فهرست مطالب ahmad shajari

The present study aimed to evaluate the frequency and risk factors of peritonitis end-stage renal disease (ESRD) pediatrics on peritoneal dialysis (PD) in Yazd City, Iran.

This cross-sectional study was conducted on ESRD pediatrics on PD in Shahid Sadoughi hospital, Yazd City, Iran from 2016 to 2020. Demographic characteristics, such as age, sex, body mass index (BMI) at the commencement of PD, underlying medical conditions, the microbiology of peritonitis, and the recovery rate were investigated. Results were evaluated using SPSS software, version 26 (SPSS Institute, Inc., Chicago, IL, USA).

A total of 23 children (56.5% females) were included in this study. The Mean±SD age was 13.30±4.38 years, and the mean BMI was 15.71±5.53. PD-associated peritonitis was diagnosed in 18 cases (78.3%). A total of 21.7% had at least one underlying disease. No significant relationship was observed between sex (P=0.9), mean age (P=0.41), mean BMI (P=0.24), and underlying condition (P=0.29) according to pediatrics with and without PDassociated peritonitis. Bacterial and fungal infections were responsible for peritonitis in 15 (62.5%) and 3 (13%) pediatrics on PD, respectively.

The frequency of PD-associated peritonitis in the ESRD children of our study was 78.3%.

The End Stage Renal Disease (ESRD) is irreversible impairment of renal function, to the extent that the patient becomes permanently dependent on alternative therapies, especially in children. We aimed to evaluate the graft and patient survival rate among iranian pediatric recipients of kidney transplantation through a systematic review and meta-analysis.

National (SID, MagIran, IranMedex, IranDoc) and international (Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science) databases of, were searched to find studies published electronically from 1985 until Nov 2019. Heterogeneity between the collected studies was determined using the Cochran’s test (Q) and I2. Meta-regression was used to investigate the factors affecting statistical heterogeneity in 1, 5, and 10-year survival of kidney transplantation in addition to subgroup analysis based on cities.

Ten studies were qualified to enter the meta-analysis. The total participants in the study were 2673 people with an average age of 13.71±3.65 years. In the random-effects model, the survival rate of 1, 3, 5 and 10 yr of kidney transplantation were 91, 88, 81 and 70%, respectively.

By providing the documented and comprehensive evidence, can be the basis of many plans, policies, and decisions of various sectors of development. These sectors include the evaluation of treatment programs and health interventions in the pediatric kidney transplantation. The results of the present study can provide an acceptable estimate of the survival rate of transplanted children in Iran and will be useful for planning prevention and treatment programs.

birth body size is an indicator of intrauterine growth and important in later health. this study was performed to assess seasonal variation of birth body size in a group of Iranian newborn.

in a retrospective design, Hospital records of 2034 of singleton newborn with gestational age >37 week and no malformation or neonatal disorder, was assessed sex delivery type birth month, birth weight, birth height, head and chest circumferences was extracted.

1038 cases (51%)of neonates were male and 692 cases (34%) born in natural vaginal delivery. no significant difference was found in seasonal mean of birth weight (p=0.285) although most mean off birth weight was in Winter and least in summer. but peak of birth height was in fall and the least in summer (mean difference: 0.40; 95% CI:0.06-0.74; p=0.013). the difference between mean of birth head circumference was significant(p=0.027) and the most mean was in Winter and least in summer (mean difference : 0.24;95% CI:0.02-0.46; p=0.030). the difference between mean of birth chest circumference was significant and the most and least mean was in fall and spring; respectively (mean difference: 0.42;95% CI:0.12-0.71; p=0.002).

birth body size is the least in newborn of  hot half of the year and most in cold holf of the year.

In Heart Failure reduced Ejection Fraction (HFrEF), there is a clear Guideline Directed Medical Therapy (GDMT) for drug treatment. However, there are usually differences between what is recommended and what is actually done in the community. Additionally, no clear data are available regarding the types and doses of drugs used for HFrEF in patients with chronic heart failure.

The present study aimed to investigate the current drug treatment for HFrEF in the community.

This cross-sectional study aimed to investigate the types and doses of drugs used by cardiologists for HFrEF patients. The data were collected using a researchermade questionnaire by attending cardiologists’ offices and reviewing patients’ drugs. Considering the probability of 20% of patients using optimal drug doses (according to a pilot study), the sample size was estimated as 250 patients. Thus, 300 patients with stable drug regimens for three months were enrolled into the study.

