eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Krishnaswami Devimeenakshi drdevi_1804@yahoo.in 1 Kasinathan SathishKumar kumarsathish16@gmail.com 2 Government Kilpauk Medical College, Chennai, Tamil Nadu, India Government Kilpauk Medical College, Chennai, Tamil Nadu, India Background and Objective: Perinatal asphyxia is one of the major contributors to neonatal mortality in developing countries. Identification of factors influencing the early outcome in perinatal asphyxia will help to plan necessary interventions. The aim of this study was to evaluate the factors influencing the early outcome of asphyxiated neonates. Methods: This retrospective cohort study was conducted on asphyxiated neonates admitted to the neonatal intensive care unit (NICU) of a tertiary Medical college hospital in Chennai, Tamilnadu, India, from January to December 2016. The relationship between the risk factors and early outcome of asphyxia was analyzed using a statistical chi-square test. A multivariate analysis was performed to determine the factors influencing the outcome. A value of p<0.05 was considered significant. Findings: Of 346 asphyxiated neonates, 42 (12.1%) died. Multivariate analysis revealed that factors like parity (OR:0.018, p-value=0.01), birth weight (OR:3.217, P-value=0.04), meconium stained liquor (MSL) (OR:3.217, p-value=0.03), APGAR score at five minutes (OR:0.533, p-value=0.04), shock (OR:4.123, p-value=0.01), and abnormal cranial ultrasound (OR:2.390, p-value=0.03), and mechanical ventilation (OR:13.496, p-value=0.03), were significantly associated with outcome. Conclusion: The current study revealed that maternal factors such as parity, intrapartum factors like MSL, low five-minute Apgar score, neonatal factors like birth weight, shock, abnormal cranial ultrasound, and mechanical ventilation had a significant impact on the mortality of neonates with perinatal asphyxia. As many of these factors are modifiable, better intrapartum monitoring and timely initiation of corrective measures may help to improve the early outcome of asphyxiated neonates. http://caspianjp.ir/article-1-230-en.pdf Asphyxia Gestational Age Birth Weight Apgar Score eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Ali Mahmoudi alimahmoudi_k@yahoo.com 1 Sanaz Mehrabani mehrabanisanaz@gmail.com 2 Mohammadreza Esmaeili Dooki esmaeilidooki@yahoo.com 3 Hoda Shirafkan hodashirafkan@gmail.com 4 Student Research Committee, Babol University of Medical Sciences, Babol, Iran Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran. Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran Background and Objective: Foreign body ingestion is one of the most common problems and reasons for emergency endoscopy in children. The aim of this study was to determine the type and location of entrapped objects and endoscopic observations in children with foreign body ingestion. Methods: This cross-sectional study was conducted on all children with complaints of foreign body ingestion who underwent upper endoscopy at Amirkola Children's Hospital, north of Iran during 2014-2021. Demographic information, type of foreign body, clinical symptoms, and examinations during hospitalization, endoscopic findings, and short- and long-term outcomes were recorded. A value of P<0.05 was considered significant. Findings: The mean age of 84 children in the study was 47.98±31.51 months and 56% of them were boys. The most commonly ingested foreign bodies were food (26.2%) and coins (25.0%). The most common location of the foreign body was the upper part of the esophagus (41.7%) and 29.7% of children were without clinical symptoms, and among those with clinical symptoms, vomiting (38.1%) was the most common symptom. The most common endoscopic findings were esophageal ulcer (11.9%). No significant relationship was found between gender and type of ingested foreign bodies (p=0.528). Conclusion: The results of the study showed that the most common foreign bodies were food and coins and that the most common site of injury was in the esophagus, and the incidence of dangerous complications in children was low, with no deaths. Therefore, monitoring of children and providing appropriate treatment based on existing guidelines are helpful. http://caspianjp.ir/article-1-215-en.pdf Child Endoscopy Foreign Body eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Tahereh Galini Moghadam taheremoghaddam@yahoo.com 1 Hassan Mahmoodi Nesheli mahmoodi86@yahoo.com 2 Associate Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran Non-Communicable Pediatrics Diseases Research center, Babol University of Medical Sciences, Babol, Iran Background and Objective: Relapse of acute lymphoblastic leukemia (ALL) usually occurs in the bone marrow, testes and brain, but the occurrence of relapse in the orbits seems to be rare. In this case, we present a relapse of ALL that occurred in the eyes. Case Report: A 9-year-old girl with Down syndrome, a known case of ALL, was in remission after complete chemotherapy ( Berlin-Frankfurt-Munich (BFM) protocol) and presented to Amirkola Children' Hospital with conjunctivitis and blurred vision. She had been in remission for one year (since 1991-1992). Paracentesis of the anterior chamber was performed to obtain a sample of the aqueous humor for cytology. The smear revealed involvement of the eye with leukemic cells. Hematologic examinations were performed. The bone marrow and central nervous system (CNS) were normal. While we continued chemotherapy for four months, the patient presented with headache and bone pain. A re-examination revealed that she had a relapse in the bone marrow and CNS. She died from leukemia, despite appropriate therapy. Conclusion: Ocular paracentesis should be performed without delay when blurred vision develops in ALL, regardless of systemic signs and symptoms. http://caspianjp.ir/article-1-204-en.pdf Acute Lymphoblastic Leukemia Down Syndrome Ocular Relapse eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Samridhi Chowdhary dr.samridhichowdhary@gmail.com 1 Rajeshwari Krishnan rajeshwari.dr@gmail.com 2 Deepak Kumar deepakk70@gmail.com 3 Binita Goswami binita.dr@gmail.com 4 Maulana Azad Medical College, New Delhi, India Maulana Azad Medical College, New Delhi, India Maulana Azad Medical College, New Delhi, India Maulana Azad Medical College, New Delhi, India Background and Objective: Acute exacerbation of bronchial asthma is a very common presentation