Mental Retardation In Children Research Articles

The Analysis Study of Gender and Risk of Congenital Hypothyroidism : A Comprehensive Systematic Review

Background: Congenital hypothyroidism is defined as a deficiency of thyroid hormone at birth and is one of the most common endocrine disorders in newborns. Congenital hypothyroidism, with a prevalence of 1 in 3000-4000 live births, is the most common preventable cause of mental retardation in children. The aim: The aim of this study to show about gender and risk of congenital hypothyroidism. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: many risk factors are involved in the development of congenital hypothyroidism in children. It should be noted that the irreversible consequences of this disease for children including mental retardation is one of the cases which to control and remove it. Accordingly, awareness of the birth season could help policymakers who plan preventive programs to reduce the false negative results among neonates, especially girls.

Prognostic factors for the development of obstetric and perinatal pathology in pregnant women under conditions of iodine deficiency

According to the World Health Organization (WHO), iodine deficiency is the main cause of mental retardation in children, and at the same time, it significantly affects the pathological course of pregnancy and childbirth. The problem is complicated by the fact that more than 100.000 children with cretinism are born annually in the world. In recent years, there has been a significant increase in endemic thyroid diseases in Ukraine, the main cause of which is insufficient iodine consumption. Iodine deficiency conditions are aggravated by socio‑economic, ecological and radiological factors, while at the same time mass and group iodine prophylaxis is carried out improperly on the state level. Objective. To determine prognostic factors for the development of obstetric and perinatal pathology in pregnant women under conditions of iodine deficiency. Materials and methods. To compile a diagnostic table of prognostic factors of the threat of miscarriage, the analysis has been performed of 185 cases of threatened abortion (111 in the first trimester, 56 in the second, 18 in the third) and 223 control observations (without the threat of miscarriage). A diagnosis was considered as confirmed if it was established using all applicable methods of examination of pregnant women. Results. The risk factors of the occurrence of perinatal pathology include hypothyroxinemia (DC=–2.5) and ioduria in pregnant women less than 100 mg/l (DC=–1.9). In the intranatal period, a negative impact is exerted by the lack of coordination and weakness of labor activity (DC=–8.1). Levels of thyroid‑stimulating hormone (TSH) in umbilical cord blood >10 mIU/ml (DC=–4.6) are the prognostically favorable factors for the postnatal adaptation of the newborn, especially TSH levels >20 mIU/ml (DC=–8.3). Conduction of iodine prophylaxis (DC=7.7) and ioduria in pregnant women 200—400 mg/l (DC=5.1) contribute to the improvement of perinatal outcomes. Conclusions. A retrospective review of the prognostic significance of the diagnostic table in 188 patients with diffuse nontoxic goiter revealed its sensitivity (76%) and specificity (68%). On the basis of the conducted research, we established risk factors for the development of obstetric and perinatal complications, and assessed their informativeness. The developed algorithm is represented by a diagnostic table for the prediction of complications of pregnancy, childbirth and adverse perinatal outcomes in women with endemic thyropathies.

The first description of a rare monogenic disease with polymicrogyria caused by a pathogenic variant in the gene WASF1 in monozygotic twins

Neurodevelopmental disorder without speech and variable seizures (NEDALVS) is a rare autosomal dominant inherited disorder, characterized by motor development delay, mental retardation, wide-based gait, autism spectrum disorders and seizures. 
 Currently, fifteen cases of NEDALVS have been described worldwide.
 NEDALVS caused by mutations in the WASF1 gene, located on the long arm of chromosome 6. Nonsense-, missense-, frameshift mutations and large deletion have been described in WASF1 gene. 
 We present the clinical case of 9-year monozygotic NEDALVS twins, accompanied by cerebral pachygyria/polymicrogyria. DNA diagnostic was performed using full genome sequencing, followed by validation using Sanger sequencing. A previously described heterozygous pathogenic variant c.1516C>T (p.R506*) in the WASF1 gene was identified.
 We performed the results of a comparative analysis based on the literature and our patients. All patients had delayed motor and psycho-speech development, severe mental retardation was in 53% of cases, lack of speech — 18%, autistic manifestations and seizures — 41%, wide-based gait — 29%, strabismus and feeding problems — 35%.
 Conclusion. WASF1 gene mutations caused a rare form of mental retardation in children. We present the first case of NEDALVS in Russian Federation and the world’s first description of pachygyria in patients, caused by WASF1 gene mutations. The use of NGS as a first-line test for research and diagnostic of neurodevelopmental disorder is determined by their non-specific clinical features.

