International Journal of Pediatrics
Volume:5 Issue: 40, Apr 2017

Heart failure is a major cause of death in thalassemia. The study aimed to determine the diagnostic value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP), to early diagnose the cardiac involvement in beta- thalassemia major patients.
80 thalassemia patients aged 7 to 18 years old (patients group), and 80 healthy age and gender matched controls were enrolled in the case-control study. Patients were selected from those attending to the clinic of Aliasghar hospital, Zahedan-Iran. They were subjected to echo-Doppler tissue and conventional examination for both right and left heart function. Data were analysis using SPSS 18.0 software.
NT-pro BNP increased in patients compared the controls (P From the study concluded that left heart dysfunctions had more correlation with NT-proBNP compared the right heart functions.

Celiac disease (CD), considered as a common chronic and genetic diseases that caused by hypersensitivity to gluten. Failure to thrive (FTT), is one of three major clinical features of CD during childhood. The current study aimed to determine the prevalence of celiac disease in children with unexplained FTT in South West of Iran.
This cross‑sectional study was conducted on 433 children 9-month to 6 years old that diagnosed as unexplained FTT referred to Abuzar Children's Hospital, Ahvaz, South West of Iran, in 2014. In this study, we examined the serum levels of anti-transglutaminase antibody (anti-tTG) in children with unexplained FTT. Data were analyzed using SPSS version 16.0 software.
The results showed that the prevalence of CD in children with unexplained FTT in was 8.8%. The mean scores of children's anti-tTG serum levels in both gender and age groups, showed no significant difference (P> 0.05).
At current study, the prevalence of CD in children with FTT was 8.8%. Since the CD is an important cause of unexplained FTT in children, the early screening and diagnosis and dietary management can be decrease the risk for long-term complications in these children.

Prevalence of overweight and obesity in children and its trend in recent years has taken a worrying figure. Overweight in childhood is the most important cause of adulthood obesity. Therefore, the present study aimed to investigate the effect ofcomprehensive health program on quality of life, weight and physical activity in Iranian overweight school-age girls.
In this quasi-experimental study, 80 overweight girls participated in a comprehensive health program for 12 weeks in 2014. The participants were randomly selected and were assigned to intervention (n=40), and control (n=40) groups. Quality of life, weight, and physical activity scores were measured in both groups before and after the program. The data were collected by using the general quality of life questionnaire Pediatric Health-Related Quality of Life (Ped- sQL4.0) in two forms (child and parent self-report), physical activity checklist, and a Digital Stadiometer. Then in the intervention group, comprehensive health program including three stages assessment, supportive planning and evaluation was administered for three months. Data were analyzed by the SPSS version 22.0 software.
Theresults showed no significant differences between the two groups in terms of demographic characteristics, weight, physical activity, and quality of life, before intervention (P>0.05). However, statistically significant difference was found between the two groups regarding changes in body weight, body mass index (BMI), physical activity scores, and quality of life, before and after intervention (P Implementation of a comprehensive health program by school nurses can decrease the growing trend of overweight and increase the quality of life and physical activity among children.

Fetus- in- fetu (FIF), is a rare congenital anomaly that occurs due to malformed fetus growing inside the twin. It occurs due to the aberration in the diamniotic monochorionic monozygotic twinning with unequal division of inner cell mass of blastocyst leading to inclusion of small cell mass inside the developing sister fetus.
The most common presentation will be with intra-abdominal mass located in the upper quadrant retroperitoneally. Complete excision with meticulous dissection is curative and allows confirmation of diagnosis.

