International Journal of Pediatrics
Volume:9 Issue: 94, Oct 2021

The need to care for premature infants causes a lot of anxiety and stress in their mothers. This study aimed to compare the effect of kangaroo mother care and Preterm infant massage on pain score, stress, anxiety, depression, and stress coping strategies of their mothers. This double-blind three-group clinical trial study was conducted in Bahar Hospital in Shahroud, Iran, in 2019. 90 Mothers with preterm infants were assigned randomly to one of the three groups. Each group consisted of 30 mothers. The massage group received three 5-min massages each day for five consecutive days. In the Kangaroo Mother Care group, the baby remained in skin to skin condition for at least 15 minutes or more during five consecutive days. The control group received only routine care in the neonatal intensive care unit. Data in all three groups were collected before and after the interventions using the Coping Responses Inventory for Adult (CRI-A), the Depression, Anxiety, Stress Scale 21, and Neonatal Infant Pain Scale. The Paired Sample T-Test revealed that the mean score of infant pain in both intervention groups before and after the intervention was statistically significant (P<0.001). The ANOVA test and The Paired Sample T-Test also showed that the mean scores of depression, Emotion-focused coping, and problem solving-based coping in mothers in all three groups, were significantly different before and after the intervention (P<0.001). Kangaroo mother care and massage can reduce the pain in preterm infants, as well as the level of anxiety, depression, and stress of mothers; and increase the strategies to deal with stress in mothers. Due to the high prevalence of birth trauma in infants in Iran, therefore, interventions are recommended to reduce it. Further studies on the factors affecting it need to be done to appropriate interventions to reduce it

Due to the importance of neonatal health, this study was performed by systematic review and meta-analysis with the aim of determining the prevalence of birth trauma in neonates in Iran. This systematic review and meta-analysis study was conducted according to the PRISMA’s checklist items. This study reviewed the articles published in Iran between 2000 and the beginning of July 2020. In this article, PICO indicators were used. Search in national databases in Iran(Scientific Information Database (SID), Iran Medex, Mag Iran, Iran Doc) and international databases(Scopus, PubMed/Medline, Embase, Web of Science (ISI), Cinahl, ScienceDirect) with keywords: Infant, Newborn, Birth Injuries, trauma, was done. The search was performed by two researchers. Data were analyzed using CMA software In this systematic review and meta-analysis study the total sample size of neonates in 9 studied articles was 42327 neonates. Also 9 articles had the necessary criteria to enter this systematic review and meta-analysis. Also, the overall prevalence of Neonatal birth trauma is 2.7% (95% CI [1.3, 5.3]), the prevalence of asphyxia in infants is 0.03 % (95% CI [0.02- 0.04]), the prevalence of brachial plexus paralysis is congenital. In infants equal to 0.02% (95% CI [0.01- 0.06]), the prevalence of congenital fracture in infants equal to 0.03% (95% CI [0.01- 0.08]), the prevalence of congenital injury in infants was 0.02% (95% CI [0.00-0.75]) and the prevalence of soft tissue injury at birth in infants was 0.02 % (95% CI [0.02- 0.03]). Due to the high prevalence of birth trauma in infants in Iran, therefore, interventions are recommended to reduce it. Further studies on the factors affecting it need to be done to appropriate interventions to reduce it.

As a tropical disease, malaria, which causes one death per minutes globally, is still common in both tropical and subtropical regions around the world. From millions of reported cases, one million cases would end in death each year. 

Different databases and search engine, including PubMed and Google Scholar, were investigated to collect required data for the completion of the present review article by two participations authors. The following keywords were used for search in these databases Malaria in Children, Plasmodium Falciparum in Children, Malaria in Paediatrics, and Plasmodium Falciparum in Paediatrics. 

47 study in English was included. Children under five years old make the majority of death reports; i.e. 90% of the whole death statistics. Although malaria is mostly common in sub-Saharan Africa, it still occurs in other tropical and subtropical countries. In other regions, malaria is the result of both immigration and travel; regardless of the sources of the disease, it can be potentially severe and, sometimes, fatal. 

