International Journal of Children and Adolescents
Volume:2 Issue: 2, Apr 2016

World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

Febrile convulsions (FC) are the most common seizure disorder in children. Lumbar puncture should be considered in any case with FC who is suspected to intracranial infections. This study determined white blood cell and polymorphonuclear cell counts, and protein and glucose levels in cere-brospinal fluids (CFS) of children hospitalized with FC.
In this cross sectional study, lumbar puncture samples of children with FC admitted to the Neurol-ogy ward of Ali-Asghar Children’s Hospital from 2010–2013 were evaluated. Recorded data included age, sex, type of seizure (simple, complex), frequent attack of FC, family history of FC or epilepsy and cerebrospinal indices (white blood cell, protein and glucose).
In this study, 91 CSF specimens of patients with FC were evaluated. Mean (SD) age of cases was 17.66±10.81 months. Fifty seven (62.6%) of cases were male. Mean glucose and protein levels of CSF was 62.57±12.30 and 21.34±9.52 milligram per deciliter, respectively. Median of WBC and PMN count of CSF were 1 and 0 cell/mm3, respectively. There was not significant relationship between patient's characteristics and CSF indices (P >0.05).
During FCs, glucose and protein levels of CSF are in normal limits. Minimally changes may occur in CSF cell counts.

To assess the incidence and risk factors of upper gastrointestinal bleeding in children admitted to pediatric intensive care unit for more than 6 hrs.
We prospectively collected medical records of children between 1 month and 18 years old admit-ted to our 10 bed PICU of a tertiary care university hospital between December 1, 2014 and May 30, 2015. De-mographic data, admission diagnosis and basic laboratory data were recorded. We defined upper gastrointestinal bleeding (UGI) as any evidence of blood in nasogastric aspirates, hematemesis and melena witnessed between minimum 6 hours to maximum 5 days after admission. We documented it and detected previously described factors for UGI bleeding such as mechanical ventilation, coagulopathy, organ failure, feeding, and drug prophy-laxis. Finally data were used in a multivariate analysis.
Of 157 medical records, 148 patients were eligible. The incidence of UGI bleeding was 34.45%. The most common indication for PICU admission was respiratory system dysfunction (32.2%). Mechanical ven-tilation, thrombocytopenia and prolonged PT and PTT were the significant factors in our study using univariate analysis and mechanical ventilation was the only significant risk factor using multivariate analysis
The incidence of UGI bleeding in PICU admitted patients is significant and mechanical ventila-tion is the most important risk factor for GI bleeding.

Given the widespread use of paraffin in the treatment of constipation in chil-dren and the possibility of long duration of drug use and the risk of drug leakage, the risk of urinary infection in these patients is considerable. The aim of this study was to determine the association between leakage of paraf-fin and the presence or exacerbation of the urinary infection and repeated attacks of urinary tract infection in children with chronic functional constipation.
In this cohort study, 80 consecutive children aged 3 to 17 with the diagnosis of chronic constipa-tion according to the Rome III criteria that received paraffin (5 to 15ml/kg/day) or polyethylene glycol (1.5grams/kg/day) treatment schedule were studied and the presence of urinary tract infection in the patients was analyzed.
There was also no difference between paraffin group and polyethylene glycol group in terms of the prevalence of urine incontinence (17.5% versus 25.0%, p=0.293) and fecal incontinence (17.5% versus 12.1%, p=0.378). In total, positive urinary culture was found in one child (2.5%) in paraffin group and in two children (5.0%) in polyethylene glycol group without significant difference (p=0.500).
The occurrence of urinary tract infection is expected in 3.75% of children with chronic func-tional constipation treated with paraffin or polyethylene glycol. The types of treatment including paraffin or polyethylene glycol do not increase the risk for urinary tract infection in these children.

