فهرست مطالب
Iranian Journal of Pediatrics
Volume:28 Issue: 2, Apr 2018
- تاریخ انتشار: 1397/02/23
- تعداد عناوین: 12
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Page 1ObjectivesWe aimed to assess BMI changes in children and adolescents with Aatention deficit hyperactivity disorder before and after treatment with methylphenidate.MethodsThis was a prospective cohort study on 90 adolescents with a diagnosis of ADHD. Clinicians measured height by a tape meter, weight by the Seca scale and BMI, was calculated. Spearmans correlation test was used to determine the correlation between age and BMI. The level of statistical significance was established with at least 0.05 in SPSS v21.ResultsResults showed that 65 patients (72.2%) were boys. Most of the participants (41) were aged between 7 - 11 years. Most of them (58 patients) had combined type of disorder. A total of 22 (24.4%) attention deficit and 10 (11.1%) hyperactive type of disorder were noted.Mean of height, weigth, and BMI in participants were significantly higher after 1 year of treatment with methylphenidate.ConclusionsADHD could be indicated as a risk factor for overweight and obesity in Iranian adolescents; thus, clinicians should consider it from the beginning of the diagnosis of ADHD.Keywords: ADHD, Overweight, Obesity, Methylphenidat, BMI
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Page 2BackgroundKidney and urinary tract stones are the major health issues; in addition, proper nutrition is probably an important factor in kidney stones formation. The current study aimed at evaluating nutritional factors in kidney stones formation in children.MethodsThe current cross sectional study, using the random sampling method, was conducted on 2 - 12-year-old children reffered to Amir Kabir hospital. The data were collected by a 24-hour dietary recall; and calcium, oxalate, vitamin C, animal protein, and water contents in each food was calculated by a food processing software (Nutritionist4). Data were analyzed by Pearson correlation coefficient, independent t test, and regression logestic analysis with SPSS version 21.ResultsAnimal protein (P = 0.0001), meal water (P = 0.023) and total liquid amounts (P = 0.011) in the case group was higher than those of the control group; in addition, daily vitamin C intake was higher in the control group, but the differences were not statistically significant (P > 0.05).ConclusionsThe relationship between kidney stones formation and nutritional factors was approved. Therefore, it may be effective to examine and treat the stone formation by considering the nutritional factors.Keywords: Nutritional Factors, Children, Kidney Stones
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Page 3BackgroundThe preemptive management of urinary bladder dysfunction in children with spinal dysraphism has contributed to renal cortical loss and scaring leading to end-stage renal disease, however, there is no consensus regarding the management and follow-up of these patients.ObjectivesThe present study has been performed to find the incidence of upper urinary tract deterioration in Iranian newborns suffering from spinal dysraphism.MethodsIn a prospective study, neonates born with the diagnosis of spinal dysraphism anomalies referred to the Childrens Medical Center, Tehran University of Medical Sciences, Iran in 2015 and 2016 were enrolled in the study. Patients were classified into synergic, dyssynergic and complete denervation groups based on the urodynamic studies. All were followed for a year.Results55 neonates with age range of 1-60 days were enrolled in the study. Five (9.1%) patients of the dyssynergic and complete denervation group, who were treated using clean intermittent catheterization, were complicated with severe febrile urinary tract infection. Hydrocephalus and vesicourethral reflux were seen in 23 (42%) and 16 (29.1%) patients, respectively. Upper urinary tract deterioration was significantly related to the type of urodynamic pattern (P = 0.02). The risk for upper urinary tract deterioration was highest in the dyssynergic group (seven out of 32 patients), while just one out of 12 patients in the complete denervation group and none in the synergic group experienced upper urinary tract deterioration.ConclusionsThis study showed that it may be an acceptable choice to perform urodynamic studies as soon as possible in all newborns diagnosed with spinal dysraphism and categorize them in low and high-risk groups.Keywords: Neonate, Urinary Bladder, Urodynamics, Spinal dysraphism
