Comparison of developmental status of 5-year-old singleton children born through assisted and natural conceptions

Approximately one percent of current live births of the world are conceived via assisted reproductive technologies [ART]. The purpose of this study was to compare the developmental status of children born through assisted and natural conceptions at the age of five years. In a retrospective cohort study, developmental status of 5 years old children was evaluated via Persian version of 60-month Ages and Stages Questionnaires. Case group consisted of 61 singletons, term babies whom were born through ART in the Research and Clinical Center for Infertility, Yazd, Iran in 2005. Control group consisted of 61 term, first child, singleton and spontaneously conceived born five years old children whom were referred to Shahid Akbari primary health care center in 2010. 58 girls [47.5%] and 64 boys [52.5%] were evaluated. Frequency of developmental delay in domains of fine motor [47.5% vs. 24.6%, p=0.008] and problem solving [60.6% vs. 34.4%, p=0.004] were more in ART born children. On logistic regression, fine motor development state was independently affected by maternal educational level [OR: 5.3, 95% CI: 1.67-16.30, p=0.004] and developmental status in problem solving domains was independently affected by maternal educational level [OR: 4.88, 95% CI: 1.25-19.07, p=0.02] and birth weight [OR: 7.1, 95% CI: 1.78-29.01, p=0.006]. Maternal educational level and birth weight are important factors that influenced developmental outcome of ART born children.

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>

prevalence of speech disorder in primary school students in Yazd-Iran

Communication disorder is a widespread disabling problems and associated with adverse, long term outcome that impact on individuals' families and academic achievement of children in the school years and affect vocational choices later in adulthood. The aim of this study was to determine prevalence of speech disorders specifically stuttering, voice, and speech-sound disorders in primary school students in Iran-Yazd. In a descriptive study, 7881 primary school students in Yazd evaluated in view from of speech disorders with use of direct and face to face assessment technique in 2005. The prevalence of total speech disorders was 14.8% among whom 13.8% had speech-sound disorder, 1.2% stuttering and 0.47% voice disorder. The prevalence of speech disorders was higher than in males [16.7%] as compared to females [12.7%]. Pattern of prevalence of the three speech disorders was significantly different according to gender, parental education and by number of family member. There was no significant difference across speech disorders and birth order, religion and paternal consanguinity. These prevalence figures are higher than more studies that using parent or teacher reports