Journal of Comprehensive Pediatrics
Volume:8 Issue: 4, Nov 2017

considering the increasing incidence of overweightness and obesity along with underweight among children, the investigation of the association between weight status and dietary pattern could provide valuable information about health of children. The aim of the present study was to assess the association between dietary pattern and weight status of rural school-aged children in Bijar County, Iran.
This cross-sectional study consisted of 255 rural school-aged children (aged 7 to 12 years) from Bijar county that were selected through simple random sampling. Dietary data were obtained by a semi-quantitative food frequency questionnaire. Also, assessment of anthropometric indices, physical activity, and demographic information was performed using standard procedures. Major dietary patterns were determined through the use of principal components analysis, and their association with child weight status was also investigated.
Three dietary patterns, including traditional, modern, and mixed were identified. After adjustment based on age, physical activity, and energy intakes, P trend was significant and showed an upward trend for the chances of being overweight and obese in the quartile of the traditional dietary pattern (p for trend = 0.04). The risk of thinness and severe thinness significantly increased when "modern" dietary pattern was greatly followed (p for trend = 0.04).
Modern and mixed dietary patterns next to the traditional dietary pattern could be found among rural children. The current findings show that the traditional dietary pattern is associated with an increased risk of obesity; however, the modern dietary pattern leads to thinness in rural areas.

Neonatal weight loss in the first few days of life is a common phenomenon yet limited information about weight loss after birth is available.
The present study aimed at determining associated factors with neonatal weight loss after birth in newborns.
In this cross-sectional study, the sample included 982 healthy, term and singleton newborns that had referred to health centers of Ilam. The mother and neonate’s demographic characteristics, and the mother’s pregnancy, childbirth and postpartum data were collected by a questionnaire. The data was analyzed using univariate and multivariate statistical analysis using the SPSS software.
The mean NWL 3 to 5 days after birth was 129 ± 92 grams. Infants had lost 4.04 ± 3.19% of their birthweight. The results of multivariate analysis (logistic regression) showed that breastfeeding (OR = 7.228, CI: 4.707 - 11.099), cesarean section (OR = 4.429, CI: 3.166 - 6.196), female gender (OR = 3.080, CI: 2.201 - 4.309), mother’s no experience of breast feeding (OR = 2.831, CI: 1.817 - 4.409), weighting more than 4000 grams (OR = 2.464, CI: 1.034 - 5.870) and jaundice (OR = 1.486, CI: 1.035 - 2.133) were amongst risk factors for neonatal weight loss (NWL) of more than 5%, while risk factors for NWL of more than 7% included only breastfeeding (OR = 2.904, CI: 1.759 - 4.796), cesarean section (OR = 2.073, CI: 1.423 - 3.019), and female gender (OR = 1.850, CI: 1.254 - 2.730).
The study findings revealed that breastfeeding and cesarean section are the strongest predictors of NWL. Therefore, it is necessary for infant-friendly hospitals to come up with strategies to reduce the rate of cesarean section and establish successful breastfeeding before mothers are discharged.

Helicobacter pylori is a common gastrointestinal pathogen in human. The mechanism of its acquisition and transmission is unclear, although the most likely mode of transmission is fecal-oral or oral-oral. Most of infections occur in childhood. The current cohort assessed the prevalence of infection in infants with different feeding strategies (exclusive breastfeeding, formula, or mixed feeding).
The current study was carried out in Vali-Asr hospital of Imam Khomeini hospital complex, Tehran, Iran, from 2012 to 2015.The study population included infants born in this hospital and registered in breastfeeding research center during the first 6 months of life. They were compared in 2 groups; exclusively breastfed, and formula or mixed fed. Mothers’ H. pylori infection was checked serologically using the enzyme-linked immunosorbent assay (ELISA) technique and those of infants by monoclonal antibody test using ELISA technique on stool samples at 1st and 6th month of life.
A total of 102 infants in 2 groups (54 exclusively breastfed and 48 formula or mixed fed) completed the study. Mothers’ serological assessments were positive in 68% of exclusively breast-fed subjects and 60% of formula or mixed fed subjects. All 1-month-old infants were negative for the infection and in the 6-month-old infants 10 cases (18.5%) were positive, 1 case was at borderline in the exclusively breastfed, and 13 cases (27%) were positive in formula- or mixed-fed subjects. This difference was not statistically significant (P = 0.302). The Mantel-Hanzel test was used to find a relationship in H. pylori positivity in mothers and infants during the first 6-month of life in each of the 2 groups. It was found that out of 37 serologically positive mothers in the breastfed group, 8 infants (22%) were H. pylori positive and in the formula and mixed-fed group, of 29 serologically positive mothers 10 infants (34%) were also H. pylori positive, but the difference between the groups was not statistically significant (P = 0.727). It meant that the prevalence of infantile H. pylori infection was similar in the 2 groups.
The current study findings showed that exclusive breastfeeding had no role in protection or facilitation of H. pylori infection.

