Caspian Journal of Pediatrics
Volume:4 Issue: 1, Mar 2018

Diabetes mellitus, type 1 (T1DM) and celiac disease (CD) are both immune-mediated. The mean rate of clinical overlap is 8%. The aim of this study was to discover the frequency of CD in children with type 1 diabetes in Mazandaran province. This retrospective descriptive study was performed in the pediatric endocrinology referral center, in Sari from 2012 to 2014. We screened all individuals aged between six months and 18 years with diabetes diagnosis after ketoacidosis, positive anti-GAD 65 antibodies, and insulin therapy. Patients with a positive tissue Transglutaminase Immunoglobulin A (tTG-IgA) antibodies test underwent endoscopic biopsy. Categorical data were tested using chi-square and quantitative data with independent sample T-test in SPSS. Date reported with 95% confidence interval. P<0.05 was considered statically significant. Of the 119 children enrolled, six cases (5%) were positive for tTG-IgA antibodies and all of them were boys (P=0.013). Histopathologically, CD was confirmed in 5 persons (4.2%). The mean age of seropositive patients was 10.3±3.3 years. History of DKA was mostly negative (83.3%) in them. The mean breastfeeding duration was 21±3.2 months, and only one had started formula after 12 months of birth. The results of the current study showed that the frequency of CD in T1DM children in north of Iran was similar to that other countries but lower than that in previous reports of Iran. The periodic screening test for CD in this high-risk group is necessary to diagnose the asymptomatic disease and prevent its complications

Mentally retarded influences social skills and adaptive behavior in children. That leads to social and communication impairment and adjusting social problem. Therefore, this research investigates the influence of puppet play therapy on adaptive behavior and social skills in male children with mentally retarded. This study is a quasi-experimental study with pre and post-tests. 30 mentally retarded male children selected through the criteria from Noreslam School of Varamin County in 2016-2017. They were assigned randomly to the control and intervention groups. The intervention group received puppet play therapy for eight treatment sessions (25 minutes for each session, twice a week). The research instruments were Vineland Social Maturity Scales and Adaptive Behavior Index of Limbert (ABIC). Statistical analysis conducted by analysis of covariance. Findings indicated that the mean’s scores of six subscales of adaptive behavior including violent and disruptive behavior (F= 2.61, p= 0.007), antisocial behavior (F= 3.41, p=0.016), rebellious behavior (F= 2.41, p= 0.011), untrustworthy behavior (F= 8.20, p= 0.008), stereotyped behavior (F= 0.87, p= 0.039), unacceptable of eccentric habit (F= 5.51, p= 0.026), and in Vineland social maturity (F= 1.09, p= 0.305) after intervention, in research groups were significantly difference. In addition, the results of variance indicated that there is not a significant difference between withdrawal behavior (F= 0.93, p= 0.34), inappropriate social behavior (F=4.23, p= 0.069), unacceptable vocal habits (F= 4.77, p= 0.078), hyperactive tendencies (F= 1.55, p= 0.223), and psychological disturbance (F=3.69, p = 0.065), five subscales of adaptive behavior. Puppet play therapy improves adaptive behavior and social skills in children with mentally retarded. Hence, it is necessary to utilize it in order to decrease social skills deficits and promote social adjustment in children with mentally retarded

Febrile seizure (FS) is one of the most common neurologic disorders in children. Electrolyte imbalance especially hyponatremia may have an important role in triggering the febrile seizure. The measure of serum electrolytes will be useful in predicting the further seizure. The aim of this study was to investigate the effect of relative hyponatremia (RH) on the risk of recurrent febrile seizures. This prospective study was performed on 334 children (6-60-month) with convulsions, referred to Amirkola children's Hospital. The patients were divided into three groups: simple febrile seizure (SFS), complex febrile seizure (CFS) and seizure without fever. In each group, the serum sodium was measured at the beginning of the admission and followed for 24 hours, and electrolyte imbalance was evaluated in seizure recurrences. Data were analyzed using SPSS-16 (student's t-test and logistic regression). Of the 334 children, 105 (31.7%) and 229 (68.3%) patients were female and male, respectively. The mean serum sodium levels in patients with SFS, CFS and control group were 136.64, 134.91 and 137.38 meq/l, respectively (p<0.05), but potassium and calcium levels were in the normal range. CFS group had a significant RH in comparison to SFS group (p<0.05). The serum sodium level was significantly lower in simple and complex seizures compared to the control group. Measurements of serum sodium levels and hyponatremia diagnosis have a key role on predicting the FS occurrence and recurrence. Therefore, physicians should be careful to administer the serums and inject the solutions for children with fever

The components of immune system are specific (adaptive immunity) and non-specific (innate immunity). Regardless of antigenic properties, the non-specific components function either as eliminators or barriers of wide range of pathogens. A person is born with innate immunity as the natural resistances, which has three kinds; anatomic mechanical and biochemical factors. The resistances are provided by innate immunity via various chemical, cellular and physical approaches. The colonization, entry and spread of microorganisms can be prevented by innate immunity. Two main sub-divided types of adaptive immunity are humeral and cellular. Active immunity resulting from the development of antibodies in response to the presence of an antigen is a long-term and acquired immunity. This review article summarizes some important potential mechanisms in innate immune system. The host renal tract which has been investigated from many aspects of the pathogenesis of urinary tract infection (UTI) are still poorly defined and require a better understanding of the pathophysiology immune system.

Kikuchi disease is a rare, benign, self-limited disease characterized primarily by fever and cervical lymphadenopathy. Diagnosis is based on excisional biopsy and pathologic study. We report a case of an atypical axillary lymph node enlargement.
Case report: This patient was a 12-year-old boy with clinical characteristics including axillary lymph adenopathy, fever and fatigue. He became asymptomatic after excisional biopsy. Histologic study reported necrotizing lymphadenitis without neutrophils (Kikuchi disease). These findings are important for diagnosis, because of the disease rarity, clinical features (such as lymphadenopathy, prolonged fever) and unidentified etiology

Foreign body ingestion and food bolus impaction are among frequent causes of mortality in pediatrics.
Case report: An 18-month girl who had foreign body ingestion presenting with recurrent vomiting after para-esophageal hernia repair was referred to Amirkola Children's Hospital. She underwent open surgery, but the symptoms re-occurred. Endoscopic evaluation showed foreign bodies in the esophagus, removed by endoscopic basket. After hiatal hernia or any esophageal surgery in children with recurrence of vomiting, the foreign body ingestion should be considered