International Journal of Children and Adolescents
Volume:4 Issue: 1, Feb 2018

Obesity in childhood increases the risk of fatty liver disease. With respect to the increased prevalence of obesity in Iran and the world, this study aimed to investigate the relationship between fatty liver and obesity in 6 -18 year-old children.

In this case-control study, 25 overweight children and 24 obese children, who had inclusion criteria, were selected by convenience sampling method. Then 27 children and teenagers with normal weight and the same sex and age were selected as the control group. Weight and height of the sparticipants were measured and recorded, liver enzymes ALT and AST were performed for them. Data was analyzed in SPSS software using chi-square test, one-way ANOVA, Tukey range follow-up, and logistic regression. The significant level was set at p<0.05.

The results showed that the relative frequency of occurrence of fatty liver increased significantly along with increasing body mass index (p<0.001). There was a significant relationship between sex, body mass index, and the prevalence of fatty liver in the participants. However, no significant relationship was found between fatty liver disease and AST and ALT (p>0.05).

There was a strong relationship between NAFLD and the abnormal body mass in children. It will be very useful if obese children to screen for susceptible to NAFLD

The S100B protein has recently been considered as an important marker for predicting severe brain damage; however, there has been very little evidence of increasing this marker in cerebral edema due to metabolic disorders such as diabetes ketoacidosis (DKA). This study was designed and performed to evaluate the prognostic role of S100B protein in predicting brain edema in children with DKA.

This case-control study was performed on children aged 22 months to 13 years who suffering moderate to severe DKA that were admitted to intensive care unit. A venous blood sample was taken from the patients during the first 6 hours of admission to the intensive care units. Based on the evidences of brain edema requiring manitol infusion, the patients were divided into 2 groups including the patients with brain edema as the cases and those without this problem as the controls. The serum level of S100B protein was measured by ELISA technique in both groups.

The mean serum level of S100B in the groups with and without brain edema was 1.07±1.15 and 0.67±0.99, respectively with no difference (p= 0.437). Based on the multivariable linear regression modeling, the presence of brain edema was not associated with the level of S100B. According to the ROC curve analysis S100B (AUC= 0.506, P= 0.967) could not predict the occurrence of brain edema children with DKA.

the increase in the serum level of S100B may not predict the likelihood of brain edema in children with DKA.

Convulsion in neonatal period is a considerable clinical issue because of its potential brain damage.One of the benign neonatal seizures known as the fifth day fits ,is due to zinc deficiency. Zinc is a rare element which has spread throughout the body fluids and tissues especially central nervous system. Reduction of neurons’ stimulation has been ascribed as the main effect of zinc on brain. In this study we aimed to determine the cerebrospinal fluid zinc levels of neonates and evaluate its relationship with seizure disorders.

In this cross sectional study,cerebro-spinal zinc levels was determined in 117 neonates in Ali Asghar children hospital,Tehran,Iran during 2012-2014.Zinc levels was measured using atomic absorption spectrophotometry. Other data about gestational age,birth weight,gender,type of delivery, seizure and underlying diseases at the time of admission was recorded too and analyzed by SPSS soft ware .

Mean cerebro-spinal zinc levels in 117 neonate was 8.96±3.87 µg/dl(between 3.5 and 24.4) and 14.5 % of them were suffered by convulsion.Of all patients, 98.3% had zinc deficiency.There was no significant difference between cerebrospinal zinc levels in two groups with and without seizures. There was no relationship between zinc and gestational age,birth weight,gender and type of delivery and underlying diseases(p>0.05).

According to the results, we found zinc deficiency in CSF of most of our patients without relationship to seizure disorders.It is recommended to evaluate zinc condition in acute ill neonates.

Neuroblastoma is the most common extracranial solid tumor in children and the most common malignancy in infant. Some tumors release vasoactive intestinal peptide (VIP), causing a profound secretory diarrhea. In this report we describe a 33 month old girl with intermittent diarrhea from 9 month ago and hypokalemia resistant to treatment .She had increased VMA in 24hour urin .After complete workup she had a mass in her thorax that resected and  her diarrhea and hypokalemia was improved.

In children with resistant diarrhea  we should consider tumors secreting VIP.

Autoimmune encephalitis is being diagnosed more and more often in the pediatric age group. It should be suspected in children with psychiatric symptoms, encephalopathy, abnormal movements or epileptic seizures. The most frequent autoimmune encephalitis in the pediatric is anti-N-methyl-D-aspartate (anti- NMDA) receptor encephalitis.

We report a four-year-old boy with encephalitis signs and symptoms and focal tonic-clonic seizures followed by behavior disorders. CSF and MRI results were normal; but in view of EEG showing delta waves, possibility of autoimmune encephalitis was considered. Then child was treated with plasmapheresis and symptoms were disappeared.

Autoimmune encephalitis is a treatable disorder and there might be a negative result in patient’s CSF antibody’s panel of autoimmune encephalitis. Electroencephalogram validated the diagnosis in this case. Considering the fact that autoimmune encephalitis is curable disorder, we recommend that the process of treatment should be started if strong clinical suspicions exists.

Pulse Oximeter monitoring has become so common over previous decades that in some health care units, blood oxygen level is now considered as the fifth vital sign. However, it seems there is still some lack of knowledge and/or experience among medical staff operating pulse oximeter and interpreting its results. The aim of this study was to investigate and compare the knowledge on Pulse Oximetry among medical staffs working with these devices.

A standardized questionnaire on the performance of pulse oximetry and influencing factors was provided to a group consisting of nurses, pediatric residents, respiratory therapists and anesthetic technicians before and after an educational program on pulse oximetry. Responses to the questionnaires before and after the course were analyzed and compared.

A total number of 101 participants completed the questionnaires which constituted 31 pediatric residents (31%), 51 nurses (50%), 7 respiratory therapists (7%) and 12 anesthetic technicians (12%). Pre course and post course mean knowledge score on pulse oximetry in participants were 10.93 ± 4.55 and 14.07 ± 1.98, respectively (p< 0.001). Implementing educational program on pulse oximetry, increased the percentage of mean knowledge score on pulse oximetry significantly from 74% to 93% (p<0.001).

Educational course for pulse oximetry, significantly improved the knowledge scores among participants in our study. Continuing medical education (CME) and adequate training programs to improve the lack of knowledge on pulse oximetry is highly recommended.

Neonates weighing less than 1500 grams (VLBW) consider nearly 4-7% of live births. VLBW infants are more likely to be hospitalized due to their complications. The aim of this study is to determine the rate of recovery, complications and predictive factors of VLBW neonate’s mortality. A cross-sectional study in NICU of Shahidakbar-Abadi Hospital in Tehran during the year 1395 was performed on all infants born with birth weight less than 1500 grams. Neonates were examined for one month from birth to discharge or expulsion or death. And information about mother and baby was extracted from medical records. Of the 9903 live births in Akbarabadi Hospital in Tehran in 1395, 264 VLBW newborns were included in the study. The survival rate was 75% (198) in this study. This study evaluated the prevalence of morbidities such as RDS, PDA , ROP , IVH, NEC, BPD, sepsis and pneumothorax. The most important morbidity in this study considered RDS. The most important factors of mortality in this study were RDS (P <0.001), PDA (P = 0.006), sepsis (P <0.001), IVH (P = 0.02), and pneumothorax (P <0.001), respectively. Considering the higher rate of survival in this study comparing with previous studies in Iran, this study shows improvement in neonatal care of VLBW infants in NICU.