Yerda Özkan Karasu, O. Miloglu, Z. Orbak, R. Orbak, Gülsüm Akkaya, Abubekir Laloğlu, N. H. Bilge
Background: Diabetes mellitus (DM) disrupts bone metabolism, leading to slowed bone development, poor bone quality, and osteoporosis. Objectives: The aim of this study was to examine changes in the bones of adolescents with type-1 diabetes mellitus (T1DM) using fractal dimension (FD) analysis method and panoramic radiomorphometric indices. Methods: Fractal dimension values and radiomorphometric measurements of 36 children with T1DM and 36 healthy individuals were compared using panoramic radiographs. The panoramic mandibular index (PMI), mental index (MI), mandibular cortical width (MCW), amount of alveolar bone resorption (AABR), antegonial index (AI), and gonial index (GI) were measured. Mandibular cortical index (MCI) was recorded as C1, C2, and C3 classes. Results: For the angulus and corpus regions, the T1DM patient group had lower FD values, and there was a statistically significant difference between the T1DM patient group and the control group (P = 0.003, P = 0.029). Mental index, MCW, and AI values were higher in the control group than in the T1DM patient group and were statistically significant (P = 0.014, P = 0.001, P < 0.001, respectively). Conclusions: In this study examining the mandible in pediatric patients with T1DM using radiomorphometric measurements and fractal analysis method, it can be concluded that T1DM affects bone morphology and trabecular structure
{"title":"Investigation of Fractal Dimension Analysis and Radiomorphometric Indices in Children with Type 1 Diabetes Mellitus","authors":"Yerda Özkan Karasu, O. Miloglu, Z. Orbak, R. Orbak, Gülsüm Akkaya, Abubekir Laloğlu, N. H. Bilge","doi":"10.5812/ijp-142061","DOIUrl":"https://doi.org/10.5812/ijp-142061","url":null,"abstract":"Background: Diabetes mellitus (DM) disrupts bone metabolism, leading to slowed bone development, poor bone quality, and osteoporosis. Objectives: The aim of this study was to examine changes in the bones of adolescents with type-1 diabetes mellitus (T1DM) using fractal dimension (FD) analysis method and panoramic radiomorphometric indices. Methods: Fractal dimension values and radiomorphometric measurements of 36 children with T1DM and 36 healthy individuals were compared using panoramic radiographs. The panoramic mandibular index (PMI), mental index (MI), mandibular cortical width (MCW), amount of alveolar bone resorption (AABR), antegonial index (AI), and gonial index (GI) were measured. Mandibular cortical index (MCI) was recorded as C1, C2, and C3 classes. Results: For the angulus and corpus regions, the T1DM patient group had lower FD values, and there was a statistically significant difference between the T1DM patient group and the control group (P = 0.003, P = 0.029). Mental index, MCW, and AI values were higher in the control group than in the T1DM patient group and were statistically significant (P = 0.014, P = 0.001, P < 0.001, respectively). Conclusions: In this study examining the mandible in pediatric patients with T1DM using radiomorphometric measurements and fractal analysis method, it can be concluded that T1DM affects bone morphology and trabecular structure","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cystic abdominal masses are relatively prevalent in the pediatric population. Ultrasound (US) often serves as the initial imaging modality for evaluating these lesions, assisting in diagnosis, and guiding clinical decisions. Objectives: This study aimed to delineate the characteristic US features of intra-abdominal cystic lesions not arising from the liver, spleen, or kidney in children and to assess their diagnostic value for providing definitive diagnoses. Methods: Conducted in the radiology department of pediatric hospitals affiliated with Mashhad University of Medical Sciences from 2019 to 2022, this cross-sectional study examined 104 children with cystic abdominal lesions. Patient demographic data and US characteristics were documented. Definitive diagnoses were established through histopathological reports, surgical outcomes, or clinical follow-up. The accuracy of US findings was evaluated against these definitive diagnoses, with the sensitivity and specificity of US features for various intra-abdominal cystic lesions being calculated. Results: The most frequent cystic lesions identified were perinatal ovarian torsion (22.1%) and duplication cysts (18.2%). Ultrasound achieved a sensitivity and specificity of 82.61% (95% CI = 0.6 - 0.94) and 100% (95% CI = 0.94 - 1), respectively, in diagnosing perinatal ovarian torsion and 89.47% (95% CI = 0.65 - 0.98) and 94.11% (95% CI = 0.86 - 0.97) in diagnosing duplication cysts. In 80.8% of the cases, the initial US diagnosis corresponded with the final diagnosis. Conclusions: Ultrasound exhibits commendable sensitivity and specificity in identifying intra-abdominal cysts not originating from the liver, spleen, or kidneys in children, demonstrating its effectiveness in the diagnostic evaluation of these lesions.
