International Journal of Pediatrics
Volume:10 Issue: 105, Sep 2022

The prevalence of diabetes mellitus is rising rapidly. Adolescence is also related to weaker medication adherence and increased risk of psychiatric disorders. This study aims to investigate the relationship between parenting style, family resilience, and regimen adherence.
This research is a descriptive cross-sectional study. 180 adolescents with type 2 diabetes and their parents were selected through convenience sampling at Mofid and Taleghani Hospitals, Tehran, Iran. The instruments were "Summary of Diabetes Self-Care Activities," "the Family Resilience Assessment Scale," and "Parenting Style and Dimensions Questionnaire". The sampling duration was from February to April 2021; descriptive statistics and Pearson correlation coefficient were performed using SPSS version 2021.
The results showed that family resilience was moderate in most participants (80%). The mean score of family resilience was 2.94±0.29 and among the subcomponents of this scale, “family Belief systems” was found to have the highest mean score (3.05±0.347). Regimen adherence was moderate in most participants (60%). Parents of Adolescents had higher uses of authoritative parenting styles (3.70± 0.54). Adherence to non-smoking (6.31± 1.23) and specific medications (5.55 ± 1.28) were higher than adherence to diet, physical exercise, blood glucose monitoring, and foot care. Authoritative parenting styles (r=0.524, P=0.000) and total family resilience (r=0. 599 P=0.000) were positively related to total regimen adherence. Family resilience was positively correlated with authoritative parenting styles (r=0.385 p=0.000). Authoritarian and permissive styles were not correlated with regimen adherence (p>0.05).
Adherence to the regimen positively correlated with family resilience and authoritative parenting styles for adolescents with type 2 diabetes.

Childhood is fundamental in human life. And, children's TV shows are among the essential communication media that affect children. Therefore, the present study addresses the role of Children's TV shows on the intelligence of children in Tehran from the perspective of national media experts.
The method is descriptive-correlational and applied in terms of purpose. The statistical population includes all national media experts (750 people). According to Morgan's table, two hundred fifty people were selected based on a random sampling method. A researcher-made questionnaire (cultural and emotional intelligence) was used to collect data. The face validity of the questionnaire was confirmed based on experts' opinions. The reliability of the questionnaire was 0.90 based on Cronbach's alpha coefficient. Descriptive statistics (mean and standard deviation) and inferential statistics (chi-square) are used to analyze the data with SPSS.
The results show a significant relationship between children's TV shows and the cultural intelligence and emotional intelligence of children in Tehran. The results also showed that children's shows affected emotional intelligence and cultural intelligence (p<0.05).
It is, therefore, suggested to pay more attention to educational and cultural aspects of children's shows to improve their intelligence and social skills.

Ectodermal dysplasia (ED) is a congenital heterogenic disorder caused by the defect in the ectoderm and its derivatives. This complex disorder has different subtypes, the most common form of which is hypohidrotic ectodermal dysplasia (HED).  Symptoms include spare hair, defects in sweat glands activity, abnormal teeth and dystrophic nails. In the present study, whole-exome sequencing was performed to identify disease-causing variants in an Iranian 4-year-old affected boy with sparse hairs, low eyelashes and eyebrows, reduced teeth, severe dry skin, and reduced sweat glands. We confirmed the pathogenicity and its novelty within silico tools. Identifying variant confirmation in the patient and segregation analysis in her family were performed using the Sanger sequencing method. A novel hemizygous missense variant [NM_001399.5: c.1001G>C; p. (Arg334Pro)] was identified within the EDA gene; and this is the third case of HED in Iran that is related to the EDA gene. The distinction between our patient’s indications and those recorded for a few past subjects may be due to the differences in the mutations involved.

The present study aimed at evaluating the demographic and laboratory factors associated with the recurrent seizure during hospitalization in the children with the first febrile seizure. This cohort study was performed in Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran, from 2018 to 2019. Totally 483 admitted children aged 6-60 months with the first febrile seizure were included. The repetition of seizure during hospitalization was considered as incidence of recurrent seizure. Among 483 children with the first febrile seizure, recurrent seizure occurred in 57 patients (11.8%). The serum level of potassium, magnesium and calcium in children with recurrent seizure significantly was lower in comparison to the patients without repeated seizure. Complex seizure was the major risk factor for recurrent seizure (relative risk: 377.74, p=0.001). The risk of recurrent seizure decreased with the increase of serum level of potassium, calcium and magnesium. The risk of recurrent seizure increased with the increase of body temperature but not significantly. The incidence rate of recurrent seizure in children with the first febrile seizure was 118 cases per 1000 population. Complex seizure was the main risk factor for the seizure recurrence. Higher serum levels of potassium, calcium and magnesium may decrease the risk of recurrent seizure.

