ORIGINAL_ARTICLE
Synbiotic for Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Clinical Trial
Introduction Antibiotic- associated diarrhea is a common problem in pediatric population. There is growing interest in probiotics, probiotics and synbiotics for prevention of this complication because of their worldwide availability as dietary supplements. The aim of this study was to assess the efficacy of a synbiotic mixture in prevention of antibiotic- associated diarrhea. Materials and Methods: In this randomized controlled trial, 218 patients ( 111 in the synbiotic and 107 in the placebo group) aged 6 months to 14 years with respiratory tract infection and/ or otitis media who needed antibiotic treatment in outpatient setting, were enrolled. They received 1 billion Colony Forming Unit of seven probiotics species plus Fructooligosaccharide in form of powder or placebo ( matched for size, shape, and volume) for 7 days. Amoxicillin, Amoxicillin-clavalanic acid, cefixim and Azithromicin were the most common drugs used by physcicians Mothers recorded stool frequency and consistency daily for 7 days. Results: We found no significant difference (P>0.05) in occurrence of diarrhea between synbiotic and placebo groups. Conclusion: This synbiotic mixture did not appear to reduce antibiotic- associated diarrhea in children. Further studies are needed to investigate the potential benefits of Synbiotics in prevention of this disease.
https://ijp.mums.ac.ir/article_2121_7dd31427535996dd5ff550a21505d75f.pdf
2014-01-01
55
62
10.22038/ijp.2014.2121
Synbiotic
Antibiotic-Associated Diarrhea
Prevention
Seyed Ali
Jafari
1
1Department of Pediatric Gastroenterology, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Hamid
Ahanchian
2
2Inflammation and Inflammatory Disorder Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohammad Ali
Kiani
kianima@mums.ac.ir
3
Department of Pediatric Gastroenterology, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Ali
Khakshour
khakshoura@mums.ac.ir
4
Department of Pediatrics, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
AUTHOR
Zeinab
Noorbakhsh
5
Department of Pediatric Gastroenterology, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Elham
Zamani
6
Inflammation and Inflammatory Disorder Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Hamid Reza
Kianifar
kianifarhr@mums.ac.ir
7
Department of Pediatric Gastroenterology, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
References
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13. Farid R, Ahanchian H, Jabbari F, Moghiman T: Effect of a new synbiotic mixture on atopic dermatitis in children: a randomized-controlled trial. Iran J Pediatr. 2011 Jun;21(2):225-30.
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16. Tasteyre A, Barc MC, Karjalainen T , et al. Inhibition of in vitro cell adherence of clostridium difficile by saccharomyces boulardii. Microb pathog. 2002; 32(5): 219-25.
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17. Doron SI, Hibberd PL, Gorbach SL. Probiotics for prevention of antibiotic – associated diarrhea. J clin Gastroenterol. 2008; 42 suppl 2: 858-63. 18. Chapman CM, Gibson GR, Rowland I. In vitro evaluation of single- and multi-strain probiotics: Inter-species inhibition between probiotic strains, and inhibition of pathogens. Anaerobe. 2012; 18(4):405-13. 19.Virk A, Mandrekar J, Berbari EF et al. A randomized, double blind, placebo-controlled trial of an oral synbiotic (AKSB) for prevention of travelers' diarrhea. J Travel Med. 2013; 20(2):88-94.
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20. Fioramonti J, Theodorou V, Bueno L. Probiotics: what are they? What are their effects on gut physiology? Best Pract Res Clin Gastroenterol. 2003;17(5):711–24.
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21. Dinleyici EC, Dalgic N, Guven S, et al. The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: single blinded randomized study. Eur J Pediatr. 2013; 172(4):459-64.
21
22. Passariello A, Terrin G, Cecere G, et al. Randomised clinical trial: efficacy of a new synbiotic formulation containing Lactobacillus paracasei B21060 plus arabinogalactan and xilooligosaccharides in children with acute diarrhoea. Aliment Pharmacol Ther. 2012; 35(7):782-8.
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23. Vandenplas Y, De Hert S. Cost/benefit of synbiotics in acute infectious gastroenteritis: spend to save. Benef Microbes. 2012; 3(3): 189-94.
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24. Johnston BC, Goldenberg JZ, Vandvik PO, et al. probiotics for the prevention of pediatric antibiotic–associated diarrhea. Cochrane Database sys Rev 2011; CD oo 4827.
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25. Can M , Besirbellioglu BA, Auki IY, et al. Prophylactic saccharomyces boulardii in the prevention of antibiotic-associated diarrhea : a prospective study. Med Sci Monit. 2006; 12(4):119-22.
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26. Jirapinyo P, Densupsoontorn N, Thamonsiri N, et al. prevention of antibiotic-associated diarrhea in infants by probiotics . J Med Assoc Thai.2002; 85 Suppl 2:8739-42.
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27. Vandenplas Y, Brunser O, Szajewska H. Saccharomyces boulardii in childhood.Eur J pediatr. 2009; 168(3):253-65.
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28. Song HJ, Kim JY, Jung SA, et al. Effect of probiotic lactobacillus (Lacidofil (R) cap) for the prevention of antibiotic-associated diarrhea : a prospective , randomized , double-blind, multicenter study. J Korean Med Sci. 2010; 25(12):1784-91.
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29. Stein G, Nanim R, Karniel E, et al. Probiotics as prophylactic agents against antibiotic associated diarrhea in hospitalized patients. Harefuah.2007; 146(7):520.
29
30. Merenstein DJ, Foster J, D Amico F.A randomized clinical trial measuring the influence of kefir on antibiotic – associated diarrhea: the measuring the influence of kefir (MILK) study. Arch Pediatr Adolesc Med. 2009; 163(8):750-4.
30
31. Kliegman RM, Stanton BF, St. Geme JW, et al. Nelson textbook of pediatrics. Ed 19th. Philadelphia: Elsevier saunders; 2011-995.