背景：腹部囊性肿块在儿科人群中较为常见。超声（US）通常是评估这些病变、协助诊断和指导临床决策的初始成像模式。研究目的本研究旨在确定非肝、脾或肾脏引起的儿童腹腔内囊性病变的特征性 US 特征，并评估其在提供明确诊断方面的诊断价值。方法：在放射科进行：这项横断面研究于 2019 年至 2022 年在马什哈德医科大学附属儿科医院放射科进行，共检查了 104 名腹部囊性病变患儿。记录了患者的人口统计学数据和美国特征。明确诊断是通过组织病理学报告、手术结果或临床随访确定的。根据这些明确诊断评估了超声检查结果的准确性，并计算了超声检查对各种腹腔内囊性病变的敏感性和特异性。结果：最常见的囊性病变是围产期卵巢扭转（22.1%）和重复囊肿（18.2%）。超声诊断围产期卵巢扭转的敏感性和特异性分别为 82.61% (95% CI = 0.6 - 0.94) 和 100% (95% CI = 0.94 - 1)，诊断重复囊肿的敏感性和特异性分别为 89.47% (95% CI = 0.65 - 0.98) 和 94.11% (95% CI = 0.86 - 0.97)。在 80.8% 的病例中，最初的 US 诊断与最终诊断一致。结论超声波在鉴别儿童腹腔内非肝脏、脾脏或肾脏来源的囊肿方面表现出令人称道的灵敏度和特异性，证明了其在诊断评估这些病变方面的有效性。
{"title":"Intra-Abdominal Cysts Not Originating from Liver, Spleen, or Kidney in Children: Assessment of the Diagnostic Value of Ultrasound Features","authors":"S. Alamdaran, Niloufar Nazeri, Seyed Mannan Naghavi, Fatemeh Dadelahi, Maryam Tavakoli","doi":"10.5812/ijp-138876","DOIUrl":"https://doi.org/10.5812/ijp-138876","url":null,"abstract":"Background: Cystic abdominal masses are relatively prevalent in the pediatric population. Ultrasound (US) often serves as the initial imaging modality for evaluating these lesions, assisting in diagnosis, and guiding clinical decisions. Objectives: This study aimed to delineate the characteristic US features of intra-abdominal cystic lesions not arising from the liver, spleen, or kidney in children and to assess their diagnostic value for providing definitive diagnoses. Methods: Conducted in the radiology department of pediatric hospitals affiliated with Mashhad University of Medical Sciences from 2019 to 2022, this cross-sectional study examined 104 children with cystic abdominal lesions. Patient demographic data and US characteristics were documented. Definitive diagnoses were established through histopathological reports, surgical outcomes, or clinical follow-up. The accuracy of US findings was evaluated against these definitive diagnoses, with the sensitivity and specificity of US features for various intra-abdominal cystic lesions being calculated. Results: The most frequent cystic lesions identified were perinatal ovarian torsion (22.1%) and duplication cysts (18.2%). Ultrasound achieved a sensitivity and specificity of 82.61% (95% CI = 0.6 - 0.94) and 100% (95% CI = 0.94 - 1), respectively, in diagnosing perinatal ovarian torsion and 89.47% (95% CI = 0.65 - 0.98) and 94.11% (95% CI = 0.86 - 0.97) in diagnosing duplication cysts. In 80.8% of the cases, the initial US diagnosis corresponded with the final diagnosis. Conclusions: Ultrasound exhibits commendable sensitivity and specificity in identifying intra-abdominal cysts not originating from the liver, spleen, or kidneys in children, demonstrating its effectiveness in the diagnostic evaluation of these lesions.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahele Mehrabi, Fatemeh Sheikhshoaei, Vahid Changizi, N. Poursalehi, Mehrzad Mehdizadeh, Faride Pak
Background: In contemporary healthcare systems, there is a growing emphasis on promoting self-care, patient empowerment, and informed decision-making. The creation of health information content is recognized as a vital tool for enhancing the health literacy of patients. Objectives: This study aimed to explore the components of children's health information in radiology centers to develop a model for producing health information content tailored to their needs. Methods: This qualitative exploratory case study involved 71 participants, including 25 children aged 6 - 14 years, 25 parents of children aged 0 - 14 years, and 23 staff members (radiology technicians and doctors) from the Radiology Department at Children's Medical Center Hospital in Tehran, Iran. Semi-structured and in-depth interviews were conducted to collect data, which were then analyzed using qualitative content analysis and selective-axial coding. Results: The developed model comprised two main dimensions: Health information content and health information format. The dimension of health information content included process information, emotional information, and self-regulating information. The dimension of health information format encompassed various formats such as informational brochures, books, educational animations, applications, and oral explanations. Conclusions: Creating health information content that aligns with children's interests and preferences can enhance their cooperation and participation in radiology examinations.
