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Papers by Mojtaba Fazel

Hospital Practices and Research

Background: Various studies indicate that in many cases, fire has broken out in hospitals. Object... more Background: Various studies indicate that in many cases, fire has broken out in hospitals. Objectives: This study aims to assess fire protection in the selected units of Imam Khomeini hospital located in Tehran, Iran in 2020. Methods: In this descriptive-analytic study, first, a researcher-made checklist was developed for the data collection by valid scientific resources (CVI=0.90 and CVR>0.62). After revising and the final confirmation of reliability, the checklist was separately completed by two members of the risk management committee in 22 units of Imam Khomeini hospital, Tehran, Iran. Cronbach’s weighted Kappa statistical test was calculated. Results: The domain of Ability and Capability of Fire Prevention was 66.1%; the domain of Responsiveness was 65.1%, and the domain of Urgent Evacuation Ability was 27.3%. In the domain of Responsiveness, the highest scores were relevant to accessing fire extinguishers cylinder in the units (95.5%) and holding fire extinguishing practice...

Journal of pediatric nephrology, 2014

Acute kidney injury (AKI) is reversible deterioration of renal function in which waste products a... more Acute kidney injury (AKI) is reversible deterioration of renal function in which waste products accumulate and fluid imbalance occurs. The epidemiology of AKI has been changing over years. The aim of this study was to evaluate the epidemiology of AKI in hospitalized children in Iran. A literature search from March 2000 to March 2014 was conducted through MEDLINE, EMBASE, Scholar.google, IranMedex, MagIran, SID, and manual reference search of identified articles. Retrospective and prospective cross-sectional studies with a clear definition of acute kidney injury or failure were included. Seven out of twenty three articles which were found met the criteria. The incidence of AKI declined from 36% (2006-2008) to 15.4% (2010-2011) in the PICU setting of three referral teaching hospitals in Tehran. According to the classification, 10% had pre-renal failure, 86% had intrinsic renal failure, and 4% had post-obstructive uropathy. Follow-up was limited to the days of hospitalization. The over...

Journal of pediatric nephrology, 2020

A 12-year-old Boy with Generalized Edema A 12-year-old boy who was referred with generalized edem... more A 12-year-old Boy with Generalized Edema A 12-year-old boy who was referred with generalized edema, nephrotic range proteinuria, hypoalbuminemia and hyperlipidemia. His laboratory investigations showed thrombocytopenia and mild anemia, the other lab tests like kidney function test, liver function tests, complements, antinuclear antibody and serum electrolytes were in normal range. His urinalysis showed normal data except proteinuria. His physical examination revealed patchy skin lesions on dorsal side of the hands and feet (figure 1). Clinical signs and symptoms of the patient improved after 6 weeks of corticosteroids usage.

Journal of pediatric nephrology, Dec 29, 2019

Urinary tract infection is one of the most common bacterial infections in children. It is prevent... more Urinary tract infection is one of the most common bacterial infections in children. It is preventable in many cases and appropriate health behaviors can protect a child from the disease or minimize its risk. Considering the relatively high prevalence of urinary tract infections in children and with regard to the important role of healthy behaviors in preventing this infection, we decided to evaluate the knowledge, attitude and practice of mothers regarding the prevention of urinary tract infections. Materials and Methods: This cross-sectional descriptive-analytic study was performed in the Pediatric Clinic of Imam Khomeini Hospital to determine the knowledge, attitude, and practice of mothers about UTI in children and to evaluate its relationships with some demographic features. The data collection tool was a researcher-made questionnaire based on the literature review. The collected data were analyzed using SPSS 22 software and P-values less than 5% were considered significant. Results: One hundred and fifteen mothers who presented to the Pediatric Clinic of Imam Khomeini Hospital participated in this study. The average knowledge, attitude, and practice score in the first part and the practice score in the second part was 6.21, 47.85, 13.86, and 10.66, respectively. A statistically significant relationship was found between the score of knowledge and attitude. The knowledge score had a significant relationship between maternal employment status, household income, and household location. There was also a significant relationship between access to information and both the knowledge and attitude scores. Conclusions: The significant relationship between access to information resources and the maternal knowledge and attitude scores confirms the importance of awareness in improving the knowledge of mothers in preventing urinary tract infection.

International Journal of Pediatrics, 2020

Background There is still controversy about the efficacy of paricalcitol in children with chronic... more Background There is still controversy about the efficacy of paricalcitol in children with chronic kidney disease (CKD). Therefore, the present study was designed to assess current evidence on the efficacy of paricalcitol in CKD children. Materials and Methods In this systematic review, an extensive search was performed on the databases of Medline, Embase, Scopus and Web of Science up to the end of October 2019. The keywords related to CKD and paricalcitol were combined and searched. Two independent researchers reviewed the papers; data were analyzed in STATA 14.0 statistical program and the effect of paricalcitol administration on serum levels of intact parathyroid hormone (iPTH), calcium (Ca), phosphorous (P), and Ca × P product ratio were reported as odds ratio (OR), and 95% confidence interval (95%CI). Results: Finally, data from three studies were included in the present study. Paricalcitol administration decreased iPTH levels in children with CKD (OR=0.12; 95%CI: 0.05 to 0.29; ...

