Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Unexplained High Activity of Aspartate Aminotransferase in an Asymptomatic Pediatric Patient58055808910310.22038/ijp.2017.25420.2162ENWajiha MaanDepartment of Pediatrics, Golisano Children's Hospital, Upstate Medical University, Syracuse, NY, USA.Qurratul Ann WarsiUniversity of California and San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, USA.Avideh RashedDepartment of Pediatrics, Golisano Children's Hospital, Upstate Medical University, Syracuse, NY, USA.Manoochehr KarjooPediatric Gastroenterology, Hepatology and Nutrition, Golisano Children's Hospital, Upstate Medical University, Syracuse, NY, USA.Journal Article20170803<span style="font-family: Times New Roman;">Elevated enzyme activities in plasma may at times be attributed to the presence of macro-enzymes. The macro-enzymes are often serum enzymes in complex with immunoglobulins, resulting in a greater molecular mass that cannot be filtered by renal glomeruli and are, hence, retained in the plasma. The aspartate aminotransferase (AST) can exist as a macro-enzyme, although it has been rarely reported. </span><br /> <span style="font-family: Times New Roman;">We describe a pediatric patient with persistently elevated serum AST activity, due to macro-enzyme formation between AST and an immunoglobulin. This is to highlight the importance of early diagnosis of macro-AST in an otherwise asymptomatic pediatric patient with isolated AST-elevation and to avoid unnecessary costly testing. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001A Rare Case of Budd Chiari Syndrome in a Child58095812921410.22038/ijp.2017.25157.2131ENAmar TaksandeProfessor, Department Of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.0000-0003-3097-7405Rewat MeshramAssociate Professor, Department Of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.Purnima YadavResident, Department Of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.Shreyas BorkarResident, Department Of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.Amol LohakareSenior Resident, Department Of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.Pankaj BanodeInterventional Radiologist, Department of Radiology, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra -4420004, India.Journal Article20170723<span style="font-size: 11pt;"><span style="font-family: Times New Roman;">A 7-year- old male child presented with the complaints of tense abdominal distension and swelling over feet since 1 month. The patient had repeated episodes of similar complaints since last two years with partial or complete relief after taking various forms of allopathic therapy. On imaging, Budd-Chiari syndrome was diagnosed which was hallmarked by occluded Inferior venacava (IVC), caudate lobe enlargement and heterogeneous liver enhancement. Initially thrombolysis done leading to complete remission for the patient for 15 days, later on again the patient developed similar complaints for which balloon venoplasty and hepatic vein stenting was done.</span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Coping Strategies of Parents with Chronic Ill Children Hospitalized in Educational Hospitals, Ahvaz-Iran58135825882510.22038/ijp.2017.23834.2014ENMahin GheibizadehAssisstant Professor, Nursing Care Research in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.0000-0002-3673-8715Zeinab GholamiDepartment of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Soodabeh BassaknejadAssociate Professor, Department of Clinical Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.Bahman CheraghianAssisstant Professor, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Journal Article20170525<strong><em><span>Background: </span></em></strong><span>The</span><span> </span><span>incidence of a child chronic disease causes high levels of stress and anxiety in the parents and caregivers. This study aimed to investigate the coping strategies of parents with chronic ill children who hospitalized in educational hospitals of Ahvaz -Iran.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>This cross sectional study conducted in two hospitals that affiliated to Jundishapur University of Medical Sciences in 2016. The total number of respondents was 252 parents (150 mothers and 102 fathers) of 150 children with chronic disease that were selected using convenience sampling. Data collection tools were a self-administered demographic and clinical checklist and standard questionnaire Of Coping Inventory for Stressful Situation (CISS). Data analysis runs using SPSS version 22.0.</span><br /> <strong><em><span>Results: </span></em></strong><span>The results showed that the dominant strategies of parents who had a child with chronic disease were task-oriented (52.3%)<sub>,</sub> and emotion-oriented (54%) strategies, respectively. The average score of problem- focused strategy in fathers was (53.67±11.1) and the average score of emotion- focused coping strategy in mothers was (53.33±10).Mothers were used emotion oriented and social diversion coping strategies significantly more than fathers. Child gender, child age, and having another ill child were significant variables in correlation with mother<sup>’</sup>s distraction; however family economic state was significant variable in correlation with social diversion (P<0.05). In fathers task- oriented coping strategies were in correlation with child age, disease duration, numbers of hospitalizations, education, job and having another ill child. Emotion oriented coping strategies was in correlation with father’s age and distraction was in in correlation with father’s job (P<0.05).</span><br /> <strong><em><span>Conclusion: </span></em></strong><span>To provide optimal care for families with chronic ill child, assessment of psychological needs and coping strategies of parents is necessary. Moreover, families with lower economic and educational level are prior for further attention. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001The Effect of Metoclopramide on Prolactin Levels in Breastfeeding Mothers: A Systematic Review and Meta-Analysis58275838903310.22038/ijp.2017.24678.2083ENShirin OsouliDepartment of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.Mojgan MirghafourvandAssociate Professor, Social determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.0000-0001-8360-4309Robabe SeyediDepartment of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.Journal Article20170702<strong><em><span style="font-size: medium;">Background</span></em></strong><span style="font-size: medium;">: Exclusive breastfeeding is beneficial to not only infants, but also mothers. Since prolactin stimulates milk production, increasing its levels through dopamine antagonists, such as metoclopramide, may enhance milk production. However, the efficacy of this method should be further studied. Therefore, this systematic review sought to determine the effects of metoclopramide on prolactin levels in breastfeeding mothers.</span><span style="font-size: medium;"> </span><br /> <strong><em><span style="font-size: medium;">Materials and Methods</span></em></strong><span style="font-size: medium;">: </span><span style="font-size: medium;"> </span><span style="font-size: medium;">In this systematic review study, International and National data bases such as PubMed,</span><span style="font-size: medium;">Google Scholar, Cochrane Library, Scopus, Web of Sciences, SID,</span><span style="font-size: medium;">Magiran, and Iranmedex</span><span style="font-size: medium;">were searched for the keywords of lactation, breastfeeding, prolactin, metoclopramide and breast milk. Articles published during 1979 to 2016 in either English or Persian was selected. The review was limited to human clinical trials examining the effects of metoclopramide on mothers’ serum prolactin levels. Two authors independently evaluated the eligibility the studies and cases of disagreement were resolved through consensus.</span><br /> <strong><em><span style="font-size: medium;">Results</span></em></strong><strong><span style="font-size: medium;">: </span></strong><span style="font-size: medium;">Five studies on the effects of metoclopramide on mothers’ serum prolactin levels were included in this systematic review. Based on their results, compared to placebo, two weeks of metoclopramide administration did not have significant effects on mothers’ serum prolactin levels (mean difference: 73.06; 95% confidence interval [CI]:-19.99 to 166.11) However, placebo-controlled studies showed significant changes in prolactin levels after using metoclopramide for three weeks (mean difference: 111.06; 95% CI: 1.93 to 220.20).</span><span style="font-size: medium;"> </span><br /> <strong><em><span style="font-size: medium;">Conclusion</span></em></strong><strong><span style="font-size: medium;">: </span></strong><span style="font-size: medium;">The result of meta-analysis showed that the use of 10 mg of metoclopramide three times a day for three weeks increased mothers’ serum prolactin levels after childbirth. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Lipoprotein Lipase (LPL) Gene Mutation: A First Report in Children58395842914010.22038/ijp.2017.25461.2163ENNadia El Idrissi SlitineNeonatal Intensive Care Department, Mohammed VI University Hospital and Research AND Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco.Fatiha BennaouiNeonatal Intensive Care Department, Mohammed VI University Hospital and Research AND Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco.Ouidad LouachamaNeonatal Intensive Care Department, Mohammed VI University Hospital and Research AND Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco.Leila HabibiNeonatal Intensive Care Department, Mohammed VI University Hospital and Research AND Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco.Naima FdilBiochemistry laboratory, Arrazi hospital, Mohammed VI University Hospital, Marrakesh, Morocco.Abdelali TaliBiochemistry Department, School of Medicine, CADI AYYAD University, Morocco.Laila ChabaaBiochemistry laboratory, Arrazi hospital, Mohammed VI University Hospital, Marrakesh, Morocco AND Biochemistry Department, School of medicine ,CADI AYYAD University, Morocco.Fadl Mrabih Rabou MaoulainineNeonatal Intensive Care Department, Mohammed VI University Hospital and Research AND Team for Childhood, Health and Development, Marrakech School of Medicine, Cadi Ayyad University, Marrakech, Morocco.Journal Article20170805<span>Genetic hyperchylomicronemia is a rare autosomal recessive disorder of lipoprotein metabolism estimated to affect approximately one per million individuals. We report a case with a rare mutation identified. It’s a genetic chylomicronemia in a Moroccan newborn baby, with massive hypertriglyceridemia and clinical signs of acute pancreatitis. She was a newborn female, first-degree of consanguineous parents. She was hospitalized for hypertriglyceridemia, complicated by acute pancreatitis; serum was noted to be milky. The genetic study found a mutation of the Lipoprotein Lipase</span><span> (</span><span>LPL) gene: homozygous pathogenic variant c.1019-3C > A. </span><br /> <span>She enjoyed good health, developed well and the triglyceride was maintained at a concentration of </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Comparison of Paraffin versus Polyethylene Glycol (PEG) in Children with Chronic Functional Constipation58435850876410.22038/ijp.2017.23726.2004ENZohreh TorabiAssociate Professor of Pediatric, Pediatric Department, Mousavi Hospital, Zanjan University of Medical Science, Zanjan, Iran.Sanaz AmiraslaniAssistant of Pediatric, Pediatric Department, Mousavi Hospital, Zanjan University of Medical Science, Zanjan, Iran.Diana DiazAssistant Professor of Pediatric Surgery, Pediatric department, Mousavi Hospital, Zanjan University of Medical Science, Zanjan, Iran.0000-0002-3391-6125Akefeh AhmadiafsharProfessor of Allergy and Clinical Immunology, Social Determinants of Health Research Center and Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.0000-0002-9202-6915Kambiz EftekhariAssistant Professor of Pediatric Gastroenterology, Pediatric department, Bahrami Children’s Hospital, Tehran University of Medical Science, Tehran, Iran.0000-0003-3471-2498Journal Article20170521<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Constipation is one of the most common disorders in children. The purpose of this study was to compare paraffin and polyethylene glycol (PEG) in the treatment of children with chronic constipation.