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Page 4ObjectivesRespiratory syncytial virus (RSV) is a major cause of respiratory infections in infants and children. The aim of this study was to evaluate clinical significance of respiratory infections as single pathogen RSV, respiratory viruses with RSV and those with bronchiolitis caused by other respiratory viruses.MethodsA total of 316 throat swabs were collected from children diagnosed with acute bronchiolitis. Real-time polymerase chain reaction was used to identify the viruses in the samples. The subjects were divided into three groups: single pathogen RSV, agents with RSV and agents without RSV. Binary logistic regression analysis was used to evaluate the corelation between single and multiple RSV infection group and infections without RSV group for parameters including age, wheezing, supplemental oxygen therapy.ResultsThe overall positivity for viruses in the study was found to be 75% with a co-infection rate of 34.2%. Compared to children with RSV alone, children with any other agents accompanying RSV, were not very likely to have fever, wheezing or supplemental oxygen therapy.ConclusionsThe findings of our study suggest that RSV still represents a large burden of bronchiolitis since it is associated with the hospitalization of children, particularly those less than six months old. We can not foresee the clinical presentation of specific agent or agents in connection to being with or without RSV in infants with any level of bronchiolitis. The study agrees with the concept that co infections with or without RSV do not increase the severity of the disease.Keywords: Respiratory Syncytial Virus, Infant, Respiratory Infection, Co, Infection, Respiratory Score, Clinical Significance
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Page 5BackgroundBrain damage and mental retardation in children can be caused by either excess or depletion of certain amino acids. Up to now there is no reliable reference interval for free plasma amino acid in Iranian children.ObjectivesThe aim of this study was to provide the reference intervals of free plasma amino acid in healthy Iranian children using high performance liquid chromatography (HPLC) as an accurate method.Methods133 children referred to Childrens Medical Center, Tehran, Iran for the annual checkup entered the study after filling out the informed consent form. Demographic data and blood samples after overnight fasting were collected. Plasma amino acid concentrations were determined by reverse phase HPLC (RP-HPLC) equipped with a fluorescence detector after precolumn derivatization of amino acids with o-phthalaldehyde (OPA).ResultsFemale children exhibited significantly higher plasma concentrations of taurine and lysine than male children. Other 20 amino acid values were not significantly different between two gender groups. Positive correlation was obsereved between age and taurine, leucine and lysine.ConclusionsOur data provided reference intervals of free plasma amino acids in healthy Iranian children. We believe our data can be used as a guideline for pediatricians to identify the significantly deviated amino acid values in children with medical issues such as genetic disorders and some acquired illnesses. Our data is also applicable for further investigations in the field of family medicine.Keywords: Amino Acid, High Performance Liquid Chromatography, Reference Intervals, Children
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Page 6BackgroundPancreatitis can be seen at any age in childhood. Therefore, it is important for pediatricians to know the diagnosis and the management of pancreatitis.ObjectivesThe aim of this study was to evaluate the etiological factors, clinical features and management of pancreatitis in children.MethodsThis study included hospitalized children who were diagnosed with pancreatitis. The clinical presentations, laboratory analyses, radiological features, etiologies and treatments were recorded.ResultsA total of 59 pancreatic attacks were recorded in 41 patients. The most common symptoms were abdominal pain and vomiting, and the most common etiological cause was idiopathic. Approximately 22% of the patients had acute recurrent episodes. Somatostatin was used to treat 61% of the attacks; however, it did not reduce the time to recovery after an attack when compared to those patients who did not use somatostatin (P = 0.36). The white blood cell counts and urea and calcium levels were significantly different between those patients who did and did not use somatostatin. Seventeen (28.8%) of the pancreatitis attacks were determined to be severe. Moreover, a mutation in the cystic fibrosis transmembrane conductance regulator was detected in two patients with recurrent pancreatitis.ConclusionsFever and irritability can be signs of pancreatitis in infants and toddlers. In our cases, the somatostatin treatment was not effective in terms of the time to recovery after an attack.Keywords: Pancreatitis, Child, Somatostatin
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Page 7BackgroundHenoch Schonlein Purpura (HSP) is one of the most common vasculitic diseases of childhood. Considering the effects of resistin in inflammation, we hypothesized that resistin was important in the pathogenesis of HSP. Therefore, the aim of this study was to investigate the serum and urinary resistin levels of patients with HSP and compare them with those of healthy subjects.Materials And MethodsThe study was performed between March 2015 and September 2015 at University of Health Sciences, Umraniye Training and Research Hospital, Department of Pediatrics. Fifteen children with HSP were evaluated during the acute phase and compared with fifteen healthy age- and sex-matched controls.ResultsA total of 30 children, 15 of whom were in the HSP group participated in the study. There were fifteen children with a median age of 8.65 ± 4.35 years in the HSP group, of whom 9 (60%) were male and 6 (40%) were female. In the