31
ORIGINAL_ARTICLE
Utility of Modeling End-Stage Liver Disease in Children with Chronic Liver Disease
Introduction: Chronic liver diseases consist of wide spectrum disorders that may be complicated by cirrhosis and therefore need to transplantation. The pediatric end-stage liver disease (PELD) score and model of end-stage liver disease (MELD) score has been used as predictors of mortality chronic liver diseases listed for liver transplantation. The aim of this study is evaluation of relation between PELDMELD score and evidence of cirrhosis in children with choronic liver disease. Materials and Method: This cross-sectional study conducted on 106 patients of chronic liver disease referred to Ghaem Haspital, Mashhad University of Medical Science, Iran during 24 months period (2010-2013). PELD and MELD score were calculated for all patients. Clincal and patholoogical findings of cirrhosis were recorded. Results: Mean age of patients was 68/3 ± 41.8 months. Mean PELDMELD score was -1/59± 9/64. There was significant correlation between PELDMELD score and clinical icter, spelenomegaly, evidence of hepatopulminary syndrome, esophageal varices, evidence of cirrhosis in tissue specimences. Conclusion: PELDMELD score appear to be benefit for detection of cirrhotic children among paients with choronic liver disease.
https://ijp.mums.ac.ir/article_2123_c971e53729932597c1097cf7c69289a8.pdf
2014-01-01
71
74
10.22038/ijp.2014.2123
Choronic Liver Disease
Cirrhosis
PELDMELD Score
Hamid Reza
Kianifar
kianifarhr@mums.ac.ir
1
Department of Pediatric Gastroenterology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Sanaz
Jafarzadeh Fakhari
2
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Maryam
Khalesi
3
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Mohammad Ali
Kiani
kianima@mums.ac.ir
4
Department of Pediatric Gastroenterology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Atefeh
Ezzati
5
Ghaem Hospital Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Seyed Ali
Jafari
6
Department of Pediatric Gastroenterology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
1. Shinkai M, Ohhama Y, Take H, Fukuzato Y, Fujita S, Nishi T. Evaluation of the PELD risk score as a severity index of biliary atresia. Journal of pediatric surgery. 2003 Jul; 38(7): 1001-4.
1
2. Wiesner RH, McDiarmid SV, Kamath PS, Edwards EB, Malinchoc M, Kremers WK, et al. MELD and PELD: application of survival models to liver allocation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2001 Jul;7(7):567-80.
2
3. Freeman RB Jr, Wiesner RH, Roberts JP, McDiarmid S, Dykstra DM, Merion RM. Improving liver allocation: MELD and PELD. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2004;4 Suppl 9:114-31.
3
4. Barshes NR, Lee TC, Udell IW, O'Mahoney CA, Karpen SJ, Carter BA, et al. The pediatric end-stage liver disease (PELD) model as a predictor of survival benefit and posttransplant survival in pediatric liver transplant recipients. Liver Transpl. 2006 Mar;12(3):475-80.
4
5. McDiarmid SV, Anand R, Lindblad AS, Principal I, Institutions of the Studies of Pediatric Liver Transplantation Research G. Development of a pediatric end-stage liver disease score to predict poor outcome in children awaiting liver transplantation. Transplantation. 2002 Jul 27;74(2):173-81.
5
6. Sanchez MC, D'Agostino DE. Pediatric end-stage liver disease score in acute liver failure to assess poor prognosis. J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):193-6.
6
7. Dehghani SM, Gholami S, Bahador A, Haghighat M, Imanieh MH, Nikeghbalian S, et al. Comparison of Child-Turcotte-Pugh and pediatric end-stage liver disease scoring systems to predict morbidity and mortality of children awaiting liver transplantation. Transplant Proc. 2007 Dec;39(10):3175-7.
7
8. McDiarmid SV, Merion RM, Dykstra DM, Harper AM. Selection of pediatric candidates under the PELD system. Liver Transpl. 2004 Oct;10(10 Suppl 2):S23-30.
8
9. Jagadisan B, Srivastava A, Yachha SK, Poddar U. Acute on chronic liver disease in children from the developing world: recognition and prognosis. J Pediatr Gastroenterol Nutr. 2012 Jan;54(1):77-82.
9
10. Freeman RB Jr, Gish RG, Harper A, Davis GL, Vierling J, Lieblein L, et al. Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula. Liver Transpl. 2006 Dec;12(12 Suppl 3):S128-36.
10
ORIGINAL_ARTICLE
Maternal Knowledge and Attitude toward Exclusive Breast Milk Feeding (BMF) in the First 6 Months of Infant Life in Mashhad
Introduction: Breast milk is a complete food for growing children until 6 months of age, and mothers, as the most important child health care, play a decisive role in their growth. So promoting their attitude toward the benefits of breastfeeding ensures guarantee child health in the future. This study aimed to assess maternal knowledge and attitude of Mashhad toward exclusive BMF in the first 6 months of infant life. Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 126 mothers who referring to Mashhad health-care centers for monitoring their 6-24 month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic tests and using SPSS 11.5. Results: Mean score of maternal attitude toward exclusive BMF was 14.32±5.28 (out of 28) and maternal knowledge score toward advantages of breast milk was 19.59±4.80 (out of 28). The incidence of exclusive BMF in the first 6 months of life study was 73.8%. Child growth was as follows: excellent growth (5.6%) and good growth (42.1%). ANOVA showed a significant difference between parents' education and maternal attitude towards exclusive BMF; whatever higher education of parents, more positive maternal attitude towards exclusive BMF (P<0.05). There was a significant direct relationship between knowledge and attitude (Spearman test, P-value= 0.000& r= 0.4). Conclusion: Maternal attitude towards exclusive BMF was moderate. It is essential to plan for mothers by officials in order to promote breast-feeding in the first 6 months of baby's life to enhance positive maternal attitude in this regard.
https://ijp.mums.ac.ir/article_2122_40480ce7acc047bafa9261ed3d186cd4.pdf
2014-01-01
63
69
10.22038/ijp.2014.2122
Attitude
Exclusive Breast Milk Feeding
Infant
Mashhad
Bibi Leila
Hoseini
1
Midwifery MSc; Faculty Member of Midwhfery Department, Sabzevar University of Medical Sciences, Sabzevar, Iran.