Journal of pediatric nephrology, 2019

Background and Aim: Giggle incontinence, also known as “enuresis risoria”, is characterized by un... more Background and Aim: Giggle incontinence, also known as “enuresis risoria”, is characterized by unexpected, involuntary, and complete bladder voiding in response to laughter. The cause is unknown; however, there are different assumptions based on several case studies. This research discusses the effectiveness of methylphenidate for giggle incontinence in children. Methods: Fifteen girls who met the giggle incontinence criteria were randomly divided to two groups: group A (n=8 girls) and group B (n=7 girls). The participants in group A took Oxybutynin chloride and the patients in group B received methylphenidate for one month. The response of the two groups to drugs was assessed. Results : Group A included 8 girls (mean age: 7.7 years) and group B comprised 7 girls (mean age: 8.4 years). Only one patient in group A showed complete response to Oxybutynin chloride. No wetting was reported by six patients in group B. Conclusion : Giggle incontinence is a rare form of incontinence. The pa...

International Journal of Pediatrics, 2019

Background: There is little information about the survival rate of pediatric peritoneal dialysis ... more Background: There is little information about the survival rate of pediatric peritoneal dialysis (PD) patients and its risk factors. Therefore, the aim of the present study was to assess survival rate and its risk factors in Iranian children undergoing PD. Materials and Methods: Demographic and laboratory data of 407 Iranian children (up to 19 years old) undergoing PD, from 20 centers in Iran were included. The outcome of interest in our study was survival rate and determination of its risk factors in PD children. The joint models of longitudinal and time-to-event data analysis was used. Results: The median duration of follow-up was 537 (interquartile range: 146 to 1,177) days. Finally, 72 (17.7%) patients died during a period of 23 years. Our results showed that one-year survival rate of PD patients was 93.6% and five-year survival rate was 76.9%. In addition, the most important risk factors for the PD all-cause mortality were age (HR=0.9301; 95% CI: 0.9031 to 0.9587), serum creati...

Pediatric Transplantation, 2011

The outcome of pediatric renal transplantation was previously reported by a single-center study a... more The outcome of pediatric renal transplantation was previously reported by a single-center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi-center nationwide study. In this nationwide report, medical records of 907 children (≤18yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow-up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10yr (n=91) and the ones with graft survival time of equal or less than 10yr (n=831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d.=3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p<0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.

Iranian Journal of Pediatrics, May 2, 2022

Background: Nephrotic syndrome (NS), like any other chronic illness, may affect the health-relate... more Background: Nephrotic syndrome (NS), like any other chronic illness, may affect the health-related quality of life (HRQoL) of children, so do the complications related to the disease, and its treatment. A better understanding of the (HRQoL) of people with nephrotic syndrome may help to better guide their treatment. Methods: Sixty children with nephrotic syndrome were assigned as the first case group, besides 81 healthy children as the first control group and 98 children with other chronic illnesses as the second control cohort. The participant and his or her caregiver were asked to fill in the standard HRQoL questionnaire. The patient's demographic data were also collected and analyzed using SPSS version 26 software. Results: 60 patients with nephrotic syndrome (mean age 9.8 ± 3.7) scored lower grades in physical, social, educational fields as well as total scores than the healthy controls (mean age 9.5 ± 2.7) and higher than the controls with other chronic diseases (mean age 9.7 ± 3.9) (P < 0.05). The emotional QOL score was close to that of the non-healthy control group. No correlation was found between the clinical phenotype of disease regarding the response to steroids and HRQOL (P > 0.05). Conclusions: The study shows that nephrotic syndrome can affect all aspects of the quality of life of patients. We suggest that comprehensive care of patients with NS be routinely managed in a multidisciplinary clinic with filling HRQOL questionnaires integrated as a common practice.

