Journal of Pediatric Perspectives
Year:2019 | Volume:7 | Issue:3 (63)|Papers Count:15

Background Most pregnant women suffer from nausea and vomiting during pregnancy (NVP) as one of the common discomforts compelling women to increasingly turn to herbal medications for help, including lemon inhalation aromatherapy as investigated in the current systematic review and meta-analysis. We aimed to evaluate the effect of aromatherapy on relieving nausea and vomiting during pregnancy. Materials and Methods In the present study, electronic sources in English (Medline [via PubMed], Scopus, Web of Science, and Cochrane Library); and databases in Persian (SID and Magiran) were systematically searched without any time constraints until February 10, 2018. Following keywords were used to find research articles related to the effect of aromatherapy on the NVP: (Nausea OR Vomiting) AND (Aromatic therapy OR Essential oil OR Essential oils OR Fragrance OR Fragrant oil OR Fragrant oils OR Scent OR Alternative Medicine OR Complementary Medicine) AND (Pregnancy). Results Four studies were included in systematic review. The results of this study reported that aromatherapy with lemon compared to placebo improves the severity of nausea and vomiting in pregnant women, but Mentha and Peppermint oil alone or in combination with lavender, showed no significant improvement. There was no significant difference between the placebo and aromatherapy groups regarding total score of nausea and vomiting among pregnant women at the third day (standardized mean difference [SMD] =-0. 347; 95% Confidence Interval [CI]:-0. 980 to 0. 287; P=0. 284, heterogeneity; I2=72%; P=0. 054). Conclusion Aromatherapy did not show any beneficial effect on nausea and vomiting among pregnant women. Only aromatherapy with lemon oil can be beneficial.

Dear Editor-in-Chief: Poliomyelitis is a highly infectious viral disease which is mainly transmitted via contaminated food and drinking water by human feces, especially in situations of poor hygiene and sanitation (1). This disease is caused by 3 types of wild poliovirus (WPV) (types 1, 2 and 3), and immunity against one type does not create immunity against other types. In our country according National Immunization Program (2), inoculation 6 doses of oral polio vaccine (OPV) induce immunity for long time against poliomyelitis. The polio eradication was a largest public health innovation is organized by the World Health Organization (WHO), and enhanced routine immunization, adequate response to outbreaks and effective surveillance are the main strategies to reach this goal (3). The last laboratory-confirmed wild polio case in Iran was reported in 1997. From 1998 to 2000, cases were imported from Pakistan/Afghanistan of wild virus circulation. The last case was an imported case from Afghanistan in December 2000 and the circulation of wild poliovirus was stopped in December 2000 and Iran is known as a polio free country from 2001 (4). According WHO report up to 2017, WPV transmission was disrupted in all countries except Afghanistan, Pakistan and Nigeria (5). Although the AFP surveillance in Iran reached to high level and gained the polio-free certification through active surveillance (6), but the role of neighboring countries which can interrupted our achievement should not be ignored. In the following we discuss a bout situation of wild WPV transmission in our neighboring countries.

Coronary aneurysms are typically seen in association with Kawasaki disease and only in rare instances, they are reported to be congenital or idiopathic. Here we report a case of a five-year-old boy who was found to have an idiopathic right coronary artery aneurysm. He presented with complaints of recurrent respiratory tract infections. His examination and investigations did not reveal any of the common etiological conditions. Echocardiography showed the right coronary artery was arising from the right coronary sinus and was dilated proximally. Cardiac catheterization revealed dilated proximal right coronary artery draining into a large pulsatile aneurysm. The child was surgically treated with an aortocaval bypass, resection and surgical ligation of the aneurysm. He has no further complications and is on follow-up.

Hemophilia is one of the most common inherited coagulation disorder; with almost half of the cases presents in the neonatal period with bleeding episodes specially post circumcision, although family history is present in about two third cases. Retroperitoneal hemorrhage is a very rare presentation of hemophilia and to the best of our knowledge has not described yet, as initial presentation of hemophilia B in the neonatal period. We are presenting retroperitoneal hemorrhage as initial presentation of hemophilia B, in the presence of family history which has not been disclosed till the baby become symptomatic.

Background Cytomegalovirus (CMV) has been known as the most common cause for congenital infections worldwide which can lead to death in fetus and neonates as well as neuropsychiatric deficits. The aim of this study was to determine the prevalence of congenital CMV infection in newly born neonates and to evaluate the medical outcomes. Materials and Methods In this cross-sectional study, 868 neonates were selected using unconditional random sampling in 2017. Neonatal saliva was given on the first or second day of birth using a Dacron swab and tested by PCR for the presence of CMV DNA. All infants with positive CMV infection went through further tests and examinations to evaluate the clinical outcomes. Results: 787 (90. 67%) and 81 (9. 33%) births were term and preterm respectively. The PCR test was positive results only in 14 term neonates (1. 61%). Thus, the prevalence of CMV infection in term neonates (n=14, 1. 61%) was higher than that of preterm infants (n=0), although there was no statistically significant difference (P>0. 05). The most common abnormalities were neutropenia (50%, n=4) followed by anemia (37. 5%, n=3). Conclusion The prevalence of CMV infection in this study (1. 61%) was within the global range and there was no association between CMV infection and birth weight, infant gender, and as well ae neonatal type. The frequency of symptomatic neonates at birth in this study was higher than the average global range, but almost the same as in developing countries.