The mean age of the patients was 62.3 ± 14 years and 65% were male. The mean Left Ventricular Ejection Fraction (LVEF) was 27.3 ± 7%. Additionally, the rates of using Beta Blockers (BBs), Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers (ACEIs/ARBs), and Mineralocorticoid Receptor Antagonists (MRAs) were 91%, 89%, and 63%, respectively. Only 5% of the patients received the target dose of BBs and 11% took the target dose of ACEs/ARBs. A significant gap was discerned between the recommended target doses and the patients’ current doses.

The frequency of consumption of BBs, ACEs/ARBs, and MRAs in HFrEF was reasonably acceptable in the study population. However, there was a marked difference between the recommended and actual drug doses for HFrEF. Hence, further studies are required to evaluate and resolve the barriers.

Aside from classic indexes of infant growth such as weigh, length and head size, other infant parameters have been investigated in different studies and its relationship with gestation age and uterine internal growth have been evaluated. these parameters include breast size, underfoot size and arm size. In this study, the correlation between underfoot size of new-borns and other classical growth indexes and the traits during the birth such as mother age and gestational age and the gender of infant is studied. In this study, the length of underfoot is selected after birth. This study is done to obtain the average of this size in the infant under study and could be the furs study in out country.
The

in this study 500 new-borns infant department of Yazd worker in 2014 were selected randomly and the information related to growth index and the traits during the birth were prepared by question and were extracted from their records. The data was analyzed by SPSS software.

in this study ,500 new-borns infant with the accepted criteria were evaluated. 51.8% of them were boy and 48.2% of theme were girl. The average of mother age was 26.52. the average of gestational age 36.2 weeks and the average of new-born weight was 2890.52 gram. The average of new-born was 49.7 centimeters and the average of head size was35.11 centimeters. The average of underfoot size of infant was 66.91 centimeters. The correlational coefficient of underfoot length than other variables (mother age, the weight, length and head size) was respectively 0.192, 0.524, 0.797,0.606 and 0.575.

there was significant and positive correlation between feet length and other indicators of uterine internal growth such as weigh and head size in the birth and the traits during the birth such as gestational age and new-born gender and can be used separately to examine the health of infant.

Due to the increasing prevalence of kidney stones in children in recent decades and the increasing public health burden and worrying complications of kidney stones in these ages and the significant relationship between levels of  1,25-Dihydroxyvitamin D and plasma calcium, the aim of this study was to evaluate the effect of vitamin D level on kidney stones in children under 18 years of age.

This cross-sectional descriptive study was conducted on 60 children, 30 of whom had kidney stones as a case group and 30 healthy children (without kidney stones) as a control group. Patient information including demographic information, history and results of necessary tests were extracted from patientschr('39') files and the necessary items were entered into a pre-designed checklist. Data were collected and analysed in SPSS software version 17.

The mean of vitamin D, serum calcium and urinary calcium in patients were 48.56 ± 20.06, 9.65 ± 0.65 and 102.59 ± 28.56  mg / dl, respectively. In terms of gender distribution, 58.7% of patients (n=27) were boys and 41.3% (n=19) were girls. In terms of stone material distribution, 52.5% of patients (n=24) had oxalate stones, 26.1% of patients (n=12) had phosphate stones and 21.7% (n=10) had uric stones. Regarding symptoms, 15.2% (n=7) of patients had pain, 10.9% (n=5) of patients had hematuria and 73.9% (n=34) were asymptomatic. There was a significant inverse correlation between serum calcium and vitamin D levels (P = 0.014).

According to this study, urinary tract stones were more common in boys under 18 years of age. Vitamin D, urinary calcium and serum levels, also being a girl or a boy are not related to the material of the stone.

Awareness of pediatric cardiopulmonary resuscitation (CPR) is obligatory for every graduated medical student. In fact, only correct and effective Cardiopulmonary resuscitation can increase the survival rate of patients with cardiopulmonary arrest and since CPR techniques and maneuvers should be done in a specific way for children, it is important to evaluate the knowledge of pediatric resuscitation.

In a cross-sectional study, multiple-choice questions were designed about basic and advanced pediatric cardiopulmonary resusitation (under 8 years) and 100 medical students enrolled in undergraduate training. Results were analyzed using the software SPSS 15.

The internschr('39') advanced awareness was significantly less than the basic knowledge (P-Value < 0.001). The awareness of students who studied in CPR was higher than students who did not (P-Value < 0.027). Moreover, students who participated in the rehabilitation of children were more aware (P-Value < 0.002) and interns who attended the Heart Ward had a higher level of awareness (P-Value < 0.001).

