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Material and methods: This is a Double blind Randomized clinical trial study which was performed on 66 children of 2-7 years of age who had been referred for first time, for nonbrain non-liver elective surgery (class 1 Anesthesia). This study was designed to define the efficacy of oral ketamine on Anxiety and Agitation and crying of children after separation from these parents, toleration of Anesthesia mask and IV needle. Sleeping before Anesthesia and entry into the operating room samples were divided in to two groups, cases and control. 5mg/kg of ketamine plus 0.2cc/kg of fruit juice was given to the case group while only 0.2cc/kg of fruit was given to the control group 30 minutes before the operation.
Results: Our results showed that 78.8% of children in the case group did not cry when they were separated from their parents and 78.8% of them did not show any resistance. 34.4% of children in the case group showed no response and 59.4% also had low response. Only 6.1% of children in the control group had no response while 78.8% of them had responses such as intense body movements and pulling of hand. 69.7% of the case group were cooperative when putting on the anesthesia mask while 75.8% of the control group refused to wear the mask, 81.8% of the children in the case group were asleep before Anesthesia while all of the children in the control group were awake and uneasy.
Conclusion: These findings indicate that ketamine can be used as a preanesthetic drug to decrease the anxiety and fear of children and to calm them before their transfer to the operating room.

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Introduction: The protein-energy malnutrition is the most prevalent cause of malnutrition and always occures in infants and children under 5 years old. According to the harmful effects of malnutrition, such as high mortality, inability of learning and decrease of mental and physical ability, reconnoite and study of malnutrition qualification is very important.
Material and Methods: This analytic cross-sectional study was carried out on 811 children under 5 years old who were living in rural zone of Arak. Based on health files, clinical inspections and interview with mothers a checklist was fulfilled for every child. Data were analysed by EPI6 software
Results: In this study, none of the children had stricken with Kwashiorkor or Marasmic-Kwashiorkor. Undernourished were seen in 7.39% and Marasmus were also seen in 1.1% of subjects. The prevalence of malnutrition was 7.5% in Wellcome, 33.55% in Waterlow-Stunting, 23.05% in Waterlow-Wasting and 30.94% in Gomez classification. There was statistically correlation between malnutrition and respiratory infection rate, milstones, birthweight, maturity and begning of helpfood (P<0.05).
Conclusion: Considering the results, the most rate of malnutrition in each classification was mild. It is suggested that increasing of familial awareness is an important factor for preventing from next damages and additional treatment costs.

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Introduction: Children play an important role in the future of every country. In under developed countries like Iran, because of cultural and economic poverty, most children have malnutrition which will be result in physical and psychological growth disorders. In as much as zinc is one of the most important and essential elements in metabolism of different substances and human growth, this study was conducted to determine the effect of zinc supplementation on percentile weight of children with growth disorders.
Materials and Methods: In order to investigate the effect of zinc sulfate syrup on increasing the weight and percentile weight of children, a double-blind clinical trial was conducted in 70 children aging 9 to 36 months. The subjects lacked any associated disease-by laboratory testing. Thirty-five children consume zinc sulfate syrup 0.6% for three months (case group) and other consume daily placebo for the same time and dose (control group). The increase of weight percentile of children were measured in three times with the interval of one month.
Results: Our findings showed that during three months, the average amount of increasing in weight percentile was 4.5% and 3.7%, respectively. T test showed that the comparison of increasing in weight percentile between two groups was not significant
Conclusion: This investigation revealed that zinc supplementation had not any remarkable effects on increasing of weight and weight percentile of children with growth disorders.

