The Comparison of the Effects of Massaging and Rocking on Infantile Colic.

INTRODUCTION: Infantile colic is a painful condition in the first months of infancy. This study was carried out with the aim of testing the hypothesis that massage treatment has a clinically relevant effect on this condition. MATERIALS AND METHODS: This randomized clinical trial was conducted among 100 infants of < 12 weeks of age with infantile colic. They were randomly assigned to either infant massage (n = 50) or rocking groups (n = 50). In the massage group, trained individuals taught the parents of the infants the massage technique and gave them a brochure. Rocking group parents was recommended to rock their infants three times a day for 1 week. Parents recorded the pattern of crying (numbers, length, and severity of crying). After 1 week of intervention, data were analysed using t-test, Chi square test, and repeated measurement analysis of variance (P < 0.05). RESULTS: Significant differences were not observed in infant and mother demographic information. Before intervention, the mean of total number, length, and severity of crying were 6.12 (1.76) time/day, 4.97 (1.37) hour/day, and 6.60 (1.54) in the massage group and 6.96 (2.9) time/day, 3 (1.31) hour/day, and 5.98 (2.22) in the rocking group, respectively. After 1 week of intervention, the mean difference of total number, length, and severity of crying were 4.08 (1.83) time/day, 2.81 (1.77) hour/day, and 2.9 (2.37) in the massage group and 0.56 (2.28) time/day, 0.27 (1.09) hour/day, and 0.02 (1.64) in the rocking group, respectively. CONCLUSIONS: This trial of massage treatment for infantile colic showed statistically significant or clinically relevant effect in comparison with the rocking group.

Efficacy of topical application of human breast milk on atopic eczema healing among infants: a randomized clinical trial.

Infant atopic eczema is an inflammatory lesion usually involving the epidermis of the skin. About 50% of infants are affected by this lesion in the first years of their lives. Studies show human breast milk (HBM) as a preventive measure and effective treatment of some sores and infections. This article evaluates the short-term efficacy of HBM versus hydrocortisone 1% ointment in infants with mild to moderate atopic dermatitis (AD). We conducted a randomized clinical trial among infants with diagnosed AD within a pediatrics unit. The majority of AD cases in both groups were considered moderate severity. There were no significant differences between these two groups at days 0, 7, 14, and 21, and the interventions of both groups were found to have the same effects. The external validity and consequently the ability to generalize the findings may be diminished as this study was conducted in a single site. Owing to HBM and the hydrocortisone 1% ointment providing the same results in the healing of AD, HBM was used because of low cost and accessibility.

Correlation between seizure in children and prolonged QT interval.

BACKGROUND: Long QT is a cardiac electrical disorder. One of the symptoms of long QT caused by fatal ventricular arrhythmia is seizure. In some studies it was indicated that up to 35% of seizures induced by long QT may be misdiagnosed as other causes of seizure. METHODS: In a case-control study, patients experiencing primary seizure with unknown etiology and referring for clinical diagnosis were selected as the case group. The control group consisted of patients hospitalized for other reasons except seizure. Corrected QT Interval (QTc) was measured for each patient on an electrocardiogram, and the two groups were compared. Long QT was defined as a QT more than 0.46 seconds. RESULTS: Among 508 subjects who were recruited in this study 254 children were in the case group and 254 were in the control group. There were 66 children experiencing seizure and long QT in the case group. In the control group, 48 children with long QT were observed; the difference was statistically significant (P = 0.02). Syncope and sudden death were not significantly different between the two groups. CONCLUSION: The present study showed that children with unknown causes of seizure have more frequently long QTc, which implies the possibility of an arrhythmic origin of some seizures. Therefore, it is advised to get an electrocardiography for patients with unknown causes of seizure.

Comparison of the effect of human milk and topical hydrocortisone 1% on diaper dermatitis.

Diaper dermatitis is one of the most common skin problems in infants and children, affecting between 7% and 35% of infants. This randomized clinical trial compared the efficacy of hydrocortisone 1% ointment with that of human breast milk in treating acute diaper dermatitis in infants ages 0 to 24 months. Infants with diaper rash were treated with either hydrocortisone 1% ointment (n = 70) or human breast milk (n = 71) for 7 days. Improvement in the rash from baseline was seen in both treatment groups on days 3 and 7; there was no significant difference in total rash scores on days 3 and 7. Treatment with human breast milk was as effective as hydrocortisone 1% ointment alone. Human breast milk is an effective and safe treatment for diaper dermatitis in infants.

