فهرست مطالب
International Journal of Pediatrics
Volume:10 Issue: 100, Apr 2022
- تاریخ انتشار: 1401/02/06
- تعداد عناوین: 20
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Pages 15695-15709Background
Abnormal growth in children with autoimmune hepatitis (AIH) is anticipated, either due to hepatic affection or the growth inhibitory effects of corticosteroids. We aimed to describe children's anthropometry with AIH, and study the factors affecting height.
MethodsThe present observational study investigates the anthropometric measures of 28 children with AIH followed at a university hospital for 9.5±3 years. We calculated the initial AIH score, the Child-Pugh score, and the pediatric end-stage liver disease score (PELD), follow-up anthropometry, and corticosteroid history. We defined abnormal growth as under nutrition (underweight, wasting, stunting), short stature, overweight, and obesity.
ResultsAt AIH diagnosis, children had a mean age of 7.4±3.1 years, ranging from 2 to 13.8; among whom ~20% had ascites, ~79% had jaundice, and ~82% had type 1 AIH, ~70% had a definite diagnosis of AIH, ~64% were Child-Pugh Score B, ~64% showed severe fibrosis/cirrhosis, and the median PELD score was 8.1 (0.1-12.1). At follow-up, their mean age was 15.9±1.6 years, with mean corticosteroid duration of 7.1±3.1 years, and remission occurred in 50%. We observed a significant improvement in the initial rates of underweight (46.4% vs. 17.8%), mainly stunted, and increased rates of overweight/obesity (14.3% vs. 32.2%). The final rates of height affection without weight affection were comparable to the initials (28.6% vs. 32.1%). Cases with abnormally low final height had significantly more frequent Child-Pugh Score B, higher PELD score, and severe hepatic fibrosis at presentation, with no difference regarding the continuation/ total duration of steroids.
Conclusionthe final height in children with AIH is significantly affected by the disease severity at presentation and not the continuation or the duration of corticosteroids use.
Keywords: Autoimmune hepatitis, Corticosteroids, Growth, final height, liver cirrhosis, fibrosis -
Pages 15710-15715BackgroundMultimodal cerebral monitoring can reduce the incidence of neurological complications as well as the hospital costs associated with caring for cardiac surgery patients. Given the prevalence of cardiac surgeries, the need for cardiopulmonary bypass devices and the few studies in this area, further studies are needed. In this study, we aimed to investigate the correlation between cerebral oximetry and mean arterial pressure during pediatric cardiac surgery.MethodThe present study is a descriptive correlational one. To obtain the results, the cerebral oximetry monitoring and blood pressure were established and baseline values were recorded. Patients were then anesthetized under the same monitoring and anesthesia method, and the cerebral oximetry and blood pressure were recorded in a checklist prepared by the researcher before, during and after the cardiopulmonary pump. Data was analyzed by SPSS software (version 25).Results58 children undergoing cardiac surgery were included in the study, 51.7% of whom were male. At the study time, the mean age of the patients was 1.92±2.05 years; and their mean weight was 9.86 ± 4.86 kg. A significant relationship was found between the mean arterial pressures (MAP) and the right and left cerebral oximetry.ConclusionAccording to the findings, there is a significant relationship between MAP and cerebral oximetry in pediatric cardiac surgery. This study shows that by increasing MAP during cardiopulmonary pump, the brain perfusion and oxygenation of the brain can be increased. Peripheral oximetry also plays an important role in reducing hospital costs related to the care of cardiac surgery patients.Keywords: Cerebral Oximetry, Mean arterial pressure, Pediatric Heart Surgery
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Pages 15716-15729BackgroundThe aim of this study was to investigate the effectiveness of strategic solution oriented therapy, the meditation technique and metacognitive therapy on mind wandering and rumination among mothers of children with an autism spectrum disorder.MethodsThe method of the research was quasi-experimental and it used a pretest-posttest design with a control group. The statistical sample included all mothers of children with ASD who were studying at special children's training centers in the south of Tehran during 2019. They were selected through purposive sampling and randomly divided into three experimental groups ((strategic solution oriented therapy (n=14), the meditation