International Journal of Pediatrics
Volume:4 Issue: 36, Dec 2016

BackgroundAtaxia telangiectasia (A-T) is a common genetically inherited cause of early childhood-onset ataxia. The infrequency of this disease, vast phenotype variation, disorders with features similar to those of A-T, and lack of definite laboratory test, make diagnosis difficult. In addition, there is no rapid reliable laboratory method for identifying A-T heterozygotes, who susceptible to ionizing radiation (IR), atherosclerosis, diabetes, and cancers. We used SMC1pSer966 (pSMC1) in-cell colorimetric ELISA to diagnosis and screen in A-T families.
With informed consent, 2cc peripheral blood was collected from the 15 A-T patients, their parents, and 24 healthy controls with no family history of malignancy, diabetes, and atherosclerosis. Extracted peripheral blood mononuclear cells (PBMCs) were cultured in poly-L-Lysine treated 96-well plate with density of 70,000 cells per well. SMC1 phosphorylation was evaluated with cell-based ELISA kit 1 hour after 5 Gy IR and the pSMC1data normalized with Glyceraldehyde-3-phosphate dehydrogenase (GAPDH).
SMC1 phosphorylation was significantly low in A-T`s PBMC (mean standard deviation [SD]: 0.075 0.034) in comparison to carriers (mean SD: 0.190 0.060) and healthy controls (mean SD: 0.312 .081), but unluckily could only discriminate A-T patients (Area Under the Curve -receiver operating characteristic [AUC-ROC]: 1.00, 1.00-1.00). This method in spite of rapidness and simplicity showed poor imprecision (22.49% coefficient of variation [CV] for intraday imprecision).
It seems pSMC1 assessment by in-cell ELISA can be used for detection of A-T patients, but it may not sensitive enough for identification of carriers. This ELISA test is very simple, rapid, and requires less than 2cc blood. Thus it may be proposed for the early differential diagnosis of A-T as an alternative method.

BackgroundAutomatic release of urine at any time of a day during sleep beyond the age of five years defined enuresis as a health disorders in children. The etiology of enuresis is still not clearly understood. Body Mass Index (BMI) is an indicator to evaluate the growth trend of individuals in a population for any specific age group. Evaluation of obesity in children is important and provides an opportunity to identify the problem and prevent disease progression. The purpose of this study was to determine the prevalence of enuresis and the association with BMI.
Materials and MethodsThe study was a cross-sectional survey based on specific age group population to determine the prevalence of enuresis conducted on the schoolchildren in Zahedan, Iran during December 2015 and February 2016. A random, multistage sample of 2,000 students was taken from fifty schools in five districts of Zahedan city and filled out some easy questions such as age and gender along with measuring weight and height. Body Mass Index categorized after calculation accordance with the formulae of BMI= Height (kg) / Weight (m) 2. The classification of BMI was accordance with percentiles of underweight in less than the 5th percentile, healthy level from the 5th to less than 85th percentile, overweight from the 85th to less than the 97th percentile and obese equal to or greater than the 97th percentile.
ResultsThe prevalence of enuresis was 17.18% for boys and 11.82% for girls, and the overall prevalence was 140 in 1000. Enuresis and non- enuresis population were different in mean of BMI (15.51±3.92 versus 17.69±5.11), so that this differential were statistically significant (PConclusionOur findings revealed that enuresis was a problem among schoolchildren, especially with smaller age and lower body mass index.