AUTHOR
Rahim
Vakili
vakilir@mums.ac.ir
2
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohammad Ali
Kiani
kianima@mums.ac.ir
3
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Ali
Khakshour
khakshoura@mums.ac.ir
4
Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran.
AUTHOR
Masumeh
Saeidi
5
Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
LEAD_AUTHOR
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13. Innis SM: Perinatal biochemistry and physiology of longchain polyunsaturated fatty acids. J Pediatr 2003, 143(4Suppl):S1-8.
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18. Seddighi P, Ghafarpur M, Jazayeri A. Effect of weaning foods, infant growth and development in Eslamshahr city. Medical Journal (Journal of Medicine, Shahid Beheshti University of Medical Sciences); 21 years, 1997, P. 14-25.
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19. Razavieh V,Pourabdolahi P,Nikkhah S. Knowledge and attitudes of mothers about feeding infant with breastfeeding applied and supplementary foods. Journal of Urmia University of Medical Sciences, No. 2, Summer 2001, Pages 120-9.
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20. Nakhshab M,Basiri H. Prevalence of malnutrition and its risk factors in children under 2 years of Sari 2000. Journal of Mazandaran University of Medical Sciences, Year XII, No. 34, Spring 2002, Pages: 47-56.
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21. Kusha A. Nutritional status of children under 1 year of Hospital Medicine Branch Community in 1991-1993 years. Journal of Zanjan University of Medical Sciences, No. 20, 1995, Pages: 5-10.
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43
ORIGINAL_ARTICLE
Mothers’ Experiences with Premature Neonates about Kangaroo Care: Qualitative Approaches
Introduction: Premature neonates admitted in NICU besides being separated from their mothers are prone to inevitably painful and stressful situations. Kangaroo care is the most effective method to get rid of this separation and its negative consequences. This study was performed to determine the experiences of mothers having premature neonates concerning Kangaroo care. Material and Methods: The present study is a qualitative research in which focus group discussion method is used for data collection. Research society consisted of mothers having premature neonates Research group reread and categorized the qualitative findings. Contents of interviews were analyzed using the conventional interpretation approach introduced by Dicklman Method. Results: Through content analysis of information emerged two major categories including mothers’ experiences about advantages of kangaroo care in interaction with neonate, and, feeling of physical-mental healthiness of neonate. Executive obstacles of kangaroo care from mothers’ standpoint were also discussed, which will be subsequently presented. Discussion: According to the obtained results, it seems vital to highlight kangaroo care as a safe and effective clinical care-taking treatment in nursery of premature neonates in all hospitals. Nurses shall provide all mothers with the needed instructions for holding the premature and lower-weight neonate properly on their chests and shall promote their knowledge level concerning positive effects of kangaroo care including induction of tranquil sleep, optimization of physiological conditions of neonate, and removal of suckling obstacles.
https://ijp.mums.ac.ir/article_2124_baebe21a171127f155dd5b2d26d92a5b.pdf
2014-01-01
75
82
10.22038/ijp.2014.2124
Experiences
mothers
Premature neonates
Kangaroo care
Tahere
Salimi
1
Department of Nursing, Faculty of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
AUTHOR
Mahsa
Khodayarian
2
Department of Nursing, Instructor of Nursing Management, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
AUTHOR
Mahshid
Bokaie
3
Department of Midwifery, Faculty of Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
AUTHOR
Mahnaz
Antikchi
4
Department of Nursing, Nursing Student and Member of Student Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
AUTHOR
Samane
Javadi
5
Department of Nursing, Nursing Student and Member of Student Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
AUTHOR
1. Alvandi S. The effects of therapeutic touch on infant colic pain. ShahidBeheshti University of Medical Sciences. 1995. PP: 52-4. [Persian]
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2. Blois M. Hold me close: Encouraging essential mother/baby physical contact. Excerpt from the author. “Birth: Care of infant and mother: Time Sensitive Issues.” Best Practices in the Behavioral Management of Health from Preconception to Adolescence, edited by William Gordon and Jodie Trafton. Los Altos: Institute for Disease Management. 2007-8. PP: 108-132.
2
3. Morelius E, Theodorsson E, Nelson N. Salivary cortisol and mood and pain profiles during skin-to-skin care for an unselected group of mothers and infants in neonatal intensive care. Pediatrics. 2005. 116 (5). PP: 1105-13.
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4. Chapra KN. “Kangaroo mother program”. Pediatrics. 1994. 4. PP: 804-810.
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5. Feldman R, Eidelman A, Sirota L. Weller A. Skin to skin contact (kangaroo care) accelerates autonomic and neurobehavioral maturation in preterm infants. Dev Med Child Neurol. 2002. 38(2). PP: 194-207.
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6. World Health Organization. Kangaroo mother care: a practical guide. Department of Reproductive Health and Research, WHO, Geneva. 2003.
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7. Ackan E, Yigit R, Atici A. The effect of kangaroo care on pain in premature infants during invasive procedures. The Turkish Journal of Pediatrics. 2009. 51 (1). PP: 14-18.
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8. Ludington-Hoe S.M. Thirty years of kangaroo care science and practice. Neonatal Network. September/October 2011. 30 (5). PP: 357-63.
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9. Engler AJ. Kangaroo care: nation survey of practice, knowledge barriers and perceptions. MCN. 2002. 27(3). PP: 146-53.
