Journal of Pediatric Perspectives
Volume:8 Issue: 75, March 2020

Intracerebral hemorrhage (ICH) is a type of intracranial bleed that occurs within the brain tissue or ventricles. The present study aimed to review the association between ICH and cerebral palsy (CP) in the preterm infants.

In the systematic review, the electronic databases of Medline, Web of Science, Cochrane, EMBASE, and Scopus were systematically searched to find the relevant studies using the main keywords of (Premature OR Preterm OR Premature Infant OR Premature Birth) AND (Cerebral Palsy) AND (Brain Hemorrhage OR Intracranial Hemorrhages OR Cerebral Hemorrhage OR Putaminal Hemorrhage) up to October 26, 2019.

Finally, three studies with 1,730 participants were enrolled in this study. In the first study, results showed no strong association between early brain lesions with subsequent neurological consequences; in addition, the association between chorioamnionitis in intrauterine life was not substantiated with the incidence of brain lesions. In the second study, results showed progression of brain lesions and neurodevelopmental disorders like other previous studies in the follow-up of very preterm (VPT) infants up to the age of two; overall, the preterm infants are at greater risk of brain damage and neurodevelopmental disorders than term infants, independent of risk factors. In the third study, a neurological assessment was performed in the fourth, 8th, 12th, and 18th months to detect the function of the neuromotor system and CP, with higher degrees of cerebral hemorrhage associated with a higher prevalence of neurodevelopmental defects.

Cerebral hemorrhage is considered a very important pathologic factor in preterm and low birth weight infants, which is associated with irreversible consequences of neurocognitive development.

"Killing men, shooting them, slaughtering children, raping women, burning and looting houses" these are only some human rights crimes that occur against Muslims in Myanmar but up to now, none of the international community has made a substantial contribution. In 2001, International Law Commission realized that the UN charter did not have much success in overcoming human rights violations, so a new concept for human law intervention called Responsibility to Protect (R2P) was invented. The central subject was "the idea that sovereign states have a responsibility to protect their own citizens from avoidable catastrophe- from mass murder and rape, from starvation- but, when they are unwilling or unable to do so, that responsibility must be borne by the broader community of states". Therefore, in its simplest and most widely accepted formulation, Responsibility to Protect (R2P) represents the responsibility of governments and the international community to protect populations from genocide, war crimes, ethnic cleansing, and crimes against humanity. According to a senior U.N. official, "Burmese authorities are carrying out a campaign of ethnic cleansing against the Muslim minority in Myanmar" which is one of the subjects covered by R2P. The purpose of writing the article is explaining the rules in International Commission on Intervention and State Sovereignty, R2P, answering the question of how the international community can intervene in reducing the disaster occurring in Myanmar, and using Responsibility to Protect (R2P) in overcoming the tragedy of the killing of Muslims in Myanmar.

 Successful weaning of the ventilator is a major challenge, especially in children. This study was conducted to compare the criteria of readiness for extubation and daily spontaneous breathing test (SBT) on the duration of mechanical ventilation and extubation failure rates.

This randomized clinical trial was conducted in the pediatric intensive care unit (PICU) of a teaching hospital (Imam Hossein Hospital) in Isfahan, Iran. Overall, 68 patients were assigned into two groups of equal number. In the intervention group, if all the readiness criteria were met the spontaneous breathing test (SPONT/PSV) was performed, and the tracheal tube was removed if the test was successful. In the control group, extubation was performed based on the physician's clinical judgment. Duration of mechanical ventilation and extubation failure rates were compared between groups.

The percentage of extubation failure was higher in the control group than in the intervention (26.4% vs. 11.7%, respectively, P=0.04). The two groups were not significantly different in terms of the percentage of reintubation (11.7% vs. 5.8%), and only the percentage of using noninvasive mechanical ventilation (NIMV) was higher in controls (14.7% vs. 5.8%, respectively, P=0.05). No significant difference was observed between the two groups in terms of the median duration of mechanical ventilation in patients with successful extubation (P=0.12). Likewise, the long-term outcomes, i.e. the length of stay in PICU and hospital were not different in the two groups (P>0.05).