</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 study is a double-blind randomized trial. Total 160 children aged 2-12 years old with chronic constipation attending the pediatric clinic of Mousavi Hospital in Zanjan (Iran) were examined by the same pediatric gastroenterologist. They randomly received PEG solution (1cc/kg/day divided in two doses) or paraffin at the same dose. Patients were assessed regularly once a week up to one month and then monthly until 6 months. Data were analyzed by SPSS version 16 software. </span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">From children enrolled in the study, 43.1% were boys with mean age 5.27±1.3 years. The male to female ratio in Paraffin and PEG groups was similar (35/45 vs. 34/46; respectively, P-value= 1.27). The mean age of the participants in paraffin group and PEG group were 5.28±1.4 and 5.24±1.9 years, respectively. The good and intermediate response to PEG in comparison to paraffin were 11.3% and 38.8% vs. 23.8% and 35%; respectively (P=0.111). In children lower than 3 years old, the improvement after receiving paraffin was significantly higher (P=0.048). The frequency of adverse effects was similar and didn’t differ significantly 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;">There was no significant difference between two groups (PEG and Paraffin groups) in terms of gender and adverse effects of drugs. However paraffin had better therapeutic effect among children less than 3 years of age.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Assessment of the Role of Maternal Characteristics, Mental Health and Maternal Marital Satisfaction in Prediction of Neonatal Birth Weight58515862910010.22038/ijp.2017.24633.2078ENKamran DehghanAssistant Professor of Neonatology, Urmia University of Medical Sciences, Urmia, Iran.0000-0001-6552-7477Mehran SoleymaniAssistant Professor od Psychology, Azarbaijan Shahid Madani University of Tabriz, Tabriz, Iran.Sahar Karbasi SalmasiMaster of Clinical Psychology, Urmia University of Medical Sciences, Urmia, Iran.Journal Article20170629<span style="font-size: medium;"><strong><em>Background</em></strong> </span><br /> <span style="font-size: medium;">Neonatal mortality comprises a large part of infant mortality, and it depends largely on neonatal birth weight. Besides maternal diseases, it seems that other important factors such as maternal demographic characteristics, mental health and marital satisfaction, affects their infants birth weight. This study conducted aiming to evaluate these affecting factors on neonatal birth weight.</span><br /> <strong><em><span style="font-size: medium;">Materials and Methods</span></em></strong><br /> <span style="font-size: medium;"> This study was descriptive – correlative, and conducted on all of the mothers and their neonates who were 200 mothers and neonates born during the summer 2015, in Urmia Kosar hospital that lasted 6 months. We used the GHQ (General Health Questionnaire), to evaluate the mental status of mothers and ENRICH for the evaluation of marital satisfaction. Demographic characteristics of mothers collected to special forms.</span><br /> <span style="font-size: medium;"><strong><em>Results</em></strong></span><br /> <span style="font-size: medium;">In this study, 200 mothers, and 200 neonates born in Kosar Hospital were studied. The mean age of the mothers was 28.06 ± 6.34 years and the duration of pregnancy was 39.14 ± 1.21 months. The amount of obtained was significant for pregnancy duration in predicting neonatal birth weight. In marital status parameters, beta amounts for economic, family and communication was significant in predicting neonatal birth weight. Among parameters of maternal mental health, correlation of depression was significant in predicting neonatal birth weight. </span><br /> <span style="font-size: medium;"><strong><em>Conclusion</em></strong></span><br /> <span style="font-size: medium;">According to results, in white race low maternal age was a risk factor for bearing low birth weight baby. Marital satisfaction and bearing no stress from husband lets the fetus grow well and reaches normal birth weight. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Relationship between the General Health of Mothers and the Anxiety of School-Age Children58635870852710.22038/ijp.2017.22712.1897ENShanaz RostamiNursing Care Research Center in Chronic Disease, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.0000-0002-8013-0344Zainab BanaeipourGanjavian Hospital, Dezful university of medical Sciences, Dezful, Iran.Kourosh ZareaAssociate Professor, Nursing Care Research Center in Chronic Disease, Ahvaz Faculty of Nursing &amp; Midwifery, Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, IR Iran.Journal Article20170326<strong><em><span>Background</span></em></strong><br /> <span>Health is influenced by different factors, the most important of which in the family environment is mothers. This study aimed to determine the anxiety levels of school-age children and their relationship with the general health of mothers in the city of Dezful, Iran.</span><br /> <strong><em><span>Materials and Methods</span></em></strong><br /> <span>In this descriptive-analytical study, 623 children aged 9- to 12-year-old studying in the fourth to sixth grades and their mothers were selected from the schools of the city of Dezful, Iran. The data collecting tools was a test battery including a demographic questionnaire, the School Anxiety Scale (SAS) designed by Philips, and the General Health Questionnaire (GHQ). The obtained data were analyzed using SPSS version 16.0 software.</span><br /> <strong><em><span>Results</span></em></strong><br /> <span>In this study, of 623 participants, 226 (36.3%) students were female and 397 (63.7%) students were male<span lang="FA" dir="RTL">.