فهرست مطالب

Archives of Pediatric Infectious Diseases - Volume:7 Issue: 4, 2019
  • Volume:7 Issue: 4, 2019
  • تاریخ انتشار: 1398/09/17
  • تعداد عناوین: 8
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  • Mehrnaz Rasoolinejad, Mohammad Sarraf*, Zeinab Najafi, SeyedAhmad SeyedAlinaghi, Banafsheh Moradmand Badie, Mohammadreza Salehi, Fabricio Azevedo Voltarelli Page 1
    Objectives

    This study aimed to evaluate the virologic failure rate of treatment for various types of antiretroviral treatment (ART) regimens in pediatric patients with HIV.

    Methods

    The present study was conducted among 75 HIV-positive pediatric patients characterized by the presence of a viral load of 200 or more copies per mL after six months of effective, continuous ART regimen. Therefore, treatment failure was defined based on virologic failure. We designed a questionnaire that included patients’ demographic characteristics, viral load markers, TCD4+ count, antiretroviral regimen received, and the probable treatment failure, along with the results of the drug resistance tests.

    Results

    In total, 22 (29.2%) children experienced treatment failure. The most common primary antiretroviral regimen was Zidovudine (AZT)/Lamivudine (3TC)/Nevirapine (NVP) (59.2%), followed by AZT/3TC/Efavirenz (EFV) (29.6%). The highest rate of virologic failure was related to the AZT/3TC/NVP regimen (68.2%). In children who used NVP, the virologic failure was significantly higher than in children on other regimens (P = 0.02).

    Conclusions

    The present study showed that patients receiving ART regimens based on reverse transcriptase non-nucleoside inhibitors, especially NVP, experienced more treatment failure than patients receiving other regimens.

    Keywords: HIVAIDS, Pediatric, Virologic Failure, Antiretroviral Therapy, Iran
  • Aziz Eghbali, Vahid Reza Siavashan, Bahador Bagheri *, Roghyae Rahimi Afzal Page 2
    Background

    At present, some evidence supports the role of Helicobacter pylori eradication in treating childhood immune thrombocytopenia (ITP).

    Objectives

    This study was designed to investigate the association between H. pylori eradication and platelet count in children with acute ITP.

    Methods

    Thirty children with a diagnosis of acute ITP and H. pylori infection were studied. This randomized and controlled study was done in Amir-Kabir Hospital, Arak, Iran. Patients were randomly allocated 1:1 to standard ITP and H. pylori treatments or standard ITP treatment. For 6 months, studied subjects had monthly follow-ups.

    Results

    The mean ± standard deviation (SD) age was 11 years with a majority of females (67.9 % vs. 32.1 %). The mean platelet count was 16.93 ± 10.1 (109/L) in the ITP and H. pylori therapy group, and15.0 ± 3.8 (109/L) in the ITP therapy group at the baseline. After 1 week of treatment, mean platelet counts increased to 136.5 ± 55.20 and 124.0 ± 45.70 in the two groups, respectively (109/L). The differences between the two groups were not statistically significant at other time intervals. Children that received ITP and H. pylori therapies had a higher rate of gastrointestinal symptoms (P < 0.01).

    Conclusions

    Our findings suggest that H. pylori eradication did not significantly affect the platelet count compared to standard ITP therapy in children with acute ITP.

    Keywords: ITP, Children, Platelet, H. pylori, Infection
  • John Rene Labib, Nesreen Mohamed Kamal Elden *, Amira Aly Hegazy, Nargis Albert Labib Page 3
    Background

    Incident reporting system (IRS) deepens the understanding of the frequency of adverse events and near misses. Voluntary reporting is an essential step to improve patient safety.

    Objectives

    The study aimed to apply an efficient and reliable system for incident reporting to enhance patient safety practices in pediatric intensive care units (PICUs).

    Methods

    A quasi-experimental pretest-posttest study design was conducted to implement a voluntary anonymous IRS in PICUs. In-depth interviews were conducted with 16 health care personnel. A tailored educational program was provided to 73 health care personnel. A questionnaire was administered before and three months after the intervention to assess their attitude towards incident reporting.

    Results

    The interviewed health care providers highlighted that no IRS was established in the PICUs and most of them never reported any event unless it was a sentinel event. They agreed that an IRS would be beneficial to PICUs. The average percentage of positive responses for “Frequency of error reporting’ increased significantly from 23.8% to 42%. Communication problems, hygienic errors, therapeutic errors, and diagnostic errors accounted for 34%, 32%, 29%, and 5% of the reported potential errors, respectively.

    Keywords: Reporting, Errors, PICU, Near Miss
  • Mogjan Goli, Zahra Pourmoghaddas, Monire Sadat Emadoleslami, Hamid Rahimi* Page 4
    Background

    Antibiotic-associated diarrhea (AAD) is of great concern in children due to the wide range of antibiotic administration among this population. Studies considering the use of synbiotics for prevention or treatment of AAD are limited. In the current study, the effectiveness of synbiotics in preventing AAD was investigated.

    Methods

    This randomized, double-blinded clinical trial was conducted on 100 patients undergoing antibiotic therapy for over five days. The patients were randomly divided into a case group receiving synbiotic therapy (Protexin; The United Kingdom) and a control group undergoing placebo therapy (consisting of starch sachets). Both groups began their medication within 24 hours after antibiotic initiation and continued it for further seven days after antibiotic therapy cessation. The two groups were compared regarding the incidence of diarrhea, stool consistency based on the Bristol Stool Scale (BSS), and the duration of diarrhea.