Quality of Life Research, 2014

Health-related quality of life (HRQOL), which is receiving increasing attention, is a multidimens... more Health-related quality of life (HRQOL), which is receiving increasing attention, is a multidimensional concept that encompasses different areas including the physiological, psychological, social, and spiritual aspects of life. The KIDSCREEN-52 questionnaire is designed to measure the HRQOL of 8-18-year-old children and adolescents. The aim of this study was to develop a Persian version of KIDSCREEN-52 and analyze the validity and reliability of the translated version. The KIDSCREEN-52 was translated into Persian in keeping with the international cross-cultural translation guidelines. A cross-sectional study was performed in the city of Tehran during 2012-2013. 328 students ranging in age from 8 to 18 years were enrolled in the study. The reliability for each dimension was estimated using Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha coefficient. To examine the validity of the questionnaire, a confirmatory factor analysis (CFA) was conducted. The Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha coefficient was higher than 0.7 in all ten dimensions except self-perception. Validity of this questionnaire was confirmed by CFA. (Relative chi square (χ (2)/df) = 1.73; root-mean-square error of approximation = 0.047; normed fit index = 0.93; Tucker-Lewis index = 0.97; comparative fit index = 0.97; and relative fit index = 0.92.) The Persian version of KIDSCREEN-52 is reliable and valid and can be used as a self-administered instrument for measuring HRQOL in children and adolescents in Iran.

Archives of Academic Emergency Medicine, Nov 24, 2019

Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in d... more Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in diagnosis of renal calculi in children, there is still no consensus. Therefore, in the present systematic review and meta-analysis, we aimed to evaluate the diagnostic accuracy of ultrasonography in identifying renal stones in children. A comprehensive search of the electronic databases including Medline, Embase, Scopus and Web of Science was conducted up to July 2019. Diagnostic accuracy studies in children were included. Data was summarized and pooled. Area under the curve (AUC), sensitivity, specificity, diagnostic score and diagnostic odds ratio were reported with 95% confidence interval (95% CI). Data from 7 articles were included. Pooled analysis showed that the area under the curve of ultrasonography in diagnosis of pediatric renal calculi was 0.94 (95% CI: 0.92 to 0.96). The sensitivity and specificity of this diagnostic modality were 0.80 (95% CI: 0.70 to 0.87) and 1.00 (95% CI: ...

Iranian Journal of Neonatology IJN, 2019

Background: Breast milk can be a source of toxic material, along with the transfer of nutrients n... more Background: Breast milk can be a source of toxic material, along with the transfer of nutrients needed for infant growth. This study was conducted to measure the level of lead in maternal and neonatal blood and breast milk in Tehran, Iran.Methods: In this cross-sectional study, 150 mothers and their infants were studied. Samples of maternal blood, fetal umbilical cord blood, breast milk, and amount of lead measured by atomic absorption method were collected. Correlations between lead levels and demographic characteristics of mother and infants were assessed.Results: The mean levels of lead in maternal and neonatal blood and breast milk were 9.79\xC2±4.31, 8.29\xC2±4.83, and 8.65\xC2±3.67 \xCE¼g/dl, respectively. The different levels of lead were associated with cord blood, maternal blood, and breast milk. No significant relationship was found between lead levels and neonatal parameters (i.e., weight, height, and head circumference). The Spearman's correlation also showed the ass...

Email: akhlaghimd@yahoo.com Relapsing polychondritis (RP) is very rare inflammatory disorder char... more Email: akhlaghimd@yahoo.com Relapsing polychondritis (RP) is very rare inflammatory disorder characterized by episodic, progressive, and destructive courses affecting cartilages. Renal involvement also is very rare presenting sign in these patients. It has seldom been described in children. We describe an 11-yearold girl with RP and complaint of frequent episodes of hematuria, and dysuria with fever and periorbital edema that auricular cartilage involvement appeared after renal involvement. Renal involvement in the setting of RP is mainly important, and need close observation.

Archives of Academic Emergency Medicine, 2020

Introduction: There is considerable controversy on the accuracy of Kidney Injury Molecule-1 (KIM-... more Introduction: There is considerable controversy on the accuracy of Kidney Injury Molecule-1 (KIM-1) in prediction of acute kidney injury (AKI) in children. Therefore, the present study intends to provide a systematic review and meta-analysis of the value of this biomarker in predicting AKI in children. Methods: An extensive search was performed on the Medline, Embase, Scopus and Web of Science databases by the end of 2019. Cohort and case-control studies on children were included. Urinary KIM-1 levels were compared between AKI and non-AKI groups. Findings were reported as an overall standardized mean difference (SMD) with a 95% confidence interval (CI). Also, the overall area under the receiver operating characteristic (ROC) curve (AUC) of KIM-1 in predicting AKI in children was calculated. Results: Data from 13 articles were included. Urinary KIM-1 levels in children with stage 1 AKI were higher than the non-AKI group only when assessed within the first 12 hours after admission (SM...

