Iranian Journal of Pediatrics

18/11/2017

Review Article

Approach to Growing Pains in Childhood in a Familial Mediterranean Fever Endemic Region

Ilke Beyitler, Salih Kavukcu

DOI: 10.5812/ijp.11546

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Growing pain, still preserving its charm, is the most common form of recurrent musculoskeletal pain in childhood. Approach to diagnosis requires significant care in geographical regions with familial Mediterranean fever (FMF) endemicity. We discuss data and a current approach to growing pains in children in an FMF endemic region.

The symptomatology may be confused with different diseases. Although unnecessary tests may be performed to reach diagnosis, sometimes patients may be misdiagnosed as having growing pain without revealing the primary underlying pathology. Definite algorithms are not developed for diagnosis of growing pains. Diagnosis is mainly based on typical clinical features of the condition. However laboratory tests and imaging methods may be used for diagnosis and differential diagnosis especially in atypical course suggesting diseases such as inflammatory ones or malignancies. Vitamin D deficiency should be investigated to give supplementation if necessary.

Some helpful algorithms may be used in evaluation of patients. In order to evaluate myalgia as growing pain in areas where FMF is endemic, fever, abdominal pain, elevated acute phase reactants and history of FMF and/or amyloidosis in family should be carefully excluded. It is important to inform parents about the alarming symptoms of extremity pain and when to urge medical advice again.

20/11/2017

Research Article

The Relationship between Range of Motion and Function of Upper Extremity in Obstetric Brachial Plexus Palsy Patients Treated with Tendon Transfer

Zeynep Hosbay, Muberra Tanrıverdi, Ela Tarakci, Atakan Aydın, Arzu Razak Ozdincler

DOI: 10.5812/ijp.5679

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Obstetric brachial plexus palsy (OBPP) refers to upper limb paralysis secondary to a sustained traction or compression injury to the brachial plexus during birth. The reported incidence in developed countries is 2 per 1000 live births. The assessment and planning of appropriate treatment is important in the early stages of OBPP. The aim of our study was to examine the relationship between the range of motion and upper extremity function of the shoulder in patients with OBPP who were treated by tendon transfer. This study included 48 patients who had shoulder tendon transfer at least 6 months ago in Istanbul Medical Faculty, Department of Plastic and Reconstructive Surgery, Department of Surgery of the Hand. Range of motion measurements were performed using a universal goniometer and the modified mallet classification was used to categorize global shoulder function. Pediatric evaluation of disability inventory (PEDI) and Canadian occupational performance measure (COPM) were used to evaluate functional ability, activity and participation. When examining relationships between range of motion and functional scores, there was a statistically significant relationship between COPMP score and external rotation, and no relationship was found between other motion functional scores. The study demonstrated that, the use of the pattern of development and motivation of patients to participate is also important among range of motion and muscle strength for upper extremity function.

22/10/2017

Research Article

Management of Foreign Bodies in the Mouth, Nose and Ears in Children in the Emergency Room

Florian Bast, Corina Lee, Natalie von Jaschke, Heidi Olze

DOI: 10.5812/ijp.6257

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22/10/2017

Research Article

The Effect of Probiotics in Prevention of Necrotising Enterocolitis in Preterm Neonates in Comparison with Control Group

Elaheh Amini, Hosein Dalili, Nikoo Niknafs, Mamak Shariat, Maryam Nakhostin, Saeid Jedari-Attari

DOI: 10.5812/ijp.7663

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16/11/2017

Research Article

Upper Extremity Impairments and Activities in Children with Bilateral Cerebral Palsy

Bulent Elbasan, Elmas Bozkurt, Deran Oskay, Cigdem Oksuz

DOI: 10.5812/ijp.7711

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Methods: Eighteen children with diparetic CP and 15 typical peers between the ages 5 - 12 years were included in the study. Manual Ability Classification System (MACS) was used for the classification of upper extremity fine motor skills; WeeFIM for activities of daily living; Abilhand-Kids for the manual abilities; and Pediatric Evaluation of Disability Inventory (PEDI) for the disability in the daily living activities respectively. Grip strength was evaluated with Jamar Hand Dynamometer, hand functions were assessed with Nine-hole Peg Test and Jebsen-Taylor test.

