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Volume 56, Issue 4 (7-1998)
Congenital cyst of the pancreas is an uncommon problem in the pediatric patient. The common symptoms at the time of diagnosis have been abdominal mass and pain or fullness, nausea and vomiting. Despite of various paraclinic methods for diagnosis, ultrasound is now recognized as the most effective and best noninvasive method for diagnosis of pancreatic cyts. Surgical intervention is the best mode of therapy. Upper abdominal cystic mass are seen in the fetus and newborn infants. In Amirkabir Hospital, during 12 years from 1981 to 1993, 8 pancreatic cysts have been operated on and only in this case it was congenital.
Volume 68, Issue 2 (5-2010)
Background: Constraint-Induced movement therapy (CIMT) is a promising treatment for improving upper limb function in adults after stroke and traumatic brain injury. It involves constraint of the less affected limb and intensive practice with the more affected limb. The purpose of this study on children with hemiplegic cerebral palsy (CP) was to evaluate the effects of CIMT on upper extremity and to make a comparison with conventional treatment. Methods: I a randomized clinical trial twelve children (seven females, five males aged between 48 and 72 months with mean±standard deviation of 59.91±9.15mo) were randomly assigned in two groups. An intensive occupational therapy program including five hours per day for 21 consecutive days was performed for all of them, while less affected limbs were placed in sling for immobilization. Before and after intervention, upper extremity function, spasticity, and motor neuron excitation were evaluated by means of peabody developmental motor scales, modified Ashworth scale, and H reflex and H/M ratio, respectively. Results: The children who received CIMT did not improved their ability to use their hemiplegic hand significantly more than the children in the control group (p>0.05). However, reports of caregivers and clinical observations showed increases in more affected limb frequency of use and quality of movement. Conclusion: Results suggest that the use of CIMT needs to more studies and should be considered experimental in children with hemiplegic CP
Volume 68, Issue 7 (10-2010)
Background: In the recent years, concerns have been raised about the incidence of reproductive disorders in human populations. The present study was aimed to determine the effects of maternal exposure to Di 2 ethylhexylphthalate (DEHP) on postnatal development of ovary in Wistar rat offsprings.
Methods: Forty female Wistar rats were randomly divided in four equal experiment groups an oil vehicle group and three DEHP-treated groups that received 10, 100 and 500 mg/kg/day Di 2 ethylhexylphthalate by gavage during lactation, respectively. The ovaries of pups were removed at 60 days of postnatal development their weights recorded and fixed in Bouin's solution subsequently 6 µm serial paraffin sections were stained with haematoxylin-eosin the structural changes of ovarian follicles and corpora lutea were studied.
Results: There was no significant difference on mean body weights of offsprings among different groups. However, the mean of ovary weight was decreased significantly (p= 0.037) in 500 mg/kg/day DEHP group. Significant decreases were seen in mean number of primary follicles (p= 0.012) and mean number and diameter of secondary (p= 0.023 and p= 0.012, respectively) and antral (p= 0.025 and p= 0.018, respectively) follicles in high dose DEHP-treated group compared to sham group. Also, mean number of corpora lutea decreased significantly (p= 0.023) at 60 days of age in ovary of offspring in 500 mg/kg/day DEHP group. Moreover, significant increases were seen in number of atretic follicles in moderate (p= 0.012) and high (p= 0.036) DEHP-treated groups.
Conclusion: Present study showed that maternal exposure to Di 2 ethylhexylphthalate during lactation affects postnatal development of ovary in offspring Wistar rats and reduces their fertility and reproductive efficiency at puberty.
Volume 69, Issue 12 (3-2012)
Background: Uterine environment and fetal period can profoundly affect health of the neonat. Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that regulates cellular stress responses and its activity is essential in both embryogenesis and postnatal life. The aim of the present study was to investigate the effects of maternal swimming on rat pups' HIF-1α levels as a key regulator of oxygen in lungs.