{"title":"Designing A Model for Production of Children's Health Information Content in Radiology Centers: A Case Study","authors":"Rahele Mehrabi, Fatemeh Sheikhshoaei, Vahid Changizi, N. Poursalehi, Mehrzad Mehdizadeh, Faride Pak","doi":"10.5812/ijp-141825","DOIUrl":"https://doi.org/10.5812/ijp-141825","url":null,"abstract":"Background: In contemporary healthcare systems, there is a growing emphasis on promoting self-care, patient empowerment, and informed decision-making. The creation of health information content is recognized as a vital tool for enhancing the health literacy of patients. Objectives: This study aimed to explore the components of children's health information in radiology centers to develop a model for producing health information content tailored to their needs. Methods: This qualitative exploratory case study involved 71 participants, including 25 children aged 6 - 14 years, 25 parents of children aged 0 - 14 years, and 23 staff members (radiology technicians and doctors) from the Radiology Department at Children's Medical Center Hospital in Tehran, Iran. Semi-structured and in-depth interviews were conducted to collect data, which were then analyzed using qualitative content analysis and selective-axial coding. Results: The developed model comprised two main dimensions: Health information content and health information format. The dimension of health information content included process information, emotional information, and self-regulating information. The dimension of health information format encompassed various formats such as informational brochures, books, educational animations, applications, and oral explanations. Conclusions: Creating health information content that aligns with children's interests and preferences can enhance their cooperation and participation in radiology examinations.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weiqiang Zhang, Yi Zhong, Qiusheng Li, Qingxia Chen
Background: The complexity of studying secondary burn wound healing in children arises from the varying ability of skin tissue regeneration across different ages. Despite advancements, there are still gaps in our understanding. Objectives: This study aimed to explore factors influencing wound healing in children with second-degree burns to guide clinical treatment and nursing practices. Methods: We conducted a retrospective analysis of children with second-degree burns treated in our burn surgery department from January 2020 to December 2022. Based on the events per variable (EPV) rule, 220 children were included. They were categorized based on the quality of wound healing 14 days post-admission (good or poor), evaluated by the healing rate and scar formation. Children's clinical data were extracted from medical records for analysis. Binary logistic regression identified factors associated with poor healing outcomes in second-degree burns. Results: Among 220 patients with secondary burns, 166 (75.46%) experienced good wound healing, while 54 (24.54%) had poor outcomes. The Hosmer-Lemeshow test indicated a good model fit (χ2 = 9.739, P = 0.28). Significant variables included burn area (odds ratio [OR] = 1.217, 95% confidence interval [CI] = 1.109 - 1.335, P < 0.05), number of drug changes (OR = 1.902, 95%CI = 1.392 - 2.599, P < 0.05), white blood cell count (OR = 1.076, 95%CI = 1.008 - 1.150, P < 0.05), neutrophil count (OR = 1.080, 95%CI = 1.018 - 1.146, P < 0.05), and neutrophil ratio (OR = 1.040, 95%CI = 1.002 - 1.081, P < 0.05). Conclusions: Effective treatment and nursing of children with second-degree burns should prioritize managing large burn areas and high levels of inflammatory markers. Additionally, minimizing drug changes during the nursing process can enhance wound healing in children.
