Journal of Pediatric Perspectives
Volume:5 Issue: 44, Aug 2017

Due to significant increases in the prevalence of overweight and obesity in adolescents in developed countries, much attention has been focused on this issue. This study aimed to determine the effectiveness of nutritional education based on Health Belief Model (HBM) on self-esteem and body mass index (BMI) of overweight and at risk of overweight adolescent girls.
The study subjects consist of 140 female students recruited from two high schools, who were randomly allocated to the intervention (n=70) and control (n=70) groups. The data collection instrument included sections on socio-demographic status, transportation method, physical status, and knowledge and attitudes of the students towards nutrition, which was designed according to HBM. As the intervention, model-based educational program was implemented through six 60-minute sessions, focusing on the overweight and at-risk students. Results were compared in the beginning, and three months after the intervention to find the possible impacts.
Average score of model structures and self-esteem of students in both groups had no significant difference at baseline, but immediately after the intervention and 3 months after treatment, the mean component scores were significantly higher in intervention group than controls (P The positive effect of this program was seen among the participants. Therefore such interventions in schools for developing effective long-term healthy behaviors have preventive and controlling effects on overweight.

There is evidence indicating impaired cardiomyocytic contractility, delayed electrical conduction and increased electrophysiological heterogeneities due to iron toxicity in beta-thalassemia major patients. In the present study, we compared the electrocardiographic and echocardiographic features of beta-thalassemia major patients with a healthy control group.
The average annual serum ferritin levels of fifty beta-thalassemia major patients were assessed. For each patient, corrected QT (QTc) intervals and QTc dispersions (QTcd) were calculated and V1S and V5R were measured. All subjects underwent two-dimensional M-mode echocardiography and Doppler study and were compared with 50 healthy subjects as a control group.
QTc interval and dispersion were significantly higher in beta-thalassemia major patients (P= 0.001). The mean V5R (20.04 ± 4.34 vs. 17.14 ± 2.55 mm) and V1S (10.24 ± 2.62 vs. 7.83 ± 0.38 mm) showed considerably higher mean values in patients in comparison with control group.Peak mitral inflow velocity at early diastole and early to late ratio in the case- group was markedly higher(P Measurement of the QTc interval and dispersion can be used for early detection of cardiac involvement, especially in asymptomatic beta-thalassemia patients with ferritin levels higher than 2,500 ng/dl.

Despite the progress made in the care transition program from the hospital to home with an emphasis on telephone counseling, an effective and safe care transition process has not been provided to patients and their families.The aim of this study was to investigate The Effect of Phone Counseling for Mothers of Premature Infants Discharged from the Hospital on Infants’ Readmission.
In this quasi experimental study, 100 mothers of premature infants were selected using convenient sampling and randomly assigned to two intervention and control groups. A demographic data questionnaire and the check list of the causes and readmission rate of premature infants were used for data collection. In the intervention group, after the discharge of premature infants, three phone calls in a week in the first four weeks, and two phone calls a week in weeks five to six were made via the landline and mobile phone for providing necessary education to mothers regarding the provision of care to infants. The communication time varied between 10 and 15 minutes in each phone call. Lastly, the rate of hospital readmission of the infants 4 weeks, 6 weeks, and 12 weeks after the intervention were assessed by phone. Telephone communication to the mothers in the control group was performed for raising their awareness of the causes and rate of hospital readmission in the neonatal intensive care unit (NICU).
Each group (case and control groups) was consisted of 50 Mothers of Premature Infants and no statistically significant difference was reported between the two groups in terms of the mean age mothers, infant age, and birth weight when discharging from the hospital and hospitalization time. The rate of hospital readmission in the intervention group 4 weeks (P=0.004), six weeks (P=0.005) and 12 weeks (P=0.006) after the intervention was significantly lower than the control group.
Telephone consultations are an affordable way for engaging and supporting the mothers of premature infants. More study is warranted to determine if these results can be applied to multiple sites and in more diverse populations, as well as if this intervention can reduce infants’ Readmission.

Hair is an ectodermal structure, and its formation is regulated by master genes important in embryology. Hair shaft consists of three major regions: the medulla, cortex and cuticle. Hair shaft abnormality will divide structural hair abnormalities into two broad categories - those associated with increased hair fragility and those not associated with increased hair fragility. We conducted a review study to assess hair shaft abnormality in children.
We conducted a review of all papers published on hair shaft abnormalities. A literature search was performed using PubMed, Scopus and Google Scholar on papers publish from 1990 to 2016. The search terms were: hair shaft abnormality, Hair loss, Hair fragility. All abstracts and full text English-language articles were studied.
While common developmental and structural features are shared in hair follicles and hair shafts. Anomalies of the hair shaft are separated into those with and those without increased hair fragility.
Although hair has no vital function, it may serve as an indicator for human health. Clinical and morphological hair abnormalities can be clues to specific complex disorders. Hair shaft abnormalities can be inherited or acquired, can reflect a local problem or a systemic disease.

