Caspian Journal of Pediatrics
Volume:2 Issue: 1, Mar 2016

Kidney stone disease has become more common in children, but it remains non diagnosed in a significant proportion of patients, due to a lack of notable signs and symptoms. All children with colicky abdominal pain or microscopic hematuria should be examined thoroughly for urolithiasis. Patients’ histories in terms of family, medical, and drug and a thorough physical examination are required to be considered during diagnostic evaluation. Thereafter, diagnostic imaging methods should be aimed to detect the size, shape and location of calculi and also urinary tract anomalies. Ultrasound should be used as the initial imaging method to evaluate children with suspected nephrolithiasis. The noncontrast computerized tomography reserved for those in whom ultrasound is unable to diagnose stone. Increased water and fluid intake and a reduction of salt consumption are the common recommen dation to those children with a history of kidney stones, though the rate of stone recurrence in children is unknown. Since metabolic disorders are the most frequent causes of stone in children, diagnostic evaluation should also target the detection of metabolic disorders including hypercalciuria, hyperoxaluria, hyperuricosuria and so on that may cause recurrent nephrolithiasis. Kidney stone is not a disease itself, but it is only a symptom. Therefore, its early diagnosis is mandatory for every child with the first stone event. In this article, we have summarized literature and emphasize that a few studies with acceptable quality are available on children with urolithiasis in Iran and the world that warrant future studies on this topic.

Urinary tract infection (UTI) is an important complication after kidney transplantation (KT). UTI may cause kidney damage and dysfunction especially in children. Therefore, the aim of this study was to evaluate the risk of UTI after KT in adult and children and compare of them.
This study was done in Shaheed Beheshti Hospital (Babol Medical University). All patients, after KT and during one month after their operation were followed and divided to two groups (according their ages): more than 18 years old (adults) and under 18 years old (Children).Then, their urine samples were sent for culture every 2-3 days during admition and every week after discharged and more than 100000 single colony count were defined positive culture. Data were analyzed using t-test and p There were 508 cases and 450 patients were adult and others were children. Among them, 109 (24%) adult and 8(13.8%) children had positive urine culture, respectivley (P > 0.05) .In adult groups, 62 (21.6%) male and 47(28.8%) female patients had positive culture. However, in children group, 2 (6.3%) boys and 6 (23.1%) girls had positive culture, respectively (P According to positive culture, there was no difference between adult and children, but females had higher risk of positive U/C than males .So, more attention was needed after KT in females.

The aim of present study was to determine the influence of stress management on affective control and distress tolerance in mothers of children with sensory-motor disabilities.
This current study was a study with pretest-posttest and treatment group. The thirty mothers of children with sensory-motor disabilities were selected from sensory-motor disabilities center in Qum by 2015. The participants were randomly divided into control (n=15) and experimental (n=15) groups. Stress management training was conducted on experimental group during 8 sessions (90 minutes, twice per week). The research instrument was Affective Control Scale (ACS, 1997) and Distress Tolerance Scale (DTS, 2005). Participants were taken pre-test measures one week prior to the start of this training. Then the questionnaire was administered at post-test. Statistical analysis was performed using analysis of variance.
The results indicated that there was a significant difference between the pretest and post-test scores in distress tolerance (±SD: 30.2±8.1, 33±9.3; F= 7.58) anxiety (±SD:40.5± 9.2, 44±8; F=1.79), anger (SD:±25.4±4.1, 39.4±5.6; F=1.03), and depressed mood (SD± 27.7± 5.3, 38.6± 7.4; F=1.70) in the experimental group (p The finding emphasized that the stress management reduced the level of distress tolerance, stress, anxiety, and anger in mothers with sensory-motor disability children. Hence, it can be considered enhancing the affective control in mothers of sensory-motor disability children in therapeutic intervention.

In recent years, the interest in relation to the identification of adaptive mechanisms through which people continue to improve their psychological well-being, despite the experience of chronic pain, has been observed. Acceptance is one of these positive psychological factors. We aimed to investigate the effect of Acceptance and Commitment Therapy for Children with Chronic Pain on externalizing symptoms in 7 to 12 year-old children.
The present study was based on quasi- experimental model According to the criteria of chronic pain; a number of children with chronic pain were selected by available sampling method from specialty and subspecialty pediatric hospitals of Tehran. Then, 20 children who according to their parents were prepared to participate in this study and met the inclusion criteria, were selected and were placed in the experimental and control group. The Child Behavior Checklist was administered in both groups at the pre-test, post-test, first and second follow-up.
The results showed that the experimental group compared with the control group showed significant change in externalizing symptoms in multiple stages. These changes continued after the treatment, primary and secondary follow-up. Chi-square related to total score in experimental group was 26.21 (p=0.001) and chi-square related to total score in control group was18.55 (p=0.069).
Generally, it can be said that this protocol can be used in clinical fields, especially in the area of improving the externalizing symptoms of children.

