Journal of Pediatric Perspectives
Year:2017 | Volume:5 | Issue:6 (42)|Papers Count:20

Background Patients' dosimetry is crucial in order to enhance radiation protection optimization and to deliver low radiation dose to the patients in a radiological procedure. The aim of this study was to assess the entrance surface dose (ESD) and radiation dose to the radiosensitive organs in pediatric pelvic radiography. Materials and Methods: The studied population included 98 pediatric patients of both genders referred to anteroposterior (AP) projection of pelvic radiography. The radiation dose was directly measured using high radiosensitive cylindrical lithium fluoride thermo-luminescent dosimeters (TLD-GR200). Two TLDs were placed at the center point of the radiation field to measure the ESD of pelvis. Moreover for each patient, 2 TLDs were placed upon each eyelid, 2 TLDs upon each breast, 2 TLDs upon the surface anatomical position of the thyroid gland and finally 2 TLDs at the surface anatomical position of the gonads to measure the received dose. Results The ESD ± standard deviation for AP pelvic radiography was obtained 591. 7± 76 μ Gy. Statistically significant difference was obtained between organs located outside and inside of the radiation field with respect to dose received (P<0. 001), as well as between the average dose received by the breast and lens of the eyes (P<0. 05). There was no difference between boys and girls with respect to average ESD, while the testes dose was statistically non-significantly lower than ovaries dose. Conclusion The ESD received by patients are relatively accordance to the international recommendations. However further reduction in patients' dose in achievable by adherence to the radiation protection optimization guidelines. The data presented in our study will serve as a baseline needed for deriving local reference doses for pediatric pelvic radiography in our hospital. The study is expected to increase the awareness of medical professionals about the radiation doses in pediatric pelvic radiography.

Ciprofloxacin is the most commonly used fluoroquinolone. Ciprofloxacin is prescribed for 1 in 44 Americans. Ciprofloxacin is a broad-spectrum bactericidal antibiotic, effective against both gram-positive and gram-negative bacteria, being especially active against the Enterobacteriacae, including many microorganisms resistant to penicillins, cephalosporins and aminoglycosides, and also is effective against Haemophilus influenzae, penicillinase-producing Neisseria gonorrhea, Campylobacter and Pseudomonas aeruginosa. Streptococci and pneumococci are weakly inhibited and there is a high incidence of staphylococcal resistance to ciprofloxacin. In neonates, the dose of ciprofloxacin is 10 mg/kg intravenously over 30-60 min infusion, and 20 mg/kg is used to treat Pseudomonas aeruginosa infection. Ciprofloxacin treatment is effective in life-threatening multi-drug resistant Pseudomonas aeruginosa. Ciprofloxacin may be administered by mouth and has a bioavailability of 70% and is mainly recovered unchanged in the urine. Ciprofloxacin is safe and well tolerated in infants. In neonates, the half-life of ciprofloxacin is 3-4 hours. For meningococcal prophylaxis, give a single dose of 30 mg/kg (up to a maximum of 125 mg) orally. Ciprofloxacin is active against Citrobacter kosery that produces brain abscesses. The mortality rate for meningitis due to Citrobacter kosery is approximately 30%. Third-generation cephalosporins and aminoglycosides failed to prevent the high rates of morbidity and mortality caused by Citrobacter infections. Ciprofloxacin is the antibiotic treatment option for systemic infection or meningitis caused by Citrobacter kosery. Ciprofloxacin has been used to treat neonatal pneumonia, meningitis, and septicemia and was effective in all cases. The aim of this study was to review the clinical pharmacology of ciprofloxacin in neonates.