Preconception care means interventions required for maternal and fetal health care and detection of pre-pregnancy risk factors. Some risk factors that have a significant effect on the outcome of pregnancy can be detected and controlled before pregnancy. The present study aimed to determine the prevalence of pre-pregnancy risk factors, and its relationship with preconception care in Isfahan-Iran.
This descriptive study was a cross-sectional research which was conducted with multi-stage sampling (stratified and cluster) from April to May 2016 on 702 women giving birth in hospitals in Isfahan (Iran). Data collection tool was a researcher made questionnaire and data were analyzed using SPSS software, descriptive statistics and chi-square test.
The results showed that, the interval between current pregnancy with a previous pregnancy less than 4 years) 22.8%), abnormal weight (13%), sexually transmitted infections (11.3%), thyroid disorders (11 % ), and history of hospitalization of infants in the intensive care unit (11.1%), were the highest pre-pregnancy risk factors reported. There was a significant positive correlation between thyroid disorder and polycystic ovary (P Results of this study showed that some of the risk factors (such as the interval less than 4 years between two pregnancies, abnormal weights and sexual infections) that generally affect pregnancy outcome, exist in women before pregnancy. Since many of these factors are easily identifiable before pregnancy, health planners and implementers need to pay special attention to this issue and identify people with these factor with screening programs before pregnancy.

One of the most important and destructive forms of child abuse is the physical abuse which can lead to the maladjustment among abused children; the aim of this study was to determine the effectiveness of trauma focused cognitive-behavioral therapy on reduction social and emotional maladjustment of physically abused children.
This study was a randomized controlled clinical trial. A number of 40 abused boys, who study in the elementary schools in Kermanshah- Iran, were selected by random cluster method, and randomly divided in intervention and control groups.Before and after Trauma-focused cognitive behavioral therapy (TF.CBT), the Sinha and Singh adjustment questionnaire were used to assess the level of social and emotional maladjustment. In the intervention group, trauma-focused cognitive behavioral therapy was held in ten one-hour sessions.
The results showed that after the intervention, the mean of social and emotional maladjustment was decreased significantly in the intervention group (P At current study, results showed that TF.CBT reduced the social and emotional maladjustment among physically abused children.

Osteoporosis is the most common metabolic bone disease that decreases bone mass, causes destruction and eventually friability. This disease is preventable, and because adolescent females are the high-risk population, teaching this age group is of the utmost importance. The aim of this study was to compare the effects of the two educational methods (Lecture and Pamphlet) on osteoporosis preventive behaviors among female students.
This was a randomized clinical trial (RCT). To collect data, demographic questionnaire, food frequency questionnaire (FFQ), and physical activity questionnaire were used. Subjects were 205 seventh-grade girls who were selected by multistage random method and allocated in two experimental (Lecture = 68, Pamphlet = 67) and 70 for control group. In the Lecture group, there were 5 sessions of training, each of which lasted 60 minutes. In the Pamphlet group, only educational pamphlets were given, and no interventions were performed in the control group. Data were analyzed through statistical software SPSS version 21.0. Descriptive statistics, chi-square tests, t-test and ANOVA were applied to analyze the data.
The mean age of the students was 13 0.856 years old and there was no difference in terms of demographic variables between intervention and control groups. The results identified the mean scores of physical activity behaviors significantly improved two mounts after the intervention in the lecture group (P=0.001).While, the men scores of the pamphlet group had no significant changes after two months, but the differences of the both group compared to the control group were significant. Considering the significant decreased in the control group (P= 001). The mean scores of calcium intake in the two lecture and pamphlet groups significantly increased (P The osteoporosis preventive behaviors intervention improved the preventive behaviors of the participants. The results showed the effectiveness of education in both Pamphlet and Lecture group, because calcium intake and physical activity were significantly increased compared to pre-intervention and the control group.

