Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901The Effect of Dates and Fennel on Breastfeeding Adequacy of Mothers: A Review11891118991515010.22038/ijp.2020.46760.3795ENRana TafrishiPediatrician, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-9375-8512Shima ShekariAssistant Professor, Department of Pediatrics, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.Mohammad AjamUrologist, Department of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Elaheh BaratiAnesthesiologist, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Seyed Masoud HaghjoyanStudent Research Committee, Bu-Ali Sina University, Hamedan, Iran.Ali RokniOrthopedic Resident, Department of Orthopedic, Kerman University of Medical Sciences, Kerman, Iran.Omolbanin HeydariDepartment of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.Farzane AshrafiniaDepartment of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.Samaneh Dabagh FekriDepartment of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.Masumeh GhazanfarpourDepartment of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.0000-0003-4639-3711Maryam Abbasi DalooeiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-6214-151XJournal Article20200224<strong><em><span>Background: </span></em></strong><span>No systematic review study was found regarding the comprehensive examination of the effects of dates and fennel on breastfeeding adequacy of mothers. The present study aimed to examine the impact of dates and fennel on breastfeeding adequacy of mothers.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>All clinical trials evaluating the effect of palm date and fennel on breastfeeding in lactating mothers were searched on the online databases of Scopus, EMBASE, Cochrane, and Web of Science and Medline with no language or time restrictions using the combination related keywords of Mesh.</span><br /> <strong><em><span>Results: </span></em></strong><span>Five studies were included in this study. The results of the first research suggested the positive relationship between consuming fennel herbal tea and dates in enhancing milk production of mothers within the early days following birth. In the second study, the mother's satisfaction with the adequacy of milk showed the positive effect of dates consumption. The results of the third research showed that 80% of mothers in the intervention group had a smoothness score of breastmilk. The higher smoothness in the intervention group showed the positive impact of consumption of date on breastmilk. In the fourth study, a galactagogue drop containing fennel, Anise, dill, parsley, cumin, and fennel flower did not affect the volume of breastmilk and weight gaining of the infant. The fifth study showed the positive impact of the herbal tea of fenugreek seeds and fennel on improving the breastfeeding adequacy with positive changes in the anthropometric indicators, the number of wet diapers, and increased number of breastmilk drinking.</span><br /> <strong><em><span>Conclusion: </span></em></strong><span>Considering the availability and inexpensiveness of fennel and dates, their usage by breastfeeding mothers is recommended for increasing breastmilk.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901The Effect of Oral Ibuprofen on Closure of Patent Ductus Arteriosus in Term Neonates: A Clinical Trial Study11901119091613210.22038/ijp.2020.46088.3758ENNabiollah AsadpourAssistant Professor, Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran0000-0002-2521-1758Mohammad Reza Malek-AhmadiAssociate Professor, Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran.Afsaneh MalekpourAssistant Professor, Department of Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran.0000-0001-6599-9028Najmeh BagheriMedical Student, Shahrekord University of Medical Sciences, Shahrekord, Iran.Journal Article20200125<strong><em><span>Background</span></em></strong><br /> <span>The function of ductus arteriosus closes within a few minutes to a few days after birth in term neonates. In some cases, the duct remains open after birth, a condition which is called patent ductus arteriosus (PDA). PDA is associated with high rates of neonatal mortality and morbidity. The present study aims to evaluate the effect of oral ibuprofen on closure of PDA in term neonates. </span><br /> <strong><em><span>Materials and Methods</span></em></strong><br /> <span>In this clinical trial, 40 neonates (at the gestational age of 37 weeks and more) aged 5 to 30 days, with confirmed PDA through echocardiography, were randomly divided into two groups (n= 20). One group received ibuprofen syrup (10 mg/kg body weight) in the first 24 hours, followed by 5 mg/kg body weight for the next four days. The other group received placebo in the same manner. On the seventh day after the beginning of intervention, neonates underwent echocardiography for examination of PDA closure. Side effects of ibuprofen were evaluated. Symptoms of kidney failure, such as oliguria, edema, and proteinuria and increased creatinine, as well as gastrointestinal side effects such as gastrointestinal bleeding and recurrent vomiting, were assessed for one month. <span> </span></span><br /> <strong><em><span>Results</span></em></strong><br /> <span>According to the results, PDA diameter was not significantly different in ibuprofen compared to the placebo groups before (p>0.05) and after (p>0.05) intervention. Frequency of PDA closure was 13 (65%) in the ibuprofen group and 10 (50%) in the placebo group with no significant difference (p>0.05). There was no significant difference in the mean systolic and diastolic pressure gradient after intervention and in mean changes in pulmonary arterial hypertension between the two groups (p>0.05). No side effects were observed in any of the groups. </span><br /> <strong><em><span>Conclusion: </span></em></strong><span>Based on the results, oral ibuprofen did not significantly affect PDA closure in term neonates.<span> </span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Evaluation of QRS, QTc, and JTc intervals in Congenital Heart Disease with Pulmonary Hypertension11911119191401010.22038/ijp.2019.3610ENAsadolah TanasanAssistant Professor of Pediatrics Cardiology, Department of Pediatrics, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.0000-0002-6791-1875Ziba HasaniMedical student, Department of Pediatrics, Hamadan University of Medical Science, Hamadan, Iran.Mehdi MoradiAssociate Professor of Cardiology, Farshchian Heart Center, Hamadan University of Medical Science, Hamadan, Iran.Farzaneh Esna AshariAssociate Professor of community medicine, Department of community medicine, Hamadan University of Medical Sciences, Hamadan, Iran.Journal Article20190919<strong><em>Background</em></strong><br /> Pulmonary hypertension (PH) in congenital heart disease affects the patient’s prognosis. Prolonged QRS and QTc intervals in ECG may intensify life-threatening dysrhythmia in patients. We aimed to investigate the correlation between QRS, QTc, and JTc intervals prolongation in ECG with PH in Congenital Heart Disease (CHD) patients.<br /> <strong><em>Materials and Methods: </em></strong>This cross-sectional study was performed in the pediatric cardiology clinic of Be’sat Hospital in Hamadan, Iran, in 2016-2018. Patients with CHD and PH were compared with CHD patients without any evidence of PH as the control group. Afterward, QRS, QTc, and JTc intervals in ECG, RV MPI, and TAPSE echocardiography were compared between the case group (PH group) and the control group. We also compared the ECG and echocardiographic results between mild and severe PH patients in the case group.