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Enuresis is one of the most common and complex problems of childhood and it affects the relationships between children, parents and coevals. It negatively affects these relationships. Studies have shown that in comparison with normal children, Enuresis children have behavioral problems and suffer them. This survey was done with this aim to determined and compare enuresis and non-enuresis children’s behavioral adjustment in Hamadan primary schools. This study was conducted by case-control method and a total of 320 pupils were studied. These subjects were selected randomly by multi-phase sampling. The interview forms were the data collecting means. It was based on children’s behavioral checklist for the school-aged children which had been reported by Russel and Cassel. The survey results showed that there was a difference in scores obtained by enuresis and non-enuresis children from the view point of self, social, physical, home and school and general personality adjustment and high percentage enuresis children had behavioral problems and there was statistical meaningful difference between the scores obtained by two groups.

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Diarrhea is one of the main reasons of mortality among children in the developed countries and half of all death is due to persisted diarrhea. This research is a cross-sectional and analytical study done on 708 children with acute diarrhea in village around Gorgan, to find out the effective factors on having persisted diarrhea in children under 5 years old. Face to face interview and determining the variable factors and examining health center records on children with acute diarrhea were the basis for filling the corresponding questionnaires. 14 days after the start of acute diarrhea, which was the second part of this research, the above questionnaires were fully completed by calling on the patient’s home. According to our investigation the risk factors related to the persisted diarrhea were as follow: Age, ethnicity, children length of breast feeding, chlorinated water, children consumed food at the time of acute diarrhea. The results from this investigation indicate that with 95% about probability 10.7%-11.3% of patients with acute diarrhea end-up with persisted diarrhea, which means diarrhea, was continued for more than 14 days. Therefore by controlling the above risk factors the mortality rate due to acute diarrhea could be reduced.

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Background & Objective: Giardiasis is one of the most prevalent human intestinal parasites, especially among children aged between 2 to 12 years old. In this study, the effects of Giardiasis on serological levels of Zinc and Iron elements were determined. Materials & Methods: A total of 100 children aged under 12 years who were admitted to the pediatric departments of hospitals affiliated to Mazandaran University with gastrointestinal complain, and diagnosed as having Giardiasis by stool examination (Direct and Formalin-ether technique and trichrome stain) in the parasitology department, were enrolled as the case group. The control group consisted of 100 age-matched healthy children. A questionnaire including age, physical growth status and clinical symptoms were completed. Serological levels of Zinc and Iron were measured by atomic absorption spectophotometer in all samples in Shilat of Mazandaran. Results: In this study, serum Iron levels were 67±25 µg/dl and 77±23 µg/dl and Zinc levels were 64±20 µg/dl and 96±23 µg/dl in case and control group, respectively. Statistical analysis showed significant differences between the serological levels of these elements, which was much higher in serum Iron levels (P<0.05). Conclusion: These results revealed those serological levels of Zinc and Iron decreased during Giardiasis due to malabsorption.

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Background&Objective: Low back pain (LBP) is common in youth, although `associated with chronic pain in adults. The purpose of this study was to determine the prevalence and risk factors of LBP in school children age 11-14. Materials&Methods: A cross sectional study was carried out on school children aged 11-14 in north of Iran. Using random multistage sampling 5000 children were selected. Demographic, mechanical and lifestyle data as well as the prevalence and LBP characteristics were collected by a questionnaire. Data analysis was carried out using SPSS (version11) software. Results: Of the original sample, 4813 (96.2%) children returned the questionnaire. Point, last month, last 6 months and annual prevalence were 15%, 14.4%, 15.6%, and 17.4%, respectively. LBP was significantly correlated with age (p<0.05), lifting (p<0.05), position and duration of watching TV, doing homework and duration of exercise (p<0.05). Conclusion: The results indicated that the prevalence of LBP in school children is relatively high. Further studies evaluating the effect of different preventive strategies to reduce the prevalence of LBP in school children is strongly recommended.