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10. Chwo MJ. A randomized controlled trial of early kangaroo care for preterm infants. Nursing Research. 2002. 10(2). PP: 129-142.
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11. Rabiee F. Focus-group interview and data analysis. Proceedings of the Nutrition Society. 2004; 63: 655-60.
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12. Adib Haj Bagheri M, Parvizi S, Salsali M. [Qualitative Research]. First edition. Tehran: Boshra; 2007. [Persian]
12
13. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004; 24(2): 105-12.
13
14. Polit DF, Beck CT. Nursing research: principles and methods (Nursing Research: Principles & Practice). 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003.
14
15. Tessier R. Cristo M. Velez S. Giron M. Ruiz Palaez JG. Charpak Y. Charpak N. Kangaroo mother care and the bonding hypothsis. Pediatrics. 1998. 102: e 17.
15
16. Salimi T, Shahbazi L, Eslami Z, Dehghanpour MH. The effects of skin contact of mother on vital signs and behavioral state of premature neonates. Iran Journal of Nursing (IJN). 2009. 22 (61). PP: 85-93. [Persian]
16
17. Goldstein Ferber S, Makhoul IR. The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: A randomized controlled trial. Pediatrics. 2004. 113 (4). PP: 858-65.
17
18. Hake-Brooks S, Cranston Anderson G. Kangaroo care and breastfeeding of mother-preterm infant dyads 0-18 months: A randomized controlled trial. Neonatal Network. May/June 2008. 27 (3). PP: 151-9.
18
19. Lawn J, Mwansa-Kambafwile J, Horta BL Barros F.C. Cousens S. Kangaroo mother care to prevent neonatal deaths due to preterm birth complications. International Journal of Epidemiology. 2010. 39. PP: iI44-i54.
19
20. Kambarami RA, Chidede O, Pereira N. Long term outcomes of preterm infants discharged home on kangaroo care in adeveloping country. Annals of Tropical Pediatrics. 2003. 23. PP: 55-9.
20
21. Cong X, Ludington-Hoe SM, McGain G, Fu P. Kangaroo care modifies preterm infant heart rate variability in response to heel stick pain: Pilot study. Early Human Development. 2009. 85. PP: 561-7.
21
22. DiMenna L. Considerations for implementation of a neonatal kangaroo care protocol. Neonatal Network. November/ December 2006. 25(6). PP: 405-12.
22
23. Sontheimer D, Fischer CB, Buch KE. Kangaroo transport instead of incubator transport. Pediatrics. 2004. 113(4). PP: 920-3.
23
24. Chia P. The attitudes and practices of neonatal nurses in the use of kangaroo care. Australian Journal of Advanced Nursing. 2006. 23(4). PP: 20-7.
24
ORIGINAL_ARTICLE
Association of Pediatric Stress Hyperglycemia with Insulin Metabolism Disorders
Introduction: Transient hyperglycemia is a condition that happens during acute physiologic stress in children. The aim of this study is to determine if there is any relation between stress hyperglycemia and diabetes mellitus and metabolic syndrome in pediatric patients. Materials and Methods: The study was performed on children hospitalized in Amirkola pediatric hospital, North of Iran, between February 2011 to January 2013. Children with a history of stress hyperglycemia were studied for the presence of metabolic syndrome or Anti GAD65 Autoantibodies. A total of 50 patients were studied. Results: None of our patients had developed type 1 diabetes. OGTT was normal in all patients. Metabolic syndrome was present in 2 cases (4%). The prevalence of insulin resistance was 16%. The most common metabolic abnormality noted was hypertriglyciredemia and one patient was positive for GAD 65 autoantibody. Conclusion: According to our data children with stress hyperglycemia do not appear to be at increased risk of developing type 1 diabetes but insulin resistance is relatively common in these patients.
https://ijp.mums.ac.ir/article_2221_35de608202554f857d8cbc48eee4801a.pdf
2014-01-01
83
87
10.22038/ijp.2014.2221
Diabetes Mellitus
Hyperglycemia
insulin resistance
Metabolic syndrome X
Peyman
Eshraghi
1
Department of pediatric Endocrinology and Metabolism, Facultyof Medicine, Mashhad University of Medical Sciences(MUMS), Mashhad, Iran.
AUTHOR
Sepideh
Bagheri
drbagheri.s@gmail.com
2
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical sciences(MUMS), Mashhad, Iran.
LEAD_AUTHOR
Setareh
Kamel
3
Medical Student, Babol University of Medical Sciences, Babol, Iran.
AUTHOR
1. Srinivasan V, Spinella PC, Drott HR, Roth CL, Helfaer MA, Nadkarni V. Association of timing, duration, and intensity of hyperglycemia with intensive care unit mortality in critically ill children. Pediatr Crit Care Med 2004; 5(4):329–36.
1
2. Karen C, MC Cown MB, Maltora A, Bruce RB. Stress induced hyperglycemia. Critic Care Clin North Am 2001; 17 (1):107-22.
2
3. Preissig CM, Rigby MR. Pediatric critical illness hyperglycemia: risk factors associated with development and severity of hyperglycemia in critically ill children. J Pediatr 2009; 155(5):734–39.
3
4. Valerio G, Franzese A, Carlin E, Pecile P, Perini R, Tenore A. High prevalence of stress hyperglycemia in children with febrile seizures and traumatic injuries. Acta Pediatrica 2008; 90(6):618-22.