In general, results obtained from the internschr('39') awareness in the present showed the importance of pediatric resuscitation training courses and participation in resuscitation operations. So, this training course should be considered as a training strategy course in the internship program.

Kidney stones are one of several serious health problems in childhood that cause nutritional and growth disorders, and may finally lead to chronic kidney failure in this group.

In this analytical study conducted through a case-control design, 30 children under the age of two with kidney stones, and 125 children of the same age and sex without stones were studied. Patient information including personal profile and the results of some necessary tests were extracted from patient records and listed in a checklist. The data was analyzed using SPSS (Version 17.0). Statistical significance was considered when p-value was <0.05.

In terms of duration of breastfeeding, a significant difference was observed between the patients with stones and patients without stones; the duration of breastfeeding was longer in the control group (p=0.003). In addition, the duration of feeding with formula milk and cow milk was longer in the case group (p=0.038 and p=0.012, respectively).

Breastfeeding can serve as a nutritional factor that plays a preventive and protective role against the formation of kidney stones in infants.

Asthma is the most common chronic airway disease in children, which is caused by genetic and environmental factors such as obesity. The aim of this study was to evaluate the relationship between obesity and asthma severity in children. This cross-sectional descriptive study included 200 asthmatic children aged 6 to 12 years in Yazd Shohadaye Kargar hospital in 2015 - 2016. The participants' demographic data were recorded. According to the Australian National Asthma Campaign, they were categorized into mild, moderate, and severe groups considering their severity of asthma. In order to compare the studied variables t, chi-square, and Mann-Whitney tests were used by SPSS 18. The results showed that 11 (27.5%) obese children had severe asthma, but only 7 children (4.4%) with normal BMI had severe asthma (P <0.001). It was also found that the mean BMI in children with severe asthma was 21.68, in children with moderate asthma was 19.73, and in children with mild asthma was 18.27 (P <0.001). Other variables including age, birth weight, maternal age, socioeconomic status, and educational level did not have any significant effect on the severity of asthma (P> 0.05). Our study showed that the prevalence of severe asthma was high in obese children and this relationship was stronger in boys. Therefore, obese children have a higher risk for severe asthma. To reduce obesity in children,  treatments such as regimen are required.

At the beginning of the birth, due to an increase in enterohepatic cycle, the baby is at high risk for jaundice, leading to a physiologic jaundice. Although phototherapy is a safe treatment, it can lead to complications such as hyperthermia, erythematous rashes, inflammatory fluids, and diarrhea. Thus, a new therapeutic approach to lowering the level of bilirubin and also reducing the need for phototherapy can be According to the studies, probiotics (pedilact) regulate intestinal function of the enterohepatic vasculature and therefore may be effective in the treatment of neonatal hyperbilirubinemia. The aim of this study was to investigate the effect of probiotics on indirect indirect bilirubin levels in the blood.
Material and This analytical study was carried out using clinical parallels and parallelism with B & A design the study population consisted of 80 neonates with Hyperbilirubinemia who were randomly divided into two groups of exposed and non-invasive subjects. Non-existent group members were treated with phototherapy only and the newborns in the exposure group received 5 drops of probiotics daily for discharge until they were received. Data were analyzed using SPSS 17 software and independent t-test, paired t-test and ANOVA The mean of indirect bilirubin reduction on the first day was 3.4 mg / dl in the phototherapy group and 3.5 mg / dl in the phototherapy + probiotic group and was not significant with p-value of 949.0. The mean of indirect bilirubin reduction per day The second one was 6.3 mg / dl in the phototherapy group and 7.mg / dl in the phototherapy + probiotic group, which was more than the phototherapy group and had no significance with p-value = 0.177. Indirect bilirubin reduction on day 3 of the phototherapy group / 6mg / dl in the phototherapy + probiotic group was 7.1 mg / dl, which is more than phototherapy group and does not have significant significance with p-value=0.618. The mean of bilirubin reduction in the phototherapy + probiotic group is slightly higher than that in the phototherapy group but is not statistically significant.

