Iranian Journal of Child Neurology最新文献

This research investigates the possible correlation between Attention Deficit Hyperactivity Disorder (ADHD) and panic attacks. Through a detailed literature review, the study focuses on a veterinary student who has experienced both ADHD and panic attacks. The primary objective of this research is to address critical questions concerning the prevalence, underlying causes, and mechanisms that may connect these two disorders. An extensive examination of existing literature indicates notable associations, carrying crucial implications for treatment methodologies. The case study exemplifies the practical difficulties encountered by individuals suffering from both ADHD and panic attacks, highlighting the necessity for tailored and meticulous management strategies.

Objectives: Migraine is a chronic and joint disease in children. The results of previous studies on the effectiveness of probiotics in preventing migraine attacks in children have been controversial. This study aims to investigate the effect of probiotics on migraine prophylaxis in children.

Materials & methods: In this clinical trial study, 41 children aged 5 to 15 with migraine enrolled the study in two control and intervention groups. Children in the intervention group (18 children) received propranolol at a dose of 1 mg per kilogram of body weight daily in two divided doses along with a 250 mg Yomogi capsule daily for three months, and children in the control group (23 children), received propranolol along with placebo for three months. The study compared the frequency and duration of headache days, PedMIDAS criteria, and parental satisfaction between the two groups before treatment, as well as one month and three months post-treatment.

Results: The number of headache days in both groups decreased over time, but in the intervention group, this decrease was more than the control group was statistically significant (P=0.045). The average PedMIDAS scale after treatment in the intervention group was 3.9 ± 3.8; in the control group, it was 8.4 ± 8.2, which was statistically significant (P=0.047). Parents' satisfaction with the treatment was statistically significantly higher in the intervention group (94.4%) than in the control group (54.5%) (P=0.011). No significant drug complications were seen in any of the two groups.

Conclusion: In children with migraine, adding probiotics to migraine treatment reduces the intensity and number of days of children's headaches and increases the Parents' satisfaction with the treatment.

Objectives: Acute necrotizing encephalopathy of childhood (ANEC) is a rare, potentially life-threatening condition. This study aimed to identify clinical profiles and outcomes of ANEC while assessing the accuracy of severity scoring in the Iranian population.

Materials & methods: The present study collected demographic, clinical, laboratory, and radiological data from children diagnosed with ANEC. Severity was measured using the ANE-Severity Score (ANE-SS), while outcomes were assessed with the Glasgow Outcome Score (GOS). This research analyzed the relationship between these scores and various parameters for statistical significance.

Results: Seven patients were included over three years, with an average age of 4.4±2.7 years (5 males). ANE-SS varied from moderate to high, with most patients experiencing moderate to severe disabilities, as indicated by the GOS. Significant correlations were found with initial serum magnesium levels, pupil light reactivity, and initial GCS score (P-value < 0.05).

Conclusion: Controlling initial magnesium levels may improve ANEC outcomes. Additionally, intact pupil light reactivity at admission was associated with a better prognosis.

Objectives: Based on case reports, researchers have observed the incidence and clinical manifestations of Guillain-Barré Syndrome (GBS) following COVID-19 infection. Current hypotheses suggest that the risk of GBS may increase with COVID-19, and worsening GBS could elevate the risk of infection and exposure to the virus. This study aimed to assess the cognitive epidemic and mortality of children under 15 years of age with GBS during the COVID-19 pandemic and to compare them to two years earlier without addressing the etiology.

Materials & methods: This cross-sectional study was conducted on all children admitted to Iranian hospitals with a diagnosis of GBS and whose clinical information was available in the national flaccid paralysis patient information registration system between April 2018 and April 2021.

Results: The total number of registered cases of GBS in the pre-COVID-19 period and during this period was 778 cases and 504 cases, respectively (total N=1282), indicating a decrease in registered GBS during COVID-19. The mean age of the patients in the pre-COVID-19 period was 9.00 ± 2.78 years, and during the COVID-19, it was 8.99 ± 2.03 years (P-value =0.998). No significant difference was found in gender distribution between the two periods (P-value =0.427). The total number of paralysis cases studied after 60 days was 14.3% before the COVID-19 period and 17.3% during the pandemic (P-value =0.216). The mortality rate in patients with GBS was 0.13% in the pre-COVID-19 period and 0.19% in the COVID-19 period (P-value =0.757).