4
5. Faustino EV, Apkon M. Persistent hyperglycemia in critically ill children. J Pediatr 2005; 146(1):30–4.
5
6. Saz EU, Ozen S, Simsek GD, DARcan S. Stress hyperglycemia in febrile children: Relationship to prediabetes. Minerva Endoc- rinologica 2011; 36(2):99-105
6
7. Vardi P, Shehada N, Etzioni A, Herkovits T, Soldreizik L, Shmuel Z, et al. Strerss hyperglycemia in childhood : a very high risk group for the development of type 1 diabetes mellitus. J Pediatr 1990; 117(1):77
7
9. Bingley PJ, Bonifacio E, Williams AJ, Genovese S. Prediction of IDDM in the general population strategies based on combination of autoantibody markers. Diabetes 1997; 46(11):1701-10.
8
10. Lemmark A. Selecting culprits in type 1 diabetes beta-cell killing. J Clin Invest 1999; 104:1487-9.
9
11. Hagopian WA, Kartsen AE, Gottsater A, Olsson M, Grubin CE, Michelsen A, et al. Quantitative assay using recombinant human islet glutamic acid decarboxylase (GAD65) shows that 64ak autoantibody positivity at onset predicts diabetes type. J Clin Invest 1993; 91:368-74.
10
12. Medline plus: Metabolic syndrome (http://www.nlm.nil.gov/medlineplus/metabolic syndrome.html).
11
13. Feldeisen SE, Tucker KL. Nutritional strategies in the prevention and treatment of metabolic syndrome. Appl Physiol Nutr Metab 2007; 32(1):46-60.
12
14. Verge CF, Stenger D, Bonifacio E, Colman PG, Pilcher C, Bingley PJ, et al. Combined use of auto antibodies (IA_2 autoantibody, GAD autoantibody, insuliun autoantibody, cytoplasmic islet cell antibody) in type 1 diabetes. Combinatorial islet auto antibody workshop. Diabetes 1998; 47:1857-66.
13
15. Razavi Z, Ramezani A. Prevalence of stress hyperglycemia in patients admitted to Qaems hospital. Journal of Gorgan Medical University 2004; 5(11): 37-42.
14
16. Saz EU, Ozen S, Simsek GD, DARcan S. Stress hyperglycemia in febrile children: Relationship to prediabetes. Minerva Endocrinologica 2011; 36(2):99-105.
15
17. Bhisitkul DM, Vinik AL, Morrow Al, She SX, Shults J, Powers Ac, et al. Pre diabetic markers in children with stress hyperglycemia. Arch Pediatr Adoles Med 1996; 150(9):936-41.
16
18. Gered G, David N, Gabriela A. Abnormal insulin sensitivity persists up to 3 years in pediatric patients post burn. J Endocri and Metab 2009; 94(5):1656-64.
17
19. Margoth C, Teran CG, Rodrigez C, Medina M. Prevalence of insulin resistance and its association with metabolic syndrome criteria among bolivian children and adolescents with obesity. 2008. Online available: httpwww. biomedcentral.com/1471-2431/8/31.
18
20. Hsiao L, Kartal LJ, MitsnefesM. Hyperinsulinemia in pediatric patients with chronic kidney disease: the role of TNF α. Pediatr Nephrol 2007; 22:1751-6.
19
21. Azizi F, Hosseinpanah F, Mehrdad M. Prevalence of metabolic syndrome in children 3-9 years old. Journal of research in medicine (Shahid Beheshti Medical University) 2007; 4(30):337-46.
20
22. Cruze ML, Goran Ml. The metabolic syndrome in childhood and adolescent. Orv Hetil 2006; 147(6):243-50.
21
23. Li C, Ford Es. Definition of the metabolic syndrome: what's new and what predicts risk. Metabolic syndrome and related disorders 2006; 4(4):237-51.
22
24. Mohammadpour-Ahranjani B, Rashidi A, Karandish M, Eshraghian MR, Kalantari N. Prevalence of overweight and obesity in adolescent Tehrani students,2000-2001: an epidemic health problem. Public health Nutr 2004; 7:645-48.
23
25. Kelishadi R, Hashemipour M, Sarrafzadegan N, Sadry GH, Ansari R, Alikhassy H, Bashardoust N. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan healthy heart program-heart health promotion from childhood. Pediatr Int 2003; 45:435-42.
24
ORIGINAL_ARTICLE
Viewpoints of Traditional Iranian Medicine (TIM) about Etiology of Pediatric Constipation
Introduction Constipation in children is a common health problem affecting 0.7% to 29.6% children across the world. Exact etiology for developing symptoms is not clear in children and the majority is considered to have functional constipation. The diagnosis is often a symptom-based clinical process. Recently developed Rome III diagnostic criteria looks promising, both in clinical and research fields. Complementary and alternative medical therapies and practices are widely employed in the treatment of the children Constipation. This article aims to be a practical guide for paediatricians and primary care physicians, to outline the current etiology an TIM for the medical management of constipation in children. Materials and Methods:To make the review more reliable, we collected the references on Pediatric Constipation epidemiology,pathogenesis and pathophysiology mainly from the journals and text book which authorized by Iranian and conventional Medical Association and represent the highest level of literature. Results: Chronic constipation is a common pediatric problem affecting children worldwide. Exact etiology in conventional Medical is unclear in the majority and is thought to be functional in origin. “Constipation” in the traditional medicine books is known as “abdominal block”and three causes of constipation: nutritional factors, intra intestinal factors, extra intestinal factors. Conclusion: Investigations from Iran and conventional medicine provide some new findings in the research and may help the future understanding of Pediatric Constipation .This detailed literature review may help the understanding and promoting the future studies on Pediatric Constipation.
https://ijp.mums.ac.ir/article_2125_174f46f222d23c04454f36cc07223b9d.pdf
2014-01-01
89
92
10.22038/ijp.2014.2125
Children Constipation
Etiology
Iranian Traditional Medicine
Mohhad Reza
Noras
1
Phd student, Students Research Committee, Faculty of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohammad Ali
Kiani
kianima@mums.ac.ir
2
Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
1. Van der Wal MF, Benninga MA, Hirasing RA. The Prevalence of encopresis in a multicultural population. J Pediatr Gastroenterol Nutr 2005; 40:345-8.