PHYSICAL ASSESSMENT AND ATOMIC ABSORPTION SPECTROPHOTOMETRIC ANALYSIS OF CADMIUM AND LEAD IN TWENTY-FIVE BRANDS OF CIPROFLOXACIN TABLETS MARKETED IN LAGOS, NIGERIA.

Ciprofloxacin is a second-generation broad-spectrum antibiotic of the fluoroquinolone class, highly effective against many bacteria. Several brands of this drug class are marketed for public consumption; hence, it has placed the public in a confused state about the best brands with suitable physical characteristics and safe oral consumption. Additionally, the adverse effects of heavy metal accumulation in drugs for oral use have made it essential to quantify the amount of such heavy metals present. Evaluating the physical quality, elemental analysis identity, and concentration of cadmium and lead in twenty-five brands of ciprofloxacin tablets marketed in Lagos, Nigeria, is the aim of this study. The physical assessment of the tablets was then methodologically evaluated for these parameters; Uniformity of weight, Hardness, Friability, and Disintegration tests. Determining the amount of Cadmium and Lead with the Atomic Absorption Spectrophotometer (AAS) and evaluating using the Permitted Daily Exposure (PDE). Among all the brands of Ciprofloxacin tablets analyzed, 96 % passed the Uniformity of weight test, 52 % passed the Hardness test, 96 % passed the Friability test, and 96 % passed the disintegration test while 2 % passed the test according to the Permitted Daily Exposure (PDE) to Cadmium. 72 % passed the test according to the Permitted Daily Exposure (PDE) to Lead. The brands that passed the physical tests have good quality and correct physical characteristics. Cadmium and lead are of no benefit to humanity in the body and because they are not easily eliminated from the body, their buildup can put people at risk for mental retardation in children, dementia, kidney damage, nerve damage, infertility, high blood pressure, and cancer at high exposure levels. Keywords: Ciprofloxacin, Permitted Daily Exposure, Physical characteristics, Atomic Absorption Spectrophotometer, Cadmium, Lead

Skrining Hipotiroid Kongenital (SHK) Pada Ibu Hamil di Puskesmas Tajurhalang Kabupaten Bogor

According to WHO, in several developed countries such as America, Japan, Australia and Europe, since 197-, neonatal screening programs for hypothyroidism have been implemented so as to reduce the occurrence of mental retardation in children (Apriliani et al., 2021). Symptoms of hypothyroidism in newborns are usually not very obvious and congenital hypothyroidism can cause severe mental retardation unless therapy is received early, so a congenital hypothyroid (HK) screening examination is very important to do(Apriliani et al., 2021). Congenital Hypothyroidism Screening is effective 48-72 hours after birth(Ida Bagus Eka Utama Wija, 2020). Based on the pre and post test scores from 30 participants, it was found that there was an increase in the good category in knowledge with an average score of 1.7 to 3.00, meaning that the counseling was successfully implemented.There needs to be awareness of pregnant women, where the task of building awareness is held by health workers, so it is hoped that health agencies which are already required to run the SHK program will be more aggressive and package their invitations to pregnant women well.