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Background & Objective: Examinations are among the most important stressors in schools and universities that result to psycho physiological outcomes but these effects on children has not been paid much attention. This study was done to determine the effect of stress of final examinations on the activation of hypothalamus-pituitary-adrenal axis (change of salivary cortisol) and autonomous nervous system (pulse rate) in children. Materials & Methods: A total of 100 children (50 boys, 50 girls) in 5th grade aged less than 12 years from two primary schools of five educational district in Tehran were chosen randomly. The subjects completed Adolescent’s Eysenck personality inventory. Physical and mental health was reviewed the medical history, clinical examinations and after controlling sleep, food, drug and sport variables, salivary samples and pulse rates were taken five times as follows: once a week before and then three times through mathematics, history and science exams and once a week after passing the exams at 9 to 10 am .Salivary cortisol samples were analysed by ELISA method. Results: Cortisol levels increased significantly during examinations in compare with cortisol levels before and after examinations. Depending to sex, psychoticism, neuroticism and extroversion –introversion variables, only the effect of psychoticism and extroversion –introversion are statistically significant (P<0.05). Also repeated analysis of variance for pulse rate indicated the increase rate of later factor (P<0.05). Conclusion: Final examinations as a stressor resource increase salivary cortisol and pulse rates of children. Personality factors can modulate the effect of examinations on salivary cortisol. Sex also modulates pulse rates increasing during academic examinations.

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Background & Objective: At least about 30 percentage of children hospitalize in hospital in their childhood. Hospitalization of children cause anxiety, due to separation from their parents ,fear of new environment, disabilities and continuation of life. This study was done to determine the effect of music on the rate of anxiety among 9-12 years old hospitalized children.

 

Materials & Methods: This semi experimental study was done on sixty 9-12 years old children who are confined to bed in Taleghani hospital in Gorgan north of Iran during 2002-3. 60 of children were divided to 2equal groups of intervention and control randomly. The tools of gathering data including information questionnaire, patients demographic, state – trait anxiety inventory for children Spillberger (STAIC), face anxiety children examined scale Piyeri (FACES) information was compared before and after the intervention the collect. For intervention group, 2 music therapies listening of music section, for the 2 continuous days and each section lasted for 20 minutes. The collected data before and after intervention were analyzed by using Kolmogrov-Smironov, c², independent-sample T test, Wilcoxon signed Ranks, Bartlet and Mann Whitney test.

 

Results: There was not any difference between the average of state anxiety and amount of face anxiety in both group before execution of music therapy but there was a significant difference for the intervention group after the music therapy (p<0.05). Also the decrease in the rate of anxiety in intervention group can related to the executing of music therapy.

 

Conclusion: Music therapy reduced the rate of anxiety among the 9-12 years hospitalized children.

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Background & Objective: ADHD is the most common mental disorder in children. Awareness of students' mental health has an important role in programming for decrementing their disorders and, improving their mental health and also preventing the complications of their decreased mental health. The aim of this study was to determine the prevalence of ADHD and some of the affecting factors among school children in Nishaboor localed in the North – East of Iran. Materials & Methods: This descriptive study was done on school children in Nishaboor during 2006. Subjectes selected by stratified cluster sampling. Data collection was done using the Conner's Parent and Teacher Scale questionnaire, and each student's questionnaires were completed by both the teacher and the parents. Data analysis was performed regarding to the mean scores of teachers and parents. The score 15 was chosen as the probable indicator for ADHD. Results: 722 students (79.6%) were involved this study. Prevalence of ADHD was 12.5%, CI95%: 10–14.8%. There was no significant difference in gender distribution. The prevalence of ADHD had a significant rise with age (P<0.05). The highest prevalence was in spring born and the lowest was in the summer born school children (P<0.05). The prevalence of ADHD had a significant relationship with father's education and was lower in students whose father had higher educations (P<0.05). Variables such as type of delivery, pariety, mother's education had no significant relationship with the prevalence of ADHD. Conclusion: In this study the prevalence of ADHD is higher than similar studies. Risk groups to be followed up by the responsible organizations.