The present study was conducted to investigate and compare the effectiveness of the minimally invasive surfactant therapy (MIST) and the INSURE technique (Intubation, Surfactant administration, and extubation) in spontaneously breathing preterm infants.
Preterm infants (28-34 weeks of gestation) born with respiratory distress syndrome between April 2013 and February 2014 were randomly selected to receive 200 mg/kg of surfactant (Curosurf) using either MIST or INSURE techniques. In the MIST group, surfactant was instilled via a thin tracheal catheter (5-f) that was then removed. In the INSURE group, the infants were first intubated, administered surfactant through passing a feeding tube through the endotracheal tube, and then extubated after 30 seconds of positive pressure ventilation. Nasal CPAP for respiratory support continued in both groups after performing the procedures. The amounts of supplemental oxygen required, intensive care requirements, and outcomes were compared between the two groups.
The present study examined 27 infants in the MIST group and 26 in the INSURE group. The amount of oxygen required by the MIST group was consistently less than that in the other group over the first 48 hours of life. The overall mean FiO2 was 42.5 ± 19.6 in the MIST group and 48.4 ± 21.6 in the INSURE group (P = 0.009). The mean duration of stay in the neonatal intensive care unit was 7.3 ± 7.2 days in the MIST group and 9 ± 10.4 days in the INSURE group (P = 0.81). In terms of early and delayed complications, no differences were observed between the two groups.
The MIST technique is a feasible and effective alternative to the INSURE technique and is advised to be performed with impunity in preterm infants (28 to 34 weeks of gestation).

Acute pyelonephritis with negative urine culture has been reported in previous studies. Dimercaptosuccinic acid (DMSA) renal scintigraphy can help diagnose pyelonephritis. The present study aimed at determining the role of DMSA renal scintigraphy in the diagnosis of urine culture negative urinary tract infection (UTI).
This cross- sectional study was conducted on 193 children (one month to 12 years) with UTI, who referred to children hospital in Qazvin, Iran, from October 2010 to October 2013. UTI was defined as signs and symptoms compatible with UTI and pyuria. Negative urine culture was defined as colony count Mean age was 35.7 ± 31.3 months (32.6% of patients were younger than one year old). Of 193 patients, 90.7% were female. Urine culture was negative in 68 (35.2%) patients. Of 80 (41.5%) patients with suspected pyelonephritis, 39 had negative urine culture. DMSA was abnormal in 59 (30.6%) patients. Of 59 patients, 24 (40.7%) had negative urine culture. Considering the DMSA renal scan as the gold standard, the sensitivity, specificity, PPV, and NPV of the urine culture for the diagnosis of pyelonephritis were 59.32%, 32.83%, 28%, and 64.70%, respectively.
About 41% of patients with pyelonephritis could have been missed based on negative urine cultures. DMSA renal scan should be considered for the diagnosis of pyelonephritis in children with a negative urine culture and abnormal urinalysis.

To determine the status of tooth decay and filling, in 7-year-old Iranian children, as well as a relationship with economic inequity
This cross-sectional study was conducted in 8 cities of Iran using random cluster sampling. In the selected cities, a number of primary schools were considered and all first grade students were evaluated. The data of the dental status of the students were collected from the health IDs completed in the beginning of the educational year.
Of 4614 selected students, 4106 participated in the study (response rate = 89%). The mean number of decayed and filled teeth was 1.7 (1.51 - 1.88) and 0.26 (0.22 - 0.29), respectively. The mean number of decayed (P = 0.330) and filled (P = 0.148) teeth showed no difference between boys and girls. The distribution of the number of decayed (1.16 to 2.06) and filled (0.15 to 0.4) teeth was different in different cities (P We evaluated the dental status of 7-year-old Iranian children in this study for the first time. According to our findings, 58% of 7-year-old children have dental problems such as carries as well as fillings. Economic inequity, in the distribution of filled teeth, indicated a high number of filled teeth in the wealthy class of the society.

Group B streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis. Although late-onset GBS meningitis is the most common form of the disease, it may happen earlier, like just a few hours after birth, known as the early-onset. GBS meningitis is associated with 30% mortality rate among infants. Of those who stay alive, 25% of them will develop adverse neurological conditions. Herein, we report a case of early-onset GBS meningitis in a female infant with brain abscess.
A 10-hour old female was admitted to the neonatal intensive care unit (of the University of Tehran) for poor feeding, irritability, lethargy, and seizure. Sepsis work-up and lumbar puncture were performed. The treatment was started with vancomycin, cefotaxime and phenobarbital. The GBS was isolated from both blood and CSF cultures. A cranial sonography revealed intraparenchymal hemorrhage. The infant’s hospital course was complicated by recurrent and intractable seizures. The brain MRI of the patient showed micro-abscess. After six weeks of medical therapy, the patient was discharged from the hospital in a good condition. Neurological evaluations of the patient, conducted two and five months after her birth, showed normal results.
Neonates with GBS meningitis are prone to adverse neurological conditions, including brain abscess. Although GBS is a normal flora in the genitourinary tracts of 15 to 30% of women, routine screening and treatments of the GBS-positive women during their course of pregnancy could reduce such serious complications.