{"title":"Analysis of Factors Influencing Trauma Healing in Children with Second-Degree Burns: A Single-Center Retrospective Study","authors":"Weiqiang Zhang, Yi Zhong, Qiusheng Li, Qingxia Chen","doi":"10.5812/ijp-143561","DOIUrl":"https://doi.org/10.5812/ijp-143561","url":null,"abstract":"Background: The complexity of studying secondary burn wound healing in children arises from the varying ability of skin tissue regeneration across different ages. Despite advancements, there are still gaps in our understanding. Objectives: This study aimed to explore factors influencing wound healing in children with second-degree burns to guide clinical treatment and nursing practices. Methods: We conducted a retrospective analysis of children with second-degree burns treated in our burn surgery department from January 2020 to December 2022. Based on the events per variable (EPV) rule, 220 children were included. They were categorized based on the quality of wound healing 14 days post-admission (good or poor), evaluated by the healing rate and scar formation. Children's clinical data were extracted from medical records for analysis. Binary logistic regression identified factors associated with poor healing outcomes in second-degree burns. Results: Among 220 patients with secondary burns, 166 (75.46%) experienced good wound healing, while 54 (24.54%) had poor outcomes. The Hosmer-Lemeshow test indicated a good model fit (χ2 = 9.739, P = 0.28). Significant variables included burn area (odds ratio [OR] = 1.217, 95% confidence interval [CI] = 1.109 - 1.335, P < 0.05), number of drug changes (OR = 1.902, 95%CI = 1.392 - 2.599, P < 0.05), white blood cell count (OR = 1.076, 95%CI = 1.008 - 1.150, P < 0.05), neutrophil count (OR = 1.080, 95%CI = 1.018 - 1.146, P < 0.05), and neutrophil ratio (OR = 1.040, 95%CI = 1.002 - 1.081, P < 0.05). Conclusions: Effective treatment and nursing of children with second-degree burns should prioritize managing large burn areas and high levels of inflammatory markers. Additionally, minimizing drug changes during the nursing process can enhance wound healing in children.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140727831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: This study seeks to evaluate the precision of ultrasonography in confirming orogastric tube placement among neonates in a Chinese neonatal intensive care unit (NICU). Methods: Radiological assessments initially gauged tube placement, followed by confirmation through ultrasonography. The agreement between the two methods was assessed using Cohen's kappa statistic, while diagnostic performance was analyzed through sensitivity and specificity calculations. Results: Out of 156 orogastric tubes, 85.3% were accurately placed in the stomach according to radiological assessment, with ultrasonography confirming 88.5% of stomach placements. Accuracy rates were 67.3% for radiological evaluation and 60.3% for ultrasonography in determining the accurate position. The agreement assessment demonstrated a sensitivity of 68.6% and a specificity of 46.3%. Conclusions: While ultrasonography shows promise in reliably verifying orogastric tube placement in newborns, it does not entirely substitute current radiological assessments. Further research is essential to discern the optimal clinical utility of ultrasonography.
