Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Causes of Non-Vaccination of Influenza in Healthcare Workers at Zanjan Educational Hospitals, Iran10167101741342410.22038/ijp.2019.41274.3483ENMojtaba Kamali AghdamAssistant Professor of Pediatric Infectious, Pediatric Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.0000-0002-1966-5702Zahra ShojaeyanGeneral Physician, Zanjan University of Medical Sciences, Zanjan, Iran.Diana DiazAssistant Professor of Pediatric Surgery, Pediatric Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.0000-0002-3391-6125Kambiz EftekhariAssociate Professor of Pediatric Gastroenterology, Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Department of Pediatric, Bahrami Children’s Hospital, Tehran, Iran.0000-0003-3471-2498Journal Article20190621<span style="font-size: x-small;"><strong>Background</strong><strong>: </strong>Influenza is an acute respiratory illness that can cause hospitalization, and confers a high mortality rate, especially in high-risk groups. Influenza vaccination for hospital staff can play an effective role in controlling nosocomial flu infections. The purpose of this study was to investigate causes of non-vaccination of influenza in healthcare workers at Zanjan educational hospitals. </span><br /> <span style="font-size: x-small;"><strong>Materials and Methods:</strong> This was a cross-sectional study conducted during three months at two Zanjan educational hospitals, Iran. Two hundred and ten workers belonging to the hospital staff were randomly selected.The reasons for not receiving the vaccine and the demographic information of the staff were recorded in a special questionnaire. The questionnaire included demographic information such as: age, gender, occupation, work place, history of Influenza vaccination last year, and reason for non-vaccination of Influenza.</span><br /> <span style="font-size: x-small;"><strong>Results:</strong>Two hundred individuals were enrolled, which included 58% of physicians and 42% of nurses. In the past year, 51% of the subjects have received influenza vaccine. Of these, 45.7% were physicians and 58.3% were nurses. The most common reasons for non-vaccination were: the belief that healthy people do not have the chance of getting the infection (28.6%), forgetfulness (24.5%), lack of adequate information and fear of complications from the vaccine (14.3%). </span><br /> <span style="font-size: x-small;"><strong>Conclusions:</strong> The status of influenza vaccination in the staff of these hospitals was relatively acceptable (51% of the subjects were vaccinated);however, it has not yet reached the ideal.According to the results, the most common reasons for non-vaccination were: wrong thinking about getting the infection, forgetfulness, and fear of complications.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001The Effect of Educational Intervention Based on Health Belief Model to Decrease and Prevent Mobile Phone Addiction among Female High School Students in Iran10175101871336110.22038/ijp.2019.40785.3438ENMohadeseh KhoshgoftarStudents Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.000-0002-6870-3920Maryam Amidi MazaheriDepartment of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0002-0169-5997Mohammad Javad TarrahiDepartment of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0002-6725-9530Journal Article20190529<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Mobile phone has played an increasingly important role in people’s lives; however, there is a global concern that it may cause adverse effects on health. This study aimed to assess the effect of educational intervention based on Health Belief Model (HBM) to decrease and prevent mobile phone addiction among female high school students. </span><br /> <strong><em><span style="font-family: Times New Roman;">Materials and Methods</span></em></strong><br /> <span style="font-family: Times New Roman;">This quasi-experimental study was done on high school students in Esfahan city in 2018-2019. During a period of 6 months, 112 female high school students were selected and randomly assigned to control and intervention groups. The educational intervention was implemented only in the intervention group (6 sessions of ninety minutes). Health Belief Model constructs were measured by self-report questionnaires and mobile phone addiction was measured by Persian version of mobile phone addiction scale before and two months after the intervention<span style="font-size: medium;">.</span> </span><br /> <span style="font-family: Times New Roman;"><strong><em>Results: </em></strong>112 students (56 in control group and 56 in intervention group) participated in the study. There was no statistically significant difference between the baseline characteristics of students in both groups as well as HBM constructs and mobile phone addiction. Two months after the intervention, the mean score of mobile phone addiction among the students of intervention group students was decreased and in control group students, the score of mobile phone addiction was increased (P ≤ 0.05). Constructs of the HBM except perceived barriers for reducing mobile phone use and perceived benefits of mobile phone use significantly increased in the intervention group compared to the control group (P <0.05).