Methods: Sixteen female Wistar rats weighing 180- 200 grams were acclimated to a new environment consisting of equal light-darkness cycle and ad lib access to chow and adapted to the stress caused by water for two weeks. The rats were divided into two swimming and control groups. Swimming training began on the first day of pregnancy in a pool and continued for 3 weeks (1 h/day, 5 days/wk). Pups' lungs were removed two days after birth and their HIF-1α concentration was determined with enzyme-linked immunosorbent assay (ELISA). Statistical analysis of the data was done using independent t-test. A p-value smaller than 0.05 was considered statistically significant.
Results: Swimming lead to a significant (P<0.001) increase in the pups' lung HIF-1α levels compared with the control group. Although 3-wk period of swimming training, showed no significant increase in weight and also lung weight of newborns. Thus it can be concluded that swimming endurance training in pregnancy, can be considered as appropriate alternative in order to embryos development.
Conclusion: Our research suggests that HIF-1α level is an essential element for the development of the lungs of embryos. Moreover, further studies on the lung HIF-1α levels at post-natal period with different modes of exercise will provide more clear insight into the mechanisms of the findings resulting from this study.
Volume 70, Issue 7 (10-2012)
Background: The aim of this study was to provide a valid Persian version of the Ages and Stages Questionnaires, in order to compensate the lack of developmental screening tools in Iran.
Methods: Forward and backward translation, face and content validity determination, and cultural and linguistic adaptation of the questionnaires were performed, consecutively. Next, a pilot study was carried out on 100 Iranian parents of 4- to 60-month-old children, recruited by consecutive sampling in Tehran, Iran during the year 2006 to determine the degree of clarity for each item and explore cultural adaptations. In order to determine inter-rater reliability, we had parents of 38 children complete the questionnaires. For determining the psychometric properties of the tests, we later recruited a representative sample of 555, 4- to 6-year-old children by consecutive sampling from health care centers in five main geographical areas in Tehran.
Results: Performing cultural and lingual adaptations, our expert team made some inevitable changes to the questionnaires. Almost in all age groups older than 10 months, cultural or linguistic changes were made in items in the “communication” domain. Overall, the questionnaires’ Cronbach alpha was 0.79. The constructive validity of the tests was also satisfactory. Another important finding was determination of the children’s developmental mean scores.
Conclusion: The culturally adapted Persian copies of the Ages and Stages Questionnai-res have proper validity and reliability for being used as developmental screening tools for children in Tehran.
Volume 73, Issue 5 (8-2015)
Fibronectin (FN) is one of the essential component of the extra cellular matrix and their important role is as regulator of cellular activities and also fibronectin is an important scaffold for maintaining tissue. Fibronectin conformational changes expose additional binding sites that participate in fibril formation and in conversion of fibrils into a stabilized, insoluble form. In fact fibronectin is a connected glycoprotein disulfide dimer with sedimentation coefficient of approximately S 13 and 440 kDa molecular mass which is exist in many extracellular matrix and plasma with concentration of approximately 300 µg/ml that during the regeneration body tissues acts in severely regulated stages until regenerate the damaged tissue. Fibronectin has domains for interacting with other extra cellular matrix proteins, cell surface receptors, glycosaminoglycans (GAGs), and other FN molecules. This combination of domains allows FNs to bind simultaneously to cells and to molecules within the surrounding matrix. Also fibronectin have binding sites for collagen/ gelatin, heparin, fibrinogen, and other molecules. In the present study important roles of fibronectin in development, regeneration especially in nerves system and important role of it in treatment of some diseases have been reviewed. Present study has reviewed 77 publications by using of PubMed, NCBI, Elsevier, EBSCO and Nature databases for describing the important roles of fibronectin in biological systems. Studies have shown that fibronectin has diverse roles such as: cellular adhesion, embryonic differentiation, assembly of extra cellular matrix, connecting and cell growth, transformation as well as cell migration that each of this roles depends to fibronectins action site. Considering the important role of fibronectin in attachment of cancer cells to basal lamina, spread neoplasm, tissue regeneration and formation of extra cellular matrix better identification the properties as well as physiological applications of fibronectin in tissues and bodies of animals can provide the better understanding of physiological mechanisms and pathophysiological effects of cells on each other, and also provides the new ways for treatment a variety of diseases.