{"title":"An Investigation of Ultrasonography as a Method for Determining Orogastric Tube Placement in Newborns","authors":"Jun Chen, Lijun Liu, Chaomei Huang, Yiheng Dai","doi":"10.5812/ijp-143559","DOIUrl":"https://doi.org/10.5812/ijp-143559","url":null,"abstract":"Objectives: This study seeks to evaluate the precision of ultrasonography in confirming orogastric tube placement among neonates in a Chinese neonatal intensive care unit (NICU). Methods: Radiological assessments initially gauged tube placement, followed by confirmation through ultrasonography. The agreement between the two methods was assessed using Cohen's kappa statistic, while diagnostic performance was analyzed through sensitivity and specificity calculations. Results: Out of 156 orogastric tubes, 85.3% were accurately placed in the stomach according to radiological assessment, with ultrasonography confirming 88.5% of stomach placements. Accuracy rates were 67.3% for radiological evaluation and 60.3% for ultrasonography in determining the accurate position. The agreement assessment demonstrated a sensitivity of 68.6% and a specificity of 46.3%. Conclusions: While ultrasonography shows promise in reliably verifying orogastric tube placement in newborns, it does not entirely substitute current radiological assessments. Further research is essential to discern the optimal clinical utility of ultrasonography.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140733112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chronic diarrhea in children poses a significant clinical challenge and can lead to adverse health outcomes. Among various causes, fat malabsorption is particularly concerning, as it may lead to inadequate nutrient absorption, malnutrition, and impaired growth. Prompt and precise diagnosis is crucial for implementing effective treatments. Objectives: The goal of this study is to utilize deep learning to create a superior diagnostic tool that exceeds traditional methods, facilitating the early identification of fat malabsorption in children suffering from chronic diarrhea. Methods: In a preliminary study involving 100 pediatric patients, 25 machine learning algorithms were evaluated. The convolutional neural network (CNN) was identified as the most effective and subsequently refined through hyperparameter tuning. Results: The CNN model exhibited exceptional performance, attaining a test accuracy of 97% and an area under the curve (AUC) score of 99.4%. These results underscore its reliability in accurately identifying cases of fat malabsorption. Conclusions: This research represents noteworthy progress in pediatric gastroenterology, merging deep learning techniques with medical expertise to develop a dependable and rapid diagnostic tool. This innovative method promises significant improvements in detecting fat malabsorption, potentially transforming clinical practices and enhancing patient outcomes in children with chronic diarrhea.
{"title":"Innovative Diagnostic Tool: Convolutional Neural Network for Early Fat Malabsorption Detection in Pediatric Patients with Chronic Diarrhea","authors":"Emre Kıymık, Erkan Kıymık, Ahmet Basturk","doi":"10.5812/ijp-142789","DOIUrl":"https://doi.org/10.5812/ijp-142789","url":null,"abstract":"Background: Chronic diarrhea in children poses a significant clinical challenge and can lead to adverse health outcomes. Among various causes, fat malabsorption is particularly concerning, as it may lead to inadequate nutrient absorption, malnutrition, and impaired growth. Prompt and precise diagnosis is crucial for implementing effective treatments. Objectives: The goal of this study is to utilize deep learning to create a superior diagnostic tool that exceeds traditional methods, facilitating the early identification of fat malabsorption in children suffering from chronic diarrhea. Methods: In a preliminary study involving 100 pediatric patients, 25 machine learning algorithms were evaluated. The convolutional neural network (CNN) was identified as the most effective and subsequently refined through hyperparameter tuning. Results: The CNN model exhibited exceptional performance, attaining a test accuracy of 97% and an area under the curve (AUC) score of 99.4%. These results underscore its reliability in accurately identifying cases of fat malabsorption. Conclusions: This research represents noteworthy progress in pediatric gastroenterology, merging deep learning techniques with medical expertise to develop a dependable and rapid diagnostic tool. This innovative method promises significant improvements in detecting fat malabsorption, potentially transforming clinical practices and enhancing patient outcomes in children with chronic diarrhea.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140385736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In Iran’s newborn hearing screening (NHS) program, OAE and AABR are administered to early identify hearing impairment in the primary health care (PHC) system. Objectives: The aim of this study was to conduct a cost-effectiveness analysis of this program integrated into Iran's health system. Methods: We examined the cost-effectiveness of AABR and OAE screening procedures in infants less than 1 month old. TreeAge 2022 software was used for cost-effective modeling. In this study, QoL and QALY were considered as the outcome measures. To evaluate the robustness of the modeling results, we used one-way sensitivity analysis. A ± 20% variation was utilized to determine target variables and estimate the costs per identification. Results: In 2022, a total of 1,106,072 babies were born in Iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). Overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. The ICER was equal to 3297.2 US PPP (Purchasing Power Parity) per QALY. According to our results, the dominant cost-effective strategy for hearing impairment screening was OAE plus AABR. After 1000 iterations, the second cost-effective strategy was found to be OAE alone, according to Monte Carlo simulation modeling. Conclusions: In this study, we evaluated the cost-effectiveness of the NHS program for detecting hearing impairment in over a million births in Iran. A two-step screening approach, including OAE and AABR, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.