</span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong><br /> <span style="font-family: Times New Roman;">According to the results, Educational intervention based on the HBM can prevent and decrease the mobile phone addiction in female students.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Investigating the Relationship between Smartphone Addiction and Loneliness and its Impact on Motivation to Progress in High School Students10187101931345610.22038/ijp.2019.41716.3514ENFatemeh TaghizadehStudent Research Committee, Psychiatry and Behavioral Research Centre, Addiction Institute, Mazandaran University Of Medical Sciences, Sari, Mazandaran , Iran.orcid.org/0000-0002-Parisa ReyhaniSari Islamic Azad University and Office of Education of Sari, Tabarestan Counselling Center, Sari, Mazandaran, Iran.Nader MolaviKashan University of Medical Sciences, Kashan, Iran.Masoudeh BabakhanianSocial Determinants of Health Research Center, Semnan University Of Medical Sciences , Semnan, Iran.0000-0002-6128-8023Masumeh GhazanfarpourNursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.0000-0003-4639-3711Firoozeh MirzaeeNursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.Zahra AbdollahiDepartment of Midwifery Education, Nasibeh Nursing And Midwifery Faculty, Mazandaran University of Medical Sciences, Sari , Mazandaran , Iran.Aniseh AhmadiIslamic Azad Uniiran, Department of Psychology (Sari Branch), Sari , Mazandaran , Iran.Fahimeh KhorasaniNursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.Journal Article20190709<strong>Background:</strong><br /> Problematic use of new communication technologies, such as smartphone, declines social relationships and increases loneliness. The purpose of the study was to determine the relationship between smartphone addiction and loneliness, the motivation to progress and other relevant variables among high school students.<br /> <strong>Materials and Methods:</strong><br /> The present cross-sectional study was conducted in Sari, Iran, in 2016. Using stratified cluster random sampling, 348 high school girls and boys (first year of high school) were selected as the study sample. Informed consent, demographic information, Loneliness Scale-Version, motivation to progress questionnaire, and smartphone addiction scale (SAS) were obtained from all students at the baseline. Data were analyzed using SPSS software version 22.0.<br /> <strong>Results:</strong><br /> The study sample consisted 396 students, including 208 (52.2%) females. According to findings, Telegram application is widely used among the students. Parental educational level, loneliness and motivation to progress are negatively correlated to smartphone addiction. Additionally, factors such as the gender (p<0.001), the type of communication software (Telegram) (p=0.04), and the father’s educational level (p=0.04) significantly predicted smartphone addiction among students.<br /> <strong>Conclusion:</strong><br /> The parental educational level especially father, gender of student, has a negative relationship with smartphone addiction, loneliness, and motivation to progress. Based on the results, the first year high school students are exposed to the risks and consequences of communication technologies. Therefore, it is imperative for Ministry of Education of Iran to consider the teaching programs about the proper usage of social network-related applications for students.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001The Comparison of Desfonak with Desferal in Patients with Beta Thalassemia Major: A Randomized Crossover Clinical Trial10195102041352310.22038/ijp.2019.41060.3459ENMohammad Reza GolpayeganiAssistant Professor of Pediatrics Hematology and Oncology, Department of Pediatrics, School of Medicine, Dr. Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000000170292334Nargece SorayaPediatrician, Department of Pediatrics, School of Medicine, Dr. Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.9876-9876-9876-9876Reza AkramipourAssociate Professor of Pediatrics Hematology and Oncology, Department of Pediatrics, School of Medicine, Dr. Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mansour RezaeiProfessor of Biostatistics, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.Journal Article20190611<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Beta thalassemia (β-thalassemia) is one of the most common genetic disorders that reduces the amount of specific chain production in hemoglobin. The aim of this study was to compare the efficacy and safety of Desfonak with Desferal in patients with β-thalassemia major in Iran. </span><br /> <strong><em><span style="font-family: Times New Roman;">Materials and Methods</span></em></strong><br /> <span style="font-family: Times New Roman;">The study was a two-treatment and two-period crossover Randomizedclinical trialdesign that was carried out on 100 thalassemic patients referred to Mohammad Kermanshahi hospital of Kermanshah city, Iran in 2018-19. Eligible patients were divided into two groups using a random number table (Group A, n=50; Group B, n=50). The group A received Desferal then Desfonak vs. (30 mg/kg in 8 h and 6 days in a week). The group B received Desfonak then Desferal. The data collection tool was a checklist, including variables of age, sex, AST, ALT, ferritin, urea, creatinine and different complications of gastrointestinal, articular, skin, respiratory system and hearing problems. The data were analyzed by STATA software (version 14.0). </span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">The results of the study showed that there are no significant statistical differences between Desferal and Desfonakin terms of different complications of GI, articular, skin, respiratory and hearing systems (P>0.05). Also, the results showed that there was no significant statistical difference between Desferal and Desfonak in terms of variables of AST, ALT, ferritin, urea and creatinine at two time periods (P>0.05).</span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong><br /> <span style="font-family: Times New Roman;">The results of this study highlighted that Desfonak and Desferal have similar efficacy and safety in patients with thalassemia major. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Cardiac Involvement in Mild Cystic Fibrosis Lung Involvement Assessed by Tissue‐Doppler Echocardiography10205102141347010.22038/ijp.2019.41556.3502ENMehdi GhaderianPediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0001-6677-6248Majid KeivanfarPediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Emam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0630-4104Shiva Barani BeiranvandPediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.Mohsen ReisiPediatric pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Emam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0002-3611-6609Journal Article20190702<span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Background:</em></strong>Cystic Fibrosis (CF) is a systemic disease affecting <span style="color: #231f20;">extra pulmonary </span>dysfunction as a result of CF-related lung disease. <span style="color: #231f20;">Because of lack of enough studies in this field and utilization of TDE in this field, we aimed to evaluate the cardiac involvement in children with CF and compare it with healthy children.</span></span><br /> <span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Materials and Methods: </em></strong><span style="color: black;">In this cross sectional study, children diagnosed with cystic fibrosis aged less than 15 years who referred to Emam Hossein Children’s Hospital, affiliated to Isfahan University of Medical Sciences, Iran, during 2018, were enrolled.</span> <span style="color: black;">Participants were 2 groups: case and control. In this study 27 children with mild cystic fibrosis lung disease and 27 healthy children were evaluated. Case groups were consisted of children with CF, and control group were healthy children. FEV1, FVC, and FEV1 / FVC of all participants were recorded based on their spirometry findings. Cardiac function tests including electrocardiogram and Doppler echocardiography were evaluated by an expert pediatric cardiologist. Spirometry and Doppler echocardiography findings in two studied groups were compared.</span></span><br /> <span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Results: </em></strong>Lateral wall tissue Doppler echocardiographic evaluation, annular peak velocity during systole and E<sup>’</sup>/A<sup>’</sup> ratio was significantly higher in children with CF than healthy children (P<0.05). In the right ventricle (septal wall) tissue Doppler echocardiographic evaluation peak velocity during early diastole, peak velocity during late diastole and annular peak velocity during systole was significantly higher in healthy children than those with CF (P<0.01). E<sup>’</sup>/A<sup>’</sup> ratio in the right ventricle (septal wall) tissue Doppler echocardiographic evaluation was significantly higher in children with CF than healthy children (P<0.01).</span><br /> <span style="font-size: x-small;"><strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong></span><br /> <span style="font-size: 11pt;"><span style="font-family: Times New Roman;"><span style="font-size: x-small;">Based on the results, it is recommended to consider tissue Doppler echocardiography in the earlier period of CF patients’ follow- up program.