Bladder Volume Wall Index In Children With Urinary Tract Infections

How to Cite This Article: Hooman N, Hallaji F, Mostafavi SH, Sharif MR, Tatarpoor P, Otukesh H. Bladder Volume Wall Index in Children with Urinary Tract Infections. J Ped. Nephrology 2013 July;1(1):18-22.Introduction: Few studies have focused on the correlation between bladder ultrasound and urinary tract infection. The aim of this study was to evaluate the bladder volume wall index in children with single or recurrent urinary tract infection.Materials & Methods: This case-control study was conducted between March 2008 and December 2009. The study was performed on one hundred children (8 boys, 92 girls) aged 4-15 years with a history of urinary tract infection and thirty-nine (20 males, 19 females) age- matched healthy children who had negative urine culture one month before investigation. The kidneys, ureters, and bladder sonography were performed in all children. Bladder volume wall index was calculated for each child and the result of 70-130 was presumed normal. Student T-test, chi-square, likelihood ratio, and risk ratio were used. P-value <0.05 was considered significant.Results: The mean bladder volume was 262.5 (±82) in recurrent urinary tract infection, 235 (±54) in single urinary tract infection, and 278 (±80) in controls (P<0.05). The bladder was thick (<70) in 37 (28 cases, 9 controls) and thin (>130) in 38 children (28 cases, 10 controls) (P>0.05). The median residual volume was not different between the two groups. The abnormal BVWI in children with vesicoureteral (VU) reflux was 75% as compared to 51% in those without VU reflux (P>0.05). There was no correlation between BVWI and age, gender, groups, vesicoureteral reflux status, or residual volume (P>0.05).Conclusions: According to our findings, the bladder volume wall index is not sensitive enough to discriminate children who are prone to urinary tract infection. Keywords: Urography; Urinary Tract Infections; Ultrasonography; Urinary Bladde

Perspectives of Nurses on Barriers of Parental Participation in Pediatric Care: A Qualitative Study

Background & Objective: Parental participation in pediatric nursing is not ideally done due to several barriers. This qualitative study aimed to explore the barriers of parental participation in pediatric care during 2011-2012. Methods & Materials: This qualitative study was carried out using content analysis approach. Data were gathered through face to face semi-structured interviews with a sample of pediatric nurses (n=11) who were recruited through purposeful sampling from a pediatric hospital in Tehran. After gaining data saturation, data were analyzed using content analysis method. Results: Four main themes were emerged as barriers of parental participation in pediatric care including mutual motivation and interest in both parties (motivation and attitudes of nurses and interest in parents), management (lack of support for nurses, nursing shortage, nurses' workload, and poor teamwork between nurses and physicians), confidence in the nursing profession, and finally undefined role for mothers. Conclusion: Findings revealed the barriers of parental participation in caring for their hospitalized children. Managers and nurses can take advantages of these findings to improve and strengthen parental participation in pediatric care units during hospitalization. &nbsp

The Prevalence of Pre-hypertension in Children with Type 1 Diabetes Mellitus

Background: Hypertension is more common in adults with type 1 diabetes mellitus (T1DM) than the general population. The aim of this study was to detect the pre-hypertensive stage in children with T1D and to evaluate its correlation with diabetic nephropathy compared to non-diabetic children. Methods: This was a prospective cross-sectional study in an out-patient clinic of a university hospital. A total of 62 which consists of 36 males and 26 females patients with stable T1D with a median age of 13 year and 42 age - sex-matched healthy children were entered in the study between September 2008 and February 2011. Three readings of blood pressure were recorded. Fasting blood sample was drawn for hemoglobin A1C (HbA 1 C), creatinine and a 24 h urine aliquot was collected to measure microalbumin, creatinine and volume to estimate glomerular filtration rate (eGFR). Results: From 62 children with T1DM, 25.8% were in pre-hypertensive stage, 4.8% Stage 1, and 1.6% Stage 2. In controls, 1 (2.4%) out of 42 children was in pre-hypertensive stage (P < 0.0001). Abnormal blood pressures were correlated with eGFR and the duration of disease (P < 0.05), but there were not associated with microalbominuria or HbA 1 C level. Conclusions: There was a higher rate of early stage of high normal blood pressure in children with T1DM compared with the healthy controls and this abnormality was only correlated with puberty stage and glomerular filtration rate

Quality of Life and Caregiver Burden Scale in Iranian Children on Continuous Ambulatory Peritoneal Dialysis

Introduction: Chronic kidney diseases are associated with a poor quality of life in patients and their families. Previous studies have shown a three-fold higher rate of exhaustion in peritoneal dialysis compared to hemodialysis patients and their families. Here we studied the quality of life and caregiver’s burden of children receiving chronic ambulatory peritoneal dialysis (CAPD) in comparison with other chronic diseases among pediatric patients.Materials and Methods: This prospective case-control survey was conducted between 2013 and 2014 in Ali- Asghar Children’s Hospital. The inclusion criteria were age below 18 years and having a chronic disease diagnosed at least six months earlier. The parents of 13 children on peritoneal dialysis (cases) and 160 children with other chronic diseases(controls) were requested to complete the Pediatric Quality of Life Inventory (PedsQL™ 4.0™) appropriate to the patient’s age and the Caregiver Burden Scale (CBS).  Independent t-test was applied to compare the variables between the two groups. P-values &lt; 0.05 were considered significant.Results: Overall, 353 questionnaires were completed. The CAPD group had a higher mean (SD) score of quality of life in all domains, including somatic symptoms [67 (25.6) vs. 18.5(15.6)], emotional symptoms [71(17) vs. 20.5(15.1)], and social functioning [58(32) vs. 21.3(20)] (p-value&lt;0.001). In addition, the case group had a lower mean (SD) score of caregiver’s burden [50(16.7) vs. 80 (13.5)] compared to the control group (P value&lt;0.001).Conclusions: CAPD children and their parents had better a PedsQL™ 4.0™ score and a lower CBS compared to children with other chronic diseases. The most affected area of the quality of life was school functioning in the CAPD group and somatic symptoms in the control group.Keywords: Quality of life; Renal Dialysis; Adaptation; Psychological; Chronic Disease; Child