Critically ill patients, especially those requiring admission to intensive care units (ICU), are at risk for stress-related gastrointestinal mucosal damage. We aimed to evaluate the frequency of proper prescription of antacid agents in a group of critically ill children admitted to PICU.
In this retrospective study, the medical records of children aged between 1 month and 15 years who were admitted in 2018-2019 to the PICU of Imam Hossein children's hospital, Isfahan, Iran, were reviewed. Demographic data, indications for PICU admission, principal diagnosis, the severity of the disease, incidence of bleeding during hospitalization, indications for stress ulcer prophylaxis, prescription of the antacid agents, type of antacid prescribed, and the patient's final outcome were recorded. All the data were gathered and organized by a medical intern. We calculated the rate of the patients who were indicated for SUP, those who were not indicated for SUP (Stress Ulcer Prophylaxis), those who received SUP (Stress Ulcer Prophylaxis), and those who did not receive SUP. Data analysis was performed with the Statistical Package for the Social Sciences software (SPSS, version 24.0, IBM, Armonk, New York).
We found that 204 (92.7%) of our patients received antacid agents for gastric SUP. Among the patients receiving SUP, 198 (90%) had an indication for SUP, and only 6 (2.7%) cases received unnecessary prophylaxis? In addition, 16 (7.2%) patients had no indication of receiving SUP and did not receive any prophylaxis. We also reviewed the type of antacid medication that was prescribed for SUP and found that 157 (72%) patients had received PPI, and 57 (30%) had received H2Ras.
The findings of the current study revealed that almost all of our study population who had an indication for prophylaxis of stress ulcer appropriately received antacid agents. We suggest that there is a crucial need to conduct large prospective and multicentric studies in pediatric centers to prepare a universally accepted guideline for the prophylaxis of stress ulcers in the pediatric age group.

Previous studies have shown that peers play an important role in the participation of children in physical activities. Nevertheless, peers’ effects on physical activity participation of children with ADHD have been rarely examined. Thus, this study aimed to examine the effects of peer acceptance on the participation of children with ADHD in physical activity with a consideration of physical self-efficacy as a mediator.
In this study, we followed the descriptive-correlational method. The participants were 92 children with ADHD aged 9 to 12 years old who attended a special school for children with ADHD. Peer acceptance, physical activity, and self-efficacy were measured by the use of standard questionnaires. Data was analyzed using Structural Equation Modeling (SEM).
Overall, the level of physical activity in children with ADHD was very low (0.98 out of 7). Peer acceptance positively influenced physical activity (T=7.769) and physical self-efficacy (T=6.967). Moreover, physical self-efficacy significantly mediated the association between peer acceptance and physical activity (P<0.001).
Our findings indicate that it is necessary to adopt appropriate strategies to increase the level of physical activity among children with ADHD. Moreover, peers play an important role in the participation of children with ADHD in physical activity and physical self-efficacy can be considered as a plausible mediator in this relationship

Guillain-Barre syndrome (GBS) is an acute immune-mediated disease that affects both adults and children. Many infectious and non-infectious conditions may trigger this disease. Apolipoprotein E (APOE) is a glycosylated protein that has a variety of lipid and non-lipid related functions. The present study aimed to evaluate the serum levels of APOE in children with GBS compared to healthy control subjects to evaluate the diagnostic and pathologic effects of APOE in GBS.
In a cross-sectional design, 124 participants were divided into the GBS group (n=61) and the control group (n=63). Blood sampling and measurement of APOE were done according to the manual of the Human APOE ELISA kit. Demographic variables and further data about GBS patients were collected from patients' medical records. Weight and height were measured using SECA scales. The analyses were performed using SPSS Statistics 21.0 software and appropriate analytical tests. P-values of <0.05 were considered statistically significant.
Mean ±SD of APOE serum levels was 8.43±3.59 micrograms/ml in the GBS group and 35.28±11.18 micrograms/ml in the comparison group. The difference between the two groups was strongly significant (P<0.001). The mean level of protein in Cerebrospinal Fluid (CSF) in GBS patients was 184.36±19.09 mg/dl. There was not any significant difference in the demographic findings between the two groups.
Our study demonstrated that the serum levels of APOE in children with GBS are lower compared to healthy subjects.