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Introduction: Among the risk factors for coronary artery disease, less attention has been paid to physical activity, especially in children and adolescents. Various studies have shown that their level of physical activity is lower than the standard for maintaining lower health. In this study, the pattern of physical activity of children and adolescents in the central regions of Iran is examined.
Method: In this descriptive study, which is part of the first phase of the Isfahan Healthy Heart Project and was conducted in 2002, awareness of the attitude and performance of 4,000 urban and rural children and adolescents in preschool to high school in Isfahan (Isfahan, Najafabad) and Markazi (Arak city) and the parents of these students and 500 teachers and school officials have been examined about physical activity and the duration of watching TV through a questionnaire. Sampling was selected in the form of a random cluster and in proportion to the urban and rural population living in the two provinces. Data were analyzed with SPSS software and p<0.05 were considered significant.
Results: About 40 percent of middle and high school students in the two provinces practiced regular sports at school less than two hours a week. Regular morning exercise and school sports were more common in girls than boys (p<0.00001), but regular extracurricular exercise and sports team membership were more common in boys (P<0.001). More than 77 percent of parents were unaware of the importance of childhood exercise in their children's health. The average TV viewing time for children of different ages was 4 hours a day.
Conclusion: The level of physical activity of middle and high school students in the central regions of Iran is less than the desired level and the duration of watching TV is more than the recommended values.

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Introduction: Idiopathic hypercalciuria (IH) has been recognized as a common disorder in childhood and is an important and common factor in formation of renal stones. Recurrent urinary tract infection is a clinical presentation of hypercalciuria. Regarding that Hydrochlorothiazide is effective in hypercalciuria treatment, therefore in this study we assessed the efficacy of Hydrochlorothiazide in preventing recurrent UTI in hypercalciuric girl patients. Materials & Methods: This research was a single blind randomized clinical trial. 100, 1 to 12 years old girls, who were followed by pediatric nephrology outpatient clinic in Vali-Asr and Amir Kabir hospitals, with the diagnosis of idiopathic hypercalciuria and at least two urinary tract infections in year, were included in study. Patients were randomly divided into two equal groups. First group received a general preventive treatment consisted of a liberal fluid , urination every 2 hours , reducing dietary salt intake , washing genitalia from front to back , wearing cotton loose underwear and complete urination. In second group, in addition to the general treatment, Hydrochlorothiazide was used with initial dose of 1mg/kg/day in a morning dosage.Then, urinary tract infection recurrence in two groups was assessed by student T test. Results: All patients who received Hydrochlorothiazide were normocalciuric. In each group, incidence of UTI non recurrence was 34% (17 cases), that was not significantly different. Conclusion: This study rejected the presence of hypercalciuria treatment effect in preventing recurrent urinary infection. Therefore, the association between UTI and IH needs to be closely studied with the attention to eliminate confounding factors.

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Introduction:Final examinations are important stressors in schools and universities that result in different psychoneuroimmunological outcomes but the study of these effects on children has not been paid enough attention to. The aim of this study is to investigate the effect of final examinations on salivary immunoglubulin A in children. Materials and Methods: In this clinical trial a total of 100 children (50 boys, 50 girls) in 5th grade, aged less than 12 years from two primary schools of 5th educational district in Tehran were choosen randomly. The subjects completed Test Anxiety Scales of Sarason & Abolghasemi. After making sure of their physical and mental health by reviewing their medical history, clinical examinations and after controlling sleep, food, drug and sport variables, based on time series design, salivary IgA samples were taken five times as followed: one week before and then three times through mathematics, history and science exams and at last one week after passing the exams at, 9 to 10 am. IgA samples were analyzed by nephlometry method. Data was analyzed using ANOVA. Results: Findings indicated that IgA level was decreased significantly during examinations comparing to IgA levels before and after examinations (p=0.01). The relations of sex and anxiety scores were not statistically significant. It means that decreased IgA levels are the same in all children. Conclusion: Final examinations as a stress resource, diminishes IgA and this change is not related to sex and test anxiety score.