{"title":"The Cost Effectiveness of Newborn Hearing Screening Program: New Approach of Iran Ministry of Health and Medical Education in 2022","authors":"Ehsan Moradi-Joo, Mohsen Barouni, Saeid Mahmoudian, Lila Vali","doi":"10.5812/ijp-139634","DOIUrl":"https://doi.org/10.5812/ijp-139634","url":null,"abstract":"Background: In Iran’s newborn hearing screening (NHS) program, OAE and AABR are administered to early identify hearing impairment in the primary health care (PHC) system. Objectives: The aim of this study was to conduct a cost-effectiveness analysis of this program integrated into Iran's health system. Methods: We examined the cost-effectiveness of AABR and OAE screening procedures in infants less than 1 month old. TreeAge 2022 software was used for cost-effective modeling. In this study, QoL and QALY were considered as the outcome measures. To evaluate the robustness of the modeling results, we used one-way sensitivity analysis. A ± 20% variation was utilized to determine target variables and estimate the costs per identification. Results: In 2022, a total of 1,106,072 babies were born in Iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). Overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. The ICER was equal to 3297.2 US PPP (Purchasing Power Parity) per QALY. According to our results, the dominant cost-effective strategy for hearing impairment screening was OAE plus AABR. After 1000 iterations, the second cost-effective strategy was found to be OAE alone, according to Monte Carlo simulation modeling. Conclusions: In this study, we evaluated the cost-effectiveness of the NHS program for detecting hearing impairment in over a million births in Iran. A two-step screening approach, including OAE and AABR, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140233270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marjan Hosseinpour, F. Maleki, H. Farrokh-Eslamlou, Z. Sahebazzamani, Javad Aghazadeh, Rasoul Entezarmahdi, Zahra Ahmadnezhad, Shahsanam Gheibi
Background: The neonatal mortality rate (NMR) is a crucial indicator of a country's population health Objectives: This study aims to assess the rates and causes of NMR in West Azerbaijan. Methods: This population-based cross-sectional study utilizes data from the Child Mortality Surveillance System (CMSS) spanning from 2013 to 2022. The study population comprised all neonates (< 28 days old) with permanent residency in any of the 17 cities within the West Azerbaijan province who died within the stated period. Mortality rates, both all-cause and cause-specific, were determined per 1 000 live births for the years 2013, 2016, and 2022. Results: The investigation covered 3 689 reports of neonatal deaths (< 28 days old) from 2013 to 2022. Of these, 53% were males, with an average gestational age of 31.85 ± 5.56 weeks. Over 72% of the deaths occurred in preterm infants, and 69% were linked to cesarean section deliveries. Perinatal prematurity was the leading cause of death during the periods examined, with rates of 32.3%, 35.2%, and 36.8% in 2013, 2016, and 2022, respectively. The distribution of neonatal mortality across the province was uneven, with Poldasht city experiencing the highest mortality rates and Shot city the lowest (9.13 and 2.89 per 1 000 live births, respectively). Conclusions: West Azerbaijan province has achieved the Health-related Sustainable Development Goal (SDG-3) of reducing neonatal mortality to below 12 deaths per 1 000 live births by 2030. Nonetheless, significant disparities in NMR persist across the province. Further epidemiological research and the development of targeted health programs are essential to address areas with elevated mortality rates.