in the pediatric emergency department, thus being a major cause of morbidity in children. Intravenous magnesium sulfate is often used for the management of acute asthma. The actual association of serum magnesium levels with the severity of the disease has been explored in various studies but lacks concrete results, especially in Indian children. The aim of this study was to assess serum magnesium levels in children with acute bronchial asthma and determine the association between magnesium levels and various parameters in asthma. Methods: This cross-sectional study was conducted in a tertiary care center in New Delhi in the year 2021-22. A total of 40 children aged 6-11 years presenting to the emergency department with acute exacerbation were included. Serum magnesium levels were determined in all patients who came to the emergency department with an acute exacerbation of bronchial asthma. The prevalence and association between hypomagnesemia and various disease and population variables were determined. Findings: The prevalence of hypomagnesemia was 20% in the included patients. Lower magnesium levels were found to be associated with lower oxygen saturation on admission, longer duration of hospitalization, deranged pulmonary function tests, and the need for mechanical ventilation. Conclusion: The results showed that hypomagnesemia was significantly associated with increased severity of bronchial asthma. http://caspianjp.ir/article-1-233-en.pdf Asthma Child Hypomagnesemia Hypoxia eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Kimiya Moulazadeh molamohsenif@gmail.com 1 Zahra Dasht Bozorgi zdashtbzrgi@gmail.com 2 Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Background and Objective: Children diagnosed with attention deficit hyperactivity disorder (ADHD) frequently exhibit challenges in emotional regulation and social interaction. This study aims to investigate the potential of narrative therapy, a collaborative storytelling approach, to enhance emotional intelligence, anger management, and social adjustment among this population. Methods: A quasi-experimental pretest-posttest design with a control group was applied for this study. The target population encompassed all children diagnosed with ADHD residing in Ahvaz City during 2023. A convenience sample of 28 participants was randomly assigned to either an experimental (n=14) or control (n=14) group. Data were collected using the Emotional Intelligence Questionnaire, the Child Behavior Aggression Scale, and the Social Adjustment Scale. The experimental group received seven 40-minute narrative therapy sessions, while the control group served as a no-treatment group. Analysis of covariance (ANCOVA) was used to analyze the data. Findings: The post-test analysis revealed a significant difference between the narrative therapy and control groups in all three domains (P<0.01). The narrative therapy group demonstrated substantially higher scores in emotional intelligence (82.18±14.05 vs. 70.54±12.11), anger management (50.12±9.31 vs. 37.49±6.75), and social adjustment (32.16±5.12 vs. 22.49±4.87). Conclusion: The findings suggest that narrative therapy constitutes an effective intervention for enhancing emotional intelligence, anger management, and social skills in children diagnosed with ADHD. Moreover, narrative therapy emerges as a valuable tool for addressing the emotional and social challenges commonly experienced by this population http://caspianjp.ir/article-1-239-en.pdf ADHD Anger Emotional Intelligence Narrative Therapy Social Skills eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Samira Pournajaf samirapournajaf@yahoo.com 1 Zahra Akbarian-Rad Zhr_akbarian@yahoo.com 2 Nesae Bozorgnezhad tarannom.paeezi@yahoo.com 3 Hemmat Gholinia Ahangar h_gholinia@yahoo.com 4 Mohsen Haghshenas Matia.mojaveri@yahoo.com 5 Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, I.R. Iran Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, IR Iran. Background and Objective: Clinical assessment of newborns in the first minutes after birth is a challenge in neonatal medicine. The aim of this study was to compare the diagnostic value of the combined and conventional Apgar scoring systems in identifying poor short-term outcomes in newborns. Methods: This prospective cohort study evaluated 660 newborns at Ayatollah Rouhani Hospital of Babol-Iran (a tertiary referral hospital), from October 2021 to November 2022. After birth, the 5th-minute conventional and combined Apgar scores were recorded. The newborns were followed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the sensitivity and specificity of the Apgar scores to predict short-term outcomes (mechanical ventilation requirement, occurrence of intraventricular hemorrhage, neonatal mortality, and retinopathy of prematurity). Findings: Out of 660 newborns 373(56.5%) males and 287(43.5%) females), Fifty-seven (8.6%) newborns had IVH, 46(6.97%), were diagnosed with ROP, 40(6.1%) newborns required mechanical ventilation, and 41(6.21%) died. The AUC of combined Apgar for predicting ROP and IVH (82% and 76% respectively) and the AUC of conventional Apgar for predicting death and mechanical ventilation (90% and 85% respectively) was higher than the others. Conclusion: The conventional Apgar score was better than the combined Apgar score for predicting mechanical ventilation requirement and death. When infants were grouped by gestational age, none of the Apgar scores was a good predictor of ROP. Also, Apgar was only a good predictor of IVH at gestational ages greater than 34 weeks, of which combined Apgar is better than the others. http://caspianjp.ir/article-1-238-en.pdf Combined Apgar Conventional Apgar Infant Newborn eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Mohsen Akhavan Sepahi akhavansepahimm@gmail.com 1 Mohammad Hossein Akhavan Sepahi mohammadakhavansepahi@yahoo.com 2 Department of Pediatric Nephrology, School of Medicine, Qom University of Medical Sciences, Qom, Iran Department of Dentistry, School of Medicine, Dentist Student, A.I. Yevdokimov Moscow State University of Medical and Dentistry Sciences, Moscow, Russia Background and Objective: Lowe syndrome (LS) is a very rare syndrome characterized by the triad of intellectual disability, cataracts, and proximal renal tubule dysfunction due to a mutation of the oculocerebrorenal (OCRL) gene encoding the OCRL-1 protein. This case report describes an LS boy with