Background and Objective: Urinary tract infection (UTI) is common in children. Recurrent UTI caus... more Background and Objective: Urinary tract infection (UTI) is common in children. Recurrent UTI causes serious complications such as renal scarring, proteinuria and hypertension. Recent studies have reported that hypercalciuria may be considered a risk factor for recurrent UTI. Methods: In this study 110 children aged 2 months to 13 years with recurrent UTI were evaluated for hypercalciuria, urinary tract anomalies and voiding dysfunction, constipation, reflux and scars of the kidney. Hypercalciuria was defined as a calcium/creatinine ratio more than 0.21 in at least two morning spot urine test. Recurrent UTI was defined as at least 3 episodes of cystitis or 2 episodes of pyelonephritis. Findings: There were 110 children: 103 female (93.6) and 7 male (6.4). Mean age was 4.35 ± 2.05. Frequency of recurrent UTI was 2.7 times. The most common symptom was dysuria (73%), recurrent UTI (60%), and abdominal pain (44%). Hematuria was seen in 60% of patients with recurrent UTI and hypercalciuri...

Urology journal, 2020

PURPOSE Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucia... more PURPOSE Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran. Materials and Methods: This cross-sectional study was conducted during 1991 - 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset. RESULTS A total of 1247 children were registered. The mean age of the children at registration was 0.69±4.72 years (range, 0.25 -18 years), 7.79±3.18 years for hemodialysis (HD), 4.24±1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4±1.95 years for the children who underwent the renal transplantation (RT) (P<.001). The mean year of follow-up was 7.19±4.65 years. The mean annual incidence of CKD 2-5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2-5 stages was...

International Journal of Pediatrics, 2019

Background: Value of Corticosteroid Randomisation after Significant Head Injury (CRASH) prognosti... more Background: Value of Corticosteroid Randomisation after Significant Head Injury (CRASH) prognostic model has not been assessed in children with traumatic brain injury (TBI). This study is designed to examine the value of CRASH model in prediction of 14-day mortality and 6-month unfavourable outcome of pediatric TBI. Materials and Methods: In a cross-sectional study, 738 children with TBI brought to the emergency ward of four hospitals were studied. For assessing the predictive value of the CRASH model discrimination power and calibration of CRASH basic model and CRASH CT model were examined. Results: The areas under the curve (AUC) of CRASH basic and CRASH CT models in prediction of 14-day mortality were 0.89 and 0.91, respectively. AUCs of the CRASH basic and CRASH CT models in predicting unfavourable outcome were 0.93 and 0.94. The value of two models in prediction of 14-day mortality (p=0.20), and 6-month unfavourable outcome (p=0.22) were equal. Both models had proper calibratio...

Journal of pediatric nephrology, 2020

Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Vario... more Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Various organs including skin, kidneys, joints, heart, and central nervous system, may be affected. One of the serious organ damages in SLE is renal involvement as lupus nephritis, which occurs in 50-75% of children with SLE. Approximately 6-12% of pediatric SLE may develop other conditions, such as JIA, JDM, and polymyositis, scleroderma, and Crohn's disease. Henoch schonlein purpura (HSP) is another disease that accompanies with SLE. There have been several reports of HSP as the primary manifestation of SLE. In this report, we aim to highlight lupus nephritis as the first presentation of SLE and its association with HSP in our patient, a 6-year-old boy with lupus nephritis and past history of HSP 4 years before initiating of SLE.

Recently, the role of B cells in the pathogenesis of nephrotic syndrome is explained by some rese... more Recently, the role of B cells in the pathogenesis of nephrotic syndrome is explained by some researchers. It has also been shown that the anti-CD20 antibody, rituximab, may be an option in the treatment of these patients. In this systematic review, we performed extensive search and identified studies on rituximab use in children with nephrotic syndrome. There are some case reports as well as larger series in this regard. The majority of these case reports and series have demonstrated the success of rituximab in the treatment of nephrotic syndrome, especially in pediatric patients with steroid-dependent and frequent-relapsing nephrotic syndrome. Nevertheless, the treatment strategies before and after rituximab infusion are not clear to date. On the other hand, it is believed that positive results on rituximab use in nephrotic syndrome are much more reported by researchers than the negative results and this is an important bias. Although most reports on rituximab use in pediatric pati...

Introduction: Although numerous studies have been done to evaluate the diagnostic value of ultras... more Introduction: Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in diagnosis of renal calculi in children, there is still no consensus. Therefore, in the present systematic review and meta-analysis, we aimed to evaluate the diagnostic accuracy of ultrasonography in identifying renal stones in children. Methods: A comprehensive search of the electronic databases including Medline, Embase, Scopus and Web of Science was conducted up to July 2019. Diagnostic accuracy studies in children were included. Data was summarized and pooled. Area under the curve (AUC), sensitivity, specificity, diagnostic score and diagnostic odds ratio were reported with 95% confidence interval (95% CI). Results: Data from 7 articles were included. Pooled analysis showed that the area under the curve of ultrasonography in diagnosis of pediatric renal calculi was 0.94 (95% CI: 0.92 to 0.96). The sensitivity and specificity of this diagnostic modality were 0.80 (95% CI: ...

