Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children
Mohammad Hasan
Kargar Maher
Pediatrician, Pediatric Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran.
author
Parinaz
Habibi
Pediatrician, Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
author
Nemat
Bilan
Pediatric Pulmonologist, Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
author
text
article
2015
eng
IntroductionChildren with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack severity is qualitatively estimated as mild, moderate and severe attacks and respiratory failure based on conditions such as respiration status, feeling of dyspnea, and the degree of unconsciousness. part of which are subjective rather than objective. We investigated clinical findings as predictors of severe attack and probable requirement for Pediatric Intensive Care Unit (PICU) admission.Materials and MethodsIn a cross sectional and analytical study 120 patients with asthma attack were enrolled from April 2010 to April 2014 (80 admitted in the ward and 40 in pediatric intensive care unit). Predictors of PICU admission were investigated regarding to initial heart rate(HR), respiratory rate (RR), Arterial Oxygen Saturation(SaO2) and PaCo2 and clinically evident cyanosis.ResultsInitial heart rate(p-value=0.02), respiratory rate (p-value=0.03), Arterial Oxygen Saturation(p-value=0.02) and PaCo2(p-value=0.03) and clinically evident cyanosis were significantly different in two groups(Ward admitted and PICU admitted)Conclusion There was a significant correlation between initial vital sign and blood gas analysis suggesting usefulness of these factors as predictors of severe asthma attack and subsequent clinical course.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
713
716
https://ijp.mums.ac.ir/article_4449_5d07496107558bdd96ed06fcc94b66b0.pdf
dx.doi.org/10.22038/ijp.2015.4449
The Trend of the Extended Program of Immunization (EPI) in Iran from the Beginning (1984) to 2013
Zohreh
Arefi
PhD Candidate in Health Education and Health Promotion, School of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran.
author
Zhila
Kazemi
Department of Public Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
author
Zahra
Shaahmadi
Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
author
Saeid
Mahmoudi
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
author
Faramarz
Shaahmadi
Savojbolagh Health Center, Alborz University of Medical Sciences, Karaj, Iran.
author
text
article
2015
eng
Introduction The extended program of immunization (EPI) in Iran is started in 1984, and it played an important and effective role in controlling many infectious diseases in community. The objective of this study was to determine the time trends of vaccination coverage by the type of vaccine among children, in the age group of 0-24 months, in Iran from the beginning of EPI (1984) to 2013. Materials and Methods This study has been conducted as a descriptive analytical research to evaluate the vaccines of extended program of immunization in Iran from 1984 to 2013. The data of this study have been obtained from the World Health Organization and UNICEF. The data of this study included the percentage of coverage for routine vaccines in Iran National immunization program in children, aged 0-24 months. The data analysis has been done by STATA, Version12. Results The coverage of all vaccines has been continuously increased from 1984 to 2013, and now the coverage for all of them is about 99 percent. All coefficients in the regression models are positive and statistically significant (P <0.05). Birth dose of Hepatitis B (HepBB) and third dose of diphtheria–tetanus–pertussis containing vaccine (DPT3) variables with coefficients of 1.52 and 1.34 had the highest rate of increasing during this period, respectively. The first dose of diphtheria–tetanus–pertussis containing vaccine (DPT1) with a coefficient of 0.65 had the lowest coefficient among other variables. Conclusion According to the findings, maintaining the wide coverage, monitoring and updating the program can play an important role to improve children's health, contagious disease prevention, and health promotion.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
717
723
https://ijp.mums.ac.ir/article_4450_60eaa266a2be2a572be15d997c31ee1d.pdf
dx.doi.org/10.22038/ijp.2015.4450
Methadone Poisoning in Children and some Factors affecting it: A Cross-sectional Study in Tabriz, Northwest of Iran
Fatemeh
Ghorbani
Department of Pediatric, Faculty of Nurcing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
author
Nasrin
Salimkhani
Children Hospital, Tabriz University of
Medical Sciences, Tabriz, Iran.
author
Sina
Pakdel
Legal Medicine Organization, Tabriz, Iran.
