Shirin Ghiasi; Hassan Mottaghi Moghaddam Shahri; Elahe Heidari; ladan Danesh
Abstract
Objectives: Prenatal detection of congenital heart disease (CHD) by using fetal echocardiography (FE) helps early diagnosis leading to prompt management and treatment. FE provides the high accurate non-invasive modality to improve the survival or life quality of CHD patients. The aim of this study was ...
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Objectives: Prenatal detection of congenital heart disease (CHD) by using fetal echocardiography (FE) helps early diagnosis leading to prompt management and treatment. FE provides the high accurate non-invasive modality to improve the survival or life quality of CHD patients. The aim of this study was to evaluate the antenatal detection of CHD by FE and compare with post-delivery echocardiography results. Method: A prospective cohort study of pregnant women referred to tertiary center Imam-Reza hospital, Mashhad, Iran for performing FE in hands of a skilled pediatric cardiologist between 2012 and 2021. Cardiac echocardiography was performed by GE Vivid 7 color Doppler and Mindray Resona 7 color Doppler with a convex probe 5-7 megahertz during late first trimester or early second trimester and after birth till 2-month later. Data was analyzed with SPSS and MedCalc software and agreement evaluated by using kappa. Result: Out of 261 studied fetuses, 101 normal cases detected in total agreement with postnatal-echo diagnosis. Acceptable diagnosis found for Septal defects; VSDs high statically detected (sensitivity= 90%, specificity= 93%). complex CHDs noted to be the mostly precise accurate prenatal diagnosis. Right Arch abnormalities, aortic stenosis, hypoplastic left heart syndrome and cardiac masses were completely acceptable but detecting coarctation of aorta faced with over-diagnosed. Prenatal diagnosed arrhythmias without structural defects mostly premature beats shifted to normal after-birth Echo. Conclusion:FE is a safe and sensitive modality in the prenatal diagnosis of CHDs. The study showed the effectiveness accuracy of early first trimester; also complete detection in both-side of defect spectrum.
Forough Rakhshanizadeh; Farhad Heydarian; Elahe Heidari; Lida Jarahi; hassan kani
Abstract
Objective: An imbalance has been reported in the oxidant-antioxidant system of infants with febrile convulsion. This study aimed to compare serum vitamin C levels between febrile children with or without seizures. Materials and Method: This multicenter case-control study was conducted on febrile infants ...
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Objective: An imbalance has been reported in the oxidant-antioxidant system of infants with febrile convulsion. This study aimed to compare serum vitamin C levels between febrile children with or without seizures. Materials and Method: This multicenter case-control study was conducted on febrile infants and children who were referred to the pediatric emergency wards of Mashhad University of Medical Science. The subjects were equally divided into two febrile groups of case (with seizure) and control (without seizures). Visible Spectrophotometer was used to determine the total vitamin C level.Results: In total, 100 febrile children were included in this study. Based on the results, there was no statistically significant difference between the two groups in terms of age, gender, and family history of febrile convulsion (FC) (P>0.05). The mean vitamin C levels in the case and control groups were 42.73±7.2 and 78.59±11.1 µg/l, respectively. There was a significant difference between the groups regarding the vitamin C level (P<0.001). Regression analysis revealed that age (P=0.74), gender (P=0.66), and family history of febrile convulsion (P=0.52) had not any correlation with vitamin C levels. On the other hand, the vitamin C levels was associated with FC (P=0.001).Conclusion: The serum levels of vitamin C in the children with febrile seizure were lower than those in the control group. Thus, the reduced vitamin C levels can be considered as a predisposing factor for FC.
Forough Rakhshanizadeh; alireza khadembashi; Elahe Heidari; Negar Morovatdar; Atefeh Soltanifar
Abstract
Introduction:Child abuse and neglect is a public health challenge with lifelong consequences for survivors. Physicians’ knowledge regarding child abuse and neglect is essential for diagnosis, treatment, and timely referral to legal authorities. This study aimed to determine pediatric residents’ ...