Background Iron deficiency is the most prevalent nutritional problem and one of the main reasons of anemia especially in girls. This study was designed to determine the effect of combined educational inference based on HBM model about preventing iron deficiency anemia on the enhancement of knowledge, attitude and behavior of high school girls in the Faridan city of Isfahan province. Materials and Methods: This quasi experiential study was conducted on 128 high school girls (divided into 64 cases and 64 controls) that was selected by the cluster random sampling method in 2015. The instrument of data collecting was a researcher-made questionnaire including demographic, knowledge, attitude, and behavior questions based on HBM model. The data were analyzed using SPSS software version16. 0 software. Results The mean age of intervention and control groups were 16. 3 ± 0. 81 and 16. 3 ± 0. 66, respectively. The knowledge, attitude and behavior of control and intervention groups had no significant difference before the education (P>0. 001). But three months after the education, the mean score of knowledge, perceived susceptibility, perceived benefits, perceived barriers, perceived severity, perceived self-efficacy, cues to action and performance had significant difference (P<0. 001). Conclusion Results of this research indicated that the education based on HBM model is effective on the enhancement of knowledge, attitude and behavior of students in the field of preventing iron deficiency anemia. So this pattern can be used as a framework for designing and performing education interventions to prevent iron deficiency anemia among high school girls.

Background The most commonly used treatment for neonatal hyperbilirubinemia (NH) are phototherapy and exchange transfusion. Among the drug therapy for NH less has been paid to the effect of zinc administration on serum bilirubin level (SBL). This study was carried out to determine the on the effect of oral zinc sulfate on the SBL in term neonates with hyperbilirubinemia. Materials and Methods In this randomized clinical trial, we studied term neonate with jaundice hospitalized in Amirkola Children’ s Hospital, Babol-Iran for phototherapy. Eligible neonates were randomly divided into two; intervention (n=30) and control (n=30) groups. Both groups received standard conventional phototherapy but the intervention group received 5 mg per day oral zinc sulfate until discharge. The outcome variables were SBL and the duration of phototherapy. Results Out of the 105 studied neonates, 50 cases were in the intervention group and 55 patients were in the control group. The mean SBL before intervention in the intervention and control groups, was 17. 4 ± 2. 1 and 17. 1± 2. 2 mg/dl, respectively (P>0. 05) but after the intervention, it decreased to 8. 8± 0. 77 and 8. 7± 0. 99 in intervention and control groups respectively (P>0. 05). The mean differences in the decrease in SBL between the two groups were 8. 8 and 8. 3 in intervention and control groups respectively (P>0. 05). But the mean duration of phototherapy in the intervention group and the control group was 4. 1 days and 3. 6 days respectively (P<0. 05). Conclusion Administration of oral zinc in neonatal hyperbilirubinemia under the phototherapy could decrease the duration of phototherapy. Further studies are needed to recommend it as an adjunctive therapy to phototherapy.

Background: Meatal stenosis is of common late complication of neonatal circumcision, albeit the appropriate post-operative care and conventional consumption of topical agents such as tetracycline. Nevertheless, its underlying etiology still remained vague. Lack of protective effects of foreskin and subsequent inflammation reaction due to chemical and mechanical irritation is thought to be the most probable cause. Materials and Methods: A retrospective review of the medical records of the male neonates, were considered eligible who referred to our pediatric tertiary center (Hazrat-e-Masumeh hospital, Qom city) for circumcision between May 2014 and April 2016. Neonates with severe phimosis and buried penis were excluded from the study. Based on the medical records the patients were divided into two groups. Patients were operated similarly, and then, those who received 1% hydrocortisone ointment post-operatively (n=91) and those who received the conventional treatment with tetracycline cream instead of hydrocortisone (n=91). Results: The mean age of neonates was 19. 2 ± 3. 6 and 21. 4 ± 2. 1 days for tetracycline and hydrocortisone groups, respectively. Meatal stenosis has occurred in 27(29. 67%) patients of the tetracycline group, and 11(12. 08%) of the hydrocortisone group (P=0. 008). Mean time to develop meatal stenosis in the tetracycline group was less than that of the hydrocortisone group (2. 3 ± 0. 4 vs. 3. 8 ± 0. 65 weeks, respectively, P=0. 03). There was no adverse effect associated with application of 1% topical ointment of hydrocortisone. Conclusion According to the results, applying the topical ointment of hydrocortisone can more effectively reduce post-circumcision meatal stenosis compared with tetracycline cream. Nonetheless, conducting further investigations designing as randomized clinical trial or experimental studies is highly encouraged.