Mobile phone is one of the most important necessary tools in today’s life which can threaten people’s health in some conditions. The present study was carried out to compare the effect of educational intervention by short message and pamphlet on the behavior of steel factory staff in Ardakan, Yazd province, Iran.
The present study was experimentally carried out on 319 staff in three groups. The intended samples were selected using the cluster sapling method. The self-made questionnaire was employed as the data collection means having 15 questions about behavior assessment. The results were utilized once their validity (face and content) and reliability was confirmed. The obtained results were analyzed using the SPSS18 statistical software.
The average score of people’s behavior before the educational intervention in the three groups of control, intervention-short message, and intervention-pamphlet was 21.2, 21.1, and 20.7, respectively (P = 0.714). After educational intervention, the average behavior score of people in the control, intervention-short message, and intervention-pamphlet was increased by 27.74, 42.91, and 38.56, respectively (P 0.05).
The educational short message and pamphlet would change the behaviors concerning the use of mobile phone among the staff members under study. However, the short message had a stronger effect on the people’s behavior than the pamphlet. Considering the importance of the mobile phone and its associated behaviors, the necessity of conducting health education intervention aiming at increasing the knowledge, it demonstrates the change of attitude and behavior among other members of the society.

Neonatal infections are one of the major causes of death in Iran. Since identifying the risk factors, types, site, bacterial causes, and case fatality rate of an infection can be effective in selecting preventive and therapeutic methods, and appropriate supportive measures, this study aimed to investigate the aforementioned factors in the neonatal intensive care unit (NICU) of Ghaem Hospital in Mashhad- Iran during a 5-year period.
This cross-sectional study was conducted from Jan 2010 to Jun 2016 on 221 infants diagnosed with infections (positive blood, cerebrospinal fluid, or urine cultures, and radiographic evidence of lung infection as well as laboratory and clinical evidence of infection). Data collection tools consisted of a researcher-made questionnaire including maternal and neonatal characteristics and clinical and laboratory evaluation. Moreover, the infants were followed up until hospital discharge or death. Data were analyzed using SPSS-16.
The incidence of neonatal infection was 11.6%. About 70% of the infants were born preterm and 52% of the infected infants were born by cesarean. The most common pathogens of sepsis were gram-negative bacteria (55%), coagulase-negative staphylococci (35%) and other gram-positive bacteria (10%). There were three main causes of infection of central nervous system (CNS): Klebsiella (66%), Escherichia coli (17%), and Acinetobacter (17%). Infant mortality rate due to infection was 28.1%. The causes of death included meningitis (60%), sepsis (27%), and UTI (16%).
According to our study, the prevalence of infection and mortality rate in our ward is higher compared to developed countries. The most common cause of infections was gram-negative bacteria, but coagulase-negative staphylococci become more prevalent and needs more attention.

Healthy dietary habits are known as a key factor for improving brain functions and cognitive ability in children and adolescents. The goal of this study was to evaluate the association of healthy food consumption with mental health in Iranian children and adolescents.
Data were obtained from the fourth national school-based surveillance survey entitled CASPIAN-IV study. In this study, 14880 children and adolescents aged 6-18 years were selected by multistage, cluster sampling method from rural and urban areas. The students and their parents completed two sets of questionnaires. The psychiatric distress included depression, worry, insomnia, anxiety, aggression, confusion, and worthless and the violent behaviors comprised of physical fight, victim and bully. The healthy foods included fresh fruits, dried fruits, vegetables and dairy products.
The participants include 13,486 students from elementary, intermediate and high school degree. The prevalence of psychiatric distress was significantly higher among high school students, while violent behaviors were more prevalent in the middle school students. According to the multivariate model (model IV), the risk of psychiatric distress was significantly lower in students with daily consumption of fresh fruits, vegetables and milk. In addition, those with daily consumption of vegetables and milk had significantly lower risk for violent behaviors.
Consumption of healthy foods may reduce the risk of psychiatric distress and violent behaviors. Therefore, in addition to its benefits, increasing healthy food consumption among children and adolescents can be useful in preventing mental health disorders.