author
Mahni
Rahkar farshi
Department of Pediatric, Faculty of Nurcing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
author
text
article
2015
eng
Introduction: Children may be intentionally or unintentionally exposed to any substance. Substance poisoning is one of the most important emergency interventions in children that cause a great number of deaths each year. Regarding the importance of this issue and recent increase in number of poisoning cases, a study with the aim of investigating cases of substance poisoning and factors involved in emerging them was carried out in Children Hospital of Tabriz.Materials and Methods: The present descriptive cross-sectional study was carried out on hospitalized children with substance poisoning diagnosis during two years. The data was collected through referring to patients’ case and using demographic information questionnaire and symptoms checklist. The data was analyzed using SPSS 13, descriptive statistics, T test, chi- square and spearman tests.Results: During two years, 97 children with the mean age of 48 months were hospitalized due to substance poisoning. 59.3% of the study population consisted of boys and 40.7% of girls. Drowsiness, decreased level of consciousness, vomiting and pin point pupil were the most common symptoms recorded in children. The relationship between the type of substance and parents’ addiction was statistically significant. However, there was no significant relationship between intentional and unintentional poisoning and parents’ addiction.Conclusion: Non-specific package, unsafe keeping, and shortage of people’s knowledge are among the most important factors involved in Methadone poisoning in children. Delivering clear information about the fatal effect of this drug on children by health- care personnel especially doctors seems necessary.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
725
731
https://ijp.mums.ac.ir/article_4456_525227d0a3dff6a91fe3d90b188add4c.pdf
dx.doi.org/10.22038/ijp.2015.4456
Hospital Cost Associated with Pediatrics Urinary Tract Infection: Before and After Health Sector Evolution Program in the West of Iran
Satar
Rezaei
Department of Public Health, School of health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
author
Khalil
Moradi
Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
author
Afshin
Akhgar Piraebi
Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
author
Mohammad
Bazyar
Children, Cost of hospitalization, Length of stay, Urinary tract infections.
author
Parivash
Heidari Orejlu
Quality Improvement Office, Gachsaran Shahid Rajaee Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.
author
text
article
2015
eng
Background: urinary tract infections (UTIs) are one of the most important bacterial infections among children throughout the world. The study aimed to estimate the cost of hospitalization associated with pediatric UTIs in Kermanshah province for the years of 2013 and 2014. Methods and materials: this was a cross sectional and descriptive study. The study subjects included all those aged 20 years and younger who were admitted to the Imam Reza hospital with the diagnosis primary of the UTI in the studied period. The data on age, sex, length of stay (LOS), and cost of hospitalization were collected by review of medical records. The data analysis was conducted by Stata V.12. Results: average of age and length of stay was 2.7 years and 6.2 days, respectively. The study showed the average cost per patient and per one day hospitalization was 9206699 and 1484951 IRR, respectively. Patient’s share of total cost of hospitalization in 2013 and 2014 was 1565710 and 982619 IRR, respectively. In addition, there are a significant positive relationship between age, being boy and length of stay and total cost of hospitalization. Conclusion: ourfinding implies that the total cost of pediatric UTIs is considerable; at about 2,614,702,516 IRR. In addition, urinary tract infections is more common among females and children with less than 4 year. The study also indicates that Health Sector evolution program causes considerable decrease the patient’s share of total cost of hospitalization (8.7 % vs. 23.4 %).
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
733
738
https://ijp.mums.ac.ir/article_4431_83d89b1a837c871df19532e811afaa9f.pdf
dx.doi.org/10.22038/ijp.2015.4431
Demographic and Clinical Characteristics of youth onset Diabetes Mellitus in Kashmir India
Riyaz
Daga
SKIMS HOSPITAL SRINAGAR KASHMIR INDIA
author
Suhail
Naik
GB Pant Children Hospital, Kashmir, India.
author
Bashir A
Laway
Professor, Head Endocrinology SKIMS, KASHMIR, INDIA.
author
Malik
Shakir
Lecture Pediatrics, GB PANT CHILDEN HOSPITAL, SRINAGAR, KASHMIR INDIA 190001
author
Wasim
Rafiq
Senior Resident, GB PANT CHILDEN HOSPITAL, SRINAGAR, KASHMIR, INDIA 190001
author
text
article
2015
eng
Diabetes mellitus (DM) is a major public health problem. Objective of current study was to know the demography, clinical characteristics and etiology of youth Diabetes mellitus (DM) in Kashmir, North India. METHODS: A prospective hospital based study, carried out in the Department of Endocrinology, SKIMS Srinagar, Kashmir India over the period from 2008 July - September 2010. Setting: A teaching, Research and tertiary care hospital at Srinagar Kashmir North India. PARTICIPANTS: All the new youth onset diabetes patients whose age were less than 25 years and were admitted in endocrinology ward for various reasons over the period from 2008 July - September 2010. PROCEDURE: All children with diabetes mellitus less than twenty five years of age were enrolled in this study. Variables recorded were demographics, clinical presentation, laboratory tests. RESULTS: A total of seventy two patients of youth onset diabetes mellitus were studied, Forty six were less than 20 years and twenty six more than 20 years of age. There were 33 males (45.8%) and 39 females (54.2%). Family history of diabetes was present in nineteen (26.4%), fourteen were less than 20 yrs and five more than 20 yrs. Fifty nine (81.9%) presented with osmotic symptoms, Thirteen (18.1%) with DKA. Hypoglycemic episodes were present in forty one patients. Sixteen patients had nephropathy and nine had Retinopathy. CONCLUSION: Diabetes mellitus is a major public health problem. Type 2 diabetes mellitus is emerging as the form of diabetes in young diabetic patients, due to epidemic of childhood obesity.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
739
747
https://ijp.mums.ac.ir/article_4459_b7030a7bef3e845b9214aad41c342898.pdf
dx.doi.org/10.22038/ijp.2015.4459
Decomposition Socioeconomic Inequality in Infant Mortality in EMRO Countries
Sara
Emamgholipour Sefiddashti
Assistant professor, Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
author
Majid
Nakhae
School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
author
Ali
Kazemi Karyani
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
author
Sadegh
Ghazanfari
Department of Management and Health Economics, School of Public Health, Tehran University of Medical Science, Tehran, Iran.