<br /> <strong><em>Results: </em></strong>In this study, 40 patients in the case group (with CHD and PH) were compared to 40 patients in the control group (only CHD without PH). There was a significant difference in QRS (p=0.005) and QTc (p=0.036) intervals between the two groups, but no significant difference in the JTc interval was observed. Of 40 patients with PH, 19 were in the mild PH subgroup, and 21 were in severe PH subgroup, in which 9 patients had irreversible PH or Eisenmenger syndrome (ES). QTc (p<0.001) and QRS (p=0.018) intervals in the severe PH subgroup with ES were significantly different from the mild PH subgroup, but the JTc interval was not significantly different.<br /> <strong><em>Conclusion</em></strong><br /> Despite longer QRS and QTc intervals in the PH group of CHD, JTc interval did not show a significant prolongation.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Hematologic Parameters of COVID – 19: A Review on Alteration of Hematologic Laboratory Findings11921119291625810.22038/ijp.2020.50620.4024ENMozhgan HashemiehPediatric Hematologist and Oncologist, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0003-1109-7285Journal Article20200721<span>Corona virus 2019 (COVID –19) is a public health emergency and according to the recent statistic of World Health Organization (WHO), this novel virus has infected all continents. During this outbreak, there is an urgent need for documentation of laboratory predictors to discriminate between mild and severe forms of this virus. In this pandemic, prompt identification of clinical and laboratory prognostic factors of progression towards critical and lethal forms of this disease is mandatory. During this new infection, lymphopenia, thrombocytopenia, sometimes neutrophilia, elevation of D-dimer, prolongation of prothrombin time<sup> (</sup></span><sup><span style="font-size: medium;"><span style="font-family: Times New Roman;">PT), and Partial Thromboplastin Time<span> (</span>PTT<span>),</span> and also increased level of fibrin degradation products (FDP) could occur. Moreover, elevation of erythrocyte sedimentation rate<span> (</span>ESR<span>)</span>, C-reactive protein<span> (</span>CRP<span>), procalcitonin, ferritin, Lactate dehydrogenase (LDH), and interleukin -6 (IL- 6) are other laboratory features. These parameters will enable risk stratification and favorable allocation of limited and technical resources particularly in under developed countries. In this review article, alteration of hematologic laboratory findings has been discussed.</span></span></span></sup>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Overview on Children Mental Health Status during Coronavirus Disease: Expressing How to Support11931119371635310.22038/ijp.2020.51046.4053ENGholamreza MohammadiAssistant Professor, Velayat Hospital, Semnan University of Medical Sciences, Semnan, Iran.0000-0002-8180-9690Kobra SheidaeeDepartment of Pediatric Neurology, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, IranSaeed Dashti DargahlooStudent Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.0000-0001-9539-2534Mohammad TabarestaniStudent Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.0000-0002-9011-8955Mohsen HosseinzadeganMedical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Science, Sari, Iran.Farzane AshrafiniaDepartment of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.Masoudeh BabakhanianStudent Research Committee, Psychiatry and Behavioral Research Centre, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.0000-0002-6128-8023Journal Article20200807<strong><em><span>Background: </span></em></strong><span>Coronavirus pandemic puts children in a more critical mental status compared to adults. Some symptoms of children’s mental disorders include extreme dependence, anxiety, fear, anger, and impatience. The present study aimed to review the studies, which have investigated the effects of coronavirus and its consequences on mental health, particularly the children, and provide some effective strategies to support them.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>In this overview, two researchers carried out the present study after comprehensive research according to the latest articles in PubMed/Medline, Web of Science, and Google Scholar until March 27 2020.</span><br /> <strong><em><span>Results: </span></em></strong><span>Ten studies examined were conducted on the children mental health status (the symptoms of depression (22.6%), anxiety (18.9%), and the prevalence of Post-Traumatic Stress Symptoms (PTSS) (30%)) as well as irritability, anger, emotional discharge and other symptoms, such as sleep disorders, nightmares, nocturnal enuresis, eating disorders, the sense of loneliness, the fear of illness and loss of parents or caregivers, understanding the physical signs of the disease in children under quarantine, news of outbreaks and school closures. This review reports that the symptoms of fear and anxiety in children of12-17 years old are higher compared to adults.</span><br /> <strong><em><span>Conclusion: </span></em></strong><span>To reduce the negative psychological effects on the children arisen from coronavirus crisis, despite the recommendations of World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF), some strategies are significantly important including physiological counseling for parents and children, access to the mental health services, and paying more attention to the children exposed to risk.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Comparison of the Therapeutic Effects of Salbutamol Nebulize with different Concentrations of Saline on Children with Bronchiolitis11939119441530310.22038/ijp.2020.46897.3805ENGholamreza SoleimaniAssociate Professor of Pediatric Infectious Disease, Department of Pediatrics, School of Medicine, Children and Adolescents Health Research Center, Research Institute for Drug Resistant Tuberculosis, Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0001-5291-6019Elham Shafighi ShahriAssistant Professor of Pediatrics, Department of Pediatrics, School of Medicine, Children and Adolescents Health Research Center, Research Institute for Drug Resistant Tuberculosis, Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0002-4732-8797Seyed Hosein Soleimanzadeh MousaviResident of Pediatric, Department of Pediatrics, School of Medicine, Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0003-3469-7048Journal Article20200229 <br /> <strong><em>Background</em></strong><br /> <br /> Bronchiolitis, which is the most common infection of the lower respiratory tract among infants, is characterized by acute inflammation, edema, increased mucosal production, and bronchospasm. We aimed to investigate the effects of saline usage with different concentrations and salbutamol on the treatment.<br /> <br /> <strong><em>Materials and Methods: </em></strong>This double-blind, randomized clinical trial was performed on 180 pediatric patients with four weeks to 24 months old admitted to Ali-Ibn-Aboutaleb Hospital in Zahedan, Iran, during 2017-18 for possible diagnosis of acute bronchiolitis. Patients were divided into three groups of 60 patients using the permissive block method. The first group received 0.15 mg of Salbutamol Nebulizer and 5 ml of normal saline 0.9%, the second group received saline 3%, and the third group received saline 5% at the same dose as the first group. Clinical status, oxygen saturation, respiratory and heart rate, intercostal retraction, dyspnea, wheezing before treatment and every 20 minutes after treatment up to 3 times, and Clinical Bronchiolitis Severity Score (CBSS) were collected.<br /> <br /> <strong><em>Results: </em></strong>In all three groups, there was an increasing trend in oxygen saturation and a decrease in respiratory rate, heart rate, and CBSS. In the first and third groups, there was a significant difference in CBSS after treatment, but in the second group, it was significant only at 20 and 40 minutes after treatment. The mean days of admission for the second group were lower.