It would be important to become familiar with the clinical presentation of malaria among pedestrians and find approaches to prompt diagnosis, appropriate treatment and sufficient prevention methods against malaria among pedestrians.

In children with lymphoblastic leukemia (ALL), cancerous metastasis to the central nervous system (CNS) is common, but there is insufficient information on this metastasis and cancer progression process. Further, the role of exosomes on cancer growth and metastasis has been the attention of many studies. Because the astrocytes involve in the blood-brain barrier and stay in contact with peripheral blood , we investigated the effect of exosomes derived Nalm6 cell line on astrocytes from human brain fetal tissue.     In this in vitro study, exosomes were isolated from the supernatant of Nalm6 cell line by centrifugation and identified by DLS, AFM and FE-SEM methods. Astrocytes were isolated from human fetal brain tissue cells and expanded and identified by GFAP antibody with immunocytochemistry. Astrocytes were treated with different concentrations of exosomes (i.e., 5, 10, 30, and 50 µg/ml),. Proliferation and migration were assessed with Trypan blue staining and scratch methods, respectively. To define tumorogensis changes in astrocytes treated by exosomes, the expression of MMP9, P53, and Cox2 genes were investigated by Real-Time PCR. According to the DLS results, the size of exosomes was about 43 nm. AFM and FE-SEM imaging indicated these exosomes have a spherical shape. Our results showed that the proliferation of astrocytes significantly increased when treated with 50 µg/ml of exosomes.Therefore, the concentration of 50 µg/ml was considered for further experiments. Astrocyte migration was significantly increased compared to the control group. Finally, our results showed tumorogenesis changes in astrocytes by increasing the expression of MMP9 and Cox2 and decreasing the expression of p53 at mRNA level. Based on our in vitro study, exosomes derived from ALL as a peripheral tumor can change the behavior of astrocytes as a target for metastasis. Further investigations on this topic are warranted to shed light on metastatic mechanisms.

The aim of this study was to investigate the effect of sleep pattern modification on increasing academic self-efficacy of sixth grade students in Kerman.

Quasi-experimental research method of pre-test-post-test with the control group and the study population including all female students studying in the sixth grade of elementary school in Kerman in the academic year 1399-99 was 2950 people and 40 people who had the highest score in Sleep Disorders for Children (SDSC) were willing to collaborate with the researcher. Samples were selected and randomly assigned to two groups of 20 (20 controls, 20 experiments). Then the experimental group participated in sleep pattern correction training sessions for 6 weeks, 1 day per week and each session for 45 minutes and the control group did not have any counseling or treatment during this period after the end of the treatment period in both groups. Post-test was taken. The instruments used in this study included the Sleep Disorders for Children (SDSC) questionnaire and McClellow and Banting (2002). Analysis of covariance (ANCOVA) was used to analyze the hypotheses.

Findings showed: sleep pattern modification has a significant effect on students' academic self-efficacy and the coefficient of effect of sleep pattern modification on academic self-efficacy was 0.489.

Sugar-Sweetened Beverages (SSBs) are one of the rich sources of calories from the diet, without having proper nutrients, and excessive consumption of these drinks can have adverse effects on the health of the individual and society. The purpose of this study was using the social cognitive theory (SCT) and perceived barriers structure to explain the adoption of preventative behaviors to consume SSBs among secondary school students. This cross-sectional study was conducted on 607 secondary school students selected using multi-stage cluster sampling. Data collection instrument was a questionnaire including students' characteristics; students' beliefs toward SSBs based on the SCT and  perceived barriers; Preventive behaviors and the amount of daily consumption of SSBs. The collected data were analyzed using descriptive and analytical tests, Pearson’s correlation coefficient and linear regression in the SPSS (version 25.0). The results showed that the average age of the participants was 13.92 ± 0.78 years. The amount of SSB use among students was unsatisfactory (3.49 glasses per day). In addition, the findings indicated that students' self-regulatory, perceived social support, perceived barriers and self-efficacy (p <0.001) had a statistically significant association with Adopting preventive behaviors  to reduce consumption of SSBs, and those constructs explained 40% of variance of students' Adopting preventive behaviors. Among the variables related to the SCT and  perceived barriers, self-regulatory, perceived social support, perceived barriers and self-efficacy were effective factors on students' Nutritional Performance toward consumption of SSBs. Hence, by using the present findings, health care providers can plan, implement and evaluate suitable interventions to reduce the consumption of SSBs in students.