Sacrum index in children suffering from different grades of vesicoureteral reflux.

This study aimed at evaluating the sacrum index in children suffering from different grades of vesicoureteral reflux. In this case-control study, according to VCUG results, children with grade III, IV and V refluxes entered the study. There were 76 children with history of urinary canal infection and normal VCUG. Sacrum index was measured in both groups and compared. There was a meaningful relationship between these two groups considering abnormality rate of the index (p = 0.001). The factor can be used as a predictive factor in determining prognosis of medical treatment and selecting those children candidate to surgery.

Does hydrochlorothiazide prevent recurrent urinary tract infection in children with idiopathic hypercalciuria?

OBJECTIVE: Idiopathic hypercalciuria (IHC) has been recognized as a common disorder in childhood, and is a major factor in the formation of renal stones and urinary tract infections (UTIs). Since hydrochlorothiazide ameliorates hypercalciuria, we assessed its efficacy in preventing recurrent UTIs in hypercalciuric girls. MATERIALS AND METHODS: This research was a single blind randomized clinical trial. One hundred 1‒12-year-old girls, who were followed in pediatric nephrology outpatient clinics of two referral hospitals in Markazi Province of Iran, were recruited. All patients had IHC and at least two UTIs in 1 year, without any underlying anatomic or functional abnormality of urinary tract. Patients were randomly divided into two equal groups. One group received instructions regarding general preventive measures for UTI and the other group, in addition to these measures, received 1 mg/kg/day hydrochlorothiazide as morning dose. Then recurrence of UTI in the two groups was evaluated. RESULTS: The mean age was 7.28 ± 1.9 years. In both groups, the incidence of UTI recurrence was 66%. CONCLUSION: On the basis of these results, we reject the hypothesis that treating hypercalciuria is beneficial in preventing repeated UTIs. The association between UTIs and IHC needs to be more closely studied and attention to eliminating confounding factors is necessary.

Correlation between sacral ratio and primary enuresis.

BACKGROUND: Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age and has a high prevalence in school aged children. In primary enuresis (PE) children have never gained control over urination or has been dry for<6months. While in secondary enuresis children have developed incontinence after a period of at least 6 months of urinary control. OBJECTIVES: The aim of this study was to investigate a possible relation between PE and sacral ratio (SR) in 5-9 aged children. PATIENTS AND METHODS: 118 children with aged 5-9 year were enrolled in this case-control study. All them were divided into two aliquots groups of 59 patients. The case study (children with PE) and the control (children without PE) groups were matched in age and sex. SR based on antero-posterior plain radiograms of pelvis was calculated. Results were then analyzed using Chi square and student t-test as appropriate. RESULTS: There were no significant differences between the two groups regarding age and gender. Mean SR in case and control group was 0.89 and 0.90, respectively. Moreover, there was no significant difference between the two groups (p=0.82). Only 1 child (1.6%) in case group showed abnormal SR while this was 7 children (11.9%) in the control group. CONCLUSIONS: This study showed that, there was no significant difference between children with PE and those without PE in terms of SR. However, multicenter and larger sample size is recommended for definite decision of this finding.

Effect of hydrochlorothiazide on reducing recurrent abdominal pain in girls with idiopathic hypercalciuria.

BACKGROUND: This study assessed the possible effect of hydrochlorothiazide (HCT) on soothing recurrent abdominal pain (RAP). METHODS: A hundred girls with RAP and IH were randomly assigned into two groups of experiment (treated with hydrochlorothiazide 1mg/kg/day) and control and all patients were followed for 3 months. RESULTS: In the experiment group, the mean of painful attacks in the first, second and third month were 0.38, 0.4 and 0.26, respectively which were far less than their counterparts in the control group. CONCLUSIONS: Single daily dose of HCT is a safe and effective therapeutic option in the treatment of RAP in children with IH.