Volume 74, Issue 3 (6-2016)
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Background: In fact, there is no doubt that medical education should be to prepare students for those clinical problems that they may encounter in their future performance. But according to the findings of previous studies in this area, one of the important priority and basic needs in education is training health workers, including physicians. Methods: In this qualitative study focuses on the content analysis of typical (conventional content analysis) was performed. The aim of this study was to determine the needs and skills required to train neonatal subspecialists in the ability to manage vulnerable neonates problems and their families specialized in the field of comprehensive health care have driven. Based on purposive sampling, the research participants, staff and alumni of the second year and above the five-year sub-specialty in neonatology, formed by the association of neonatal diseases were chosen. Saturation as a termination criterion was applied to the collected data. Method of data collection was semi-structured interviews and focus group discussions. Reliability means the adequacy and accuracy that was measured by four methodological criteria: credibility, confirmability, transferability and dependability. All phases of study were recorded elaborately and the researchers reported all findings in the same speech research participants. Results: Respondents consider themselves some week points in neonatal medicine education; they expressed their opinions in three categories with four subcategories as follow: "competent person knowledgeable", "weakness of the curriculum", "educational challenges", "need to review the curriculum", "the need to reform medical education system in the country", and "effective strategies for teaching". Conclusion: Editing curriculum to teach coherent and comprehensive clinical skills in one hand, social support and health care for vulnerable children and families in other hand will improve care for vulnerable neonates. |
Volume 74, Issue 5 (8-2016)
Background: Acetabular dysplasia is a well-known cause of early osteoarthritis of hip which may appear at any time (perinatal, breast-feeding and childhood). The aim of this study was to evaluate the clinical and radiographic outcomes of children with de-velopmental dysplasia of hip (DDH) after undergoing open reduction, capsulorrhaphy and Pemberton osteotomy procedures.
Methods: This study prospectively conducted on 13 patients with DDH who attended to Razi Hospital at Ahvaz Jundishapur University of Medical Sciences at Ahvaz, Iran, from April 2012 to March 2015. Inclusion criteria were children with age range of 18 months to 8 years and acetabular index≥ 40 degree. Exclusion criteria were the age less than 18 months or above 8 years, connective tissue diseases, secondary dislocation due to previous infection, and acetabular dysplasia with specific syndrome. All patients were evaluated before surgery and at least one year after surgery in terms of clinical evaluations, dislocation or subluxation of hip, congruity of hip and radiological out-comes according to grading systems of McKay, Tonnis grading system, Severin classi-fication and acetabular index, respectively. All patients underwent open reduction, capsulorrhaphy, and Pemberton’s osteotomy in single-stage surgery and if necessary femoral shortening was performed.
Results: Ten patients (12 hips) were evaluated. Of those, 4 patients (40%) had right hip involvement. The mean age score was 38.92±12.37 months (range: 24-65 months). Acetabular index showed significant reduction after surgery in compare to before sur-gery (P= 0.002). According to Tonnis grading, 91.6% of cases were in I-II classes. Moreover, 66.6% of cases at clinical examinations of McKay criteria had excellent and good results after surgery. According to Severin radiographic findings criteria, 83.2% of cases were in I-III classes after surgery. There was statistically significant improvement in patients according to different grading systems.
Conclusion: In conclusion, Pemberton osteotomy could be an effective procedure and also in conjunction with other surgical procedures for the treatment of patients with DDH who presented in higher age and late.