Background Decayed, Missing, and Filled Teeth (DMFT) indicator is one of the most epidemiologic indexes in dentistry indicating the situation of oral and dental health among people of a society. The present study has been conducted with the aim of determining the dmft index among Iranian first-grade elementary students. Materials and Methods This study was conducted on 3, 000 (1, 500 girls and 1, 500 boys), first-grade elementary students in Mazandaran province through descriptive-analytical method. Sample members were gathered using random sampling method. Participants were checked sitting at a conventional seat on the natural light using disposable mirror and dental explorer by a senior dental student. Results The total dmft of students was 4. 08 ± 2. 93 at which there were no significant differences between the dmft of boys and girls. dmft of students in urban areas was 3. 94 ± 3 and in rural areas the dmft of students was 4. 43 ± 2. 66 that the statistical difference between these two groups was significant (P=0. 032). dmft difference between healthy people and those with systemic disease was not significant (P=0. 818). Conclusion The results of this study showed that dental health status of first-grade students in Mazandaran province needs more attention in order to get closer to the international standards in this regard. Also, preventive measures such as Fluoride therapy and fissure sealants, and teaching the appropriate way of brushing and flossing must be used.

Background The role of parents during childhood is very important. Imbalances in parenting roles may cause severe emotional and physical injuries in children. The current study aimed at comparing parenting role tasks in parents of children who affected to mental/physical disabilities. Materials and Methods In the current cross sectional study, the parenting role tasks questionnaire was completed for 230 married couples with at least one child with disability and the parents were selected by convenience sampling method. The parenting role tasks were compared between mothers and fathers. Independent t-test, chi square and analysis of variances was used to compare the scores between fathers and mothers based on studied variables including demographic variables, types of child disabilities and history of trauma and seizure. Results Among enrolled children, 49 (21. 3%) had mental and 99 (43%) affecting to physical disabilities. A significant difference regarding the parenting role tasks between mothers and fathers; therefore, the mean score of mothers for parenting role tasks was significantly higher than that of fathers regarding different variables such as demographic data, seizure, trauma, and the type of disabilities in the child (P<0. 001). Conclusion The total score of parenting role tasks questionnaire and scores of its four subscale, including primary cares, leisure time, education and training and improving cognitive level, was higher in mothers than fathers. Our results indicated that the negative effect of children’ s disabilities on the balance of parental role and more pressure is bearing by mothers.

Background The health promoting behaviors determine the health status in the present and future. The medical students, as developers and providers of professional care, play a key role in the promotion of health. Hence, determining the health promoting behaviors among them is of the essence. The present study aimed to investigate the health promoting behaviors among the students at Kermanshah University of Medical Sciences, Kermanshah city, Iran. Materials and Methods This descriptive, analytical and cross-sectional study was conducted in 2014-2015 on a sample of 380 students majoring at Kermanshah University of Medical Sciences. To collect the required data, an instrument comprising the demographic questions and health-promoting lifestyle profile II questionnaire by Walker et al. (1987) was used. Data were analyzed using The IBM SPSS Statistics Software version 21. 0. Results The mean age of students were 20. 07± 2. 04 years old. In addition, of the total of 351 subjects of the present study, 134 students (39%) were male and 217 (61%) were female, and in terms of marital status, 330 of the participants (94%) were single. Further, the majority of students were studying doing BSc degrees (230 students or 65. 5%), and 52. 7% were residing in dormitories. The status of health promoting behaviors was average. In addition, the highest and lowest scores related to the spiritual growth (3. 24± 0. 59) and physical activities (2. 25± 0. 641), respectively. Conclusion The results of the present study revealed that the status of the students’ health promoting behaviors at Kermanshah University of Medical Sciences was average. Therefore, more accurate planning is vital to improve the status of the students’ health promoting behaviors.

