Caspian Journal of Pediatrics
Volume:2 Issue: 2, Sep 2016

Cancer is a major source of distress such as aggression and anxiety. It becomes a traumatic and painful for both children and their family. Therefore, the aim of this study was to investigate the influence of painting therapy on the reduction of aggression and anxiety among hospitalized children with cancer (8-12 aged).
The study was semi-experimental with pretest-posttest and treatment group. Thirty hospitalized children with cancer (8-12 aged), who obtained one score above the mean scores in Spence Children's Anxiety Scale and Children's Inventory of Anger (ChIA) were selected from Shafa Hospital in Ahvaz. Then, they were randomly divided into the control and experimental groups. The intervention group received techniques of painting therapy for 11 treatment sessions (60 minutes for each session, twice per week). Data were analyzed using covariance.
The results indicated that there was a significant difference between the pretest and post-test scores in aggression (±SD: 60.9±13.56, 40.90±8.52; F=118.79, p Findings indicated that painting therapy impacted on the reduction of the aggression and anxiety in children with cancer. Therefore, it would be considered as the therapeutic interventions for releasing the negative emotion in children with cancer.

Diabetic ketoacidosis (DKA) is the final consequence and life-threatening complication of severe insulin deficiency in type 1 diabetes with occurrence of 20-40%. The aim of this study was to investigate the incidence and predisposing factors of DKA and its consequences.
This retrospective study was performed on 128 diabetic patients in Amirkola Children’s Hospital in 2005-2013. Patient's data were recorded in a predetermined questionnaire. The data were analyzed using SPSS.18.
Of all 128 hospitalized diabetic patients, 103 patients (80.5%) were referred for the first time and 25 (19.5%) patients were previously treated with insulin. Of total 128 patients, 71 (55.5%) had some degree of ketoacidosis that severe ketoacidosis was the most common form (in 36 cases; 50.7%). Among patients with the diagnosis of ketoacidosis (71 patients), 54 patients (76%) presented with DKA as the first symptom of diabetes. Generally, the predisposing factors of ketoacidosis were seen in 39 (54.9%) patients, which were due to infections and insulin therapy discontinuation in 27 (69.23%) and 12 (30.76%) of them, respectively. In patients with previous diagnosis of diabetes mellitus and history of admission with diabetic ketoacidosis, 70.58% had previous treatment cessation.
In the current study, the incidence of ketoacidosis was high (55.5%). This subject seems to be related to lack of information about diabetes mellitus among population who require the universal education. On the other hand, in respect to high incidence of DKA among patients with cessation of previous insulin treatment, rigorous and complete training of them is critical.

Microorganisms that cause early neonatal sepsis are usually already colonized rectovaginal area in mothers. The most common of these organisms is group B streptococci (GBS) and intestinal gram-negative bacteria mostly Escherichia coli (E.coli). The use of prophylactic antibiotics against GBS has increased in recent years. This study aimed to determine the current situation and frequency of E.coli and GBS colonization in mothers and their infant.
All pregnant women with gestational age≥26 weeks, progressive labor pain and no history of using antibiotic were entered into the current study. A sterile cotton swab culturing from distal third of vaginal and rectum of mothers, and six hours after delivery from external ear canal, nose, groin and umbilicus of infant has been taken. All samples were transferred to the laboratory in Stuart’s media, and then cultured to standard media within 24 hours and the main two organisms in neonatal sepsis (E.coli and GBS) were isolated from mother's and infant's cultures.
E.coli and GBS were 56.3% and 11.2% respectively in rectovaginal culture, and 29.8% and 8.8% in infants’ body surface culture. There was a significant difference in rectovaginal GBS colonization between term (13.6%) and preterm (3.2%) (P=0.005), while the frequency of positive E.coli culture was 52.8% in term deliveries and 68.1% in preterm ones, showing a significant difference (P=0.009).
Since E.coli is more common in preterm delivery in this geographical region, in cases of amniotic membrane rupture, mothers should be adequately protected with prophylactic antibiotics against neonatal sepsis.