<br /> <br /> <strong><em>Conclusion</em></strong><br /> <br /> It seems that due to its cost-effectiveness, lack of complication and earlier efficacy of 5% hypertonic saline in the treatment of bronchiolitis, hypertonic saline 5% instead of normal saline 0.9% is more effective and more cost-beneficial achieved in bronchiolitis remedy.<br /> Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Clinical and Biochemical Characterizations of Pediatric Patients with Urea Cycle Disorders in Upper Egypt: A Case- Control Study11945119571633510.22038/ijp.2020.50809.4039ENTahia H. SaleemMedical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt.0000-0001-8575-4714Nagwan I. RashwanPediatric Department, Faculty of Medicine, South Valley University, Qena, Egypt.Mohammed H. HassanMedical Biochemistry Department, Faculty of Medicine, South Valley University Qena, Egypt.0000-0003-2698-9438Bahaa HawaryPediatric Department, Faculty of Medicine, Aswan University, Aswan, Egypt.Doha Abd-Elraheim SalamaMedical Biochemistry Department, Faculty of Medicine, South Valley University Qena, Egypt.Nahed A. MohamedMedical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt.Mohamed Elsayed Mohamed AhmedChemistry Department, Faculty of Science, Sohag University, Sohag, Egypt AND Analytical Biochemistry Diploma, Chemistry Department, Faculty of Science, Menoufia University, Menoufia, Egypt.Eman Ahmed Abd-ElmawgoodPediatric Department, Faculty of Medicine, South Valley University, Qena, Egypt.Journal Article20200728<strong><em>Background: </em></strong>The diagnosis of inborn errors of metabolism is generally challenging. We aimed to explore various types of urea cycle disorders (UCDs), and their clinical presentations and biochemical findings among Egyptian pediatric patients.<br /> <strong><em>Materials and Methods: </em></strong>This case-control study was conducted on 86 participants categorized into 43 pediatric patients suspected to have UCDs and 43 age- and sex-matched healthy controls, recruited from the Pediatric Outpatient Clinics, Inpatients Pediatric Departments, PICU and Neonatal Intensive Care Units of Qena, Assiut and Aswan University Hospitals, Egypt. In addition to the clinical assessments and routine laboratory investigations, colorimetric assays of blood lactate and ammonia, and plasma free amino acids assays using high performance liquid chromatography (HPLC), were performed for all included children. For patients with abnormal aminograms, the five enzymes of the urea cycle were measured in their liver tissue homogenates, using chemical methods.<br /> <strong><em>Results: </em></strong>The results showed that 25 out of 43 suspected patients were confirmed to have UCDs. The most frequent type of UCDs was Ornithine transcarbamylase (OTC) deficiency (48%), followed by Argininosuccinate synthase (ASS) deficiency (36%) and the least frequent was arginase (ARG) deficiency (16%). The main clinical presentations were poor oral intake (100%), followed by lethargy (96%), hypotonia (68%), vomiting (64%), and hepatomegaly (48%). There were normal glucose and ABG values with significantly higher ammonia; lactate and the measured plasma free amino acids among patients with UCDs vs. the controls (p˂0.05).<br /> <strong><em>Conclusion: </em></strong>The most frequent types of UCDs among pediatric patients in Upper Egypt were OTC and ASS deficiencies. In addition to clinical suspicion, assays of lactate, ABG, glucose, ammonia and aminogram may be helpful biochemical tests in diagnosing UCDs. Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Investigating the Effect of Zinc Deficiency on the Risk of Urinary Tract Infection in Children11959119661566110.22038/ijp.2020.47133.3819ENFariba ZabihiDepartment of General Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.Mina MostafaviDepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mohammad EsmaeiliDepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.CJASN-0673-06-15Massoud Issapour CheshaniDepartment of Urology, Islamic Azad University, Mashhad Branch, Mashhad, Iran.0000-0003-1481-6775Journal Article20200311<strong><em><span>Background</span></em></strong><br /> <span>Urinary Tract Infection (UTI) is a common infectious disease among children. Deficiency in micronutrients such as zinc, is believed to play a role in predisposing children to UTI. However, rare studies have been conducted on this subject. The present study aimedto compare the serum zinc level between children with UTI and normal controls.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>In this case-control study, which was conducted on children with UTI who referred to 17<sup>th</sup> Shahrivar and 22<sup>th</sup> Bahman hospitals, Mashhad- Iran, during 2016-2017, patients suspicious of UTI were assessed by urine culture. The urine sample of the patients who were not toilet-trained was collected using urinary bags, and those who were toilet trained were asked to collect the clean catch mid-stream urine. Demographic data, urinary symptoms, type of cultured microorganism, and colony count were recorded. Data were analyzed using SPSS V. 20.0.</span><br /> <strong><em><span>Results: </span></em></strong><span>Overall, 104 children (52 cases and 52 controls) were included. The groups had significant differences regarding sex, age, and weight (p <0.05). Serum zinc level was 60.0± 17.1 µg/dl in the case group and 83.0±15.7 µg/dl in the control group (P=0.001). After being adjusted for demographic factors, the zinc deficiency proved to be a significant predictor of UTI (OR= 8.633, 95% confidence interval=3.084-24.171, p <0.001).</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>According to the results of our study, serum zinc level was markedly lower among patients with UTI. Zinc deficiency can put the children at an eight times higher risk for developing UTI, independent of age and gender.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Comparison of Vitamin D Levels in Children with Musculoskeletal Pain with and without Hypermobility of Joints11967119721533910.22038/ijp.2020.46872.3807ENMahsa Choroom KheirabadiDepartment of Pediatric Rheumatology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.Mahdieh Mousavi TorshiziDepartment of Pediatric Rheumatology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-3560-2664Payman SadeghiDepartment of Pediatric Rheumatology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-3217-7199Journal Article20200301<strong><em>Background</em></strong><br /> Vitamin D supplementation has been suggested as a part of an interdisciplinary approach for the management of chronic musculoskeletal pain in children and adolescents. This study aimed to compare vitamin D serum levels in Iranian children with chronic musculoskeletal pain with and without hypermobility.<br /> <strong><em>Materials and Methods: </em></strong>This cross-sectional study was performed on otherwise healthy children aged 16 years or younger with chronic musculoskeletal pain, who were admitted to the rheumatology clinic of Bahrami Children Hospital, Tehran, Iran, from January 2018 to January 2019. Chronic musculoskeletal pain was defined as recurrent episodes of musculoskeletal pain within the past month to the past week. The subjects were categorized into two groups, with or without hypermobility. Hypermobility was diagnosed using Modified Criteria of Carter and Wilkinson. Serum 25-hydroxy vitamin D (25-(OH)D) level and baseline characteristics were compared, and 25-(OH)D <strong><em>Results: </em></strong>A total of 72 children (41 girls and 31 boys, with the mean age of 7.36 ± 2.42 years) were included. Most participants (73.6%) were 3 to 7 years old. Sixty-four patients (88.8%) were diagnosed with vitamin D deficiency (25(OH)D <strong><em>Conclusion</em></strong><br /> Our study results suggested a high prevalence of vitamin D deficiency among children and adolescents with chronic musculoskeletal pain, but the difference in vitamin D deficiency between children with and without hypermobility was not statistically significant.