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The Effect of Adding Homeopathic Treatment to Rehabilitation on Speech and Social Development of Children with Cerebral Palsy
Firoozeh Sajedi,Vida Alizad,Fatemeh Behnia
Iranian Journal of Pediatrics , 2007,
Abstract: Objective: Cerebral palsy (CP) is a static encephalopathy. In addition to motor developmental delay, most patients have speech and social developmental delay. Recently, complementary medicine like homeopathy has been used in the treatment of neurodevelopmental disorders. This study has been conducted to determine the effect of adding homeopathic treatment to rehabilitation on speech and social development of children with spastic cerebral palsy. Material & Methods: This study was a double blind clinical trial. Twenty-four subjects were recruited from a clinic in Tehran during 2004. In this study, minimization technique was used and subjects were divided into case and control groups. The routine rehabilitation techniques were performed for 4 months in both groups. The control group received placebo and the case group homeopathy drugs. The subjects were 1-5 years old with spastic cerebral palsy, speech and social developmental delay. Level of speech and social development were assessed by Denver Developmental Screening Test II (DDST II) in the two beginning of the study and 4 months later. Findings: The average age, in the case and the control group was 28 and 28.4 months respectively. The level of speech and social development in the case group in comparison with the control group had no statistically significant difference (PV=0.17 and PV=1 respectively). Conclusion: Adding homeopathy to rehabilitation had no significant effect on the level of speech and social development of CP children. Regarding the proved effects of homeopathy mentioned in different articles on the developmental status of children with CP, it is not possible to reject the effects of homeopathy on speech and social development of children with CP.
Evaluating the Validity and Reliability of PDQ-II and Comparison with DDST-II for Two Step Developmental Screening
Soheila Shahshahani,Firoozeh Sajedi,Roshanak Vameghi,Anooshirvan Kazemnejad
Iranian Journal of Pediatrics , 2011,
Abstract: Objective:This research was designed to identify the validity and reliability of the Prescreening Developmental Questionnaire 2 (PDQ-II) in Tehran in comparison with the Denver Developmental Screening Test-II (DDST-II). Methods: After translation and back translation, the final Persian version of test was verified by three pediatricians and also by reviewing relevant literature for content validity. The test was performed on 237 children ranging from 0 to 6 years old, recruited by convenient sampling, from four health care clinics in Tehran city. They were also evaluated by DDST II simultaneously. Interrater methods and Cronbachs α were used to determine reliability of the test. The Kappa agreement coefficient between PDQ and DDST II was determined. The data was analyzed by SPSS software. Findings:All of the questions in PDQ had satisfactory content validity. The total Cronbachs α coefficient of 0-9 months, 9-24 months, 2-4 years and 4-6 years questionnaires were 0.951, 0.926, 0.950 and 0.876, respectively. The Kappa measure of agreement for interrater tests was 0.89. The estimated agreement coefficient between PDQ and DDST II was 0.383. Based on two different categorizing possibilities for questionable scores, that is, "Delayed" or "Normal", sensitivity and specificity of PDQ was determined to be 35.7-63% and 75.8-92.2%, respectively. Conclusion:PDQ has a good content validity and reliability and moderate sensitivity and specificity in comparison with the DDST-II, but by considering their relatively weak agreement coefficient, using it along with DDST-II for a two-stage developmental screening process, remains doubtful.
The Effect of Kangaroo Care on Physiologic Responses to Pain of an Intramuscular Injection in Neonates
Firoozeh Sajedi,Zahra Kashaninia,Mehdi Rahgozar,Fariba Asadi Noghabi
Iranian Journal of Pediatrics , 2007,
Abstract: Objective: Pain in neonates can be associated with various risks. So, it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but nonpharmacologic interventions like Kangaroo Care (KC) is found to be effective. The objective of this study was to assess the efficacy of KC on physiologic responses to the pain of an intramuscular injection of vitamin K in term neonates.Material & Methods: One hundred healthy term neonates were enrolled for this study during 2 months. The inclusion criteria were gestational age 37-42 weeks, normal vaginal delivery, birth weight 2500-4000 gr, age more than 2 hours and Apgar score more than 7 at 1 minute. They were randomly assigned to intervention and control groups. In the intervention group, the neonate was held in KC for 10 minutes before the injection until 3 minutes after injection. In the control group, the neonate was in the prone position in the isolette. The primary outcome measures were heart rate and blood oxygen saturation rate before, during and 3 minutes after injection.Findings: The heart rate during and 3 minutes after injection for neonates given KC were significantly lower than for neonates in control group (P<0.001). The blood oxygen saturation rate during and 3 minutes after injection for neonates given KC were significantly higher than for neonates in control group (P<0.001). Conclusion: KC given before injection seems to effectively decrease pain from injection. It is a simple, safe and effective analgesic and should be considered for minor invasive procedures in term neonates.