Multiple pregnancies are responsible for the increased risk of maternal and neonatal morbidity and mortality. This study aimed to compare the perinatal outcome between multiple and singleton pregnancies.
This is a retrospective cohort study. A sample of 50 multiple birth neonates- born in Fatemieh Hospital of Hamadan, Iran in 2015- was selected using simple random sampling. Meanwhile, they were compared with 50 single birth neonates in the same center on gender, gestational age, mean birth weight, Apgar score, the use of Assisted Reproductive Techniques (ART), delivery method, cause of neonatal admission, duration and short outcome of neonatal hospitalization. The data were collected from the medical files of neonates and their mothers. The data were analyses using SPSS version 16.0 software.
In this study, 100 neonates (50 single births and 50 multiple births) were compared. The mean gestational age and mean birth weight of multiple births were lower than that of single births (P0.05). A significant difference was found on the frequency of in vitro fertilization (IVF) method, rate of cesarean section and preterm delivery (P In this study, multiple pregnancies were associated with maternal complications including preterm delivery and the increased cesarean section rate, and neonatal complications such as low birth weight, prematurity and increased rate of neonatal hospitalization that increases risk of perinatal morbidity and mortality.

Low birth weight (LBW) is considered as one of the important health indicators in evaluating prenatal care as well as determining scale of infant's health in the society. The study aimed to investigate maternal diseases during pregnancy and its impact on LBW in rural areas of Kurdistan province, Iran.
This study was conducted in nested case-control study method in rural areas of Kurdistan province- Iran in 2015-2016. In this study, 182 infants less than 2,500gr as case and 364 infants weighing 2,500 g and more as control were entered the study. Information about case and control groups was extracted by investigating records of pregnant women care. Data was analyzed using software Stata-12 with point and interval estimation of odds ratio (OR) using conditional logistic regression.
The results of single-variable analysis of conditional logistic regression showed that there is a statistical relationship between blood pressure during pregnancy, iron deficiency anemia, mother's thyroid problems, oral and dental problems, and history of bleeding during pregnancy in case and control groups (P The results of this study indicated significant relationship between the diseases of pregnancy (such as blood pressure during pregnancy, iron deficiency anemia, and history of bleeding during pregnancy) and Low birth weight in infants. The birth of a LBW infant can be to a large extent prevented by diagnosing and preventing these diseases and required trainings for pregnant women.

Students with learning disabilities often encounter problems with their lessons due to the disorder in reading and writing and face to some challenging situation such as auditory and visual memory problem, sustaining attention, inhibiting impulses, motor coordination, auditory and visual perception and discrimination. The purpose of this study was to investigate the effectiveness of storytelling on auditory memory of students with reading disabilities of Marivan city, Iran.
The research method was quasi-experimental with pretest-posttest design with a control group. Sampling method was replaced in this study using an available sampling method on 30 students in two groups (15 experimental and 15 control people). The experimental group test abilities were trained in 12 one-hour session. Inclusion criteria were having a learning disorder (only dyslexic), third grade elementary school and having no other abnormalities and exclusion criteria were students who did not attend the regular sessions. Digit span subtest the Wechsler figures Fourth Edition were used to collect data. Collected data were analyzed by using SPSS version 21.0 software in two levels of descriptive and inferential statistics (ANCOVA).
The results showed that 66% of participants were female, also, according to the parent's literacy level, the results showed that the highest level of fathers’ literacy was between high school and diploma (46.7%) as well as the highest level of mothers’ literacy was under diploma (50%). The results showed that storytelling had a significant impact on improving dyslexic students’ auditory memory (P Auditory processing is not only a skill, but it also includes a combination of skills that are basic to the processes of listening, communicating and learning, as well as higher level skills such as synthesis and integration of auditory and auditory memory which rely on healthy auditory processing system. The results of this study confirmed the effectiveness of storytelling on the aural memory.

Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) of unknown etiology. Isolated oculomotor nerve palsy is found rarely in children with MS. We present a case of MS in 10-year-old boy, who had bilateral ptosis associated with medial gaze restriction. The extraocular muscle examination demonstrated bilateral adduction palsy, impaired upward and downward deviation, and bilateral ptosis. Magnetic resonance imaging of brain revealed demyelinating changes in the midbrain.