<br /> <br /> Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901The Effect of Development Education on Fine Motor Skills of 18-Month-Old Children11973119861580710.22038/ijp.2020.48779.3915ENJamile AhmadiMSc, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0003-0939-0490Mahbobeh Ahmadi DoulabiPhD, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences,Tehran,Iran.0000-0002-3289-9474Firoozeh SajediProfessor of Pediatrics , Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.Malihe NasiriAssistant professor of biostatistics, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-000314967442Journal Article20200514<strong><em><span>Background</span></em></strong><br /> <span>The initial years of life particularly the first two years are regarded as the most important brain development period</span><span>.</span><span> The development of children is an important determinant of health throughout the whole of life. We aimed to evaluate an educational program to improve the fine motor skills of 18-month-old children.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>This randomized clinical trial was conducted in the city of Saqqez, Iran in 2015-2016. Seventy 18-month-old infants were randomly assigned to control (n=35), and intervention (n=35) groups. The training of fine motor skills was given to the mothers of the children of intervention group, including: painting, building a tower, stringing, tearing and crushing a piece of paper, targeting and dropping. Fine motor skills were measured before intervention and 4 and 8 weeks after the intervention using</span><span> ASQ-II</span><span> screening tool (Age and Stage Questionnaire, Second Edition). Data were analyzed using SPSS software version 20.0. </span><br /> <strong><em><span>Results: </span></em></strong><span>In the intervention and control group, 51.5% (n=17) were male and 48.5% (n=16) were female. Statistical test of Chi-square showed that there was no statistically significant difference in terms of gender (p=0.59). According to independent t-test, there was no significant difference in the mean of fine motor score before intervention in the two groups with (p = 0.13). The repeated measurement test showed that 4 and 8 weeks after training, the scores of fine movements with (p = 0.04) became significant.</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>Based on the results, developmental skills training </span><span>compared with control group</span><span> improved the fine motor skills of 18-month-old children in this study. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Evaluation of Serum Chemerin and Lipid accumulation product as Predictors of Non-Alcoholic Fatty Liver Disease in Simple Obese Egyptian Children11987119991616410.22038/ijp.2020.50244.3999ENMohammed Hashem MahgoobMD, Department of Pediatrics, Faculty of Medicine, Minia University, Minia, Egypt.0000-0002-7947-0501Nageh Shehata MohamedMD, Department of Pediatrics, Faculty of Medicine, Minia University, Minia, Egypt.https://orcid.org/00Nagwa Ismail OkailyMD, Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia, Egypt.Mohamed Ahmed AminMD, Department of Diagnostic Radiology, Faculty of Medicine, Minia University, Minia, Egypt AND Department of Pediatrics, Faculty of Medicine, Minia University, Minia, Egypt.Journal Article20200707<strong><em>Background</em></strong><br /> The increase in the prevalence of obesity worldwide has led to non-alcoholic fatty liver disease (NAFLD) becoming one of the most common causes of chronic liver disease. Chemerin is a novel adipokine which regulates adipogenesis which is also a marker of systemic and vascular inflammation. Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. We aimed to evaluate the clinical usefulness of both serum chemerin and LAP as predictors of NAFLD in children with simple obesity.<br /> <strong><em>Materials and Methods: </em></strong>This was a prospective cross-sectional study including 65 obese children with age range of 6–18 years old from pediatric obesity and endocrine outpatient clinic, Children’s University Hospital, Minia University, Egypt, in addition to 30 healthy children, age and sex matched as control group. The included children were subjected to careful history taking, thorough clinical examination and laboratory investigations including liver enzymes, fasting blood glucose (FBG), fasting serum insulin, lipid profile and serum chemerin. Then LAP was calculated using waist circumference and serum triglyceride.<br /> <strong><em>Results: </em></strong>Serum chemerin and LAP were significantly higher in obese children (p-<0.01). LAP had 95.2% sensitivity and 70.5% specificity at a cut-off point > 41; while serum chemerin at a cut-off point of > 271.7 ng/dl showed an 85.4% sensitivity and 51.4%% specificity for prediction of liver steatosis in our obese participants.<br /> <strong><em>Conclusion</em></strong><br /> Based on the results, serum chemerin may be considered as an acceptable indicator of NAFLD in obese children but LAP is a more available, easy and inexpensive tool to predict NAFLD in those children.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Ultrasonographic Evaluation of Placenta Thickness and Fetal Cord Cross Section in Gestational Diabetes Mothers Compared to Control Group12001120091489110.22038/ijp.2020.45444.3727ENMohammad Momen GharibvandDepartment of Radiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahwaz, Iran.0000-0002-1877-8019Mohammad Ghasem HanafiDepartment of Radiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahwaz, Iran.0000-0003-1533-5244Mohamad Reza FadaeeDepartment of Radiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahwaz, Iran.Journal Article20191230<strong><em>Background</em></strong><br /> The metabolic enhancement resulted from hyperglycemia in gestational diabetes leads to macrosomia, which can affect the placenta. In gestational diabetes mellitus (GDM) pregnant women, the thickness of placenta and cord diameter can change at ages prior to treatment initiation. Therefore, this study was conducted to examine the thickness of placenta and umbilical cord in mothers with gestational diabetes, compared to the control group, in order to indirectly investigate the effects of hyperglycemia on fetus.<br /> <strong><em>Materials and Methods: </em></strong>In this cross-sectional study, pregnant women in the gestational ages ranged 28-32 weeks, who underwent a 3-hour glucose test to detect gestational diabetes mellitus, were evaluated using ultrasound in terms of placenta thickness and umbilical cord area, compared to the control group.<br /> <strong><em>Results: </em></strong>Out of 93 pregnant women in gestational ages of 28-32 weeks, 45 had gestational diabetes and 48 of them were selected as the control group. The mean age of the individuals was 26.33 years old with standard deviation of 4.88. There was a significant increase in the thickness of the placenta and the transverse diameter of the cord in the case group and there was a direct and significant relation (p <0.05). Also, there was a significant relationship between cord area and the thickness of placenta (p <0.05).<br /> <strong><em>Conclusion</em></strong><br /> The thickness of placenta and consequently the cord area in mothers with gestational diabetes increases independently from changes caused by macrosomia and fetus weight.