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Introduction: Hydronephrosis in infancy and childhood is a frequent urinary malformation. We were unable to find any reports concerning rate and causes of hydronephrosis in Iranian children therefore, we decided to evaluate it, in under 12 years old children. Materials and Methods: This was a descriptive study done in a 9-month period starting from Novemger 2004. All children under 12 years old who had visited Amir Kabir hospital of Arak for UTI or FTT were enlisted and an ultrasonography was requested. If hydronephrosis was detected, then a VCUG was performed. For those with normal VCUG results, if hydronephrosis persisted in the follow up sonography, the next step was an IVP or DTPA scan. Results: 65 patients (39 girls and 26 boys) were evaluated for hydronephrosis. 18.5% presented with FTT , 75.4% with UTI and 6.1% with FTT+UTI. The most prevalent causes of hydronephrosis were VUR (40%) and UPJO (23.5%). Grade I hydronephrosis was the most prevalent form (65%), however when VUR was present , it was mostly grades III or IV (27% and 19% respectively). 70% of girls and 31% of boys had VUR and the average age at the time of diagnosis was 2-3 years. Conclusion: Vesicouretero reflux and UPJO are the most prevalent causes of hydronephrosis and must be evaluated in children with hydronephrosis.

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Introduction: Chronic and relapsing abdominal pain is one of the most common reasons that bring children to pediatric clinics. About 20% of these children are suffering from idiopathic hypercalciuria. Since Hydrochlorothiazide is effective in relieving hypercalciuria, we assessed its effects on reducing these relapsing pains in girls with idiopathic hypercalciuria. Materials and Methods:In this single blind clinical trial study, 100 girls, aged 5-12 years old, with chronic relapsing abdominal pain and hypercalciuria were divided to two groups by random block design. All children and their parents were trained about consuming plenty of liquids and decreasing salt in foods. In addition to these measures, Hydrochlorothiazide (1 mg/kg/day) was also administered to children in the case group. The control group was assessed for the number of abdominal pain episodes for 3 months following the commencement of the diet and the case group for 3 months after becoming normocaciuric. The results were analyzed by T-test. Results: The mean number of pain episodes in Hydrochlorothiazide group in the first, second, and third months were 0.38, 0.4, and 0.26 respectively much lower than the corresponding months in the control group which were 1.60,1.94, and 1.84 in that order (p<0.001). Conclusion: It seems that single dose daily Hydrochlorothiazide is a safe and effective drug in the treatment of chronic relapsing abdominal pain in children with idiopathic hypercalciuria.

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  Background : Urine tract infection(UTI) among children is the most prevalent bacterial infection and the second prevalent infection after Viral Flu.Regarding this cfact that urine culturing has very important role in diagnisis and perseverance of this disease and sampling method has significant effect on this disease remedy.

  In this study the effect of genital area ablution on decreasing the contamination of urine culture is examined.

  Methods and Materials: This study is in the form of case_controlled.In this study 620 little girls (3-12 years –old) referring to Amir Kabir children special clinic are examined.Population under investigation was cpatients who had not history of taking antibiotic during last seven days, sondage and genital anomaly and inflammation and genital discharge. 

  Patients were randomly entered in two different groups one with ablution and the other without ablution.After data collection, available inputs were statistically analyzed with SPSS and the effect of genital area ablution was determined on decreasing the contamination of urine culture.

  Results: Among 310 patients in with_ablution group 11 patients were reported UTI(3/7%).3 patients were contaminated (1%),296 patients were normal (95/3%).Among 310 patients in the second group,14 patients were reported UTI(4/7%),6 patients were contaminated(2%),290 patients were normal(93/3%).Contamination rate in with_ablution group were 1% and in the other group was 2%Based on Pvalue :0/491 in both groups no significant statistically difference were found between these two groups and the analysis result distribution in both groups in a=0/05 level were statistically the same.

  Conclusion: In both group no significant statistically difference were found between these two groups ,so we concluded that the genital area ablution doesn’t have such an effect on decreasing the contamination of urine culture and we don’t suggest ablution of genital area in children before providing urine sampling.