Peritoneal dialysis is one of the most efficient treatment in ESRD. Peritoneal sclerosis and malnutrition are side effects of peritoneal dialysis. Cancer antigen 125(CA125) is made by peritoneal mesothelial cells and increases during peritoneal inflammation. Peritoneal biopsy s an invasive method using for diagnosis of peritoneal sclerosis but serum CA125 is a noninvasive method used for prediction of peritoneal dialysis recently. The aim of this study was to investigate the relationship between serum CA125 with peritoneal function and malnutrition parameters.
This cross- sectional study was carried out in Yazd 2014. A total of 50 peritoneal dialysis patients were selected by convenience sampling. A questionnaire consists of malnutrition and peritoneal functional parameters and demographic characteristics of patents was completed. SPSS version 20 and T test. Anova, chi -square and logistic regression tests used for data analysis.
In this study, there was a direct association between serum CA125 and serum triglyceride, LDL and invers more association between CA125 and serum albumin but there was no association between CA125 and peritoneal function parameters.

Procedural sedation may be needed in many diagnostic and therapeutic procedures in children. To make pediatric procedural sedation as safe as possible, protocols should be developed by institutions. Response to sedation in children is highly variable, while some become deeply sedated after minimal doses, others may need much higher doses. Child developmental status, clinical circumstances and condition of patient should be considered and then pharmacologic and non-pharmacologic interventions for sedation be selected. Drug of choice and administration route depend on the condition of the child, type of procedure, and predicted pain degree. The drugs might be administered parenteral (intravenous or intramuscular) or non- parenteral including oral, rectal, sublingual, aerosolized buccal and intranasal. The use of intravenous medication such propofol, ketamine, dexmedetomidine, or etomidate may be restricted in use by pediatric anesthesiologist or pediatric critical care specialists or pediatric emergency medicine specialists. In this review article we discuss on non-parenteral medications that can be used by non- anesthesiologist.

Urinary screening program for asymptomatic urinary abnormalities among primary school children may facilitate preventing, halting, and deferring the progression of some diseases.. To describe the urine examination findings in healthy primary school beginners in Yazd (Iran)..Patients and A complete physical examination in the morning with a midstream urine sample collection obtained from 3014 students in two educational areas of Yazd, Iran. Students with positive test results in the first screening were retested. The urine samples of those with two abnormal results were analyzed using dipstick and microscope concurrently.. Children (1527 girls, 1487 boys) were screened and urinary abnormalities were detected in 94 (3.1%) subjects at the first screening. Proteinuria was the most common abnormality, detected in 54 (1.79%), and next, hematuria was present in 16 subjects. Of these children, 24 (0.79%) cases were positive in the second screening. In the third analysis of samples, abnormal findings in the patients included one isolated hematuria, eight isolated proteinuria, and two combined hematuria and proteinuria. 19 out of 3014 (0.63%) had a familiar history of renal diseases and three of them had renal disease.. Urinary screening can detect chronic renal disease in its earliest stages that may help to prevent the deterioration of future renal function. In addition, a long-term follow-up of the children with hematuria and proteinuria is suggested..

Migraine is the most common acute intermittent primary headache in children and prophylactic therapy is indicated in children with frequent or disabling headaches. The purpose of this study was to evaluate the efficacy and safety of topiramate (TPM) for migraine prophylaxis in children. In a quasi-experimental study, monthly frequency, severity and duration of headache, migraine disability, and side-effects were evaluated in 100 children who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi University of Medical Sciences, Yazd, Iran from April 2011 to March 2012, and were treated with 3 mg/kg/day of TPM for three months. Fifty eight (57.4%) girls and 42 (41.6%) boys with the mean age of 10.46±2.11 years were evaluated. Monthly frequency, severity, and duration of headache decreased with treatment from 15.34±7.28 to 6.07±3.16 attacks, from 6.21±1.74 to 3.15±2.22, and from 2.28±1.55 to 0.94±0.35 hours, respectively, and the Pediatric Migraine Disability Assessment score reduced with TPM from 32.48±9.33 to 15.54±6.16. Transient side-effects were seen in 21% of the patients, including hyperthermia in 11%, anorexia and weight loss in 6%, and drowsiness in 4%. No serious side-effects were reported. TPM could be considered as a safe and effective drug in pediatric migraine prophylaxis.