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Background & Objective: Vaccination is one of the most effective ways in preventing the hepatitis B viruse. This study was done to evaluate the response rate to hepatitis B vaccine in under one-year children in Gorgan, Iran. Materials & Methods: This cross-sectional descriptive study was carried out on 215, children of 7-12 month of age (55.3% male, 44.7% female), in Gorgan, northern Iran during 2006. These subjects already had received the three-time vaccination against hepatitis B. Anti-HBs, Anti-HBc and HBsAg level of these children serum were determined, using ELISA technique. Results: In 30 (14%) subject's serum, there was not detected any antibodies against the viruses. Out of 185 children positive for HBS, 4 cases belong to HBC viruses. As a whole, 86% of the samples, had more than ten international unit of HBS. The meanSD of the titred antibodies in male and female were 158.8412 and 187.5513.83 respectively. The response not to three-times vaccination in male and female were 84% and 89.9% respectively. Conclusion: This study showed that in spit of vaccination, there are cases with virus-contamination. The reasons for absence of any response to the vaccination in some of this children can be due to deficiency in the immune system, improper genetic background which can not be stimulated by that vaccination, inadequate proper conditions for the preservation of vaccine, and the type vaccine used. Also the procedure of vaccine inoculation, the vaccine preservation condition and transportation should be taken into considertion.

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Background and Objective: Anthropometric indeces are the best methods for determining of malnutrition and obesity in children and young adulescent worldwide. This study was designed to compare the physical growth status between Turkman and non-Turkman in rural area in Gorgan in North of Iran. Materials and Methods: This cross – sectional descriptive was done on 551 children of 2-5 years of age, Turkman and 895 of non-Turkman in the rural area of Gorgan North of Iran during autumn 2005. Height, weight and personal identification recorded by questioners. BMI percentile and under -1sd ,-2sd and -3sd from NCHS used for comparison. Data were analyzed by using Chi-Square and T-student tests. Results: Mean±SD of height in female Turkman and non-Turkman were 95.3±8.1 and 90.5±8.4 cm respectivly means±SD of height were 96.0±7.6 and 90.9±8.6 cm in Turkman and non-Turkman, respectively. Male childrens mean±SD of weight in were 14.5±2.4 and 14.2±2.9 and in male Turkman and non-Turkman children respectively. Also means±SD of weight were 15.0±2.03 and 14.5±2.3 cm in Turkman and non-Turkman male children, respectively. Turkman children are about 426 gram heavier and 4.9 cm taller than non-Turkman in all of age groups (P<0.05). Stunting and underweight were observed in 13.2% and 1.9% in Turkman group less than non-Turkman respectively by -2sd criterion. There was a significant differences between two groups by stunting (P<0.05). Obesity and overweight exist in Turkman group 24.5% and 2.6% less than in non-Turkman respectively. The difference in obesity statistically was significant between two groups (P<0.05). Underweight was shown in female more than male (7.2% vs 4.2%) and obesity in female less than male (25.6% vs 28.9%). Conclusion: This study showed that secular growth in two groups is incompatible and it is better in Turkman group than non-Turkman group. Malnutrition in Turkmans was less than Non-Turkmans children.

