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1.
Abeer Atef El Ashmawi Nayera E. Hassan Waheeba Ahmed Zarouk Marwa Farouk Mira Aya Khalil Sahar A. El-Masry Gamila S.M. El-Saeed Mohamed S. El Hussieny Omar Hosni Dwidar 《The Gazette of the Egyptian Paediatric Association》2018,66(3):71-77
Central obesity is an important predictor of all-cause mortality. Children of obese parents bear a greater risk to develop obesity themselves.
Objective
To find possible correlations in central obesity and other cardio-metabolic parameters between mother and daughter.Subjects and methods
The current study measured anthropometric, laboratory, radiologic and genetic data for 120 centrally obese mothers and their 200 daughters aged from 12 to 18?years old.Results
Twenty-two percent of the daughters was overweight, 15.5% obese and 30% had central obesity. Genotype E3/E4 of apolipoprotein E was the most frequent genotype in mothers group (38.3%) and daughters with visceral obesity (46.7%) while E3/E3 was the most frequent genotype in daughters group without visceral obesity (42.9%). In both mothers and daughters, disturbed lipid profile was found in those with E3 allele, while increased BMI and weight were found among those with alleles E2 and E4 respectively. Daughters genotype E3/E4 had the highest significant values of most of the studied anthropometric measurements and lipid profile, while mother's genotype E4/E4 had the highest significant values of most of the studied anthropometric measurements and insulin.Conclusion
A key role could be played by the mother in the primary prevention of central obesity due to the consistent association of central obesity indices between mothers and daughters. 相似文献2.
Mousa Ahmadpour-Kacho Nesa Asnafi Maryam Javadian Mahmood Hajiahmadi Nazila Taleghani 《Iranian journal of pediatrics.》2010,20(4):401-406
Objective
The Apgar score as a proven useful tool for rapid assessment of the neonate is often poorly correlated with other indicators of intrapartum neonatal well-being. This study was carried out to determine the correlation between umbilical cord pH and Apgar score in high-risk pregnancies.Methods
This is a prospective cross-sectional, analytic study performed on 96 mother-fetal pairs during 2004-2005 at Shahid Yahyanejad Hospital, which is affiliated to Babol University of Medical Sciences. Apgar score at 1 and 5 minutes after birth was taken and an umbilical cord blood gas analysis was done immediately after birth in both groups. Mothers came with a labor pain and were divided into high-risk and low risk if they have had any perinatal risk factors. Other data like gestational age, birth weight, need for resuscitation and admission to the newborn ward or Neonatal Intensive Care Unit was gathered by a questionnaire for comparison between the two groups. P-value less than 0.05 was considered being significant.Findings
The gestational age and birth weight were the same in high-risk and low risk mothers. Mean umbilical artery blood pH in high-risk mothers was significantly lower than in low risk mothers (P=0.004). Mean Apgar scores at 1 and 5 minutes were significantly lower in high-risk mothers than in low risk mothers (P<0.05). According to the Kendal correlation coefficient there was no significant correlation between Apgar score at 1 and 5 minutes and umbilical cord pH in low risk group (r=0.212, P=0.1). But in high-risk group there was significant correlation between Apgar score at 1st and 5th minute and the umbilical cord pH (r=0.01, P=0.036 and r=0.176, P=0.146, respectively).Conclusion
Combination of Apgar score and umbilical cord pH measurement in high-risk pregnant mother could better detect jeopardized baby. 相似文献3.
Pelin Ertan Havva Evrengul Serkan Ozen Sinan Emre 《Iranian journal of pediatrics.》2012,22(4):543-546
Background
Nephropathic cystinosis is an autosomal recessively inherited metabolic disorder presenting with metabolic acidosis, Fanconi syndrome and renal failure.Case Presentation
We present a 6-year-old girl with severe growth failure, hyponatremia and hypokalemia. Her parents were 4th degree relatives. Two relatives were diagnosed as end stage renal failure. She also had persistant hypokalemic hypochloremic metabolic alkalosis. Her renal function was normal at presentation. She was thought to have Bartter syndrome with supporting findings of elevated levels of renin and aldosterone with normal blood pressure, and hyperplasia of juxtaglomerular apparatus. Her metabolic alkalosis did not resolve despite supportive treatment. At 6th month of follow-up proteinuria, glucosuria and deterioration of renal function developed. Diagnosis of cystinosis was made with slit lamp examination and leukocyte cystine levels. At 12th month of follow-up her metabolic alkalosis has converted to metabolic acidosis.Conclusion
In children presenting with persistant metabolic alkalosis, with family history of renal failure, and parental consanguinity, cystinosis should always be kept in mind as this disease is an important cause of end stage renal failure which may have features mimmicking Bartter syndrome. 相似文献4.