SOCIAL SUPPORT THROUGH FAMILY COPING MECHANISMS FOR CHILDREN WITH MENTAL RETARDATION IN SPECIAL NEEDS SCHOOL (SLB) BANDA ACEH

Mental retardation is a condition in which mental development is below average since birth or childhood, typically associated with overall lower intellectual development. The global prevalence of mental retardation in children is 14.8%. According to the 2018 Basic Health Research (Riskesdas) data, the prevalence of mental disorders and emotional disabilities in Indonesia was 9.8%, marking a 6% increase compared to 2013. The disability rate among children aged 5-17 in Indonesia is 3.3%, which includes cases of mental retardation. This study aims to explore the relationship between social support and coping mechanisms in families with mentally disabled children attending Special Needs Schools (Sekolah Luar Biasa) in the city of Banda Aceh in 2023. The research methodology is analytical, with a total population of 50 individuals. The sample consists of 50 parents of mentally disabled children selected through purposive sampling. The research was conducted from January 7th to 12th, 2023, and involved both univariate and bivariate analyses. The study's results indicate that out of 50 respondents, the most common type of social support is instrumental support, with 33 individuals (66%), and the majority of coping mechanisms fall into the adaptive category, with 35 individuals (70%). The p-value obtained is 0.004, suggesting a significant correlation between social support and coping mechanisms among parents of mentally disabled children. Hence, parents should keep learning about intellectual disabilities and become better at taking care of children with such challenges.

Anterior segment indices in mentally retarded children

To compare the anterior segment indices between mentally retarded and normal children. The current study was conducted as a cohort. In this study, 73 mentally retarded and 76 normal children were selected from normal school and special schools for mentally retarded children using random cluster sampling method. Mental retardation in children was confirmed by a psychologist. Optometry examinations including visual acuity and refraction were performed for all participants, and ultimately, corneal imaging measurements were taken by Pentacam. The mean age of mentally retarded and normal children was of 13.30 ± 1.83 and 13.05 ± 1.82 years, respectively (P = 0.180). A multiple generalized estimating equations model demonstrated that there is a significant association between central corneal thickness (CCT) (coef = 1.011, P < 0.001), corneal diameter (CD) (coef = 0.444, P = 0.046), anterior chamber depth (ACD) (coef = 0.23), P < 0.001) and index of vertical asymmetry (IVA) (coef = 0.12, P < 0.001) and mental retardation. Cerebral palsy children had higher keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry(IHA), and index of height decentration (IHD) compared to those without cerebral palsy (P < 0.05). Children with moderate mental retardation had higher index of surface variance (ISV), IVA, IHA, and IHD than those with mild mental retardation (P < 0.05). The mean and standard deviation of CCT, CD, ACD and IVA index in mentally retarded children were 535.3 ± 46.68 micron, 11.87 ± 0.42 mm, 3.29 ± 0.24 mm and 0.25 ± 0.18 mm, respectively. These indices in the normal group were 525.53 ± 47.52 micron, 11.84 ± 0.38 mm, 3.15 ± 0.28 mm and 0.17 ± 0.05 mm, respectively. The findings of this study showed that some anterior segment indices were different in mentally retarded compared to normal children. Moreover, some keratoconus indicators were worse in cerebral palsy children and children with higher grade mental retardation. So, it is important to consider keratoconus screening in these children.

Diagnosis of Congenital Hypothyroidism by Analysis of Medical Records

Congenital hypothyroidism is one of the causes of mental retardation in children that can be prevented if recognized and treated early. Thyroid hormones play a role in the development of the central nervous system. It is known that 95% of CH do not show typical clinical signs and symptoms at birth and the duration of early intervention to prevent mental retardation is short. Therefore, most developed countries have conducted neonatal screening programs for early detection of CH. The purpose of this study was to determine the diagnosis and management of congenital hypoteroid based on medical record analysis. This research method is a cross-sectional descriptive study with a quantitative approach to patient medical records. Data were analyzed in accordance with the standard diagnosis and management of congenital hypoteroid issued by the Pediatric Association in 2017. The clinical practice guidelines explain that congenital hypothyroidism can be transient or permanent and is classified according to the location of the disorder: primary (in the thyroid gland) or secondary (in the pituitary and/or hypothalamus); severity of hypothyroidism: (serum TSH levels &gt; 100 mIU/L are considered severe; and age of onset of hypothyroidism. The most common form is permanent primary CH (high serum TSH levels) due to thyroid dysgenesis. Permanent CH requires lifelong treatment while transient CH does not. The results of the study have met clinical guidelines, namely CH screening in newborns is positive if the TSH level is ≥ 20 mU/L. Infants with positive screening results must be confirmed by re-checking serum TSH and FT4. The diagnosis of CH is made when TSH levels are high and FT4 is low. In non-screened infants, the diagnosis is made through clinical symptoms and serum TSH and FT4 examination.