Conclusion: Despite the decline in the frequency of diagnosis and referrals of patients with GBS during the COVID-19 period, no difference was found in the demographic characteristics and clinical outcomes of children with GBS in the pre-COVID-19 period and during this pandemic.

Objective: This study investigated the efficacy of telerehabilitation (TR) in school-based Occupational Therapy (OT) for children with Specific Learning Disorder (SLD), focusing on occupational competence and parental satisfaction, aiming to contribute empirical insights to the discourse on the educational well-being of this population.

Materials & methods: The study adopted a Randomized Controlled Trial (RCT) design involving 31 children diagnosed with SLD, implementing TR and in-person interventions alongside a control group. Outcome measures included the School Self-Concept Inventory, Child Occupational Self-Assessment (COSA), and Canadian Occupational Performance Measurement (COMP), analyzed using descriptive and inferential statistics (ANOVA, post hoc tests).

Results: Both TR and in-person interventions exhibited significant enhancements in academic self-efficacy (F=23.96, p<0.001, Partial ȵ²=0.461), occupational competence (F=70.59, p<0.001, Partial ȵ²=0.716), and parent satisfaction (F=17.03, p<0.001, Partial ȵ²=0.378) compared to the control group. Notably, no significant differences emerged between the TR and in-person groups, emphasizing their comparable effectiveness in improving outcomes.

Conclusion: In conclusion, the study demonstrated the efficacy of TR and in-person interventions in school-based OT for children with SLD. The cohesive outcomes in academic self-efficacy, occupational competence, and parental satisfaction highlight TR as a versatile modality. This research, grounded in robust methodology, encourages further exploration of TR's transformative role in enhancing the holistic well-being of children with SLDs.

Objectives: To evaluate the need for lumbar puncture (LP) in children aged 6 to 60 months experiencing their first febrile seizure, regardless of seizure type, and to determine if LP is particularly beneficial for those under 12 months old.

Materials & methods: In this retrospective study, data from 253 children who presented with first febrile seizure were analyzed. All patients in this study underwent LP and were divided into two groups based on their cerebrospinal fluid (CSF) results: non-pleocytosis and pleocytosis. Patients were evaluated for age, sex, familial history of seizure, and type and duration of seizures. They were also evaluated based on laboratory results, including blood tests, CSF analysis, and electroencephalography.

Results: Sixty-seven (25.9%) of the 253 patients were under 12 months of age, and only two of the 67 patients (2.8%) had pleocytosis. Patients younger than 12 months did not have a higher rate of complex febrile seizure or pleocytosis than those over 13 months of age. None of the patients had bacterial meningitis. Regarding viral meningitis, seven patients (5.3%; age mean SD, 12.3±1.8 months) were diagnosed with enteroviral meningitis, though only one of them had pleocytosis. When compared to the non-pleocytosis group, the pleocytosis group showed no differences in clinical characteristics (age, sex, familial history of seizure, type, and duration of seizure), laboratory results, or the use of antiepileptic drugs.

Conclusion: The present study suggests that LP should be carefully considered in children with first febrile seizure, including children under 12 months of age.

Objectives: This study aimed to determine the prevalence of central auditory processing disorder (CAPD) in elementary school students in Kerman, Iran, during 2018-2019.

Materials & methods: This cross-sectional study was conducted on 1369 elementary school students in Kerman. These students were selected by cluster sampling from different areas of Kerman and then screened using the Buffalo Model Questionnaire (BMQ). Based on the data obtained from the questionnaire, normal children were excluded from the study. Then, children with suspected central auditory processing disorder (CAPD) underwent ear exams and were excluded from the study in case of abnormal results in the tympanic membrane examination (rapture-effusion). The remaining subjects underwent peripheral audiometry evaluation, and children with abnormal audiometry were excluded from the study. Finally, the remaining children with suspicious screening results, a normal examination, and normal audiometry underwent a specific test to detect Central auditory processing disorder. Data analysis was carried out using SPSS software.