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Background and Objective: Opium usage for sedating/relieving from diarrhea or cough causes a public health problem. In the northeast of Iran (Golestan province), opium is used widely for symptomatic therapy of routine illnesses in young children. It may cause severe intoxication and even death. This study was done to determine the toxification with opium in five years old children in Golestan Privine in Iran. Materials and Methods: This cross-sectional study was performed in collaboration with “Adverse Drug Reaction (ADR) Committee” in Golestan University of Medical Sciences. All members of ADR committee in pediatric centers trained to complete a certain valid questionnaire in children under 5-years-old, which either referred or admitted for opium intoxication (September 2006 to February 2007). Data analyzed by Chi-square and Fisher exact tests. Results: In this survey, 67 opium-intoxicated children were recruited. Minimum age of the subjects was 6 days and maximum was 5-years-old. In 41.3% of subject. The opium was given by the mother with low awakness and 61.2% of in toxicated children reside with rural area. More that 80% of the parant had the educational level below. The highschool diploma in 63.6% of cases the pure form of opium were consumed, diarrehea anxiety, were the two main cause for consuming the opium. In this study four subjects decleard dead due to toxification of the opium. Conclusion: Opium intoxication has a high prevalence among children under 5-years-old in our area. Therefore it is suggested that the intoxicated children accompanied with parant ambigious explanation opium toxification should be taken seriously.

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Background and Objective: Asthma is the most prevalent chronic disease during childhood and it is estimated that 4.8 million children involved in asthma all over the world and its prevalence and incidence is increasing. The aim of this study was to identify the peak-flow meter application on quality of life in asthmatic children. Materials and Methods: This clinical trial study was done on 80 asthmatic children between 7 to 15 years old which referred to Shahid Beheshti hospital clinic in Kashan, Iran during 2009. Susan Sylvia questionnaire included 3 parts, was filled for every child. The questions in any section had three options in which there were 5 items in activity limitation, 13 questions in symptoms and 6 questions in emotional functions. Every question had 1 to 3 points and whole questionnaire taken 23 to 69 points. The children were learnt to measure their PEFR (Peak Expiratory Flow Rate) 3 times a day using Peak flow meter device and upon the results, the management procedure was changed. After 3 months the outcome were evaluated and data analyzed by SPSS-15 and paired t-test. Results: Mean age of patients was 8.82±2.75 years old. Thirty three subjects (41.3%) were girl. The average score in emotional functions was 13.1±3.07 before and 14.35±3.7 after using peak-flow meter (P<0.05). The average score in activity limitation was 7.33±1.57 and 8.47±0.67 before and after using peak-flow meter, respectively (P<0.05). The average score in symptoms before and after pek-flow meter was 28.81±5.13 and 32.02±5.62, respectively (P<0.05). Finally total score of quality of life showed significant increase in children after using peak-flow meter (P<0.05). Conclusion: This study showed that the application of pek-flow meter increase emotional functions, decrease limitation of activity and symptoms in asthmatic children. Therefore, it is suggested pek-flow meter dievice taking into account in asthma management of asthmatic patients particularly in children.

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Background and Objective: The prevalence of behavioral disorders in children with mentally ill parents are higher compared with children of healthy parents. This study was carried out to assess the behavioral disorders in children with major depressive mothers. Materials and Methods: This case – control study was done on 50 children (6-11 years) of mothers with major depressive as case group and 50 children of healthy mothers as controls in Bandar Abbas, Iran drung 2009. With psycological interview, DSM-4-R and Beck tests, deprsion in mother were confirmed. The psycological health of control mothers were confirmed using Minnesota multiphasic personality inventory (MMPI) and questionnaire health general (QHG). The behavior disorders of children in two groups were compared using Achenbach child behavior questionnaire. Data were analyzed using SPSS-17, Chi-Square and student’s t tests. Results: Somatic complains, anxiety and depression, social problems, thought problems, externalization, internalization and antisocial behavior scores, were significantly higher in cases compared to controls (P<0.05). No significant differences in isolation and attention behavior were noticed between cases and controls. Conclusion: Behavior disorders in children with depressive mothers are common.