BERMAIN “EGO” PSIKOANALITIS DALAM BIMBINGAN DAN KONSELING PADA ANAK TUNA GRAHITA

The aim of this research is to find out how to provide guidance and counseling techniques for mentally retarded children, then find out what the process of educating mentally retarded children is. Children with mental retardation or also known as mentally retarded because of their limited intelligence make it difficult for them to take part in classical educational programs in regular schools, therefore mentally retarded children need special educational services that are tailored to the child's abilities. The method used is a qualitative case study, with data analysis techniques used, namely pattern matching and explanation creation. The results of this research show that children with special needs can be minimized, but in a small way and over a very long period of time. For example, how to communicate, a counselor must be able to provide guidance services for this kind of thing. The causes of mental retardation in children are, firstly, it could be heredity factors, parenting style factors, nutritional factors, social factors, and so on. Because it is possible that when the baby is in the womb he lacks vitamins, this could also be a cause of mental retardation in children. The hope is that with psychoanalytic play therapy, mentally disabled children will receive guidance and learning to increase their IQ. Of course, this kind of thing is done by providing lessons and examples of games repeatedly in play therapy. So by giving examples over and over again, they can easily memorize what their teacher has taught them even though they are slow to digest it.

Partial trisomy 9p and partial monosomy 7p of an infant inherited from maternal balanced translocation: a case report

BackgroundSubchromosomal deletions and duplications are the leading cause of congenital malformations and mental retardation in children. With the recent clinical application of genomic microarrays in the evaluation of patients with developmental delays and congenital malformations, it has led to the discovery of several new microdeletion and microduplication syndromes. However, there are no published reports involving patients with both microduplications in the 9p21.1-p24.3 region and microdeletions in the 7p22.1-p22.3 region.Case presentationWe report an infant with an autosomal abnormality confirmed by conventional karyotype combined with copy number variations sequencing (CNV-seq), showing the patient with an unbalanced translocation. The karyotype of the patient was 46, XX, der (7)t (7;9) (p22; p21) and CNV-seq results showed an approximately 32.34-Mb duplication in 9p21.1-p24.3 (200000-32540000) and an approximately 3.3-Mb deletion in 7p22.2-p22.3 (40000-3340000).ConclusionsThe patient carried an unbalanced translocation 46, XX, der (7)t (7;9) (p22; p21) derived from her mother. The clinical presentation is closely related to the size and position of the missing and duplicated chromosomes. To our knowledge, the simultaneous occurrence of de novo partial trisomy 9p(9p21.1-p24.3) and partial monosomy 7p (7p22.2-p22.3) has not previously been reported up until now. The present study additionally demonstrated that CNV-seq combined with karyotype is able to reliably detect unbalanced submicroscopic chromosomal aberrations.

NURSING CARE OF CHILDREN WITH FEBRILE CONVULSION WITH HYPERTHERMIY NURSING PROBLEMS IN SRIKANDI ROOM JOMBANG HOSPITAL

Background : Febrile seizures are disorders that arise due to an abnormal increase in body temperature (&gt; 38 0 C). Febrile seizures are often associated with epilepsy and the risk of mental retardation in children.&#x0D; Method : The design of this research is a case study using the subject of 2 pediatric patients who experienced febrile seizures with hyperthermia nursing problems on the first day, nursing care was carried out 3 consecutive days by providing warm compresses or tepid sponge interventions.&#x0D; Results : The results showed the problem of hyperthermia with warm compresses or a tepid sponge, the problem was resolved in reducing the increase in body temperature.&#x0D; Analysis : To carry out nursing care for clients who experience febrile seizures with priority problems of hyperthermia.&#x0D; Conclution : Warm compresses or tepid sponges can be used in hospitals as additional therapy to lower body temperature.