</span> </span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Evaluation of Maternal Anxiety in Mothers of Infants Admitted to the Neonatal Intensive Care Unit10215102241339210.22038/ijp.2019.41018.3458ENZhilla Heydarpoor DamanabadDepartment of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.0000-0001-6969-4109Leila ValizadehDepartment of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.0000-0001-7047-5309Mohamadreza Mansouri AraniPhD Candidate in Nursing Education, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.Mohammadbager HosseiniPediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.Mohammad Asgari JafarabadiRoad Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.Morteza MansourianHealth Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.0000-0002-2482-5424Arash ZiapourPhD Student of Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.orcid.org/0000-0001-Omid SafariDepartment of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.Amin MirzaeiPublic Health Department, Ilam University of Medical Sciences, Ilam, Iran.Babk RastegarimehrMSc, Abadan Faculty of Medical Sciences, Abadan, Iran.Journal Article20190610<span style="font-family: Times New Roman;"><strong><em>Background: </em></strong>Preterm birth and subsequent admission of the infant to neonatal intensive care unit (NICU) can be distressing for parents and lead to their anxiety. The aim of this study was to evaluate maternal anxiety in mothers of infants admitted to the NICU and determine the characteristics associated with maternal anxiety.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Materials and Methods: </em></strong>This study is a descriptive, cross-sectional study with participation of 100 mothers with infant that was born premature and hospitalized in NICU (mothers were selected through convenient sampling method) of Al-Zahra hospital, affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. Data collection tools included baseline characteristics (21 items), and Spielberger State-Trait Anxiety Inventory (STAI). Data were analyzed using SPSS software (version 23.0).</span><br /> <span style="font-family: Times New Roman;"><strong><em>Results: </em></strong>The results of study showed that 62% (n=100) of mothers had moderate level of state anxiety and (54% (n=100) had moderate level of trait anxiety, mean (SD) state anxiety score was 48.62(6.00) and mean (SD) trait anxiety was 32.45(3.63. There was statistically significant difference regarding state anxiety mean scores and number of delivery, education level, gestational age at birth weeks and child order (P<0.05). </span><br /> <span style="font-family: Times New Roman;"><strong><em>Conclusion: </em></strong>Based on the results, mother of premature infants had moderate level of state anxiety. Having university degree, the mothers whose premature infants were at 33 weeks gestational age and mothers who had third or more delivery number and their child order was third and over had experienced state anxiety. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Decretion of Late Onset Sepsis with Enteral Low Dose Lactulose in Very Premature Infants: A Double-Blind Randomized, Placebo-Controlled Pilot Study10225102331335410.22038/ijp.2019.41124.3466ENAmir-Mohammad ArmanianAssociate Professor of Isfahan Faculty of Medicine, Division of Neonatology, Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.0000-0003-1324-2220Nima SalehimehrMD, General Physician, Department of Health, Academic Member of Almahdi-Mehr Isfahan Higher Education Institution, Isfahan, Iran.Hosein SaneianMD, Associate Professor of Isfahan Faculty of Medicine, Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.0000-0003-0428-3637Elahe ShiraniMD, Resident of Pediatrics, Medical Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.Mostafa HajiRezaeiMD, Kashan University of Medical Sciences, Kashan, Iran.Journal Article20190614<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Neonatal sepsis contributes substantially to neonatal morbidity and mortality, and is an ongoing major global public health challenge. We aimed to evaluate the effects of enteral feeding supplementation of low dose lactulose on the incidence of late onset sepsis in very premature infants. </span><br /> <strong><em><span style="font-family: Times New Roman;">Materials and Methods</span></em></strong><br /> <span style="font-family: Times New Roman;">In this randomized placebo-controlled trial preterm neonates with very low birth weight (VLBW) randomly received enteral supplementation of 1% lactulose (1 g per 100 mL feeds) (n=27) or distilled water (placebo, n=25) simultaneous with increasing volumes of milk. Incidence of late onset sepsis was considered as primary outcome. Feeding intolerance, time to reach full enteral feeding and duration of hospitalization in the course of the study were considered as secondary outcomes.