technique (n=14), metacognitive therapy (n=14)), and one control group. Each of the experimental groups was under treatment for 1.30 hour while the control group did not receive any therapy. The subjects were assessed before and after the treatment using Mind-Wandering Questionnaire (MWQ), and Rumination Response Scale (RRS). All statistical analyses were performed using SPSS ver. 25.ResultsThe majority of mothers (32.1%) were between 25 and 30 years of age and concerning the educational degrees, the mothers with a diploma comprised the biggest percentage (44.6%). The results showed that all of the solution-oriented strategic methods, meditation, and metacognitive therapies can significantly decrease the mind wandering and rumination in the mothers of children with an autism spectrum disorder (P <0.05), while solution-oriented strategies showed higher effects than meditation and metacognitive approach.ConclusionAccording to the test results, the solution-oriented strategic method, meditation method, and metacognitive method were respectively effective in reducing mind wandering, with the first one having the most impacts, and the last method being the least influential one.Keywords: Strategic Solution Oriented Therapy, The Meditation Technique, Meta-Cognitive Therapy, mind wandering, Rumination, Autism spectrum disorder
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Pages 15730-15736Background
Concern about possible GI dysfunction in ASD is intensified by high rates of feeding concerns and consequent medical sequelae in ASD. Etiological factors contributing to the pattern and prevalence of atypical intake in ASD remain elusive, but may involve pathophysiological processes in the GI tract. In this study, we evaluated the gastrointestinal symptoms of patients with autism spectrum disorder in Mashhad, Iran.
MethodsThis is a cross-sectional study performed during September 2015 and April 2018 on patients referred to pediatric gastrointestinal clinics of Ghaem and Noor Hedayat centers by definite diagnosis of autism spectrum disorder (ASD). All subjects were interviewed to answer some questions about the gastrointestinal manifestations like constipation, chronic abdominal pain, diarrhea, recurrent vomiting, gastro-esophageal reflux, nausea, and agitation. For each patient a checklist was completed including demographic, history and physical examination variables.
ResultsDuring the period of study, 46 definite ASD patients were enrolled in the study. The mean age of the participants was 7.72± 2.80 years (range: 2-16). Most of the patients were male (37, 80.4%). Diarrhea (occasional or chronic) was seen in six patients (13%) and constipation in 21 patients (45.7%). There was no significant difference between the gastrointestinal symptoms and gender or age of the patients (P>0.05). An important finding in physical examination was tooth decay, which was found in 21 patients (45.7%).
ConclusionGI symptoms, with the high prevalence in ASD patients, should be considered as major problems; and preventive strategies must be taken for resolving them. Constipation was the most prevalent symptom, which can be related to the nature of the disease or other mechanisms.
Keywords: Autism spectrum disorder, gastrointestinal symptom, Constipation, Diarrhea -
Associated Congenital Heart Anomalies in Children with Cleft Lip and Palate: A Cross Sectional StudyPages 15737-15745BackgroundCleft lip and palate has a frequency of 1 per 700 live births, making it among the most prevalent orofacial congenital anomalies of the craniofacial region. Congenital heart disease is the most commonly associated disease with oral cleft. Hence, we have reviewed the association between heart disease and cleft lip and/or palate in the pediatric population.MethodsIn this cross-sectional study, the patients with oral clefts referring to the hospitals affiliated with the Mashhad University of Medical Sciences during 2015 to 2016 were evaluated. Demographic, clinical, and echocardiographic data were collected and analyzed statistically.ResultsOne hundred twenty two patients with cleft lip and/or palate underwent echocardiography (49.2% males, 50.8% females). Based on Z-score outcomes, most of the patients with scores above zero had isolated cleft palate (63.6%). Patients with Z-scores of 0 to -1.3 and lower than -1.3 mostly had both cleft lip and palate (61.3%) or isolated cleft palate (55.5%), and these differences were significant (p=0.010). Furthermore, the frequency of the patients with Z-scores lower than zero was significantly higher in cleft lip and palate cases with congenital heart disease compared to non-congenital heart disease cases (43 vs. 19; p=0.002). The patients with pathologic symptoms in the physical examination were mainly diagnosed as abnormal based on their echocardiography (71.2%), and those without these symptoms were mainly diagnosed as normal based on their echocardiography (59.2%) with significant differences (p=0.001).ConclusionsNo significant difference was observed regarding the distribution of different types of congenital heart disease between the different types of cleft lip and/or palate.Keywords: Cleft lip, Cleft palate, congenital heart disease