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Neonatal Sepsis among Neonates at Public Hospitals in Jimma, Ethiopia12011120211513510.22038/ijp.2020.44435.3681ENEbissa BayanaSchool of Nursing and Midwifery, Institute of health, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia0000-0001-5611-6799Kidist EndaleSchool of nursing and midwifery, Institute of health, Faculty of health Sciences, Jimma University, Jimma, EthiopiaAdugna OlaniSchool of nursing and midwifery, Institute of health, Faculty of health Sciences, Jimma University, Jimma, EthiopiaYonas BiratuSchool of nursing and midwifery, Institute of health, Faculty of health Sciences, Jimma University, Jimma, EthiopiaKenenisa TegenuSchool of nursing and midwifery, Institute of health, Faculty of health Sciences, Jimma University, Jimma, EthiopiaJournal Article20191113<strong><em>Background</em></strong><br /> Neonatal sepsis is one of the major causes of neonatal morbidity and mortality globally. Its incidence varies from 1 to 4 cases per 1,000 live births in developed countries. The burden of the problem occurs in the developing world while most confirmation is derived from developed countries. This study is aimed to assess the prevalence of neonatal sepsis and associated factors among newborns admitted in neonatal intensive care units.<br /> <strong><em>Materials and Methods</em></strong><br /> An institutional based cross-sectional study was conducted in two hospitals in Jimma town, Ethiopia, 2019. Sampling was taken consecutively to select the study participants. Face to face interview with the mothers and document review was used to collect data by using a structured questionnaire. The data was checked for completeness, coded, cleaned and entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Binary and multivariable logistic regression was used to understand association between dependent and independent variables. P-value <strong><em>Results</em></strong><br /> This study found that 52.6% of the neonates had neonatal sepsis during admission. Among these, 39.8% were early onset of neonatal sepsis and 12.8% were late onset of neonatal sepsis. Factors such as maternal Urinary tract infection, maternal fever, chorioamnionitis, and age of neonates (0-7 days), male sex and resuscitation at birth were significantly associated to neonatal sepsis.<br /> <strong><em>Conclusion</em></strong><br /> This study identified that rate of neonatal sepsis was high and maternal related factors were significant predictors of neonatal sepsis. Therefore, health professionals should work on risk factors associated with sepsis to decrease its prevalence and other complications.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Prevalence of Anti-Erythrocyte Alloantibodies and Relevant Factors among the Patients with Thalassemia Major in Kermanshah, Iran12023120301635510.22038/ijp.2020.50697.4028ENMohamad Reza GolpayeganyAssistant Professor, Department of Pediatrics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mohamad Reza TohidiAssistant Professor, Department of Pediatrics, Pediatric Nephrology Division, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000-0002-4189-4480Sara HookariDepartment of Biostatistics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000-0001-9811-3481Bahareh FouladiStudent of Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.Journal Article20200724<strong><em><span>Background</span></em></strong><br /> <span lang="EN">The major treatment for</span><span> thalassemia </span><span lang="EN">is a transfusion. The present study aimed to determine the frequency of </span><span>erythrocyte alloantibodies</span><span lang="EN"> and the relevant factors among the patients with thalassemia major in Kermanshah city, Iran.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span lang="EN">This</span><span lang="EN">cross-sectional study was performed on 218 thalassemia major patients with 2-48 years old, referred to thalassemia boarding clinic at the Dr. Mohammad Kermanshahi Hospital in Kermanshah city, Iran. Blood samples from thalassemia patients (</span><span>5 ml) </span><span lang="EN">were examined in terms of the presence of </span><span>erythrocyte</span><span lang="EN"> antibodies (using the screening antibody test), and additional information including age, blood </span><span>Rh</span><span lang="EN">, spleen status was extracted from the patients’ </span><span>profile</span><span lang="EN">. The information was finally analyzed using SPSS software version 20.0.</span><br /> <strong><em><span>Results: </span></em></strong><span lang="EN">A total of 74 patients (33.9%) had alloantibody, and 144 (67.1%) lacked antibody. The mean age of the subjects was 21.85</span><span lang="FA" dir="RTL">±</span><span lang="EN">8.083 years. The oldest and youngest subjects were 48 and 2 years old, respectively. The sample population included 114 men (52.3%) and 104 women (47.7%).<span> </span>35.8% of the patients underwent splenectomy. There was no significant relationship between blood Rh, spleen status, and incidence of alloantibodies </span><span>(all P> 0.05)</span><span lang="EN">.</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span lang="EN">The high prevalence of Alloimmunization in the present study requires a more detailed examination of donated blood for compatibility of </span><span>main </span><span lang="EN">and sub blood groups.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Association between Anterior Cervical Angle of the Uterus and Preterm Birth12031120371637610.22038/ijp.2020.51129.4056ENSedighe BornaMaternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.0000-0001-5231-0148Sedigheh HantoushzadehDepartment of Obstetrics and Gynecology, School of Medicine, Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.Sodabeh KazemiReproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran.0000-0002-3953-2018Zahra PanahiDepartment of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Razieh AkbariDepartment of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Mamak ShariatDepartment of Medicine, Guilan University of Medical Sciences, Rasht, Iran.Journal Article20200810<strong><em>Background</em></strong><br /> Predicting preterm delivery can help obstetricians and midwives for better management of pregnancy care. Therefore, we aimed to investigate the relationship between cervical length and uteroservical angle with the occurrence of preterm delivery.<br /> <strong><em>Materials and Methods: </em></strong>The present cohort study was conducted on 100 pregnant women with singleton pregnancy referred for routine control to perinatology ward of Imam Khomeini Hospital in Tehran between Jan 2019-Apr, 2019. All included cases were undergoing transvaginal sonography to measure the anterior cervical angle and length. Maternal demographic and clinical data, as well as delivery data of pregnant women, were obtained from their medical records. Logistic regression was conducted to estimate the predictors of pre-term delivery. All analyses were performed using Stata 14.0.<br /> <strong><em>Results: </em></strong>Among 100 pregnant women, 17 had preterm delivery. Pregnant women with bleeding during pregnancy were reported with a higher preterm delivery rate (23.53% vs. 4.82%) (<em>p </em>=0.01). The difference of mean cervical angle between pregnant women with the term and preterm delivery was statistically different (102.12° in women who delivered pre-term vs. 86.15° in term group, p <0.001).<br /> <strong><em>Conclusion</em></strong><br /> According to the results, pregnant women with bleeding during pregnancy and those with a higher mean of cervical angle were more prone to pre-term delivery. Therefore, the anterior cervical angle and bleeding during pregnancy can be considered as predictors for preterm birth.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Treatment Protocol of Ventilator-Associated Pneumonia based on Microbial Susceptibility in Pediatric Intensive Care Unit, Isfahan, Iran12039120511453310.22038/ijp.2020.44508.3684ENMajid KeivanfarPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0003-0630-4104Nazanin ZibanejadPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.Hamid RahimiPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.Sharareh BabaeiPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.Monir Sadat EmadoleslamiPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0001-5153-4596Mohsen ReisiPediatrics Pulmonology Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0002-3611-6609Journal Article20191116<strong><em>Background</em></strong><br /> Choosing a unique empiric treatment for ventilator associated pneumonia (VAP) can be challenging. We aimed to determine the antimicrobial susceptibility pattern of Intensive Care Unit (ICU) of the only referral pediatric hospital in Isfahan in order to design the optimal empiric treatment protocol.