Maliheh Kadivar Bahareh Yaghmaie Bahar Allahverdi Leila Shahbaznejad Nosrat Razi Ziba Mosayebi 《Iranian journal of pediatrics.》2013,23(4):458-466
Objective
Apparent Life-Threatening Events (ALTEs) is an episode that is frightening to the observer and is characterized by some combination of apnea, color change, altered muscle tone, choking, and gagging. This study was designed to evaluate and follow up neonates who presented with clinical manifestation of an ALTE in a year.Methods
In this prospective observational study, all of the neonates with episode of ALTE who were admitted to the Children''s Medical Center (CMC) in Tehran, from June 15th 2010 to May 14th 2011 were enrolled in the study. Data from patients consisting of history, physical examinations, and paraclinical findings were recorded in a checklist and all followed up 3 to 6 months after discharge.Findings
During the study period 18 neonates were admitted due to ALTE episode(s) with mean age of 15±13 days. Nine (50%) neonates had previous attacks of ALTE. The most frequent complaint was cyanosis in 12 (67%) and apnea in 8 (44%) patients. In 10 (56%) the event lasted less than one minute, 13 (72%) were awake, 17 (95%) in supine position and 13 (72%) on their parent''s lap. Primary antagonistic impression on admission was sepsis in 11 (61%) and concomitant seizure in 5 (28%). The most common final diagnosis according to repeated physical examinations, result of paraclinical investigations and follow up was sepsis 4 (22%) and aspiration 9 (50%). ALTE recurred in none of the neonates during follow up.Conclusion
The rate of ALTE seems to be higher than in this study owing to high incidence of recurrent ALTE. Although most of these attacks regress spontaneously, more attention should be paid for the underlying diseases. 相似文献5.
Riddoch CJ Mattocks C Deere K Saunders J Kirkby J Tilling K Leary SD Blair SN Ness AR 《Archives of disease in childhood》2007,92(11):963-969
Objective
To measure the levels and patterns of physical activity, using accelerometers, of 11‐year‐old children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC).Design
Cross‐sectional analysis.Setting
ALSPAC is a birth cohort study located in the former county of Avon, in the southwest of England. This study used data collected when the children were 11 years old.Participants
5595 children (2662 boys, 2933 girls). The children are the offspring of women recruited to a birth cohort study during 1991–2. The median age (95% CI) of the children is now 11.8 (11.6 to 11.9) years.Methods
Physical activity was measured over a maximum of 7 consecutive days using the MTI Actigraph accelerometer.Main outcome measures
Level and pattern of physical activity.Results
The median physical activity level was 580 counts/min. Boys were more active than girls (median (IQR) 644 (528–772) counts/min vs 529 (444–638) counts/min, respectively). Only 2.5% (95% CI 2.1% to 2.9%) of children (boys 5.1% (95% CI 4.3% to 6.0%), girls 0.4% (95% CI 0.2% to 0.7%) met current internationally recognised recommendations for physical activity. Children were most active in summer and least active in winter (difference = 108 counts/min). Both the mother and partner''s education level were inversely associated with activity level (p for trend <0.001 (both mother and partner)). The association was lost for mother''s education (p for trend = 0.07) and attenuated for partner''s education (p for trend = 0.02), after adjustment for age, sex, season, maternal age and social class.Conclusions
A large majority of children are insufficiently active, according to current recommended levels for health.Regular physical activity in children is associated with improved health.1,2,3 A recent systematic review of the evidence relating physical activity to health concluded that children should spend at least 60 min in moderate to vigorous physical activity (MVPA) each day, in order to promote a broad range of health improvements.3 Few studies4,5,6 worldwide have collected objective physical activity data in large samples of children and we lack population‐based objective data describing levels and patterns of children''s activity. Nevertheless, physical activity is frequently implicated in the escalating levels of type 2 diabetes7 and obesity8,9,10,11,12 in children. We report here on objectively measured physical activity levels and patterns in a large contemporary cohort of 11‐year‐old children—the Avon Longitudinal Study of Parents and Children (ALSPAC). 相似文献6.