a different familial complication. Case Report: We report a 7-year-old boy presented with failure to thrive (FTT), congenital cataract, leg deformity, genu varus, short stature, renal tubular acidosis (Fanconi syndrome), mental retardation and normal glomerular filtration rate who was diagnosed with LS 6 years ago. This family includes the parents and 4 sons, the eldest and the youngest are normal, and the second and third children in the family have persistent microscopic hematuria. Conclusion: The present case study shows that nephrocalcinosis caused by Lowe syndrome could leads to recurrent microscopic hematuria http://caspianjp.ir/article-1-234-en.pdf Congenital Cataract Intellectual Disability Kidney Stone Lowe Syndrome Proteinuria eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Milad Fadaei Dehcheshmeh miladfadaei71@gmail.com 1 Ali Shamsi Majelan alishamsim@yahoo.com 2 Department of Sport injury and Corrective exercise, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran Associate Professor, PhD of Sport injury and Corrective exercise, Department of Sport injury and Corrective exercise, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran Background and Objective: Children with intellectual impairment (II) show poor motor skills due to their low cognitive abilities. Considering the impact of participation in physical activities, the aim of the present study was to investigate the effect and durability of exercises and games on fundamental motor skills (FMS) of II children. Methods: This randomized controlled study assessed 60 boys with mild II in three groups, exercises (aerobics and resistance), sports games (basketball and futsal), and control (in eight weeks), using the TGMD-2. The prevalence and association between hypomagnesemia and various disease and population variables were determined. The data were analyzed using SPSS at the significance level of P<0.05. Findings: In boys with mild II (mean age=9.80±1.15 years), there were significant differences in the "intergroup" between the intervention and control groups in motor competence, locomotor skills (running, hopping, leaping, jumping and sliding) and object control (throwing and rolling) at post-test (P=0.001) and follow-up (P<0.05). There were significant differences between all groups in hitting in the post-test and in the follow-up examination (P<0.05). In the "intragroup", there were significant differences in all variables in the exercises and games during the pre-test and post-test, the pre-test and follow-up (except the gallop) and the post-test and follow-up (P=0.001). Conclusion: This study revealed the positive effect of the interventions on most of FMS variables, and the sports game group performing better. Due to the modality of the physical activity interventions, the integration of these two types of interventions may show a better effect. http://caspianjp.ir/article-1-251-en.pdf Child Intellectual Disabilities Motor Development Physical Activity Sport eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Harsha Neelam neelam.harsha.hn@gmail.com 1 rakesh kotha dr.rakeshkotha@gmail.com 2 Alimelu Madireddy asvnrao@yahoo.com 3 Department of Neonatology, Niloufer Hospital, Hyderabad, India Department of Neonatology, Niloufer Hospital, Hyderabad, India Department of Neonatology, Niloufer Hospital, Hyderabad, India Background and Objective: Basilar invagination and atlas assimilation are significant craniovertebral anomalies that typically present with symptoms in the 3rd and 4th decades of life. These anomalies are concerning because they are in close proximity to the vital structures surrounding the foramen magnum, including the brainstem and spinal cord. However, these conditions are rarely reported in younger populations, making early diagnosis and intervention in such cases particularly difficult. Case Report: This report presents the case of a term neonate born to a primigravida mother by emergency lower segment cesarean section. The infant, who was initially discharged after resolution of respiratory distress, was readmitted at two weeks of age with generalized weakness. The initial management approach focused on treating the condition as late-onset sepsis and meningitis. However, after ruling out other causes for the generalized hypotonia, subsequent computed tomography (CT) of the head and spine revealed compressive myelopathy secondary to basilar invagination and atlas assimilation, as well as gross hydrocephalus. These findings emphasize the presence of a craniovertebral anomaly at an exceptionally early stage of life.. Conclusions: This study revealed the positive effect of the interventions on most of FMS variables, and the sports game group performing better. Due to the modality of the physical activity interventions, the integration of these two types of interventions may show a better effect. http://caspianjp.ir/article-1-240-en.pdf Craniovertebral Anomalies Hypotonia Neonate Neuroimaging eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Manivelu Sankaranathan Shrimathy shrimams6868@gmail.com 1 Krishnaswami Devimeenakshi drdevi_1804@yahoo.in 2 Department of Pediatrics, Kilpauk Medical College, India Department of Pediatrics, Kilpauk Medical College, India Background and Objective: Birth trauma refers to injury sustained by the newborn due to mechanical forces during the birth process. It's associated with increased mortality and morbidity. The aim of this study was to determine the incidence of birth trauma in various modes of delivery and to analyze the risk factors for birth trauma. Methods: This cross-sectional study was conducted from March-October 2021 in a medical college hospital in Chennai-India. All live-born singleton term neonates delivered in the hospital during the study period were screened for birth trauma through a detailed clinical examination and relevant investigations. The risk factors contributing to birth trauma were investigated. The frequency of birth trauma was compared in various modes of delivery. Univariate and multivariate analysis was done for the risk factors. Results were expressed as odds ratio (95% confidence interval). P-value<0.05 was considered statistically significant. Findings: Among the 2300 live births screened, there were 22 neonates who developed birth trauma, which corresponds to an incidence of 9.5/1000 live births. Birth trauma occurred more frequently in instrumental