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Background and Objective: There is not a general protocol strategy about the necessity of routine microscopic examination of tonsillar samples in children. This study was conducted to determine the histopathological characteristic of tonsillar tissue in 1250 children, Tabriz-Iran. Materials and Methods: This descriptive study was conducted on 1250 children (724 male and 526 female) aged 2-14 years old who underwent tonsillectomy in Tabriz, Iran during 2008-11. Variables including age, sex, clinical diagnosis and surgical indications were recorded. Paraffin blocks were prepared from samples of tonsillectomy and stained with haematoxylin and eosin. Histopathologocal results were categorized in four groups: Follicular hyperplasia, follicular hyperplasia with infection, malignancy and normal. Results: None of the children had initial clinical suspicion of tonsil tumor. Patients’ primary complaints were as follows: 92.5% mouth breathing, 93% nocturnal snoring, 74.3% recurrent and chronic cold and infections, 56.4% sore throat, 48.2% halitosis, 26% nocturnal apnea, 22.2% dysphasia, and 18.2% anorexia. Children with tonsillar hypertrophy and obstructive symptoms (57%), and tonsillar hypertrophy and recurrent infections (42.2%) underwent tonsillectomy. In the histopathlogical examination of all patients being hyperplasia together with lymphoid hypertrophy were observed and there was no evidence of malignancy in any of the patients. Conclusion: No instance of malignancy was found in the histopathological examination of children’s tonsil-removed tissues and all of the tonsils had benign hyperplasia with lymphoid hypertrophy.

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Background and Objective: Children constipation is one of the common causes of abdominal pain. Cow´s milk in children diet is suggested to be one of the main cause of chronic constipation. This study was performed to determine the effect of cow´s milk elimination from children diet with chronic constipation. Methods: This quasi-experimental study, was performed on 80 children with chronic constipation. Rome-III criteria were considered for disease diagnosis. Cow’s milk was eliminated for three weeks from children’s diet and the clinical symptoms in children were surveyed, subsequently. Results: Constipation was cured in 33.8% of children as result of cow's milk free diet. The rate of treatment response in affecting children whom their disease in began under 2 years of age (52.6%) was significantly higher than others (16.6%) (P<0.05). Children treatment was not significantly related to child’s gender and amount of milk consumption. Conclusion: Eliminating of cow's milk from the diet improves the chronic constipation in children.

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Background and Objective: Hematuria is one of the common causes of pediatric nephrology and urology diseases and is reported in 0.5-2% of children. This study was performed to determine the causes of hematuria in infants and children. Methods: This descriptive study was done on 200 infants, children and adolescents in one month to 18 year old ages with chief complaint of hematuria in Hamadan, Iran. Patients were evaluated by urinalysis, urine culture, measurement of calcium, creatinine and uric acid in random urine sample and abdominal sonography. Results: Microscopic and gross hematuria was detected in 79.5% and 20.5% of patients, respectively. Hematuria was idiopathic in 74 (37%) of patients. Urinary tract stones (18%), urinary tract infections (15.5%), hypercalciuria (13%), hyperuricosuria (10%), urinary tract anomalies (5.5%) and glomerulonephritis (1%) were diagnosed as causes of hematuria. Conclusion: In 56% of patients, hematuria was caused by three common etiologies of stone, urinary tract infections and crystalluria.

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Background and Objective: Urinary tract infection is the second common bacterial infection in children. Constipation as a risk factor in urinary tract infection was reported by several studies. This study was carried out to evaluate the relationship between rectal diameter and constipation with urinary tract infections in children. Methods: This case – control study was performed on 40, 2-12 years old hospitalized children with urinary tract infections as cases and 40 healthy children with the same age as controls in Boali Hospital in Sari, Iran. Rectal diameter was measured by ultrasonography. Demographic characteristics, rectal diameter, during of infectious and disease clinical signs were recorded for each subject. Results: Constipation was observed in 62.5% and 17.5% of cases and controls, respectively (P<0.05). Rectal diameter was 47.64 mm and 26.48 mm in case and control groups, respectively (P<0.05). Conclusion: Regarding to increasing of rectal diameter in patients with urinary tract infections in comparison with healthy subjects, ultrasonography can be a reliable method either to confirm or reject the presence of constipation in urinary tract infections.