Clinical phenotype and genetic analysis of twelve children with ring chromosomes

To explore the prevalence and clinical manifestations of ring chromosomes among children featuring abnormal development. From January 2015 to August 2021, 7574 children referred for abnormal development were selected, and their peripheral blood samples were subjected to G-banded chromosomal karyotyping analysis. Twelve cases of ring chromosomes were detected, which have yielded a prevalence of 0.16% and included 1 r(6), 2 r(9), 1 r(13), 1 r(14), 2 r(15), 1 r(21) and 3 r(X). The children had various clinical manifestations including growth and mental retardation, limb malformation, and congenital heart disease. For two children with r(9) and two with r(15) with similar breakpoints, one child with r(9) and one with r(15) only had growth retardation, whilst another with r(9) and another with r(15) also had peculiar facies and complex congenital heart disease. The r(X) has featured some manifestations of Turner syndrome. Ring chromosomes are among the common causes for severe growth and mental retardation in children with diverse clinical phenotypes. Clinicians should pay attention to those with developmental anomalies and use chromosomal analysis to elucidate their genetic etiology.

Epilepsy and Mental Retardation in Children with Cerebral Palsy – Bulgarian Study

Epilepsy is common in children with cerebral palsy (CP). In a group of 521 children with cerebral palsy it was found that 58% (n = 303) of the affected had epilepsy and 74.5% (n = 388) had mental retardation. We found ahigher percentage of symptomatic epilepsy in a combination of CP with mental retardation – 84.2% (n = 255), while only 15.8% (n = 48) of children with normal intellect had epilepsy. In our CP patients, the focal seizures were the most common – 34.7% (n = 181), followed by the secondary generalized 29.6% (n = 154) and the generalized seizures (tonic, clonic and generalized tonicclonic) 25.3% (n = 132), most often with early onset, with 43.5% (n = 132) of them with onset in the first year of life. The earlier onset of the epileptic seizures correlated with a more severe mental retardation. We found that symptomatic epilepsy and severe mental retardation are most common in children with spastic quadriparesis.

Epidemiological studies on urinary schistosomiasis and bacterial co-infection in some rural communities of Abia State, Nigeria

Urinary Schistosomiasis though being second to malaria as the most economically devastating disease is highly neglected in Nigeria. Infant it was only in 2010 that it was introduced into the Integrated Disease Surveillance and Response (IDSR). This has made the control of the disease more challenging despite its known high endemicity in the country. Several studies have shown that the disease can lead some dangerous complications ranging from gross mental retardation in children to renal complications such as bladder cancer. In Abia State Urinary Schistosomiasis is endermic is same rural communities, however not much attempt has been made on bacteria co-infection and to establish some socio – economic variable and clinical presentations carried out a cross – sectional survey of some school children between the ages of 5 – 16 years and above. A questionnaire was administered also. Urine samples were subjected to parasitological and bacteriology studies to determine prevalence, intensity tract infection. A Urinary Schistosomiasis pooled prevalence of 23.1% in Akwete community, 33.9% in Ozuitem and 0% in Ohuruisinmiri communities. Escherichia coli was the most prevalent micro-organism in co-infection with the prevalence rate of 37.5%, Klebsiella spp 15.6%, Pseudomonas spp 9.4%, Streptococcus spp 6.3% and Proteus spp 3.1%.

A comparative study to assess the knowledge regarding mild and moderate mental retardation of children among primary school teachers in selected urban and rural schools, Jalandhar (Punjab) with a view to develop an information booklet.