</span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">Differences in baseline characteristics were not statistically important. The incidence of late onset sepsis was significantly lower in lactulose group compared to placebo (14.8% vs. 40%, p=0.04). The mean time to reach full enteral feeding was 12.85±3.33 and 15.20±5.24 in the lactulose vs. placebo group (p=0.03). Duration of hospitalization, occurrence of necrotizing enterocolitis and body weight on the 30<sup>th</sup> day of life were not significantly different between the two groups.</span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong><br /> <span style="font-family: Times New Roman;">Enteral feeding supplementation with low dose lactulose in very premature infants for prebiotic purposes was deemed to be safe and reduced the incidence of late onset sepsis in our study.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Prognostic Factors for Improvement of Attention Deficit Hyperactivity Disorder (ADHD)10235102421373010.22038/ijp.2019.42692.3578ENHoda ShirafkanPhD Student of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-5682-1153Akbar FotouhiProfessor/MD PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.Javad Mahmoudi-GharaeiProfessor/MD, Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.Seyyed Ali MozaffarpurAssociate Professor/MD, PhD, Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.Mostafa HosseiniProfessor/PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.0000-0001-7932-0047Mehdi YaseriAssociate Professor/PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-4066-873XJournal Article20190821<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Attention-deficit/hyperactivity disorder (ADHD) is usually accompanied with other comorbidities that make treatment suboptimal and results in inadequate outcomes. Investigating the factors having an effect on improvement of ADHD can lead to better outcomes and a higher adherence to medication. </span><br /> <strong><em><span style="font-family: Times New Roman;">Materials and Methods</span></em></strong><br /> <span style="font-family: Times New Roman;">This historical cohort study was carried out on records of 6 to 13 year old patients with ADHD during the years 2008 to 2015 in the Children's Medical Center in Tehran, Iran. Baseline characteristics of patients such as gender, birth weight, the age of the first diagnosis, weight, severity of ADHD at the baseline, time duration of receiving the Methylphenidate, types of comorbidity, and dosage of Methylphenidate were extracted from hospital records. The Generalized Estimating Equation (GEE) was used to develop a multivariable model. This model is based on a stepwise procedure. </span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">One hundred and thirty-nine children (75.5% boys, mean age of 97.8±26.8 months) were assessed. Time duration of receiving Methylphenidate (OR=1.06; p< 0.001), severity of ADHD at the baseline (OR=0.94; p< 0.001), and dosage of Methylphenidate (OR=2.34; p< 0.001) had a significant relationship with improvement. In this study any relationship between improvement of ADHD and other factors was not found.</span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong><br /> <span style="font-family: Times New Roman;">In this study, the clinical severity of ADHD at baseline, logarithm of dosage of Methylphenidate, and time duration of receiving the Methylphenidate were associated with improvement of ADHD.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Using Social Cognitive Theory to Investigate the Risk Factors of Waterpipe Smoking among Southeastern Iranian Adolescents10243102531334410.22038/ijp.2019.40663.3429ENMohammadreza RajabalipourInstructor, School of Health, Bam University of Medical Sciences Bam, Iran.0000-0003-1556-4696Hadi KhoshabAssistant Professor, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran.Mohammad Reza BaneshiProfessor, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences. Kerman, Iran.Nouzar NakhaeeProfessor, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.Hamid SharifiAssociate Professor, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health. Kerman University of Medical Sciences. Kerman, Iran.Fateme TavakoliMSc, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health. Kerman University of Medical Sciences. Kerman, Iran.Abedin IranpourNeuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.0000-0002-7746-5709Journal Article20190525<span style="font-size: x-small;"><strong><em>Background</em></strong>: Explaining the risk factors of waterpipe smoking (WS) is very necessary in prevention programs. The aim of this study was determining the risk factors and the prevalence of WS in adolescents based on the social cognitive theory (SCT). </span><br /> <span style="font-size: x-small;"><strong><em>Materials and Methods: </em></strong>This cross-sectional study was conducted among urban adolescents in two provinces located in the South East of Iran. We recruited 1,218 adolescents (girls=595 and boys=623) through multistage sampling during the period October 2017 to February 2018. The data collection tool was <span style="font-family: Calibri;">a self-administered standardized questionnaire that included basic baseline characteristics</span>, SCT constructs items and questions about WS behavior in the participants. The data were analysed using SPSS software version 22.0.