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Background and Objective: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. 20-50% of ADHD affacted children have sleep disorders which can cause cognitive and behavioral disorders. This study was done to determine the sleep problems in children with ADHD. Method: In this case control study, 52 children with ADHD was considered as cases and 52 school age children without ADHD as a control group in Gorgan, northern Iran during 2013. Sleep habits (CSHQ) and DSM-IV questionnaires were filled for each child. Results: Sleep problems were observed in 45 (86.5%) and 36 (69.2%) of children in case and control group, respectively (P<0.05). The mean score of sleep problems in case and control group was 48.25±6.61 and 45.87±6.23, respectively (P<0.05). The score of resistance to sleep, anxious habits of sleep and waking during night in cases were more than controls (P<0.05). Conclusion: Sleep problems in children with ADHD are more frequent than children without ADHD.

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Background and Objective: Poisoning is a major public health problem and a serious form of the common causes of hospital emergency visits in many countries. Incidence of toxicity based on cultural and economic characteristics of communities are varied. This study was done to determine the pediatric poisoning factors in children.

Methods: This descriptive-cross sectional study was performed on 201 patients younger than 12 years old with posinnig symptoms whom referred to hospitals in Shahroud city of central part of Iran from April 2011 to March 2012. Demogaphic data, posinnig symptoms, posinnig agents, time of hospitalization and outcome of posinnig for each child were recored in quetionare.

Results: Opium was the most common consumed material with (51.2%) while metadon considered to be the major opium. 180 (89.6%) and 21 (10.4%) children were poisoned accidentaly by their parant respectively. The clinical manifestation of the affected children were 15 (7.5%), 11 (5.5%), 93 (46.3%), 26 (12.9%), 19 (2.5%) and 22 (10.9%) without any symptoms, neuro-respiratory, nervous, gastrointestinal, gastrointestinal-respriatory and weakness respectively. Two children were died in the course of this project. There was a significant statistical correlation between the reason for poisoning and age parant education level and type of poisoning. Also, there was a relation between the type of poisoning and place of residence (P<0.05).

Conclusion: This study shows that the most common cause of poisoning among children was opiums.

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Background and Objective: Chronic and recurrent abdominal pain affect about 7-20% of children in school age, and it is responsible for 2-4% of children's medical referrals. Helicobacter pylori infection in children can cause gastrointestinal problems in childhood, and the lack of treatment and eradication can lead to serious complications. This study was done to evaluate the prevalence of Helicobacter pylori ELISA stool antigen in children with chronic abdominal pain.

Methods: In this case control study, 33 children with chronic abdominal pain and 30 normal children were evaluated. The stool was tested by ELISA method to evaluate Helicobacter pylori antigen.

Results: 15.2% of chidern in the chronic abdominal pain group were positive for Helicobacter pylori. No positive case was found among control group. This difference between case and control groups was significant (P<0.05).

Conclusion: Considering the high prevalence of Helicobacter pylori antigen in children with chronic abdominal pain, it is suggested that children with chronic abdominal pain without a definite cause screened for Helicobacter pylori infection.

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Background and Objective: Spastic diplegia cerebral palsy is a movement disorder originating from brain injury before, during, or immediately after birth. Exercise plays an important role in motor recovery. This study was performed to determine the effect of high-intensity circuit training on balance and activity daily living in children with cerebral palsy (CP).
Methods: In this clinical trial, 34 children with cerebral palsy were randomly divided into two groups of 17 including occupational therapy (control group) and circuit training group with occupational therapy as interventional group. Berg balance scale and activity scale for kids were used to assess changes in balance and activity of daily living before and after 12 weeks of exercise, respectively. High-intensity circuit training consisting of 3 rounds and each round consisting of 6,
30-second stations and a 30-second break between stations, which were performed three times a week for 12 weeks. Occupational therapy was performed one session per week.
Results: The rate of balance and activities of daily living and its components in the circuit training group with occupational therapy showed a significant improvement compared to control group (P<0.05).
Conclusion: Circuit trainings with occupational therapy can further improve the performance of balance and activity of daily living in children with Spastic diplegia cerebral palsy compared to occupational therapy.