Validity and Reliability Determination of Denver Developmental Screening Test-II in 0-6 Year-Olds in Tehran
Soheila Shahshahani,Roshanak Vameghi,Nadia Azari,Firoozeh Sajedi
Iranian Journal of Pediatrics , 2010,
Abstract: Objective:This research was designed to identify the validity and reliability of the Persian version of Denver Developmental Screening Test II (DDST-II) in Iranian children, in order to provide an appropriate developmental screening tool for Iranian child health workers. Methods:At first a precise translation of test was done by three specialists in English literature and then it was revised by three pediatricians familiar with developmental domains. Then, DDST-II was performed on 221 children ranging from 0 to 6 years, in four Child Health Clinics, in north, south, east and west regions of Tehran city. In order to determine the agreement coefficient, these children were also evaluated by Ages and Stages Questionnaires (ASQ) test. Because ASQ is designed to use for 4-60 month- old children, children who were out of this rang were evaluated by developmental pediatricians. Available sampling was used. Obtained data was analyzed by SPSS software. Findings:Developmental disorders were observed in 34% of children who were examined by DDST-II, and in 12% of children who were examined by ASQ test. The estimated consistency coefficient between DDST-II and ASQ was 0.21, which is weak, and between DDST-II and the physicians examination was 0.44. The content validity of DDST-II was verified by reviewing books and journals, and by specialists; opinions. All of the questions in DDST-II had appropriate content validity, and there was no need to change them. Test-retest and Inter-rater methods were used in order to determine reliability of the test, by Cronbachs α and Kauder-Richardson coefficients. Kauder-Richardson coefficient for different developmental domains was between 61% and 74%, which is good. Cronbachs α coefficient and Kappa measure of agreement for test-retest were 92% and 87% and for Inter-rater 90% and 76%, respectively. Conclusion:Persian version of DDST-II has a good validity and reliability, and can be used as a screening tool for developmental screening of children in Tehran city.
Needs assessment of rehabilitation specialists for training in child development (0-8 years old)
Roshanak Vameghi,Firoozeh Sajedi,Masoud Gharib,Enayatollah Bakhshi
Pajouhan Scientific Journal , 2013,
Abstract: Introduction: This study intends to determine the needs assessment of rehabilitation specialists for training in child development (0-8 years old).Material and Methods: This study is a cross -sectional, descriptive- analytic. At the first, a questionnaire was made for the assessment of the knowledge and skills of the specialists that work in the rehabilitation team of the children with developmental disorders (occupational therapy, speech therapy, physiotherapy, technical orthopedics, preschool children education, audiometry, social working and psychology of children with special needs). The content and face validity and reliability of the questionnaire were determined. Then 400 rehabilitation specialists fill in the questionnaires. After data collection and analysis, the needs of these specialists were determined.Results: The Cronbach's Alpha of questionnaire was 0.93, which was good. One hundred and four persons (43.2%) knew the most necessity to skill increasing in normal children development indexes as the first priority. Sixty-four persons (26.1%) knew the most necessity in primary prevention methods from developmental disorders as the second priority and 66 persons (27.2%) knew the methods of early detection and intervention in developmental disorders as the third priority. One hundred and twenty five persons (45.1%) knew the most necessity to knowledge increasing in normal children development indexes as the first priority. Seventy- six persons (27.4%) knew the most necessity to the methods of early detection and intervention in developmental disorders as the second priority and 74 persons (26.2%) knew the primary prevention methods from developmental disorders as the third priority.Conclusion: It is necessary to plan and perform training of the different rehabilitation specialists for increasing the knowledge and skills in children development themes that they have sensed as the most necessities.
How Effective is Swedish Massage on Blood Glucose Level in Children with Diabetes Mellitus?
Firoozeh Sajedi,Zahra Kashaninia,Samaneh Hoseinzadeh,Akram Abedinipoor
Acta Medica Iranica , 2011,
Abstract: "nThis study was conducted to determine the effect of Swedish massage on blood glucose level in children with diabetes mellitus (DM). It was prospective randomized controlled trial study that conducted on 36 children, 6-12 years old with DM, recruited from a hospital in Qom City, Iran. The children were randomly assigned to intervention and control groups. Swedish massage was performed 15 minutes, 3 times a week, for 3 months in intervention group. The blood glucose levels were evaluated immediately after every session of massage in two groups. The mean ages of children in the intervention (n=18) and control (n=18) groups were 9.05 ± 1.55 and 9.83 ±2.03 years respectively. There was statistically no significant difference in blood glucose levels before intervention between two groups (P=0.586), but the blood glucose levels were lower significantly in intervention group in comparison with control group after intervention (P<0.0001). Addition of Swedish massage to daily routines; exercise, diet and medication regimens, is an effective intervention to reduce blood glucose level in diabetic children.