 

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Background: Leukemia, due to its widespread prevalence, high mortality rate, high treatment expenses, and long hospital stay, influences the families and their children to a great extent. This study was done to explore the experiences of parents whose children suffer from leukemia. Materials and Methods: Using qualitative research approach with applying content analysis method, 22 participants were interviewed in two teaching hospitals during 2 months. The study started by purposive sampling and continued by a theoretical one till data saturation. The obtained data were constantly analyzed through content analysis method. Results: Data analysis showed that “finding no solution in life, having a lot of problems, errors in treatment, concealing the illness, faith in God, parents’ devotion, hospital facilities, and consistency were the level 3 codes of parents’ experiences and “parents’ reaching a dead-end in life” was the main theme or core category of this study. Conclusion: Using a qualitative approach for exploring the experiences of parents with a child suffering from blood cancer helped recognize them more profoundly than quantitative methods. On the other hand, “parents’ reaching a dead-end in life” as the theme shows the importance of attention to parents’ problems. Using these experiences can increase hope among parents and help conduct the treatment more effectively.

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Background: Sleep behavior and movement disturbance (SBMD) is of a relatively high prevalence in children and has a significant impact on their performance in daily activities and quality of life. Snoring, on the other hand, is considered one of the main causes of sleep disturbance in children. This study aims to assess the relationship between snoring and SBMD in 2 to 12 years old children in Qom city.

Materials and Methods: In this case-control study, 100 children with snoring and 100 healthy children were studied over 3 months. The parents took Berlin questionnaire on snoring and childhood sleep questionnaire. Data analysis was done using SPSS software version 18.

Results: There was a significant correlation in mean SBMD between case (13.78) and control (11.45) groups (p<0.001). Independent t-test indicated a significant difference between the case and control groups in the mean of SBMD (p<0.001). Also, significant relationships were seen between snoring and adenotonsilar hypertrophy (p<0.001) and apnea and SBMD (p=0.036), but there was not any relationships between SBMD and age, children less than 7 and more than 7 years old (p=0.231), and severity of snoring and SBMD (p=0.202).

Conclusion: This study demonstrates the importance of sleep disorders, especially snoring and SBMD and their relationship, in children. Sufficient attention to this issue can raise parents and physicians awareness and pave the way for early diagnosis and treatment of these disorders.

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Background: There are few studies related to effects of exercise training, including concurrent training, on hormonal changes in children. Hence, the aim of this study was to Compare theeffects of 6 weeks of resistance training and concurrent resistance and endurance training on aerobic power (VO2peak) and resting levels of growth hormone and cortisol in healthy children.

Materials and Methods: The subjects ofthis quasi-experimental study were 35 healthy boys between 9-11 years old, which were randomly divided into three groups of concurrent training (n=12), resistance training (n=11), control (n=12). Experimental groups were trained during 6 weeks 3 times a week.Control group were performed only their routine activities. VO2peak test was taken 48 hours before and after implementation of 6-weeks protocols and samples were selected from all subjects.Measurement of resting levels of GH and cortical was performed with ELISA method. For data analysis, one way ANOVA and paired t-test were used.

Results: The results showed that VO2peak and resting levels of GH increased significantly in concurrenttraining group (p=0.001, p=0.003, respectively). Resting level of cortisol in concurrent group was significantly lower than the other groups (p<0.05) and it was reducedsignificantlyin concurrent training and resistance training groups (p=0.001, p=0.036).

Conclusion: It seems a concurrent training period has greater benefits on VO2peak and resting levels of GH and cortical in children in comparison with resistance training.

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Background: Accidents and injuries one of the main causes of death and disability in the world and the most significant causes in children referred to hospital. So, this study aimed to assess the health belief model constructs and function of the mothers referred to health centers in the city of Khorramabad in the preventive behaviors of accidents and injuries in children.

Materials and Methods: This cross sectional and analytical study was done on 261 mothers with children aged less than 5 years are referred to health centers in the city of Khorramabad in 2014. Data was collected with a questionnaire based on the Health Belief Model. The data collected were analyzed by software SPSS-20.