    Results

    The members of case and control groups were not statistically different regarding age, gender distribution, length of hospitalization, the frequency of defecation, and stool consistency based on BSS before antibiotic therapy, primary and final diagnosis, the type of antibiotics prescribed, and duration of antibiotic therapy (P > 0.05). The incidence of AAD was significantly less in the case group compared with the control group (P = 0.016), while those with AAD did not show significant difference regarding the duration of diarrhea, stool consistency based on BSS, and the frequency of defecation a day (P = 0.51, 0.26, and 0.18, respectively).

    Conclusions

    The findings of this study showed that early initiation of synbiotics and its long-term administration following antibiotic therapy cessation could considerably prevent AAD; however, in case of AAD occurrence synbiotic therapy cannot positively affect duration, stool consistency, and the frequency of defecation.

    Keywords: Synbiotic, Antibiotic-Associated Diarrhea, Children, Hospitalization
  • Nirvana Tavahen, Zahra Pourmoghaddas, Behnoosh Esteki, Nahid Aslani, Hamid Rahimi* Page 5
    Background

    Vitamin D plays an important role in regulating the immune system, calcium and phosphorus homeostasis, and bone formation. This micronutrient plays an important role in the incidence and severity of respiratory infections.

    Objectives

    The aim of this study was to evaluate the vitamin D serum level in children with acute lower respiratory infections (ALRIs) and its association with the severity of infection with vitamin D serum level.

    Methods

    This cross-sectional study was conducted on 99 children with ALRIs aged 20.13 ± 17.55 months who were selected with a simple random sampling technique. The children were examined and evaluated at the time of admission. Their data, including demographic characteristics and the findings of the physical examination and laboratory, were recorded in the questionnaires. Serum level of 1,25-dihydroxy vitamin D3 [1,25(OH)2D] and 25-hydroxyvitamin D3 [25(OH)D] were measured by HPLC method.

    Results

    children with severe acute lower respiratory infection had a significant lower level of 25(OH) D (P = 0.02). Indeed, data analysis showed a level of 25(OH) D inversely associated with severity of acute lower respiratory infections in children (B = -0.7, P = 0.00).

    Conclusions

    The severity of the lower respiratory tract infections was inversely proportional to the level of 25(OH)D, and it may be hoped that increasing 25(OH)D level may reduce the severity of ALRIs.

    Keywords: 1, 25-Dihydroxyvitamin D3, 25-Hydroxyvitamin D3, Lower Respiratory Tract Infection, Pneumonia, Bronchiolitis
  • Borna Salemi, Abdoulreza Esteghamati, Shirin Sayyahfar, Farah Bokharaei Salim, Hossein Keyvani, Khadijeh Khanaliha * Page 6
    Background

    Parasites infection is one of the public health issues among children all over the world. The limited available data indicates that working children often suffer from poor health.

    Objectives

    In this study, the frequency of intestinal parasitic infection in working children related to Sobh-e Rooyesh School was evaluated for the first time in Tehran, Iran.

    Methods

    Fresh stool samples were collected from 175 working children associated with Sobh-e Rooyesh School in Tehran and transferred to Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, which then examined by the wet mount examination with Phosphate-buffered saline and formalin ether concentration and agar plate culture. The trichrome staining was performed using stool samples conserved in Phosphate-buffered saline.

    Results

    The results showed that in general the frequency of parasitic infection was 77/175 (44%). The frequency of Blastocystis hominis as the most common parasites was (32.6%) followed by (9.1%) related to Giardia lamblia and (8%) samples were positive for Entamoeba coli. Frequency of helminthic infection was 3/175 (1.7%) including 2/175 (1.1%) Hymenolepis nana and 1/175 (0.57%) Ascaris lumbricoides.

    Conclusions

    The frequency of intestinal parasitic infections was relatively high among working children in Tehran. Frequency of protozoan infection was more than that of helminth infection. It is suggested that additionally necessary treatment, health education and personal hygiene should be provided to prevent transmission.

    Keywords: Intestinal, Infection, Parasites, Tehran, Children, Iran
  • Sergey Viktorovich Minaev *, Mikhail Alexandrovich Axelrov, Alina Mashchenko, Igor Nikolaevich Gerasimenko Page 7
    Objectives

    The aim of this study was to determine the effectiveness of various diagnostic methods of HCL in children.

    Methods

    From 2005 to 2019, we examined 154 children with suspected HCL. A total 93 (60.4%) children had HCL, and 61 (39.6%) had nonparasitic cysts. All children received clinical and laboratory examination with US. We divided patients with HCL into Group I (CL type of HCL, 27 patients), Group II (CE1 type, 32 patients), and Group III (CE2 type, 34 patients).

    Results

    Comprehensive examination, including clinical manifestations of disease together with US and ELISA, showed sensitivity of 59.8% and specificity of 47.5% for all types of HCL.

    Conclusions

    We found that the most informative diagnostic approach for all types of HCL in children is a combination of clinical manifestations together with US and ELISA.

    Keywords: Hydatid Cyst, Echinococcosis, Ultrasonography, ELISA, Diagnostic, Children
  • Abdollah Karimi, Zahra Pourmoghaddas *, Arefeh Fayazi, Farid Imanzadeh Page 8

    Salmonella typhi is a Gram-negative microorganism. This enteric pathogen causes a variety of signs and symptoms, but the more prevalent is fever and gastrointestinal signs. It is important to consider this microorganism in the differential diagnosis in patients coming from the regions with a high prevalence of salmonella typhi and unusual signs and symptoms.

    Keywords: Salmonella, Lymphadenopathy, Child