Comparison of growth parameters of 5-year-old singleton children born in assisted versus natural conception

<p><b>INTRODUCTION</b>At present, about 1% of newborns are delivered through assisted reproductive technologies (ART) worldwide. This study aimed to evaluate and compare the growth parameters of children born in assisted and natural conception at 5 years of age.</p><p><b>MATERIALS AND METHODS</b>In a cross-sectional case control study, weight, height and head circumference of 5-year old children were assessed. The case group consisted of term, singleton babies who were products of ART in the Center for Infertility of Shahid Sadoughi University, Yazd, Iran in 2005. The control group consisted of term, fi rst child, singleton and spontaneously conceived 5-year-old children who were referred for vaccination to primary health care center of Shahid Akbari in 2010.</p><p><b>RESULTS</b>Fifty-eight girls (47.5%) and 64 boys (52.5%) "with equal numbers in each of the 2 groups" were evaluated. Sex distribution, mean ages of fathers and mothers were not statistically significant different in both groups. Children born after ART tend to have lower birth weight, smaller birth head circumference and lower weight at 5 years of age. Having low birth weight (<2500 g), being underweight and having short stature at the age of 5 were more common in babies born through ART.</p><p><b>CONCLUSION</b>Growth retardation is more prevalent in babies born through ART. Thus, growth assessment, parents' knowledge about child physical development, and timely and accurate follow-up of these children are necessary for early detection of any growth disorders.</p>

Effect of body massage on increase of low birth weight neonates growth parameters: a randomized clinical trial

Admission of low birth-weight [LBW] neonates in neonatal intensive care unit [NICU] causes their deprivation of tactile and sensory stimulation. The purpose of this study was to evaluate efficacy of body massage on growth parameters [weight, height and head circumference] gain velocity of LBW in Yazd, Iran. A randomized clinical trial study was conducted on LBW neonates whom were admitted to NICU of Shahid Sadoughi Hospital, Yazd, Iran from March to December 2011. Neonates were randomly assigned to two groups. In group one, 20 neonates were received massage three times in a day for consecutive 14 days by their mothers. In group two, intervention consisted of standard and routine care as control group. The primary endpoints were efficacy in increase of mean of weight, height and head circumference that were evaluated 14 days after intervention, at ages one and two months. Secondary outcome was clinical side effects. 17 girls and 23 boys with mean gestational age of 34.4 +/- 1.22 weeks were evaluated. In the body massage group, only weight at the age of two months was significantly higher than the control group [mean +/- SD: 3250 +/- 305 vs. 2948 +/- 121 gr, p=0.005]. No adverse events were seen in the two groups. Body massage might be used as an effective and safe non-medical intervention for increasing of weight gain velocity in LBW preterm neonates

Efficacy of chloral hydrate and promethazine for sedation during electroencephalography in children; a randomised clinical trial

The purpose of this study was to compare efficacy and safety of oral chloral hydrate [CH] and promethazine [PZ] for sedation during electroencephalography [EEG] in children. In a parallel single-blinded randomized clinical trial, sixty 1-10 year old children referred to EEG Unit of Shahid Sadoughi Hospital from January 2010 to February 2011 in Yazd, Iran, were evaluated. They were randomized to receive orally 70 mg/kg chloral hydrate or promethazine 1 mg/kg. The primary outcome was efficacy in adequate sedation and successful recording of EEG. Secondary outcome included clinical side effects, time from administration of the drug to adequate sedation, caregiver's satisfaction on a Likert scale, and total stay time in EEG Unit. Twenty four cases with mean age 2.9 +/- 1.9 years were evaluated. Adequate sedation [Ramsay sedation score of four] was obtained in 43.3% of PZ and 100% of CH group [P=0.00001]. Also in 70% of PZ and 96.7% of CH group, EEG was successfully recorded [P=0.006]. So, CH was a more effective drug. In CH group, EEG was performed in shorter time after taking the drug [32.82 +/- 9.6 vs 52.14 +/- 22.88 minutes, P<0.001] and the parents waited less in the EEG unit [1.29 +/- 0.54 vs 2.6 +/- 0.59 hours, P<0.001]. They were also more satisfied [4.6 +/- 0.6 scores vs 3.1 +/- 1.4 scores, P=0.001]. Mild side effects such as vomiting in 20% of CH [n=6] and agitation in 6.6% of PZ group [n=2] were seen. No significant difference was seen from viewpoint of side effects frequency between the two drugs. The results of the present study showed that chloral hydrate can be considered as a safe and more effective drug in sedation induction for sleep EEG in children

Afebrile seizure subsequent to initial febrile seizure

<p><b>INTRODUCTION</b>Febrile seizure (FS) is the most common paediatric neurological problem. The purpose of this study was to determine the frequency of afebrile seizures subsequent to FS in children with initial FS and to evaluate its risk factors.</p><p><b>METHODS</b>A prospective study was conducted on all children (age 6 months to 6 years) referred with initial FS to the Shahid Sadoughi Hospital, Yazd, Iran, between August 2004 and March 2006, who were followed up for at least 15 months for the occurrence of subsequent afebrile seizures.</p><p><b>RESULTS</b>161 boys and 120 girls (mean age 2.12 ± 1.33 years) were followed up for 34.1 ± 7.8 months. 87 (31%) patients had complex FS and 19 (6.7%) patients had subsequent afebrile seizure, with a mean occurrence time of 10.6 ± 6.4 months. Univariate analysis using chi-square test showed that initial FS within one hour of developing fever (p = 0.0001), neurodevelopmental delay (p = 0.0001), family history of epilepsy (p = 0.0001), recurrent FS (p = 0.003) and focal FS (p = 0.04) were risk factors for subsequent afebrile seizure. On multivariate analysis, neurodevelopmental delay (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.3-3.4), initial FS within one hour of developing fever (OR 1.7, 95% CI 1.2-2.1) and family history of epilepsy (OR 1.5, 95% CI 1.1-1.9) were significant factors.</p><p><b>CONCLUSION</b>Special attention should be paid to children with FS during history-taking and developmental assessments to identify high-risk patients and those who might need prophylactic anticonvulsants.</p>

[Relationship between delivery type and successful breastfeeding]

Exclusive breastfeeding has a major effect on decreasing the mortality of the children, particularly in developing countries. The aim of this survey was to study the effect of type of delivery on success of exclusive breastfeeding. In a case-control study; 344 women including two equal groups of 172 cases were chosen based on the type of delivery, vaginal or by cesarean section, and followed for 6 months the way of feeding their infants and the rate of exclusive breastfeeding among them. The rate of exclusive breastfeeding was significantly lower in the mothers delivered by cesarean section than who delivered vaginally [13.4% vs. 41.8%]. The average duration of breastfeeding among the women with vaginal delivery was significantly longer than the cases with cesarean delivery [4.5 +/- 1.7 months vs. 4.0 +/- 1.5 months]. The rate of the onset of breastfeeding in the first hour of delivery was significantly higher among the group with vaginal delivery than the group with cesarean section [82% vs. 38%] and finally the rate of formula feeding among the infants of the mothers with cesarean section was higher than in the infants of the mothers with vaginal delivery [33% vs. 22%]. Cesarean section decreases the exclusive breastfeeding and hence attempts should be made to encourage the mothers for vaginal delivery and breastfeeding as well. Besides, discussing the benefits of breastfeeding for both mother and infant, supports the fact that mothers should be advised to attain executive breastfeeding