Results: In this study the mean and standard deviation of age of mothers was 28.98±5.37 years and the mean score of function and self-efficacy were 59.1±14.74 and 69.1±11.07 respectively. Moreover, the mean scores of the other health belief model constructs such as perceived sensitivity, severity, benefits and barriers was higher than average. There was significant negative correlation between self-efficacy and perceived barriers (r=-0.256, p<0.01), and also between the perceived barriers and function (r=-0.391, p<0.01).

Conclusion: According to the score of the function of mothers and the other constructs of health belief model, training programs based on the model directly and indirectly in the form of multimedia training package recommended to promote preventive behaviors of accidents occur in children.

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  Background: The prevalence of constipation in childhood is 0.7% to 29.6%. Inorganic causes are considered as the most common cause of constipation in children. Polyethylene glycol (PEG) is the most effective and safest laxatives which is usable in children in the long-term. This study was conducted to evaluate and compare the effect of PEG treatment and probiotic bacilluscoagulans and bifidobacterium and probiotic to enhance the growth of probiotics.

  Materials and Methods: In this double blind clinical trial study(interventional study), 120 children aged 2-16 years with chronic functional constipation enrolled the study based on ROME III criteria. The bowels became empty by using liquid paraffin. Then, children were randomly divided into three groups of polyethylene glycol+placebo and Probiotics+placebo and polyethylene glycol+probiotics recipients. After 6 weeks of treatment, treatment success rates between the three groups were compared before and after the study Data analyzed by SPSS 20 software.

  Results: The results of the study conducted on the three groups for treatment of constipation showed that the effect of polyethylene glycol and probiotic on treatment was considerable before and after treatment but the levels of effect was similar in the comparison of groups. The simultaneous use of two drugs was more effective than a single drug.

Conclusion: Overall, the results of our study showed that concurrent use of polyethylene glycol and probiotics is much more effective in the treatment of constipation.

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Background: Height and weight growth failure are among the most important health disorders affecting children less than two in the developing countries. Failure to treat this disorder can lead to the development of serious conditions including increased mortality and types of disability. The aim of the present study is to investigate the factors affecting the height and weight growth of children less than two years old.

Materials and Methods: This historical cohort study was conducted on a sample of 2030 children less than two in Khorramabad who were selected using stratified and cluster sampling methods. Based on household records, data related to the height and weight were recorded as quantitative variables and finally were modeled using a longitudinal marginal model, identity link functions and the R software.

Results: Based on the marginal model, the effect of such variables as child's age, child's gender and mother's educational attainment were significantly related to the child's height and weight. Moreover the child's birth order had significant relationship with only the child's height. However, the variable of exclusive breastfeeding during the first six months was no significantly related to weight and height growth of the children.

Conclusion: Given the results, it seems that monitoring the growth of the children of the illiterate mothers, specially the girls and the children with first birth orders are the most important approaches to deal with growth disorders among this population.

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Background: Under-nutrition has multiple negative impacts on child's growth and development and it has a high prevalence among hospitalized children. Assessment of the food insecurity status is one of the most important indicators of malnutrition among communities, therefore the aim of the current study is to evaluate the prevalence of food insecurity and its social, economical and nutritional determinants among children hospitalized in Tabriz pediatric hospital.

Materials and Methods: The current cross-sectional study was carried out among 236 hospitalized children in Tabriz pediatric hospital. Demographic information including age, weight, height, household size, child order and household income were gathered by face to face interviews with parents. Food security was assessed by a Household Food Security questionnaire. Statistical analysis was performed by Excel 2007, Epi-info and IBM SPSS Statistics 21 software.

Results: The prevalence of food insecurity among hospitalized children in Tabriz pediatric hospital was 44.9%, while 26.3% and 18.6% had moderately and severely food insecurity, respectively. Its prevalence in females was more than in males. Low household income, low educational attainment of parents, rural residency and household size were potent determinants of food insecurity(p<0.05). All indices of nutritional status in food insecure group were lower than in secure group. Although this difference did not achieved significant threshold.