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Introduction:Child abuse and neglect is a public health challenge with lifelong consequences for survivors. Physicians’ knowledge regarding child abuse and neglect is essential for diagnosis, treatment, and timely referral to legal authorities. This study aimed to determine pediatric residents’ and pediatricians’ knowledge and attitude regarding child abuse and neglect.Methods: In this cross-sectional study, pediatric residents› and pediatricians› knowledge and attitude regarding child abuse and neglect were measured using a standard questionnaire with confirmed validity and reliability. In this questionnaire, knowledge score ranged from 0 to 17, and attitude score ranged from 10 to 50. After collecting the questionnaires and calculating the scores, the information was entered into the SPSS software (version 22), and statistical analysis was performed.Results: A total of 80 participants, including 38 pediatric residents and 42 pediatricians, participated in this research. Among them, 71.3% were female, and 28.8% were male. The mean score of knowledge and attitude in all participants was 14.05 ± 1.88 out of 17 and 41.39 ± 4.36 out of 50, respectively. The mean score in the pediatric residents and pediatricians was 13.42 ± 2.02. and 14.62 ± 1.57 for knowledge and 40.66 ± 4.32 and 42.05 ± 4.35 for attitude, respectively. Regarding knowledge, 19 participants (23.8%) had a good score, 35 (43.8%) had a moderate score, and 26 (32.5%) had a poor score (p=0.24). There was a significant difference in terms of knowledge score among four academic groups (first-year resident, second-year resident, third-year resident, and pediatrician) (p=0.031), as the score wassignificantly higher in pediatricians than in residents (p=0.004). However, no significant difference was observed for attitude score (p=0.056). In general, and regarding all participants, no significant relationship was observed between attitude score and knowledge score (p=0.059).Conclusion: Most pediatric residents and pediatricians participating in the present study had moderate knowledge and attitude toward child abuse and neglect, and less than a quarter of the participants had good knowledge in this regard. Also, the pediatricians had significantly higher knowledge scores than the pediatric residents. These results emphasize the importance of more education for pediatric residents regarding child abuse and neglect and continuing education programs for pediatricians.
Farhad Heydarian; Maryam Bagherian; Elham Bakhtiari; Elahe Heidari; Forough Rakhshanizadeh
Abstract
AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted ...
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AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted on the children with febrile seizures referred to the Emergency and Pediatric Wards of hospitals affiliated with Mashhad University of Medical Sciences. They were LP candidates; nonetheless, their parents did not consent to the performance of this procedure. The children were randomly assigned to three groups. In the first group, videos of the location and method of LP were presented to the parents. The second group received this information via posters, and the parents in the third group were given a verbal explanation. Results: The children included 49 (4.54%) females with a mean age of 15 months. There was a significant relationship between the reason for parental refusal of LP and their final satisfaction (P=0.022). There was a significant relationship between parents' satisfaction with the performance of LP and their education (P=0.029). The film method had the lowest chance of success, and the verbal explanation method enjoyed the most remarkable success in enhancing parental satisfaction (P= 0.013).Conclusion: Although the use of posters and videos was less effective than verbal explanation, it increased the satisfaction of LP in some parents. In fact, it is more beneficial to try to alter parental misperceptions of LP in non-emergency situations.
Elaheh Heidari; Maryam Emadzadeh; Ezzat Khodashenas; Farideh Najm Sarvari; Hamid Ahanchian; Amin Heidari; Mahdi Mottaghi
Abstract
Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: ...
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Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: This systematic review was conducted via searching in databases such as PubMed, Scopus, Web of Science, and Cochrane Library until August 2019. Randomized clinical trials regarding the effects of systemic corticosteroids on children with bronchiolitis aged less than two years were evaluated in the retrieved studies. The quality of the studies was assessed based on the Jadad scale. Result: Three studies were included in this systematic review. In two studies, dexamethasone versus placebo were used, and in one study, prednisolone was applied. In one study, use of dexamethasone versus placebo resulted in the faster resolution of respiratory distress, shorter duration of respiratory distress syndrome, reduced oxygen therapy time, and reduced length of hospital stay. In another study, children receiving treatment with dexamethasone had no significant difference in the clinical score, respiratory rate, and pulmonary function compared to the control group. In another study, use of prednisolone within two weeks led to the partial improvement of rhinitis, wheezing, breathing problems, nocturnal respiratory symptoms, and coughing. However, no significant difference was observed between the prednisolone treatment and control groups after 12 months.Conclusion: Despite the improvements in respiratory symptoms, evidence is scarce regarding the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years. Therefore, well-designed randomized clinical trials on large sample sizes are required in this regard.
Zahra Amirian; Fatemeh Behmanesh; Elahe Heidari
Abstract
Recent studies have reported a relationship between vitamin D and atopic diseases such as asthma, allergic rhinitis, and atopic dermatitis, which is due to the recently discovered vitamin D receptors on many immune system cells. Among all atopic diseases, asthma has been studied the most in this regard. ...