control group, there were 15 children with 6 (60%) males and 4 (40%) females, aged 3 to 16 years. The serum resistin level of the HSP group (53.96 ± 33.61 ng/ml) was significantly higher than that of the control group (19.46 ± 4.42 ng/ml) (PConclusionsThe effects of resistin in vasculitic disorders have not been clearly demonstrated so far. In our study serum and urinary resistin levels were significantly higher in patients with acute stage of HSP than that in the healthy control group. According to our results, serum and urinary resistin levels could be used as a diagnostic or prognostic marker and be considered as a secondary epiphenomenon in children with HSP.Further studies are warranted to elucidate the pathogenic mechanisms by which serum and urinary resistin levels elevate in HSP patients with kidney involvement and relapses.Keywords: Adipocytokines, Henoch Schonlein Purpura, Resistin
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Page 8BackgroundChildren seem to be more susceptible to deleterious effects of air pollution related to respiratory functional parameters as compared to adults and thus quite perceptively assessment of these pathological changes among children is necessary. The present study aimed to assess the effects of air pollution on respiratory functional parameters among primary school children in Tehran, Iran.MethodsThis cross - sectional survey was performed on 102 children aged less than 12 years studying at a primary school in Tehran in 2015. At two time points with healthy and unhealthy air conditions (December 2015 and May 2016), all eligible children were evaluated with respect to respiratory functional parameters (FEV1, FEV1/FVC, FVC, PEF, FEF25 - 75) using a spirometer.ResultsThere were significant differences in respiratory some parameters including FEV1 (P = 0.013) and PEF (P = 0.003) between the two times of respiratory assessment, no difference was found in some others such as FVC, FEV1/FVC and FEF25 - 75.ConclusionsAir pollution can be harmful for respiratory functional status in children by reducing FEV1 and PEF parameters.Keywords: Spirometry, FEV1, PEF, Air Pollution, Pollutants
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Page 9BackgroundIntoxication with Atropa belladonna is endemic in Eastern Anatolia especially in springtime. However, in literature, there are no much studies about Atropa belladonna intoxication in childhood.ObjectivesThis study examines clinical and laboratory findings of pediatric Atropa belladonna intoxication cases.MethodsHospital official database was searched for international classification of diseases code of intoxication. The inclusion criteria included individuals under the age of 15 and who had a history of Atropa belladonna ingestion.ResultsThe most frequent clinical findings were mydriasis, flushing, and meaningless speech. There was a significant rise in the white blood cell count, glucose, aspartate aminotransferase, and C - reactive protein levels.ConclusionsAtropa belladonna intoxication clinically causes anticholinergic syndrome and can result in deteriorations in some laboratory tests.Keywords: Atropa Belladonna, Plant Poisoning, Children
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Page 10ObjectivesTo analyze the clinical characteristics of scrub typhus (ST) initially misdiagnosed as Kawasaki disease (KD) in children.MethodsThis study was conducted through a review of medical records of children with ST from March 2005 to June 2015.ResultsAmong 182 incomplete KD patients, 11 patients were ST. Red lips, strawberry tongue, and BCG site redness were not reported. Presence of eschars was reported in 5 patients. Group 1 patients (n = 6) were initially treated by using intravenous immunoglobulin (IVIG) and among them, one patient had an eschar after IVIG use. Group 2 patients (n = 5) were also initially diagnosed as KD but were not treated because eschar was detected in four patients before use of IVIG. One patient had no eschar but had a positive serologic test before IVIG use.ConclusionsWhen children have symptoms similar to KD but without red lips and strawberry tongue, clinicians should search for an eschar and perform serologic tests for ST.Keywords: Scrub Typhus, Kawasaki Disease, Eschar
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Page 11IntroductionVanishing white matter disease (VWM) is considered as one of the most frequent types of inherited childhood leukoencephalopathies. Various neurological and non-neurological manifestations have been reported in this type of leukodystrophy; however, seizures are rarely described in infantile type of VWM.Case PresentationTo patient is a 12 months old boy who experienced frequent seizures at 4th month of age. The seizures were resistant to anti-epileptic drugs and caused 3 periods of hospitalization. Magnetic resonance imaging (MRI) demonstrated demyelinating pattern and whole exome sequencing (WES) reported homozygous mutation (c.922G > A) in EIF2B2 gene in exon 8 leading to an amino-acid substitution (p.Val308Met).ConclusionsInfantile onset of vanishing white matter disease can be considered as one of few childhood leukodystrophies that are associated with early onset seizures.Keywords: Leukodystrophy, Vanishing White Matter, Seizure, Epilepsy