Background Birth of a premature infant and hospitalization in the neonatal intensive care unit (NICU) is a stressful phenomenon and lead to parents’ anxiety. In such situation, fathers have important role to reduce mothers’ anxiety. This study aimed to investigate the effect of family-centered intervention in the NICU on the anxiety of parents. Materials and Methods In this clinical trial, 60 parents of premature infants hospitalized in the NICU were assigned to two groups using randomization with the block size of 6. Before the intervention, the anxiety of the mothers was measured in both groups. The fathers in the control group received only the routine care of the ward, but those in the intervention group were educated about mother supporting and newborn care 3 times. Furthermore, the parents were given the opportunity to be with their infants for 3 days in order to exchange ideas in the non-visiting hours. One day after the intervention, the anxiety of the mothers was measured in both groups. Data was analyzed by SPSS software (version 11. 0). Results Most of newborns in both group have delivered by caesarian section (71. 4 vs. 64. 3%). Investigating the difference between the mean total anxiety scores of parents in the two groups before and after the intervention showed a significant reduction in the anxiety score of the intervention group (97. 37 to 75. 70) (P<0. 000), but no significant difference in the control group (P<0. 320). Conclusion Results of this study demonstrated that family-centered care and paternal supports reduces the anxiety of the parents of premature infants.

Background The acquisition of knowledge by parents of children with asthma plays an important role in the treatment of children. Thus, it is important to understand their needs and provide this information through available methods such as a website. The aim of this study was to determine the content of a pediatric asthma website based on the evaluation of parents information needs. Materials and Methods This cross-sectional study was conducted by a descriptive-analytical approach in Kerman, Iran. Data were collected using a semi-structured questionnaire. The questionnaire was distributed among a sample of 300 parents visiting allergy and asthma specialists’ offices. Three experts confirmed validity of the questionnaire. The reliability of the questionnaire was confirmed using the test-retest method on 40 participants (r = 0. 82). Data were analyzed using descriptive and analytical statistics by SPSS version 20. 0 software. Results Participants demanded information concerning asthma nutrition (79. 0%), prevention (78. 1%), treatment (77. 1%), medications (72. 4%) as well as general information (71. 4%) and information about etiology of the disease (70. 5%), respectively. The results showed that the fathers use the Internet significantly more than the mothers (p=0. 0001). There was a statistically significant relationship between participants’ educational level and the type of resources they use to obtain information (P<0. 05). Conclusion This study highlighted the most important information needs of parents of children with asthma. The results indicated that most parents have access to the Internet and prefer to get their required asthma information from it. Therefore, providing required information to parents through a website can offer them the opportunity to increase their corresponding level of knowledge and skills.

Background: Cutaneous leishmaniasis (CL) is considered as one of the issues and problems of public health in most tropical parts of Iran. The CL is a very important disease, because of its dermal lesions on patient’ s bodies. This study was conducted to determine the effectiveness of education based on BASNEF model on promoting preventive behavior of CL among students. Materials and Methods This study was a quasi-experimental study which was performed on 192 middle school students that resident in endemic areas of Qom province-Iran based on BASNEF model. Students were divided into several groups then they were selected as experimental and control groups using cluster sampling method; Data collection was done by researchers made Questionnaire before and two months after intervention. After two months of students training, the data were collected again and analyzed via Chi-square, t-independent, and generalized linear model (GLM) statistics. Results: The findings showed that 46. 95% and 46. 1% of students were males in experimental and control groups, respectively. The mean age in experimental and control groups were 13. 8± 1 and 13. 9± 9 years old, respectively. There was no significant difference in term of demographic data in experimental group in comparison of control group (P>0. 05). Mean scores of knowledge, attitude, enabling factors, behavioral intentions and behavior as components of BASNEF Model increase significantly two months after the educational intervention among experimental group comparing to control group (P<0. 05). Mean scores in subjective norms among students has increased, but there was no significant relationship between subjective norms in experimental group in comparison of control group (P >0. 05). Conclusion: According to the finding, educational intervention based on BAZNEF model can elevate knowledge, attitude, enabling factors, behavioral intentions and behavior of students for prevention and control of CL.