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Pages 15746-15754BackgroundThe COVID-19 pandemic has significantly impacted people's sports and physical activities. Many studies have examined these effects from different points of view. This study investigates the challenges of COVID-19 in sport for all, emphasizing Children's Sport and Physical Activity.MethodsThis research is applied in terms of purpose and descriptive-analytical in terms of data collection, and is conducted by the use of the field method. The population included all experts in children's sports, kindergarten teachers, primary school teachers, and managers of the clubs active in children's sports in Gorgan (N = 750). The sample was determined based on the statistical population and Morgan table (n = 257). A 22-item researcher-made questionnaire with a five-point Likert scale was used to collect the data and assess the effects of COVID-19 on children's sport in three dimensions and ten components. Given the normal distribution of data, the correlated t-test was used to measure the effects. And Friedman's test was used to prioritize the challenges of COVID-19 in sport for all, emphasizing children's sports.ResultsThe results showed that the challenges of COVID-19 in sport for all with an emphasis on children's sports and physical activities are jeopardizing the physical health of children, increasing the issues related to holding competitions and festivals, increasing unemployment of sports coaches, increasing governmental restrictions for the operation of sports facilities, reducing investment in children's sports, endangering the physical health of individuals, loss of human resources, the financial crisis of sports centers, reducing the income of health-related sports centers and increasing psychological problems (Social Phobia, anxiety and fear of Sports).ConclusionsThe results revealed that the challenges raised by COVID-19 in children's sports and physical activity can be managed by giving priority to low-risk sports in open spaces, games, and competitions without spectators, providing unemployment insurance services to children's sports activists, using technology in sports classes, providing support packages and banking facilities for sports center owners and observing health practices.Keywords: COVID-19, sport for all, Physical Activity, Children
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Pages 15755-15771Background
The increasing frequency of computed tomography (CT) scans for a range of purposes, particularly pediatrics, has raised concerns regarding the population's radiation exposure and subsequent chances of cancers. This study aimed to estimate the effective doses of pediatrics radiation and induced cancer risks from five most common CT scan procedures in Yazd Province, Iran.
MethodsData of pediatric patients from four age groups of ≤1, 1-5, 5-10, and 10-15 years old were retrospectively collected from 6 educational institutions located in diverse areas of Yazd Province. For each participant, the effective doses and REID (risk of exposure-induced death) rate were estimated by Impact Dose and PCXMC software, respectively. Then, the findings were reported by categorizing the patients regarding their effective diameter.
ResultsThe effective doses and REID values did not show any significant differences among the studied age groups. The highest mean of effective dose was recorded for the scan of abdomen-pelvis (average ± standard deviation, 5.24±3.19 mSv) followed by chest (3.76±2.28 mSv), brain (1.25±1.07 mSv), and sinus (0.65±0.4 mSv) examinations. The highest REID was documented for chest scan (490±314 excess deaths in one million scans) followed by abdomen-pelvis procedure (404±280).
ConclusionThe radiation doses delivered to the pediatric patients and the associated fatal cancer risk with common CT procedures were comparably in the same range of the previous studies. Our findings can represent an estimation of the radiation-induced risks of CT scans and can be used for extending the knowledge of clinicians and researchers.