</span> The results demonstrated that the anxiety of school-age children were without 37.2% anxiety, 48.8% normal anxiety and 14% severe anxiety. The general health of mothers were 46.1% normal healthy, 45.4% partial healthy, 8% on the eve of the disease, and 0.5% unhealthy. </span><br /> <span><span> </span>It showed there was a significant positive correlation between general health of mothers and anxiety score of children (P < 0.001, r = 0.245). Moreover, the children’s anxiety scores were associated with all the dimensions of the mother GHQ.</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>There was a significant relationship between the health of mothers and their children’s anxiety level. Thus, it is recommended to utilize strategies including conducting training programs and providing counseling for such children and their families in schools and health centers.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Association of Exposure to Fine Particulate Matter and Risk Factors of Non-Communicable Diseases in Children and Adolescents58715880853810.22038/ijp.2017.22739.1900ENParinaz PoursafaPhD Candidate, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.Mohammad Mehdi Amin2Professor of Environmental Health Engineering, Department of Environmental Health Engineering, Environment Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.Marjan MansourianAssociate Professor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.Yaghoub Hajizadeh4Associate Professor of Environmental Health Engineering, Department of Environmental Health Engineering, Environment Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.Babak SadeghianHead of Air Quality Monitoring Laboratory, Isfahan Department of Environment, Isfahan, Iran.Roya KelishadiProfessor of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0001-7455-1495Journal Article20170327<span style="font-family: Times New Roman;"><strong><em>Background: </em></strong>Risk factors of non-communicable disease (NCD) origin from early life, and exposure to environmental pollutant may be a predisposing factor. This study aimed to investigate the association of air quality index (AQI) and fine particulate matter (PM<sub>2.5</sub>) with some NCD risk factors in a sample of Iranian children and adolescents.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Materials and Methods: </em></strong>This cross-sectional study was conducted in 2014 to 2016 among children and adolescents, aged 6-18 years, in Isfahan, Iran. Physical examination, including weight, height, and blood pressure, was conducted by standard methods. Fasting blood sample was obtained for fasting blood glucose, total cholesterol, high density lipoprotein-cholesterol, low-density lipoprotein- cholesterol, and triglycerides. The mean AQI and PM<sub>2.5 </sub>values from the study time till one year prior to the survey were used. Multiple linear regression analysis was conducted for the association of AQI and PM<sub>2.5 </sub>with other variables.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Results: </em></strong>Participants consisted of 186 children and adolescents with mean (SD) age of 10.52(2.38) years. Exposure to higher level of PM<sub>2.5</sub> had significant associations with higher levels of systolic blood pressure, low-density lipoprotein cholesterol, and triglycerides. It also had positive relationship with other risk factors and inverse association with low-density lipoprotein cholesterol (LDL-C), but these associations were not statistically significant. The corresponding figures were not significant for AQI.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Conclusion: </em></strong>At current study results showed that exposure to higher levels of fine particulates was associated with some NCD risk factors in children and adolescents. Early life prevention of NCDs can lead to large reductions in disease risk; adverse effects of ambient pollutants should be considered in this regard. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Evaluation of an Infant with Cholestasis and Congenital Hypopituitarism58815886914310.22038/ijp.2017.25561.2174ENWahhaj BegDepartment of Ecology and Evolutionary Biology, University of Connecticut, Connecticut, USA.Sara KarjooAssistant professor, Department of Pediatric Gastroenterology, Johns Hopkins All Children’s Hospital, St Petersburg, Florida, USA.Manoochehr KarjooPediatrician and Gastroenterologist
Upstate Medical University, Syracuse New York USA.Journal Article20170810<span>We are reporting an infant with persistent abnormal liver function, neonatal jaundice, and intermittent hypoglycemia. Evaluation confirmed congenital hypopituitarism, in the absence of congenital anomalies and midline defect. His jaundice and abnormal liver function improved after treatment with Levothyroxine and hydrocortisone.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Comparison of Efficacy and Side Effects of Different Administration Routes of Misoprostol (Oral, Vaginal, and Sublingual) for Second-Trimester Abortion58875895875210.22038/ijp.2017.23605.1988ENAnisodowleh NankaliMaternity Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.Nasrin JalilianMaternity Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.Farahnaz KeshavarziMaternity Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.Ronak RezaeiResearch Committee of Students, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mansour RezaeiBiostatistics Department, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.Journal Article20170515<strong><em><span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Background</span></span></em></strong><br /> <span style="color: black; font-size: 11pt;"><span style="font-family: Times New Roman;">The current study was designed to compare the effectiveness and side effects of oral, vaginal, and sublingual misoprostol in termination of second-trimester pregnancy.</span></span><br /> <span style="font-family: Times New Roman;"><strong><em><span style="font-size: 11pt;">Materials and Methods: </span></em></strong><span style="color: black; font-size: 11pt;">In this clinical trial (2014 to 2015), 85 pregnant women in the second trimester of pregnancy were included in Imam Reza hospital, Kermanshah, Iran. They were randomly divided into three groups as follows: oral misoprostol (n=28), vaginal misoprostol (n=30), and sublingual misoprostol (n=27). Misoprostol was administered orally (oral misoprostol group), vaginally (vaginal misoprostol group), or sublingually (sublingual misoprostol group). The dosage was similar in three groups (400 micrograms every four hours up to a maximum of five doses). The mothers were followed and induction-abortion interval time, number of dosages required, and misoprostol side effects were documented. The data were analyzed by SPSS version 20.0 software.