delivery. The most common birth trauma was subgaleal hemorrhage followed by cephalhaematoma. Risk factors such as short stature, abnormal fetal presentation, abnormal birth weight and maternal illnesses were significant determinants of birth trauma. Conclusion: The results of this study showed that when pregnancy is complicated by factors such as maternal short stature, maternal illness, abnormal fetal presentation, and abnormal birth weight, the risk of birth trauma is increased. http://caspianjp.ir/article-1-245-en.pdf Birth Injuries Delivery Obstetric Femoral Fractures Newborn eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Armon Massoodi armonmassoodi@gmail.com 1 Sara Dehbozorgi Dehbozorgi.sa@gmail.com 2 Nasim Nekouei Shoja nnekouei@gmail.com 3 Seyedeh Maryam Zavarmousavi maryamzavarmousavi@gmail.com 4 Assistant Professor of child and adolescent Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Research Center for Psychiatry and behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Assistant Professor of Children and Adolescents' Psychiatry, Department of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, Rasht, Iran Background and Objective: Attention-deficit/hyperactivity disorder (ADHD) is a disorder of childhood and adolescence characterized by persistent symptoms of increased activity and impulsive behavior. Totally, 2-5% of schoolchildren exhibit specific and comprehensive symptoms of ADHD. The aim of the present study was to investigate the comparison of risperidone and aripiprazole in the treatment of ADHD children. Methods: A literature search was performed in the electronic databases of Embase, PubMed, Web of Science, Scopus, and Google Scholar for articles published from inception between 2005 and 2022. Persian keywords and their English equivalents in Mesh were used to search all domestic and foreign articles in all databases. This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and the quality of articles was assessed using the risk of bias checklist. Findings: Of the 320 articles initially identified, 8 were eventually included, with 4 articles published from Iran and 4 articles from other countries. Totally, 50% of the studies were related to Iran. The age of the studied subjects ranged from 3 to 18 years, and 283 children were studied and investigated. In 90% of the studies, with p>0.05, there was no significant difference in the efficacy of the two drugs, risperidone and aripiprazole. Conclusion: In general, both risperidone and aripiprazole are effective for the treatment of ADHD and can be used according to the clinical conditions and medical history of the child. http://caspianjp.ir/article-1-205-en.pdf Aripiprazole Attention Deficit and Hyperactivity Disorder Child Risperidone eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Kavous Shahsavarinia Kavous.shahsavari@yahoo.com 1 Alireza Razzaghi razzaghi.alireza1@gmail.com 2 Farzad Rahmani rahmanif@tbzmed.ac.ir 3 Hassan Soleimanpour h_mofid1357@yahoo.com 4 Ayda Khalili Khaliliayda1371@gmail.com 5 Mohammad Saadati hcm.2020@gmail.com 6 Research Center for Evidence-Based Medicine, Iranian EBM Center: A JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran. Children Growth Research Center, Research Institute for Prevention of Non-Communicable disease, Qazvin University of Medical Sciences, Qazvin, Iran Emergency and trauma care research center, Tabriz University of Medical Sciences, Tabriz, Iran. Cardiovascular Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran. Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran. saadatim@khoyums.ac.ir Background and Objective: Providing timely and high-quality health services for pediatric burn cases is vital in reducing the death probability. The aim of this study was to demonstrate the value of P-Baux and R-Baux indexes in anticipating burn-related consequences among children. Methods: The present cross-sectional investigation was carried out in 2018 at a burn referral center located in Tabriz. Through the census method, all children <12 years old who were admitted to the hospital with burn symptoms during the sampling period were included in the study. Data collection was carried out through a researcher-developed questionnaire. R-Baux and P-Baux scores were computed based on the patient's records. Data were analyzed using SPSS17 through multivariate logistic regression with a significance level of 0.05. Findings: A total of 213 children were included in the study. In terms of mortality, the area under curve (AUC) of the R-Baux and P-Baux scores was similar (0.959). Moreover, the AUC of the outcomes for intensive care unit (ICU) admission and need for intubation was 99%. Logistic regression revealed a significant correlation between the need for intubation and death with both P-Baux and R-Baux scores (p<0.05). Admission to the ICU was only significantly related to the P-Baux score (p=0.022). Conclusion: Utilizing P-Baux and R-Baux scores not only anticipates the death rate but also allows health service providers to prioritize patients and prepare proper facilities to prevent pediatric burn-related mortalities. http://caspianjp.ir/article-1-224-en.pdf Accident Baux Score Burn Injury Prevention eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Keerthana Srinivas kirthana_95@yahoo.co.in 1 N Rashmi dr.rashminagaraj@gmail.com 2 R Srinivasan r.srinivasan@schoolofbusinessdesign.com 3 Department of Pediatrics, JSS Medical College Hospital, JSSAHER, Mysuru, India Associate Professor, Department of Pediatrics, JSS Medical College Hospital, JSSAHER, Mysuru, India Professor and Director, SOIL School of Business Design, Gurgaon, India Background and Objective: The use of educational and entertainment screens has increased enormously since the coronavirus disease 2019 (COVID-19) pandemic. The artificial blue light emitted from these devices affects the circadian rhythm, and the use of these devices one hour before bedtime may delay the onset and total amount of rapid eye movement (REM) sleep. Therefore, this study was conducted to investigate the role of digital media in children’s lives and its effects on various health domains, especially sleep. Methods: This cross-sectional observational study was conducted in the Pediatric Department of a Tertiary Medical College Hospital, Mysuru, India, over a period of 18 months from January 1, 2020 to June 30, 2021 on a total of 200 eligible subjects aged 3 to 12 years. Parents/caregivers were interviewed using a two-part questionnaire to obtain details of screen time and sleep quality. The responses were recorded and analyzed. Findings: A majority (61%) of subjects spent 2 hours or less gaming without the use of a screen device. A significant association was found between screen use 30 minutes before bedtime and delay in falling asleep (P=0.001). Second, longer total screen time per day was associated with higher body mass index (BMI) (P=0.036) for age and gender. Conclusion: Sleep onset is delayed when screen use is stopped shortly before bedtime. With increasing age, total screen time per day increases significantly. Higher screen time is associated with higher BMI for age and gender. Screen use during mealtimes is very high among preschool and school-age children.  