Thalassemia is the most common hereditary disorder worldwide. The patients’ survival is dependent on lifetime blood transfusion which leads to iron overload and its toxicity on various organs including endocrine glands. The study aimed to investigate endocrine disorders in patients with Beta-thalassemia major in the Southern Khorasan province, Iran.
In this descriptive cross sectional study of the 42 patients with Beta thalassemia major blood samples were taken in the fasting to check laboratory tests such as fasting blood sugar, calcium, phosphorous, thyroid stimulating hormone (TSH), thyroxine (T4), luteinizing hormone (LH), follicle stimulating hormone (FSH), parathyroid hormone (PTH), Ferritin. Data analyzed using SPSS version 16.0 software.
85.7% of patients had endocrine disorders. The most common endocrine abnormalities were hypogonadism (71.4%), hypoparathyroidism (21.4%), diabetes (14.3%), and hypothyroidism (7.2%), respectively.
Our results concluded that endocrine evaluation must be carried out regularly in patients with thalassemia major. Patients who have abnormal endocrine laboratory results should be reevaluated for compliance with chelation therapy and the transfusion program.

Hepatoblastoma is a common liver malignancy in children and commonly presents with primary tumors. In hepatoblastoma, lung is the most common place to metastasis. Chemotherapy have led to many improvements in the local control of hepatoblastoma. A main goal of treatment for hepatoblastoma is to achieve complete tumor resection.
The patient was a 2.5 years old boy with abdominal distention and abdominal pain. Abdominal and pelvic ultrasound and thoracic and abdominal CT was performed for the patient and the results of them showed a large and hyperecho mass in the liver and several nodular lesions in lung segments. After doing some other tests, the diagnosis for the patient was hepatoblastoma. After chemothetapy the primary tumor was removed by surgery. Follow-up by CT scan after second chemotherapy showed that the lesions in the liver were removed, but lung masses were still unchanged and after second surgery, lung masses were removed too. The outcome has been favorable with no recurrence as of 20 months after the operation.
In our case, the patient did not respond to chemotherapy and as main treatment, surgery was carried out, that shows its importance in the treatment of hepatoblastoma.

World Health Organization has recommended all countries to introduction of Pneumococcal Conjugate Vaccine (PCV) in routine immunization schedule, especially those countries with higher rate of mortality in children. However, Islamic Republic of Iran and more than 50 other countries including Algeria, Antigua and Barbuda, Belarus, Belize, Bhutan, Bosnia and Herzegovina, Brunei Darussalam, Cabo Verde, Chad, China, Comoros, Cook Islands, Croatia, Cuba, Czech Republic, Democratic People's Republic of Korea, Dominica, Egypt, Equatorial Guinea, Estonia, Gabon, Grenada, Guinea, Haiti, India, Jamaica, Jordan, Malaysia, Maldives, Malta, Montenegro, Nauru, Poland, Romania, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, San Marino, Serbia, Seychelles, Slovenia, Somalia, South Sudan, Sri Lanka, Syrian Arab Republic, Tajikistan, Thailand, The former Yugoslav Republic of Macedonia, Timor-Leste, Tonga, Tunisia, Turkmenistan, Tuvalu, Ukraine, Vanuatu, and Viet Namhave not introduced PCV till April 2016.

False Aneurysms are uncommon in the pediatric population. We report a case of false aneurysm of the common femoral artery (CFA) after accidental arterial puncture, during a phlebotomy for blood sample. The lesion was surgically resected and arterial continuity restored by end to end anastomosis. The postoperative course was uneventful.

Kawasaki Disease (KD) is a vasculitis with multi-organ involvementof unknown etiology; it is the most common cause of pediatric-heart diseases in developed countries. Treatment with Intravenous Immunoglobulin (IVIG) prevents coronary artery lesions; although there are some IVIG-resistant cases, combination therapy with corticosteroids and IVIG is one of the recommendations for treatment of these cases. The aim of this study was to compare these three options for treatment of Kawasaki Disease and to evaluate their ability to deal with coronary artery complication of Kawasaki Disease.
A prospective cross- sectional study of hospitalized cases of Kawasaki Disease, conducted in pediatric department of Imam Reza hospital, Mashhad-Iran, during 2013 to 2015 (18 months). Based on demographic and clinical data of these patients, children with high risk of unresponsiveness to IVIG therapy (based on Harada score), were determined and treated with IVIG and corticosteroids- combination initially. Follow-up patients for heart complications were 6 weeks.
Twenty five patients (89.2%) out of total 28 hospitalized patients in this period of time who fulfilled diagnostic criteria were considered as complete Kawasaki Disease. Coronary Artery Lesions (CALs) were shown in 4 patients during the follow-up period, with high risk in patients with incomplete presentation (33.3% versus 12%, P The current study showed that IVIG plus intravenous methylprednisolone (IVMP) combination therapy is a safe and effective treatment regimen in prevention of CALs.

