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Background and Objectives: Congenital heart defects (CHDs) are the most common type of birth defect. Affected children and adolescents with CHD require special care in dentistry because of their susceptibility to infective endocarditis from poor oral hygiene infections. The purpose of this study was to design and evaluate a mobile-based educational oral health application for children and adolescents with CHD. Materials & Methods: This developmental study was conducted in 2021-2022 at the Pediatric Cardiovascular Research Center in Isfahan. My Structured Query Language (MySQL) system was used to design the database of educational oral health application. Also; the development phase was based on the Android platform. The design and development of a mobile-based educational oral health application was carried out in five stages, including analysis, design, development, implementation, and evaluation. A researcher-made questionnaire was used to evaluate the application. The statistical population of this was composed of 51 children and adolescents (3-18 years of age) with CHD and their parents. Results: The results of the evaluation of the usability of the educational oral health app from the children and adolescents' perspective with CHD showed that the "user-friendliness", "ease of use" and " educational impacts" of the app were evaluated as good. Conclusion: The usage of this mobile application can be useful in improving the oral and dental health of children and adolescents with CHD. [ABSTRACT FROM AUTHOR]

Background: Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome. Methods: This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data. Results: Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%. Conclusion: Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested.

Background: Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome. Methods: This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data. Results: Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%. Conclusion: Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested. [ABSTRACT FROM AUTHOR]

Background As congenital gastrointestinal diseases are pretty common and can lead to fatal consequences when combined with congenital heart diseases, we conducted a study in Iran to explore the relationship and prevalence of these two conditions. Our objective was to identify the types and frequency of congenital heart diseases in children who also have gastrointestinal anomalies. Materials and Methods: This was a cross-sectional analytical study. The research population was the patients referred to the Gastrointestinal Clinic of Hazrat Masoumeh Children's Subspecialty Hospital during the 2011-2017. In this study, the echocardiography in the patients’ files performed by a pediatric heart specialist was examined, and in the next step, the patients were divided into two groups with and without heart disorders. Gastrointestinal abnormalities were also recorded in the relevant checklist. Finally, the recorded information was entered into SPSS software version 22, and Chi-square and Fisher exact tests were used to compare the qualitative findings. The significant level for all tests was considered to be 0.05. Results: The average age of the children in this study was 7.93±7.74 months. 105 boys (54.7%) and 87 girls (45.3%) were examined. 167 children (87%) had cardiovascular abnormalities and 25 children (13%) had no abnormalities. The most common types of cardiovascular abnormalities were 69 (35.9%) septal defects, 36 (18.8%) atrial septal defects, and 22 (11.5%) pulmonary valve stenosis. The least frequent abnormalities were cardiomyopathy in three (1.6%) and ventricular inter-atrial septal defects along with atrial septal defects in one (0.5%) patient There was not a significant correlation between congenital heart diseases and frequency of closed anus, rectovaginal fistula, Hirschsprung, anal stenosis, rectal prolapse, perianal fistula, esophageal atresia, pyloric hypertrophy, intestinal obstruction, annular pancreas, biliary atresia, diaphragmatic hernia, Meckel's diverticulum.(P>0.05). A significant relationship was found only between omphalocele and pyloric hypertrophy with the presence of cardiovascular disorders (P<0.05). Conclusion: The results showed that congenital heart diseases have a high prevalence in infants with gastrointestinal anomalies, so cardiac examination is mandatory in all infants with gastrointestinal anomalies. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CH) is one of the most preventable causes of mental retardation throughout the world. The aim of this study was to evaluate the sensitivity and specificity of filter paper in screening for congenital hypothyroidism and to determine an appropriate cut-off point for filter TSH for recalling screened neonates. Methods: In this cross-sectional study (descriptive analytic), the records of 2739 neonates who had been recalled during the CH screening program in the east of Tehran, Iran (health care centers of the Iran University of Medical Sciences), from March 2011 to March 2015, were studied. According to the CH screening program in Iran, the TSH on filter paper>5 is the current cut-off point for recalling the neonates. The data was analyzed with SPSS software, version 21. The ROC curve was used to determine the TSH cut-off point and the sensitivity and specificity of the filter test. The relationship between the filter and serum TSH was also determined. The study was approved by the Ethics Committee of the Iran University of Medical Sciences. Results: The recall rate was 5.4%. The prevalence of hypothyroidism was 3/1000 neonates (164). The prevalence in males and females was 51.1% and 48.9%, respectively, with no significant difference. The number of recalled neonates diagnosed as patients with congenital hypothyroidism based on the filter TSH level was 5