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases caused by a deficiency in adrenal enzymes that lead to changes in cortisol and aldosterone levels. This study aimed to assess the bone mineral density of the spine and femoral head in children and adolescents aged 5 and 20 years, suffering from different types of congenital adrenal hyperplasia and treated with corticosteroids and to study the associated factors. We studies 44 patients, 26 girls and 18 boys, who were treated with corticosteroids with a physiological dose of 15-20 mg/m2 since infancy. A questionnaire was completed by patients and their parents admitted to the Endocrinology Clinic of Imam Reza Hospital of Mashhad. The patients' bone density was then measured, and the association with different factors, such as age, gender, height, weight, type of CAH, type and duration of receiving corticosteroids, the 17-hydroxyprogesterone level, bone activity markers, vitamin D level, and puberty stage, was analyzed, using SPSS software. No significant correlation between the bone density level and variables such as the duration and dose of corticosteroid consumption, age, sex, time of diagnosis, 17-hydroxyprogesterone level, calcium, and phosphorus, was found. Other variables such as height, weight, puberty stage, and vitamin D levels were found to play a significant role in determining the bone density level. It is highly recommended to consider the side effects and complications when starting treatment with corticosteroids in patients with CAH. Bone densitometry should regularly be done, osteoporosis prophylaxis should be considered using weight-bearing exercises and calcium and vitamin D supplements, and the level of vitamin D should be monitored.

Asthma is the most common chronic disease in childhood and cause of hospitalization.Intravenous magnesium sulfate is recommended as a complementary therapy for asthma exacerbation.This study investigate the effect of oral magnesium sulfate on moderate and severe asthma exacerbation in children.  This double-blind clinical trial was performed on 40children 5-12 years old with asthma exacerbation who referred to Pediatric Emergency Department of Quaem Hospital in Mashhad, Iran. Patients were randomly assigned into two groups , received magnesium sulfate (300 mg every 12 hours) or placebo capsules for 5 days. Asthma severity score based on Siriraj clinical asthma score (SCAS) contained in the questionnaire was recorded for each patient at 0, 2, 6, and 24 hours after first visit, and then daily up to 5 days. The patients were divided into three groups by researcher: A(Mild) :0-8, B(Modrate):8-16, C(Severe):16-24.  The mean age of subjects was 8.20 ± 2.49 age and mean weight was 26.32 ± 8.65 kg. Classification of asthma severity in the magnesium group included 5 patients in A, 14 in B and 1 in C and in placebo group 8 in A,8 in B and 4 in C .The present study, controlling the effect of weight as a covariate, didn't indicate a significant effect of oral magnesium sulfate on asthma symptoms in 5-12 years old children (P=0.15); however, after considering the severity variable as moderator, indicated a minor effect on symptom improvements in B score.  Adminstration of oral magnesium sulfate Within 5 days, didn't improve asthma exacerbation in5-12 years old children.So, more studies with different dose and duration are needed to determine efficacy of oral mgso4 in asthma exacerbation.