author
text
article
2015
eng
Introduction
The preservation and promotion of the health in children who are one of the most vulnerable parts in any society has an important role in the health system of each country. In this study, the socioeconomic factors affecting the infant mortality in Eastern Mediterranean Regional Office (EMRO) countries have been examined during the time period from 2000 to 2013.
Materials and Methods
This study was a panel data type estimated by using the method of random effects. The Likelihood ratio (LR) and Wooldridge tests have been applied to investigate the hetereoskedasticity and autocorrelation. The data used in this study have been collected from the websites of the World Bank and the World Health Organization (WHO). The studied panel has been evaluated by Feasible Generalized Least Squares (FGLS) method due to the existence of hetereoskedasticity.
Results
The results showed that the variables of per capita national income logarithm, vaccination coverage of Measles, the education level of 15 to 24-year-old women, per capita health expenditures, and the accessibility of improved health facilities, had an inverse association with the mortality rate of children. All variables except vaccination coverage for Measles had significant association. The per capita national income also had the greatest impact in decreasing the mortality rate of children.
Conclusion
The findings indicate that socioeconomic inequality in infant mortality in EMRO countries is determined not only by health system functions but also by factors beyond the scope of health authorities such as education system, and economic variables.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
749
756
https://ijp.mums.ac.ir/article_4429_1d93fd70be87e17baa906260c39758e4.pdf
dx.doi.org/10.22038/ijp.2015.4429
Incidence of thrombocytopenia and changes in various platelet parameters, in blood culture positive neonatal sepsis
Sartaj
Bhat
Senior Residents, Department of Pediatrics, Government Medical College, Srinagar Kashmir, India
author
Suhail
Naik
Senior Residents, Department of Pediatrics, Government Medical College, Srinagar Kashmir, India
author
Wasim
Rafiq
Senior Residents, Department of Pediatrics, Government Medical College, Srinagar Kashmir, India
author
Syed
Tariq A
Assistant Professor, Department of Pediatrics, Government Medical College, Srinagar Kashmir, India
author
text
article
2015
eng
Abstract Objective: To assess the incidence of thrombocytopenia and changes in various platelet parameters, in culture positive neonatal sepsis. Methods: This was prospective study conducted over a period of one year from December 2009 to November 2010 in neonatal intensive care unit of DDUH Hospital, a tertiary care hospital in Delhi, North India. All babies who were admitted during this period were evaluated prospectively for evidence of sepsis. Results: sepsis was diagnosed in 560 neonates. Among 560 neonates, 80/560 (14.28%) had Culture positive sepsis. Out of 80 blood culture positive neonates 73 were term neonates and 7 were near term. Gram positive sepsis occurred in 21/80 (26.25%), gram negative sepsis in 54/80 (67.5%), and fungal sepsis in 5/80 (6.25%). Incidence of thrombocytopenia in Gram negative sepsis was (35/54) 64.81%, in gram positive sepsis (15/21) 71.41% and in fungal sepsis was (3/5) 60%. Mean platelet count at the onset of sepsis in all the patients was 123287.5±49428.68. The mean duration of thrombocytopenia in gram positive sepsis was 4.66 ±2.6 days, in gram negative sepsis 4.39 ± 2.22 days and in fungal sepsis 5.2±1.3 days. MPV at the time of onset of sepsis (MPV) was high in gram positive sepsis than in gram negative sepsis (11.57±0.88 Vs 11.29 ± 0.76). The MPV of thrombocytopenic neonates was significantly higher than that of non-thrombocytopenic neonates (p < 0.01).