Volume 76, Issue 3 (6-2018)
Methods: This case-control study investigated 6 to 18 months old infants, who referred to comprehensive health centers affiliated to Qazvin University of Medical Sciences, Iran, from August to December 2017. The sample size in this study was 200 infants and the participants were evaluated in two groups of 100 subjects (developmental delay and normal development). Anthropometric indices at birth were collected from healthcare records, and developmental status was measured using the ages and stages questionnaire (ASQ). The developmental status of the children was measured in five domains, i.e., motor (gross and fine motor skills), problem-solving, personal-social skills and communication. A significance level was considered statistically <0.05.
Results: The mean age of the infants in the developmental delay group was 12.63±1.72 months and the mean age of the infants in control group was 12.68±1.69 months and 45.6% of children in the developmental delay group were female and 54.4% of children in the developmental delay group were male. The most prevalence developmental delay in case group was in the area of personal-social domain (26.9%) and the lowest prevalence developmental delay in the area of the gross motor (12.7%). No correlation was found between head circumference (P= 0.32) and height at birth (P= 0.11) and developmental status. However, there was a significant relationship between developmental delay in the area of the communication (P= 0.04) and gross motor (P= 0.02) with birth weight. Pearson correlation indicate a correlation between developmental delay in the area of the gross motor and birth weight (P= 0.01).
Conclusion: It seems that birth weight was a factor that is associated with developmental delay. In this study low birth weight correlated with developmental delay in communication and gross motor aspects of ASQ.
Volume 78, Issue 12 (3-2021)
Methods: In this analytical cross-sectional study, 87 preterm infants were enrolled in the study by convenience sampling during the period of April 2016 to the end of March 2017 from two educational hospitals of Shahid Beheshti University of Medical Sciences (Imam Hussein hospital and Mahdiyeh hospital). Demographic and other initial data such as age, sex, gestational age, and the data about clinical problems observed at birth were collected through infants' medical records and were recorded in a special form for each infant. Also, the ASQ test was used to assess infants' developmental status at one year of age.
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Results: Based on the findings, 23 infants (26.4%) had the abnormal developmental condition at the end of one year. There was a significant relationship between infants' developmental status and their age, birth height, one-year-old weight, one-year-old height, duration of ventilator use, Apgar scores at first and twentieth minutes, seizures, reflex reduction, pneumonia, breastfeeding status in the first year of life, Retinopathy of prematurity (ROP), receiving occupational therapy services, and electrocardiogram (ECG) findings at one year of age. Among these variables, only breastfeeding status in the first year of life was able to predict infants' developmental status at the end of one year (OR=0.18).
Conclusion: This study showed that the risk of developmental delay in preterm infants who are breastfed in the first year of life or fed the combination of breast milk and supplemental feeding is one-fifth lower than other preterm infants who were not breastfed. |
Volume 81, Issue 11 (1-2024)
Methods: In this cross-sectional study, from 79 - from September 2013 to September 2018 at Motahari Clinic of Shiraz University of Medical Sciences, Shiraz Iran - eligible children with developmental disabilities, 37 patient who had brain MRI were selected as a sample and children scores in five ASQ clinical areas and MRI findings were reviewed and compared. Patients suffering from metabolic, genetic, trauma, infection and neoplasms problems and diseases were excluded from the study.
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Results: Out of 37 patients studied, 23 were female and 14 were male with a dispersion of three 3 to 60 months of age. 31 of these children had at least one abnormal finding in brain MRI images and the other six were completely normal. In relation to the imaging findings, the highest frequency is related to abnormal head circumference with a prevalence of 54% and the lowest frequency is related to abnormal myelinization with a prevalence of 10.8%. Results of MRI findings correlation with developmental domains demonstrated that Children with white matter disorder on MRI show severe gross motor abnormality (P<0.049) and who had MRI finding of cortical problems suffer from developmental delay in fine motor area. (P<0.001).
Conclusion: Considering the mentioned findings; brain MRI can be a useful diagnostic tool in children with developmental delay and also focusing on the developmental area that is more likely to be affected, MRI can help with treatment and rehabilitation process of these children in the future. |
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