</span><br /> <span style="font-size: x-small;"><strong><em>Results </em></strong></span><br /> <span style="font-size: x-small;">The ever use prevalence of WS in boys was 43.8% (n= 264), and in girls 27% (n=160). WS in family member (OR=1.87, CI: 1.32-2.63; p<0.001) and intimate friends (OR=2.34, CI: 1.70- 2.26; p<0.001) were the most important risk factors for adolescents. In the relation of WS with constructs of SCT: outcome expectations (OR=0.64, 95% CI: 0.50-0.84; p<0.001), outcome expectancy, (OR=0.65, 95% CI: 0.55-0.85; p=0.002) self-efficacy, (OR=0.30, 95% CI: 0.23- 0.41; p<0.001), and situational perception (OR=0.63, 95% CI: 0.47- 0.84: p=0.002) were the most important and related factors of WS. Boys were 1.92 times (OR: 1.06 – 2.43; p<0.001) more exposed to water-pipe smoking than girls. </span><br /> <span style="font-size: x-small;"><strong><em>Conclusion</em></strong></span><br /> <span style="font-size: medium;"><span style="font-size: x-small;">The prevalence of WS was notable in students especially in boys. Peer group and family are important risk factors for tendency toward WS in adolescence. Also, lower score in SCT constructs such as knowledge, self-efficacy and situational perception in adolescents are important risk factors for WS in participants.</span> </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Tumor Necrosis Factor alpha, N-terminal Pro Brain Natriuretic Peptide and Interleukin-6 Correlations with Doppler Tissue Imaging findings in Major Thalassemia Patients10255102681328010.22038/ijp.2019.40837.3445ENNoor Mohammad NooriChildren and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran.0000-0002-0732-6412Alireza TeimouriChildren and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran.0000-0002-8356-4260Maryam Nakhaee MoghadamChildren and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran.0000-0002-0080-862XHossein BagheriEnglish Department, Medical School, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran.Journal Article20190601 <br /> <span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Background</em></strong> </span><br /> <br /> <span style="font-family: Times New Roman; font-size: x-small;">In respect to abnormalities in thalassemia patients and the effects of TNF_α, IL_6, and NT-pro-BNP on echocardiography findings the study aimed to investigate TNF_α, NT-pro-BNP and IL_6 correlations with Doppler tissue imaging findings in major thalassemia. </span><br /> <br /> <span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Materials and Methods</em></strong>: This case-control study was performed on 112 healthy children and 112 patients with thalassemia in Ali Asghar hospital, Zahedan, Iran, in 2017. Healthy children were selected from those that referred to the pediatric clinics for routine check-up. Fasting blood samples were taken to measure TNF-α, NT-pro-BNP and IL_6 serums. Those thalassemia patients who had regular transfusions of hemoglobin higher than 10 g/dl and 48-72 h after packed red blood cell transfusion and those who were asymptomatic were entered to the study. Participants underwent echocardiography by pediatric cardiologist in Doppler method. </span><br /> <br /> <span style="font-family: Times New Roman; font-size: x-small;"><strong><em>Results</em></strong><strong>: </strong>NT-pro-BNP, TNF_α and IL_6 were lower in controls (P<0.001). Height, weight and BMI were higher in controls (P<0.001). Right ET, left ET, IVSD, PWD, PWS, EF, FS, left ET', left ICT', left IRT', right ET', right IRT', right S', right Peak A', VE', VA', left and right MPI', LVMI were different in case and control (P<0.05). Right Peak A (P=0.049), PWD (P=0.032), Left MPI' (P=0.02) and LVMI (P=0.005) were correlated with IL_6. IVSD (P=0.01), LVDS (P=0.01), EF and FS (P<0.001), left ET' (P=0.02), left ICT' (P<0.001), right ET' (P=0.001), right S' (P=0.002), left MPI’ (P<0.010) were correlated with NT-pro-BNP. </span><br /> <br /> <span style="font-size: x-small;"><strong><em>Conclusion</em></strong></span><br /> <br /> <span style="font-family: Times New Roman; font-size: x-small;">NT-pro-BNP, TNF_α, IL_6 were higher in thalassemia patients and NT- pro-BNP was correlated with some of the echocardiography findings. This suggests that NT-pro-BNP would be the best biomarker for evaluation of cardiac functions in thalassemia patients.