The relationship between maternal awareness, socioeconomic situation of families and metabolic control in children with type 1 diabetes miletus in an Iranian population

Background: Type 1 diabetes mellitus (T1DM) is one of the most common chronic pediatric conditions, with potentially life-threatening sequels. However, good metabolic control can protect the patients against sequels. Objectives: The aim of this study was to examine the relationship between awareness of the mothers about this disease on improving diabetic children metabolic control and also, to examine the relationship between socioeconomic situations of families and control of diabetes in this group of patients. Patients and Methods: This is a cross-sectional descriptive analytic study on 80 diabetic children and their mothers, who were registered in the diabetes association of Iran, for outpatient control of disease. Diabetes knowledge was measured by Michigan diabetes knowledge test and glycemic control was assessed by glycosylated hemoglobin (HbA1c). To assess the socio-economic status of a diabetic child's family, educational level, occupational and marital status of parents were asked and the socioeconomic status (SES) was evaluated with Hollingshed four-factor index of SES. Results: Mothers' mean knowledge score was 17.72, children's mean HbA1c was 7.77 and mean of SES was 27.89. There was no significant correlation between children's HbA1c and mother's SES. Also, there was an inverse linear relationship between mothers' knowledge score and children's HbA1c and there was a direct linear relationship between the mothers' knowledge score and SES. Conclusions: Finally, based on the results obtained in this study, it can be concluded that the awareness of mothers of T1DM children has a good impact on blood sugar control, whereas the SES of families has no direct effect on blood sugar control. Additionally, SES can indirectly impact on the consciousness of mothers and lead to the reduction of HbA1c. © 2015, Iranian Society of Pediatrics

Neuroimaging in children with first afebrile seizures: To order or not to order?

Seizures are common in children and 5 of all medical attendances to accident and emergency departments are related to seizures. The role of emergent neurolmaging for those children with first afebrile seizure is, however, not well-defined. We reviewed medical charts of 125 children who were admitted with a new-onset afebrile seizure to the Pediatric Ward of Rasool Akram Hospital and underwent CT scan or MRI of the brain. Neuroimaging was performed for 95 (119/125) of these children over the first few hours of their arrival to the Emergency Department. In 90 (107/119) of them, the result was normal. There was a significant relationship between abnormal neuroimaging and focal seizure (P < 0.001), and with age under 2 years (P < 0.002). Therefore, it is recommended that CT scan or MRI to be performed in children with first afebrile seizure who present with focal seizures, abnormal neurologic findings, or age under 2 years

Risk factors for intraventricular hemorrhage in very low birth weight infants in Tehran, Iran

Intraventricular hemorrhage (IVH) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants; 80-90 of cases occur between birth and the third day of life. In a retrospective case control clinical study, files of all premature infants with birth weights < 1500 grams admitted between April 2004 and October 2005 to the Neonatal Intensive Care Unit (NICU) of Akbar Abadi Hospital were reviewed. We determined risk factors that predispose to the development of high-grade IVH (grades 3 and 4) in VLBW infants. Thirty-nine infants with IVH grade 3 and 4 were identified. A control group of 82 VLBW infants were also selected. Prenatal data, delivery characteristics, neonatal course data and reports of cranial ultrasonography were carefully collected for both groups. Those variables that achieved significance (p<0.05) in univariate analysis were entered into multivariate logistic regression analysis. A total of 325 VLBW infants were evaluated. Mortality rate was 21.5. Multivariate logistic analysis showed that the following factors are associated with greater risk of high-grade IVH occurrence: lower gestational age (OR: 3.72; 95 CI: 1.65-8.38), birth weight (OR: 3.42; 95 CI: 1.65-8.38), mechanical ventilation (OR: 4.14; 95 CI: 1.35-12.2), tocolytic therapy with magnesium sulfate (OR: 4.40; 95 CI: 1.10-24.5), hyaline membrane disease (HMD, OR: 3.16; 95 CI: 1.42-7.45), symptomatic hypotension (OR: 2.32; 95 CI: 1.06-5.42), hypercapnia (OR: 1.9; 95 CI: 1.1-3.4) and Apgar score at 5 minutes (OR: 1.58; 95 CI: 1.59-6.32)

SENSORY HEARING LOSS IN CHILDREN WITH MUMPS WITH MUMPS INFECTION

Objective:Mumps infection is endemic in Iran and mumps parotiditis is a common disease in Iranian children. There has been a dramatic decrease in the worldwide incidence of mumps since the introduction and use in 1968 of the very effective and inexpensive mumps vaccine.In Iran probably due to a higher percentage of unvaccinated young person