{"title":"Rates and Causes of Neonatal Mortality In North-West of Iran","authors":"Marjan Hosseinpour, F. Maleki, H. Farrokh-Eslamlou, Z. Sahebazzamani, Javad Aghazadeh, Rasoul Entezarmahdi, Zahra Ahmadnezhad, Shahsanam Gheibi","doi":"10.5812/ijp-143632","DOIUrl":"https://doi.org/10.5812/ijp-143632","url":null,"abstract":"Background: The neonatal mortality rate (NMR) is a crucial indicator of a country's population health Objectives: This study aims to assess the rates and causes of NMR in West Azerbaijan. Methods: This population-based cross-sectional study utilizes data from the Child Mortality Surveillance System (CMSS) spanning from 2013 to 2022. The study population comprised all neonates (< 28 days old) with permanent residency in any of the 17 cities within the West Azerbaijan province who died within the stated period. Mortality rates, both all-cause and cause-specific, were determined per 1 000 live births for the years 2013, 2016, and 2022. Results: The investigation covered 3 689 reports of neonatal deaths (< 28 days old) from 2013 to 2022. Of these, 53% were males, with an average gestational age of 31.85 ± 5.56 weeks. Over 72% of the deaths occurred in preterm infants, and 69% were linked to cesarean section deliveries. Perinatal prematurity was the leading cause of death during the periods examined, with rates of 32.3%, 35.2%, and 36.8% in 2013, 2016, and 2022, respectively. The distribution of neonatal mortality across the province was uneven, with Poldasht city experiencing the highest mortality rates and Shot city the lowest (9.13 and 2.89 per 1 000 live births, respectively). Conclusions: West Azerbaijan province has achieved the Health-related Sustainable Development Goal (SDG-3) of reducing neonatal mortality to below 12 deaths per 1 000 live births by 2030. Nonetheless, significant disparities in NMR persist across the province. Further epidemiological research and the development of targeted health programs are essential to address areas with elevated mortality rates.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Human adenovirus (HAdV) commonly affects children hospitalized with any form of respiratory infection (RI). Severe HAdV infection leads to one of the most serious types of infantile RI, with rapidly progressive illness and a poor prognosis. Objectives: This study investigated the relationship between aspartate aminotransferase (AST) levels and the severity of HAdV RI in children. Methods: We collected clinical data from 665 cases of HAdV RI in children hospitalized at the pediatric ward of Changde First People's Hospital between January and December 2019. We analyzed the relationship between AST levels and disease severity. Results: Of the 665 HAdV-positive cases, 89.8% were < 6 years of age. Among them, upper RI was diagnosed in 18.8% of cases, bronchiolitis in 4.8%, and mild pneumonia in 48.1%. Severe pneumonia was observed in 28.2% of cases. The 665 patients in the cohort were divided into a mild group (n = 477 cases, 71.73%) and a severe group (n = 188 cases, 28.27%). Univariate analysis showed that children with severe HAdV RI had a lower age of onset and lower hemoglobin and serum albumin levels while having higher platelet counts, lactic acid dehydrogenase, creatine kinase, creatine kinase isoenzyme, alanine aminotransferase, and AST levels compared to those with mild infections (P < 0.05). Multivariate analysis revealed that these factors were related to disease severity (P < 0.05). The ROC curve analysis indicated that the area under the AST curve was 0.782. When the intercept value was 52.5 U/L, the sensitivity was 60.6%, and the specificity was 83.4%. Conclusions: Serum AST levels can serve as a predictor of adenoviral RI severity in children.
{"title":"Evaluation of Risk Factors for Children with Severe Adenovirus Respiratory Infection: Retrospective Study","authors":"Yiyi Ding, Xiangqiong Liu, Rong Hu, Hongyan Tang","doi":"10.5812/ijp-134296","DOIUrl":"https://doi.org/10.5812/ijp-134296","url":null,"abstract":"Background: Human adenovirus (HAdV) commonly affects children hospitalized with any form of respiratory infection (RI). Severe HAdV infection leads to one of the most serious types of infantile RI, with rapidly progressive illness and a poor prognosis. Objectives: This study investigated the relationship between aspartate aminotransferase (AST) levels and the severity of HAdV RI in children. Methods: We collected clinical data from 665 cases of HAdV RI in children hospitalized at the pediatric ward of Changde First People's Hospital between January and December 2019. We analyzed the relationship between AST levels and disease severity. Results: Of the 665 HAdV-positive cases, 89.8% were < 6 years of age. Among them, upper RI was diagnosed in 18.8% of cases, bronchiolitis in 4.8%, and mild pneumonia in 48.1%. Severe pneumonia was observed in 28.2% of cases. The 665 patients in the cohort were divided into a mild group (n = 477 cases, 71.73%) and a severe group (n = 188 cases, 28.27%). Univariate analysis showed that children with severe HAdV RI had a lower age of onset and lower hemoglobin and serum albumin levels while having higher platelet counts, lactic acid dehydrogenase, creatine kinase, creatine kinase isoenzyme, alanine aminotransferase, and AST levels compared to those with mild infections (P < 0.05). Multivariate analysis revealed that these factors were related to disease severity (P < 0.05). The ROC curve analysis indicated that the area under the AST curve was 0.782. When the intercept value was 52.5 U/L, the sensitivity was 60.6%, and the specificity was 83.4%. Conclusions: Serum AST levels can serve as a predictor of adenoviral RI severity in children.