BACKGROUND:
Little is known about physical activity (PA) in young children and about the relationship between their PA and that of their parents.OBJECTIVE:
The main purpose of the present study (Y-Be-Active) was to examine the daily PA levels of young children and their parents, and to explore the relationship between children’s and parents’ PA.METHOD:
Fifty-four children (mean age 4.3 years) and their parents (54 mothers, mean age 35.8 years; 50 fathers, mean age 38.2 years) wore accelerometers for three weekdays and two weekend days. Parents also completed questionnaires on family sociodemographics and PA habits.RESULTS:
Children spent most of their time in light PA. Almost all children attained 30 min of daily moderate-to-vigorous PA (MVPA), and most boys and girls attained 60 min of daily MVPA on weekdays. Only 60% of fathers and approximately one-half of mothers attained 30 min of daily MVPA on weekdays and weekend days. Children’s and fathers’ PA were correlated on weekends. Few parents (20% to 30%) participated regularly in organised PA with their child. Fathers’ involvement in PA with their children was associated with higher MVPA in children.CONCLUSIONS:
Many young children and parents did not meet current Canadian recommendations for daily PA. Parental involvement in PA with their young children, particularly the involvement of fathers, appeared to promote higher levels of MVPA in young children. 相似文献7.
Shohreh Maleknejad Abtin Heidarzadeh Morteza Rahbar Afshin Safaei Babak Ghomashpasand 《Iranian journal of pediatrics.》2013,23(4):417-422
Objective
Constipation is a major debilitating problem in children. We aimed to assess the serum lead levels of 2-13 year-old children complaining from constipation who referred to our center in Guilan province, Northern Iran.Methods
This cross-sectional study was done on ninety 2-13 year-old children referring to 17th Shahrivar Hospital, complaining from constipation (case group) and 90 healthy children The demographic data as well as the children''s serum lead levels were evaluated and recorded. Data were analyzed using SPSS software. Chi-square test was used as applicable.Findings
Lead poisoning was significantly more frequent in the case group (37.8%) compared with the control group (8.9%). The frequency of lead poisoning in the case group compared with the control group, was significantly higher in children <7 years old (40.2% vs. 10%), boys (40.9% vs. 9.3%), girls (34.8% vs 8.3%), residents of old houses (43.1% vs. 9.7%), residents of new houses (28.1% vs. 8.5%), residents of low-traffic areas (26.8% vs. 5.3%), urban residents (40.5% vs. 9.9%), children whose fathers had low risk (33.3% vs. 10.9%) and high risk jobs (40.7% vs. 3.8%).Conclusion
The frequency of lead poisoning was higher in children suffering from constipation.No significant difference was found between the two groups with respect to their sex, age, father''s job, and living in urban or rural areas. 相似文献8.
Amit Agrawal Sudhakar Ratanlal Joharapurkar Ata-Ullah Khan 《Iranian journal of pediatrics.》2010,20(1):118-122
Background
Only few reported cases of tectocerebellar dysraphia with occipital encephalocele have been reported in the literature.Case Presentation
Three month baby boy, the first child of healthy, consanguineous parents presented with a small swelling over the occipital region since birth. The child also used to have apneic spells without cyanosis and spontaneous recovery. CT scan showed absence of the cerebellar vermis, absence of tectum and the 4th ventricle communicating with the occipital menigocoele sac and an occipital bone defect. The excision of the encephalocoele sac was performed, however the child continued to have apneic spells and did not do well.Conclusion
In our child irregular respiration probably was the manifestation of the tecto-cerebellar dysraphia syndrome complex and associated shunt malfunction followed by seizures decompensated the physiology of the child leading to fatal outcome. 相似文献9.
