Comparing the effect of body wash with marshmallow plant and lukewarm water on reducing the temperature of febrile children: a randomized clinical trial.

BACKGROUND: Fever is the most common reason for children's visits to medical centers. Its management is an essential duty of a pediatric nurse. The aim of this study was to determine the effect of body wash with Marshmallow plant on children's fever. METHODS: This parallel clinical trial was performed on 92 children aged 6 months to 10 years with a tympanic temperature above 38.3 °C. Participants were randomly assigned to groups. Simultaneously with receiving acetaminophen, body wash was performed in the control group with lukewarm water and in the intervention group with white Marshmallow extract. The children's temperature; from the beginning of the study was checked and recorded every 15 min in the first hour and in the 4th and 6th hours. The time duration to resolve fever, the frequency of afebrile children at different times of the study, and the value of temperature reduction were primary outcomes. Heart rate, the need to administer the next dose of acetaminophen, and the time of fever recurrence were recorded as secondary outcomes. RESULTS: The mean time duration to resolve fever in the intervention group was shorter than in the control group (B = 8.181, 95% CI 3.778-12.584, p < 0.001). The frequency of the children without fever was higher in the intervention group during different times of the study (p < 0.001). The mean value of temperature reduction in the intervention group was higher than the control group (B = -0.27 °C, 95% CI: -0.347 to -0.193, P < 0.001), although, after adjusting the effect of confounding variables it was not significant (P = 0.127). The mean of adjusted heart rate change (p = 0.771), the time of fever recurrence (P = 0.397), and the frequency of children requiring the next dose of acetaminophen (p = 0.397) did not show a significant difference between the groups. CONCLUSION: Body wash with Marshmallow extract reduced children's fever in a shorter period of time and to some extent a greater extent than the control group without side effects. Therefore, it can be used as an effective and safe complementary method to help reduce fever. However, more studies are necessary for this field. TRIAL REGISTRATION: Registration in Iranian Clinical Trials (RCTs) on 31.08.2020 with registration code: IRCT20200809048345N1.

Transient abnormal myelopoiesis in pediatrics with trisomy 21.

Transient abnormal myelopoiesis is common among Down syndrome patients. Although no therapeutic measures are required, close monitoring of comorbidities such as gastrointestinal bleeding is required. Long-term follow-up is promising for a healthy future and reduced requirement of unnecessary therapeutic measures including chemotherapy and remission of the pathology.

Dyserythropoiesis and myelodysplasia in thiamine-responsive megaloblastic anemia syndrome.

The case of thiamine-responsive megaloblastic anemia (TRMA) presented here speculates the need early diagnosis, continuous monitoring, follow-up, and regulated treatment plan for the patients. Complications and systemic manifestations are likely to enhance in otherwise circumstances.

Promethazine and Oral Midazolam Preanesthetic Children Medication.

AIMS: Several kinds of drugs have been investigated in preschool children as a preanesthetic sedation after various routes of administration for surgeries. This study aims to compare the efficacy of promethazine and oral midazolam for premedication in children aged 3 to 9 years who were scheduled for surgeries. METHODS: This is a double-blind randomized controlled study conducted on 93 patients between the age of 3 and 9 years at Loresten University of Medical Sciences Teaching Hospital, Khoramabad, Iran. The subjects were grouped into P (promethazine), M (midazolam), and C (control). About 0.3 mg/kg of oral promethazine was administered to patients in group P, 0.5 mg/kg of oral midazolam was administered to patients in group M, and 3 mL of normal saline as placebo was administered to patients in group C. Patient satisfaction, sedation and emotional score, systolic blood pressure (SBP), diastolic blood pressure, respiratory rate (RR), and heart rate (HR) were recorded. RESULTS: There was no statistically significant difference among the 3 groups. However, the period after medication, it was observed that SBP, diastolic blood pressure, RR, and HR in group C were statistically significantly higher than those in groups M and P. These 2 groups are similar in terms of SBP, RR, and HR. The emotional scores were comparable for the 2 groups. It was between 3.97 ± 0.6 to 1.7 ± 0.5 in group M and from 3.45 ± 1.17 to 2.745 ± 0.997 in group P in a Kruskal-Wallis test. CONCLUSIONS: This study shows that both test groups reduce stress at the time of anesthetic induction and separation from their parents with similar effect. Both of the anesthetics are easily administered without the necessity of an additional equipment. A shorter period to maximal sedation for midazolam is an advantage, thus, making the drug helpful, mostly in the outpatient setting.

A 10-year prevalence of congenital hypothyroidism in Khorramabad (Urban Western Iran).