According to the results, daily SPONT/PSV test reduce extubation failure more than physician's clinical judgment in pediatric population. However, type of extubation protocol did not affect mortality, the duration of mechanical ventilation and stay in the PICU.

Sickle cell nephropathy is a major cause of morbidity and mortality in sickle cell anaemia (SCA). Proteinuria contributes to progression of renal damage. Icroalbuminuria is an early feature of SCN and progression to advanced kidney damage is delayed if regression is achieved with angiotensin converting enzyme inhibitors. We aimed to determine the effect of Lisinopril on microalbuminuria in children with SCA.

In this single-blind, two parallel-arm, placebo-controlled randomized trial study, 170 children aged 1-18 years with SCA and microalbuminuria were randomized into intervention and placebo groups using simple random sampling technique. The intervention and placebo groups received 0.1 mg/kg/day of Lisinopril and 100 mg/day of Vitamin C, respectively and were followed up for 3 months. Microalbuminuria and GFR were determined at baseline, 1, 2, and 3 months. Data were analyzed using SPSS software version 23.0.

The mean baseline microalbuminuria was 134.2±72.5 mg/g in the intervention group and 107.6±58.0 mg/g in the placebo group (P= 0.009). The mean baseline GFR in the intervention and placebo groups were 122.0±35.6 ml/min/1.73m2 and 121.0±35.6 ml/min/1.73 m2, respectively. There was a significant regression of microalbuminuria in the intervention (84.6%), similar but higher than the placebo group (62.5%) at the end of 3 months’ study. The mean GFR after 3 months on treatments was 115.4±26.3 ml/min/1.73 m2 and 117.0±33.9ml/min/1.73 m2 (p=0.055) in the intervention and placebo groups, respectively. 

Lisinopril causes significant regression of initial microalbuminuria in children with SCA.

Due to the low knowledge and practice of parents in the therapeutic care of sick children and the importance of blended instruction in families, we aimed to determine the effect of blended instruction on improving knowledge and practice of parents of children with chronic kidney disease (CKD) in the therapeutic care of children.

In this quasi-experimental study, 42 parents of children with CKD participated, who were referred to the Nephrology Clinic of Abuzar Children's Hospital in Ahvaz, Iran were selected and randomly divided into two equal groups of interventional and control (n=21). First, both groups completed the demographic questionnaire, the parental knowledge questionnaire about CKD, and Family Assessment Device. For the intervention group, the researcher performed blended educational intervention including lecture, educational videos, and compact discs for 4 sessions of 90-minutes, whereas no educational intervention was carried out for the control group. Data were gathered one month after educational intervention and analyzed using SPSS software version 22.0.

There was no significant difference in the mean scores of parental knowledge (p = 0.38), and in the mean scores of general family practice (p=0.75) between the two groups before the intervention; while after the intervention, there was an essential difference in the mean scores of the parental knowledge and general family practice between the two groups (p<0.001). However, there was no significant difference in the knowledge and practice domains before and after the intervention in the control group.

Blended Instruction can be used as an effective way to increase knowledge and practice in parents of children with CKD in the therapeutic care of children.

Increased metabolic rate of hyperglycemia in gestational diabetes causes macrosomia, which can also affect the fetal heart. The thickness of the walls of the heart and its function in women with gestational diabetes mellitus (GDM) can change over time before treatment. We aimed to evaluate fetal cardiac structure in terms of ventricular wall thickness and its function in women with GDM and normal pregnancy for indirect evaluation of the effects of hyperglycemia on the heart.

In this case-control study, pregnant women who referred to Imam Khomeini hospital, Ahvaz, Iran that had normal ultrasound anomaly scan between the ages of 18 to 22 weeks; in 26-28 weeks of pregnancy using 3-hour glucose tolerance test, based on the results were divided into two groups of gestational diabetes (cases, n=45), and normal (control, n=48 group). Fetal echocardiography was performed between the ages of 28 to 32 weeks and the thickness of the ventricular and inter-ventricular septum and the shortening fraction were compared.

