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Showing 8 results for Pediatrics
Epidemiologic study of scald burns in victims in Tehran burn hospital
Kamran Aghakhani , Saeed Mohammadi , Amir Molanaei, Azadeh Memarian , Maryam Ameri ,
Volume 71, Issue 7 (10-2013)
Abstract

Background: Damages caused by scald burns are common and can cause severe complications and death. The purpose of this study was to define risk groups and then methods of prevention and treatment is designed to fit.

Methods: Data for this retrospective study of hospitalized patients in Shahid Motahari Hospital in Tehran from 2007-2011 were compiled. Data including age, sex, cause of burn, and degree of burn and ultimate fate of the victims were collected from scald burns. Burns caused by boiling water and hot food (Scald) , in two age groups : 12 and under 12 years ( children) and more than 12 years ( adults) were compared in terms of statistics .

Results: A total of 1150 patients consisting of males (57.9%) and females (42.1%) were studied. The most common age was 1 year old and 50% of patients were under 3 years of age. 87.9% burned with boiling water and 12.1% had experienced burns with hot food. Incentive to burn was 0.3% cross burning and 99.7% incident. A maximum number of burns in children 12 years and younger males (42.1%) and a minimum number in men over 12 years (15.7%) were observed. Mean percentage of burns was 11% in over 12 years group and 30.9% in 12 and under 12 years group. The average hospital stay was 11.4 days and the mortality rate was 4.8%. The final status of the patients was as fallows: full recovery 904 cases (78.6%), partial recovery 134 (11.7%), clearance with personal consent 41 (3.6%), death 55 (4.8%) and 16 cases (3.1%) were among other reasons.

Conclusion: In general it can be said, scald burns incidence in individuals aged 12 and younger were more than the older ones and the mean of burns was lower in individuals with over 12 years old. There was a sexual preference for males under 12 years. Mortality rate in the two groups has not any statistically significant difference. There was no statistically significant association between sex and mortality rate. Some of our findings are depending on cultural, social and economic conditions, so generalized this findings to other geographical areas should be done with caution.


Epidemiology of orthopedic trauma in children and adolescent in a referral center in Tehran: a prospective study
Kamran Aghakhani , Ebrahim Ameri , Maryam Ameri , Seyed Ali Mohtarami ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: Orthopedic trauma is a common type of injury in children and may cause deep and permanent psychological and physical damage both for the patient and the parents. This study aimed to analyze the epidemiology age, gender distribution and the mechanism of injury in patients presenting to a level I trauma center in urban population of Tehran. Methods: In this prospective descriptive study, the patients under 19 years old with orthopedic trauma who were hospitalized in Tehran Shafa University Hospital were entered. This hospital is the main orthopedic referral center in Iran. The patients were prospectively evaluated from April 2013 to March 2014. The data were collected and analyzed. Results: The study included 1081 patients under 19 years old. There was a male predominance (76.8% n= 830). The boys had a higher mean age 11.04±5.06 year, versus girls with mean age 8.67±4.63 year (P< 0.05). The peak age of boys was 18 and the girls had two peaks at three and nine. The fractures occurred in upper limb in 70.8% (n= 621) and 29.2% (n= 256) in lower limb of patients. There were 27 cases with joint dislocation, 5 cases with knee ligamentous injuries, 128 cases with soft tissue injuries and 44 cases with spine injuries. The most frequent mechanism in both gender were falls from standing position (48.5%). The most common fractures were foreman both bone fractures (n: 146 16.7%), elbow supracondylar fractures (n: 134, 15.3%) and distal radius fractures (n: 84, 9.6%). The most fractures occurred in summer (30.1%) and the least in winter (18.1%). Conclusion: Evaluation of epidemiologic factors can lead to the best prediction and treatment planning of trauma. Early recognition of injury, even minor, and expected care using specialized teams will help to improve outcomes for these patients. This study determines the most at risk children for trauma and fractures and may help the parents to prevent damage.
Frequency and risk factors for GI bleeding in children admitted to the PICU of bahrami children's hospital
Kambiz Eftekhari, Armen Malekiantaghi, Neda Habibi ,
Volume 80, Issue 9 (12-2022)
Abstract
Background: Gastrointestinal bleeding (GIB) associated with stress is an important complication in critically ill children admitted to the Intensive care unit (ICU), which can lead to serious complications and in some cases death. Only a limited number of studies have been conducted on the risk factors of gastrointestinal bleeding in Pediatric Intensive care unit (PICU), most studies have been conducted in the adults and neonates, therefore, the aim of this study was to evaluate the frequency of risk factors related to gastrointestinal bleeding in children admitted to the PICU.
Methods: This was a cross-sectional study. In this study, in a period of three years from (March 2016 to March 2019), all patients admitted to the PICU of Tehran Bahrami Children's Hospital were examined. The sample size was calculated 380. Demographic information, diagnosis during hospitalization, underlying disease, and initial tests during the first 24 hours of hospitalization were recorded in the checklist. To evaluate the demographic findings between patients with and without UGIB, chi-square and Fisher tests were used. A p-value of less than 0.05 was considered significant.
Results: 462 patients were studied, of which about (58%) were male. The mean age of the samples was 48 months and the average length of hospital stay in PICU was ten days. In general, (21.21%) of patients had gastrointestinal bleeding on the first day and (12.12%) on the second day of hospitalization. Gastrointestinal bleeding occurred in 50 patients (10.82%). Use of ventilator, pulmonary diseases, coagulation and blood diseases were significantly more common in patients with gastrointestinal bleeding than in children without gastrointestinal bleeding. Cardiac, neurological, hepatic, and renal disease were not significantly different in patients with gastrointestinal bleeding compared to children without gastrointestinal bleeding.
Conclusion: The occurrence of gastrointestinal bleeding in critically ill patients admitted to the PICU is a serious risk. The most important risk factor for upper gastrointestinal bleeding is mechanical ventilation. Other risk factors of gastrointestinal bleeding are lung disease, coagulation diseases, hematologic and oncologic disease.

