Journal of Comprehensive Pediatrics

Research Article

24/8/2015

Use of Recombinant Factor VIIa Utilization Among a Hospitalized Pediatric Population

Nathan E Thompson, Melissa Meuler, John P Scott

Results: Over the three year period 887 doses of rFVIIa were administered to 186 patients. Only 4% of patients received rFVIIa for an FDA approved indication. The most common indication for off-label usage was refactory bleeding either during or following cardiothoracic surgery, accounting for 83% of all doses administered off-label. Despite being only a small portion of all patients receiving rFVIIa, the group receiving rFVIIa for an FDA approved indication received the majority of doses dispensed (72.6% of all doses). A significant difference (P < 0.0001) was noted in the dose administered to patients in the on-label versus off-label groups. Patients in the on-label group received a median dose of 113.6 mcg/kg (IQR 54.5 mcg/kg - 172.7 mcg/kg) versus a median dose of 74.4 mcg/kg (IQR 20.0 mcg/kg - 128.8 mcg/kg) in the off-label group.

Research Article

24/8/2015

The Prevalence of Obesity in School Children of Zahedan-Iran; Double Burden of Weight Disorders

Fahimeh Soheilipour, Atefeh Ghanbari Jolfaie, Zeinab Pourzahabi, Maryam Lotfi, Maziar Moradi Lakeh

Patients and Methods: This cross-sectional study was performed on 3582 school children, among which 1786 were girls and 1796 boys in 2012. The students aged 6 to 13 years old and selected based on a stratified random method. The body mass index (BMI) was measured for each student and being overweight/obesity was determined based on CDC 2000 definitions. Prevalence proportions were estimated by weighing the sample. The study was performed at primary and guidance schools of Zahedan. Samples were stratified from two geographic regions of Zahedan (Zone 1 and 2).

Results: In the sample, 78.9% were under 85th percentile, 11.8% were overweight (85th - 95th percentile) and 9.3% were obese (> 95th percentile). Weighted estimate for the prevalence of obesity/overweight in girls, boys and all 6 - 13 years old students were 16.2%, 18.4% and 17.4%, respectively. Presence of overweight/obesity was related to school type (private to public schools OR = 2.13, 1.80 - 2.52) and increasing age (OR = 1.12, 1.04 - 1.20).

Case Report

24/8/2015

A Rare Case of Pediatric Nosocomial Liver Abscess Developing During Dialysis Therapy

Medha Mittal, Sumidha Jain

Case Presentation: We reported a case of liver abscess developing in a 6-year-old boy admitted with sepsis and multiorgan dysfunction syndrome including acute kidney injury. He received peritoneal and subsequently hemodialysis, as he did not improve on peritoneal dialysis. He developed fever while on hemodialysis, which was due to a liver abscess developing during the course of hospital stay. The abscess was in the right lobe of the liver with a volume of 40 mL. Staphylococcusaureus is the leading cause of pyogenic liver abscesses in children and infection acquired from hospital. The patient received vancomycin and responded well with complete resolution and did not require any drainage procedure. He may have acquired bacteremia during dialysis with subsequent hepatic seeding.

Conclusions: Though rare, liver abscess may develop even in patients undergoing short-term dialysis therapy. Liver abscess is a medical emergency and if not treated promptly may lead to significant mortality. Invasive therapeutic procedures, like drainage is associated with further risk of complications. Therefore, a high index of suspicion should be kept when evaluating a patient who develops unexplained fever while being on hemodialysis. Early medical intervention through appropriate antibiotics can significantly reduce the morbidity and mortality. Strict infection control policies should be followed to prevent such nosocomial infections.

Research Article

29/8/2015

The Relationship Between Maternal Awareness, Socioeconomic Situation of Families and Metabolic Control in Children With Type 1 Diabetes Miletus in an Iranian Population

Fahimeh Soheilipour, Atefeh Ghanbari Jolfaei, Fariba Khodapanahandeh, Asadollah Rajab, Hamid Salehiniya, Marjan Asoudegi, Zeinab Tamannaie, Nahid Rahimzadeh

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.

Research Article

24/8/2015

Neonatal Mortality and its Main Determinants in Premature Infants Hospitalized in Neonatal Intensive Care Unit in Fatemieh Hospital, Hamadan, Iran

Behnaz Basiri, Farzaneh Esna Ashari, Maryam Shokouhi, Mohammad Kazem Sabzehei

Results: Neonatal death rate was overall 27.4%, which was significantly higher in gestational age subgroup of less than 28 weeks compared with other gestational age subgroups. The most prevalent etiologies of neonatal death were respiratory distress syndrome (73.8%), congenital abnormalities (13.8%) and sepsis (5.4%), respectively. Preeclampsia and history of multiple pregnancies were more prevalent in non-survived neonates. According to multivariable regression modeling, low gestational age, low birth weight, low Apgar scores, need for intensive supports, history of disease in mother, occurrence of pneumothorax, multiple gestation and preeclampsia could all strongly predict occurrence of death in premature infants.

Journal of Comprehensive Pediatrics: Aug 2015, 6 (3), 5 articles.