BACKGROUND AND OBJECTIVES OF THE STUDY: Mental retardation is not a disease but a condition in which the intellectual faculties are never manifested or have developed sufficiently to enable the retarded person to acquire such knowledge. The objective of the study to assess the knowledge score regarding mild and moderate mental retardation of children among the school teacher in urban &amp; rural area, to compare the knowledge score regarding mild and moderate mental retardation of children among the urban and rural school teachers, to find out the association between urban and rural school teacher knowledge score regarding mild and moderate mental retardation and with their demographic variablesandto develop an information booklet regarding mild and moderate mental retardation. METHODOLOGY: A comparative non-experiment is used. The setting is a urban and rural primary schools, Jalandhar. The sample includes 60 primary school teachers selected by purposive sampling technique. The tool consisted: Part 1 demographic variables and Part 2 Self structured knowledge questionnaire. Reliability of the tool was established by using split half method. RESULTS: The findings of the study show that the mean score and SD of rural primary school on knowledge according to area. Definition and epidemiology the mean score is 3 and SD is 0.5, according to etiology the mean score is 5.6 and SD is 0.5, according to types the mean score is 1.2 and SD is 0.833, according to characteristics the mean score is 2.1 and SD is 0.600, according to sign and symptoms and diagnostic tests the mean score is 0.7 and SD is 0.441, according to prevention the mean score is 2.4 and SD is 0.527 and according to management the mean score is 4.5 and SD is 1.236. CONLUSION: Majority (60%) of urban primary school teachers had satisfactory knowledge regarding mild and moderate mental retardation in children while the majority (83.3%) rural primary school teachers had satisfactory knowledge regarding mild and moderate mental retardation in children.

Screening for congenital hypothyroidism in Malang, East Java in 2020

Introduction: Congenital hypothyroidism is defined as a state of thyroid hormone deficiency present at birth. Congenital hypothyroidism must be diagnosed immediately because delay in therapy may cause irreversible neurological deficits, such as mental retardation in children. However, this condition can be prevented by screening in newborns so that congenital hypothyroidism can be diagnosed and treated early, and can result in better neurological development. This study aims to determine the congenital hypothyroidism ratio in Malang from March to November 2020.&#x0D; Methods: The descriptive analysis method was used in this research. The subjects were neonates aged 0 – 28 days with a gestational age of 36 weeks and were involving the Health Office in both the Regency and the City of Malang. The data about identity, gender, age at screening, and gestational age were collected. A laboratory screening test was performed by taking a blood sample from the heel or vein for a TSH test. If the result was positive with a TSH value &gt; 20 U/mL, the subject would be recalled for having a confirmation test and referred to a pediatric endocrinologist.&#x0D; Results: There were 2024 (88.34%) subjects were successfully screened from a total of 2291 subjects. The recall rate for congenital hypothyroidism was 1:2024 (0.04%).&#x0D; Conclusion: The ratio of congenital hypothyroidism cases in Malang from March to November 2020 was higher than the global ratio, which was 1:3000. The high rate of congenital hypothyroidism in Malang indicated the need for congenital hypothyroidism screening in newborns.&#x0D;

Etiological, clinical, and laboratory evaluation of congenital hypothyroidism and determination of levothyroxine (LT4) dose at treatment interruption in differentiating permanent vs. transient patients.

Congenital hypothyroidism (CH) is the most common cause of preventable but irreversible mental retardation in children, although the risk has been widely abolished by national neonatal screening programs. The aim of this study was to determine, (a) the cause of CH, (b) the etiological cause of persistent CH and (c) to investigate the role of laboratory and clinical data in predicting persistent and transient CH. Patients diagnosed with CH, who started L-thyroxine treatment and were followed up for at least three years were included. Patient data were reviewed retrospectively. Serum thyroid hormones were measured four weeks after discontinuation of therapy at age three or earlier. Cases with a thyroid-stimulating hormone (TSH) value of >10 mIU/mL were accepted as permanent hypothyroidism, while cases with normal TSH values for six months after cessation were accepted as transient hypothyroidism. There were 232 treated cases, of whom 108 (46.6%) were female, and 169 (72.8%) were eventually diagnosed with transient CH. The best cut-off point for predicting permanent status was determined as LT4 cut-off dose ≥1.45 mcg/kg/day. The median (range) duration of L-thyroxine treatment in transient hypothyroid cases was 24 (range: 6-36) months, and treatment was discontinued before the age of three years in 64%. There were 232 treated cases, of whom 108 (46.6%) were female, and 169 (72.8%) were eventually diagnosed with transient CH. The best cut-off point for predicting permanent status was determined as LT4 cut-off dose ≥1.45 mcg/kg/day. The median (range) duration of L-thyroxine treatment in transient hypothyroid cases was 24 (range: 6-36) months, and treatment was discontinued before the age of three years in 64%.

Household caregivers' knowledge and control of helminthiasis in preschool children in a rural community of Enugu state, Nigeria.