Hospital Practices and Research

Background: Various studies indicate that in many cases, fire has broken out in hospitals. Object... more Background: Various studies indicate that in many cases, fire has broken out in hospitals. Objectives: This study aims to assess fire protection in the selected units of Imam Khomeini hospital located in Tehran, Iran in 2020. Methods: In this descriptive-analytic study, first, a researcher-made checklist was developed for the data collection by valid scientific resources (CVI=0.90 and CVR>0.62). After revising and the final confirmation of reliability, the checklist was separately completed by two members of the risk management committee in 22 units of Imam Khomeini hospital, Tehran, Iran. Cronbach’s weighted Kappa statistical test was calculated. Results: The domain of Ability and Capability of Fire Prevention was 66.1%; the domain of Responsiveness was 65.1%, and the domain of Urgent Evacuation Ability was 27.3%. In the domain of Responsiveness, the highest scores were relevant to accessing fire extinguishers cylinder in the units (95.5%) and holding fire extinguishing practice...

Journal of pediatric nephrology, 2014

Acute kidney injury (AKI) is reversible deterioration of renal function in which waste products a... more Acute kidney injury (AKI) is reversible deterioration of renal function in which waste products accumulate and fluid imbalance occurs. The epidemiology of AKI has been changing over years. The aim of this study was to evaluate the epidemiology of AKI in hospitalized children in Iran. A literature search from March 2000 to March 2014 was conducted through MEDLINE, EMBASE, Scholar.google, IranMedex, MagIran, SID, and manual reference search of identified articles. Retrospective and prospective cross-sectional studies with a clear definition of acute kidney injury or failure were included. Seven out of twenty three articles which were found met the criteria. The incidence of AKI declined from 36% (2006-2008) to 15.4% (2010-2011) in the PICU setting of three referral teaching hospitals in Tehran. According to the classification, 10% had pre-renal failure, 86% had intrinsic renal failure, and 4% had post-obstructive uropathy. Follow-up was limited to the days of hospitalization. The over...

Journal of pediatric nephrology, 2020

A 12-year-old Boy with Generalized Edema A 12-year-old boy who was referred with generalized edem... more A 12-year-old Boy with Generalized Edema A 12-year-old boy who was referred with generalized edema, nephrotic range proteinuria, hypoalbuminemia and hyperlipidemia. His laboratory investigations showed thrombocytopenia and mild anemia, the other lab tests like kidney function test, liver function tests, complements, antinuclear antibody and serum electrolytes were in normal range. His urinalysis showed normal data except proteinuria. His physical examination revealed patchy skin lesions on dorsal side of the hands and feet (figure 1). Clinical signs and symptoms of the patient improved after 6 weeks of corticosteroids usage.

Journal of pediatric nephrology, Dec 29, 2019

Urinary tract infection is one of the most common bacterial infections in children. It is prevent... more Urinary tract infection is one of the most common bacterial infections in children. It is preventable in many cases and appropriate health behaviors can protect a child from the disease or minimize its risk. Considering the relatively high prevalence of urinary tract infections in children and with regard to the important role of healthy behaviors in preventing this infection, we decided to evaluate the knowledge, attitude and practice of mothers regarding the prevention of urinary tract infections. Materials and Methods: This cross-sectional descriptive-analytic study was performed in the Pediatric Clinic of Imam Khomeini Hospital to determine the knowledge, attitude, and practice of mothers about UTI in children and to evaluate its relationships with some demographic features. The data collection tool was a researcher-made questionnaire based on the literature review. The collected data were analyzed using SPSS 22 software and P-values less than 5% were considered significant. Results: One hundred and fifteen mothers who presented to the Pediatric Clinic of Imam Khomeini Hospital participated in this study. The average knowledge, attitude, and practice score in the first part and the practice score in the second part was 6.21, 47.85, 13.86, and 10.66, respectively. A statistically significant relationship was found between the score of knowledge and attitude. The knowledge score had a significant relationship between maternal employment status, household income, and household location. There was also a significant relationship between access to information and both the knowledge and attitude scores. Conclusions: The significant relationship between access to information resources and the maternal knowledge and attitude scores confirms the importance of awareness in improving the knowledge of mothers in preventing urinary tract infection.

International Journal of Pediatrics, 2020

Background There is still controversy about the efficacy of paricalcitol in children with chronic... more Background There is still controversy about the efficacy of paricalcitol in children with chronic kidney disease (CKD). Therefore, the present study was designed to assess current evidence on the efficacy of paricalcitol in CKD children. Materials and Methods In this systematic review, an extensive search was performed on the databases of Medline, Embase, Scopus and Web of Science up to the end of October 2019. The keywords related to CKD and paricalcitol were combined and searched. Two independent researchers reviewed the papers; data were analyzed in STATA 14.0 statistical program and the effect of paricalcitol administration on serum levels of intact parathyroid hormone (iPTH), calcium (Ca), phosphorous (P), and Ca × P product ratio were reported as odds ratio (OR), and 95% confidence interval (95%CI). Results: Finally, data from three studies were included in the present study. Paricalcitol administration decreased iPTH levels in children with CKD (OR=0.12; 95%CI: 0.05 to 0.29; ...