Obesity causes depression and undermines mental health in adolescents. It is also related to adulthood diseases and mortality. The current study drew upon an educational intervention to modify some Health Belief Model constructs to preventing overweight and obesity among adolescents.
In this quasi-experimental study 100 boy students recruited from selected boys junior high schools in Isfahan. They were randomly assigned to intervention (n=50) and control (n=50) groups. In 4 training sessions, a nutritionist introduced different types of healthy foods and explained how to consume them. A sports coach also taught how to do physical exercises well in 4 sessions (each one 90 minutes in terms of nutrition and physical activity). Data of pretest and posttest gathered from demographic and a valid questionnaire were fed into the SPSS software, version 20.0 and analyzed using relevant statistical tests.
The independent t-test revealed that, before the intervention, there was no significant difference between the two groups in the mean scores of knowledge, perceived benefits, perceived barriers, physical activity, and nutrition behavior (P>0.05); but, after the intervention, this difference between the two groups was significant (P Considering the positive effect of model base education to improve obesity related life style in adolescents, it seems that planning and implementing these kinds of interventions in schools will be useful to promote healthy life style in students.

The initial years of life particularly the first two years are regarded as the most important brain development period. This study attempted to determine the effect of care package on motor development in 12-month-old infants in Saqqez-Iran.
This study was a clinical trial conducted in 2016 on 70 infants of 12 months of age selected randomly in intervention and control groups in Saqqez-Iran. The care package was taught to mothers of infants in intervention group) by the researchers based on the book "Ages and Stages Learning Activities 0-5 years". These teachings for gross motor, included walking, pulling and pushing the toys, swinging, playing with ball, crawling, etc. and for fine motor skills included building towers, painting, filling a box with household items and emptying it, giving children books, stringing, etc. Motor skills (gross and fine) were measured by Age and Stage Questionnaire (ASQ-2) screening tool before intervention, 4 and 8 weeks after the intervention. Data were analyzed using SPSS version 20.0 software.
In the intervention group, 56.2% and in the control group 51.4% were female, respectively. Results showed that 4 and 8 weeks after the intervention in gross movement, average scores in the intervention group were more than the control group (P = 0.02), and mean score in three times (before intervention, 4 and 8 weeks after the intervention) was significant difference (P = 0.002). Also, for fine movement, results showed that in this area average scores in the intervention group were more than the control group (P=0.02); and the average score was a significant difference in that three times (P=0.01).
Results revealed that the impact of care package in intervention group compared with control group in level of significance led to an improvement in motor skills domain (gross and fine movement) in 12-month-old infants in this study.

The association of hypothyroidism with hypertension is an uncommon phenomenon. Hypertension adds to cardiovascular risk in any population and hypertension due to hypothyroidism is reversible with hormonal replacement. Although there are various case studies exists in adults but such reports are rare in children.

Morning reports, along with clinical rounds and practical tutorials are common, useful, and valuableprocedures in clinical education.This method has standards that play an important role in helping the students in learning, when complete.The purpose of this study was to evaluate the effective items in morning reports of clinical wards of Mashhad University of Medical Sciences.
This cross-sectional study was conducted from October 2016 until January2017inteaching hospitals in Mashhad University of Medical Sciences.The questionnaire in this studyincluded items evaluatingmorning report, based onISO10015Standard, with confirmed reliability and validity.In this questionnaire, 36 items affecting the quality of a morning report were evaluated. The questionnaires were completed by attending the morning report sessions of 18 clinical sections in educational hospitals and examining existing profiles. The obtained data was analyzed by SPSS softwareversion 16.
The results of this study showed that mean time of starting the morning report was 7:54 AM.Percentage of attendance of professors was 50%, assistants 61.1%,interns 77.8%, and externs 77.8%.The case being reviewed was selected by assistantorchiefassistantin 50% of cases based on common diseases; in 28% of cases, based on the patient's condition and according to the severity of the diseases, and in 22% based on the diseases mentioned in the course curriculum.Regarding effective environmental factors, the morning report was held away from the noise in 94.4% of cases, had a black/white board in 88.9%, dataprojectorin94.4% withmean room size of 70 m2.Mean numberof cases introduced at each session was 2.6 cases.In each session, the first presenter was an intern in 77.8% of cases and extern in 22.2% of cases.In none of the sessions, professors of pharmacologyor pathology were present and only in 16.7% of the sessions, radiology professors attended the sessions.
Morning report had a goodcondition in internalandsurgical wards ofteaching hospitals of Mashhad University of Medical Sciences,butis still far fromstandard conditions.Thus,serious measures should be taken to standardize the morning reports in teaching hospitals.