Maternal cardiac disease has a significant impact on fetal health and increase the risk of neonatal complications. This case-control study was conducted to determine the prevalence and risk factors of fetal and neonatal morbidities of mothers with cardiac disorders. In this retrospective case-control study, all pregnant mothers with underlying cardiac diseases, from March 2012 to September 2017, referred to Imam Khomeini Hospital were enrolled in the study through convenience and sequential sampling. The case group included 100 pregnant mothers with cardiac diseases and the control group comprised 200 expectant mothers without any cardiac diseases. Neonatal and maternal complications were investigated respectively. The mean age of mothers was 35.44 ± 4.52 years in the case group and 32.04 ± 4.92 years in the control group. Type of delivery, place of delivery, hospitalization ward, maternal age, gravidity, and gestational age were significantly different between the two groups (P = 0.001), as were neonatal weight, gestational age, 5-min Apgar score (P = 0.001), and 1-min Apgar score (P = 0.005). Need for resuscitation and respiratory distress were significantly higher in cases (P = 0.001). This study found that investigated complications were more frequent in neonates of mothers with heart diseases. Detection of these complications can improve the outcomes in these neonates.

Individuals with cleft lip and palate (CLP) experience a number of dental anomalies, which affected on the patient’s facial anatomy and self- esteem. Dental complications are considered as a contributing factor in cleft formation. The purpose of this study was to evaluate the prevalence of various kinds of maxillary dental anomalies in group of children with CLP in city of Sari, Iran. This cross-sectional study was performed to evaluate the panoramic radiographs of 84 patients (age 7-19 years-old), with CLP who were selected by census method and attended private and public dental and/or orthodontic clinics in Sari during 2020- 2021. The frequency of maxillary dental anomalies including hypodontia, microdontia and macrodontia, ectopic eruption, rotation and supernumerary tooth were examined by orthodontist and radiologist. Standard Pearson chi-squared tests were used for all dental anomalies. Data were analyzed using SPSS software through the Mann-Whitney and chi-squared tests. At least one maxillary dental anomaly was reported in 83.3% of patients with CLP. The unilateral CLP (61.9%) was the most common type of cleft. The tooth agenesis was observed in 63.09% of subjects with more frequently on the left side (35.7%) followed by rotation (35.71%), microdontia (34.5%), supernumerary teeth (11.9%), and macrodontia (5.9%). No difference in gender was observed in the prevalence of these anomalies. According to our resultsthemostprevalent cleft types was UCLP with left side predominance. Hypodontia, rotation and microdontia, were the most prevalent developmental dental anomalies among children with CLP in Sari, Iran.

Emotional eating has already been linked to certain predictors and correlates. So, the aim of this study was to determine the effectiveness of mindfulness and diet training on psychological flexibility and self-regulation behavior in overweight adolescents.

The present study was an applied and semi-experimental pretest-posttest design with control group. The statistical population of this study included all female adolescents of the first high school in Tonekabon, Iran, who were studying in the academic year of 2018-2019, among which 30 students were selected by multistage cluster sampling method using random sampling method in two groups of mindfulness training (n=15), and control group (n=15). Data were collected using The Brawan et al. Self-Regulation Questionnaire (1991), Bond et al.'s The Acceptance and Action Questionnaire (2011) in two periods before and after the mindfulness intervention. Data were analysed using SPSS software version 22.0.

According to the results of covariance analysis of mindfulness training showed on mental flexibility that mindfulness training was effective on mental flexibility of overweight adolescent girls with F = 161.47 and P <0.005. Moreover, these results showed that mindfulness training has been effective on mental flexibility of overweight adolescents with F = 376.28 and P <0.005.

Based on the results, mindfulness training is effective in improving mental flexibility and self-regulatory behavior in the tendency of overweight adolescents in the first year of high school with a body mass index above 21.5 (BMI≥21.5). Therefore, mindfulness training method is an efficient, practical and effective method in improving mental flexibility and self-regulatory behavior and can be used by counselors and therapists to improve mental flexibility and self-regulatory behavior.

Although there was no evidence of vertical transmission at the beginning of the pandemic, this hypothesis has been strengthened over time and there is evidence to support the hypothesis. In the present article, we present a case of Covid- 19 in a newborn from a mother with a recent Covid -19 infection.