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
757
766
https://ijp.mums.ac.ir/article_4465_6e17a23540033c921fdb5f308b7284eb.pdf
dx.doi.org/10.22038/ijp.2015.4465
Hiatal Hernia as a Mysterious Diagnosis; a Case Report
Ghamartaaj
Khanbabaee
Associate Prof. of pediatric pulmonology, Department of Pediatric Pulmonology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Farid
Imanzadeh
Associate Prof. of pediatric gastroenterology, Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Masood
Kiani
Fellow of pediatric pulmonology, Department of Pediatric Pulmonology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Amirhossein
Hosseini
Fellow of pediatric gastroentrology, Mofid children hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Neda
Ghiam
MsHSc candidate, Dalla Lana school of public health, University of Toronto, Toronto, Canada
author
text
article
2015
eng
Introduction: Proximal displacement of stomach and gastro-esophageal junction into the thoracic cavity results in a condition known as hiatal hernia (HH). Sometimes this entity is neglected in practice and the patient is handled as gastroesophageal reflux disease, asthma or other non-surgical diagnosis.Case: Here we present a 6 months-old female infant who present with bloody emesis since two months of age. She evaluated and labeled as gastritis and managed with proton pump inhibitors. Finally, after developing respiratory complaints, a strange retro cardiac shadow help physicians in reaching the correct diagnosis.Discussion: In primary work up of patents with gastrointestinal or respiratory complaints we should consider some anatomical abnormalities that can easily be missed. HH is one of these neglected entities especially in pediatric population.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
767
770
https://ijp.mums.ac.ir/article_4448_82e800da21087f5a145d011a3a5a02d1.pdf
dx.doi.org/10.22038/ijp.2015.4448
Pediatric Vision Screening: some General Knowledge for Pediatricians
Fatemeh
Sharifi
Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran ; Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Hamid Reza
Rahimi
Student Research Committee, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Arash
Omid Tabrizi
Ophthalmologist, School Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Saeid
Shahinfar
Mashhad, Mashhad University of medical science, Mashhad, Iran
author
Alireza
Attaei Nakhaie
Department of pediatric and pediatric neurology, Ghaem Hospital, Mashhad, Mashhad University of medical science, Mashhad, Iran
author
text
article
2015
eng
Primary vision care is recommended for infants and young children .Childhood is critical time to prevent loss of vision and to optimize treatment so some eye disorders in children must be diagnosed at this time.To detect risk factors and visual abnormalities, the eye screening done by pediatricians and other primary care providers is necessary. The process that should occur at each child visit to identify those patients who require referral to ophthalmologist and can be a preventative health measure. Thus, it is important that pediatricians increased knowledge about the eye conditions that may affect their youngest patients. This article reviews the most important pediatric eye condition that primary care providers may encounter.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
771
775
https://ijp.mums.ac.ir/article_4425_0c59729cc34699bb0c67d8b987c99263.pdf
dx.doi.org/10.22038/ijp.2015.4425
The Age of Criminal Responsibility in Children: some of Islamic Views
Mohammad Rasool
Ahangaran
Associate Professor, University of Tehran, Campus Farabi, Tehran, Iran.
author
Zahra
Abbasi
MA,Jurisprudence and Islamic law, Tehran University, Tehran.
author
text
article
2015
eng
The age of criminal responsibility of children in the Islamic Penalties Act has been determined as religious Bulugh (puberty) Nasab. According to this, criminal authorities hold girls criminally liable and punishable at 9 complete lunar years and boys at 15 complete lunar years. Unfortunately, our legislator has set criminal responsibility of children based on sexual maturity; therefore, thousands of newly born infants who are unable to think have been liable to punishment, while in the realization of criminal responsibility there is a need for intellectual maturity (growth) in addition to sexual maturity; that is, in the realization of criminal responsibility of children, there are two necessary conditions: “attainment of puberty boundary” and “achieving growth and attainting intellectual maturity”; otherwise, the child has no criminal responsibility and we cannot hold him liable for his action and punish him. In this research, an attempt is made to address the problems of the Act by drawing on the Islamic sources.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
777
787
https://ijp.mums.ac.ir/article_4455_e4ba093c16bbbcf93caa0a42f3e81d0c.pdf
dx.doi.org/10.22038/ijp.2015.4455
Emergency Management of Common Diseases in Children
Hasan
Rajabi
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Masumeh
Saeidi
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Gholamreza
Khademi
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Acute respiratory infections, diarrhea and fever are very common in children below the age of five years. All children suffer from these illnesses several times each year. However, during natural disasters like floods children are even more vulnerable to these diseases and death. Pneumonia, diarrhea, measles and malaria, and associated malnutrition, are responsible for over 60% deaths in children under five. During an emergency the proportion of children dying of the above mentioned diseases may be higher. It is possible for health workers to treat most sick children at health camps or in the community and save them from dying. This survey describes the steps to be followed by a health worker when managing a sick child in emergency situations.
International Journal of Pediatrics
Mashhad University of Medical Sciences
2345-5047
3
v.
4.1
no.
2015
789
798
https://ijp.mums.ac.ir/article_4502_ae6a6bc5f8ba7ca3dd09e62510429843.pdf
dx.doi.org/10.22038/ijp.2015.4502