Keywords: Pediatrics, CT scan, Effective Dose, Cancer Risk, Impact Dose, PCXMC Software -
Pages 15772-15778BackgroundNeonatal asphyxia is one of the most common neonatal problems. And kidney injuries are one of the most important complications of asphyxia in infants. Therefore, this study was designed to evaluate the effect of administering aminophylline on improving the renal function of asphyxiated preterm infants.MethodsIn this single-blind randomized clinical trial, forty term neonates with perinatal asphyxia were randomized to intervention (n=21) and control (n=19) groups, respectively, receiving a intravenously single dose of aminophylline (5 mg/kg) or an equal volume of placebo (5% dextrose in water) during the first 3 hours of life. Daily urine output, 24-hour fluid intake, weight and serum creatinine were recorded during the first 5 days of life.ResultThe incidence of severe kidney dysfunction was not significantly different between the two groups. (2 infants in the group of intervention with aminophylline and 3 in the control placebo group; p=0.23). Plasma creatinine (Pcr) levels were increased in both groups on the second day and reached the maximum in the third day. Then it gradually decreased during the fourth and fifth days of life. There was no significant difference in Pcr & GFR between the groups in these five days (p>0.05). However, urinary output/input ratio was higher in the aminophylline group in the first three days of life.ConclusionProphylactic administration of aminophylline in asphyxiated neonates could not change the process of renal failure in the patients but could increase urinary output in the first days of life.Keywords: Perinatal asphyxia, Renal function, Aminophylline, Acute kidney injury
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Pages 15779-15788BackgroundChild abuse is a significant global concern, with short-term and long-term consequences for the lives of children who are victims of violence. For effective action by decision-makers, the information and analysis obtained from surveillance systems must be used to determine the problem, the magnitude of maltreatment, its relationship with other issues, and the likelihood of preventing maltreatment.ObjectivesDue to the importance of child abuse and the management and control of this event, this study was conducted to design and evaluate a child abuse surveillance system.MethodsThe system was designed in Visual Studio version 2017 using the C# programming language and ASP.NET framework. SQL Server was used to store the data. The design of the child abuse surveillance system was evaluated according to the usability evaluation.ResultsThe minimum data set was indexed to collect and store data on abused children by the standard format. Web-based child abuse surveillance system (CASS) has 3 types of users. The system evaluation results showed that the highest number of problems were related to the principle of "help and documentation".ConclusionDesigning a CASS is a practical step in managing and controlling the data of abused children. This system and registration of information will help professionals, managers, and decision-makers make the right decisions to take care of injured children with up-to-date informationKeywords: Surveillance system, Child abuse, Child maltreatment, Surveillance
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Pages 15789-15801BackgroundThe integration of art in the curriculum is essential for the development of children's creativity and prevents the lack of connection between mathematics and science with the real demands and needs of the world. As an art-centered integrated approach, STEAM can help teachers, students and employers meet this need. The present study was conducted to design a STEAM curriculum model for elementary schools in Iran.MethodsThe research method used in this article is qualitative thematic analysis. The study population included all existing research on STEAM in databases of Amazon, ProQuest, UNESCO, Google Scholar, Eric, and Emerald from 2000 to 2020. Sampling was done purposefully or theoretically, i.e. through the conscious selection of specific individuals or elements for research by the researcher. Then, 200 articles and 10 books were selected as purposive samples.Content analysis covers a wide range of methods and techniques. The theme network, developed by Stride-Sterling in 2001, is used in theme analysis in this research. The theme network systematizes the basic themes, the organizing themes, and the pervasive themes, based on a specific process.ResultsSTEAM curriculum design was inferred based on Drack interdisciplinary skills approach model, after content analysis. The analyzed curriculum elements include objectives, content, teaching methods, assessment, learning activities, time and space.ConclusionIdentifying the components of the STEAM-based curriculum based on the Drake interdisciplinary approach can be used by teachers and school principals to design teaching and write lesson plans, and to help foster creativity in students. To connect with the real world and the job market.Keywords: STEAM, creativity, ART, Interdisciplinary approach
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Pages 15802-15812BackgroundThe opportunities and conveniences brought by the developing technology greatly reduce the workload of individuals. The restrictions occurring from the Covid pandemic also allow us to easily do all our work from home over the internet. However, this situation has caused a serious decrease in the physical activity rate of individuals. The decrease in physical activity increases the tendency for eating easily accessible and unhealthy foods, leading to a move away from healthy nutrition habits. Unhealthy nutrition, on the other hand, causes negative situations in our body, both physically and physiologically. The aim of this study is to examine whether the motivation of adolescent athletes to participate in physical activity is related to and predicted by the variables of body appreciation and attitude towards healthy nutrition.MethodsThis research is a relational study aiming to determine whether body appreciation and attitude levels towards healthy nutrition predict the adolescents’ motivations for participating in physical activities. A total of 335 athletes, 104 (31%) girls and 231 (69%) boys, playing basketball in Istanbul and Mersin in 2021-2022, voluntarily participated in the study. They were between the ages of 12-17. Attitude Scale for Healthy nutrition, Body appreciation Scale and the Motivation Scale for Participation in Physical Activity were used for data collection. Stepwise multiple linear regression was used in data analysis.ResultsIt was revealed that the variables of body appreciation and attitude towards healthy nutrition have significant roles in predicting the motivation of adolescent athletes for participating in physical activities. The variable of Attitude for Healthy nutrition, included in the model in the first stage, explained 16% of the total variance. In the second stage, when the body appreciation variable was added to the model, the explained variance increased to 18%. The regression coefficients manifested that these two variables are positively correlated with motivation to participate in physical activities. Thus, the two-stage model predicted 18% of the total variance.ConclusionBoth physical characteristics and attitudes towards healthy nutrition are effective in the motivation of adolescent athletes to participate in physical activities.Keywords: Participation in physical activity, Body appreciation, Healthy eating
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Pages 15813-15822Background
This study aimed at investigating the effects of an online corrective exercise intervention on correcting forward head and kyphosis as well as reducing feelings of fatigue and pain in adolescents.