</span><br /> Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Study of the Spatial Pattern of Malnutrition (Stunting, Wasting and Overweight) in Countries in the World Using Geographic Information System10269102811324010.22038/ijp.2019.40204.3410ENAli AlmasiSocial Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000-0002-1506-7289Alireza ZangenehSocial Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.Shahram SaeidiSocial Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000-0003-4050-3465Samira Rahimi NaderiTehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.Maryam ChoobtashaniKermanshah University of Medical Sciences, Kermanshah, Iran.Fariba SaeidiKermanshah University of Medical Sciences, Kermanshah, Iran.Mohammad Reza SalahshoorDepartment of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mahnaz SolhiDepartment of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran.Arash ZiapourPhD Student of Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.orcid.org/0000-0001-Journal Article20190507<span style="font-family: Times New Roman;"><strong><em>Background: </em></strong>Malnutrition is a great challenge for the public health system. Therefore, this study aimed to study the spatial pattern malnutrition using GIS in the world's countries.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Materials and Methods: </em></strong>In this cross-sectional study, secondary child malnutrition data analysis was conducted using World Health Organization data from 2005 to 2016. The data were analyzed by Arc/GIS 10.6 software. The prevalence rates of malnutrition were exported into Arc/GIS10.6 to visualize key estimations, and the excess risk of malnutrition of each country was calculated. In this regard, the spatial patterns of variables of the prevalence of stunting in children under 5 (%), prevalence of wasting in children under 5 (%), and prevalence of overweight in children under 5 (%) were evaluated by GIS. </span><br /> <span style="font-family: Times New Roman;"><strong><em>Results: </em></strong>Our findings showed that the prevalence of stunting, wasting and overweight in children under 5 was not accidental and has emerged in the cluster form based on a regular occurrence in countries around the world. Furthermore, the results of our research indicated that the mean center and standard deviation of stunting and wasting included most of the African and Asian countries especially in the Middle East, but the mean center and standard deviation of overweight included more areas of the world. Overweight has included many parts of the world and its spatial distribution is more than stunting and wasting. Overweight was observed the African, Asian and European countries. </span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion: </span></em></strong><br /> <span style="font-family: Times New Roman;">The spatial pattern of malnutrition was clustered in the world. The results of this study could be the starting point for the development of appropriate malnutrition interventions and policies globally. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Hutchinson-Gilford Progeria Syndrome10283102891390110.22038/ijp.2019.42913.3592ENJhon Camacho-CruzMD Pediatrician, Associate Instructor Department of Pediatrics, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia. Grupo de Investigación Materno – Infantil. Línea Pediatría.0000-0003-0898-9223Luz Dary Gutiérrez-CastañedaMSc. in Human Genetics, Biotechnology Doctor (c), Assistant Professor, Department of Genetics, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia. Grupo de Investigación Ciencias Básicas en Salud.Daniela PulidoMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Catalina EcheverriMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Betty BernalMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Luisa Bautista3Medical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Lizeth AngaritaMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Andrés VillamilMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Laura GuarinMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Vanessa BenavidesMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Natalia LancherosMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Juan PardoMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Monica BautistaMedical Student, Grupo de Investigación Ciencias Básicas en Salud y Grupo de Investigación Materno – Infantil. Línea Pediatría. Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, D.C. Colombia.Journal Article20190902The Hutchinson-Gilford syndrome or progeria is a laminopathy generated by mutations that affect LMNA gene. This produces an abnormal protein named progerine which alters the formation of the cellular membrane inducing premature aging of all cells. In the present review aspects related to the pathophysiology and clinical characteristics of this syndrome are shown.