18/11/2017

Research Article

Duckett versus Modified Bracka Technique for Proximal Hypospadias Repair A 10-Year Experience

Afsaneh Sadeghi, Alireza Mirshemirani, Ahmad Khaleghnejad Tabari, Naser Sadeghian, Mohsen Rozroukh, Javad Ghoroubi, Leila Mohajerzadeh, Mehdi Sarafi

DOI: 10.5812/ijp.7752

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Results: One hundred sixty four cases with a mean age of 2.70 ± 2.6 (range 0.5 - 13) years underwent proximal hypospadias repair. Follow up ran in average to 5 (range 1 - 10) years.Chordee was seen in 19 (11.58%) cases which 15 (78.9%) cases released and 4 (21.1%) corrected by dorsal Nesbit plication. Fifteen of 164 (9.1%) cases had meatal stenosis: 5 in Bracka and 10 in Duckett group, all of which were repaired by dilatation. Six patients in Duckett group and only one in Bracka series had urethrocutaneous fistula. One case in Bracka group and five cases in Duckett series underwent re-operation.

16/10/2017

Research Article

Development of a Support System for Parents of Premature Infants

Seyedeh Saeedeh Mousavi, Reza Chaman, Parisa Mohagheghi, Seyed Abbas Mousavi, Ahmad Khosravi, Afsaneh Keramat

DOI: 10.5812/ijp.9578

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Methods: The method is based on four key steps. 1) Explaining parents’ needs, including comprehensive review of quantitative studies, meta-synthesis of qualitative studies conducted in Iran by search of Iranian databases (IranMedex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) and comparative study. 2) A comprehensive review to identify effective interventions in supporting PPI and ranking interventions. 3) Designing a model to support PPI. 4) Evaluating designed system for supporting the PPI.

Results: The results of this study identified five critical steps which the PPI experienced and 14 effective interventions to support them. Preconception: care before the next pregnancy; prenatal: preparing parents to see their baby for the first time, supporting parents in breastfeeding (BF), kangaroo care (KC) and infant massage; neonatal: spiritual self-care, individualized behavioral and developmental care programs, using scales to assess infant's behavior, supporting parents in BF, KC and infant massage, support forums for parents, relieving parents’ stress, sharing information and communication, family nurture interventions, supporting parents in transferring between neonatal units (NU), facilitating collaborative care in NU; discharge: discharge planning, support forums for parents, sharing information and communication and home: home support programs, individualized behavioral and developmental care programs, supporting parents in BF, KC and infant massage. Support forums for parents, sharing information and communication.

16/10/2017

Research Article

Comparison of Adenosine Deaminase Level in Serum and Synovial Fluid in Patients with Juvenile Idiopathic Arthritis and Its Relation to Inflammatory Acute Phase Reactants

Khosro Rahmani, Seyed-Reza Raeeskarami, Vahid Ziaee, Payman Sadeghi, Mohammad-Hassan Moradinejad, Mohammad-Taghi Haghi-Ashtiani

DOI: 10.5812/ijp.9888

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Results: 80% of the patients had oligoarticular and 20% polarticulare JIA. There was a significant relation between erythrocyte sedimentation rate (ESR) and high level of synovial fluid ADA. Synovial ADA level was significantly higher than serum ADA in polyarticular JIA. C-reactive protein (CRP), leukocytes and platelets count were increased in high levels of synovial fluid ADA. No correlation was observed between level of serum and synovial fluid ADA.

18/11/2017

Research Article

Balloon Valvuloplasty for Pulmonary Stenosis in Children: Immediate Outcome and Cardiac Remodeling during Midterm Follow-up

Hamid Amoozgar, Mina Salehi, Mohammad Borzoee, Gholamhossein Ajami, Mohammad Reza Edraki, Nima Mehdizadegan, Hamid Mohammadi

DOI: 10.5812/ijp.10058

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Methods: In this prospective study, we first reviewed immediate outcome of 104 pediatric patients with mean age of 3.64 ± 4.33 years and mean weight of 11.32 ± 7.7 kg at the time of BPV who were treated at our tertiary pediatric heart center from June 2010 to August 2014, and then on midterm follow up (mean follow up time was 2.0 ± 1.87 years) the patients were reassessed by 2D, M-mode, Doppler and tissue Doppler echocardiography for cardiac remodeling and pulmonary valve function. P value less than 0.05 was considered as statistically significant.

Results: This study showed right ventricular pressure and pulmonary valve stenosis decreased significantly immediately after procedure and peak instantaneous pressure gradient remained acceptable on follow up. However, the patients had significant diastolic dysfunction in midterm follow up while tricuspid inflow velocities and E/A ratio had no statistically significant correlation with right ventricular pressure and residual VPS. These patients had significant increased tricuspid valve Aa velocity and E/Ea ratio and had significant difference with normal references of age during follow up period. Also pulmonary artery diameters were in normal range for body surface area after the procedure.

