders, special attention to the birth weight of infants and performing regular care during pregnancy and afterwards for SGA children can prevent many developmental problems.

Background Multicentric carpotarsal osteolysis (MCTO), a skeletal dysplasia presents in early childhood mimicking juvenile idiopathic arthritis (JIA). Recognition of this syndrome is essential to avoid unnecessary treatment with immunosuppressive agents because of different course and treatment. Case Report A 3-year-old boy presented with swelling and restriction of right wrist joint and left ankle joint. Possibility of Oligoarticular (or pauciarticular) JIA was considered. On evaluation his inflammatory parameters were normal. There was poor response to oral steroids and methotrexate. He was lost to follow up and presented at 9 years of age with varus deformities of hand and feet. Radiographs revealed absent carpal and tarsal bones. Based on clinical and radiological examination-MCTO was diagnosed. Oral alendronate was started and clinical improvement was noted. Conclusion Mimickers of JIA like MCTO, Farber’ s disease should be actively looked when inflammatory parameters are normal or response to therapy is not appropriate.