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare genetic disease that is inherited as an autosomal recessive, and its cause is a genomic defect in tyrosine kinase; this disorder is mainly characterized by a lack of pain sensation, inability to sweat, and mental retardation.1 The probability of being born with this disease is about 1 in 125 million .2 The US National Institutes of Health puts the number of people with the disease at less than 5,000 in the United States. This institute has stated that about half of people with CIPA show signs of hyperactivity or emotional instability, and many people suffer from intellectual disabilities.2 Also, these patients are prone to multiple and frequent injuries, bruises, cuts, burns, bone fractures, and dislocations. In therapeutic and clinical conditions, to help the patient return to health faster, special exercises are designed and implemented with the opinion of experts.3 Performing these exercises is often associated with difficulties due to the patient's condition. To reduce these difficulties, virtual reality can be used in the rehabilitation of these patients. Virtual reality technology and video games can play a role in motivating and effective health care by creating simulated, motivating, interactive, and realistic environments. To date, the major applications of these technologies include medical simulation, telemedicine, medical education and health services, pain control, visualization for surgery, rehabilitation, and treatment of fear and trauma.4Since there is no treatment method for this disorder, encouraging patients to follow treatment instructions, raising awareness of health issues, monitoring and training patients for self-care in a remote manner, training people around and other caregivers, and continuous follow-up of their condition by nurses and other members of the health team can play an important role in reducing mortality in these people .5 In this field, health information technology can play an important and effective role. In recent years, mobile health technology has revolutionized the traditional way of providing health services by using wireless technologies such as Bluetooth, WiMAX, and Wi-Fi and sending text messages, data transfer, and access to various electronic health services. This has made it easier and provided a great opportunity for developing countries by saving scarce resources and telemedicine education, as well as health systems.5 Also, mobile applications have made it possible to record, transmit, and receive feedback anytime and anywhere, which facilitates remote monitoring and timely recommendations for healthcare. Mobile applications can also enhance self-care.6 Accordingly, considering the type of CIPA disease and the lack of suitable treatment for it, it seems that the use of mobile health technologies can bring many benefits, including long-term follow-up and care, reducing the significant financial burden for the patient, and healthcare systems. Transportation can increase personal empowerment and flexibility in life, and ultimately lead to significant positive effects on the quality of life of these patients.

Background: Congenital heart defects (CHD) are the most common type of birth defects. The main screening tests used to identify babies with congenital heart defects include prenatal echocardiography and postnatal clinical assessment. Routine pulse oximetry has been reported as an additional screening test that can potentially improve the early diagnosis of critical congenital heart disease (CCHD). Methods: This study is a multi-stage evolutionary study that was conducted for 12 months from March 2021 to March 2022 at Pediatric Cardiovascular Research Center in Cardiovascular Institute, Isfahan, Iran. In the first phase, after identifying the topic and aims of the present study, questions were designed through the PICO method including (population, intervention, control, and outcomes). Then conducting systematic searches, the quality of all existing clinical guidelines (CG) of this field were evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and a committee consisting of pediatric cardiologists and neonatologists in the field. Next, based on the opinions of experts, the quality of 1 out of 6 clinical guidelines for early detection of critical congenital heart disease at birth by pulse oximetry was assessed as optimal. Finally, the clinical guidelines draft was evaluated using the Delphi method and the panel of experts. After expert panel meetings and consensus between members, the final version of the guideline for early detection of critical congenital heart diseases at birth by pulse oximetry was developed. Results: In the present study, criteria of clinical practice regarding the stages of newborn screening by pulse oximetry at birth were determined based on the evidence and health conditions and were presented in twenty-eight recommendations and six sections. The final recommendations were presented in the results section. Conclusion: The finding of the present study showed that physicians, nurses, and midwives can apply the recommendations of this clinical guideline for the early detection and referral of neonates with critical congenital heart disease.

