International Journal of Pediatrics
Volume:1 Issue: 2, Dec 2013

Because of airway stimulations during bronchoscopy and lack of direct access to the airway, preferred method of anesthesia for rigid bronchoscopy is already controversial. In this study we compared inhalation anesthesia with total intravenous anesthesia (TIVA) for rigid bronchoscopy. Method and Materials: 30 patients aged 2-6 years were chosen divided into two same groups. Anesthesia in group I maintained with halothane and in group II maintained with remifentanil and propofol. Oxygenation, heart rate, respiratory rate, coughing, bucking, laryngospasm, bronchospasm were evaluated during and after surgery. Also operation success and surgeon’s satisfaction were recorded as well. Demographic findings were the same in both groups. Oxygenation and heart rate were more stable in group II (P=0.047 and P=0.026 respectively) but there was no significant difference in respiratory rate between two groups (P=1). Success rate was also similar in both groups but surgeon’s satisfaction was significantly higher in TIVA (P=0.003). There was not any significant different between complications in two groups. We suggest TIVA for rigid bronchoscopy because of better oxygenation, more homodynamic stability, surgeon’s satisfaction, lack of air pollution and less interference with surgeon’s visual field.

Children are one of the most vulnerable groups to sub-optimal nutritional intake in most societies. We have investigated some of the potential determinants of malnutrition in children of 2-5 years of age. Methods and Materials: A cross sectional study was conducted to determine the relationship between nutritional status (weight for age, height for age and weight for height) and dietary and socioeconomic factors in 671 children (24-59 months of age) from selected health centers in Mashhad city, Iran. Children were assessed for weight and height and the care givers were interviewed and a questionnaire was completed by the interviewers. The data were analyzed using SPSS13 software and the Z-scores were calculated using the WHO anthropometric software package. The study showed that 24.4% of children were mildly underweight, 4.3% were underweight, 13% were mildly stunted, 23.6% of children were mildly wasted and 3.1% were stunted. Educational attainment, whether the children had been breast feed, average daily consumption of milk, feeding practices and type of first food were found to be the main factors determining nutritional status in our study. A higher daily consumption of milk, lower age at which first solid food was started; lower age for consumption of meat and good feeding practices may resolve malnutrition in this population. These findings support the need for a family-based prevention program that focus on guiding parents to foster appropriate feeding practices as well as to promote healthy food intake in the children. Future research should determine the cost-effectiveness of both short- and long-term interventions for child malnutrition.

Sometimes physicians need to assess some markers on selected children's cerebrospinal fluid according to lumbar puncture (LP). Although immediate diagnosis and treatment especially for meningitis in necessary, But just at this moment, due to some incorrect believe in society, some parents may not allow physician to LP. The reality is that most of these people, if they have enough information about this issue, will not interfere. This study aimed to assess the knowledge and attitudes of parents toward this subject. Through a cross - sectional study we evaluated 91 parents of children, who must been undergone LP as physician’s decision, selected during 18 months using purposive sampling. The data collection tool was a questionnaire that consisted of two sections of the child and the parent's knowledge and attitudes. Scientific validity of the questionnaire was confirmed by content validity. To achieve the objectives, SPSS 15 and descriptive statistics and chi-square test were used. 61 parents(67%) mentioned fear of some side effects as the main reason of their children 's LP discontent. The most important cause of fear was low back pain according to 50 (54.9%) parents 's view. 70 parents (76.9%) had some satisfaction after performing LP. There was statistically significant difference between proportion of satisfied parents and non-satisfied ones (p<0.001). Average score parental satisfact ion for LP was (7.2 +3.2 87). It seems that improvement of parents 's information about LP process and it's benefits by health care group, may influence on their belief and cooperation during diagnostic tests.