Abnormal umbilical cord pH can be indicated a distress imposed of newborn and can also be useful in determining the prognosis of the newborn. There are different views about the effect of the neonatal delivery method on the blood gas analysis of the umbilical artery. This study aimed to determine the effect of the method of delivery on umbilical artery pH.
In this Cross –sectional study, 150 singleton newborns of 37 to 42 weeks, with birth weight 2500 to 4000 g, were allocated. The samples were calculated for values, based on similar studies, and were devided into two groups, including vaginal delivery and caesarian section under spinal anesthesia which have the least difference in pH. Umbilical artery blood gas analysis of both groups were studied. Finally, using statistical T-test for the quantitative data and chi-square for the qualitative data, hypotheses were answered. P-value less than 0.05 was considered statistically significant.
Average gestational age was between 39±0.9 weeks and 76(50.6%) and 74 (49.4%) of neonates were male and female respictivly. The average birth weight was 3368.7 ± 473.5 g. In this study, average umbilical artery pH at birth by vaginal delivery and by cesarean section section was 7.25±0.06, 7.26 ±0.06 respectively. (P>0.05).. In this study, in both groups significant differences were seen in all the blood gas values except the umbilical cord artery pH.
Our study showed that the pH level of umbilical artery blood was in normal range among newborns of both groups, but Po2 and Pco2 were more appropriate in vaginal deliveries. Due to the prognostic value of umbilical artery PH and the essentiality of prognosis in the newborns under stress, we recommend that this study should be done in the emergency situation, too.

Feeding intolerance is prevalent in very low birth weight (VLBW) neonates and is a barrier for better and faster growth in these neonates. Some studies have supported the administration of oral probiotic to decrease feeding intolerance. The aim of this study was to evaluate the effect of probiotic on feeding intolerance in VLBW neonates. This randomized clinical trial study was conducted on 60 VLBW neonates who were randomly divided into two equal groups. In the case group, the infants received probiotic in addition to routine therapy. Duration of hospitalization, time to reach to full enteral feeding and birth weight, the numbers of vomiting and defecation, c-reactive protein rising, daily weight gain were compared between two groups. No significant differences were observed between two groups in regard with gender, birth weight, method of delivery and gestational age. Mean of duration of hospitalization was 42.27 and 31.6 days in control and drug groups, respectively and there was significant difference (P-value=0.005). There was no significant difference between two groups in terms of reaching full enteral feeding, the numbers of vomiting and defecation, time to reach to birth weight, CRP rising and daily weight gain but these results were better in probiotic group. This study showed that prophylactic administration of probiotic had significant role in reducing the duration of hospitalization of VLBW neonates and was effective in reaching full enteral feeding. It is suggested that the administration of probiotic can be helpful for feeding tolerance in VLBW neonates.

Foreign Body Aspiration (FBA) represents a life-threatening emergency .It occurs primarily in children below 3 years. Generally, the most common aspirated FB is organic material such as nuts or beans. Sharp Foreign Bodies (FBs) are of particular concern to the attending clinician, because of their potential to perforate the air passage and cause possible complications. Here in, we report a rare case of sharp metallic pin aspiration in a child.
Case report: A 15-month-old boy was referred to our Emergency Ward due to the sudden onset of chocking and dysphagia which were transient. His mother was a tailor. He had history of ingestion of the similar pin two months ago. Chest radiography identified the radiopaque pin in the left side of chest. Rigid bronchoscopy was done and a sharp metallic pin was removed. Aspiration of a sharp, metallic FB is a serious injury. Pain X-ray can confirm the diagnosis .FB inhalation is preventable by creating public awareness and parenteral education to keep small objects out of children.
Aspiration of a sharp, metallic FB is a serious injury. Pain X-ray can confirm the diagnosis. FB inhalation is preventable by creating public awareness and parenteral education to keep small objects out of children.

Combination of congenital diaphragmatic hernia (CDH) and anorectal malformation (ARM) is rare. In this report, we describe a combination of imperforate anus and CDH in one of twins who conceived by Assisted Reproductive Technology (ART).
Case Report: A female preterm newborn at 27 weeks of gestation was referred to our neonatal intensive care unit due to respiratory distress. She was conceived by ART and had combination of imperforate anus and CDH. She expired 18-hours after birth as a result of severe lung hemorrhage and there was no possibility of surgical repair due to poor clinical condition. In spite of the low incidence of birth defects in the ART-conceived babies, continuing surveillance of them is necessary and the report of their birth defects is helpful.