Epidemiological investigation and clinical findings of various types of vasculitis in children of eastern Iran
Abdolreza Malek, Mahdieh Vahedi, Nafiseh Pourbadakhshan,
Volume 81, Issue 4 (7-2023)
Abstract
Background: Vasculitis is a heterogeneous group of diseases that means an inflammatory process in blood vessels. Diagnosing vasculitis in children is challenging due to the variety of symptoms. Classification of childhood vasculitis is usually based on clinical phenotypes, size of affected vessels (small, medium, or large), and pathology of inflammatory infiltrates. The aim of this study is to investigate the epidemiological information on types of vasculitis and their clinical symptoms in children in eastern Iran.
Methods: This 3-year descriptive cross-sectional study was performed on all male and female patients with any vasculitis referred to the outpatient clinic and rheumatology department of Akbar Children's Hospital from the beginning of September 2017 to the end of September 2020. Has been. This study was based on information obtained from the checklist (information from the inpatient and outpatient records and information in the HIS). Checklist information included age, gender, drug history, history of surgery, clinical symptoms in different systems, season of disease onset, etc.
Results: Out of 263 children, 135 (51.33%) had Henoch-Schonlein and 100 (38/02%) of them had Kawasaki. The numbers of Behcet, Takayasu and Churg-Strauss patients were 20, three and two, respectively. In most subgroups, female patients were more common than male patients. Kawasaki and Takayasu had the lowest and highest age of onset, respectively. The most common seasons of appearance for Henoch-Schonlein and Kawasaki were autumn and summer respectively. In most subgroups, skin rashes are the most common clinical symptom, with, the most common types being petechiae and purpura.
Conclusion: In the present study, the most common type of vasculitis diagnosed in children in eastern Iran was reported by Henoch-Schonlein and Kawasaki respectively, which was completely different from the most common types of vasculitis in adulthood and indicated the importance of age in diagnosing the type of vasculitis. The necessity of clinical suspicion of these two diseases in children with skin rashes, along with matching with other clinical findings, is undeniable.

Investigating the incidence of complications caused by common national vaccinations in children and infants in Shahrood city
Fatemeh Saeedi, Mahdieh Zaki Zade , Mohammadbagher Sohrabi , Mostafa Enayat Rad , Sina Habib Zade , Mansooreh Fateh,
Volume 81, Issue 7 (10-2023)
Abstract
Background: With a national vaccination program, we have achieved success in the prevention of infectious diseases in the community especially in children. Despite this great success, the side effects of vaccination may not encourage some people in the community to get vaccinated. In this study, we investigate the prevalence of common side effects of vaccination in Shahrood city.
Methods: This study investigated the incidence of complications caused by vaccination in infants and children under seven years old in Shahrood city in a 5-year period from April 2016 to March 2020. We collected demographic and clinical information, by referring to the health centers and complications recorded after routine vaccinations such as fever, rash, diarrhea, swelling and other complications of vaccination were collected.
Results: Findings Among the 429 registered complications between 2016 and 2020, most complications were related to pentavalent and trivalent vaccines. Among the registered complications, high fever is the most common complication in both term and pre-term groups. (202 cases, 47.1%) other complications included maculopapular rash (59 cases), mild local complications (55 cases), vomiting (41 cases), and continuous screaming (36 cases), respectively. Among these, 123 cases were resolved without treatment, 297 cases were resolved with drug treatment on an outpatient basis, and only  eight cases required hospitalization.
Conclusion: In general, the vaccination program is highly effective despite having limited side effects.  Knowing this information, can increase vaccination in the country.