Results: One thousand three hundred sixty-nine primary school students with a mean age of 9.15 ±2.63 years enrolled in this study. 52%% of students were male. 8.03% of them had CAPD. A statistically significant relationship was found between the prevalence of CAPD and gender (P<0.001), place of residence (P<0.001), history of middle ear inflammation (P<0.001) and history of head injury.

Conclusion: The quality of life of these students with CAPD can be improved via timely recognition of CAPD and the provision of appropriate preventive and therapeutic facilities.

Objectives: This study aimed at culturally adapting, validating, and standardizing the Ages and Stages Questionnaire, third edition (ASQ-3) by implementing a nation-wide cross-sectional methodological study in order to provide a valid and reliable tool for determining the developmental status of Iranian children.

Materials & methods: This cross-sectional and methodological study was conducted on Iranian children between 1-66 months. The ASQ-3 tool was translated; following that, its face and content validity, as well as the cross-cultural adaptation were assessed by 51 specialists and experts in the field of pediatrics and child development. In order to determine the reliability of the ASQ-3 (using Cronbach's alpha), and cut-off points. All statistical analyses were performed using STATA software.

Results: This study was enrolled in 2 phases. The face and content validity, as well as the cultural relevance of the Persian version of ASQ-3 was confirmed using panel of specialists views then researchers investigated 11,740 children aged 1-66 months in order to evaluate the reliability of the tool. The Cronbach's alpha coefficients (reliability) determined for the ASQ-3 and the cut-off points for the ASQ-3 of different age groups and domains were determined by calculating one and two SDs below the mean; the latter represents the main cut-off point, and the interval between the two represents the monitoring zone according to the ASQ-3 technical manual.

Conclusion: The results of this study showed that the Iranian version of ASQ-3 is valid and reliable; moreover, the cut-off points designated for it can be implemented in the Iranian children community to assess their developmental status.

Objectives: Pain and its control is a significant health problem worldwide. The present study aimed to determine the effects of white noise (bird sound) on the severity of muscle vaccination pain in children under two years old.

Materials & methods: This study was a case-control study conducted in 2021. The samples included seventy children under two years old referred to the health centers in Ramsar City, Iran. The samples were selected using the convenient sampling method and divided into experimental and control groups. The data were collected using the demographic characteristics questionnaire, facial expression, and pain assessment in pediatric patients (FLACC). They were then analyzed by SPSS16 using an independent t-test and analysis of covariance (P<0.05).

Results: A significant difference was observed between the severity of muscle vaccination pain in children in the two groups (p=0.042); the pain intensity mean in the experimental group (6.45±2.01) was lower than the control group (8.94±1.28).

Conclusion: This method can be a harmless and inexpensive intervention to reduce pain intensity and behavioral pain responses in infants during painful procedures, especially vaccination.

Objectives: Premature infants (born before 37 weeks of gestational age) frequently experience feeding difficulties due to underdeveloped oral motor skills and poor chewing, swallowing, and breathing coordination. In order to improve oral feeding efficiency in these infants, Oral-Motor Stimulation (OMS) has been used in various studies. This systematic review study will aim to assess the effectiveness of OMS for oral feeding in preterm infants.

Materials & methods: The authors will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. They will conduct a search in electronic databases, including PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials in The Cochrane Library (CENTRAL), Medline via PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for nursing and related healthcare texts without language restrictions from the first month of 1991 to the fifth month of 2024 to achieve the study objectives. All Randomized Controlled Clinical Trials (RCT) examining the effect of OMS on oral feeding in preterm infants will be included in this study.

Results: The primary outcome of this systematic review will be oral feeding, and the secondary outcomes will include duration of hospitalization, weight gain, and feeding efficiency. Two independent reviewers will select and extract data for the study. The Cochrane Risk of Bias Tool (RoB2) will be used to evaluate potential biases in the study. Publication bias will be evaluated using funnel plots, Begg's, and Egger's tests. The degree of heterogeneity among the studies will be assessed using the I2 statistic and the χ2 test. Analyses of subgroups will also be carried out. All meta-analyses will be conducted using Stata V.14.

Conclusion: This systematic review protocol for preterm infants will aim to promote evidence-based decision-making and support the development of clinical practice guidelines in preterm feeding.