MethodsThe present study enjoyed a causal-comparative design. The participants included 40 females aged 13-15 years. Upper cross syndrome was measured by the use of Image J software and Spinal Mouse. Feeling of fatigue and pain were assessed through questionnaires. During correctional training, the intervention group performed corrective exercises for eight weeks, three sessions per week, and each session lasting 30-45 minutes within the WhatsApp application.
ResultsBody mass index (mean 22.86) in female adolescents was in the normal range (between 18.5 and 25), although it was close to its high level. The results showed that an online training course improved and corrected the condition of forward head (P=0.000) and kyphosis (P=0.000) in female adolescents. Furthermore, this training period has significantly reduced the feeling of fatigue (P=0.000) and pain (P=0.000). In addition, the results of the follow-up test revealed that the positive effects of an online correctional training period remained constant over time (P=0.000).
ConclusionCorrective movements are effective in strengthen the muscles of the neck and back, and stretching the anterior muscles of the neck and chest in people with anterior head and kyphosis; while improving the condition of the head and kyphosis in adolescents, they can also reduce the feelings of fatigue and pain. Moreover, practicing methods for correcting abnormalities can be used online and virtually.
Keywords: Upper Cross Syndrome, Fatigue, Pain, online intervention -
Pages 15823-15834BackgroundToday, there are many concerns about the level of physical activity of students and due to its importance in students’ health; many studies have attempted to investigate the factors affecting the levels of physical activity among the students. This study also seeks to investigate the role of peer’s social support in the students’ physical activity behavior with the mediating role of physical self-efficacy.MethodsThe present study enjoys a cross-sectional descriptive-correlational design. The statistical sample included 384 high school students in Azadshahr city (Golestan province, Iran) in 2019. Three standard questionnaires including peer social support, physical self-efficacy and physical activity behavior were used to measure the research variables. Structural equation modeling was used to analyze the data.ResultsDescriptive data showed that 191 students had at least three sessions of physical activities per week. Furthermore, the mean scores of the peers’ social support, physical self-efficacy and physical activity behavior were 3.60, 3.60 and 3.28, respectively, which were above the average. The findings demonstrated a significant relationship between the peer’s social support and students’ physical self-efficacy (T=55.711). The results also revealed that there is a positive and significant relationship between peer social support and the students’ physical activity behavior (T=3.285). Moreover, physical self-efficacy has a positive and significant relationship with the students’ physical activity behavior (T=4.295). Finally, the mediating role of physical self-efficacy was confirmed (T=3.302).ConclusionThe results of this study show the importance of peer’s social support in increasing physical self-efficacy and physical activity behavior of students in the school environment.Keywords: Social Support, physical self-efficacy, Physical Activity, School, peers
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Pages 15835-15841Background
Oral and dental diseases are among the most common diseases in the world that are usually initiated in childhood and adolescence. With risk factors like those of the other important non-contagious diseases, they cause pain, discomfort, deformity, and even death. As it is preventable, the promotion of the related care behaviors by identifying the effective factors is very important. Therefore, the present study aimed to determine the factors affecting oral health self-care behaviors in seventh-grade students in Behbahan city using the health belief model.
MethodThis descriptive-analytical study was performed on 360 seventh-grade students in Behbahan city, Iran, through a two-stage cluster sampling. The data collection tool was a questionnaire designed based on the Health Belief Model and the DMFT checklist. The collected data were analyzed using SPSS software V. 20.