http://caspianjp.ir/article-1-242-en.pdf Behavioural Sleep Problems Screen-Based Electronic Gadgets Screen Time Sleep eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Mohammad Ali Molavi shayanmolavi@yahoo.com 1 Samaneh Tahmasebi Ghorabi samaneh.tahmasebi70@gmail.com 2 Fazl Saleh fazlsaleh@yahoo.com 3 Abdolmajid Nazemi Qeshmi Dr_amnazemi@yahoo.com 4 Seyede Saba Mazloumi Saba_mazloomi@yahoo.com 5 Masoumeh Mahmoudi M.mahmudi6934@yahoo.com 6 Arian Karimi Rouzbahani ariankarimi1998@gmail.com 7 Department of Pediatric Hematology-Oncology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran Department of Pediatric Hematology-Oncology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Department of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Department of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Children's Hospital Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran Background and Objective: Leukemia is the most common type of cancer and the main cause of cancer-related mortality in individuals≤15 years. Leukemia is not only caused by an underlying genetic disease, but a number of environmental variables also contribute to its occurrence. The aim of the current study was to determine the incidence rate of various types of leukemia in children admitted to Bandar Abbas Hospital between 2011 and 2017. Methods: All children referred to Bandar Abbas Children's Hospital between 2011 and 2017 who were diagnosed with leukemia were included in this retrospective cross-sectional study. The files in the archive department of the hospital and the information provided by the attending physician were the two sources of information needed for this study. Data such as age, gender, type of leukemia and place of residence were collected from the patient records. SPSS-22 was used to analyze the data. Findings: Of 89 patients diagnosed with acute leukemia between 2011 and 2017, 83(93.3%) were diagnosed with acute lymphoblastic leukemia (ALL). B-cell ALL was the most common form of leukemia (69.7%). Boys developed leukemia more frequently than girls (61(68.5%) and 28(31.5%) cases respectively). Most patients with leukemia (70.8%) were aged 1-10 years. Conclusion: According to the results, ALL was the most common type of leukemia in Hormozgan Province. In addition, the prevalence of leukemia was higher in boys than girls in this province. It is recommended that the risk factors affecting the different types of leukemia in this province be investigated in future studies. http://caspianjp.ir/article-1-223-en.pdf Child Hormozgan Incidence Leukemia eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Kian Nasernejad rahmatimfrmd@gmail.com 1 Reza Johari Fard rjoharfard@gmail.com 2 Parvin Ehteshamzadeh ehteshamzadehp@gmail.com 3 Saeed Bakhtiarpour bakhtiyarpours@gmail.com 4 Mohammad Hossein Mohebbi Nouredinvand mohebinourmh@gmail.com 5 Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Department of Psychology, Masjed Soleiman Branch, Islamic Azad University, Masjed Soleiman, Iran Background and Objective: Children with attention deficit hyperactivity disorder (ADHD) often exhibit elevated levels of aggression and deficits in empathy, negatively impacting their social and academic lives. The present study aimed to investigate the effects of mindfulness-based art therapy on aggression and empathy among children with ADHD. Methods: A study was conducted with 44 ADHD-diagnosed children in Amol City, Northern Iran, during the 2023 academic year, using a pre-test, post-test, and control group design. Participants were randomly divided into an experimental group (n=22) and a control group (n=22). The experimental group received ten 60-minute mindfulness-based art therapy sessions. Data were collected using the Child Behavior Aggression Scale and The Children’s Empathy Quotient, with analysis performed using analysis of covariance. Findings: Aggression scores significantly decreased in the experimental group (58.91±2.97 at pre-test; 39.82±2.70 at post-test) compared to minimal changes in the control group (60.17±3.12 at pre-test; 58.27±3.79 at post-test). Conversely, empathy scores significantly increased in the experimental group (18.41±4.95 on the pre-test; 27.50.50±5.45 on the post-test). These findings indicate that mindfulness-based art therapy produced significant reductions in aggression and enhancements in empathy among children with ADHD (P<0.001). Conclusions: Mindfulness-based art therapy has proven effective in reducing aggression and enhancing empathy in children with ADHD. This method promotes emotional regulation, self-awareness, and social skills, making it particularly beneficial for those unresponsive to traditional therapies. By integrating mindfulness techniques, psychotherapists can assist children in managing emotions, curbing impulsive behavior, and improving social interactions, offering a promising therapeutic approach for this population. http://caspianjp.ir/article-1-250-en.pdf ADHD Aggression Art Therapy Child Empathy eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Zahra Nazari Taloki zahra_nazari_taloki@yahoo.com 1 Department of Clinical Pharmacy, School of Pharmacy, Babol University of Medical Sciences, Babol, Iran Dear Editor Migraine is a common neurological disorder in children and adolescents with an estimated prevalence of 11%, which can affect the quality of life and academic performance. Recent evidence suggests that although medications such as topiramate (with and without vitamin D3 supplementation), pregabalin, levetiracetam, amitriptyline, riboflavin, flunarizine and