Journal of pediatric nephrology, 2019

Background and Aim: Giggle incontinence, also known as “enuresis risoria”, is characterized by un... more Background and Aim: Giggle incontinence, also known as “enuresis risoria”, is characterized by unexpected, involuntary, and complete bladder voiding in response to laughter. The cause is unknown; however, there are different assumptions based on several case studies. This research discusses the effectiveness of methylphenidate for giggle incontinence in children. Methods: Fifteen girls who met the giggle incontinence criteria were randomly divided to two groups: group A (n=8 girls) and group B (n=7 girls). The participants in group A took Oxybutynin chloride and the patients in group B received methylphenidate for one month. The response of the two groups to drugs was assessed. Results : Group A included 8 girls (mean age: 7.7 years) and group B comprised 7 girls (mean age: 8.4 years). Only one patient in group A showed complete response to Oxybutynin chloride. No wetting was reported by six patients in group B. Conclusion : Giggle incontinence is a rare form of incontinence. The pa...

International Journal of Pediatrics, 2019

Background: There is little information about the survival rate of pediatric peritoneal dialysis ... more Background: There is little information about the survival rate of pediatric peritoneal dialysis (PD) patients and its risk factors. Therefore, the aim of the present study was to assess survival rate and its risk factors in Iranian children undergoing PD. Materials and Methods: Demographic and laboratory data of 407 Iranian children (up to 19 years old) undergoing PD, from 20 centers in Iran were included. The outcome of interest in our study was survival rate and determination of its risk factors in PD children. The joint models of longitudinal and time-to-event data analysis was used. Results: The median duration of follow-up was 537 (interquartile range: 146 to 1,177) days. Finally, 72 (17.7%) patients died during a period of 23 years. Our results showed that one-year survival rate of PD patients was 93.6% and five-year survival rate was 76.9%. In addition, the most important risk factors for the PD all-cause mortality were age (HR=0.9301; 95% CI: 0.9031 to 0.9587), serum creati...

Pediatric Transplantation, 2011

The outcome of pediatric renal transplantation was previously reported by a single-center study a... more The outcome of pediatric renal transplantation was previously reported by a single-center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi-center nationwide study. In this nationwide report, medical records of 907 children (≤18yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow-up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10yr (n=91) and the ones with graft survival time of equal or less than 10yr (n=831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d.=3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.

Iranian Journal of Pediatrics, May 2, 2022

Background: Nephrotic syndrome (NS), like any other chronic illness, may affect the health-relate... more Background: Nephrotic syndrome (NS), like any other chronic illness, may affect the health-related quality of life (HRQoL) of children, so do the complications related to the disease, and its treatment. A better understanding of the (HRQoL) of people with nephrotic syndrome may help to better guide their treatment. Methods: Sixty children with nephrotic syndrome were assigned as the first case group, besides 81 healthy children as the first control group and 98 children with other chronic illnesses as the second control cohort. The participant and his or her caregiver were asked to fill in the standard HRQoL questionnaire. The patient's demographic data were also collected and analyzed using SPSS version 26 software. Results: 60 patients with nephrotic syndrome (mean age 9.8 ± 3.7) scored lower grades in physical, social, educational fields as well as total scores than the healthy controls (mean age 9.5 ± 2.7) and higher than the controls with other chronic diseases (mean age 9.7 ± 3.9) (P < 0.05). The emotional QOL score was close to that of the non-healthy control group. No correlation was found between the clinical phenotype of disease regarding the response to steroids and HRQOL (P > 0.05). Conclusions: The study shows that nephrotic syndrome can affect all aspects of the quality of life of patients. We suggest that comprehensive care of patients with NS be routinely managed in a multidisciplinary clinic with filling HRQOL questionnaires integrated as a common practice.