Vitamin D is an essential hormone for growth and development of bones in children. There is a lot of evidence for deficiency of this vitamin in Middle East females. This study conduct to find a way to combat deficiency in girls during rapid growth phase of puberty in academic year. One hundred and two Middle School girls who had not consumed any vitamins supplement have been participated in this randomized clinical trial. They allocated randomly in two case groups who received 50,000 or 100,000 IU vitamin D3 in October and three months later in January or in control group who received vitamin E. At the end of winter blood samples for 25-hydroxyvitamin D were checked. The mean of 25-hydroxyvitamin D were 5.5±1.5 ng/ml, 15.2±6 ng/ml, 23.0±6.8 ng/ml in control, 50,000 and 100,000 IU vitamin D groups respectively (P<0.05). Neither dosage of vitamin D could raise 25-hydroxyvitamin D above 20 ng/ml in all cases. However, none of the students in 100,000 IU of vitamin D3 had severe deficiency in winter. Headache, dizziness, and weakness were the most common complain after vitamin D consumption, but no difference between groups detected (P>0.05). Urine calcium/creatinin ratio was equal in case and control groups (P>0.05). 100,000 IU of vitamin D3 every three months (equal to 800IU/day) can raise 25-hydroxyvitamin D above 12 ng/ml in all cases but for area with high prevalence of sever deficiency, dosage more than 100,000 IU every three months or shorter interval recommended to achieve optimal level.

Despite an increasing prevalence of obesity and hypertension in young age, there is limited information on the contribution of body mass index (BMI) to blood pressure (BP) in these populations, especially in developing countries. This study examines the association between BMI and BP in four populations of school age children across southern region of Islamic republic of Iran.

Urinary tract infections are common in children. The available gold standard method for diagnosis, Tc-99m dimercaptosuccinic acid scan is expensive and exposes patients to considerable amount of radiation. This study was performed to compare and assess the efficacy of Power Doppler Ultrasound versus Tc-99m DMSA scan for diagnosis of acute pyelonephritis. A quasi experimental study was conducted on 34 children with mean age of 2.82.7 years who were hospitalized with their first episode of febrile urinary tract infection. All children were evaluated in the first 3 days of admission by Doppler Ultrasound and Tc-99m DMSA scan. Patients with congenital structural anomalies were excluded. Each kidney was divided into three zones. The comparison between efficacy of Doppler Ultrasound and DMSA scan was carried out based on number of patients and on classified renal units. Based on the number of patients enrolled; the sensitivity, specificity, positive and negative predictive values and accuracy of Doppler Ultrasound were 89%, 53%, 70%, 80% and 74%, respectively but based on the renal units, it was 66%, 81%, 46%, 91% and 79%, respectively. Although Doppler Ultrasound has the potential for identifying acute pyelonephritis in children, but it is still soon to replace DMSA scan.

Acute glomerulonephritis (AGN) is a type of renal disease which indicates the inflammation of glomerulus and nephrons. This study was carried on 94 children, <15 years old with the diagnosis of AGN who were admitted to Qom and Yazd's hospitals between 2000 and 2006. Data were collected using hospital records on admission, progression notes and outpatient follow up. Among 94 patients, 55.3% were male and 44.6% were female. Mean age of patients was 8.2±2.7 years old. Acute post streptococcal glomerulonephritis (APSGN) was reported in 92.5%, membranoproliferative glomerulonephritis in 4.2%, hemolytic uremic syndrome in 2.1% and IgA nephropathy in 1.06%. There was no significant differences between GN types and gender (P=0.54). Clinical manifestation included edema in 68.8%, oliguria in 36.3%, gross hematuria in 69.1%, HTN in 61.7% and anuria in 1.06%. Microscopic hematuria was detected in all patients. In the time of follow up none of patients had hypertension, 3.1% had proteinuria and 6.3% had microscopic hematuria. APSGN is the most common causes of AGN in Qom and Yazd's children. Early diagnosis and treatment of APSGN may protect children from long term morbidity and mortality and improve quality of life.

According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonoraphy. Mean of thyroid volume in male and female was 9.08 ± 2.49 and 7.93 ± 3.2 milliliter which the differences was significant (P<0.003).Differences between thyroid volume and weight was significant (P=0.001). Mean of female weight and proportion of thyroid volume to their weight was 61.83 ± 12.09kg and 0.130 ± 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 ± 9.05kg and 0.126 ± 0.028 (P<0.003). Results of study is similar to other studies. Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumption.

Cerebrovascular accidents are the most common complications in premature neonates (gestational age <37 weeks). Intraventricular hemorrhage (IVH) and hydrocephaly are the most common presentations of these accidents. Premature neonates less than 28 week age or 1000 gr have maximum risk of cerebrovascular accidents with prevalence of 30 percent. Early screening in high risk pregnancies with real-time ultrasonography can detect these lesions and affect on final prognosis. The purpose of this study is evaluation of brain ultrasonongraphic findings of 60 premature neonates born in Yazd University Hospitals, Yazd, Iran and relationship between these findings and delivery type