cinnarizine may be effective in reducing the frequency of migraine attacks in pediatric patients, they are not helpful to improve quality of life improvement or decrease the duration of migraine attacks [1]. We would like to propose curcumin, a bioactive polyphenolic diketone from turmeric, as an innovative therapeutic approach for pediatric migraine and highlight its valuable effects. Although the exact pathophysiology and etiology of migraine remain unclear, oxidative stress, inflammation and neuroendocrine disparities have been recognized as major risk factors in the onset of migraine attacks. Among the miraculous effects of curcumin, we count its antioxidant, anti-inflammatory, neuroprotective and pain-relieving properties, which make it a promising candidate for addressing migraine-related mechanisms. The remarkable effect of curcumin on migraines is therefore no coincidence. In this context, recent research has shown that curcumin offers notable benefits, including a marked decrease in the severity, frequency, and duration of migraine attacks, as well as a significant improvement in quality of life [2-6]. The efficacy and safety of curcumin in children and adolescents have been confirmed [7]. In emphasizing its safety in pediatric neurological disorders, the recently published clinical study on the effect of curcumin in the treatment of intractable pediatric epilepsy should not be ignored [8]. Although this idea has not yet received attention, it is an indication that this natural drug deserves further consideration and evaluation as a novel, effective treatment for migraine in children that could potentially improve the quality of life of these patients. http://caspianjp.ir/article-1-270-en.pdf Curcumin Inflammation Migraine Neuroprotective Pediatric Pharmacotherapy eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Robabe Salehi salehi.r.65@gmail.com 1 Azra Mohammadpanah Ardakan azramohammadpanah@ardakan.ac.ir 2 Department of Psychology, Ardakan University, Yazd, Iran Department of Psychology, Ardakan University, Yazd, Iran Background and Objective: The aim of this study was to investigate the life experiences of mothers of children with Down syndrome (DS) and to examine parents' cognitive-emotional strategies against stress. Methods: A sequential exploratory method was chosen in this mixed-method study. In the qualitative phase, ten mothers with DS children were selected to be interviewed using purposive and phenomenological methods. The interviews were analyzed using the Colaizzi method. In the quantitative phase, 32 questionnaires on cognitive emotion regulation by Garnefsky (2006) were completed by the parents of DS children and 34 questionnaires by the parents of normal children. The results were then analyzed using the ANCOVA method. Findings: Four main categories were identified in the qualitative phase: mothers’ emotions over time, problems over time, efficiency and performance experiences, and management of problems. The quantitative results showed that the mean and standard deviation of blaming others was 7.98±0.56 in the group of parents of DS children, and 9.95±0.54 in the group of parents with normal children. Moreover, the mean acceptance was 14.66±0.56 in the group of parents with DS children and was 12.84±0.55 in the group of parents with normal children. In other words, blaming others and acceptance were lower (p=0.05) and higher (p=0.03) in the group of parents with DS children than in parents with normal children, respectively. Conclusion: It can be concluded that the group of parents with DS children achieved a greater increase in cognitive emotion regulation skills compared to other parents. http://caspianjp.ir/article-1-249-en.pdf Cognitive Emotion Regulation Down syndrome Lived Experience Mothers Parents eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Elham Shahgholi eshahgholi@gmail.com 1 Seyyed Mohsen Sadatinejad sadatinejad71@gmail.com 2 Mohammad Kajiyazdi mkajiyazdi50@gmail.com 3 Associate Professor of Pediatric Hematology and Oncology, Tehran University of Medical Sciences, Tehran, Iran Pediatric Cardiology, MD, Tehran University of Medical Sciences School of Medicine, Tehran, Iran Associate Professor of Pediatric Hematology and Oncology, Tehran University of Medical Sciences, Tehran, Iran Background and Objective: Eighty percent of childhood leukemia cases are classified as acute lymphocytic leukemia (ALL), with genetic abnormalities identified in the majority of instances. We conducted an examination of the early clinical manifestations of pediatric ALL and the minimal residual disease (MRD) following treatment with standard cytogenetic testing in children. Methods: This descriptive and analytical study involved patients diagnosed with ALL who were admitted to three hospitals in Tehran, Iran, from 2020 to 2021. The clinical features assessed included splenomegaly, hepatomegaly, and lymphadenopathy. Laboratory tests conducted comprised complete blood count, lactate dehydrogenase levels, tumor lysis tests, bone marrow aspiration, MRD assessment, and cytogenetic analysis, with a p-value<0.05 considered statistically significant. Findings: A total of eighty-four patients participated in the study. No significant associations were identified between early splenomegaly, lymphadenopathy, limping, tumor lysis, mediastinal mass, and cytogenetics or MRD. Hepatomegaly was found to correlate with the absence of unfavorable structural mutations, whereas anemia was associated with the presence of mutations. A white blood cell (WBC) count of less than 50,000/µl was linked to lower MRD levels, and a platelet count of less than 50,000/µl was associated with the del9p21 mutation and unidentified structural mutations (P<0.05). Additionally, lactate dehydrogenase (LDH) levels of less than 1000 IU/L were related to unfavorable numerical mutations. Conclusion: This study found that anemia, a platelet count below 50,000, and LDH levels under 1,000 are significantly associated with mutations and cytogenetics. Further controlled studies in this area could be beneficial. http://caspianjp.ir/article-1-243-en.pdf Acute Lymphoblastic Leukemia Child Clinical Laboratory Test Cytogenetic Signs and Symptoms eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Fatemeh Mollaalinejad ffattememolaalinejad@gmail.com 1 Marzieh Mahmudimanesh m_mahmudi69@yahoo.com 2 Ahmad Sadeghi ahmadsadeghi1363@gmail.com 3 Fatemeh Eidi