1
2. de Araujo Sant’Anna AM, Calcado AC. Constipation in school-aged children at public schools in Rio de Janeiro, Brazil. J Pediatr Gastroenterol Nutr 1999; 29:190-3.
2
3. Yong D, Beattie RM. Normal bowel habit and prevalence of constipation in primary-school children. Ambulatory Child Health 1998; 4: 277-82.
3
4. Liem O, Harman J, Benninga M, Kelleher K, Mousa H, Di LC. Health utilization and cost impact of childhood constipation in the United States. J Pediatr 2009; 154:258-62.5. Braganza S, Ozuah PO, Sharif I. The use of complementary therapies in inner-city asthmatic children. J Asthma 2003; 40: 823–7. 6. Verhoef MJ, Russell ML, Love EJ. Alternative medicine use in rural Alberta. Can J Public Health 1994; 85:308–9.
4
7. Davis MP, Darden PM. Use of complementary and alternative medicine by children in the United States. Arch Pediatr Adolesc Med 2003; 157: 393–6.
5
8. Neuhouser ML, Patterson RE, Schwartz SM, Hedderson MM, Bowen DJ, Standish LJ. Use of alternative medicine by children with cancer in Washington state. Prev Med 2001; 33: 347–54.
6
9. Kristoffersen AE, Norheim AJ, Fønnebø VM. Complementary and Alternative Medicine Use among Norwegian Cancer Survivors: Gender-Specific Prevalence and Associations for Use. Evid Based Complement Alternat Med. 2013; 2013: 318781
7
10. Jean D, Cyr C. Use of complementary and alternative medicine in a general pediatric clinic. Pediatrics. 2007 Jul;120(1):e138-41.
8
11. Sawni A, Thomas R. Pediatricians' attitudes, experience and referral patterns regarding Complementary/Alternative Medicine: a national survey. BMC Complement Altern Med. 2007 Jun 4; 7:18.
9
12. Kemper KJ, Vohra S, Walls R. American Academy of Pediatrics. The use of complementary and alternative medicine in pediatrics. Pediatrics 2008; 122(6):1374–86.
10
13. Loening-Baucke V. Constipation in early childhood: patient characteristics, treatment, and longterm follow up. Gut 1993; 34:1400-4.
11
14. Rasquin A, Di LC, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006; 130:1527-37.
12
15. Avicenna. Canon of Medicine. (3rdedn), 1989; Soroosh Publisher, Tehran.
13
16. Aghili MH. Kholasat-ol-Hekmaa. (1stedn), 2011; Ismaeelian Publisher, Tehran.
14
17. Gorgani I. Zakhira Kharazmshahi. (1stedn), 2001; Farhangestan Publisher, Tehran.
15
18. Gorgani I. Al-Igraz Al-Tibbieh and Al-Mabahis al-Alaieh. (1stedn), 2005; Tehran University Press, Tehran.
16
19. Meysari. Alaii daneshname. (1stedn), 1994; Tehran University Press, Tehran.
17
20. Azam Khan M. Aksir Azam. (1stedn), 2004; Institute of Medicine Studies and Islamic medicine press, Tehran.
18
21. Arzani MA. Akbari Medicine. (1stedn), 2008; Jalal Publisher, Tehran.
19
22. Nafis ibn Eyvaz. Sharh al-Asbab va al-Alamat. (1stedn), 2008; Jalal Publisher, Tehran.
20
23. Ahvazi A. Kamel as-Sinna at-Tibbiat. (1stedn), 2009; Tehran University Press,Tehran.
21
24. Aghili MH. Aghili Treatments (1stedn), Iran University of Medical Sciences Publisher, 2008; Tehran.
22
ORIGINAL_ARTICLE
A Treatable Refractory Epilepsy: A Case Report
Introduction Biotinidase deficiency is a life threatening inborn error of metabolism specially when delayed in diagnosis. We report a 2-month-old male infant that presented with refractory infantile spasm, alopecia and seborrheic dermatitis. With a high suspicion of the biotinidase deficiency we started biotin 10 mg daily orally before definite diagnosis was made. Rapid treatment was life-saving and all complications disappeared rapidly. With this report we tried to explain the clinical manifestations of biotinidase deficiency and show the importance of early diagnosis and treatment in resolving the complications.
https://ijp.mums.ac.ir/article_2126_dfbff82c3ce73a8f39df5b47c8e0aed1.pdf
2014-01-01
93
96
10.22038/ijp.2014.2126
Biotinidase Deficiency
Biotin
Refractory Epilepsy
inborn error of metabolism
Javad
Akhondian
akhondianj@mums.ac.ir
1
Professor of Pediatric Neurology Ward, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Farah
Ashrafzadeh
ashrafzadehf@mums.ac.ir
2
Professor of Pediatric Neurology Ward, Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mehran
Beiraghi
3
Assistant Professor of Pediatric Neurology Ward, Faculty of Medicine,Mashhad University of Medical
Sciences, Mashhad, Iran.
AUTHOR
Forugh
Rakhshani
4
Assistant Professor of Pediatric Neurology Ward, Faculty of Medicine,Mashhad University of Medical
Sciences, Mashhad, Iran.
AUTHOR
1. Rezvani I, Rosenblatt D. Defects in metabolism of amino acids. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Elsevier; 2011.P.430-3.
1
2. Wolf B. Clinical issues and frequent questions about biotinidase deficiency. Mol Genet Metab 2010; 100:6-13.
2
3. Nothjunge J, Krageloh-Mann L, Suormala T, Baumgartner E. Biotinidase deficiency: A congenital metabolic disease which can be successfully treated with vitamin. Monatsschr Kinderheilkd 1989; 137:737-40.
3
4. Rezvani I, Rezvani G. An Approach to Inborn Errors of Metabolism In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Elsevier; 2011.P 416-417.
