Caspian Journal of Pediatrics
Volume:6 Issue: 2, Sep 2020

Asthma is one of the most common persistent inflammatory respiratory disorders. Comorbidities are relatively common in asthma. The aim of this review study was to find comorbid disorders in children with asthma.

For the purpose of this review, we searched databases including Scopus, Google scholar, PubMed, SID, Irandoc and up-to-date. Key words for the search included children asthma, comorbidity and pediatric asthma. There were no time limitations for the search. Full text articles in English language were included in this study.

Neuropsychiatric comorbidities were Attention-deficit/hyperactivity disorder (ADHD) (11.5%), oppositional defiant disorder (ODD) (10.7%), separation anxiety disorder (6.1%), social anxiety disorder (3.8%), specific phobias (2.3%), agoraphobia without panic (1.5%), (mild) manic episodes (1.1%), major depressive episodes (MDE) (0.8%), movement (tic) disorder (0.8%) and dysthymia (0.4%). The prevalence of sinusitis was 13% in children with asthma (17). Prevalence of asthma in chronic rhinosinusitis with polyposis (CRSwP) is 26-48%, but the prevalence of CRSwP in asthmatic patients is only 7%. Asthma was prevalent in 25-35% patients with allergic rhinitis, and rhinitis symptoms were present in 75-90% of asthmatic patients. Asthma and obstructive sleep apnea (OSA) commonly coexist. Snoring (49.5%), gastro-esophageal reflux disease (GERD) (46.3%), atopic dermatitis (27.3%), allergic sinusitis (20%) and food allergy (10.5%) were common in children with asthma.

Our review has revealed that allergic rhinitis, gastroesophageal reflux, obesity, food allergy, obstructive sleep apnea, allergic conjunctivitis, chronic rhinosinusitis and psychological abnormalities are common comorbidities in children with asthma.

Pneumomediastinum (PM) is caused by alveolar rapture. If air leak persists, subcutaneous emphysema occurs. The PM and subcutaneous emphysema have various etiologies. Common causes are respiratory tract infections and asthma exacerbations. Rarely, the PM occurs secondary to foreign body aspiration, and the life-threatening complications will occur without proper treatment.

Case report: 

we report a 2.5- year- old boy who was presented with cough, fever, neck swelling and respiratory distress to Amirkola Childrenchr('39')s Hospital. On examination, he had subcutaneous emphysema (SCE) in neck and upper thorax. He had pneumomediastinum in radiography. The patient was treated with oxygen, antibiotic, and due to the suspicious history of foreign body aspiration he underwent bronchoscopy by which pieces of nuts removed from his right main bronchus.

PM and SCE are rare presentations of foreign body aspiration and in such circumstances, the possibility of foreign body should be considered.

Levamisole is an anthelmintic drug used in the treatment of patients with a diagnosis of steroid-dependent nephrotic syndrome. Skin rash has been reported as a drug side effect, but adverse events are really rare.

Case report: 

The case presented in this article was a 14-year-old boy with steroid-dependent nephrotic syndrome, treated with levamisole due to frequent relapse. He was admitted with rash, weakness, fatigue, fever, and weight loss. Levamisole was discontinued, and the patient’s condition improved in the following two weeks. One year later, the nephrotic syndrome relapsed, and he received prednisolone and levamisole. He was admitted to the hospital six months after re-administration of these drugs because of vasculopathy, and unfortunately, he died due to disseminated intravascular coagulation (DIC).

Although levamisole is a suitable and cost-effective therapy for remission maintenance in steroid-dependent nephrotic syndrome, it is highly recommended to discontinue the drug without re-administration in case of reoccurring adverse effects, especially skin rash and systemic reaction, in addition to close monitoring of the patients under treatment.

Anxiety disorder is the most common type of psychiatric disorders in children. The aim of this study was to compare two anxiety-prevention programs including FRIENDS for Life (FFL) and Coping Cat (CC) for anxious male children.