The purpose of this study is to provide a model of physical education curriculum for primary school children based on the biophysical field of the document of fundamental change.
This study applies the mixed method in its design. In the qualitative part, semi-structured interviews were conducted with 16 experts and specialists of the physical education curriculum through a theoretical sampling method until the theoretical saturation was reached. In the next stage, 384 physical education teachers in Tabriz were randomly selected and evaluated using a questionnaire obtained from the obtained indicators. Research tools included library study, interviews and questionnaires. In the qualitative part, the open, axial and selective coding method based on the Glaser model was used, and in the quantitative part, the structural equation method (Smart PLS software) was implemented.
Results and The belief, socio-emotional, cognitive, biological, sports, skill-physical, informational and educational elements were identified as the basic components of the physical education curriculum of elementary school students based on the biophysical field of the fundamental transformation document.  Therefore, it is recommended to use the results of this study to improve the physical education curriculum of students.

Biliary atresia (BA) is an important etiology of liver disease in pediatric patients which manifests as extrahepatic cholestasis. Alagille criterion is a combination of noninvasive findings for the diagnosis of BA. In this regard, the current retrospective study aimed to evaluate the diagnostic accuracy of Alagille criteria for BA.
This cross-sectional study was conducted in Ghaem Hospital, affiliated to Mashhad University of Medical Sciences during 2009-2014. All infants less than 2 years old with cholestasis referred to the pediatric gastrointestinal ward were included in this study. Alagille criteria were evaluated for each patient, and BA was confirmed with intraoperative cholangiography. Finally, sensitivity, specificity, and positive and negative predictive values of Alagille criteria were determined according to the final diagnosis.
In general, 92 patients were included in this study. The male-to-female ratio and the mean age of patients were 54/38 and 42±5 days (ranging between 1 and 5 months), respectively. There was a significant difference between the two groups in terms of gender, onset time of jaundice, and the presence of the acholic stool (P=0.02, 0.04, and 0.005, respectively). Eventually, the acholic stool had the highest sensitivity, specificity, and positive and negative predictive values.
Based on the findings, the presence of the acholic stool was the most valuable criterion for the diagnosis of BA among all Alagille criteria.

Although celiac disease is considered one of the preconditions and predisposing factors for chronic constipation in children, accurate statistics on the prevalence of the celiac disease among Iranian children with chronic functional constipation is not available. The present study aimed to determine the prevalence of celiac disease in children suffering from chronic constipation.
This cross-sectional study was conducted on 360 children over one year of age with chronic constipation. A sample of venous blood was extracted from all subjects and the serologic studies of total IgA, IgA TTG, and IgG TTG were performed using the ELISA technique. Upper gastrointestinal endoscopic biopsy was also scheduled for those children with the positive IgA TTG. 
Two patients with raised levels of both IgA and IgA TTG antibodies were assessed by endoscopy, and a definitive diagnosis of celiac disease was confirmed in one of them leading to the overall prevalence of 0.27% for celiac disease among children with chronic constipation.         
In total, 0.27% of children with chronic constipation in the area under investigation suffer from celiac disease.

ADHD is the most prevalent psychiatric health issue in youth, which may also affect adults. Environmental and genetic factors both contribute significantly to the development and progression of this condition. Monoamine oxidases, which catalyze the metabolism of dopaminergic neurotransmitters, are involved in the pathogenesis of ADHD. The purpose of this study was to determine the connection between polymorphic variations rs6323 and uVNTR in the (Un translate variable nucleotide tandem repeat) MAO-A gene and the risk for ADHD in Iranian-Azeri children.
Clinical evaluation was used to recruit 137 ADHD patients (female 22, male 115) and 100 controls (female 48, male 52) from the East Azerbaijan region in northern Iran. Genomic DNA was taken from their peripheral blood samples and genotyping was performed using PCR-based amplification of target sites. SPSS (Version 16) and the javastat online statistics program (http://statpages.org/ctab2x2.html) were used for statistical analysis.
The rs6323TT genotype was shown to be a significant risk factor for ADHD (OR 3.619, 95 percent CI 0.878-17.213, p = 0.044). In comparison, no significant differences in allele frequencies were observed between ADHD patients and the control group (p > 0.05). The 5R allele of uVNTR was shown to have a substantial protective impact against the development of ADHD (OR0.349, 95 percent confidence interval 0.151-0.797, p = 0.006).
Our findings indicate that MAOA gene polymorphisms may play a role in the start and development of ADHD in Iranian-Azeri youngsters. However, more research with larger sample sizes is necessary to corroborate these results.