Cleft lip and cleft palate (also, known as or facial clefts), are amongst the most common congenital deformities affecting the jaw and face as well as the most common defects associated with lip and palate. Thus, the current study was an attempt to investigate the prevalence and risk factors of or facial clefts in Iranian children.
The present study, was conducted through a systematic search for articles recorded in the internal database (SID, IranMedex and Magiran), and external authoritative databases (Google scholar, PubMed, Science Direct, MEDLINE, CINAHL and EMBASE) using the keywords including "cleft lip", "Iranian", "cleft palate", and "children" from 2000 to 2016. Then, 61 articles were collected. 47 studies with associated incidence or prevalence of cleft lip and cleft palate were included.
According to the findings of the review of the studies conducted in Iran, it is revealed that the prevalence of cleft lip and cleft palate was from 0.78 to 2.14 in Iranian children. It was revealed that several factors contributing to the development of this disorder consist of Family history ( P According to the results of the present study, the prevalence of cleft lip and cleft palate is high in Iran in comparison with international studies. Furthermore, the prevalence of this disorder is reported to be higher in males than females. Therefore, it is recommended arrange the practical programs in order to help parents eliminate or diminish the factors that affect the prevalence of this disorder and complications.

Prenatal care is a good opportunity for evaluating and improving maternal-fetal attachment. In the present study the effect of early education of fetal movement counting in the second trimester on maternal-fetal attachment was evaluated.
52 eligible pregnant women were selected through simple sampling and then randomly allocated into control (n=29), and intervention groups (n=23). First, demographic characteristics questionnaire and Cranely’s Maternal-Fetal Attachment Scale (MFAS), were completed by pregnant women. Face to face training about counting and recording the daily fetal movement was provided in the intervention group and from the 24th to 28th weeks of pregnancy, daily counting of fetal movements were conducted. Then at the end of the 28th week of pregnancy, MFAS was again completed by both groups. Data analysis was conducted using SPSS version16.0.
The mean score of MFA scale in the intervention group was 86.63±11.62 and in the control group was 87.48±10.31 (total score of 120). No significant difference was observed between two groups. After the intervention, the mean score of MFA was increased to 96.30±10.81 in the intervention group and 88.64±10.31 in the control group. The difference was statistically significant between two groups (P The present study showed that education of fetal movement counting would significantly increase maternal-fetal attachment. The training of this method is inexpensive and its performance is easy, and it could be recommended to mothers as a useful intervention.

Urethralduplication is a rare condition occurs as a congenital malformation either independently or in the setting of other congenital malformations such as caudal duplication syndrome. Its prevalence becomes even rarer if it manifests as two side-by-side tracts in coronal plan.
Nonetheless, we introduce a unique presentation of complete coronal urethral duplication accompanied by astounding manifestations of gastrointestinal malformations different from what is expected for a normal hind gut or caudal duplication syndrome. A 6-year-old boy with complete coronal duplication of urethra along with duplication of appendix, sigmoid and rectum as well as developmental delay, attracted our attention to report.

Phenylketonuria (PKU), is one of the most common metabolic diseases that resulted in mental retardation. The study aimed to investigate the incidence of phenylketonuria in Lorestan province, Iran.
The study was an observational-descriptive study which included all identified cases of patients from April 2006 to February 2016. The required data were collected from patient's records. The Entered variables in data survey checklist included gender, date of birth, County Residence, parental education, parental occupation, parental kinship, conducting genetic consultation and screening. Recorded data were analyzed in Stata-12 software after completion.
Newborns were identified with Phenylketonuria during the years 2006 to 2016 and incidence rate calculated 1.91 per 10,000 live births. The highest incidence rate of disease was 3.86 per 10,000 live births in 2014. Delfan (Nurabad) County and Borujer County had maximum and minimum rate of incidence with 5.94 per 10,000 and 0.64 per 10,000, respectively. Among 74 patients, 42 (56%), were female and there was patient's parental kinship in 82% of parents that about 92 percent of suffering children parents had done genetic consultation.
The incidence of phenylketonuria in the Lorestan province is more than other provinces. Given that most cases of patients resulted from cousin marriages, paying attention to the screening tests prior to marriage, particularly in familiar marriage is essential.