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Celiac disease (CD) is an autoimmune disorder that harms the epithelium and lamina propria of the small intestine in genetically predisposed individuals. CD negatively affects oral and dental health. Objectives: This research explored the DMFT index and enamel defects (ED), as well as their association with oral health-related quality of life in children with CD. Methods: In this descriptive-analytical cross-sectional study, 50 children with CD (case group) and 50 healthy children (control group) were examined. The World Health Organization criteria were used to determine the DMFT index. Aine's classification was employed to diagnose ED, and the standard CHILD-Oral Impacts on Daily Performances scale was used to assess child oral health-related quality of life (COHRQoL). The Chi-Square test and Mann-Whitney test were utilized for data comparison. P-values < 0.05 were considered statistically significant. Results: The average DMFT was 2.58 ± 2.39 in the case group and 2.08 ± 1.61 in the control group. According to the Mann-Whitney U test, this difference was not statistically significant (P = .223). The frequency of ED in the case group was significantly higher at 52%, compared to 16% in the control group (P < .001). Additionally, there was a significant difference in the frequency of ED between boys and girls in the two groups (P < .001). The COHRQoL score in the case group, with an average of 24.44 ± 19.91, was significantly higher than that in the control group, which had an average of 13.35 ± 13.65 (P = .002). In both the case and control groups, a significant positive relationship was observed between the COHRQoL score in children and the DMFT index (P < .001). There was also a significant relationship between the COHRQoL score in children with ED in both the case and control groups (P = 0.004). Conclusions: According to the results, there was no difference in the DMFT index between the 2 groups. However, as the DMFT index increased in both groups, the COHRQoL score also increased. The number of ED cases was higher in celiac patients, and this had a significant effect on the COHRQoL score. Additionally, the COHRQoL score was higher in celiac patients compared to the control group.
{"title":"Examine the Relationship between DMFT Index, Enamel Defects, and Oral Health-Related Quality of Life in Children with Celiac Disease","authors":"F. Amirabadi, Shirin Saravani, Pedram Pourdian","doi":"10.5812/ijp-135046","DOIUrl":"https://doi.org/10.5812/ijp-135046","url":null,"abstract":"Background: Celiac disease (CD) is an autoimmune disorder that harms the epithelium and lamina propria of the small intestine in genetically predisposed individuals. CD negatively affects oral and dental health. Objectives: This research explored the DMFT index and enamel defects (ED), as well as their association with oral health-related quality of life in children with CD. Methods: In this descriptive-analytical cross-sectional study, 50 children with CD (case group) and 50 healthy children (control group) were examined. The World Health Organization criteria were used to determine the DMFT index. Aine's classification was employed to diagnose ED, and the standard CHILD-Oral Impacts on Daily Performances scale was used to assess child oral health-related quality of life (COHRQoL). The Chi-Square test and Mann-Whitney test were utilized for data comparison. P-values < 0.05 were considered statistically significant. Results: The average DMFT was 2.58 ± 2.39 in the case group and 2.08 ± 1.61 in the control group. According to the Mann-Whitney U test, this difference was not statistically significant (P = .223). The frequency of ED in the case group was significantly higher at 52%, compared to 16% in the control group (P < .001). Additionally, there was a significant difference in the frequency of ED between boys and girls in the two groups (P < .001). The COHRQoL score in the case group, with an average of 24.44 ± 19.91, was significantly higher than that in the control group, which had an average of 13.35 ± 13.65 (P = .002). In both the case and control groups, a significant positive relationship was observed between the COHRQoL score in children and the DMFT index (P < .001). There was also a significant relationship between the COHRQoL score in children with ED in both the case and control groups (P = 0.004). Conclusions: According to the results, there was no difference in the DMFT index between the 2 groups. However, as the DMFT index increased in both groups, the COHRQoL score also increased. The number of ED cases was higher in celiac patients, and this had a significant effect on the COHRQoL score. Additionally, the COHRQoL score was higher in celiac patients compared to the control group.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140445333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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