The female neonate was born from Normal Vaginal Delivery (N.V.D) in a primiparous 30-year-old woman. Her mother was presented at 36 weeks and complained of fever and cough symptoms. The mother admitted in Taleghani hospital with labor pain without clinical signs of Covid- 19 when she had 39 weeks of G.A. All stages of labor progressed normally based on Friedman Curve and a female neonate with meconium-stained was born. The neonate apgar score dropped gradually  and central cyanosis and tachycardia appeared about 20 minutes after birth. Immediately, laboratory tests, cardiac counseling, and transformation to the Neonatal Intensive Care Unit (NICU) NICU were done. Both moderate to severe Tricuspide Regurgitation (T.R) and positive Reverse Transcription Polymerase Chain Reaction (RT-PCR) Covid- 19 were reported. A set of antibiotic, antiviral, and blood product replacement treatments was prescribed based on clinical signs and laboratory results. On the 28 th day of the birth, the neonate was discharged in good general condition, while his RT-PCR Covid- 19 result was negative.

The vertical transmission of Covid -19 in neonates is possible. Therefore, the health care providers should be considering the important points in caring for these neonates.

  Kawasaki disease (KD) is an acute vasculitis that affects small and medium-sized arteries. During the coronavirus disease 19 (COVID-19) pandemic, a significant increase in children with KD symptoms who had COVID-19 was reported, known as the multisystem inflammatory syndrome in children (MIS-C). We describe 2 cases of KD following the COVID-19.

Two 2.5 and 3.5-year-old boys presented to the Shahid Sadoughi Hospital with weakness, fever, nausea, and vomiting for several days. The other symptoms were maculopapular rash, cracked lips, erythematous palms, conjunctivitis, and lymphadenopathy. Respiratory symptoms were observed in none of them. The course of the disease was moderate to severe in both, and they were treated entirely.

COVID-19 infection in children may present without any respiratory symptoms. Thus, Pediatricians should consider these atypical presentations and not restrict COVID-19 tests only for patients with typical presentations to prevent missing such cases and irreversible complications.

Children's knowledge of dental science is important for their oral health. Picturebooks can aid in teaching children scientific and practical concepts with the use of easy-to-understand pictures. The aim of the present study was to determine an appropriate topic for each chapter of the book  and design the pictures in a suitable manner for 3 to 6 year old children. In this cross-sectional study, a pediatric dentist selected the topic of each chapter and two pediatric dental residents explained the chosen topic to the painter with the help of pictures from reference books. Then, the designed images were modified during 6 months of weekly meetings in Kerman Dental School and in case of more than 90% agreement between the two residents, a pediatric dentist reviewed the images and then the final approval was obtained.In the present picturebook, topics are consistent with pediatric dentistry text books.The book was designed in 18 chapters and 131 schematic images. The pictures in each chapter are based on a particular topic relevant to pediatric dentistry. Each chapter consists of 3-15 images. Harmony in the chosen colors and the image continuity were positive aspects, achieved through the close cooperation between our pedodontist and illustrator.In this research, a book was designed by the research team (pediatric dentists) that tries to answer the common questions of parents about pediatric dentistry and teach children the scientific topics of pediatric dentistry in the form of schematic and storytelling images.

Pictures can be useful in children’s learning processes and strengthen their thinking and imagination. It is possible to teach new concepts to children using pictorial books. The pictorial book ‘Dana and Dentistry’ has been designed by a pedodontist by getting assistance from a painter. The present study aimed to qualitatively evaluate the pictures in this book by a target group, i.e., the preschool children.

This cross-sectional study was conducted in 3 kindergartens in Kerman-Iran in 2019 in order to examine children's views on the images of 18 chapters of the book designed by pediatric dentists "Dana and Dentistry". The children replied to the question on each chapter after viewing the pictures in each chapter of the book on a pictorial checklist by color painting. Multivariate analysis of variance and binomial analysis were used to analyze the data and a significance level of less than 0.05 was considered.