Antonio Marte Alfonso Papparella Lucia Pintozzi 《African Journal of Paediatric Surgery》2015,12(4):227-231
Background:
Minimally invasive surgery is the current approach to perform heminephroureterectomy (HN) in children. This can be obtained through a transperitoneal (TP) or a retroperitoneal approach. Here, we report our experience using a TP approach.Materials and Methods:
From 2005 to 2014, 22 TP laparoscopic upper poles HN were performed at our institution. There were nine girls and 13 boys aged between 20 months and 6 years (mean age 3.9). Eight patients were diagnosed prenatally, 17 patients presented with urinary tract infection (UTI) and three with vomiting and failure to thrive. The indication for HN was reflux nephropathy and UTI in non-functioning upper pole in 19 patients and cystic dysplasia in 1 patient. The surgical technique involved the following steps: Cystoscopic recognition; positioning of 3-4 trocar (right HN); identification of the kidney (detachment of the colon); isolation and low ligation of the dilated ureter; decrossing from renal vessels; section of the parenchyma by LigaSure; haemostasis with clips and LigaSure; drain.Results:
The mean operative time was 154 min (range: 81-220 min). All patients were discharged from the 2nd to 4th day. Neither major complication nor conversion was recorded. 1 patient presented leakage of urine for 7 days from the drainage which resolved spontaneously. At ultrasound follow-up, 5 patients showed a secondary perirenal cyst, 2-5 cm diameter that resolved spontaneously.Conclusion:
The results indicate that laparoscopic upper pole heminephrectomy is the treatment of choice in cases of non-functioning dilated lower segments of duplicated kidneys. The use of laparoscopic approach offers a good working space, a good visual control of the vessels and allows a very low isolation of the ureteral stump which counterbalance the peritoneal violation.Key words: Duplex kidney, heminephrectomy, infants, laparoscopy 相似文献10.
Ma. Martha Vela-Huerta Norma Amador-Licona Susana Anaya-Aguirre Juan Manuel Guizar-Mendoza Ana Velazquez-Bustamante Blanca Murillo-Ortiz 《Iranian journal of pediatrics.》2012,22(4):475-480
Objective
Intensified management of gestational diabetes mellitus can normalize birth weight. However, it is still unknown whether intrauterine exposure to maternal diabetes is a risk factor for changing hormone levels involved in the development of insulin resistance in these infants. We compared insulin and leptin levels in appropriate for gestational age (AGA) infants of diabetic and non diabetic mothers.Methods
We performed a cross-sectional study in the department of Neonatology of the Hospital of Gynecology-Pediatrics, in Leon, Mexico. We evaluated 182 full term AGA newborns (86 infants of diabetic and 96 of non-diabetic mothers). A venous blood sample was taken from cord blood immediately after the separation of the placenta and glucose, insulin and leptin levels were measured. In all diabetic mothers HbA1c was also evaluated immediately post-partum.Findings
Leptin, insulin and insulin resistance index were significantly higher in infants of diabetic mothers. Leptin levels were positive correlated with insulin, parents‘ body mass index and age in the entire group. In infants of diabetic mothers only insulin levels showed a significantly correlation, whereas in those of non-diabetic mothers only mothers‘ age was significantly correlated with leptin levels.Conclusion
AGA infants of diabetic mothers showed higher leptin, insulin levels and insulin resistance index than those of non-diabetic mothers. 相似文献11.
Andreas Chiabi Marlene Djoupomb Evelyne Mah Seraphin Nguefack Lawrence Mbuagbaw Joseline Zafack Madeleine Ghoyap Thérèse Nkoa Pierre Fernand Tchokoteu 《Iranian journal of pediatrics.》2011,21(4):441-448
Objective
Sepsis is an important cause of morbidity and mortality in neonates especially in developing countries where identification of the germs and treatment is often unsatisfactory. The aim of the study was to assess the clinical presentation, and bacteriological profile of neonatal infections, and the sensitivity of the causative germs to antibiotics.Methods
We carried out a prospective analytic study in the Yaounde Gynaeco-Obstetric and Pediatric Hospital in Cameroon over a 6 months period from 18th November 2008 to 18th May 2009. On the basis of history and/or clinical findings and paraclinical investigations, 218 neonates out of a total of 628 admissions were investigated and managed for neonatal infection.Findings
The most frequent symptoms were fever (44.95%), refusal to feed/irritability (32.11%), and respiratory distress/cough (28.90%). Premature birth and prolonged rupture of membranes were the most frequent risk factors. Klebsiella spp, Escherichia coli and Enterobacter spp were the most frequent germs identified in respectively 28.6%, 21.4% and 14.3% of the positive samples. Overall sensitivity of the cultures to ampicillin, netilmicin and gentamycin was poor at 29.4%, 31.4% and 18.9% respectively, whereas imipenem, ofloxacin, ciprofloxacin and ceftazidime had the best sensitivities in 91.7%, 90%, 85.3% and 69.4% of the cultures respectively. The mortality rate was 22%, and low birth weight, premature birth and septicemia were significant risk factors for death.Conclusion
Mortality from neonatal sepsis in this context is still high and there is an upsurge of multi-resistant germs to currently used antibiotics, calling for the need for rational use of antibiotics in the management of these infections. 相似文献12.