f.eidi8993@gmail.com 4 Department of Health Information Technology, Student Research Committee, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Assistant Professor in Biostatistics, Department of Public Health, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Assistant Professor, Department of Public Health, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran MSc in Pediatric Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Background and Objective: Ensuring children's health is a critical indicator of public health improvement, underscoring the importance of conducting studies in this area. The aim of this study was to examine the epidemiology of poisoning among children admitted to Esfarayen Hospital from 2019 to 2024. Methods: This cross-sectional study investigated the medical records of all children <18 years with poisoning admitted to Imam Khomeini Hospital in Esfarayen between 2019 and 2024 and the number of patients was 1140. Data including age, sex, cause of poisoning and poisoning outcomes were collected using hospital records, and analysis was performed using SPSS 26, R software. Findings: In this study, the incidence of poisoning was higher in girls (59.6%) compared to boys (40.4%). Among the 1,140 children hospitalized due to poisoning, 593 pediatric (52%) were older than 13 years, 83 cases (7.3%) were between 6 and 12 years old, and 464 children (40.7%) were younger than 6 years. The most common causes of poisoning were, respectively, opioid medication (31.1%), alcohol (4.4%), gasoline and kerosene (1.2%), carbon monoxide (0.9%) pesticides (4.4%), detergents (2.9%), non-opioid medication (55.1%). Given the time series model, poisoning cases are showed a stable trend and forecasts shows around 4 opium and 9 drug poisoning cases in 2025. Conclusion: The high prevalence of drug poisoning, education on proper drug storage and psychological issues is important. Furthermore, considering the high rate of opium poisoning in children under five, social welfare interventions are necessary to identify at-risk children and provide essential family counseling. http://caspianjp.ir/article-1-257-en.pdf Child Epidemiology Poisoning eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Sahar Sadr Moharrerpour drsaharsadr@gmail.com 1 Soheil Osia s.osia109@yahoo.com 2 Sajedeh Hajipour hajipour1365@gmail.com 3 Sajedeh Omidbakhsh omidbakhsh_sajedeh@yahoo.com 4 Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, IR Iran Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, IR Iran Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, IR Iran Background and Objective: The most common cause of acute kidney injury (AKI) in children is hemolytic uremic syndrome (HUS). HUS is characterized by the triad of thrombocytopenia, non-immune hemolytic microangiopathic anemia, and AKI. HUS has no specific manifestations, but it usually presents with fatigue, pallor and decreased urine output. Abdominal pain is one of the symptoms usually caused by Shiga toxin-producing E. coli, although fever is rare. Severe gastrointestinal tract involvement occurs in 5 to 10% of cases. The patient described presented with diarrhea, vomiting and abdominal pain and underwent surgery for an acute abdomen with a diagnosis of toxic megacolon. This is a rare complication of HUS. Case report: A 7-year-old boy was admitted to the emergency room with fever, vomiting, and bloody diarrhea and received conservative treatment. On the second day, the abdominal pain worsened and he had tenderness and guarding on examination, which was diagnosed as acute abdomen. After the diagnosis of acute abdomen, surgery was performed, which led to a diagnosis of toxic megacolon. The day after surgery, the patient became pale and oliguric. The patient's tests included Hb: 7.5gr/dl, PLT: 67000ml, Cr: 2.5 mg/dl, BUN: 42mg/dl, LDH: 3320 U/L and schistocytes were observed on the peripheral blood smear, the patient was diagnosed with HUS and underwent hemodialysis treatment. Conclusion: This case reminds us that HUS can present with very rare symptoms such as toxic megacolon. Therefore, it is necessary to be familiar with all the symptoms of HUS. http://caspianjp.ir/article-1-221-en.pdf Acute Kidney Injury Diarrhea Hemolytic- Uremic Syndrome eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Prajwala Hassan Vasudev prajwalahv@gmail.com 1 Ritik Raj raj345824@gmail.com 2 Deepak Anil deepakanil7@gmail.com 3 JSS Medical College, JSS Academy of Higher Education and Research, India JSS Medical College, JSS Academy of Higher Education and Research, India JSS Medical College, JSS Academy of Higher Education and Research, India Background and Objective: The SARS-CoV-2 virus has affected people of all ages. Children with SARS-CoV-2 infections are not a widely explored area, but they are important in prognosticating COVID-19 infections. The aim of this study was to investigate the clinical epidemiological traits of SARS-CoV-2-affected children and their correlation with comorbidities. Methods: A single-centre retrospective study was done among 81 COVID-19-confirmed children from April to August 2023 in Mysuru, India. Data on epidemiological characteristics, outcome status, and systemic co-infections was analyzed using IBM SPSS 26. The relationship between categorical variables was established using the chi-square test/Fisher’s exact test. The level of statistical significance was set at a p-value < 0.05. Findings: The maximum COVID-19-positive children belonged to the age group of 0-2 (34.6%). Neurological co-infections were the most prevalent at 47.6%, presenting with axial hypotonia, febrile seizures, hypoglycemia, and cerebral encephalopathy. Neurological co-infections were the most prevalent at 47.6%, presenting with axial hypotonia, febrile seizures, hypoglycemia, and cerebral encephalopathy. There was a significant association between outcome status and cardiovascular system involvement (P value = 0.003). Conclusion: Since most of the children had a co-infections and the most common cause was bactrial infection, children should be monitored for at least one month after hospitalization. The goal is early detection to stop co-infections or empirical treatment in high-risk cases. http://caspianjp.ir/article-1-253-en.pdf Child Co-Infection COVID-19 Pandemic eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Elham Shahgholi eshahgholi@gmail.com 1 Mehrdad Sedighian m.sedighiyan86@gmail.com 