The effect of Early Mobilization on the length of intensive care unit stay in pediatrics under ventilator: A Pilot study
Jamalodin Begjani , Bahareh Yaghmaei, Azam Mahmoudi , Mohammad Mehdi Rajabi ,
Volume 82, Issue 1 (4-2024)
Abstract
Background: Prolonged stay in intensive care unit (ICU) can worsen the patient's prognosis and represents a significant economic burden. Previous studies have reported the effectiveness of early mobilization in reducing length of stay in ICUs for adult patients; However, conflicting results have been reported regarding its effects on pediatric patients. Therefore, this research aimed to investigate the impact of early mobilization on the length of stay in the pediatric intensive care unit (PICU) in ventilated children.
Methods: This pilot quasi-experimental study was conducted on 60 children admitted to the Children's Medical Center hospital from March 2020 to June 2021. For the control group, routine care (standard physiotherapy) was started on the second day of intubation and continued until discharge from the intensive care unit. In this study, we used an early mobilization protocol including active and passive exercises. The intervention was implemented by Pediatric intensive care unit nurses under supervision of a pediatric critical care fellowship physician. In the intervention group, passive exercises were started on the second day of intubation. At each shift, the nurses check the level of sedation and presence of delirium in the patients using the Richmond Agitation-Sedation Scale and the Cornell Assessment of Pediatric Delirium questionnaire. If the results showed that the sedation was not deep and delirium was not present, then active exercises were initiated. If the child did not achieve an adequate score indicating the absence of deep sedation and delirium, the patient remained in the passive exercise phase. The length of stay was recorded based on the patients' records. Descriptive and inferential statistics were used for data analysis using SPSS version 23.
Results:  The results showed that there was no significant difference in the length of stay in the pediatric intensive care unit (PICU) between the control (23.20±6.34 days) and intervention (22.60±6.18 days) groups (P=0.77).
Conclusion: The implementation of early mobilization did not significantly reduce the length of PICU stay for pediatric. The researchers are advised to identify and evaluate evidence-based guidelines for implementing early mobilization in children with different diagnoses.

Defecation habits in children with rectal prolapse: a retrospective analysis
Mohadeseh Shad, Ali Samady Khanghah , Reza Shojaeian, Khashayar Atqiaee,
Volume 82, Issue 7 (10-2024)
Abstract
Background: Rectal prolapse, characterized by the extrusion of the rectal mucosa through the anal sphincter, is a relatively rare condition in children. This condition can be attributed to several anatomical and functional factors. This study aimed to investigate defecation habits in children with rectal prolapse.
Methods: This retrospective study was conducted from 2017 to 2021 in Akbar and Sheikh children's hospitals. The study population included 50 children under the age of 14 who were diagnosed with rectal prolapse and visited the hospitals. Data were collected using pre-prepared checklists and analyzed using SPSS version 24. Inclusion criteria were children under 14 years diagnosed with rectal prolapse, while exclusion criteria included incomplete data or other severe unrelated health conditions.
Results: The results showed that 67.4% of the sample were boys, and the most affected age group was children under 2 years (38.8%). A total of 57.1% of the children had daily bowel movements, and 68.2% reported consistently hard stools. Additionally, 48% of the children experienced pain or burning during defecation.
Conclusion: The findings of this study indicate that children with rectal prolapse often face challenges related to stool consistency and defecation pain, despite having frequent bowel movements. These results emphasize the need for targeted interventions to improve stool consistency and manage pain to effectively prevent and treat rectal prolapse.

Comparison between two methods of sedation with ketamine and sedation with ketamine combined with local anesthesia in repairing finger injuries in children
Behrang Rezvani Kakhki , Morteza Talebi Deloei , Maryam Sobhani, Maryam Ziyaei,
Volume 82, Issue 10 (1-2025)
Abstract
Background: Controlling pain and anxiety in children is important and at the same time more difficult compared to adults. In the present study, an attempt has been made to reduce the overall dose and, as a result, the complications caused by ketamine by adding local anesthesia with lidocaine after analgesia and intravenous sedation with ketamine.
Methods: A double-blind, randomized clinical trial was carried out at the emergency ward of Khatam Al-Anbia Hospital, Zahedan, between June 2018 and March 2019. A total of 60 children with finger injuries with the age range of 1 to 5 years were divided into two groups of 30 people by random block method. The control group was injected with only intravenous ketamine at a dose of 1.5 mg/kg, and the intervention group was injected with local anesthesia with lidocaine after the injection of intravenous ketamine. Data analysis was performed using SPSS software (version 21) with descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistical tests (Student’s t-test, chi-square test, and Mann-Whitney U test) at a significance level of P<0.05.
Results: The recovery time in the intervention group (29.27±9.48 minutes) was significantly less than the control group (35.90±10.59 minutes) (P=0.01). No significant cardiopulmonary complications occurred in the two groups. The incidence of vomiting (P=0.08) and the drop in blood oxygen saturation percentage (P=0.3) were higher in the control group than in the intervention group, but it was not statistically significant. Adding local anesthesia to intravenous injection of ketamine significantly delays the duration of the second repetition of ketamine injection (P=0.01), But it did not affect the time of the first and third repetition of ketamine dose.
Conclusion: The findings of this study indicate that the intervention group required significantly fewer ketamine doses than the control group. Notably, adjunctive lidocaine local anesthesia was associated with shorter recovery times and prolonged intervals before second-dose ketamine administration, while no such effects were observed for the first or third doses. These results imply that lidocaine supplementation could optimize intravenous ketamine therapy by accelerating recovery and reducing subsequent dose requirements, though additional research is needed to validate these observations.

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