Helminthiasis causes iron deficiency anemia, pica, growth, and mental retardation in children. Deworming exercises are being included as part of various interventional programs to reduce the disease burden. However, the success or failure of such activities in terms of household caregivers' knowledge and practice of deworming is not usually adequately evaluated, thus this study. This was a cross-sectional descriptive study carried out in the rural community of Enugu State, Nigeria. Pretested semi-structured interviewer-administered questionnaire was used. Inferential statistics, χ2 test, and t-test were also used in the analysis for categorical and continuous variables, respectively. A total of 294 preschool children and 250 caregivers were studied. Among the caregivers, 212 (71.9%) had good knowledgeand 149 (50.5%) had good practice of deworming. There was a statistically significant association between the age of respondents and knowledge score (χ2 = 6.471, p = 0.039) and between the educational level of respondents and practice score (χ2 = 30.632, p < 0.001). Most respondents in the rural community had a good knowledge of worm infestation and only half had good practice of deworming. Also, there was a significant difference between the age of respondents and knowledge of helminthiasis and between the educational level of respondents and deworming activities of respondents.

Evaluation of the developmental outcome in children with congenital hypothyroidism.

Background:Congenital hypothyroidism (CH) is one of the most common endocrine diseases and one of the major causes of mental retardation in children. So we aimed to evaluate the developmental outcome of children with CH.Methods:This case-control study was performed on two 3-6-year-old groups of 100 patients. The case group was children with CH, referred to Endocrine Clinic of Amirkola Children's Hospital (2011-2017) and the control group was healthy children and normal from other states. The Denver developmental screening test-II (DDST_II) was used to assess the developmental factors and disorders in four areas of gross motor, fine motor, personal-social and language. Data were analyzed by SPSS 21 using descriptive statistics, t-test and chi-square, and a p<0.05 was considered significant.Results:The mean age of 200 children in the case and control groups was 54.62±15.72 and 59.68±15.64 months, respectively. In the case group, 45% and 55% of them had transient and permanent CH, respectively. All four criteria of DDST_II in the control group as well as gross motor in the case group were normal, but fine motor, personal-social and language were reported normal in 94, 95 and 93% of the case group, respectively. All subjects with abnormal DDST_II, had a negative neonatal screening tests.Conclusion:The results obtained from DDST_II indicated that 6% of children with CH had an abnormal development, all who had an onset of medical treatment over 30 days, which makes it important to screen the neonatal thyroid disease and diagnose this disease timely.

Challenges for Midwives' Healthcare Practice in the Next Decade: COVID-19 - Global Climate Changes - Aging and Pregnancy - Gestational Alcohol Abuse.

Midwives are multifaceted healthcare professionals whose competence spectrum includes a large variety of knowledge and skills going from antenatal care to education and research. The aim of this review is to suggest the future challenges midwives are going to face in the upcoming decade of this Century. COVID-19 and other infections will reasonably impact healthcare workers all over the world. Midwives are frontline healthcare professionals who are constantly at risk of contagion as their job implies close contact with women, physical support and hand touch. Also, menstruation waste plays a large role in the pollution of waters, severely impacting hygiene in the developing countries and fueling climate change. Appropriate disposal of used menstrual material is still insufficient in many countries of the world especially because of lack of sanitary education on girls. As educators, midwives will be more involved into preventing inappropriate disposal of menstrual hygiene devices by educating girls around the world about the green alternatives to the commercial ones. Despite the evidences about the fertility decrement that occurs with aging, women keep postponing reproduction and increasing their chance being childless or suffering complications related to the advanced maternal age. Teen pregnancies are as well an important issue for midwives who will be called to face more age-related issues and use a tailored case to case approach, enhancing their family planning skills. Another crucial role of midwifery regards the information about the risk of drinking alcohol during gestation. Alcohol assumption during pregnancy is responsible for serious damage to the fetus causing a wide range of pathological conditions related to Fetal Alcoholic Spectrum Disorder, leading cause of mental retardation in children of western countries. On the whole, midwives have demonstrated their willingness to expand their practice through continuing professional development, and through specialist and advanced roles especially in preventive and educational positions.