BACKGROUND: Stenotic nares and malocclusion are common congenital disorders in the brachycephalic breeds of cats which cause respiratory and oral problems in these breeds, respectively. OBJECTIVES: In this study, the prevalence of two congenital disorders, stenotic nares, and malocclusion, the correlation among them in brachycephalic breeds of cats referred to several private veterinary clinics in Tehran were evaluated. METHODS: 90 brachycephalic cats were evaluated for stenotic nares, and malocclusion and indices was checked, then determined the prevalence percentage and correlation with the statistical data between stenotic nares and malocclusion in brachycephalic breeds of cats were referred to several private veterinary clinics in Tehran. RESULTS: Malocclusion was diagnosed in 35 cats (38.9 %), stenotic nares were detected in 31 cats (34.4 %), and two diseases were diagnosed in 17 cats (18.9 %) concurrently in 90 brachycephalic cats. According to a statistical test, the probabilities of identifying the second disease are 2.7 times higher if one of the two disorders is identified. CONCLUSIONS: The prevalence of stenotic nares and malocclusion in brachycephalic cats is very high and there is a significant correlation between two disorders so clinicians should have great attention in their clinical examination of these two disorders in these breeds. [ABSTRACT FROM AUTHOR]

Background and Aim: Phenylketonuria is a genetic and congenital metabolic disorder with autosomal recessive transmission. In this disease phenylalanine is not converted to tyrosine due to lack of phenylalanine hydroxylase enzyme which results in increased phenylalanine level in the blood and brain. The aim of this study was to compare IQ scores between the children with phenylketonuria and healthy children referring to Besat Hospital in Sanandaj in 2017-2018. Material and Methods: This case-control study included all the patients referring to PKU and pediatric clinics who had been under treatment since birth as our case group , and healthy children referring to other pediatric clinics of the hospital as control group. Goodinow’s intelligence test was used to measure cognitive, mental abilities and childrenchr('39')s intelligence. Data were analyzed by chi square and independent t-test. Results: The results showed that 46 (69.7%) patients were male and 20 (30.3%) were female. The mean age of the subjects was 6.34±2.52 years. There was no significant difference in the IQ mean scores between the two groups (p>0.05). Conclusion: The most important clinical signs of this disease are mental retardation, microcephaly, behavioral disorders, seizure, limb stiffness, restlessness, unrest, hyperactivity, eczema and light colored skin and hair. Diagnosis of the disease before the third week of life, and proper nutritional therapy with necessary care before the age of one month can decrease the symptoms of the disease. Key words: PKU, IQ, Children

Background: Congenital heart diseases are the second group of congenital anomalies in infants. These disorders are a major cause of death in the first year of a child's life. Early detection helps to treat these diseases better. In this study cardiology consultations of hospitalized infants in the neonatal intensive care unit were evaluated. Methods: In this cross-sectional study, two hundred and fifty pediatric cardiology consultations conducted in Shahid Beheshti Hospital in the year 2012 were reviewed. Information such as the cause of consulting, delivery type, age of parents, relative couples, family history of congenital heart disease, maternal medications, maternal background diseases, the final diagnosis, and prognosis follow-up of the patients were recorded in a designed questionnaire. Finally, the data were entered into the SPSS software, version 16 (IBM SPSS, Armonk, NY, USA) and analyzed using descriptive statistics and chi-square test. P-value of less than 0.05 was considered significant. Results: The mean age of the consulted neonates was 4.845±5.14 days with a gestational age of 33.933±3.65 weeks. Male sex and cesarean section were the most frequent. Fifty-six percent of consulted infants were male. The present study revealed that prematurity (76%), murmurs (30.8%), respiratory distress syndrome (14.4%) and cyanosis (13.2%) were the most common causes of the cardiac consultation seeking among infants. Seventy-six percent of infants were consulted due to prematurity. Eighty-four percent of infants had a normal conditions. Septal defects (ventricular or atrial septal defect) and patent ductus arteriosus were the most common disease diagnosed with the prevalence of 27.5 and 17.5%, respectively. There was a significant relationship between preterm labor and congenital heart disease (P