<br /> <strong><em>Materials and Methods: </em></strong>In this cross-sectional study 343 isolates were detected from 243 pediatric patients, from August 2017 to December 2018 in Imam Hossein Hospital, Isfahan, Iran. In suspicious cases of VAP, sampling was performed via non-Bronchoscopic Bronchoalveolar Lavage (NB-BAL). Microbial susceptibility and resistance were assessed. The treatment protocol of VAP was prepared based on existing guidelines.<br /> <strong><em>Results: </em></strong>Out of 343 isolates 42 (12.2%) of the positive cultures were <em>Candida albicans</em> and 301 (87.8%) were bacterial isolates. Gram-negative bacteria were the most common organisms with the cumulative percentage of 62.9% of bacterial isolates. When tested with oxacillin, 61.5% of <em>Staphylococcus aureus</em> were MSSA and 38.5% were MRSA. The mentioned common gram-negative organisms had more than 25% resistance to at least one antibiotic from three or more antibiotic classes. However, <em>P.</em> <em>aeruginosa</em> showed below 20% resistance to majority of antibiotics. Twenty-seven (11.1%) of patients had VAP, 25 (92.6%) of whom were gram-negative infections.<br /> <strong><em>Conclusion: </em></strong>The limited time period and sample size without any follow-up, made it impossible to define an effective treatment protocol. We defined our antibiogram in accordance with the existing standard guidelines and we designed a local protocol. An effective antibiotic against MRSA should be used in the empiric treatment of VAP. Also, in presence or absence of multidrug-resistant (MDR) pathogen risk-factors, it is necessary to use two effective antipseudomonal antibiotics from different antibiotic classes.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Association between Second to Fourth Digit Ratio with Handwriting Quality and Speed among Elementary School Children12053120601532710.22038/ijp.2020.47498.3854ENSaeed GhorbaniAssistant Professor, Department of Physical Education and Sport Science, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran .0000-0001-5670-8030Ahdiyeh YadolahzadehAssistant Professor, Department of Physical Education, Farhangian University, Tehran, Iran.0000-0003-0792-9704Masoud ShakkiMSc, Department of Physical Education and Sport Science, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran.0000-0002-8698-5730Saharnaz NoohpishehMD, Department of Physical Education and Sport Science, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran.Journal Article20200330<strong><em><span>Background</span></em></strong><br /> <span>Genetic impacts on handwriting legibility and speed, especially in early childhood, are not well understood. The present study used a 2D:4D ratio as a biological marker to investigate the associations between genetic factors with quality and speed of handwriting among the elementary school children. </span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>The present study used a comparative-correlational method. Participants included 109 boys and 114 girls attending second and third grades in regular elementary schools in 2019 in Golestan province, Iran. The Persian Handwriting Assessment Tool (Havaei et al. 2017), and photocopy method were used to measure handwriting performance and 2D:4D ratio, respectively. Legibility in copying and dictation, as well as the speed of handwriting, were assessed as dependent variables. </span><br /> <strong><em><span>Results: </span></em></strong><span>The results showed that boys and girls had identical age and education. Moreover, it was revealed that boys had significantly lower 2D:4D ratio in both right and left hands compared to girls (P<.001). Furthermore, a negative association was observed between right 2D:4D ratio with word space in copying (r=-.23, P<.001) as well as a significant positive association between left 2D:4D ratio with word formation (r=.13, P=.04) in the dictation of boys. Additionally, the results indicated a significant negative association between right 2D:4D ratio with word alignment in the dictation of girls (r=-.20, P=.02). No other significant associations were observed between 2D:4D ratio and handwriting performance. Finally, no significant differences were observed between boys and girls in handwriting performance. </span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>According to the results, the 2D:4D ratio does not positively affect handwriting quality and speed in elementary school children. </span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901The Reconnaissance of Iranian Adolescent’s Perceptions of Radiology Imaging Process12061120681640810.22038/ijp.2020.49229.3940ENMohammadamin AmeriDepartment of Medical Imaging and Radiation Sciences, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.0000-0003-1522-6339Marzieh ReshadatianDepartment of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.0000-0002-5028-8685Mohammadhossein Haghighi ZadehBiostatistics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Journal Article20200602<strong><em><span>Background</span></em></strong><br /> <span><span>Since adolescents do not frequently refer to pediatricians or even general practitioners, hospitals and clinical standard systems are not designed to meet their needs. Therefore, the present study aimed to identify adolescent’s views and feelings of the X-ray imaging process, suggest some age-appropriate facilities to respond to their needs to have a good experience of attending to radiology centers and appropriate interactions between middle adolescents and radiographers.</span></span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>In this cross-sectional study,<span> 60 adolescents (30 girls and 30 boys) from </span>four secondary schools participated in the study. Their<span> opinions and feelings regarding the waiting room, the imaging room, and their interactions with the radiographers were collected using the completed questionnaire. </span>The questionnaire <span>has been created </span>by the Irish researcher (Davis), and its validity and reliability have been examined.</span><br /> <strong><em><span>Results: </span></em></strong><span><span>The major complaints of adolescents (36.7%) was the lack of comfortable seats in the waiting room. They preferred watching TV in the waiting room to play music. None of the adolescent girls were nervous in the X-ray room, and 13.3% of boys stated that they were nervous. Twenty-two of the adolescents said the radiographer was quiet. 10% of girls stated that the radiographer was quite rough in dealing with them; however, none of the boys made such a statement.</span></span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>The<span>results showed that adolescents do not receive optimal care during X-ray imaging. It was suggested that age-appropriate educational posters to be installed on the wall, and television programs to be displayed in the radiology departments, as well as training courses on how to interact with adolescents for radiographers.</span></span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Use of Amitriptyline to Improve Persistent Vomiting in Pediatrics: A Case Report12069120741556710.22038/ijp.2020.46056.3755ENAngela GraceSt. Rafael General Hospital, Cancar, Manggarai Regency, East Nusa Tenggara, Indonesia0000-0002-1560-972XJournal Article20200122<strong><em>Background</em></strong><br /> Cyclic Vomiting Syndrome (CVS) is a Functional Gastro-Intestinal Disorder (FGID) which remains under-recognized. In Indonesia, CVS has never been reported.