Quality of Life Research, 2014

Health-related quality of life (HRQOL), which is receiving increasing attention, is a multidimens... more Health-related quality of life (HRQOL), which is receiving increasing attention, is a multidimensional concept that encompasses different areas including the physiological, psychological, social, and spiritual aspects of life. The KIDSCREEN-52 questionnaire is designed to measure the HRQOL of 8-18-year-old children and adolescents. The aim of this study was to develop a Persian version of KIDSCREEN-52 and analyze the validity and reliability of the translated version. The KIDSCREEN-52 was translated into Persian in keeping with the international cross-cultural translation guidelines. A cross-sectional study was performed in the city of Tehran during 2012-2013. 328 students ranging in age from 8 to 18 years were enrolled in the study. The reliability for each dimension was estimated using Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha coefficient. To examine the validity of the questionnaire, a confirmatory factor analysis (CFA) was conducted. The Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha coefficient was higher than 0.7 in all ten dimensions except self-perception. Validity of this questionnaire was confirmed by CFA. (Relative chi square (χ (2)/df) = 1.73; root-mean-square error of approximation = 0.047; normed fit index = 0.93; Tucker-Lewis index = 0.97; comparative fit index = 0.97; and relative fit index = 0.92.) The Persian version of KIDSCREEN-52 is reliable and valid and can be used as a self-administered instrument for measuring HRQOL in children and adolescents in Iran.

Archives of Academic Emergency Medicine, Nov 24, 2019

Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in d... more Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in diagnosis of renal calculi in children, there is still no consensus. Therefore, in the present systematic review and meta-analysis, we aimed to evaluate the diagnostic accuracy of ultrasonography in identifying renal stones in children. A comprehensive search of the electronic databases including Medline, Embase, Scopus and Web of Science was conducted up to July 2019. Diagnostic accuracy studies in children were included. Data was summarized and pooled. Area under the curve (AUC), sensitivity, specificity, diagnostic score and diagnostic odds ratio were reported with 95% confidence interval (95% CI). Data from 7 articles were included. Pooled analysis showed that the area under the curve of ultrasonography in diagnosis of pediatric renal calculi was 0.94 (95% CI: 0.92 to 0.96). The sensitivity and specificity of this diagnostic modality were 0.80 (95% CI: 0.70 to 0.87) and 1.00 (95% CI: ...

Iranian Journal of Neonatology IJN, 2019

Background: Breast milk can be a source of toxic material, along with the transfer of nutrients n... more Background: Breast milk can be a source of toxic material, along with the transfer of nutrients needed for infant growth. This study was conducted to measure the level of lead in maternal and neonatal blood and breast milk in Tehran, Iran.Methods: In this cross-sectional study, 150 mothers and their infants were studied. Samples of maternal blood, fetal umbilical cord blood, breast milk, and amount of lead measured by atomic absorption method were collected. Correlations between lead levels and demographic characteristics of mother and infants were assessed.Results: The mean levels of lead in maternal and neonatal blood and breast milk were 9.79\xC2±4.31, 8.29\xC2±4.83, and 8.65\xC2±3.67 \xCE¼g/dl, respectively. The different levels of lead were associated with cord blood, maternal blood, and breast milk. No significant relationship was found between lead levels and neonatal parameters (i.e., weight, height, and head circumference). The Spearman's correlation also showed the ass...

Email: akhlaghimd@yahoo.com Relapsing polychondritis (RP) is very rare inflammatory disorder char... more Email: akhlaghimd@yahoo.com Relapsing polychondritis (RP) is very rare inflammatory disorder characterized by episodic, progressive, and destructive courses affecting cartilages. Renal involvement also is very rare presenting sign in these patients. It has seldom been described in children. We describe an 11-yearold girl with RP and complaint of frequent episodes of hematuria, and dysuria with fever and periorbital edema that auricular cartilage involvement appeared after renal involvement. Renal involvement in the setting of RP is mainly important, and need close observation.

Archives of Academic Emergency Medicine, 2020

Introduction: There is considerable controversy on the accuracy of Kidney Injury Molecule-1 (KIM-... more Introduction: There is considerable controversy on the accuracy of Kidney Injury Molecule-1 (KIM-1) in prediction of acute kidney injury (AKI) in children. Therefore, the present study intends to provide a systematic review and meta-analysis of the value of this biomarker in predicting AKI in children. Methods: An extensive search was performed on the Medline, Embase, Scopus and Web of Science databases by the end of 2019. Cohort and case-control studies on children were included. Urinary KIM-1 levels were compared between AKI and non-AKI groups. Findings were reported as an overall standardized mean difference (SMD) with a 95% confidence interval (CI). Also, the overall area under the receiver operating characteristic (ROC) curve (AUC) of KIM-1 in predicting AKI in children was calculated. Results: Data from 13 articles were included. Urinary KIM-1 levels in children with stage 1 AKI were higher than the non-AKI group only when assessed within the first 12 hours after admission (SM...