Background Glucagon-like peptide-1 hormone (GLP-1) contributes to the regulation of insulin and glucose concentration. However, the effects of fasting on GLP-1 response in different people has not been determined yet. The aim of the present research was to investigate the effect of fasting on GLP-1 and the lipid profile of obese and thin women. Materials and Methods: In this research, 25 obese and thin women whose age ranged from 35 to 45 years were selected through a convenient sampling method and were divided into two groups of obese (n=12, body mass index ˃ 30 kg/m2) and thin (n=13, body mass index=18-20 kg/m2). GLP-1 in both groups was measured in four phases: 3 days before the beginning of Ramadan, 14 days after the beginning of Ramadan, 28 days after the beginning of Ramadan and 2 weeks after the end of Ramadan. Repeated – measure ANOVA was used to statistically analyse the data. Results GLP-1 was reduced from phase 1 to 3 of the research. However, it was increased after Ramadan. In the thin group, GLP-1 was increased in 14 days of fasting, but did not show any change at the end of Ramadan, and also two weeks after this month. However, none of these changes were statistically significant. The two groups did not diverge from each other significantly in any of the phases. Conclusion The present findings showed that fasting has no significant effect on the GLP-1 and lipid profile indices of the obese and thin women.

Background: Breastfeeding is an ideal nutritional method that has many benefits for mothers, infants and the health system. Negative attitude toward breastfeeding is accompanied with unpleasant consequences. We aimed to determine the predictors of breastfeeding attitude in Iranian breastfeeding mothers. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on 346 mothers in the first 24-48 hours after delivery in selected hospitals of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Convenience and continuous sampling method was used in this study. The Iowa Infant Feeding Attitude Scale (IIFAS), Breastfeeding self-efficacy scale-short form (BSES-SF(, and researcher made questioner for socio-demographic, obstetric and breastfeeding characteristics were used for data collection. Results: The mean score of attitude was 45. 90 ± 4. 68 out of 11-55, which indicates a positive attitude toward breastfeeding. The results showed a significant relationship between mother age, breastfeeding self-efficacy score, mother’ s employment status, planned pregnancy, selected feeding method for infant, and the breastfeeding duration of the previous child with breastfeeding attitude score (P<0. 05). According to multiple linear regression model, maternal age (B=0. 110, P=0. 015), breastfeeding self-efficacy (B=0. 102, P=0. 001), maternal employment (B=1. 286, P=0. 021), and planned pregnancy (B=1. 638, P=0. 003) were predictors of breastfeeding attitude in mothers. Conclusion: According to the results maternal age, breastfeeding self-efficacy, maternal employment and planned pregnancy were predictors of breastfeeding attitude in mothers. Hence, development of suitable educational programs tailored to the needs of mothers, during pregnancy and the postpartum period and adequate support of mothers are essential to improve and enhance breastfeeding attitude and self-efficacy in breastfeeding mothers.

Background: There is a rapid spurt in non-communicable diseases because of some significant changes in nutrition patterns around the globe. Controlling the main risk factors, namely lack of physical activity and smoking, might decrease more than 50% of the deaths and disabilities caused by these factors. This study aimed to investigate the effective factors of healthy food behavior based on the application cognitive social theory to 13 to 15-year-old students. Materials and Methods: This cross-sectional study was performed on 330 students aged 13– 15 years, in Zarrin-Dasht County, Fars Province, south of Iran who were randomly selected from public schools assigned to the study in 2016. The data gathering tools were demographic questionnaire, a researcher-made questionnaire of social cognitive theory (outcome expectations, outcome values, self-efficacy, social support, and self-regulation), and another questionnaire on nutritional behavior. Questionnaires were completed by students. For analyzing data, the SPSS-22 software, multiple regression, and correlation tests were used. Results: 330 students aged 13– 15 years with seventh, eighth and ninth educational grade participated in this study. Among different constructs of social cognitive theory, outcome expectations (P=0. 001), social support (P=0. 005), and self-regulation (P=0. 001), have made significant contribution to the explanation of the variance of appropriate nutritional behavior among the students. In total, these variables account for approximately 63% of the variance of nutritional behaviors. Conclusion According to the results of this study outcome expectations, social support, and self-regulation might be effective in designing educational interventions to achieve healthy food behavior in students.