Prevalence of urolithiasis is increasing in children and maybe hematury is only sign. This study was conducted to investigate clinical manifestation and etiology of urolithiasis in children younger than 14 year-old. This descriptive and case-series study was carried out on 100 patients referring to Sahamie Pediatric hospital in Qom in 2007-8. Age, sex, family history, clinical manifestation (fever, dysuria and Pain) and laboratory tests (Na, K, Ca, P, urea, Cr, Albumin, Alkaline phosphates of serum; ABG, urine sediment, urine culture; Na, K, Ca, P, Cr, oxalate and citrate of urine/24h and cysteine in random sample of urine) were determined. Ceratenin correcting formula was used for adequacy controlling of urine collecting. Hypocitraturia (56.8%), hypercalciuria (29.4%), hyperuricosuria (26.3%), hyperoxaluria (14.7%), phosphaturia (8.4%) and cystinuria (6.3%) were detected. Also, 54% patients had urinary tract infection. Pain (27.7%), fever (33.3%), irritability and dysuria (62.2%) and hematuria (77.7%) were seen. Positive family history was reported in 23% of patients. Most common clinical manifestations in children with stone were hematuria, dysuria, fever and pain. The common etiology of urolithiasis respectively was hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria, phosphaturia and cystinuria.

Recent studies have suggested theophylline for prevention of kidney dysfunction in asphyxia. This study was designed to determine whether theophylline could prevent or ameliorate kidney dysfunction in term neonates with perinatal asphyxia. We assigned 36 severely asphyxiated term infants (Apgar score? 5) into 2 groups to receive intravenously a single dose of either theophylline (5mg/kg; n =17) or placebo (n =19) during their first 60 minutes of life. The 24-hour fluid intake and the urine volumes were recorded during the 1st, 3rd, and 5th days of life. Severe kidney dysfunction was defined as a serum creatinine level elevated up to more than 1.50 mg/dL for at least 2 consecutive days after a fluid challenge, or 0.3-mg/dL/d rising levels of serum creatinine.On the 1st day, the 24-hour fluid balance was more positive in infants receiving placebo compared to infants receiving theophylline. Over the next few days, the change in fluid balance favored the theophylline group. Significantly higher serum creatinine values were recorded in the placebo group on the 3rd day. Severe kidney dysfunction was present in 2 infants of the theophylline group (11.7. %) and in 8 (42.1%) of the controls. The glomerular filtration rate was markedly increased in the theophylline group. There was no difference in the severity of the asphyxia between the infants of the theophylline and control groups. Prophylactic theophylline, given early after birth, has beneficial effects on reducing kidney dysfunction in neonates with asphyxia.

Reye's syndrome is defined as fatty liver degeneration and acute encephalopathy following diffused abnormal mitochondrial activity. We reported a two year old girl admitted with lethargy and meningismus Despite no evidence of blood sugar decrease, history of previous viral disease or drug use, complete tests showed Reye syndrome as the final diagnosis. Conservative protocols and treatment including carnitine and antibiotic therapy were administered and finally, the patient was discharged in good condition. Normal blood sugar, no evidence of previous viral infection or drug use are uncommon manifestations in Reye's syndrome which were present in this case. Treatment included carnitine and antibiotic therapy with considerable response.

The requirement of vitamin D for breast-fed term infants remains an area of controversy. Different dosage is needed according to environmental factors such as sunlight exposure. Reception of more than 400 I.U. of vitamin D daily produces hypercalcemia. A random urine calcium/creatinin ratio (UCa/Cr) is a screening test for detection of hypercalciuria. Setting adequate values of vitamin D3 prophylaxis by random UCa/Cr in infant population of Yazd city in Iran, is the aim of present study. A total of 90 healthy, full term newborns of both genders were enrolled in the study. They were divided equally into three receiving vitamin D3 prophylaxis groups as follow: (I) 200 IU/daily, (II) 400 IU/daily and (III) 50000 IU two times in fifteen and sixty days after birth. A random urine specimen from each subject was analyzed for calcium, creatinin and serum 25-hydroxy-vitamin D at the end of three months of life. From all 90 studied infants, 25 (83.3%) infants with 200 IU/daily vitamin D3, 23 (76.7%) infants with 400 IU/daily vitamin D3 and 28 (93.3%) who received 50000 IU two times (76 infants, 84.4%) had hypercalciuria and 14 (15.6%) infants remained with low values of Ca/Cr ratios. According to high prevalence of hypercalciuria in this survey, it is recommended to evaluate the vitamin D level in infants and use proper amount of supplemented vitamin D. It seems that 200 IU/daily could be used in infants in our area.