In the present study, 79 children aged 4 to 6 years participated, 48.1% and 51.9% of the children were female and male, respectively. The mean overall score of the 18 questions on the checklist was 16.19 ± 0.18, and the mean correct response to each question on the checklist was >60%, which was significant (P=0.0001).

The pictorial book ‘Dana and Dentistry’ has been designed well from more than 60% of children’s viewpoints to teach various dental subjects to children.

 The picture book "Dana and Dentistry", with practical topics of pediatric dentistry, telling stories for preschoolers as simple line drawings, is in the initial design stage. Parents play a pivotal role in choosing books for offspring. Therefore, parents' correct understanding of illustrations in the book was of great importance. The present study aimed at designing the dental mobile application of "Dana and Dentistry" and evaluating the quality of its illustrations from the parents' perspective. 

In this cross-sectional study, 320 parents with a child under 7 years of age were randomly selected in Kerman, Iran. To check the parents' opinions about the picture book of Dana and Dandan, the "Dana and Dental" application was installed on their mobile phone. One week later, a dental student surveyed the quality of the app's images through a researcher-made questionnaire from parents through cyberspace. Data were analyzed using SPSS software version 24. 

 Of parents enrolled in the survey, 86.25% were female and 13.75% male, with a mean age of 32.51±5.4 years. The subject of book chapters was predictable for more than 90% of participants. The quality score of illustrations was above 9 (out of 10). There was no significant correlation between the qualitative evaluation of illustrations and parental age (P = 0.511), and gender (P = 0.526). 

  The illustrations on the mobile application of "Dana and Dentistry" were clear and expressive from more than 90% of parents' point of view, and they reported this application suitable for their child.

Considerable increase in gut motility after probiotic supplementations consumption is indicated in recent studies. The present study conducted to clarify whether supplementation with Saccharomyces boulardii can palliate the abdominal pain frequency in children with Functional Abdominal Pain (FAP). The present clinical trial was conducted on children referred to the Pediatric Departments of the Emam Khomeini hospital, Ilam, Iran, and Shahid Beheshti Hospital, Kashan, Iran. Finally, patients were randomized to receive either 250 mg oral supplementation with Saccharomyces boulardii supplementation, Zist Thakhmir company, or placebo, twice daily for 3 weeks before the first clinical assessment. The intensity of the symptoms were evaluated using the OUCHER PAIN scale. A total of 104 FAP children with a mean age of 9.51±3.52 years enrolled in the study. 52 of them randomly were assigned to the treatment group and 52 patients were assigned to the placebo group. Statistical analysis demonstrated that treatment with Saccharomyces boulardii was effective in the treatment group after the 1st week of study. (P-value=0.001) To best of our knowledge, our investigation is the first trial which assess a correlation between taking Saccharomyces boulardii and symptoms reduction in FAP children through its probiotic effects. This disorder can be considered as a multifactorial disease which further investigations is needed to figure its risk factors and treatment modalities.

Hearing loss may affect many aspects of a person's life. The age of cochlear implantation (CI) is often considered an important predictor of language skills of children with CI, but little is known about the benefits of early CI on speech intelligibility development in these children. This study aimed to compare language skills as well as intelligibility of speech in prelingual deaf patients who received CI before the age of six years and those who received CI after the age of six years with an 8-year follow-up.

This 8-year longitudinal, retrospective case–control study was conducted in 2021 at a cochlear implant center in Tehran, Iran. Thirty-one patients were included in two groups: late cochlear implant (n = 15), and early cochlear implant (n =16). The Test of Language Development- Primary (TOLD-P3) was used to assess the participants 'language skills. The intelligibility of the participants' speech was assessed through the Persian version of the Intelligibility Context Scale (ICS) and the speech intelligibility rating (SIR).

These two groups did not show a significantly difference in terms of the language scores (P>0.05) but had a significantly difference in terms of the SIR and the ICS scores (P<0.05). Speech intelligibility had a significantly negative correlation with the age of CI (P<0.001), and had a significant positive correlation with language skills (P<0.001).