The French law, contrary to the Iranian law, has given the mother a kind of representation for guardianship and training of the child. This is a development that was established in France in 1970, and in Article 6 of the Iranian Family Protection Act of 2012, the granting of representation to the mother over the legal procedure for demand of the child or the incompetent has been entrusted. There are two different attitudes in the interpretation of this article; some of which are considered as "establishment of the notion of the guardianship" for the mother, while others believe that this article constitutes a kind of representation to the mother as a lawyer or guardian. The present article uses an analytical-descriptive method to explain the nature and principles of the representation of the mother for guardianship of the child. The result of the article suggests that the Iranian legislator's purpose of the assignment of representation to the mother in accordance with Article 6 of the Family Protection Law of Iran, adopted in 2012, is not to prove the guardianship for the mother like French law, but merely to grant representation and the right of the legal procedure for demand of the alimony of the child or the incompetent, maintaining the interests and observing their desire.

Background: There might be a close link between neonatal icterus and/or neonatal phototherapy and childhood asthma. The present study aimed to assess the relationship between neonatal icterus and/or phototherapy and the likelihood of childhood asthma among Iranian population. Materials and Methods The present case-control study was performed on 102 consecutive asthmatic children hospitalized at Children’ s Medical Center, Tehran, Iran. Asthma was diagnosed by a pediatric asthma and allergy specialist based on clinical manifestations and/or spirometry results for children older than 5 years. A total of 113 sex and age-matched children without asthma who were admitted to other wards during the same period of time were selected as the control group. Data were collected by a researcher-made checklist including data regarding participants’ age, gender, and gestational age, history of neonatal icterus and history and duration of phototherapy, filled by participants’ parents/guardians. Results: There was a significant difference between cases and controls with respect to preterm birth, history of phototherapy and duration of phototherapy. History of icterus was not associated with childhood asthma. In the multivariable logistic regression model, both history of phototherapy (P=0. 029), and duration of phototherapy (P=0. 03) were considered as determinants for occurrence of childhood asthma. Conclusion According to the results, history of neonatal icterus was not associated with childhood asthma, but history and duration of phototherapy were both determinants of childhood asthma.

Background: Peer education is one of the most effective strategies for changing behavior in adolescents, which provides the unique learning opportunities for promote health behaviors. The aim of this study was to systematically review the effect of peer education on health promotion of Iranian adolescents. Materials and Methods: In this systematic review, all interventional studies were searched from Web of Science, Scopus, Embase, Cochrane, Medline (via PubMed) as English databases and SID, Magiran and Irondoc as Iranian databases using keywords such as "adolescent, teenager, student, peer group, education, health and Iran" between January 2000 to October 2018. Two reviewer studied the full text of the articles and their main findings were extracted and categorized. The quality of the articles were checked and verified using the Effective Public Health Practice Project (EPHPP) tool. Results: Finally, 20 articles (with total 6, 652 adolescents) which met inclusion criteria were investigated and reviewed systemically in four categories including the effect of peer education on prevention of diseases, mental health, nutritional behaviors, and prevention of high-risk behaviors in adolescents. In all categories, the results showed the equal or greater effect of peer education on knowledge, attitude, practice, self-efficacy and health behavior of adolescents compared to other methods such as education by teacher, health personnel, lecture, pamphlet and booklet. Only effect of education by the physician was more than peer education. Conclusion: According to the results, peer education improves the knowledge, attitude, health behavior, and self-efficacy of adolescents and as a result, it will promote the adolescent health.

Background: Patients with rheumatologic diseases have higher rates of cardiovascular disease. Accelerated atherosclerosis and early coronary artery disease have become important causes of death and hospitalization in those patients which may be attributed to metabolic changes in lipids. We aimed to clarify the cardiovascular risk in children with juvenile idiopathic arthritis (JRA), and systemic lupus erythematosus (SLE), and its relation to lipid profile and disease activity index. Materials and Methods In this cross sectional comparative study which was done in Minia Children University Hospital, Egypt, we measured lipid profile (cholesterol, triglycerides, low and high density lipoproteins), erythrocyte sedimentation rate, and C-reactive protein in 15 patients with JRA (group1), and 15 patients with SLE (group 2), and in 30 healthy children as controls (group 3). Results Results showed that there were no significant differences between group 1 (JRA) patients, and controls in total cholesterol, triglycerides, low and high density lipoproteins, but there were high statistically significant differences between group 2 (SLE) patients, and controls in total cholesterol, triglycerides, low density lipoproteins (p<0. 001), and in high density lipoproteins (p<0. 008). There were positive significant correlations between disease activity index in JRA patients with total cholesterol (r=0. 633, p=0. 011), triglycerides (r=0. 523, p=0. 046), and low density lipoproteins (r=0. 548, p=0. 034). Also, positive significant correlations between disease activity index in SLE patients with total cholesterol (r=0. 579, p=0. 024), triglycerides (r=0. 559, p=0. 030), and low-density lipoprotein (r=0. 533, p=0. 041). Conclusion Children with rheumatologic diseases can be at high risk of arthrosclerosis and cardiovascular events due to lipid profile change which may be associated with subclinical arthrosclerosis, so continuous monitoring of lipid profile can decrease mortality and co-morbidity.