<br /> <strong><em>Case Presentation</em></strong><br /> A 10-year-old girl was frequently admitted due to her intense vomiting in a local, limited resource private hospital in Manggarai Regency, East Nusa Tenggara, Indonesia, and had always been diagnosed with Gastro-Esophageal Reflux Disease (GERD). Her episodes were characterized by vomiting every 30-60 minutes at first, gradually declining over 3-4 days, and recurring in about 6-7 days. All the available test results were unremarkable. Symptoms were resolved after the administration of amitriptyline. She was discharged with continuous amitriptyline for two weeks and went into remission.<br /> <strong><em>Conclusion</em></strong><br /> CVS should always be considered in repeated vomiting among children regardless of the rarity in daily practice. Recognition of this disorder is important to establish the prompt diagnosis and timely intervention, thus improving the quality of life of the children.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901A Few Steps Ahead to Select ACE2 in Pediatric COVID-19 Treatment: A Review of Literature12075120801590510.22038/ijp.2020.48616.3908ENSeyed Hhosein Soleimanzadeh MousaviResident of Pediatric, Department of Pediatrics, School of Medicine, Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.0000-0003-3469-7048Zeinab TavakolikiaMedical Practitioner, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.Journal Article20200509This review study aimed to examine the relationship between Coronavirus (COVID-19) and its uses in renin-angiotensin-aldosterone system (RAAS) to infect the patient using the related studies in this regard. Finally, the logical method of using the related medicine, and the benefits and harms of using these Medications will be indicated in the treatment of novel coronavirus. It is hoped that a short step will be taken in the attitude of scientists to plan further studies on the pediatric treatment of upgrading COVID-19.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Validation of the Persian Version of Edinburgh Postnatal Depression Scale in Iranian Women12081120891641210.22038/ijp.2020.51174.4063ENTahereh Galini MoghadamAssistant Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Sari Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.0000-0001-6454-6983Somayeh MoeindarbaryAssistant Professor, Department of Obstetrics and Gynecology, Neonatal and Maternal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-2421-2203Fatemeh Vafi SaniMaster of Operating Room, Department of operative room and anesthetics, School of paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran.Alireza SalehiStudent Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.Atefeh AhmadiNursing Research Center, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.0000-0001-5366-9849Fahimeh KhorasaniStudent Research Committee, Kerman University of Medical science, Kerman, Iran.0000-0002-1809-9649Masumeh GhazanfarpourStudent Research committee, Kerman University of Medical Sciences, Kerman, Iran.0000-0003-4639-3711Journal Article20200812<strong><em>Background</em></strong><br /> The aim of this study is to evaluate the psychometric properties of the Persian versionof the Edinburgh Postnatal Depression(EPDS) among Iranian mothers in postpartum period.<br /> <strong><em>Materials and Methods: </em></strong>This secondary analysis examines 200 Iranian mothers registered to receive prenatal care in health centers in Kerman, Iran. The subjects were selected using convenience sampling method. The reliability (Cronbach’s α coefficient), construct validity (confirmatory factor analysis (CFA), and exploratory factor analysis (EFA) were assessed. Model fit index (e.g., the root mean square error of approximation [RMSEA]), the Goodness of Fit Index (GFI), and the Comparative Fit Index (CFI) were calculated.<br /> <strong><em>Results: </em></strong>The overall Cronbach’s α was estimated at 0.70 with subscales ranging from 0.70 to 0.88. EFA identified three factors with extractable eigenvalue >1.00, which accounted for 62% of the total variance. The eigenvalues of the first three factors were 4.11, 1.09, and 1.012. The first factor, labeled "anhedonia", contained items 1 and 2. The second factor, labeled "anxiety", consisted of items 3, 4, and 5, which explain 19.61 of variance. The last factor, labeled "depression", contained items 7, 8, 9, and 10. Item 8 loaded equally on anhedonia and depression factors. The screen plot also suggested three factors. In addition, CFA verified the model extracted from the EFA. The three-factor model displayed an acceptable fit (CFI = 0.94, TLI = 0.92, RMSEA = 0.06, p=0.001).<br /> <strong><em>Conclusion</em></strong><br /> The results of EFA, CFA, and internal consistency revealed that the Persian version of 10-item EPDS instrument was valid and reliable, and can be used to screen and identify Iranian mothers with anxiety and depression in postpartum period.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Factors Related to the Age at Menarche in Iran: A Systematic Review and Meta-Analysis12091121041581910.22038/ijp.2020.49222.3939ENSaeideh NasiriStudent Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0002-5576-015XMahrokh DolatianDepartment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0002-1424-1951Fahimeh Ramezani TehraniReproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Hamid Alavi MajdDepartment of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0001-7772-2923Azam BagheriDepartment of Midwifery, Kashan University of Medical Sciences, Kashan, Iran.0000-0003-0352-1269Pooneh MalekifarDepartment of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran.Journal Article20200602<strong><em>Background</em></strong><br /> Reduced age at menarche is an important health indicator for women and may be associated with complications such as an increased risk of asthma, breast cancer, ovarian cancer, type 2 diabetes. We aimed to examine the factors related to the age at menarche in Iran.<br /> <strong><em>Materials and Methods: </em></strong>In this systematic review and meta-analysis, an advanced search with no time restriction was conducted in online databases such as the Web of Science, Embase, Medline, Scopus, and Persian databases of SID and Magiran, as well as the Google Scholar search engine, until the end of 2019. The publication heterogeneity and bias of the extracted studies were evaluated by the Q test and Begg’s test, respectively.<br /> <strong><em>Results: </em></strong>In this study, 12 articles with a total sample size of 17672 were included. Based on the findings of these studies, the body mass index (BMI), the mother’s age at menarche, physical activity, nutrition, and socioeconomic status were correlated with the age at menarche for Iranian girls. A negative correlation was found between BMI (r=-0.07), and socioeconomic status (r=-0.57) with the age at menarche (p <0.05). A positive correlation existed between the girl's age at menarche and that of the mother (r=0.42, p <0.05). Moreover, correlation was weak and positive between the age at menarche and physical activity (r=0.14, p <0.05). The quantitative results of the studies were incomplete to establish a relationship between nutrition and age at menarche.<br /> <strong><em>Conclusion</em></strong><br /> Due to the effects of numerous factors on the age at menarche, it is suggested that longitudinal studies be conducted to investigate the role of all the known factors, especially environmental factors, on the age at menarche.Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Effect of Crocus sativus (Saffron) on Cervical Ripening and Progress of Labor in Primiparous Term Women: A Randomized Double-Blind Placebo-Controlled Trial12105121151617210.22038/ijp.2020.50061.3992ENBahareh Ali-Akbari SichaniMSc. of Midwifery, Student Research Committee, School of Nursing and Midwifery, International Branch of Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0003-2355-2097Tayebeh DaroonehPh.D Student of Reproductive Health, Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Farzaneh Rashidi FakariPh.D Student of Reproductive Health, Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0001-7498-475XFariborz MoattarProfessor, Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan Medical University, Isfahan, Iran.Malihe NasiriAssistant Professor of Biostatistics, Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-000314967442Samireh Delpak- YeganehBoard of Specialized Gynecology and Obstetrics, Academic Officer of Maternity Ward, Zahraye Marzieh Hospital, Isfahan, Iran.Somayeh EsmaeiliPharm.D. Ph.D. Associate professor, School of Traditional Medicine, Traditional Medicine & Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Giti OzgoliPh.D. of Reproductive Health, Associated Professor, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0003-2111-7024Journal Article20200630<strong><em><span>Background: </span></em></strong><span>Saffron is a perennial plant native to Iran which has been traditionally prescribed to facilitate labor. We aimed to investigate the effect of <em>Crocus sativus</em> (Saffron) on cervical ripening and progress of labor in a sample of primiparous term Iranian women. </span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>This randomized double-blinded study, was conducted on 60 primiparous women whose gestational age was 40 weeks or longer and who had referred to Hazrat Zahra Marzieh hospital in Isfahan, Iran. Inclusion criteria were: singleton pregnancy, cephalic presentation of the fetus, lack of uterine contractions, intact amniotic sac and having a low-risk pregnancy. The intervention (n=30), and control groups (n=30) respectively received one saffron capsule (250 mg, the content of total flavonoid in each saffron capsule was calculated 0.13-0.18 mg), and one placebo capsule for 3 consecutive nights. Bishop scores of the samples were recorded before and after the intervention. </span><br /> <strong><em><span>Results: </span></em></strong><span>The mean Bishop score before inclusion in the study did not show significant difference between two groups (P>0.05). However, on third day of study, this score in saffron group was higher than the placebo (Saffron: 3.93±1.10 vs. placebo: 2.52±1.57) (P=0.001). Further, the mean Bishop score in saffron group was higher on third day of study compared to before their inclusion in the study (before: 2.42±1.19 vs after: 3.93±1.10) (P=0.001). But the placebo group did not show a significant difference before and after inclusion in the study (P=0.16). The average length of first and second stages of labor in saffron group was shorter than in the placebo (P>0.05).</span><br /> <strong><em><span>Conclusion: </span></em></strong><span>It seemsconsumption of oral saffron capsules, affects cervical softening and ripening, and progress of labor.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Relationship of Mothers’ Spiritual, Social, and Mental Health and Self-efficacy with Child Development: A Path Analysis12117121291608810.22038/ijp.2020.49573.3966ENRogayyeh SohrabiMSc, Department of Midwifery, School of Nursing and Midwifery, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Sedigheh Amir Ali AkbariPhD, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0002-4976-5085Mahbobeh Ahmadi DoulabiPhD, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Maliheh NasiriAssociate Professor, Department of Basic sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-000314967442Journal Article20200614<strong><em><span>Background</span></em></strong><br /> <span>Developmental disorders are important in children, but there is not enough information regarding risk factors, and their effects on developmental disorders. We aimed to design a relational model and assess the relationship of mothers’ spiritual, social, and mental health and self-efficacy with child development.</span><br /> <strong><em><span>Materials and Methods: </span></em></strong><span>The present analytical cross-sectional study enrolled 285 mothers with 18-month-old children through multistage sampling in health centers in Tehran, Iran. Mothers completed the following questionnaires in four months to collect the data: a demographic questionnaire, Paloutzian and Ellison’s Spiritual Health Scale, Keyes’ Social Health Scale, Goldberg’s mental health scale, Sherer’s Self-Efficacy Scale (SES), and the Ages and Stages Questionnaires (ASQ).The data and theoretical Path Model were analyzed using SPSS software version 19.0 and LISREL software version 8.8. </span><br /> <strong><em><span>Results: </span></em></strong><span>Developmental delay was observed in 21.8% (n=62) of children. Maternal spiritual health, both directly (β=0.35), and indirectly, had an increasing and positive effect on the children’s development through increasing social health, increasing self-efficacy and decreasing mental health score (β=0.206). Maternal social health, both directly (β=0.16), and indirectly, had an increasing and positive effect on the children’s development through increasing self-efficacy (β=0.0465). Maternal mental health had a direct and decreasing effect on the children’s development (β= -0.14), but mother’s self-efficacy had a direct and increasing effect on the children’s development (β= 0.31. The final path model was well-fitted (RMSEA=0.025, GFI=1, NFI=1).</span><br /> <strong><em><span>Conclusion</span></em></strong><br /> <span>Considering the results and the impact of factors such as spiritual, mental health, social health and self-efficacy on one another and the developmental delay in children, it appears necessary to screen for these factors for early diagnosis and intervention.</span>Mashhad University of Medical SciencesInternational Journal of Pediatrics2345-50478920200901Telemedicine: an Essential Requirement for the Health Care Providers, with Emphasis on Legal Aspects12131121421644510.22038/ijp.2020.51593.4099ENMolkizadeh Amir HosseinDepartment of Law, Mashhad Branch, Islamic Azad University, Mashhad, Iran.0000-0002-0599-3211Rahim BaghbanDepartment of Law, Mashhad Branch, Islamic Azad University, Mashhad, Iran.0000-0003-2878-2270Somayeh RahmanianMashhad Branch, Islamic Azad University, Mashhad, Iran.Saeed BayyenatAssistant Professor of Anesthesiology , Department of Anesthesiology, Baqiyatallah University of Medical Sciences, Tehran, Iran.Mohammad Ali KianiDepartment of Law, Mashhad Branch, Islamic Azad University, Mashhad, Iran AND Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-7869-0828Journal Article20200828Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. These technologies allow communications between patient and medical staff with convenience as well as the transmission of medical, imaging and health informatics data from one site to another. It is also used to save lives in critical care and emergency situations. Although telemedicine systems have many advantages, including the distribution of high quality medical services to remote areas, failure to comply with infrastructure will reduce the efficiency and quality of their services. Issues such as building the infrastructure of the medical information industry, including the legal infrastructure, and thus providing a suitable platform for the legal and ethical issues of Telemedicine, as well as obtaining the necessary permits and requirements, will play an important role in the successful implementation of a Telemedicine system. The purpose of this study was to become more familiar with the field of Telemedicine and its services, as well as to review some legal issues in the field of e-health. Telemedicine is not able to solve the problems of the health and social systems, but the problems of the health and social systems cannot be solved without Telemedicine.