4
5. Kalayci O, Coskun T, Tokatli A. Infantile spasm as the initial symptom of biotinidase deficiency. J Pediatr 1994; 124:103-104.
5
6. Mikati M, Zalloua P, Karam P, Habbal MZ,Rahi A. Novel Mutation Causing Partial Biotinidase Deficiency in a Syrian Boy With Infantile Spasms and Retardation. Child Neural 2006; 21:978-81.
6
7. Salbert BA, Pellock J, Wolf B. Characterization of seizures associated with biotinidase deficiency. Neurology 1993; 43 (7) 1351.
7
8. Collins JE, Nicholson NS, Dalton N, Leonard JV. Biotinidase deficiency-early neurological presentation. Dev Med Child Neural 1994; 36:268-70.
8
9. Rathi N, Rathi M. Biotinidase deficiency with hypertonia as unusual feature. Indian pediatrics 2009; 46:65-7.
9
10. McDonald L, Rennie A, Tolmie J, Galloway P, McWilliam R. Investigation of global developmental delay. Arch Dis Child2006; 91:701-705.
10
11. Wolf B, Grier RE, Heard GS. Hearing loss in biotinidase deficiency. Lancet 1983; 11: 1365-6.
11
12. Wolf B, Spencer R, Gleason T, Hearing loss is a common feature of symptomatic children with profound biotinidase deficiency. Journal of Pediatrics 2002; 140: 242-46.
12
13. Genca GA, Sivri-Kalkanoğlub HS , Dursunb A, Aydınc A, Tokatlıf A, Sennaroglud L,et al. Audiologic findings in children with biotinidase deficiency in Turkey. Int Journal of Ped Otorhinolaryngology 2007; 71: 333–9.
13
14. Georgala S, Schulpis K, Papakonstantinou ED, Kalogirou S, Michas T. Possible involvement of partial biotinidase deficiency in alopecia areata. JEADV 1996; 7(2): 135–8.
14
15. Barry Wolf, Gregory S. Heard. Screening for Biotinidase Deficiency in Newborns: Worldwide Experience Pediatrics 1990; 85: 512 -17.
15
16. Pomponio RJ, Hymes J, Pandya A, Landa B, Melone P, Javaheri R, et al prenatal diagnosis of heterozygosity for biotinidase deficiency by enzymatic and molecular analyses. Prenatal Diagnosis 1998; 18:117–122.
16
17. Grünewald S, Champion MP, Leonard JV , Schaper J , Morris A. Biotinidase Deficiency: a Treatable Leukoencephalopathy. Neuropedi- atrics 2004; 35(4): 211-16.
17
18. Bousounis DP, Camfield PR, Wolf B. Reversal of Brain Atrophy with Biotin Treatment in Biotinidase Deficiency. Neuropediatrics 1993; 24(4): 214-7.
18
ORIGINAL_ARTICLE
Glutaric Acidemia Type 1: Case Report
Introduction: Glutaric academia type I is a metabolic disorder that is caused due to deficiency of glutaryl-CoA dehydrogenase. Macrocephaly is a common sign in GA1, although many infants usually appear healthy at birth. Case Report A 5.5 year old boy with GA1was admitted to NICU. Chief compliance of patient for hospitalization was pneumonia and sepsis and he was intubated and mechanically ventilated. This disease was diagnosed with signs of set developmental delay at 8 months oldand during these years; he was under control for nutritional counseling with a nutritionist and pediatrician. Nutritional support for this patient was in NICU. Conclusion Medical treatment combined with nutritional support in GA1 managementsigns of serious illness; also dietary treatment control may are needed to reduce progression of the neurological damage.
https://ijp.mums.ac.ir/article_2127_c58bab9c4a376db951d4022e19b1772d.pdf
2014-01-01
97
99
10.22038/ijp.2014.2127
Glutaric Academia
Medical Treatment
Neurological Damage
Zarin
Banikazemi
mium@mums.ac.ir
1
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohsen
Mazidi
2
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohsen
Nematy
mazidim911@mums.ac.ir
3
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
1. Barić I, Zschocke J, Christensen E, Duran M, Goodman S, Leonard J, et al. Diagnosis and management of glutaric aciduria type I. Journal of inherited metabolic disease. 1998; 21(4):326-40.
1
2. Goodman SI, Kratz LE, DiGiulio KA, Biery BJ, Goodman KE, Isaya G, et al. Cloning of glutaryl-CoA dehydrogenase cDNA, and expression of wild type and mutant enzymes in Escherichia coli. Human molecular genetics. 1995;4(9):1493-8.3. Chow SL, Rohan C, Morris AA. Rhabdomyolysis in glutaric aciduria type I.
2
J Inherit Metab Dis.2003; 26(7): 711–2.
3
4. Chow S, Rohan C, Morris A. Case Report: Rhabdomyolysis in Glutaric Aciduria Type I. Journal of inherited metabolic disease. 2003; 26 (7):711-2.
4
5. Kölker S, Christensen E, Leonard J, Greenberg C, Burlina A, Burlina A, et al. Guideline for the diagnosis and management of glutaryl-CoA dehydrogenase deficiency (glutaric aciduria type I). Journal of inherited metabolic disease. 2007; 30(1):5-22.
5
6. Morton DH, Bennett MJ, Seargeant LE, et al. Glutaric aciduria type I: a common cause of episodic encephalopathy and spastic paralysis in the Amish of Lancaster County, Pennsylvania. Am J Med Genet. 1991; 41:89-95.
6
7. Haworth JC, Booth FA, Chudley AE, deGroot GW, Dilling LA, Goodman SI, et al. Phenotypic variability in glutaric aciduria type I: Report of fourteen cases in five Canadian Indian kindreds. J Pediatr. 1991 Jan;118(1):52-8.