Anaplastic lymphoma kinase-positive (ALK+) large T-cell lymphoma (ALCL) is a rare type of lymphoma and it involves lymph nodes, but in some rare situations, it involves lungs, firstly. There are very rare cases in the world that have this type of disorder complicated with tuberculosis (TB). In this report, we present a boy who was referred to our hospital with TB and ALK+ALCL.

Short stature is estimated to account for half of the new visits to pediatric endocrine practices. Therefore, evaluating its underlying causes seems essential in order to choose the best treatment. Recently, some studies revealed the impact of ACAN, which encodes for aggrecan, mutations on growth ranging from mild idiopathic short stature to severe skeletal dysplasia.

Here, we describe clinical and molecular characteristics of an Iranian family with short stature using exome sequencing and co-segregation analysis through Sanger sequencing.

A novel variant of ACAN mutation c.1604delG (p.Arg535fs) was identified in the heterozygote pattern which was confirmed through co-segregation analysis in family members.

We have found a novel variant within the ACAN gene in association with insignificant bone abnormality without a high incidence of familiar bone malformation. In order to achieve better clinical outcomes, we suggest genetic testing at an earlier age and also long-term GH treatment for children who are at risk of ACAN mutations. Children who are born small considering their gestational age, or who have persistent short stature, advanced bone age, midfacial hypoplasia, joint problems, or broad toes, can be candidates for ACAN sequencing.

Pulmonary sequestration (PS) is characterized by a separate segment of the lung that receives anomalous vascular supply separate from the pulmonary arteries. Here we report the case of a 4-year-old girl with dyspnea and recurrent pneumonia who was finally diagnosed as a case of PS.

A 4-year-old girl was admitted to Imam-Reza hospital, Mashhad city, Iran, with a history of coughing and dyspnea from two years ago. On the CXR, consolidation can be seen in the left lower lobe. As there was a high likelihood of aspiration or pneumonia following her past medical history, the patient underwent bronchoscopy. More investigation with HRCT revealed vascular anomaly. CMRI (Cardiac Magnetic Resonance Imaging) showed no cardiac abnormality. More findings showed a large collateral artery originated from left lateral side of abdominal aorta. This collateral artery went upward to the LLLL (the Lower Lobe of Left Lung) and anastomosed directly with two large posterior segmental tributary of the left lung pulmonary veins. Hyper-vascular pattern of both lungs was also observed in the MRI.

To avoid misdiagnosis, PS should be considered in differential diagnosis in infants with chronic cough and dyspnea. These patients should be referred to a tertiary center to receive appropriate treatment.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provokes the host immune responses and induces severe respiratory syndrome by overreaction of immune cells. IL-1β is a pro-inflammatory cytokine highly associated with the related inflammation and cytokine storm, and several IL-1β antagonists are being used to treat cytokine release syndrome (CRS). Accordingly, some studies and clinical trials are investigating the effects of IL-1β antagonists for controlling Coronavirus disease 2019 (COVID-19) associated CRS. Here, we will review any interaction and association between IL-1β and SARS-CoV-2 infection.

Juvenile injuries by intraorbital foreign body in extremities are common and usually trivial (1) but they may lead to debilitating sequels in the head and neck. Because of their availability in comparison to other sources of trauma, accidental injuries may occur while children play with their friends. Injuries by pencils are special types of intraorbital foreign body, the final outcome of which is dependent to concurrent injuries of the ocular and also neurologic structure and comorbiditie. Orbital injury requires comprehensive evaluation, especially in child victims when there is not sufficient information regarding trauma mechanism and the intraorbital foreign body should be ruled out before any closure of wounds, as shown in the sample case presented here. In school age children with a history of falling, intraorbital fragments of pencils should be kept in mind. Preoperative information about the true number and exact location of retained fragments is paramount for an appropriate management. When there is high suspicion for retained foreign body, further detailed studies with CT and if needed MR scans and in selected cases plain X- ray are very helpful.