Seyed-Ali Jafari Atieh Mehdizadeh-Hakkak Hamid-Reza Kianifar Paria Hebrani Hamid Ahanchian Elaheh Abbasnejad 《Iranian journal of pediatrics.》2013,23(6):669-674
Objective
Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota and dysregulated immune mediators due to massive exposure to antibiotics. Probiotics as immunomodulatory and anti-inflammatory substances are considered to improve both clinical and biochemical intestinal and pulmonary function in CF patients. We decided to investigate the effects of probiotics on quality of life and pulmonary exacerbations in children with cystic fibrosis.Methods
In a prospective, randomized, controlled clinical trial, 37 CF patients (2-12 years old) were randomly divided into two groups. 20 patients of probiotic group took probiotics (2×109CFU/d) for one month while 17 patients of control group took placebo capsules. Quality of life was determined using PedsQL™4.0 questionnaire at the beginning, then three and six months after completing the treatment period. Rate of pulmonary exacerbation in probiotic group patients was also evaluated during three months after intervention and compared to the same three months of the previous year. Results were analyzed using SPSS (11.5). P<0.05 was considered statistically significant.Findings
Significant improvement was observed in the mean total score of parent reported quality of life among probiotic group patients in comparison with placebo group at 3rd month (P=0.01), but this was not significant at 6th month of probiotic treatment. Rate of pulmonary exacerbation was significantly reduced among probiotic group (P<0.01).Conclusion
Probiotics are considered as useful nutritional supplements on reducing number of pulmonary exacerbations and improving quality of life in patients with cystic fibrosis. Effects of probiotics seem to be temporary and probably continuous ingestion might have more stable improving effects on quality of life. 相似文献13.
Ali Rabbani Mohammad-Esmaeil Motlagh Kazem Mohammad Gelayol Ardalan Farzaneh Maftoon Safiyeh Shahryari Shahnaz Khodaei Aria Sotoudeh Mohammad-Reza Mohammadi Javad Mahmoudi Gharaei Hassan Zia-aldini Kobra Kamali Moluk Motaghian Kheironesa Mostakhdemin Hosseini Ali Salavati Ahmad Rabbani Nima Parvaneh 《Iranian journal of pediatrics.》2010,20(2):160-166
Objective
We estimated pubertal development of 7,493 normal Iranian girls aged 6 to 20 years in a cross-sectional study.Methods
Pubertal stages were assessed according to Tanner. The mean ages to achieve secondary sexual characteristics as well as the mean age at menarche were estimated. Weight and height were measured and body mass index (BMI) was calculated. Reference curves for different breast stages and menarche were constructed. The percentiles for attaining each stage were compared to data proposed by Tanner.Findings
The mean age at breast bud stage (B2) was 10.10, pubic hair stage (P2) was 9.83, and menarche age was 12.55 years. The anthropometric variables were interpreted in different maturity stages. The mean age at attainment of puberty was compared with those of other populations.Conclusion
Not only the onset of puberty in Iranian girls but also the duration of puberty is similar to data from most other countries. A lower age limit for the definition of precocious puberty than the traditional 8 years is documented for Iranian girls. However, it should be noted that considering the rate of evolution of pubertal findings is more important than the age of their appearance. 相似文献14.