BackgroundChildhood obesity has become a global epidemic. In the recent studies has reported risk of thyroid dysfunction due to obesity. Therefore, this study intends to compare the relative frequency of thyroid function disorders in obese and overweight children with non-obese children.
Materials and MethodsThis case-control study during 2015 to 2016 in Birjand, Iran was done on 137 children and adolescents (6 to 18 years), with overweight and obesity as case group and 137 non-obese subjects as control group. Body mass index (BMI), thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured, and analyzed using SPSS software version19.
ResultsTSH level in obese children was significantly more (PConclusionOverweight and obesity in children and adolescents can be effect on increase of TSH and decrease of FT4 and FT3. Long-term studies with larger sample size is suggested.

BackgroundPediatric acute lymphoblastic leukemia (ALL) is the most common, yet curable childhood malignancy within the pediatric cancers; but in most developed and developing countries cost of cancer treatment in children with ALL is high. So, we specified the range of expenses for the treatment of pediatric cancer and compared the results in developed and developing countries.
Materials and MethodsTo evaluate treatment costs in childhood ALL, a review was taken place through published papers during the years 2000 to 2015. We searched multiple well known databases such as Medline, Scopus, ISI Web of Science and Google Scholar on January 2015 with "cost effectiveness", "cost utility", "cost minimization", "cost analysis", "economic evaluation", "childhood", "acute lymphoblastic leukemia", and "ALL" as our keywords.
ResultsRegarding the reviewed evidence the essential result was that the total costs for treatment of pediatrics ALL in developing countries such as Asian countries were considerably lower than the costs reported from high income countries in Europe and North America. So different protocols were performed to treat ALL and this matter was significant due to the different durations of hospitalization.
ConclusionAccording to the results, the total costs for treatment of pediatrics ALL in developing countries were considerably lower than the costs reported from high income countries.

BackgroundThe current study was conducted to investigate the relationship between unwanted pregnancy based on couples’ opinions and infant nutrition type in women referred to the health centers in Mashhad city and their husbands.
Materials and MethodsIn this analytical-descriptive study, unwanted or wanted progenies were studied from the viewpoints of 366 women referred to the health centers in Mashhad city, Iran and their husbands, and also their relationships with infant nutrition type at the age of 4 months. The data were collected through questionnaires. The validity and reliability of the method and instruments were confirmed by content validity and test-retest. Moreover, data analysis was done using SPSS-16.0 software.
ResultsThe average age of women in wanted pregnancy was 26.43±4.57 years and 27.57±5.22 years in unwanted women. The results showed a statistically significant relationship between unwanted pregnancy from the viewpoints of couples and infant's nutritional status (P=0.03). The prevalence of unwanted pregnancy in women with lower education (middle and high school) was higher than those with higher education.
ConclusionOur results showed a significant association between baby’s nutrition and unwanted pregnancy. Furthermore, an increased use of non-exclusive breastfeeding in unwanted pregnancy is necessary. Hence, proper use of contraceptive methods, preventing the adverse consequences of unwanted pregnancy such as non-exclusive breastfeeding, useful educational strategies, counseling and health services are necessary to be taken into account.

BackgroundBronchiectasis is defined by permanent and abnormal widening of the bronchi. Although this process occurs in the context of chronic airway infection and inflammation, since there is no accurate estimation of the etiology of the disease. This study aimed to determine the most important cause of bronchiectasis in Tehran, Iran.
Materials and MethodsIn this retrospective cohort study we used the information of 91 patients admitted to two subspecialty lung hospitals in Tehran-Iran, where a wide range of bronchiectasis patients from around the country referred during 2013to 2014 period. Patients referring with the manifestation of chronic productive cough who had not responded to conventional treatment with the evidences of bronchiectasis on high resolution computed tomography were included. Data were analyzed using SPSS-16.0.
ResultsThe etiology of bronchiectasis was diagnosed in 73 of 91 patients (80.2%), the most important of which included cystic fibrosis, post infectious, and primary ciliary dyskinesia (PCD). The most common causes of bronchiectasis in the children group (Age ≤ 18 years), were cystic fibrosis (57.1%), allergic bronchopulmonary aspergillusis (14.3%) and PCD (9.5%), respectively. In the adults group (Age >18 years), the most common causes were post infectious (22.6%), PCD (15.7%) and cystic fibrosis (14.3%), respectively.
ConclusionMain causes of bronchiectasis in this study were not significantly different from other studies. Special attention should be paid to the probable causes of bronchiectasis in order to effectively execute on-time diagnosis, proper treatment and management of complications.