Cefepime is a fourth-generation cephalosporin which is approved in Europe and in the USA. Food and Drug Administration (FDA) approves cefepime in the treatment of febrile neutropenia. Cefepime is active against gram-negative microorganisms such as Escherichia coli, Haemophilus influenzae, Enterobacter, Klebsiella, Morganella, Neisseria, Serratia, and Proteus species. Cefepime is also active against gram-positive microorganisms such as Streptococcus pneumoniae, Streptococcus agalactiae, and Staphylococcus aureus. Cefepime binds to plasma proteins ≤ 20%, and it is excreted unchanged in the urine. Cefepime distributes widely in body tissues and fluids such as cerebrospinal fluid, bile, bronchial secretions, ascites fluid, and middle ear. In neonates, the half-life of cefepime ranges from 3.59.61 and 5.09.80 hours, and in adults it is 2.1 (range, 1.3 to 2.4 hours).
The rank order of the top 10 pediatric pathogens was analyzed and the comparative antimicrobial potency of broad-spectrum parenteral cephalosporins was exterminated. The rank order of the top 10 pediatric pathogens was Streptococcus pneumoniae (15.5%) > Haemophilus influenzae (14.6%) > Staphylococcus aureus (13.8%) > Moraxella catarrhalis = coagulase-negative staphylococci (8.0%) > Escherichia coli (7.8%) > Pseudomonas aeruginosa (5.2%) > Klebsiella spp. (4.8%) > Enterococcus spp. (4.7%) > beta-hemolytic streptococci (4.4%). Cefepime is the most active antibiotic among β-lactams. Cefepime is active against Enterobacter species (MIC90), 2 µg/ml; 99.3% susceptible, whereas the susceptibility rates of other broad-spectrum β-lactams (ceftriaxone, ceftazidime and piperacillin-tazobactam), were significantly lower (78.4 to 81.5). Cefepime remains a very potent alternative for the treatment of contemporary pediatric infections. The aim of the present study was to review the clinical pharmacology of cefepime in infants and children.

Floor time therapy is the center of Greenspan developmental model. In Family-based of this model, to enhance the abilities of the child, family functioning is set the objective as a general unit, the purpose of this study was developing a Family-based Floor Time Therapyand evaluating its effectiveness on the developmental profile of children with interactive disorders.
This research study was conducted according to the pretest-posttest design. The statistical population of the study consisted of all Mashhad preschoolers with depression and anxiety disorders along with their mothers. They were selected by using voluntary sampling and assigned to groups. In order to examine the effectiveness of therapy, the researcher–made instruments of Developmental Family Function Assessment Questionnaire and Greenspan Functional Emotional Developmental Scale were used.
According to the result there were significant differences between the control and floor time therapy groups of depressed children in developmental stages 4, 5 and 6 (P Family-based floor time therapy, can increase the effectiveness of floor time therapy and be used as an effective therapy for the treatment of preschoolers with depression and anxiety disorders.

There are differences in the age at menarche in different countries and it seems that in recent decades gradually the age of puberty is declining. The aim of the present study was to determine the age at menarche and its related factors in school girls in Zanjan city, Iran.
This cross-sectional study was conducted on 1,500 healthy school girls between 6-17 years old who were selected on the basis of a multistage probability sampling. Age at menarche, birth weight, family size, Body Mass Index (BMI), fast food consumption, and physical activity, were recorded. Data were analyzed using SPSS version 16.0.
Out of 1,500 students, 273 girls (18.2%) had experienced menarche with a mean age of 12.6±1.6 (95% confidence interval [C]: 12.4-12.8), and a median age of 13 years. The prevalence of early menarche, was 10.3%, (95% CI: 6.6%-14.1%). A significant association between menarche and BMI, frequency of fast food consumption and birth rank was observed; however, we didn’t find a significant association between physical activity (P>0.05) and birth weight (P>0.05) with menarche.
The mean age of menarche in our study was 12.6±1.6 years old, similar to other studies in Iran, and it was significantly associated with higher BMI.

The Internet is an integral part of our everyday life. Aside from its positive effects, what have garnered researchers’ attention are its adverse side effects and adolescents’ addiction to it. The present study aimed to determine the prevalence of Internet addiction and its relationship to anxiety, stress, and depression among Iranian high-school students in Shahr-e Kord, Iran.
The current cross-sectional study was conducted on 417high-school boys and girls in Shahr-e Kord in 2016. In order to gather data, a two-section questionnaire was applied. It included personal information and Young’s Internet Addiction Test, which explored the status of Internet addiction, and the Depression Anxiety and Stress Scales 21 (DASS-21), which investigated anxiety, stress, and depression among the students. The data were analyzed using SPSS version 20.0 software.
As for the prevalence of Internet addiction, 69.5% of the students were normal users, 27.6% had a mild addiction to the Internet, and 2.9% were severely addicted to the Internet. The results revealed that the mean score of anxiety, depression, and stress among the Internet Addiction was significantly higher than that among the normal Internet users (P Given the prevalence of Internet addiction among students in this study which is similar to some Europe countries and its significant association with anxiety, stress, and depression, it appears necessary to plan to take interventional measures and educate students about the optimal use of the Internet.