</span></span><br /> <span style="font-family: Times New Roman;"><strong><em><span style="font-size: 11pt;">Results: </span></em></strong><span style="color: black; font-size: 11pt;">The mean (standard deviation) age of the sample was 28.27 (±4.97) years. Mean gestational age was 16.58 weeks and mean gravidity was 1.99. Mean number of administered misoprostol doses was 3.89 and most patients responded to three doses of misoprostol. Mean abortion time was 20.08 hours. No side effects were reported in 60% of the subjects. Others experienced side effects such as nausea (16.5%), fever and chills (12.9%), and vaginal bleeding (9.4%). The abortion duration in 35.3% of the subjects was within 18 hours. The most successful method was oral route (82.1%), followed by vaginal route (80%), and sublingual route (70.4%). The abortion duration was statistically different between the three groups (P= 0.001).</span></span><br /> <span style="font-family: Times New Roman;"><strong><em><span style="font-size: 11pt;">Conclusion: </span></em></strong><span style="color: black; font-size: 11pt;">Finding of the presented study showed that misoprostol is a safe medication to be used for medical abortion in the second trimester of pregnancy. Oral route of administration was superior to vaginal or rectal use of misoprostol. </span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001The Predictors of Healthy Eating Behavior among Pregnant Women: An Application of the Theory of Planned Behavior58975905916210.22038/ijp.2017.25576.2176ENAynaz ChitsazSocial Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.Maryam JavadiChildren Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.Chung-Ying LinDepartment of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.Amir PakpourSocial Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.0000-0002-8798-5345Journal Article20170811<span style="font-family: Times New Roman;">Background</span><br /> It has been documented that maternal nutrition is associated with positive birth outcomes. This study was aimed at determining the predictors of healthy eating behavior among pregnant women in Qazvin, Iran in the context of the theory of planned behavior (TBP).<br /> Materials and Methods<br /> In this longitudinal study, 182 pregnant women who were referred to teaching hospitals in Qazvin in 2016 were recruited for participation. Data were obtained using TPB-specific questionnaires at baseline. The same pregnant women were asked to complete a food frequency questionnaire (FFQ) 3 months later. A series of hierarchical regression analysis was conducted to examine factors associated with healthy eating behavior among pregnant women. <br /> Results<br /> The pregnant women reported low amounts of whole grain consumption and low-fat dairy product consumption. All TPB variables significantly predicted healthy eating behaviors at three-month follow-up. Perceived behavioral control (PBC) and behavioral intention were found to be the strongest predictors of healthy eating behaviors among pregnant women. The pregnant women’s subjective norms had the weakest relationship with healthy eating behaviors. The TPB model together with age provided a moderate to high explanation of consumptions in low-fat dairy products (R<sup>2</sup>=0.57, P<0.01), fruit (R<sup>2</sup>=0.30, P<0.01), vegetable (R<sup>2</sup>=0.28, P<0.01) and whole grains (R<sup>2</sup>=0.44, P<0.01).<br /> Conclusion<br /> The TPB explained significant variation in intention and healthy eating behaviors among pregnant women. Future studies should target on the PBC and intention to promote healthy eating behaviors among pregnant women.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Evaluating Sleep Disorders amongst Children with Attention Deficit/ Hyperactivity Disorder (ADHD)59075917915010.22038/ijp.2017.25322.2149ENKhalil EsmaeilpourDepartment of Psychology, Faculty of Education and Psychology. University of Tabriz, 29 Bahman Bolvard, Tabriz, Iran.Leila Mehdizadeh FanidDepartment of Biology Faculty of Natural Sciences. University of Tabriz, 29 Bahman Bolvard, Tabriz, Iran.0000000349354080Azam Hosein NejadDepartment of Psychology, Faculty of Education and Psychology. University of Tabriz, 29 Bahman Bolvard, Tabriz, Iran.Journal Article20170730<strong><em><span>Background: </span></em></strong><span>The attention deficit/ hyperactivity disorder (ADHD) is one of the most compromising mental disorders of childhood and adolescence. Subsequently, different studies in recent years were conducted on the relationship between sleep disturbances and ADHD in children. About 30% of children and 60% to 80% of adults with ADHD develop sleep disorders, which may result in cognitive and behavioral changes in the patients. The current study aimed at comparing sleep disorders in children with ADHD and their normal peers in Tabriz, Iran. </span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>The current case-control study was conducted on the target population of children within the age range of 6 to 12 years, which included 50 children with ADHD receiving medication, 55 children with ADHD symptoms without receiving any medication, and 71 normal children, all of which screened from the school students of Tabriz using the child symptom inventory-4 (CSI-4) and selected by the multi-stage cluster sampling method. The children's sleep habits questionnaire (CSHQ) was completed by their mothers and data were analyzed using the multivariate analysis of variance (MANOVA). </span><br /> <strong><em><span>Results: </span></em></strong><span>According to the results of the current study, a significant number of children with ADHD showed sleep disorder that can accounts for some degree of their behavioral dysregulation. There was a significant difference among the study groups regarding the subscales of sleep resistance and sleep duration, daytime sleep, parasomnia,<span> </span>and sleep apnea (p<0.05). However, evaluation of the sleep onset delay, anxiety, and nighttime awakening hypotheses showed no significant difference between ADHD and normal children (P> 0.05).