Background: There are several therapeutic methods for the premenstrual syndrome (PMS). Although psychotherapy has been introduced for women with PMS, no regular reconsiderations of these treatments are available. Aim of the present meta-analysis was conducted to evaluate the effect of psychotherapy interventions on the PMS. Materials and Methods: The present systematic review and meta-analysis was conducted no restriction in date of publication until 13th March 2018 on electronic international databases of Medline (via PubMed), Scopus, Web of Science, and Cochrane Library as well as Iranian databases, such as Magiran, Medlib, and SID, using equivalent keywords in Persian. The quality of studies and data extraction was assessed by two authors. The standardized mean difference (SMD) measure was applied to calculate the main effect size. Results: Seven trials were included in systematic review. Depression level [SMD =-0. 978; p<0. 001; 95% Confidence Interval (CI):-1. 466 to-0. 490, seven trials, and anxiety (SMD=-0. 911; p<0. 001; 95% CI:-1. 46 to-0. 355, four trials in women with premenstrual syndrome decreased significantly in psychotherapy group compared to control group]. However, high heterogeneity among trials were found in trials assessed the effect of psychotherapy on outcome depression (p<0. 001, I2=78%) and anxiety (p=0. 015 I2=71%). Conclusion: Our meta-analysis gives strong support for the beneficial effect of psychotherapy on anxiety and depression in women with premenstrual syndrome. These findings should be interpreted with caution in light of limitation including high heterogeneity.

Background Diabetes is the most common endocrine glands disease. Among the factors contributing to increased incidence of diabetes in adolescents is lack of physical activity. Various studies indicate prevalence of sedentary lifestyle in children and adolescents. Therefore, in this research the factors affecting performing physical activity have been examined with the aim of preventing diabetes using the planned behavior theory in girl students. Materials and Methods In this cross-sectional study, 185 female students were chosen through random multistage sampling method. The data collection instrument was a questionnaire consisting of four sections including demographics, awareness about diabetes, the constructs of planned behavior theory about physical activity, and international physical activity questionnaire (IPAQ). Data analysis was performed with the help of SPSS 16, through Pearson correlation coefficient and generalized linear model (GLM). Results: The mean age of the students was 11. 51± 0. 76 years. The mean scores of different components were as follows: awareness (4. 85± 1. 49), attitude (35. 84± 3. 56), mental norms (21. 96± 4. 53), controlling perceived behavior (15. 02± 2. 65), and behavioral intention (15. 21± 2. 50). There was a significant relationship between the intention of performing physical activity and attitude (P<0. 001), mental norms (P<0. 001), and controlling perceived behavior (P<0. 001). The results of fitted GLM showed that only the perceived behavior control construct was significant in terms of predictive power for performing physical activity (P<0. 001). Conclusion According to the results, the intention of performing physical activity had a significant relationship with the constructs of attitude, mental norms, and perceived behavior control.

Background: Training of Pediatric residents is a dynamic process which should be changed as the nature and epidemiology of pediatric diseases change. We aimed to determine the educational needs of Pediatric residents. Materials and Methods: In this systematic review after selecting appropriate keywords and their combinations, an extensive search was done in databases of Medline, EMBASE, ProQuest and Ovid, Web of Science, Cochrane Library, and Scopus as well as Persian databases, such as Magiran, Medlib, and SID, using equivalent keywords in Persian, to find related articles to Pediatric education. The full text of the articles was studied by two reviewers and the main findings were extracted and categorized. Quality of studies was evaluated using STROBE statement. Results: Data from nine studies were entered in this study. According to the findings, the necessity of changing Pediatric resident curriculum seems to be necessary in accordance with the conditions of the community. So, subspecialties for Pediatric resident training should be considered; these items can be include: cardiology, development, hematology and oncology, endocrinology, infectious diseases, respirology, palliative care of neurology, emergency, neonatology, gastroenterology, nephrology, gynecology, child psychiatry, behavioral psychology, surgical specialties, orthopedics and adolescents, dermatology, ophthalmology, and otolaryngology. Conclusion Pediatric residents need sufficient, specific training to enable them to competently investigate and treatment of children complaints. So, Pediatric resident curriculum should be developed to be in according to Pediatric educational needs, and also to support the learner’ s personal development by contributing to enhancing their self-respect and confidence, motivation and aspirations.