Increasing the x-ray film to focus distance (FFD), has been recommended as a practical dose optimization tool for patients undergoing conventional radiological procedures. In the previous study, we demonstrated a 32% reduction in absorbed dose is achievable due to increasing the FFD from 100 to 130 cm during pediatric chest radiography. The aim of this study was to examine whether increasing the FFD from 100 to 130 cm is equally effective for other common radiological procedures and performing a literature review of published studies to address the feasibility and probable limitations against implementing this optimization tool in clinical practice.
Radiographic examination of the pelvis (AP view), abdomen (AP view), skull (AP and lateral view), and spine (AP and lateral view), were taken of pediatric patients. The radiation dose and image quality of a radiological procedure is measured in FFD of 100 cm (reference FFD) and 130 cm (increased FFD). The thermo-luminescent dosimeters (TLD) were used for radiation dose measurements and visual grading analysis (VGA) for image quality assessments.
Statistically significant reduction in the ESD ranged from 21.91% for the lateral skull projection to 35.24% for the lateral spine projection was obtained, when the FFD was increased from 100 to 130 cm (P0.05).
Increasing the FFD from 100 to 130 cm has significantly reduced radiation exposure without affecting on image quality. Our findings are commensurate with the literatures and emphasized that radiographers should learn to use of an updated reference FFD of 130 cm in clinical practice.

Oral Health is a criterion for general health. Oral diseases have a chronic process as well as multifactorial nature. Predisposing factors are the strongest factors in behavior formation at personal level. The aim of this study was to determine the strongest predisposing factors affecting oral health behavior among Iranian school age children.
This descriptive-analytical study was conducted on 441 students (9-12 years old) in Rafsanjan city, Iran. Researcher-made questionnaire was used as data collection tool designed based on the reviewing scientific references, text and qualitative research, consisted of three parts including 8 demographic questions, 8 predisposing factors (Knowledge, Attitudes, Perceived Susceptibility, Severity and Benefits, Subjective Norms, Motivation to Comply and Observational Learning) and checklist of weekly behavior of tooth brushing. Data were analyzed using SPSS version 16.0 software.
Mean score of majority of constructs, except for Knowledge, were at optimum level. Frequency of tooth brushing behavior of twice and more per day was equal to 66.1%. There was a statistically significant positive relationship between tooth brushing behavior and Knowledge of students (r=0.1, P Perceived severity and knowledge were most important predisposing factor and predictor of tooth brushing behavior among children. Considering these factors in designing interventions to improve the behavior of brushing is recommended.

An adequate level of calcium intake during growth years can extensively help to stabilize calcium level and increase bone density. However, calcium intake in female school-age students is low. This study aimed to determine effect of educational programs on milk consumption based on the theory of planned behavior among 7th grade girl students in Kashan city, Iran.
This studywas interventional quasi‑experimentalresearch. 220 girl students (110 for interventional group and 110 for control group), were selected by simple random sampling from schools in Kashan city, Iran. The researcher-made questionnaire based on theory of planned behavior used for data collection. Interventional programs were performed using lectures, poster, and pamphlet. The questionnaire was completed by the students twice, before and two months after the implementation of educational program. Data were analyzed by SPSS version 20.0 using descriptive statistics and independent t-test.
After the implementation of the educational programs, the rate of milk consumption at home significantly increased among the interventional group (P Educational programs based on the theory of planned behavior led to an increase in the scores of attitude, subjective norm, perceived behavioral control, and milk consumption intention among girl students. Thus, educational interventions and programs should be designed and implemented based on the theories of health education.