Risk factors associated with cerebral palsy in children born in eastern and northern districts of Tehran

Cerebral palsy is a group of non-progressive motor impairment syndromes caused by lesions of the brain arising early in development. In this study, we evaluated perinatal risk factors of children born in eastern and northern districts of Tehran city, when perinatal records were widely available. This was a case-control study performed on one to six year-old children living in Tehran, at healthcare centers of Shahid Beheshti University of Medical Sciences and Asma Rehabilitation Center, over 12 months. During the study period, 112 subjects in the case and 3465 in the control groups were studied. The main factors associated with cerebral palsy were [odds ratios, confidence interval]: neonatal convulsion [81.35, 35.09-188.6], low Apgar score [<5] at 5 min or beyond [21.83, 13.13-36.26], low birth weight [5.83, 3.47-9.77], mother's complication during pregnancy [7.83, 4.23-14.50] and maternal age over 35 years [3.88, 2.03-7.42]. Neonatal encephalopathy, low birth weight, and high risk pregnancy were the most powerful independent predictors of cerebral palsy in this population. The majority of infants with cerebral palsy were born at term; therefore, cerebral palsy is quantitatively mainly an issue of term infants

effects of health education through face to face teaching and educational movies, on suburban women in childbearing age

The aim of the study was to compare the effects of 'face-to-face education' and 'educational movies' on 'knowledge' and 'practice' of women of child-bearing-age, in terms of health-care during pregnancy and during infancy in a suburban region near Tehran City, Iran. In this quasi-experimental study, the sample included 873 married women. Questionnaires for knowledge and practice assessment were designed. The women were assigned to three groups: control [group I], face-to-face education [group II], and educational movie [group III]. Knowledge questionnaires were completed before and immediately after intervention. Practice questionnaires were completed before and three months after intervention. Both questionnaires consisted of two types of questions: type A [concerning infant care issues] and type B [concerning prenatal health care]. There was a significant difference in post-test knowledge between groups I and II and between groups I and III, but not between groups II and III. In terms of post-test practice, the changes were determined for every individual question, and significantly, better results were seen in group II, especially concerning type B questions. Face to face education lead to better practice than educational movies. In addition, significantly better practice occurred regarding child health care issues rather than prenatal issues in both groups. Realistic and tangible issues, those easy to practice, and with little or no economical burden imposed on the family, progressed from the knowledge state to the practice state more successfully in both groups

Muscle tonicity of children with spastic cerebral palsy: how effective is Swedish massage?

Massage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of Swedish massage on the muscle tonicity of children with spastic cerebral palsy [CP]. This study was a single blind clinical trial conducted on forty children with spastic CP, recruited from clinics of the University of Social Welfare and Rehabilitation Sciences. They were randomly assigned to intervention and control groups. Routine occupational therapy techniques were performed during a 3 monthperiod in both groups, while the intervention group also received Swedish massage for 30 minutes before every rehabilitation session. Muscle tonicity was evaluated at the beginning of the study and 3 months later using the Modified Ashworth Scale. The average ages of children in the intervention [n=13] and control [n=14] groups were 49.5 and 42.1 months respectively. Although after intervention, tonicity of upper and lower limbs, trunk and neck in the intervention group in comparison with controls had no significant differences, there were statistically significant differences in reduction rate of tonicity in upper limbs and trunk between the two groups [P <0.05]. Massage therapy is not a panacea for improvement of spasticity in children with CP but the encouraging results of other studies on children with CP indicate that further studies are needed for more definite results

Effect of lamotrigine on prophylaxis of pediatric classic migraine

This study was conducted to evaluate the preventive effect of lamotringine on migraine aura and migraine attacks in children, afflicted with classic migraine. Conducted between October 2005 and April 2008 in the neurology clinic of Kashani hospital, Shahrekord, this study was a clinical trial, aimed at evaluating the prophylactic effects of Lamotringine administered to 21 children suffering from migraine with aura. Of the subjects, 52.4% of patients were female. The most common type of aura was visual [42.9%]. Following use of Lamotrigine, significant reductions were seen in the frequency [from 5 +/- 0.83 to 3.04 +/- 1.65] and in intensity [from 6. 33 +/- 1.08 to 3.66 +/- 1.1] of migraine aura [P= 0.002]. After 6 months of drug usage 66.6% of patients were improved. Lamotringine is effective in reducing the migraine aura and intensity of attacks in patients suffering from migraine with aura, and is hence beneficial for prophylactic therapy in children with classic migraine

Motor developmental delay in 7500 Iranian infants: prevalence and risk factors

The purpose of this study was to determine the prevalence and the most common risk factors of motor developmental delay in infants. Following ethical approval, a study was carried out on the prevalence and risk factors of infants with motor developmental delay. The first stage was conducted through a cross-sectional study to determine the prevalence of motor developmental delay on 7500 infants and the second stage was an analytic case - control survey to identify the most common risk factors on 140 infants, aged one month to three years with motor developmental delay. Data was collected using a demographic questionnaire, the Parents Evaluation of Developmental Status questionnaire, the Denver Developmental Screening Test II, a neurological assessment form, and the movement and tone assessment form. The prevalence of motor developmental delay in 7500 infants was 18.7/1000. The most common risk factors in infants with motor developmental delay were prematurity [25.6%], low birth weight [19.2%], neonatal seizures [7.5%], hyaline membrane disease [6.7%], systemic infections of mothers during pregnancy [5.9%], severe neonatal hyperbilirubinemia [5%] in sequence. Motor developmental delay was significantly correlated with consanguinity of parents [p=0.001], prematurity [p=0.046], abnormal head circumference at birth [p=0.038], and low birth weight [p=0.026]. The prevalence of motor developmental delay appears to be high and further studies should focus on different preventive strategies, controlling the most common risk factors and emphasizing on early detection and treatment of high risk infants