Depression in Mothers of Children with Cerebral Palsy and Its Relation to Severity and Type of Cerebral Palsy
Firoozeh Sajedi,Vida Alizad,Ghafar Malekkhosravi,Masoud Karimlou
Acta Medica Iranica , 2010,
Abstract: "nChildren with cerebral palsy (CP) suffer from several problems, so the family especially the mothers undertake a lot of social and emotional difficulties. The purpose of this study was to determine the severity of depression in mothers of children with CP in comparison with mothers who have normal children and its relation to the type of CP and severity of the disability. During this descriptive-analytic study, 43 mothers who had younger than 8 year-old children with CP under rehabilitation services in SABA clinic, related to the University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran, were selected as the case group by simple sampling. A data registration form and the Beck Depression Inventory II were completed by them. The type of CP and the severity of disability were determined by a pediatrician and an occupational therapist respectively, using the Gross Motor Function Classification System (GMFCS). Seventy-seven mothers of normal children, serving as the control group for comparing with case group, filled in the same questionnaires. There were significant differences in the mean depression scores (P=0.003) between the two groups. Having a child with CP also increases the risk of developing depression in mothers as much as 2.26 times (OR=2.26). There were no statistically significant differences in depression scores and the severity of disability and also among the five types of CP. It seems that having a child with CP is probably associated with higher prevalence and severity of depression in mothers. So treatment or prevention of depression in mothers of children with CP is highly recommended for improving the rehabilitation process and achieve better results in these children.
Temporary Strict Maternal Avoidance of Cow’s Milk and Infantile Colic
Omid Rezaei,Somaye Shahzamanian,Sahe lHemmati Gorgani,Firoozeh Sajedi
Acta Medica Iranica , 2009,
Abstract: Infant colic is a common problem characterized by excessive crying and fussing. We examined whether colic symptoms of exclusively breast-milk-fed infants would be improved by temporary strict maternal avoidance of cows milk. This study is analytic and experimental. Sixty-six subjects were recruited during winter of 2006 from a clinic in Isfahan, Iran. Breast-milk-fed in-fants with "colic", age 3-6 months and to be in otherwise good health were referred by pediatri-cians. The intervention was 1 week period of strict maternal avoidance of cows milk while they continued exclusive breast-milk-feeding. All infants showed improvement in distressed behavior (crying and fussing) during intervention. The total recorded crying and fussing time was reduced by an average of 31%. A significant difference was found in cry and fuss time between first and last 2 days of intervention (P = 0.000). Cows milk proteins may play an etiologic role in colic. We propose that a brief intervention with strict maternal avoidance of cows milk may be an effective treatment for colic in some breast-milk-fed infants.
COMPARISON THE EFFECT OF SIMULTANEOUS SENSORY STIMULATION AND CURRENT OCCUPATIONAL THERAPY APPROACHES ON MOTOR DEVELOPMENT OF THE INFANTS WITH DOWN SYNDROME
Hossein KARIMI,Sepideh NAZI,Firoozeh SAJEDI,Nazila AKBAR FAHIMI
Iranian Journal of Child Neurology , 2010,
Abstract: ObjectiveNeuromuscular characteristics in Down syndrome result in generalized muscular hypotonia, developmental delays and sensory integration deficits. The aim of this study was to compare the effects of simultaneous sensory stimulations and current occupational therapy approaches on motor functions development of infants with Down syndrome.Materials & MethodsEighteen infants with Down syndrome, aged 6 -18 months, were evaluated in two groups: intervention group (simultaneous sensory stimulation and occupational therapy) and control group (occupational therapy alone). They attended the program 3 times a week for 6 months and each session lasted 45 minutes. Motor functions were assessed before, during, and after intervention in the two groups, using GMFM test.ResultsMean motor function increased in both groups according to the GMFM test (P = 0.000). Comparison of the changes showed that although the mean difference of this variable was higher in the intervention group, the difference was not statistically significant (P = 0.576).Mean motor deficit reduced in both groups during the period of the study,which was statistically significant (P < 0.05). Comparison of the difference in mean motor deficit in the first and last evaluations showed that this difference was more in the intervention group but statistically insignificant (P = 0.617)ConclusionEarly use of simultaneous sensory stimulations can improve the quality of motor skills in Down syndrome infants. It is suggested that it may be used as an early intervention in association with other methods in the rehabilitation of these patients. However, more studies in this regard are warranted.
ContSteg: Contourlet-Based Steganography Method  [PDF]
Hedieh SAJEDI, Mansour JAMZAD
Wireless Sensor Network (WSN) , 2009, DOI: 10.4236/wsn.2009.13022
Abstract: A category of techniques for secret data communication called steganography hides data in multimedia me-diums. It involves embedding secret data into a cover-medium by means of small perceptible and statistical degradation. In this paper, a new adaptive steganography method based on contourlet transform is presented that provides large embedding capacity. We called the proposed method ContSteg. In contourlet decomposi-tion of an image, edges are represented by the coefficients with large magnitudes. In ContSteg, these coeffi-cients are considered for data embedding because human eyes are less sensitive in edgy and non-smooth re-gions of images. For embedding the secret data, contourlet subbands are divided into 4×4 blocks. Each bit of secret data is hidden by exchanging the value of two coefficients in a block of contourlet coefficients. Ac-cording to the experimental results, the proposed method is capable of providing a larger embedding capacity without causing noticeable distortions of stego-images in comparison with a similar wavelet-based steg-anography approach. The result of examining the proposed method with two of the most powerful steganaly-sis algorithms show that we could successfully embed data in cover-images with the average embedding ca-pacity of 0.05 bits per pixel.
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