Background and Objective: Urinary tract infection (UTI) is common in children. Recurrent UTI caus... more Background and Objective: Urinary tract infection (UTI) is common in children. Recurrent UTI causes serious complications such as renal scarring, proteinuria and hypertension. Recent studies have reported that hypercalciuria may be considered a risk factor for recurrent UTI. Methods: In this study 110 children aged 2 months to 13 years with recurrent UTI were evaluated for hypercalciuria, urinary tract anomalies and voiding dysfunction, constipation, reflux and scars of the kidney. Hypercalciuria was defined as a calcium/creatinine ratio more than 0.21 in at least two morning spot urine test. Recurrent UTI was defined as at least 3 episodes of cystitis or 2 episodes of pyelonephritis. Findings: There were 110 children: 103 female (93.6) and 7 male (6.4). Mean age was 4.35 ± 2.05. Frequency of recurrent UTI was 2.7 times. The most common symptom was dysuria (73%), recurrent UTI (60%), and abdominal pain (44%). Hematuria was seen in 60% of patients with recurrent UTI and hypercalciuri...

Urology journal, 2020

PURPOSE Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucia... more PURPOSE Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran. Materials and Methods: This cross-sectional study was conducted during 1991 - 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset. RESULTS A total of 1247 children were registered. The mean age of the children at registration was 0.69±4.72 years (range, 0.25 -18 years), 7.79±3.18 years for hemodialysis (HD), 4.24±1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4±1.95 years for the children who underwent the renal transplantation (RT) (P<.001). The mean year of follow-up was 7.19±4.65 years. The mean annual incidence of CKD 2-5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2-5 stages was...

International Journal of Pediatrics, 2019

Background: Value of Corticosteroid Randomisation after Significant Head Injury (CRASH) prognosti... more Background: Value of Corticosteroid Randomisation after Significant Head Injury (CRASH) prognostic model has not been assessed in children with traumatic brain injury (TBI). This study is designed to examine the value of CRASH model in prediction of 14-day mortality and 6-month unfavourable outcome of pediatric TBI. Materials and Methods: In a cross-sectional study, 738 children with TBI brought to the emergency ward of four hospitals were studied. For assessing the predictive value of the CRASH model discrimination power and calibration of CRASH basic model and CRASH CT model were examined. Results: The areas under the curve (AUC) of CRASH basic and CRASH CT models in prediction of 14-day mortality were 0.89 and 0.91, respectively. AUCs of the CRASH basic and CRASH CT models in predicting unfavourable outcome were 0.93 and 0.94. The value of two models in prediction of 14-day mortality (p=0.20), and 6-month unfavourable outcome (p=0.22) were equal. Both models had proper calibratio...

Journal of pediatric nephrology, 2020

Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Vario... more Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Various organs including skin, kidneys, joints, heart, and central nervous system, may be affected. One of the serious organ damages in SLE is renal involvement as lupus nephritis, which occurs in 50-75% of children with SLE. Approximately 6-12% of pediatric SLE may develop other conditions, such as JIA, JDM, and polymyositis, scleroderma, and Crohn's disease. Henoch schonlein purpura (HSP) is another disease that accompanies with SLE. There have been several reports of HSP as the primary manifestation of SLE. In this report, we aim to highlight lupus nephritis as the first presentation of SLE and its association with HSP in our patient, a 6-year-old boy with lupus nephritis and past history of HSP 4 years before initiating of SLE.

Recently, the role of B cells in the pathogenesis of nephrotic syndrome is explained by some rese... more Recently, the role of B cells in the pathogenesis of nephrotic syndrome is explained by some researchers. It has also been shown that the anti-CD20 antibody, rituximab, may be an option in the treatment of these patients. In this systematic review, we performed extensive search and identified studies on rituximab use in children with nephrotic syndrome. There are some case reports as well as larger series in this regard. The majority of these case reports and series have demonstrated the success of rituximab in the treatment of nephrotic syndrome, especially in pediatric patients with steroid-dependent and frequent-relapsing nephrotic syndrome. Nevertheless, the treatment strategies before and after rituximab infusion are not clear to date. On the other hand, it is believed that positive results on rituximab use in nephrotic syndrome are much more reported by researchers than the negative results and this is an important bias. Although most reports on rituximab use in pediatric pati...

Introduction: Although numerous studies have been done to evaluate the diagnostic value of ultras... more Introduction: Although numerous studies have been done to evaluate the diagnostic value of ultrasonography in diagnosis of renal calculi in children, there is still no consensus. Therefore, in the present systematic review and meta-analysis, we aimed to evaluate the diagnostic accuracy of ultrasonography in identifying renal stones in children. Methods: A comprehensive search of the electronic databases including Medline, Embase, Scopus and Web of Science was conducted up to July 2019. Diagnostic accuracy studies in children were included. Data was summarized and pooled. Area under the curve (AUC), sensitivity, specificity, diagnostic score and diagnostic odds ratio were reported with 95% confidence interval (95% CI). Results: Data from 7 articles were included. Pooled analysis showed that the area under the curve of ultrasonography in diagnosis of pediatric renal calculi was 0.94 (95% CI: 0.92 to 0.96). The sensitivity and specificity of this diagnostic modality were 0.80 (95% CI: ...