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Recent studies have reported a relationship between vitamin D and atopic diseases such as asthma, allergic rhinitis, and atopic dermatitis, which is due to the recently discovered vitamin D receptors on many immune system cells. Among all atopic diseases, asthma has been studied the most in this regard. However, the role of vitamin D in other atopic diseases such as allergic rhinitis and atopic dermatitis is a matter of controversy. In this paper, we review the literature on the association between atopic diseases and vitamin D level with a focus on the childhood period. As of today, the role of vitamin D in atopic march is not clear and studies show controversial results. Therefore, further studies with adequate sample sizes and correction for perplexing factors are needed since this could be an innovative treatment in atopic children. It is also advisable to examine high-risk groups of children for vitamin D deficiency. According to the extracted data, vitamin D has a protecting effect against atopic diseases. At the same time, no evidence was found for such an association in some studies, thus, further studies are needed to clarify this issue.
Maryam Khalesi; Farhad Heydarian; Seyed Javad Sayedi; Shima Badzai; Elahe Heidari
Abstract
Convulsion with mild gastroenteritis is an afebrile seizure associated with viral gastroenteritis in a healthy child without fever, dehydration, electrolyte imbalance, meningitis, or encephalitis. Convulsion with mild gastroenteritis is more common in children aged 1 to 2 years. Usually, Convulsions ...
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Convulsion with mild gastroenteritis is an afebrile seizure associated with viral gastroenteritis in a healthy child without fever, dehydration, electrolyte imbalance, meningitis, or encephalitis. Convulsion with mild gastroenteritis is more common in children aged 1 to 2 years. Usually, Convulsions are brief generalized tonic colonic type. Most convulsions occur within first 24 hours of illness onset. Rotaviral gastroenteritis is known as the most common type of gastroenteritis associated with Convulsion. Laboratory investigations are normal. Also EEG and neuroimaging are usually normal. Long term antiepileptic treatment is not necessary. It is usually a benign condition with good prognosis and no risk for developing epilepsy in future. Considering this etiology of seizure could prevent supernumerary evaluations and long-term antiepileptic treatment.
Hassan Mottaghi; Elahe Heidari; Shirin Sadat Ghiasi
Abstract
Congenital heart defect (CHD) is the most common type of congenital malformation in live births with a wide and variable spectrum in each population. The prevalence of this malformation is reported to be 8 cases per 1,000 live births. The CHD is also accompanied by multiple complications, such as prematurity, ...
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Congenital heart defect (CHD) is the most common type of congenital malformation in live births with a wide and variable spectrum in each population. The prevalence of this malformation is reported to be 8 cases per 1,000 live births. The CHD is also accompanied by multiple complications, such as prematurity, low birth weight, termination of pregnancy, mortality, and morbidity. The concomitant of this defect with extra-cardiac anomalies result in the enhancement of mortality and morbidity. Due to the importance of CHD and role of genetic and environmental factors on CHD, prenatal diagnosis is an issue of fundamental importance. The prenatal diagnosis increases the survival rate and reduces complications, mortality, and morbidity. Fetal echocardiography as a non-invasive and safe method enables the pediatric cardiologists to diagnose CHD prenatally with high sensitivity and specificity. Regarding this, the present study was conducted with the aim of reviewing the literature on the prenatal diagnosis of CHD using fetal echocardiography. Based on the reviewed studies, the role of fetal echocardiography and its indications were defined. Accordingly, fetal echocardiography was suggested as a profitable method for the prenatal diagnosis of CHDs even in the low-risk pregnancies.
Ezzat Khodashenas; Alireza Ataei Nakhaei; Elahe Heidari
Abstract
The purpose of this study is to report a case of severe back pain following lumbar puncture (LP), which was associated with an accidental tether cord syndrome (TCS) in MRI. The patient was a 10-year-old boy that was hospitalized in the pediatric ward for severe headache and to rule out meningitis. First, ...
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The purpose of this study is to report a case of severe back pain following lumbar puncture (LP), which was associated with an accidental tether cord syndrome (TCS) in MRI. The patient was a 10-year-old boy that was hospitalized in the pediatric ward for severe headache and to rule out meningitis. First, LP was performed for him, but he suffered very severe back pain after LP. Lumbosacral MRI was performed to rule out collection or abscess formation, but the evidence of the TCS was accidentally found; however, it was too unexpected before. In the short term follow up, the symptoms of the patient were completely resolved by using analgesics. It was shown that his pain was as a result of LP. In general, although sometimes severe lower back pain after LP may be overwhelming, if neurologic examination were normal, it is important to assure parents that it would be resolved.