Background Febrile seizure is the most common seizure disorders. Febrile seizure is divided into two groups of simple and complex seizures. The aim of this epidemiological study was to assess the risk factors involved in the incidence of febrile seizures between the children referred to Besat hospital in the city of Sanandaj (Iran). Materials and Methods The present paper is a cross-sectional study performed on 334 children with 6-60 months of age hospitalized in Besat hospital in Sanandaj due to febrile seizures in 2014 and 2015. The data collection tool was a checklist including some information such as age, gender, final diagnosis and type of seizure, residential location, serum level of electrolytes and CBC. After collecting the data, description and analytical analysis were performed through SPSS version 20 software to assess the data. Results Among the 334 children (average age 22. 4+ 12. 8 months) hospitalized because of febrile seizures, 57. 5 present were boys and the majority of them were living in the urban areas (72. 2‰ ). Also, 81 percent of the children were hospitalized due to simple febrile seizures and upper respiratory tract infection (URTI) was the most common cause of febrile seizures with 42. 8 percent. There was not seen any significant statistical association between the type of seizure and the variables of sex, residential location, age group and serum level of electrolytes (P>0. 05). However, the association between residential location and age group with the cause of febrile seizures was statistically significant (P<0. 05). Conclusion Given that the results of this study indicated that URTI is the most common cause of febrile seizures among the children.

Background The ligation of the patent processus vaginalis (PPV) is the challenging issue during the orchidopexy in the patients who suffering undescended testis (UDT). In the present study we aimed to comparing the advantages of the orchidopexy with high-ligation method and the san-ligation method as a modified orchidopexy in our more than 6 years` experiences. Materials and Methods The medical records of 2, 659 boys with UDT who undergone orchidopexy in xx hospital, Qom-Iran, between February 2010 and October 2016 were analyzed. The exclusion criteria were consisting of critical cases, presence of concomitant obvious clinical hernia, re-operation due to re-ascending, abdominal UDT, and coincidence with other anomalies. Two surgical method were performed based upon the medical records: 1-orchidopexy with PPV high-ligation, and 2-orchidopexy with PPV san-ligation. Results A total of 2, 659 medical records with 3, 208 UDTs were reviewed. Of them, 2, 210 (79. 4%) patients had unilateral UDT. Of the total UDTs, 1, 956 (61%) UDTs were located in the inguinal canal. The mean age of the patients was 21. 3 ± 2. 7 months. Of the total UDTs, 2, 187 (68. 2%) and 1, 021 (31. 8%) were undergone orchidopexy with high-ligation and san-ligation PPV, respectively. The operative time significantly decreases in the san-ligation PPV group (11. 2 minutes vs. 18. 4 minutes; P =0. 03). A total of 207 (6. 45%) complications were occurred in the 187(7%) patients. The commonest complication was spermatic cord/testicular edema which was no significant difference in both surgical groups (P=0. 769). Conclusion The modified orchidopexy with san-ligation of PPV does not significantly increase the risk of post-operative complications. However, this method significantly reduces the operative time.

Background: The use and effectiveness of traditional lead gonad shields in pediatric pelvic radiography has been challenged by several literatures over the past two decades. The aim of this study was to develop a new radioprotective gonad shields to be use in pediatric pelvic radiography. Materials and Methods: The commercially available 0. 06 mm lead equivalent bismuth garment has cropped squarely and used as ovarian shield to cover the entire region of pelvis. In order to prevent deterioration of image quality due to beam hardening artifacts, a 1-cm foam as spacer was located between the shield and patients pelvis. Moreover, we added a lead piece at the cranial position of the bismuth garment to absorb the scatter radiations to the radiosensitive organs. In girls, 49 radiographs with shield and 46 radiographs without shield was taken. The radiation dose was measured using thermoluminescent dosimeters (TLDs). Image quality assessments were performed using the European guidelines. For boys, the lead testicular shields was developed using 2 cm bismuth garment, added to the sides. The prevalence and efficacy of testicular shields was assessed in clinical practice from February 2016 to June 2016. Results: Without increasing the dose to the breast, thyroid and the lens of the eyes, the use of bismuth shield has reduced the entrance skin dose (ESD) of the pelvis and radiation dose to the ovaries by 62. 2% and 61. 7%, respectively (P<0. 001). Image quality remained diagnostically acceptable in all shielded and non-shielded images, without non-diagnostic or poor quality image. In boy patients, the prevalence of shielding in lead and developed testicular shields were obtained 63. 25% and 19. 74%, respectively; the accuracy positioning of the shield 90% and 34%, as well as. Conclusion: The ovarian shield designed in this study has significantly reduced the radiation dose to the ovaries without adversely affecting diagnostically image quality. The testicular shield has improved the accuracy positioning of the shield. These developed shields have potential to be use in clinical practice.