Conclusion: In the current study, a high prevalence of food insecurity in hospitalized children in hospital has been reported. Therefore the need for suitable interventions to reduce its prevalence has been warranted.

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Background: One of the common and important public health problems is failure to thrive in during childhood .The purpose of this study was to investigate the relationship between health belief model structures with mothers' performance in preventihg growth retardation in children aged 1-5 years in Shazand city in 2014.

Materials and Methods: In this analytical and cross-sectional study, 202 mothers with children aged one to five years in the Shazand city were selected by random sampling. The data were collected by using a researcher-developed valid and reliable questionnaire by self-report method. The questionnaire included demographic characteristics of the mothers, the maternal practice cheklist and health belief model dimensions. Finally, the data were analyzed by SPSS20 T-test, Chi-square, correlation, ANONV and regression.

Results: The mean age of subjects was 28.76±5.28 years and a mean age of children was 26.49±14.74 months. Most common level of education for mothers was diploma (76.7%). The mean score of mothers' behavior was 70.65. Among the structures, self- efficacy had the largest score(69.8) and external practice guide had the lowest (38.91). In regression analysis, for predicting behavior by health belief model stuctures, self efficacy, perceived benefits and barriers were main predictors of behavior that predicted 10% of behavior changes(R²=0.101).

Conclusion: The results of this study reveale that the design of educational interventions should be based on self-efficacy, perceived benefits and perceived barriers as the most important predictors of maternal behavior.

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Abstract

Background: One of the problems in children with cerebral palsy is impaired eating and drinking liquids. The purpose of this study is to compare the effect of oral motor stimulations on feeding function in the children with spastic cerebral palsy by two medical and family centered approaches.

Materials and Methods: This research was a descriptive-analytical cross sectional study that performed on 40 children 2-8 year olds with spastic Cerebral Palsy from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Applied instruments were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) and oral motor assessment scale(OMAS). Data were analyzed by statistical tests such as: Kolmogorov-Smirnov, reporting mean, standard deviation, data analysis frequncy distribution table, independent t-test, dependent t-test, chi-square and MANOVA.

Results: The difference of swallowing function assessed by OMAS in both groups managed by family centered and clinician centered approach prior and post management statistialy was meaningful (p=0.001(. The difference between swallowing function of both groups post intervention was not meaningful in view of first and second assessor, also it had no statistical significance(p=0.89 , p=0.07)

Conclusion: In general, we can conclude that oral motor stimulation is effective on swallowing function of cerebral palsy children in both treated groups. The effect of these stimulations on swallowing function in children with cerebral palsy between clinician centered and family centered approaches was equal.

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Abstract

Background: One of the common and important health problems is failure to thrive in childhood. The purpose of this study was to determine the effect of education on preventive behaviors of failure to thrive in mothers with children based on health belief model.

Materials and Methods: This study is an interventional one in which 100 mothers with children one to five years involved (samples divided into two case and control groups, each of 50) sampling was done by a simple random method. For collecting information, a researcher-made questionnaire based on the health belief model and performance check list were used. Then, case group was trained for one month. 3 months after training, data were gathered and analyzed by Spss20 software. In addition to descriptive statistics, tests such as Chi-square, paired t-test and independent T-test were used.

Results: The mean age of case and control was 29.98±5.51 and 25.35±5.30 years old, respectively. The average age of children was 23.31 ± 13.14 and 27.55 ± 14.01months, respectively. Before the intervention, no significant difference was seen between groups. The average score in case group before intervention was as: knowledge(31.87±14.24), perceived susceptibility(64.23±5.86), perceived severity(64.41±9.34), perceived benefits(61.75±6.79), perceived barriers(67.91±8.14), self-efficacy(68.00±7.87), cues to action(44.53±6.82) and action(70.00±9.77). However, after the intervention, significant differences between groups in all variables were obserred.

Conclusion: According to the results, education based on health belief model is recommended for promoting preventive behaviors of failure to thrive.

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