Background
Fully understanding the determinants and sequelae of fetal growth requires a continuous measure of birth weight adjusted for gestational age. Published United States reference data, however, provide estimates only of the median and lowest and highest 5th and 10th percentiles for birth weight at each gestational age. The purpose of our analysis was to create more continuous reference measures of birth weight for gestational age for use in epidemiologic analyses.Methods
We used data from the most recent nationwide United States Natality datasets to generate multiple reference percentiles of birth weight at each completed week of gestation from 22 through 44 weeks. Gestational age was determined from last menstrual period. We analyzed data from 6,690,717 singleton infants with recorded birth weight and sex born to United States resident mothers in 1999 and 2000.Results
Birth weight rose with greater gestational age, with increasing slopes during the third trimester and a leveling off beyond 40 weeks. Boys had higher birth weights than girls, later born children higher weights than firstborns, and infants born to non-Hispanic white mothers higher birth weights than those born to non-Hispanic black mothers. These results correspond well with previously published estimates reporting limited percentiles.Conclusions
Our method provides comprehensive reference values of birth weight at 22 through 44 completed weeks of gestation, derived from broadly based nationwide data. Other approaches require assumptions of normality or of a functional relationship between gestational age and birth weight, which may not be appropriate. These data should prove useful for researchers investigating the predictors and outcomes of altered fetal growth.15.
Alireza Fahimzad Masoomeh Taherian Reza Dalirani Ahmadreza Shamshiri 《Iranian journal of pediatrics.》2010,20(1):97-100
Objective
Urinary tract is one of the most common sources of infection in children under the age of two years. Many known and unknown risk factors predispose to this important disease in children. This study was conducted to determine whether using a specific type of diaper plays a role in urinary tract infection (UTI) in girls under the age of 2 years.Methods
This case control study was performed in hospitalized children; girls with their first urinary tract infection were selected as cases, and those admitted for other reasons comprised the control group. Two groups were matched for age (±1 month), and other known risk factors for UTI. Type of diapers (superabsorbent, standard disposable and washable cotton), used for these children during six months, from October 2007 to March 2008, were compared in both groups.Findings
59 matched pair infant girls less than 2 years were selected. It was revealed that in cases with UTI superabsorbent diapers were used more frequently than in controls (Odds ratio=3.29, P-value=0.005) There were no significant differences in other factors like number of diapers used per day, the time between defecation and diaper change, mothers’ educational level, level of family income and mother''s occupation.Conclusion
The use of superabsorbent diapers could be a risk factor for urinary tract infection in infant girls. 相似文献16.
17.
Objective
Comparing the effect of topical human milk application and dry cord care on cord separation time.Methods
This research was a randomized clinical trial study on 130 singleton and mature newborns. Newborns were placed randomly in groups of topical application of human milk and dry cord care. The umbilical separation time was compared in the two groups. Data was analyzed by SPSS software. Independent Samples t-Test, χ2, Fisher were used in this study.Findings
Median time of cord separation in human milk application group (150.95±28.68 hours) was significantly shorter than dry cord care group (180.93±37.42 hours) (P<0.001).Conclusion
Topical application of human milk on the remaining part of the cord reduces the cord separation time and it can be used as an easy, cheap and non invasive way for cord care. 相似文献18.
19.
Sandeep Budhiraja Daljit Singh Puneet A. Pooni Gurdeep S. Dhooria 《Iranian journal of pediatrics.》2010,20(1):82-90
Objective
Lung function tests have become an integral part of assessment of pulmonary disease. As few studies on pulmonary function tests have been carried out in young children in India, the study was carried out in normal urban and rural school children in Ludhiana district of North India to determine pulmonary functions in the age group 6–15 years and to find its correlation with regards to age, sex, height and weight.Methods
The study group included 600 normal children between 6–15 years age from different urban and rural schools in the region. A preformed questionnaire was interviewed and detailed general physical and systemic examination was done. Pulmonary function tests were measured by using Micromedical Gold standard fully computerized portable auto spirometer (Superspiro Cat No. SU 6000).Findings
The present study shows, all the three independent variables (age, weight and height) have linear positive correlation with lung function parameters, both for boys and girls. Lung function values in boys were significantly higher as compared to that of girls. Urban children had higher lung function parameters than rural children except IRV, FEF25%. Among all anthropometric parameters, height was the most independent variable with maximum coefficient of correlation.Conclusion
Equations derived from the present study for estimation of the expected values of lung function will help to interpret the observed lung function values in children of North India. 相似文献20.
Shahnaz Khaghani Hamid Ezzatpanah Najmeh Mazhari Mohammad Hadi Givianrad Hossein Mirmiranpour Fatemeh Shahi Sadrabadi 《Iranian journal of pediatrics.》2010,20(1):53-57