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001Identification of a Novel Intragenic Deletion of the PHKD1 Gene in a Patient with Autosomal Recessive Polycystic Kidney Disease10291102971385810.22038/ijp.2019.42674.3576ENLeandros LazarosGenesis Genoma Lab, Genetic Diagnosis, Clinical Genetics & Research, Athens, Greece.0000-0001-7488-0416Danai PalaiologouGenesis Genoma Lab, Genetic Diagnosis, Clinical Genetics & Research, Athens, Greece.Amelia PantouGenesis Genoma Lab, Genetic Diagnosis, Clinical Genetics & Research, Athens, Greece.Chaido KoumanzeliNeonatal Intensive Care Unit, 2nd Department of Pediatrics, Athens University Medical School, 'P. & A. Kyriakou' Children’s Hospital of Athens, Athens, Greece.Ioannis KapetanakisNeonatal Intensive Care Unit, 2nd Department of Pediatrics, Athens University Medical School, 'P. & A. Kyriakou' Children’s Hospital of Athens, Athens, Greece.Emmanouel KanavakisGenesis Genoma Lab, Genetic Diagnosis, Clinical Genetics & Research, Athens, Greece.Journal Article20190820<strong><em>Background</em></strong><br /> Autosomal recessive polycystic kidney disease (ARPKD) is caused by mutations in the <em>PKHD1</em>gene. In the present study, we describe a severe case of ARPKD carrying a point mutation and a novel four-exon deletion of <em>PKHD1</em> gene.<br /> <strong><em>Materials and Methods</em></strong><br /> The <em>PKHD1</em>, <em>PKD1 </em>and<em> PKD2 </em>genes were analyzed using next-generation sequencing, whereas the <em>PKHD1</em> gene exon deletions/duplications were screened using multiplex ligation-dependent probe amplification.<br /> <strong><em>Results</em></strong><br /> The c.2279G>A (p.Arg760His) mutation and a deletion encompassing exons 24-27 of <em>PKHD1</em> gene were detected in compound heterozygosity in the affected neonate. The complete documentation of the genetic basis of the disease offered the possibility of a targeted prenatal diagnosis in the following pregnancy of the couple.<br /> <strong><em>Conclusion</em></strong><br /> Given that the molecular analysis of ARPKD is mainly based on sequencing techniques, the <em>PKHD1</em> gene exon deletion/duplication screening should be performed as a complementary assay in patients suspected to have ARPKD in the absence of two pathogenic mutations.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504771020191001The Effect of Iron Replacement Therapy on Electrocardiographic Consequences in Pediatric Patients10299103091350610.22038/ijp.2019.41543.3504ENVahid ShahriariDepartment of Pediatrics,Faculty of Medicine,Birjand University of Medical Sciences, Ghafari Street, Birjand, Southern Khorasan, Iran.0000-0003-0677-6929Fatemeh TaheriAssociate Professor of Pediatric, Birjand Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences (BUMS), Birjand, Iran.0000-0001-6037-212XForod Salehi AbarghoueiAssociate Professor of Pediatric Cardiology Department of Pediatrics, School of Medicine Cardiovascular Diseases Research Center Birjand University of Medical Sciences, Birjand, Iran.0000-0003-3173-2207Journal Article20190703<strong><em>Background</em></strong><br /> Sudden cardiac death is an important problem, because the patients have no opportunity to receive medical service. Recently some electrocardiogram (ECG) parameters are used for predicting arrhythmias, including P wave duration for predicting atrial arrhythmias and corrected QT and T wave peak to end interval (Tp-e), for predicting ventricular arrhythmias. Iron deficiency is the most prevalent nutrient disorder worldwide in which iron loads in different tissues including myocardium are decreased. We aimed to investigate the relationship between iron deficiency and arrhythmogenic ECG parameters. Then we compared electrocardiographic parameters of iron deficient patients before and after iron replacement therapy.<br /> <strong><em>Materials and Methods</em></strong><br /> In the first phase of study, ECG and blood samples were taken from 9-18 years old healthy adolescents for CBC and ferritin tests. They were divided into three groups according to serum ferritin: group 1 (ferritin below 15), group 2 (ferritin 15-30), and group 3 (ferritin above 30) ng/ml. In phase two, group 1 were given standard iron replacement therapy. We compared ECG parameters in three groups and then in group 1 before and after treatment.<br /> <strong><em>Results</em></strong><br /> The number of individuals in three groups was 120 (group 1= 25, group 2= 26 and group 3= 69). The results showed that all parameters were significantly higher in group one and the lowest in group three. Also, there was a significant decrease in these parameters after treatment in group one (P<0.05).<br /> <strong><em>Conclusion</em></strong><br /> Based on the results, Iron deficiency through decreased myocardial iron load can prolong ECG parameters and elevate risk of arrhythmia. Also, iron replacement therapy can reduce this risk.