</span><br /> <strong><em><span>Conclusion: </span></em></strong><span>Since children with ADHD usually have more sleep problems, considering the sleep quality in such children is of great importance; in the treatment of such children their sleep problems should be considered particularly. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Umbilical Cord Hernia: Report of an Unusual Case59175922892810.22038/ijp.2017.24438.2063ENMohammad SabzeheiDepartment of Pediatrics, Hamadan University of Medical Sciences, Hamadan, IR Iran.0000-0001-5304-3512Manouchehr GhorbanpourDepartment of Surgery, Hamadan University of Medical Sciences, Hamadan, IR Iran.Masoomeh MahdianDepartment of Pediatrics, Hamadan University of Medical Sciences, Hamadan, IR Iran.Nishteman SadeghiDepartment of Pediatrics, Hamadan University of Medical Sciences, Hamadan, IR Iran.Journal Article20170620<span>C</span><span>ongenital umbilical cord hernia is fairly common in infants and it is rarely associated with other anomalies. Sometimes, large umbilical cord hernia is confused with Small omphaloceles. We report an unusual case of umbilical cord hernia associated with patent vitello-intestinal duct (PVID), and Meckel's diverticulum underwent surgery and discharged with good general condition. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Comparison of the Effects of Educational Software and Training Booklet on Maternal Self-efficacy and Infant Care Behavior in Iranian Mothers: A Randomized Controlled Trial59235934915610.22038/ijp.2017.25500.2165ENSomayeh JamalivandMSc in Midwifery, Department of Midwifery, Tabriz University of Medical Sciences, International Branch Aras, Tabriz, Iran.Mojgan MirghafourvandAssociate Professor of Midwifery group, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.0000-0001-8360-4309Sakineh Mohammad-Alizadeh CharandabiAssociate Professor of Midwifery Group, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.Journal Article20170807<strong><em><span>Background: </span></em></strong><span>To achieve the optimal care of baby, mothers need to have sufficient self-efficacy in infant care. This study aimed to compare the effects of educational software and training booklet on the maternal self-efficacy and infant care behavior. </span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>This randomized controlled trial was done on 126 Iranian pregnant women. The Participants were assigned into two intervention groups (42 women received software and 42 women received booklet) and a control group (42 women received routine trainings) through block randomization. A training session was provided orally to the participants in both intervention groups. Then they were provided with the booklet or software. The questionnaires of standard maternal self-efficacy and researcher-made infant care behavior were completed before intervention and at the end of the fourth week of postpartum. </span><br /> <strong><em><span>Results: </span></em></strong><span>Before the intervention, there was no significant difference in terms of the mean scores of the maternal self-efficacy (P=0.192) and infant care behavior (P=0.937) between groups. Controlling the baseline values, a statistically significant increase was observed in the mean scores of the maternal self-efficacy in the booklet group (mean difference: 3.7; 95% Confidence Interval: 2.2 to 5.2) and software group (2.5; 1.0 to 3.9) compared to the control group; however, no statistically significant difference was observed between the two intervention groups. In addition, there was no statistically significant difference in the infant care behavior mean score between the groups at the end of the study (P=0.398). </span><br /> <strong><em><span>Conclusion: </span></em></strong><span>The results indicate the effectiveness of both the software and booklet in enhancing the maternal self-efficacy. The effect of booklet was more compared to the Educational Software, but not statistically significant.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Effectiveness of a Training Program based in PRECEDE Model on Fruit and Vegetable Consumption among Female Students59355944796910.22038/ijp.2016.7969ENAli Khani JeihooniDepartment of Public Health, Fasa University of Medical Sciences, Fasa, Iran.Seyyed Mansour Kashfi2Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.Saeideh Zareei KooshkghaziDepartment of Public Health, Fasa University of Medical Sciences, Fasa, Iran.Seyyed Hannan KashfiMSc. of Teaching in English, Faculty Member of Larestan Nursing School, Shiraz University of Medical Sciences, Shiraz, Iran.Journal Article20161206<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Fruit and vegetable consumption increases students' health and growth and strengthens their mental activities. The present study aimed to investigates a training program based on PRECEDE model on fruit and vegetable consumption by female students in high schools of Fasa, 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;">This is a quasi –experimental study. The research sample includes 100 female high school students in Fasa city, Fars Province, Iran, who were randomly assigned to two groups of control (n=50) and experimental (n=50) groups. Data collection instrument was a questionnaire that included items on demographic characteristics and the PERCEDE model components (knowledge, attitude, enabling and reinforcing factors and performance). Educational intervention for the experimental group was carried out in four sessions which each lasting 55 to 60 minutes, and subjects were followed for 2 months. The questionnaires were administered to both groups before and 3 months after the intervention. The collected data was analyzed by SPSS version 18.0 statistical software. </span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">The average performance score of experimental and control groups regarding fruits and vegetables consumption was 15.15±2.44 and 14.96±2.12 (before the intervention) and 28.22±2.22 and 16.1±11.32 (after the intervention). Mean scores of predisposing (knowledge and attitude), reinforcing, and enabling factors showed a significant difference in the experimental group in comparison 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;">The significant increase in student performance scores regarding fruits and vegetables consumption at the end of the study indicates the positive effect of education on promoting knowledge and changing attitudes of individuals. Therefore, the design and implementation of the training program based on the PRECEDE-PROCEED model can promote healthy eating habits and increase fruits and vegetables consumption among students. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001A Novel Experience in Treatment of Liver Hydatidosis in Pediatrics: A Clinical Trial Study59455952799810.22038/ijp.2016.7998ENMarjan JoodiSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-6373-1722Ali AlamdaranSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-5966-2856Elham BazrafshanSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Morteza PeyvandiSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mehdi FathiSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Reza NazarzadehSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Elmira ZohorianSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Aghigh Ziaee-mehrSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Farideh Jamali-BehnamSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Amir Mohammad DaliliMedical Student, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mahdi Parvizi- MashhadiSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Khalil AlizadehSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Ali AzadmandSurgical Oncology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20161107 <br /> <strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">Hydatidosis is a conventional health public problem in most parts of the world. Safe treatment of patients with hydatidosis has been a topic of debate for a long time. Surgical treatment always was associated with high morbidity and mortality. Medical treatment is also controversial. In this study, alternative procedure named Percutaneous, Aspiration and hypertonic Saline Instillation (PAHSI) was applied to treat patients with hydatidosis.</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 single-blind clinical trial, thirty-eight patients, ranging in age between 6 months and 16 years, with 81 hepatic hydatid cysts underwent PAHSI treatment. The consecutive steps including sonographic guidance, aspiration of cyst content and injection of 15% saline hypertonic were carried out in this method. Patients with multiple cysts also were treated by this procedure.</span><br /> <strong><em><span style="font-family: Times New Roman;">Results</span></em></strong><br /> <span style="font-family: Times New Roman;">Participants were 18 boys (47.3%) and 20 girls (52.6%) with mean age </span>of 8.08<span style="text-decoration: underline;">+</span> 3.92 years. Almost half of the patients had single cyst (52.63%).<span style="font-family: Times New Roman;"> During 2- year follow- up, no recurrences were observed; therefore, re-hospitalization and possible complications reduced considerably. Furthermore, this method was applicable to cure multiple cysts. </span><br /> <strong><em><span style="font-family: Times New Roman;">Conclusion</span></em></strong><br /> In PAHSI strategy, it seems that the complications of surgery (laparotomy and anesthesia) decreased since no complications observed after procedure, and cosmetic results in future are much better due to avoidance of incision.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Effect of Probiotics on Serum Bilirubin Level in Term Neonates with Jaundice; A Randomized Clinical Trial59535958915510.22038/ijp.2017.24996.2117ENYadollah Zahed PashaProfessor of Pediatrics and Neonatology, Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Department of Pediatrics, Babol University of Medical Sciences, Babol, IR Iran.Mousa Ahmadpour-kachoProfessor of Pediatrics and Neonatology, Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Department of Pediatrics, Babol University of Medical Sciences, Babol, IR Iran.0000-0001-8572-2026Abes Ahmadi JaziFellow of Neonatology, Amirkola Children’s Hospital, Department of Pediatrics, Babol University of medical Sciences, Babol, IR Iran.Hemmat GholiniaMSc in Statistics, Health Research Institute, Babol University of Medical Sciences, Iran.Journal Article20170717<strong><em><span style="font-family: Times New Roman;">Background</span></em></strong><br /> <span style="font-family: Times New Roman;">In recent years, tendency to use drugs has been increasing in the treatment of neonatal jaundice. Several drugs have been used since then, but the effect of probiotics on serum bilirubin level (SBL) is not so clear. This study was conducted to evaluate the effect of probiotics on SBL and the duration of phototherapy in term neonates with hyperbilirubinemia.</span><br /> <span style="font-family: Times New Roman;"><strong><em>Materials and Methods: </em></strong>In this randomized clinical trial, we studied 150 term neonate with jaundice hospitalized for phototherapy in Amirkola Children’s Hospital, Babol- Iran, during October 5, 2016 till May 19, 2017. Eligible neonates were randomly divided into two; intervention (n=75), and control (n=75) groups. Both groups received standard conventional phototherapy, but the intervention group received 10 drop/day of probiotics (Pedilact Zisttakhmir. Co. Iran), until hospital discharge. The outcome variables were SBL and the duration of phototherapy. The data was analyzed by SPSS 22.0 and the P </span><<span style="font-family: Times New Roman;"> 0.05 was considered significant. </span><br /> <span style="font-family: Times New Roman;"><strong><em>Results: </em></strong>The mean SBL before intervention in the intervention and control groups was 16 ±1. 