BACKGROUND: Congenital hypothyroidism in infants is the cause of mental retardation in children, it can be detected in patient and treated at a relatively cheap rate, preventing patient retard. This study aimed to determine the prevalence of congenital hypothyroidism among Khorramabad children. METHODS: In the present study, we identified all patients who had received levothyroxine prescriptions during the study period (2007-2017). Using this as a congenital hypothyroidism surrogate marker, we considered the congenital hypothyroidism prevalence in children above 3 years. RESULTS: Of 574 patients who had received levothyroxine during the neonatal period up to 3 years, the results of one-variable logistic regression analysis showed that the chance of temporary disease in children with small thyroid ultrasonography was 62% less, than for those without problems, and this difference was significant. The chance of temporary disease in children who had other cases was 87% less than those without problems, and this difference was statistically significant. CONCLUSION: The overall prevalence of congenital hypothyroidism in young patients up to 3 years is 0.143%, these values are at least twice those of previous estimates. This proposes an elevation in autoimmune thyroid disease, which is similitude to the rising prevalence of diabetes type 1, which possibly indicates a rising incidence of autoimmunity in youth.

Leukocytosis in patients with favism and association with blood transfusion.

INTRODUCTION: Leukocytosis is a condition marked by abnormal increase in leukocyte count due to an inflammatory response as a defense against most of the infections, or bone tumors; including leukemia. The aim of this study is to analyze the effect of blood transfusion in leukocytosis patients with favism as compared to patients treated with antibiotics or combination of both. METHODS: A total of 97 patients with favism who were referred to the University hospital in 2016-2017 were studied. KEY FINDINGS: These patients experienced acute hemolysis following beans meal. These patients were either treated with blood transfusion, antibiotics or combination of both. CONCLUSIONS: This study shows that blood transfusion is an effective therapeutic option for the treatment of leukocytosis. Antibiotics are not deemed necessary for the treatment and blood transfusion alone, can decrease leukocytes to the normal level.

Pentalogy of Cantrell in Full Term Neonate.

Pentalogy of Cantrell (PC) is an uncommon congenital disorder characterized by severe defects in the chest and abdomen, including abdominal visceral prolapsed via umbilical cord (omphalocele), defect in the lower part of the sternum, defect in the front of the diaphragm, defects in the anterior part of the pericardium, and the ectopiacordis. Here, we report a 2-hour-old girl, weighing 3,500 g, who was referred to Shahid Madani Hospital in Khorramabad due to the large omphalocele on her chest with pulsating mass above it. The baby was the first child of a 24-year-old mother who was born with an uncomplicated vaginal delivery. Very rare cases of PC are born as a term new-born.

Mermaid Syndrome: A Case Report of a Rare Congenital Anomaly in Full-Term Neonate with Thumb Deformity.

The mermaid syndrome (sirenomelia) is an extremely rare anomaly, an incidence of 1 in 100,000 births, in which a newborn born with legs joined together featuring a mermaid-like appearance (head and trunk like humans and tail like fish), and in most cases die shortly after birth. Gastrointestinal and urogenital anomalies and single umbilical artery are clinical outcome of this syndrome. There are two important hypotheses for pathogenesis of mermaid syndrome: vitelline artery steal hypothesis and defective blastogenesis hypothesis. The cause of the mermaid syndrome is unknown, but there are some possible factors such as age younger than 20 years and older than 40 years in mother and exposure of fetus to teratogenics. Here, we introduced 19-year-old mother's first neonate with mermaid syndrome. The mother had gestational diabetes mellitus and neonate was born with single lower limb, ambiguous genitalia, and thumb anomalies, and 4 days after birth, the neonate died due to multiple anomalies and imperforated anus.

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup.

AIMS: Croup is a clinical syndrome which included inspiratory stridor, coughing with a dog-like sound, noise obstruction and respiratory distress symptoms. This present study was conducted to compare the effects of cold drink and dexamethasone, and the effects of their co-administration on children's croup. MATERIALS AND METHODS: In this study, all patients with croup admitted to the emergency ward of Madani Hospital Khorramabad were divided through the simple randomized method into 3 groups after informed consents were taken from their parents. The first group was given cold drink, second group with dexamethasone (DM), and the third group were given the combined treatment simultaneously. The patients in the first and second groups who did not show signs of improvement received the simultaneous treatment similar to the third group. The data were analyzed using the SPSS software through descriptive statistics and inferential statistics including multi-field variance analysis and co-variance analysis. RESULT: The results of the study indicated a statistically significant between the 3 group in terms of improvement time-scale of croup clinical symptoms (P=0.001). There was no significant difference observed between the effects of other variables on improvement time-scale of croup clinical symptoms. CONCLUSION: The cold drink has less treating effect than DM and combined simultaneous treatment method. Also, DM had more influence than simultaneous treatment method. In addition, other variables including age, sex, birth weight, BMI, respiratory allergy and previous croup history did not influenced improvement time-scale and only type of intervention influenced improvement time-scale of croup clinical symptoms.