Our aim was to evaluate the prevalence and population ratio of violence in our center which is one of the tertiary referral centers of trauma in Tehran. We also aimed to evaluate the motiva-tions of the struggle, the instrument used, and the type of injuries in the patients who had referred to us after a struggle.
In this cross-sectional retrospective study, all 152 patients who had referred to Rasool Akram Hospital for violence and struggles between October 2009 and March 2010 were evaluated. A self-made ques-tionnaire containing data- including age, sex, level of education, job, time of the struggle, previous history of reference to the Forensic Medicine Organization for violence, history of alcohol and substance abuse, type of the injury, the instrument used for mayhem, and the part of the body injured- was filled. The data was entered into the SPSS software version 11.5 and analyzed using t test (for quantitative) and chi 2 test (for qualitative) variables.
115 (75%) patients were female and 37 (25%) were male. Most of the patients were in the age group of 10 to 20 years (n=66; 43.4%). Most of the patients’ level of education was 8th grade (n=66; 43.4%). They were mostly housewives (n=33; 54.6%) and 24 (15.8%) were unemployed. Most had referred after domes-tic violence (n=106; 61.7%). A total of 73 (48%) had the previous history of violence and reference to the Fo-rensic Medicine Organization. History of alcohol, opium, and stimulants were present in 14 (9.2%), 23(15.1%), and 12(7.9%), respectively. The most common type of injuries were abrasions and bruises (n=113; 74.3%). The most common location of the injury was in the head and neck (n=70; 46.1%).
Attention to the social position of women and youth is warranted in our country. Especially, re-garding the high prevalence of domestic violence, educating women to cope with dangerous situations seems quite necessary.

Febrile convulsions (FC) are the most common seizure disorders in children. Lumbar puncture should be considered in any case with FC who is suspected to intracranial infections. This study determined white blood cell and polymorphonuclear cell counts, protein and glucose levels in cerebrospinal fluids (CFS) of children that were hospitalized with FC.
In this cross sectional study, lumbar puncture samples of children with FC admitted to the Neurology ward of Ali-Asghar Children’s Hospital from 2010–2013 were evaluated. Recorded data included age, sex, type of seizure (simple, complex), frequent attack of FC, family history of FC or epilepsy and cerebrospinal indices (white blood cell, protein and glucose).
In this study, 91 CSF specimens of patients with FC were evaluated. Mean (SD) age of cases was 17.66±10.81 months. Fifty seven (62.6%) of cases were male. Mean glucose and protein levels of CSF was 62.57±12.30 and 21.34±9.52 milligram per deciliter, respectively. Median of WBC and PMN count of CSF were 1 and 0 cell/mm3, respectively. There was not significant relationship between patient's characteristics and CSF indices (P >0.05).
During FCs, glucose and protein levels of CSF are in normal limits. Minimally changes may occur in CSF cell counts.

Headache in children and adolescents is among the most common complaints that can cause impairment in their function. The current study is designed to evaluate the frequency and type of headaches and use of analgesics in a sample of female high school students in Tehran.
Three hundred female high school students were included in the study during September 2011 to April 2012. All students were examined about headache. If students had positive history of headache, the second step of examination and physical exams were considered. Frequency and types of headaches and analgesic con-sumption were recorded. The effect of headache on daily function of students was evaluated by MIDAS scale. Data were analyzed using SPSS software version 14.
Two hundred seventeen students (72.3%) had headaches. Among them, 86 (39.6%) people experi-enced tension type headaches and 68 (31.3%) migraine type headaches. Mean frequency of headache was 6.6 ± 4.8 episodes per month. Mean MIDAS score was 35.3±5.85 in migraine type headaches and 13.4% of cases had severe disability in daily activities due to headaches. One hundred seventy nine (82.5%) used analgesics for their headaches.
According to high prevalence of headache in female students of Tehran, disabilities in daily ac-tivities due to migraine headache and also large amount use of analgesic in them, a screening of female students for headache and appropriate management is recommended.

The present study aimed to assess the role of magnesium sulfate (MgSO4) sup-plementation after cardiac surgery in pediatric patients, evaluating the incidence of cardiac complications, such as arrhythmia.
In this study, 105 children scheduled for elective cardiac surgery were randomly divided into 3 groups. The first group, as the placebo group, received saline. Groups 2 and 3, on the other hand, respectively received 25 mg/kg and 50 mg/kg MgSO4 during the recovery phase of cardiac surgery.
The results showed no significant difference among the study groups regarding the levels of Mg, Ca, and K at the time of admission to the Cardiac Intensive Care Unit (CICU). However, the patients re-ceiving 50 mg/kg MgSO4 (group 3) had a significantly lesser occurrence of arrhythmia compared to the control group (group 1). Furthermore, the patients in groups 2 and 3 had a lesser length of CICU stay after surgery in comparison to group 1. No association was found between MgSO4 consumption and the types of arrhythmia and the time of mechanical ventilation.
Supplementation with MgSO4 after cardiac surgery seems to reduce the incidence of arrhyth-mia and length of CICU stay in pediatric patients. This effect on the incidence of arrhythmia seems to be dose related.