Background: Despite the reduction of infant mortality in the world, complication of preterm birth is a major cause of infant mortality. The present study aimed to evaluate the effect of abdominal massage and non-nutritive sucking on physiological parameters of preterm infants in neonatal intensive care units in Emam Reza Hospital in Kermanshah, Iran. Materials and Methods: In this randomized controlled clinical trial, 42 infants who had the inclusion criteria, were selected and randomly assigned to three groups of abdominal massage and non-nutritive sucking and control (14 infant for each group). Abdominal massage in the first intervention group with the "I Love You: method and non-nutritive sucking in the second intervention through sucking a pacifier were performed twice in day for 15 minutes. The control group also received typical unit care. In order to analyze the data, the SPSS 22. 0 software for analytical as well as descriptive statistical methods was used. Results: The results of this study showed that the studied groups, at 9 AM and 9 PM of 5 consecutive days, had a significant difference with each other in terms of physiological parameters of the mean scores of respiratory rate, heart rate, and oxygen saturation level (p<0. 05); as the mean of changes of Respiratory rate, Heart rate and Oxygen saturation level in the abdominal massage group had a significant statistical difference with each of the control and non-nutritive sucking groups (P<0. 05); but there was no statistically significant difference between non-nutritive group and the control group (P>0. 05). Conclusion: Abdominal massage had positive effect on the physiological parameters of preterm infants, but non-nutritive sucking had no effect on these parameters, so abdominal massage may be effective on improvement of physiological indices in preterm infants.

Background Born of a child with hearing loss is a stressful and unexpected experience for the parents. Understanding the experience of the mothers of children with hearing loss is a crucial to provide an appropriate care for this group of mothers. This study aimed to understand the concerns of the mothers who have a child with congenitally hearing loss. Materials and Methods In this qualitative content analysis, 35 mothers with child hearing loss participated in the semi-structural and deep interviews through a purposeful sampling method. Data were analyzed by using qualitative content analysis provided by Graneheim et al. Results Concerns of mothers of children with hearing loss were categorized in three main themes: ‘ the concerns of nature of hearing loss’ , ‘ the social concerns’ and ‘ concerns about future’ . Remarkably, the participants live with fear of the possibility of another deaf child birth in the next pregnancy or next generations were the most important concern of mothers. Conclusion Mothers of deaf children are experiencing the varieties of concerns. To cope with these concerns, they need a special consideration by society and health professionals. Modification of the concerns can decrease the child-related stress and consequently encourage them to involve in child care.

Combination of congenital esophageal atresia and subsequent hypertrophic pyloric stenosis is a rare condition which occurs in early infancy. The underlying etiology and pathophysiology of this association still remains unclear. In this paper we report a unique case of hypertrophic pyloric stenosis, for the first time, which occurred in an infant who underwent surgery for type I esophageal atresia. Therefore, we intend to highlight the role of poor nutrition intake in the incidence of this condition.