Background: Congenital heart diseases are the second group of congenital anomalies in infants. These disorders are a major cause of death in the first year of a child's life. Early detection helps to treat these diseases better. In this study cardiology consultations of hospitalized infants in the neonatal intensive care unit were evaluated. Methods: In this cross-sectional study, two hundred and fifty pediatric cardiology consultations conducted in Shahid Beheshti Hospital in the year 2012 were reviewed. Information such as the cause of consulting, delivery type, age of parents, relative couples, family history of congenital heart disease, maternal medications, maternal background diseases, the final diagnosis, and prognosis follow-up of the patients were recorded in a designed questionnaire. Finally, the data were entered into the SPSS software, version 16 (IBM SPSS, Armonk, NY, USA) and analyzed using descriptive statistics and chi-square test. P-value of less than 0.05 was considered significant. Results: The mean age of the consulted neonates was 4.845±5.14 days with a gestational age of 33.933±3.65 weeks. Male sex and cesarean section were the most frequent. Fiftysix percent of consulted infants were male. The present study revealed that prematurity (76%), murmurs (30.8%), respiratory distress syndrome (14.4%) and cyanosis (13.2%) were the most common causes of the cardiac consultation seeking among infants. Seventy-six percent of infants were consulted due to prematurity. Eighty-four percent of infants had a normal conditions. Septal defects (ventricular or atrial septal defect) and patent ductus arteriosus were the most common disease diagnosed with the prevalence of 27.5 and 17.5%, respectively. There was a significant relationship between preterm labor and congenital heart disease (P<0.001). Additionally, prematurity associated with respiratory distress syndrome and using assisted reproductive techniques. Conclusion: The higher prevalence of congenital heart disease in the present study, compared with other studies, reflects the fact that cardiology consultation based on clinical suspicion leads to the more identification of congenital heart disease that means the right referral of newborns for consultation was accompanied with a higher incidence of heart failure. [ABSTRACT FROM AUTHOR]

Introduction: Superior oblique palsy (SOP) is the most common cause of paralytic strabismus. Therefore, this study aimed to compare the frequency, etiology and outcome of surgical approaches in SOP with other vertical strabismus. Methods: This is a cross sectional study that was performed on 303 medical files of patients who referred to Yazd eye clinic from 1999-2012 with at least 6 months post operative follow up. The study instrument involved a questionnaire containing 11 questions that was used for data gathering. Results: In this study, within 303 patients, 50 cases (16/5%) suffered from SOP (group A) and 253 cases from other vertical strabismus (group B).The most frequent causes of either group were congenital and trauma. The mean age of patients with congenital cause was 16/82 in group A and 12/81 years in group B while the mean age with traumatic cause was 24/63 in group A and 23/26 years in group B. Sixty percent (60%) of operated patients in group A underwent one set of surgery while in group B mostly had two sets of the surgery. The most common surgical approach in either group was IO Recession. The rate of strabismus correction was 71/5% in group A and 77/8% in group B. SCH, diplopia, conjunctivitis were the most frequent complications in either group. Conclusion: By one set surgical approach of IO Recession, strabismus correction is observed in the most patients with SOP or other vertical strabismus and the surgery was not followed by severe complications.

Background: Choledochal cyst is a congenital disease of hepatobiliary system. Patients with the disease differ in terms of gender and symptoms. In this study, we aimed to evaluate the patients from clinical signs and symptoms, diagnostic methods and treatment perspectives.Methods: In this retrospective study, we evaluated the data from the medical records of patients with choledochal cyst admitted in Ghaem and Omid hospitals affiliated to Mashhad University of Medical Sciences in Mashhad, Iran during 1994 to 2011.Results: The medical records of 23 (18 women and 5 men) patients were evaluated. The mean age of the patients was 24.6 years. The most common type of the disease was choledochal cyst type 1. The most common type of surgery performed in the patients, respectively was resection of biliary cyst, cholecystectomy and Roux-en-Y hepaticojejunostomy. No mortality was observed during the hospital stay or follow-up period. Surgical complications were minor and patients recovered by conservative measures.Conclusion: Regarding the favorable results of surgical treatment of choledochal cysts, timely and definite diagnosis of this congenital anomaly and proper planning for its surgery are of special importance.

"nBackground: Obstructive gastrointestinal (GI) malformations are one of the most important congenital problems and have different clinical manifestations, which depend on the severity and location. Although, complete obstructive lesions cause classic intestinal obstructive symptoms in infants, incomplete obstruction might be asymptomatic until adulthood and sometimes cause unusual symptoms, which need extensive work up. Moreover, this delay could produce significant complications. Near all of these lesions are surgically correctable; therefore awareness of this possibility is important in order to prompt appropriate management and referral plan. "nCase report: In this report, we introduce five infants who had congenital GI malformations with different presentations such as vomiting, hematemesis, growth failure and steatorrhea. Appropriate time of diagnosis caused surgical correction of lesions except in one patient with very unusual presentation who was diagnosed late. As a result, in this case, severe growth and developmental delay appeared. "nConclusion: Congenital gastrointestinal obstruction has different manifestations. Awareness can help to survive patients.