Ninety-three pregnant women were participants. The mean age of the subjects was 26.33+ 4.88 years. There was a significant and direct relationship between right ventricular wall thickness, left ventricular thickness and intra ventricular septum, besides, right ventricular fractional shortening increased significantly in the diabetes group compared to the normal pregnancy group (P< 0.05); however, there was no significant difference in left ventricular function between the two groups.

Based on the results, significant increases in the right ventricular wall thickness, left ventricular thickness and intra ventricular septum, as well as right ventricular fractional shortening; which points to the importance of fetal echocardiography in GDM.

Breast engorgement is a common postpartum problem that has been identified as the third maternal factor that leads to a decrease or discontinuation of breastfeeding and breast abscess. Considering the side effects of chemical drugs during lactation, the aim of the present review study was to investigate the effect of non-pharmacological treatments on reduction of breast engorgement in breastfeeding women.

The search process was to find the clinical trials regarding the correlation of preterm infant weight with aromatherapy on different electronic databases, including Cochrane, Web of Science, EMBASE, Scopus, and Medline (via PubMed). No time and language restrictions were considered in this study.

According to the results, a significant decrease was seen in breast severity of engorgement in hollyhock compress (p<0.001); in a study, Ginger compression group was more effective than control group (p<0.001). In addition, the herbal compress was more effectiveness than hot compress groups. In another study, the cabbage leaves and gel packs groups reduced significantly in pain compared to the control group,  In a study, Intermittent compress (hot and cold) was more effective than acupressure in decreasing the intensity of breast hyperemia in lactating women.  Some studies showed that cabbage is beneficial on breast engorgement and some studies did not find any significant difference between studies.

Hollyhock, Ginger, Herbal compress and Cabbage leaves were effective for treatment of breast engorgement in Lactating women.

Entrepreneurship education seeks to provide students with the knowledge, skills and motivation to encourage entrepreneurial success in a variety of settings. The present study has been developed with the aim of designing a Competency Model for Educational Employee Students and Graduates in Management and Educational Planning.

This is a mixed (qualitative and quantitative) and applied research. Statistical population of the research in the qualitative d graduates of Psychology and Educational Sciences have been selected as the ssection consists of 23 Professors, entrepreneurs, and graduates of Psychology and Educational Sciences through purposeful sampling. In the quantitative section, 125 professors, entrepreneurs anample, using Morgan Table and through available sampling method. In addition, Delphi method in the qualitative section, and structural equations in the quantitative section have been used for information analysis.

Qualitative results showed that in this research, 6 main competency titles and 42 subordinate competency titles have been identified for entrepreneurship in educational sciences, and the results of quantitative section confirmed these competencies through structural equations. Research results also showed that competency in learning management and human resource development and policy making and professional management of educational business and learning have been of greater importance than other competencies in success of an entrepreneur in the field of educational sciences.

Based on the results, the framework suggests that one's system should include skills, knowledge, and attitudes that are the constituents of learning behaviors within a range that facilitate the development and use of such behaviors to lead to optimal learning outcomes.

Breastfeeding is the best food for infants. Prolactin is combined with the corresponding receptors on the alveoli that produce milk, and milk production begins. We aimed to review the effect of fennel and black seed on breast milk, prolactin levels and anthropometric index in human and animal samples.

After selecting the keywords related to the research question, searching of the online databases (Medline, EMBASE, Scopus, Web of Science, SID and Magiran) were done. After reviewing the retrieved studies based on the title, abstract and full text, and related articles were selected according to the inclusion criteria.