Pain may be described as a sensation of hurt or strong discomfort and is the body's way of sending message to the brain that an injury has occurred. Pain medicines block these messages or reduce their effect on the brain. Accurate administration of analgesia have a long –lasting effect on children whole experience of medical care and affects parent's and children's future reaction to pediatrics emergency departments. The purpose of this study was to evaluate pain management on children in our emergency department. In this study we evaluated the relief of pain and anxiety on 100 children who referred to our pediatric Emergency Department (ED) in Imam Reza Hospital- Mashhad. The patients were assessed based on the American Academy of Pediatrics (AAP) recommendations about pain. Patients were gone under IV Line 97%, Intubation 5% and Lumbar Puncture 28%. Training had been provided to 70% participants in the Emergency Department. Nonpharmacologic stress reduction was used in 35% of cases. Family presence was allowed only in 5%. Prehospital pain controlling was began on 20% of patients and continued in ED on 40%. At the time of discharge 40% prescribed analgesics. Sedation and pain prophylaxis was provided for 10% of patients undergoing painful procedures in ED. According to results, pain management in our Pediatric Emergency Department was inadequate. Physicians and prehospital EMS providers should be justified about the importance of pain relieving and trained how to use all available analgesic and sedative options.

Hepatitis B is a disease caused by the hepatitis B virus (HBV), which is transmitted through percutaneous (i.e., puncture through the skin) or mucosal (i.e., direct contact with mucous membranes) exposure to infectious blood or body fluids. HBV can cause chronic infection, resulting in cirrhosis of the liver, liver cancer, liver failure, and death. Persons with chronic infection also serve as the main reservoir for continued HBV transmission. This is a prospective cross sectional study was performed in Children Medical Center Hospital on 396 medical personals (including 172 students, 92 interns, 56 residents and 56 fellowships) during September 2012 to October 2013. All of medical staff had done HB vaccination. In 93% of them the vaccination was complete. The others, 16% had only one, and 84% had two dose injections. 73% didn’t check HBsAb after vaccination. Results showed in 21.4% of fellowships, 42.8% of residents, non of interns and 35% of students, had checked HBsAb. Hepatitis B is a vaccine-preventable disease. HB is a serious world wide infection and medical staff are one of the most high risk groups. So Vaccinate their and HBS Antibody titer determination after complete vaccination is mandatory.

Present children are the investments of community in the future. Preparing children health which leads to the stability of community health, provided to accurate implementation of educational and health programs in the community and especially in mothers. So it is necessary to determine the relationship between parent's literacy with growth rate in children. This cross-sectional descriptive-analytic study was conducted on 300 mothers referring to 10 selected Mashhad health-care centers for monitoring their 6-24-month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic statistics and using SPSS 16. Present findings showed a significant relationship between literacy level of parents with child growth status, breast feeding rate, junk food consumption, referring to health care center for growth monitoring, the age of initiating supplementary nutrition, the use of oil and butter in baby food and rate of attending in educational classes. So that higher literacy level of parents was associated with using more formula, less junk food, oil and butter in baby's food and more referring times to health care center for monitoring child growth, desirable growth, and also initiating supplementary food more at the assigned time (P<0.05). Parent's literacy level influence on children growth status. However, with increasing parent's literacy level, using formula for infants has been increased, but breast milk feeding is also high in this group.

CAM (Complementary and Alternative Medicine) therapies have become increasingly popular in pediatric populations. phytotherapy are the most common CAM used in children. Yet, little is known about children’s preferences for CAM. But It is expected to become more widely integrated into the modern medical system, including the medical curriculum.The aim of this study is to introduce the prevalence and characteristics of CAM use in Pediatrics disease. Further research is warranted to examine the safety and effectiveness of this popular non-allopathic approach to children’s health.

Hypothyroidism is usually associated with delayed pubertal development but in rare occasions precocious puberty may ensue which is seen in cases of prolonged and untreated hypothyroidism. This is also called the Van Wyk Grumbach syndrome.Here we present 4 cases of precocious puberty due to hypothyroidism.