Eradication of polio as a largest public health innovation is led by the World Health Organization (WHO) in the world (1). The main strategies to reach this goal included improved routine immunization, adequate response to outbreaks and effective surveillance (2). Acute Flaccid Paralysis (AFP) surveillance has considered as a comprehensive program for polio eradication, by identification of areas of poliovirus transmission as well as cases of importation. Polio-free certification should be confirmed through surveillance (3). AFP surveillance has some indicators, where used to determine sufficient sensitivity of surveillance to detect poliovirus transmission in communities (4). Table. 1 shows two cores of AFP surveillance performance indicators including non-polio AFP and stool adequacy rates for Iran in 2016 (5). In the year of 2016 recorded the 776 AFP cases (Non polio AFP rate: 4. 2 per 100, 000 <15 years) in by the surveillance system in Iran and all of them discard for confirmed polio. In this year the proportion of adequate stool specimens, Cases notified within 7 days from onset of paralysis, Cases investigated within 48 hours from notification, specimens in lab within 3 days from collection and AFP Cases investigated after 60 days from onset of paralysis were 95. 5%, 87. 8%, 98. 7%, 62. 2% and 51. 2%, respectively. Except investigated AFP Cases after 60 days from onset of paralysis indicator and the percent of specimens in lab within 3 days from collection, other AFP surveillance indicators are achieved in Iran.

Background Vitamin D deficiency is associated with physiologic changes that are similar to pathogenesis of preeclampsia. Although association of vitamin D and preeclampsia has been studied previously, their results are not consistent. The aim of this study was to investigate the relationship of serum vitamin D and calcium with preeclampsia severity. Materials and Methods: This case-control study was conducted in 75 healthy pregnant women and 74 pregnant women with preeclampsia (46 mild preeclampsia and 28 severe preeclampsia) in Qazvin, Iran in 2015. Serum vitamin D, calcium, and albumin were measured; corrected calcium was also calculated. Hypocalcemia and vitamin D deficiency were compared between the groups. Logistic regression analysis was used to study the independent association of hypocalcemia and hypovitaminosis D with preeclampsia. Results Mean serum vitamin D level was 27. 7± 15. 3, 22. 9± 15. 9, and 27. 6± 16. 6 in normal, mild preeclampsia, and severe preeclampsia groups (P> 0. 05); also vitamin D deficiency was not different between the groups. Hypocalcemia in severe preeclampsia group was more frequent than normal group (25. 9% vs. 6. 6%, P: 0. 017). Hypocalcemia was associated with severe preeclampsia after adjustment for age, parity, and calcium supplement consumption (OR: 6. 7, 95% CI: 1. 45-30. 79; P: 0. 015). Conclusion There was not any association between vitamin D deficiency and preeclampsia in the present study, however low corrected serum calcium was associated with about six times increased risk of sever preeclampsia. More studies are needed to determine the role of hypocalcemia and vitamin D in preeclampsia.

Background Septicemia is a life-threatening condition particularly among pediatric population. Early initiating a proper empiric antimicrobial treatment prior to definite isolation of the pathogen through blood culture has pivotal role in reducing further mortality and morbidity. The aim of this study was to evaluate the epidemiological properties of a distinct Iranian population by patients’ age and gender throughout the year. Materials and Methods As a retrospective study between March 2013 and March 2017, all consecutive patients referred to the Hazrat Masumeh hospital of Qom-Iran with suspicious of septicemia were reviewed. Patients with prior history of antibiotic consumption as well as patients over 6 years of age were excluded; incomplete hospital records were also excluded from further evaluations. Prespecified data-extraction forms were used to collect data including characteristics of patients and the results of antibiogram. Results Total of 378 patients were enrolled in this study and 200 of them were boys (52. 91%). Escherichia coli (11. 6%) and Klebsiella (9. 5%) were the most common isolated pathogens (Gram-negative) after coagulase-negatives. Escherichia coli, Citrobacter (Gram-negative), and Staph. Aureus (Gram-positive) were the most common pathogens among age group of 0-1 year. Winter had the greatest outbreak of bacteremia (29. 1%) and the autumn had the least incidence (21. 4%). The least and the most antimicrobial resistance were associated with Imipenem (1. 8%) and Ampicillin (78. 78%), respectively. Conclusion Escherichia coli and Klebsiella were the most common isolated bacteria in patients suspected to bacteremia in our region. Imipenem and Ampicillin had the least and the most antimicrobial resistance in our population, respectively.