BackgroundProviding healthcare for students is one of the primary duties of the states. This study aimed to analyze the contents of the science textbooks of Junior High School course in terms of the components of health education in Iran.
Materials and MethodsThis descriptive study was conducted through content analysis. To collect data, a researcher-made check list including: physical health, nutritional health, the environment, environmental health, family health, accidents and safety, mobility, physical education, mental health, prevention of risky behavior, control and prevention of diseases, disabilities, public health and school health, was used. The samples were the science textbooks of Junior High School course (7th, 8th and 9th grades). Analysis unit was all pages of the textbooks (texts, pictures and exercises). Descriptive method (frequency table, percentage, mean and standard deviation [SD]) was used to analyze the data and non-parametric Chi-square test was used to investigate the probable significant differences between the components.
ResultsThe results showed that the authors of sciences textbooks of Junior High School course have paid most attention to the component of control and prevention of diseases (21.10%) and have paid no attention to the component of "mental health". Also, there were significant differences among the components of physical health, family health, the environment and environmental health in terms of to be addressed in the science textbooks of Junior High School (PConclusionIt can be generally concluded that the health education components are not equally covered in the sciences textbooks of Junior High School course and some of them either have not received any attention or just a little.

BackgroundSeveral studies have examined the relationship between Human Development Index (HDI) and various health outcomes. The aim of this study was to investigate the relationship between HDI, and infant mortality rate, mortality rate of children under one year and under 5 years, maternal mortality rate, and total fertility rate.
Materials and MethodsIn this ecologic study, data on HDI, total fertility rate (TFR), maternal mortality rate (MMR), neonatal mortality rate (NMR), infant mortality rate (IMR) and mortality rate in children under 5 years of age (ResultsIn this study, a negative significant correlation was observed between HDI and IMR (r = -0.878, P = 0.001), NMR (r = -0.870, 95% CI: -0.902, -0.828, P = 0.001), IMR, children under one year old and under 5 years, and MMR mostly occur in developing countries. There was a correlation between HDI and its components, and the neonatal, infants, children under 5 years, maternal mortality rate and total fertility. The average annual percentage change of HDI also had a correlation with neonatal, infants, children under 5- year mortality rate, total fertility and maternal deaths.

BackgroundThe absence of pain relief in infants can lead to harmful effects; so, this study aimed to investigate the effect of local heat on the pain of vitamin K injection in the infants.
Materials and MethodsThis randomized clinical trial was conducted on 80 healthy infants. For the control group, 1 mg vitamin K was injected into the vastus lateralis muscle by a nurse. In the 3 intervention groups, respectively 5, 10 and 15 minutes before the injection, hot-water bag at 37 °C was placed on the quadriceps muscle and then injection was done with the same condition as in the control group. Immediately after the injection, the Neonatal Infant Pain Scale (NIPS) was completed. Data analysis was done using SPSS version 21.0 software.
Results41(51.25%) girls and 39 (48.75%) boys were participated. First-minute Apgar of all samples were 8.64±0.557. Birth weight was 3335.37±339.51 grams and the minimum gestational age 36.37±1.01 weeks. The mean pain score in the first minute in the control group was 3.6± 2.136, which was 3.3± 1.976 in the 5-minute warm-up group, and this amount was reached to 1.6± 1.569 in 10-minute warm up group, and 0.6± 0.821 in 15 minute warm-up group (P=0.008). The mean pain scores in the control group for the second minute was 1.0±1.835, which was reduced to 0.25± 0.716 in the 10-minute and 15-minute warm-up group (P=0.023).
ConclusionLocal heating before the injection procedure can be effective in reducing pain in infants and the pain will reduce by increasing the local heating time (15 minutes).