Introduction & Objective: Despite mild and self limited manifestation of rubella , involvement of fetus as a consequence of prenatal infection is very important and can lead to congenital rubella syndrome (Cs). The aim of this study was the evaluation of immunity rate against rubella virus in women who were in child bearing ages. Materials & Methods: This survey was performed with cooperation of health center on 248 cases of women who are offered for pre marriage serologic test and their titers of IgG antibody against rubella with Elisa method was measured. Results: Out of 248 specimens , 41 (16.5%) were non immune against rubella and 207 (83.5%) were immune. The frequency of immune serologic titer was highest in the age groupof 18-23 years and was lowest in the age group of 30-34 years. Of 138 cases that lived in the urban area, 121 cases (87.7%) were immune and 17 cases (12.3%) were non immune and out of 110 cases that lived in rural areas , 86 cases (78.2%) were immune and 24 cases (21.8%) were non immune. Education level of most women were graduated from high school (50.8%) , whereas the rate of illiterate women was least (1.6%). In this study nobody had a history of vaccination against rubella and 16 cases (6.5%) had a history of rubella infection. Conclusion: On the basis of this study 83.5% of subjects in studied group were immune against rubella and 16.5% were non-immune. This study showed that women in child bearing ages should be checked for rubella and vaccinated against it, if they are non immune.

Background and purpose: The congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. The incidence rate of the disease is different in various societies, but it is reported in approximately 1 per 3000-4000 births. The purpose of this study was to determine the epidemiological features of congenital hypothyroidism in Qazvin province. Material and methods: This cross sectional, descriptive study was conducted in 141 infants hospitalized with hypothyroidism who were selected through census sampling in 2011-2012 in Qazvin province. The data was collected through patients' files obtained from health deputy department and analyzed in SPSS. Results: The patients were 63 girls and 87 boys. No significant relationship was seen between initial TSH and sex, weight, and type of childbirths. The rate of CH was observed to be more in winter, while the lowest rate of the disease was seen in spring. No significant relationship was found between the prevalence of disease and sex of the newborns and season of birth. Most patients had normal body weight. The parents of 45 infants had consanguineous relationships. Among the newborns 43 were rural and 98 were urban. In 69.5% of the cases sampling was done between 3 to 5 days after birth. The mean time for starting treatment was 33.62 days. The incidence rate of CH was 24.3 and 3.49 per thousand live births in 2011 and 2012, respectively. Conclusion: High incidence of CH in Qazvin providence signifies the need for continuous screening and complementary studies to identify probable risk factors. [ABSTRACT FROM AUTHOR]

Background: Chylothorax is rare in infancy. It may be iatrogenic or congenital. That is caused by escape of lymph into the pleural space. Case: This is a girl born to a 30-year-old mother by cesarean section. At the age of 7 days, she was admitted to Amirkola children hospital for RDS and cyanosis. Chest X-ray showed a diffuse radio-opacity on the right parts of thorax and a slight shift of heart and mediastinum to left. There was a copius milky pleural fluid in puncture, and chyle (Presence of lymph) was confirmed. After insertion of a chest tube, fluid puncture and feeding the baby with MCT, fluid discharge stopped. After 2 months we gradually replaced MCT with breast milk. The infant is now living without any symptoms.

Congenital dislocation of the knee (CDK) is a rare congenital anomaly and the incidence of the CDK is estimated as 1 per 100,000 births. Diagnosis is made through clinical inspection and X-ray radiography. Our patient is a newborn male with congenital dislocation of the left knee. After diagnosis, the knee was reduced successfully within 24 hours of birth and then serial casting was performed. After one year of follow-up, the knee appears normal and prognosis is excellent. In some reports the best time for reduction of dislocated knee is within 24 hours after birth and delayed reduction is suggested to increase the difficulty of treatment, but some authors have suggested waiting of 1 month for spontaneous reduction of CDK. The aim of this report is emphasis on early reduction of congenital dislocation of the knee, and also precise evaluation for ruling out related disorders. [ABSTRACT FROM AUTHOR]