26/11/2017

Research Article

A Qualitative Approach to Find Nursing Diagnoses for Non-Physical Health Problems in Mothers of Children with Cancer

Lida Nikfarid, Maryam Rassouli, Leili Borimnejad, Hamid Alavimajd

DOI: 10.5812/ijp.10500

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15/11/2017

Research Article

Effect of a Supportive-Training Intervention on Mother-Infant Attachment

Mohammad Arshadi Bostanabad, Hossein Namdar Areshtanab, Masoumeh Balila, Mohammad Asghari Jafarabadi, Kobra Ravanbakhsh

DOI: 10.5812/ijp.10565

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Methods: The present clinical trial was conducted in the NICU of 29 Bahman hospital, Tabriz. Sixty fathers of hospitalized premature infants were divided into intervention and control groups. Before the intervention, the mother-infant attachment was measured by the AVANT cheek list. The training intervention was applied to the parents of the intervention group for 2 days and the fathers were conducted to bedside of their infants to visit them and exchange ideas with their wives. The control group only received the routine cares in the unit and ultimately, the mother-infant attachment was re-measured in both groups.

23/10/2017

Research Article

Renal Complications of Sickle Cell Syndrome in Southern Iran

Mahdi Shahriari, Mohammad-Hossein Fallahzadeh, Leila Malekmakan, Sayyed-Yousef Mojtahedi

DOI: 10.5812/ijp.11016

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Results: Ninety seven patients with mean age of 8.5 ± 3.4 years (55.4% males) were divided into three groups; 30 cases with sickle cell disease, 31 patients with sickle cell trait, and 36 cases with sickle thalassemia. Enuresis was present in 20 (22.9%) patients > 5 years. Significant proteinuria was not observed, but micro albuminuria was found in 14 (14.4%) patients. GFR was in normal range when calculated with creatinine clearance, but glomerular hyper filtration was present in 5.2% by Cystatin C formula. Mean serum creatinine was in low normal range (0.5 ± 0.1) but mean serum Cystatin C (0.9 ± 0.1) was higher than the normal range especially in Sβ patients (P = 0.023).

18/11/2017

Research Article

Percentiles of Oxygen Saturations (SpO2) and Heart Rates (HR) in Premature Infants in the Delivery Room

Sinan Uslu, Umut Zubarioglu, Sehrinaz Sozeri, Mesut Dursun, Ali Bulbul, Aysegul Uslu, Evrim Kiray Bas, Ebru Turkoglu Unal, Duygu Besnili Acar

DOI: 10.5812/ijp.11650

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1/11/2017

Research Article

Dental Age Estimation in Southern Turkish Children: Comparison of Demirjian and Willems Methods

Halenur Altan, Ahmet Altan, Ozlem Akinci Sozer

DOI: 10.5812/ijp.11726

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Methods: In this retrospective study, panoramic radiographs of 745 southern Turkish children (382 boys and 363 girls) aged between 4 and 15.99 years were examined by one investigator. According to Demirjian and Willems method, the mean difference between chronological and dental age was calculated for each sex and age group. The Wilcoxon test was used to compare all data. Statistical analysis was performed to test the validity of Demirjian and Willems methods by comparing the mean estimated and chronological age.

18/11/2017

Research Article

Microsomal Liver Function in Patients with Phenylketonuria Assessed by 13C-Methacetin Breath Test

Renata Mozrzymas, Monika Dus-Zuchowska, Lukasz Kaluzny, Anna Miskiewicz-Chotnicka, Aleksandra Lisowska, Jaroslaw Walkowiak

DOI: 10.5812/ijp.12535

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Results: The values of cumulative percentage dose recovery at 120 minutes of the test (CPDR median < interquartile range >) were significantly lower in the PKU group than in the control group (25.1 < 21.8 - 28.83 > vs 32.8 < 27.4 - 34.1 >; P = 0.0067). The lower values of the maximum momentary 13C recovery (Dmax) were observed in the PKU group than in the control group (26.6 < 22.4 - 28.7 > vs. 32.1 < 27.18 - 34.08 >; P = 0.0227). The values of time to reach Dmax (Tmax) did not differ (20 < 17 - 20 > vs. 20 < 20 - 20 >; P = 0.8410). The values of CPDR, Dmax and Tmax were not different between the group with abnormal (> 10 mg/dL) and normal (< 10 mg/dL) Phe level (P = 0.2799; 0.7959; 0.4812, respectively).