ResultsThe results showed that the mean DMFT index and students' performance score for oral health behaviors were 2.08 and 1.76, respectively. There was a significant difference between the two genders in terms of DMFT index and performance score (P = 0.007). In this study, there was a significant relationship between oral health behaviors and perceived sensitivity, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. There was also an indirect and significant relationship between perceived barriers and behavior (r = 0.271, p = 0.001).
ConclusionBased on the results of this study, the structures of the health belief model were effective on students' oral self-care behaviors. Therefore, it is recommended to focus on the mentioned structures to promote these behaviors.
Keywords: self-care, Health-Related Behaviors, Oral Health, Health belief model, Students -
Pages 15842-15852BackgroundMother’s nutrition during lactation is a factor affecting the quality and quantity of their milk. The present study aimed to investigate the direct and indirect effects of macronutrients on the amount of their energy intake.MethodThis cross-sectional study was conducted in Khorramabad, and the target population included lactating mothers with a lactation period of 12 months or less. Using the dietary record (DR) in three days, the participants’ nutritional status and food intake were assessed. For distinguishing the importance of variables based on their direct and indirect effects on energy, non-parametric path analysis was employed.ResultsThe median level of energy intake was 1719.60 calories. Carbohydrates and proteins had the strongest and weakest effects on energy intake, respectively; and the strongest indirect effect was observed in fiber, MUFA, and Isoleucine.ConclusionConsidering the path coefficients related to direct and indirect effects and the effect of each macronutrient on the amount of energy intake, lactating mothers should be informed with the help of intervention programs about the importance of having proper nutrition to receive adequate nutrients and energy.Keywords: Lactation, Lactating Mother, Nutritional Status, non-parametric path analysis
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Pages 15853-15864BackgroundMucopolysaccharidosis type I (MPS1) is caused by mutations in the gene which encodes the enzyme alpha-L-iduronidase. Deficiency of this enzyme causes a range of clinical symptoms in patients. The main treatment for MPS1 is hematopoietic stem cell transplantation. But its morbidity and mortality rates are significant and require matched marrow donors. Another method of treating MPS1 is enzyme replacement therapy (ERT). This study was performed to determine the effects of ERT in patients with MPS1.MethodsSeven patients with MPS1, admitted in Imam Reza Hospital of Mashhad, Iran, during 2014, were included in the study. They were treated with a single dose (0.58 mg/kg) of enzyme laronidase and followed in 0, 3, 6, 9 and 12 months. The urinary glycosaminoglycan’s (GAG), shoulder and elbow joint range of motion, volume of liver and spleen, and six-minute walking test were evaluated. Data was analyzed by SPSS software (version 16.0).ResultsThe mean age of the patients was 22.43±5.85 months at the baseline. During follow-up, the level of urinary GAG showed a significant reduction (p=0.004), the volumes of liver (p<0.001) and spleen (p=0.004) were significantly reduced, and the result of 6-minute walking test was significantly increased (p<0.001). The side effects included generalized skin erythema as an allergic reaction in one patient and two episodes of fever during drug administration in one patient.ConclusionAccording to the results, the treatment with L-iduronidase in patients with MPS1 was effective and mostly safe.Keywords: L-iduronidase, Enzyme replacement therapy, Mucopolysaccharidosis type 1
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Pages 15865-15880
Meningitis can quickly become a life-threatening sickness and therefore is considered a medical emergency. Viruses, after bacteria, are known as main pathogens involved in meningitis; therefore, we investigated the prevalence of viral meningitis worldwide and evaluated the clinical and preclinical features for rapid detection of viral meningitis. The results showed that the most prevalent viruses in viral meningitis are Enterovirus, Coxaci, Tick-borne encephalitis virus, Herpesviridae family; and the most prevalent viruses in aseptic meningitis are Echovirus, Enterovirus, Coxaci and HSV. The findings revealed differences in the prevalence of various viruses in these two types of meningitis, even though there was no significant difference in clinical manifestations between viral and bacterial meningitis. This indicates the importance of laboratory diagnostic methods for discriminating between these two types of meningitis.