Ten studies were included into review. One study indicated the arousal serum levels of prolactin in lactating mothers using fennel. Four studies showed the fennel as alone or embodied in the herbal tea can increase breast milk. In contrast to the above four studies, a combination of fennel, anise, cumin, dill, parsley and fennel flower had no effect on breast milk volume and neonate weight gain.Two studies inspected the effects of fennel in animal studies. Although 140 and 280 μL doses of fennel have significantly increased prolactin in comparison with 35 and 70 μL g doses, this increment is not sufficient to increase breast milk and, subsequently, to elevate neonates weight with fennel to dairy goats have enhancement and reduction effect, respectively on performance and negative energy balance in early lactation. In another study, black seed improved milk production in cows, while it did not change composition of milk and prolactin.

Based on the results, fennel is recommended to increase breast milk, prolactin levels in lactating women.

Atrial myxomas are uncommon in the pediatric population but are very important due to pursuant atrioventricular valve obstruction and systemic embolic events. Concerning multiple symptoms ranging from congestive heart failure to neurological deficits, the diagnosis of this disease is complicated. This paper reports a case of left atrium myxoma in a child treated with a surgical excision of the tumor. Surgical excision appears to be curative, as shown in postoperative echocardiogram of this patient. To be precise, an immediate and timely diagnosis of myxoma by echocardiography, allowed the immediate surgical treatment of this rare, benign but potentially lethal cardiac tumor.

Vitamin D is a fat-soluble vitamin that has an important function in bone metabolism, muscle activity, nervous system, and immunity. In this study, we compared the vitamin D level of children with congenital heart disease (CHD) with healthy control.

This case-control study was conducted on 56 children with CHD diagnosed with echocardiography and 56 healthy children with no sign of CHD matched for age, sex, and use of vitamin D supplementation. Participants were gathered from those who referred to the cardiac clinic of Vali-e-Asr hospital, Birjand, Iran, in 2017. Two ml of the blood sample was taken from all participants and serum vitamin D was assessed using Roche Diagnostic kit (Germany). The data analysis was achieved using SPSS software version 16 with descriptive statistics and Chi-square test.

The median age of participants was 7 months (ranged1-24). The mean vitamin D serum level of all participants was 32.19 ng/ml (SD=28.79) (normal > 20). The level of vitamin D in the case and control group was 16.82 ng/ml (29.85-9.38), and 34.95 ng/ml (46.60-26.52), respectively; and this difference was significant (P<0.05). In the CHD patients group, 15 patients had vitamin D deficiency and 5 patients had high vitamin D levels. In the healthy patients’ group, these numbers were 2 and 21, respectively.

Based on the results, children with CHD had significantly lower levels of vitamin D; therefore, we suggest more vitamin D supplement be used for patients with CHD than healthy children.

The colicky infants generally present around 6–8 weeks postpartum then then is suddenly relieved by 3-4 months. A few studies assessed the effect of fennel on colicky infants. The aim of this systematic review and meta-analysis was to assess whether fennel is effective on infantile colic.

Two independent authors separately searched the articles on the national (Irandoc, Magiran, Medlib, SID, and Barakatkns), and the international databases (Medline, EMBASE, Web of Science, Scopus and Cochran Central Register of Controlled Trials) without any time limitation since the inception to August 2019. The keywords of the search were: (Colic) AND (Foeniculum OR Fennel OR Foeniculum vulgare) AND (Infant OR Children OR Baby).

Four studies were conducted to assess the impact of fennel on the infantile colic. A Foeniculum Vulgarein in combination with other herbal medicines was found to be more effective than control group on crying time on infantile colic (SMD= O.708; 95% CI= -0.951 to -0.465; P<0.001). Heterogeneity was 0% and non-significant. According to one study, in the 3rd and 7th days of the treatment in comparison with the previous times, both the fennel group (P = 0.004, P=0.05, respectively), and the gripe water group (P = 0.037, P=0.002, respectively) indicate the statistically significant difference. Moreover, none of the infants cried for more than 2 hours in the two groups. After treatment, an insignificant difference between the two groups (fennel and gripe water groups) was observed.

Fennel alone or in combination with other herbal medicine is effective on infantile colic. Concerning the high heterogeneity, there is a need of future trials to reach a certain conclusion.