16/11/2017

Research Article

Osteocalcin Level in Children with Steroid Dependent/Frequently Relapsing and Steroid Resistant Nephrotic Syndrome

Emad E Ghobrial, Hanan Abdel-Aziz, Riham H El Sayed, Athar M Abdel-Aliem

DOI: 10.5812/ijp.14229

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Background: Children with nephrotic syndrome (NS) may be at risk for metabolic bone disease because of biochemical derangement caused by renal disease as well as steroid therapy. Osteocalcin (OC) functions as an inhibitor of bone mineralization. We aimed to evaluate linear growth and bone turnover markers (including serum osteocalcin) in children with steroid-dependant/frequently-relapsing and steroid resistant NS in comparison to a matched control group.

Results: Serum OC levels were significantly higher in both SDNS/FRNS and SRNS than in control group, with P value 0.02 and 0.01, respectively. There was statistically significant negative correlation between OC and serum calcium. There was a negative correlation between height for age percentile and number of relapses. There were also negative correlations between height for age percentile and steroids, cyclophosphamide and cyclosporine duration of treatment. We found that both of our patients groups (SDNS/FRNS and SRNS) showed lower height for age percentile compared to control group (P = 0.017 and 0.001 respectively).

17/11/2017

Research Article

Utilization of Extracorporeal Membrane Oxygenation In Pediatric Cardiac Surgery: A Single Center Experience, 34 Cases in 8 Years

Cenap Zeybek, Mustafa Kemal Avsar, Ozgur Yildirim, Arda Ozyuksel, Mehmet Salih Bilal

DOI: 10.5812/ijp.14402

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Methods: ECMO was used in a total of 34 postoperative congenital cardiac surgery cases, whose operations had been performed by the same congenital cardiac surgery team. Patients’ ages were between 3 days to 15 years. ECMO was used in four different indications; in case of unsuccessful weaning from cardiopulmonary bypass (OR-ECMO), in low cardiac output syndrome (LCOS-ECMO), in refractory post cardiac arrest (CPR-ECMO) and in respiratory insufficiency after RSV infection (RSV-ECMO).

Results: The follow-up period of patients ranged from 1 to 80 months, whereas ECMO duration ranged from 23 to 2218 hours. Six cases were OR-ECMO, 13 were LCOS-ECMO, 12 were CPR-ECMO and 3 were RSV-ECMO. Out of a total of 34 cases, 20 (58%) cases were weaned from ECMO. Two of the patients, who were able to be weaned from ECMO passed away in the hospital; however, the other 18 patients (52.9%) were discharged from the hospital without having any significant neurological deficits. The top survival rate (69%) and weaning from ECMO was in the LCOS-ECMO group and the worst weaning from ECMO support (33%) was in the RSV-ECMO. The worst survival rate (25%) was in the CPR-ECMO group. Sepsis and associated multiple organ dysfunction were observed as the major cause of mortality in these patients. The most common complications were bleeding and mechanical complications related to cannulation.

12/6/2017

Brief Report

Clinical Presentation in a Series of Eight Children with Abdominal Tuberculosis: Experience of a Single-Center in Turkey

Merve Usta, Nafiye Urganci, Nazan Dalgic, Nuray Uslu Kızılkan, Tugce Kurtaraner, Cetin Ali Karadag

DOI: 10.5812/ijp.9766

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Results: There were six girls and two boys with a mean age of 13.6 ± 2.8 years (range, 7 - 16 years). Abdominal pain and weight loss were common complaints in all patients (100%) at presentation; fever was present in four (50%) patients and abdominal distension in two (25%) patients. Mean duration of symptoms before diagnosis was 2.5 ± 1 months. Laparotomy performed in six patients, and the peritoneum was the most common infection site (in 5 patients). Chest X-rays of 7 patients indicated lung involvement. The most common abdominal computed tomography and ultrasonography finding was ascites. Bowel wall thickening was recorded in 2 patients and ileal thickening in 1 patient. Inguinal lymphadenopathy and multiple mesenteric lymphadenitis were present as single cases.

Iranian Journal of Pediatrics

Published by: Kowsar

Iranian Journal of Pediatrics: Dec 2017, 27 (6), 18 articles.