This quasi-experimental study was performed using pre- and post-tests with two experimental and control groups. The population of this study included primary schoolchildren in District 5 of Tehran in 2019. Totally, 45 students aged 8 years were selected from 5 schools by cluster random sampling and were randomly assigned into 3 groups of 15. The two experimental groups participated in the one-hour therapy sessions of FFL and CC programs on a weekly basis. The Spence Childrenchr('39')s Anxiety Scale (SCAS, 1998) was used to collect research data. Data were analyzed using multiple analysis of covariance (MANCOVA) via SPSS 24.

The results showed that both FFL and CC programs were effective on preschool childrenchr('39')s anxiety (F=16.46; P=0.001). However, this effectiveness was not found in control group. Moreover, by examining the pairwise comparison between the effectiveness of the FFL and CC programs, it was observed that the FFL was more effective than the CC for the anxiety of preschool children. The value of Eta coefficient indicated the effectiveness of FFL in all subscales.

Anxiety-prevention programs including FFL and CC have been effective in reducing childrenchr('39')s anxiety. Hence, the application of these two interventions in schools helps anxious children to gain a deeper understanding of their various emotions and feelings to reduce their anxiety.

More recently, gender differences in risk behaviors are less common for females than males to exhibit high-risk behavior. The aim of this research was to predict high-risk behaviors based on the psychological motives in female teenagers.

In this cross-sectional study, all high school students in the academic year of 2019-2020 in Shiraz, Iran were the statistical population of the current report. Using the convenience sampling method, a sample of 180 people was selected from this statistical population. The Iranian Adolescent Risk-taking Scale (IARS) and Scale for the Motivation of Risk-taking Activity (SBM) were used to measure the studied variables.

Age range in this study: 15-18 years old, M=15.50, SD=1.40. As the findings revealed, the values of β and t indicated that the motivation for excitement (β=0.346; t= 3.317; p=0.001) and for irresponsibility (β=0.202; t=1.975, p=0.05) played the most pivotal role in predicting the tendency to use narcotics, respectively. In addition, the values of β and t also demonstrated that motivation to seek excitement (β=0.351; t=3.412; p=0.001) played the most important role in predicting teenage girlschr('39') tendency to drink. Finally, irresponsibility (β=0.207; t=1.972; p=0.05) and accounting (β=-0.191; t=-2.094; p=0.038) had the most important role in the prediction of smoking tendency variable, respectively.

The findings showed that the emotional and unhealthy motivations had the most pivotal role in predicting female adolescentschr('39') tendency to use drugs. Moreover, emotional motivation played the most important role in predicting the tendency of teenage girls to use alcohol.

The reasons for the failure of exclusive breastfeeding (EBF) in the world are different and it changes over time. The aim of this study was to determine the frequency and causes of failure of EBF in infants in Babol, North of Iran.

This cross-sectional study was performed on infants referred to the health care centers affiliated by Babol University of Medical Sciences for 6-month age vaccination. Inclusion criteria were parental satisfaction, 6-month infant and lack of infant’s congenital anomalies. Mother and infant’s demographic information and breastfeeding outcomes were completed by mother’s self-declaration. A 4-option question was asked of the mother regarding infant nutrition including breastfeeding only, formula feeding only, relative formula feeding and relative breastfeeding. Descriptive and analytical indicators were used for data analysis.

Totally, 371 infants with the mean birth weight of 3265.82±514.19 g were entered into the current study. Most of them (72.2%) used at least one of the following cases: pacifier, bottle, sugar water or complementary feeding during the first 6 months of life. According to these results, the rate of failure in EBF was 72.2%. Based on the 4-option question on exclusive breastfeeding, 63.6% of infants had exclusively breastfed. Regression analysis was shown that the maternal age (p=0.012) and gestational age at birth (p=0.039) were predictors of EBF discontinuation.

In the present study, the rate of failure in EFB was 72.2%. The most common cause of failure in EBF was the uses of pacifier, bottle and sugar water which was occurred due to the lack of awareness of mothers. Moreover, the maternal age and gestational age at birth were effective factors of EBF. The EBF can be improved by planning in educating and supporting mothers, especially in cases where there is preterm delivery.