7
8. Shaw V, Lawson M. Clinical paediatric dietetics: John Wiley & Sons; 2008.
8
9. Strauss KA, Puffenberger EG, Robinson DL, Morton DH. Type I glutaric aciduria, part 1: Natural history of 77 patients. Am J Med Genet C Semin Med Genet. 2003 Aug 15; 121C (1):38-52.
9
10. Kölker S, Garbade SF, Greenberg CR, Leonard JV, Saudubray J-M, Ribes A, et al. Natural history, outcome, and treatment efficacy in children and adults with glutaryl-CoA dehydrogenase deficiency. Pediatric research. 2006; 59(6):840-7.
10
11. Strauss KA, Lazovic J, Wintermark M, Morton DH. Multimodal imaging of striatal degeneration in Amish patients with glutaryl-CoA dehydrogenase deficiency. Brain. 2007 Jul; 130 (Pt 7):1905-20. Epub 2007 May 3.
11
12. Boneh A, Beauchamp M, Humphrey M, Watkins J, Peters H, Yaplito-Lee J. Newborn screening for glutaric aciduria type I in Victoria: treatment and outcome. Mol Genet Metab. 2008; 94:287–29.
12
13. Kölker S, Christensen E, Leonard JV, Greenberg CR, Boneh A, Burlina AB, et al. Diagnosis and management of glutaric aciduria type I–revised recommendations. Journal of inherited metabolic disease. 2011; 34(3):677-94.
13
14. Mader I, Zschocke J, Dichgans J, Schulz JB. Adult onset glutaric aciduria type I presenting with a leukoencephalopathy.Neurology.2002; 59:1802–4.
14
ORIGINAL_ARTICLE
Congenital Rickets: Report of Four Cases
Introduction: Vitamin D deficiency and rickets continue to be health problems in developing countries and most of the infants with congenital rickets may present with hypocalcemic seizure. Case Report In this article, the report on four infants who presented with hypocalcemic seizures but subsequently were found to have congenital rickets is presented. All of them had hypocalcaemia and low level of serum 25- hydroxy vitamin D. Their mothers had not received vitamin D supplementation during pregnancy and so evidence of vitamin D deficiency was presented. Conclusion: Although current vitamin D supplementation guidelines for infants was effective in prevention of rickets in Iranian children, it is necessary to evaluate women before pregnancy to prevent this entity. Also infants without vitamin D supplementation therapy who present with seizures during the first 6 months of age should undergo biochemical and other investigations for rickets.
https://ijp.mums.ac.ir/article_2128_b121bca3765010d6e63b9de9ac4ed91d.pdf
2014-01-01
101
105
10.22038/ijp.2014.2128
Congenital rickets
Vitamin D deficiency
Hypocalcemia
Seizure
Rahim
Vakili
vakilir@mums.ac.ir
1
Department of Pediatrics Endocrinology,Faculty of Medicine, Mashhad University of Medical Sciences(MUMS), Mashhad, Iran.
AUTHOR
Peyman
Eshraghi
2
Department of Pediatrics Endocrinology,Faculty of Medicine, Mashhad University of Medical Sciences(MUMS), Mashhad, Iran.
AUTHOR
Alireza
Ataei Nakhaei
3
Department of Pediatrics Endocrinology,Faculty of Medicine, Mashhad University of Medical Sciences(MUMS), Mashhad, Iran.
AUTHOR
Saba
Vakili
4
Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
AUTHOR
Ali
Khakshour
khakshoura@mums.ac.ir
5
Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran.
AUTHOR
Masumeh
Saeidi
6
Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
AUTHOR
Behjat
Zarif
7
Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Somayeh
Nateghi
8
Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
1. Bereket A. Rickets in developing countries. Endocr. Dev 2003; 6:220-32.
1
2. Taha SA, Dost SM, Sedrani SH. 25-hydroxy vitamin D and total calcium: extraordinarily low plasma concentration in Saudi mothers and their neonates. Pediatric Res .1984; 8:739-41.
2
3. Pehlivan I, Hatun S, Androgen M, Babaoglu K. Gokalp AS. Maternal vitamin D deficiency and vitamin D supplementation in healthy infants. Tur J pediatr2003; 43:315-20.
3
4. Alagöl F, Shihadeh Y, Boztepe H, Tanakol R, Yarman S, Azizlerli H, et al. Sunlight exposure and vitamin D deficiency in Turkish women. J Endocrinal Invest 2000; 23: 173-7.
4
5. Andiran N, Yordam N, o20h A. Risk factors for vitamin D deficiency in breasted newborns and their mothers. Nutrition 2002; 18: 47-50.
5
6. Heshmat R, Mohammad K, Majdzadeh Sh, Forouzanfar MH, Bahrami A, Ranjbar omrani GH, et al. vitamin D deficiency in Iran : Amulti – center study among differernt urban areas. Iranian J publ Heath 2008, supp1:72-8.
6
7. Hatun S, oaken B, Orbit Z, Done ray H, et al. vitamin D deficiency in early infancy J.Nutr. 2005; 135(2):279-82.
7
8. Bereket A. Nutritional Rickets LWPES/ESPE 8th joint meeting. Meet the expert session’s handout September 9-12 2009, New York.
8
9. Mughal MZ,Salama H,Greenaway T,Laing I,Mawer EB. Florid rickets associated with prolonged breast feeding without vitamin Dsupplementation.BMJ.1999; 318: 39-40.
9
10. Innes AM, sushi MM, Prasad G, Also it S, Friesen FR, chadley AE, et al. congenital tickets caused by maternal vitamin D deficiency. pediatric child Health 2002;7(7): 455-8.
10
11. Specker BL. Nutrition in pregnancy and lactation.In:Holick MF,Dawson-Hughes B, eds. Nutrition and bone health.Totowa, new jersey: Humana press; 2004:150-2.
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