9 and 16.9±1.9 mg/dl, respectively (P>0.05.After 24, 48 and 72hours it decreased to 13.73±1.72, 10.92±1.87 and 10.25±1.32 in the intervention and 13.66±1.91, 11.01±1.69 and10.09 ±1.38 in the control groups, respectively but comparison of the amount of SBL reduction between the two groups was not significant (P>0.05). The duration of phototherapy in the intervention group and the control group was 3.61±1.17 days and 3.72±1.18 days respectively (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;">Oral probiotics in neonates with jaundice has no significant effect on SBL and the duration of phototherapy. Further studies are needed to with longer time follow-up. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Extremity Fracture Diagnosis Using Bedside Ultrasound in Pediatric Trauma Patients Referring to Emergency Department; A Diagnostic Study59595964921010.22038/ijp.2017.25714.2189ENShervin FarahmandDepartment of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.Abdullah ArshadiDepartment of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Shahram Bagheri-HaririDepartment of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-9818-0411Shahriar ShahriarianDepartment of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Mona ArbabPostdoctoral research fellow, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.Mojtaba SedaghatCommunity Medicine Department, Tehran University of Medical Sciences, Tehran, Iran.Journal Article20170818<strong><em><span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Background</span></span></em></strong><br /> <span style="font-size: 11pt;"><span style="font-family: Times New Roman;">This study performed to assess the efficacy of ultrasound in screening upper and lower extremities fractures in comparison with standard X-ray in pediatric trauma patients.</span></span><br /> <strong><em><span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Materials and Methods</span></span></em></strong><br /> <span style="font-size: 11pt;"><span style="font-family: Times New Roman;">This was a prospective diagnostic study conducted at the emergency department of Imam Khomeini Complex Hospital, Tehran, Iran. All patients with the age under 18-year-old admitted with limb trauma were first evaluated by attending emergency medicine physician using ultrasound and then underwent necessary X-rays. Thereafter, the ultrasound reports were compared with X-ray reports regarding measurement of its accuracy.</span></span><br /> <strong><em><span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Results</span></span></em></strong><br /> <span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Forty patients with the mean age of 9.47 ± 5.26 years (minimum of 2 and a maximum of 17 years) entered the study (75% were male). The average time of performing ultrasound in pediatric population is 3.99± 0.83 minutes which is statistically significant compared to X-ray, 16.12 ± 4.15 minutes (P<0.001). The overall sensitivity, specificity and accuracy of ultrasound in detecting fractures in evaluated pediatrics were 100%, 100% and 100%, respectively. The results showed an almost perfect agreement between ultrasound and X ray for detecting upper and lower extremity fractures in pediatrics population (k=1.00). </span></span><br /> <strong><em><span style="font-size: 11pt;"><span style="font-family: Times New Roman;">Conclusion</span></span></em></strong><br /> <span style="font-size: 11pt;"><span style="font-family: Times New Roman;">It is likely that ultrasound could be an accurate and time saving substitute for X-ray in screening for limb fractures in pediatric trauma patients admitted in emergency department.</span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-504751020171001Evaluation of Antibiotic Sensitivity of Urinary Tract Pathogens among Children in Zahedan, South East of Iran59655974861510.22038/ijp.2017.22970.1924ENSimin Sadeghi BojdChildren and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0003-1652-6237Gholamreza SoleimaniChildren and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0001-5291-6019Alireza TeimouriChildren and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0002-8356-4260Elham ZarifiMedical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Somaye RashidiPediatric Assistant of Zahedan University of Medical Sciences, Zahedan, Iran.Journal Article20170417<strong><em><span>Background</span></em></strong><br /> <span>Urinary tract infection (UTI), are the most frequent and serious infection in childhood around the world. The present study aimed to evaluate antibiotic sensitivity of urinary tract pathogens among children in Zahedan, South East Iran.</span><br /> <strong><em><span>Materials and Methods</span></em></strong><br /> <span>This cross-sectional study analyzed 396 patients aged 1-18 years with positive urine and suspected UTI. Gender and age of children, kind of isolated bacteria in urine culture, susceptibility and resistance of these bacteria to current antibiotics were studied. Bacterial growth for more than 10<sup>5 </sup>CFU/ml was considered as positive. Data analyzed by SPSS version 21.0. </span><br /> <strong><em><span>Results</span></em></strong><br /> <span>The most common age of urinary tract infection were < 1 year and 1-7 years for boys and girls, respectively, and the variation of sex distribution was significant in different age groups (P = 0.003). The most prevalent cause of UTI was Escherichia coli</span><span>(E.coli) (77%), in total ages and both gender, afterward was Enterobacter (8.1%) and Klebsiella (7.1%). E.coli sepsis was highly sensitive to nitrofurantoin (74.7%), ciprofloxacin (72.5%), and amikacin (64.6%), both highly resistant to trimethoprim and sulfametoxazole (74.8%), ampicillin (66.9%), and nalidixic acid</span><span>(51.1%); and its resistance to ceftriaxone was increasing.</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <strong><em><span><span> </span></span></em></strong><span>In this study resulted that E. coli was the first responsible pathogen in proven culture of UTI in children, which was increased in resistance to popular antibiotics like Ampicillin, Sulfamethoxazole-trimethoprim</span><span>and Nalidixic acid. In several countries, emphasize the need for local population specific surveillance for guiding empirical therapy for UTI in children.</span>