The long-term outcomes of early and late CI were similar in terms of the development of language skills but too different in terms of the intelligibility of speech. The age of CI had no effect on the language development but had a significant effect on speech intelligibility.

One of the most important factors in maintaining and improving children's health is the quality of diet. The aim of this study was to determine the micro and macro nutrient intakes in children aged less than five years old with malnutrition. The cross-sectional study included 75 under-five children referring to primary health care center in Taft. Children classified in two groups by nutritional status according to a variety of anthropometric indicators. Food intake was assessed using 24 hour food recalls and then was compared to the recommended daily amount (RDA). Anthropometric measures of age, height/length and weight and measurements head circumference were obtained and compared with reference anthropometric indices to assess nutritional status The subjects consisted of 41 boys and 34 girls who were 36 (48%) in the malnourished group and 39 (52%) in another group. The analysis of food intake indicated that most micronutrients were within recommendations, except for calcium, zinc, iron and folate (P<0. 05). The intake of macronutrients, was above recommendations and energy intake was in the general appropriate level. The findings of the study indicated that the appropriate level of macronutrients intake was used and the problem was mainly existed in micronutrients’ consumption. Based on the results we recommended planning for nutrition education program.

The present study was designed to determine association passive smoking with dental caries and cotinine biomarker among 8-12 years old children of Semnan, Iran. This cross sectional study was concocted on two groups of 8-12 years old children exposed (n=100) and non-exposed to passive smoking (n=100) in of Semnan (Iran). The sampling method was two-stage cluster sampling design. The data collection tool a standard checklist consisted of demographic, laboratory and dental characteristics. Examination was performed by a dentist on a dental unit and the dental indicators were measured for two groups. Also, salivary cotinine was measured and recorded using ELISA method by special cotinine kit (De salimetrics medi tec, USA). Univariate and Multivariable Logistic Regression model and area under the ROC curve were used to data analysis by STATA 14 software. Univariate logistic regression model showed a statistically significant difference between the exposed and unexposed groups with passive smoking in term of the salivary cotinine level, age , sex , decayed, missing, and filled teeth (dmft) index, decayed, and filled teeth (dft) index and missing teeth (mt) (P-Value ≤0.20). However, multiple logistic regression model showed a statistically significant relationship between the decayed, missing, and filled teeth (dmft) index and passive smoking (OR=1.28; 95% CI: 1.05 – 1.38). This study showed that the risk of decay of deciduous teeth is higher in children exposed to passive smoking, therefore, passive smoking should be considered in the implementation of programs to prevent tooth decay in children.

Asthma is a chronic inflammatory disease of the lead to hypertrophy and dilatation of the right ventricle. Aim of study to evaluate and compare left and right ventricular systolic and diastolic function of the heart based on echocardiographic criteria in children with moderate to severe asthma and non-asthmatic children referred to Hazrat Rasouland Firoozabadi Hospitals of Tehranin 2019.

In this case-control study, 50 patients with a definite diagnosis of moderate to severe asthma(case group) and 50 healthy individuals (control group) were studied and compared in terms of clinical and echocardiographic measures. Blood pressure, heart rate, body height and weight of all children were recorded. The patients who were >6 years underwent pulmonary function tests using spirometry. Conventional and TDI echocardiography was performed bya single experienced pediatric cardiologist on two groups blindly and echocardiographic data was collected.

The results showed that the left ventricular stroke volume was significantly lower in patients with asthma. Also, in the right ventricular SV, significantly lower values were found in the group of patients under study than healthy individuals (P=0.01). The E/A ratio in both groups was higher than one with a mean and standard deviation of 1.72±0.26 in the case group compared to 1.92±0.32 which was not significantly different.

The results of this study showed that asthma can affect ventricular contraction in children. Contrary to previous studies and despite the observation of cardiac systolic dysfunction in patients with asthma, diastolic dysfunction in these patients was not observed even by tissue Doppler echocardiography.Keywords: Asthma, Cardiac function, Echocardiography