Breastfeeding is a natural way to provide nutrients required for proper growth and development of infants. In view of that, it is of great importance to enhance the knowledge of mothers on exclusive breastfeeding in the first six months after birth and the time of starting complementary feeding. This study aimed to assess the training needs of mothers on exclusive breastfeeding, was conducted in the city of Qom, Iran.
This cross-sectional study was conducted on 292 mothers who had children aged 6 to 12 months old. The subjects were selected via multistage sampling method. Using a researcher made questionnaire, the required data was collected via face-to-face interviews. The collected data were analyzed via descriptive and analytical tests. The significance level was set at 0.05
Of all, 42.5% (n=124) of the children were exclusively breastfed. The mean of knowledge of mothers on exclusive breastfeeding was 10.3±1.5 (of a total score of 12), their mean of maternal attitudes was 38.7±3.3 (of a total score of 44), and their mean score of performance was 6.5±1.8 (of a total score of 9). There was a significant and direct relationship between maternal education level and their knowledge and attitude scores (PThe results showed that mothers had a desirable level of knowledge, attitude, and performance in terms of exclusive breastfeeding. With promoting knowledge, mothers had a more favorable attitude and a higher score of breastfeeding performance.

Acyclovir (9-[2-hydroxyethoxymethyl] guanine) is an acyclic nucleoside analogue of guanosine which is a potent and selective antiviral agent. Acycloviris converted to the monophosphate by thymidine kinase the virus-specific form of this enzyme and is subsequently converted to the triphosphate by the host cell kinase. Acyclovir triphosphate inhibits viral DNA-polymerase terminating the chain and is the active form. It is 30 times more potent against the herpes simplex virus enzyme than the host enzyme. Acyclovir triphosphate is fairly rapidly broken down within the host cells by cellular phosphatases. Resistance due to changes in the viral genes coding for thymidine kinase or DNA polymerase cause acyclovir-resistant herpes simplex virus and has been the cause of pneumonia, encephalitis and mucocutaneous infections.
Acyclovir can be administered orally or intravenously. When it is given orally, only 10-20% of the dose is absorbed. Acyclovir is widely distributed throughout the body, reaching concentrations in the cerebrospinal fluid which are 30 to 50% of those in the serum. In neonates, the half-life of acyclovir is about 5 hours, but it is 2.5 hours in children over 3 months old. The herpes simplex virus is transmitted vertically from infected mothers to fetuses and the administration of 400 mg acyclovir orally three times daily from 36 weeks of pregnancy until delivery has been suggested. Alternatively, a cesarean section can be performed to avoid the transmission of the herpes simplex virus to fetuses. The aim of this study is to review the effects and pharmacokinetics of acyclovir in neonates.

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Up to 50% of these children suffer from at least one comorbid sleep disorder. Considering the deleterious effects of sleep problems on all aspects of children's life, this study was designed to investigate the impact of a sleep hygiene intervention on sleep habits in children with ADHD and comorbid sleep disorders.
This randomized controlled trial, was conducted on 62 children aged 7 to13 years with diagnosis of ADHD and comorbid sleep disorders. Children's Sleep Habits Questionnaire (CSHQ) was completed by children's mothers and then the participants allocated randomly into experimental (n=28) and control (n=28) groups. Mothers of the children in experimental group received a sleep hygiene educational intervention which was delivered through a training session and a booklet followed by two telephone calls and educational text messages. Participants in the control group received usual clinical care. The post-test was performed two months after intervention.
56 children (case and control groups) completed the survey (mean age 8.62 ± 1.57 years). Data analysis showed that, compared with control children, experimental children had a significant- reduction in mean scores of Bedtime resistance (PThe sleep hygiene intervention improved sleep problems in a sample of children with ADHD by parent report. The findings of this study support the design, implementation and evaluation of educational programs on good sleep-hygiene practices for children and adolescents.