2 Mohammad Kajiyazdi Mkajiyazdi50@gmail.com 3 Leili Koochak Zadeh l.koochakzadeh@gmail.com 4 Maryam Amirmohseni Maryam.amirmohseni@gmail.com 5 Associate Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Clinical Nutrition, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran Associate Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran Assistant Professor of Hematology & Oncology, Department of Pediatrics, School of Medicine, Childrens Medical Center, Tehran University of Medical Sciences, Tehran, Iran Tehran University of Medical Sciences, Tehran, Iran Background and Objective: Therapeutic response to intravenous immunoglobulin (IVIG) for the treatment of immune thrombocytopenia (ITP) in children may itself be influenced by various factors. The aim of the present study was to investigate the factors associated with the response rate to IVIG treatment in children with ITP. Methods: The population of this cross-sectional study included children under the age of 15 who were diagnosed with ITP and admitted to Bahrami Hospital in Tehran from 2021 to 2022. Information on each patient including age, gender, comorbidities, platelet count at diagnosis and duration of treatment at baseline was obtained by reviewing the hospital's data registry. Treatment outcomes, including treatment success and disease recurrence or chronicity, were also recorded. A p- value of 0.05 was considered significant. Findings: Of the 41 patients examined, 7 (17.1%) cases failed to respond to IVIG treatment and received additional treatment with corticosteroids. There was a significant difference between patients with and without response to IVIG treatment. The mean initial platelet count was 22676.47±18514.07 and 13857.14±7883.07 per cubic millimeter, respectively, indicating a significant difference between the two groups (P value=0.045). An initial platelet count of less than 9,000 was predictive of non-response to IVIG treatment. Conclusion: In children with ITP, the response rate to IVIG administration was high, with patient gender and initial platelet count influencing the response. Therefore, male gender and a low platelet count on admission are predictive factors for a lower response to treatment in these patients. http://caspianjp.ir/article-1-252-en.pdf Immunoglobulins Intravenous Response to treatment Thrombocytopenic eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Sara Ardalankia ardalankia.sara@gmail.com 1 Fatemeh Behnia behnia.f@gmail.com 2 Independent Researcher, Verona, Italy Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Background and Objective: One of the core diagnostic criteria for autism is restricted and repetitive patterns of interests or behaviors. Content analysis of these limited obsessional interests suggests they are mostly focused on physical systems. Children with autism express their obsessional interests in different ways. One of them being through their drawings. However, a content analysis of such drawings has not being performed to date. The aim of this case series was to perform an observational content analysis of the drawings of children with high-functioning autism. Case series: Six children with high-functioning autism who reportedly exhibited intense obsessional interests were selected for the study. Drawings produced by these children both at home and in therapeutic settings were collected. The authors analyzed the contents in these drawings. The contents of the drawings produced by all cases were related to physical systems and mechanical or electrical object categories with details regarding components, types, brands, attributes, dynamics, and functions. Conclusion: These results show that the contents of the drawings of children with high-functioning autism are affected by their obsessional interests. The specific details of these drawings exemplify their fascination with physical systems and are consistent with the hypersystemizing theory of autism. http://caspianjp.ir/article-1-231-en.pdf Autistic Disorder Child Drawing Obsessive behavior Physics eng Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, IR Iran Caspian Journal of Pediatrics 2423-4729 2383-3106 2024-05 10 1 0 0 article Mehdi Tehrani-Doost tehranid@sina.tums.ac.ir 1 Azar Mohammadzadeh a-mohammadzadeh@farabi.tums.ac.ir 2 Fatemeh Eslamdoust-Siahestalkhi fatemeh.eslamdoost@gmail.com 3 Maryam Zavar Mousavi Maryamzavarmousavi@gmail.com 4 Research Center for Cognitive and Behavioral Sciences, Tehran University of Medical Sciences, Tehran, Iran Research Center for Cognitive and Behavioral Sciences, Tehran University of Medical Sciences, Tehran, Iran Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Background and Objective: Attention deficit-hyperactivity disorder (ADHD) is often associated with difficulties in social and emotional relationships. This study aimed to investigate the effect of methylphenidate on theory of mind ability and facial emotion recognition in children with ADHD. Methods: This was an interventional study. A total of 25, school-age children with ADHD were selected for this study at Roozbeh Hospital in Tehran, Iran in 2019. The method of diagnosing ADHD was using the semi-structured KSADS-PL interview, Conner's Parent Rating Scale, Raven's Progressive Intelligence Test, Happe Strange Stories Test, and Facial Emotion Recognition task. The children then took methylphenidate for 6 weeks and were reassessed using the mentioned instruments. Findings: The mean age and IQ of the children in our study were 8.88±1.47 years and 114.53±11.91, respectively. After treatment, children showed significantly better performance in blocks of the Strange Stories Test, including mental state (p=0.05), physical (p=0.01), natural (p=0.01), and unlinked (p=0.02). A significant difference was observed in emotion recognition between pre- and post-treatment. After the intervention, children showed better accuracy in identifying angry (p=0.006), happy (p=0.022), and sad faces (p=0.002). The comparison of scores related to Conner’s test after treatment with methylphenidate showed significant improvement in inattention (p= 0.002), hyperactivity (p= 0.008), and ADHD index (p= 0.005). Conclusion: Methylphenidate can improve social cognition components, including theory of mind ability and emotion recognition in children with ADHD. http://caspianjp.ir/article-1-256-en.pdf ADHD Facial Emotion Recognition Methylphenidate Theory of Mind