Keywords: Meningitis, Virus, Meta-analysis -
Pages 15881-15900BackgroundCystic fibrosis (CF) is the most common life-threatening hereditary disease among Caucasian populations. Due to the side effects caused by this disease and the high amount of drugs used by the affected patients, performing extensive research seems necessary to find the treatments with greater effectiveness and fewer side effects. The use of Complementary and Alternative Medicine (CAM) is common in both developing and developed countries, but currently available studies performed on the effectiveness of CAM on improving symptoms and reducing complications of CF patients are very limited.ObjectiveThis systematic review was performed to evaluate the effects of CAM therapies on patients with CF.MethodsSix credible medical databases (including Cochrane, Science Direct, Embase, ISI, PubMed, and Scopus) were investigated from the beginning of 2000 to the end of 2020, in order to find relevant English-language publications.ResultsFrom among 1213 articles screened, 57 studies with 2525 patients were included in this study. These articles were then sub-grouped into four categories, including ‘acupuncture’, ‘body techniques’, ‘dietary supplements/nutrition/diet’, and ‘herbal medicine’.The articles evaluating one of the four parameters of quality of life, pain, pulmonary function, or body mass index were included to be evaluated.ConclusionAlthough we have not evaluated all the studies in the field of the effect of complementary medicine on CF, the review consisting of a large number of these articles showed that despite the great potential of complementary and alternative medicines in this field, extensive research is still needed in this regard.Keywords: Cystic fibrosis, Complementary, Alternative Medicine, Systematic review
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Pages 15901-15909BackgroundFetal demise can complicate aneuploidy screening in a multi fetal pregnancy. The cell-free DNA (CF-DNA) from a non-viable conception may be discordant with the viable fetuses. The Aim of study was to review the waiting period, follow-on single fetal demise in a twin gestation before performing NIPT (Non-Invasive Prenatal Testing).MethodsIn this review article we searched through online databases of CINAHL, Cochrane, Database of Abstracts of Reviews of Effects (DARE), PubMed, Medical Library, and Google Scholar for English literature between 2011 to 2020, with the following keywords: “NIPT”, “non-invasive prenatal screening testing”, “cell-free DNA”, “vanishing twin” and “co-twin demise”. We included the studies regarding the duration between the twin vanishing or reduction and NIPT false results.Results201 studies across the eight scientific websites were detected; 178 of which were excluded for duplication or being irrelevant. And 29 studies were fully read. 4 case series, finally, met the criteria for systematic review. The findings suggested that the NIPT screening test can be falsely-positive several weeks after vanishing twins although the live fetus is normal. Therefore, the time duration in which the placenta can release CF-DNA of the vanished twin is unknown. In addition, several weeks after reduction, the fetal CF-DNA increases and then decreases, thus CF-DNA analyzing in multifetal pregnancies with reduction can be challenging as well.ConclusionIn pregnancies with vanishing twin or reduction, evaluating NIPT results is more complex than single fetal pregnancy. According to the reviewed studies, after a fetal demise, the cytotrophoblast continues to release to the CF-DNA in the maternal circulation for a variable time, which may cause a false-positive result if the demised twin is aneuploidy.Keywords: Cell-free DNA, non - invasive prenatal testing, fetal demise, vanishing twin, multifetal pregnancy
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Pages 15910-15918BackgroundIdentifying the factors that affect adolescents’ participation in physical activity is considered as an important topic concerning public health.ObjectivesThe purpose of the present study was to test the effects of the constructs of the planned behavior theory on the physical activity behaviors of beginner Volleyball adolescent students.MethodsWe used a descriptive-correlational approach in the present study. The participants comprised 112 middle school students from Urmia, Iran, 2020. The Research was conducted on the basis of the Theory of Planned Behavior, and the physical activity behaviors were objectively measured by the use of an accelerometer. To analyze the data, we used the structural equation method.ResultsResults showed that attitude and perceived behavioral control had significant impacts on the intention to physical activity (both T>1.96). However, no significant effect was observed for the subjective norm on intention to physical activity (T=0.152). Moreover, intention to physical activity significantly affected the moderate-to-vigorous physical activities (T>1.96). Finally, attitude and perceived behavioral control had significant effects on moderate-to-vigorous physical activities through a mediation by intention to physical activity (all P<0.001). The daily MVPA was 45.48 minutes, which is below the WHO-guideline.ConclusionsFindings indicate that those participants with more positive attitudes and higher perceived behavioral control had greater intentions to engage in physical activitiesKeywords: Attitude, subjective norms, behavioral control, Physical Activity, accelerometer