Desirable oxygenation of preterm newborns has particular importance, for this reason different methods have been proposed to improve oxygenation of the newborns; one of these methods is the newborn's position. The aim of this study was to determine the effect of the position of low birth weight neonates on arterial oxygen saturation and heart rate.
This interventional study was conducted with simple non-randomized method in 2014-15 on 40 very low birth weight neonates, and each of them was initially in supine position for 120 minutes, then after 10 minutes of resting they were in prone position and each of them was in left lateral position, and during this period, arterial oxygen parameters and heart rate were recorded every 15 minutes, individual characteristics in a questionnaire for each newborn were analyzed using descriptive statistics, Repeated measurement test and paired sample test comparison.
Average oxygen saturation percentage in supine position was 96.74±2.09 and in prone and left lateral positions was 97.41±1.91 and 96.14±2.36, respectively which was statistically significant (P=0.032). Heart rate in the three positions was in normal range but the range of heart rate fluctuations in prone position was slightly less that was not statistically significant (P=0.596).
Results of the current study showed that the prone position made more desirable oxygenation and heart rate fluctuations compared to supine and left lateral position in preterm newborns. So this position can be used in care service of newborns with low birth weight if there is no prohibition of using this position.

Thalassemia/haemoglobinopathy is a hereditary disease with increased erythropoiesis and expansion of the bone marrow cavity. Consequently, there is a reduction in trabecular bone tissue resulting in osteopenia/osteoporosis. The present study was performed to determine bone mineral density (BMD) in children and adolescents with major thalassemia and its correlation with serum ferritin level.
Seventy children and adolescents with major thalassemia were divided into two groups, (each group with 35 patients). Patients with serum ferritin level more than 1500 ng/dl were defined as case group and those with serum ferritin level lower than 1500 ng/dl were defined as control group. Thyroid and parathyroid function tests were performed as well as calcium and phosphorus serum level were checked. Dual X-ray Absorptiometry (DXA) was the diagnostic test for osteoporosis. Only patients with transfusion-dependent thalassemia major were enrolled. Patients with delayed puberty, hypothyroidism or parathyroid dysfunction, renal failure, liver failure, growth hormone deficiency and also those who used Calcitriol were excluded from the research.
Results showed that the mean serum ferritin in patients who had femoral osteoporosis was higher from those with osteopenia and normal density in the femur. (p=0.001). In addition, the mean serum ferritin in patients with vertebral osteoporosis was higher than that in those with osteopenia and normal bone density in the vertebral bones, (p=0.002). There is a significant difference between serum ferritin in different bone densities.
Bone density is a good indicator of bone status in patients with major thalassemia and we recommend measuring it annually.

The aim of this study was to describe the one-decade experience in Percutaneous Nephrolithotomy surgery in children with kidney stones in Tehran, Iran.
All patients (less than 18 years old) undergoing Percutaneous Nephrolithotomy at our referral medical center, were reviewed in this cross-sectional study. All the demographics, surgical data and post-operative information were obtained to identify the stone free rates and complications.
In a total, 119(56.4%) cases of 211 patients who underwent Percutaneous Nephrolithotomy in our study were male and 92(43.6%) cases were female. The mean age of participants was 137.15±60.11 months (range: 9-204). The most common presenting symptom was pain (62.6%). The mean stone burden was 23.5 ± 9.68mm and the mean operative time was 109.95±37.1 min. Overall, stone clearance rate was 73.9% after single PNL. Among those patients who had renal malformation, the stone free rate was (13/19) 68.4% for PCNL. The postoperative complication rate was 5/47 (10.6%) during all procedures and there were no major operative or postoperative complications.
According to the findings, pediatric PCNL with the acceptable stone free rates could be considered as a safe and effective procedure among children with complex stones and renal malformation.

Tacrolimus is a main drug for induction and maintenance immunosuppression for patients with kidney transplants in many centers. One of important side effect of drug is post-transplant diabetes mellitus .Of course; diabetes ketoacidosis (DKA) is rare. In this report, a 12-year-old girl with DKA was presented after 45 days of kidney transplantation.