International Journal of Children and Adolescents
Volume:5 Issue: 1, Feb 2019

This case report is presenting a girl about two years old that she was admitted to Ali Asghar tertiary pediatric hospital with periorbital edema and petechia and purpura. Her Manifestations were weakness, low appetite, irritability, weight loss, aphasia, from 6 mounts before admission. After evaluation the heart, endocrine, Neurologic system and Genetic consulting it had revealed the exact nature of it. It had diagnosed by a very rare autosomal recessive anemia that is called Thiamin Response Megaloblastic Anemia (TRMA). After 3 years, his brother has been came for similar symptoms and same diagnosis.

Major causes responsible for high morbidity and mortality rates in burn patients are bacteria and Candida spp. Candidemia is considered to lead to high mortality among these patients. In this study, we aimed to determine the frequency of Candida albicans among burn patients In Shahid Motahari Burns Hospital, Tehran, Iran In 2017-2018.

In this cross-sectional study, we recruited 116 burn patients from BICU of Shahid Motahari Burns hospital. 71 burn patients met the inclusion criteria: Age under 14 years, persistent fever despite of antibiotic administration, inappropriate general condition, and color change of burn wound. We conducted statistical analysis using IBM SPSS, version 24. Descriptive analysis of the variables was done by mean and standard deviation (SD). Chi-Square Test of Independence and Fisher Exact test were used for the assessment of potential associations between categorical variables.

16.3 percent had candidemia: C. albicans 8.6 percent, C. krusei 4.3 percent and C. glabrata 3.4 percent. There was a statistically significant association between candidemia and burn percentage, burn degree and administration time of total parenteral nutrition (TPN(p<0.001, p<0.001, p<0.001, respectively).

C. albicans was showed to be the significant pathogen among burn patients in Shahid Motahari Burns Hospital.

Severe combined immunodeficiency is a rare, fatal syndrome of diverse genetic cause in which there is combined absence of T-lymphocyte and B-lymphocyte function (and in many cases also natural killer, or NK lymphocyte function). These defects lead to extreme susceptibility to serious infections. Without intervention, the T and B-cell dysfunction usually results in severe infection and death in children by age 2 years. Here, we report a case of SCID in a 37-day-old male infant was admitted to pediatric intensive care unit (PICU) in our hospital with complain of the right knee swelling.

A 7.5-year-old male with mild intermittent asthma presented with a complaint of sudden shortness of breath and subsequently cyanosis that led to respiratory arrest. Although Asthma is the most prevalent chronic respiratory disease globally, it is affecting children through all ages (1). This condition is described as a chronic inflammatory airway disease. However, there are several phenotypes of this chronic inflammatory that are seen among the pediatric population (2). According to guidelines, asthma has four levels of mild intermittent, mild persistent , moderate persistent , severe persistent that the classification of which are based on the severity of symptoms, spirometry parameters including forced expiratory volume in one second (FEV1) and peak expiratory flow(PEF)(3). At each level the patients can experience the acute asthma exacerbation which is defined as the respiratory distress that does not respond to outpatients’ treatments either with or without history of corticosteroid therapy. Each episode of this condition can cause the respiratory failure. Therefore, acute asthma is defined as a medical emergency in pediatric population which is leading to nearly half of millions of pediatric intensive care unit (PICU) hospitalizations annually (4-6) In this study, we reported a case of mild intermittent asthma with rapid decompensation to respiratory arrest.

The prevalence of childhood asthma has increased dramatically throughout the world over the past 3-4 decades. Asthma has a wide range of risk factors including genetic factors, environmental and lifestyle factors. Due to the different outbreaks of asthma in different parts of the world, even in different cities of a country, it can be attributed to difference in the prevalence of asthma risk factors in different parts of the world. The aim of this study was to evaluate the frequency of inciting and inducing asthma factors in children referred to the clinic of Hazrat Ali-Asghar Hospital in Tehran and to introduce these factors to their parents and society in order to prevent exposure to them. Consequently, this might help reduce the prevalence of asthma and even symptoms of the disease and improve the quality of life of the patients.

This descriptive cross-sectional study was conducted in Tehran. All the children aged from 1 to 18 years’ old who had been diagnosed with asthma and referred to educational clinic of Hazrat Ali-Asghar hospital from March 2017-2018 were recruited in this study. The method of performing this study was to distribute a self-administered checklist to children parents. Data such as age, sex and inciting and inducing factors of asthma were evaluated and questioned. This study was approved by the IUMS Committee of Ethics. Data were analyzed using SPSS software version 24.

One hundred asthmatic children entered the study, of which 67% were boys. The mean age of patients was 66.1 ± 37 months. Inciting factors were respectively pulmonary infection (90%), exposure to cold weather (74%), exercise and intense activity (65%), fast food consumption (53%), history of hospitalization due to Pulmonary infection (52%), sinusitis and adenoid hypertrophy (44%) and allergic rhinitis (38%). Inducing factors for asthma included atopic dermatitis, positive family history in first-degree relatives and contact with detergents (37%), exposure to cigarette smoke at home (35%), having a pet (22%), preterm birth (16%), contact with dust (house renewal) and mites (13%), and maternal smoking during pregnancy (1%).

Given the awareness of inciting and inducing factors of asthma, it may be possible to prevent asthma attacks in these patients, as well as identify those who are at increased risk for the disease and prevent or delay the onset of the disease.

Bacterial meningitis is a medical emergency for which a very on time management should be done. Among laboratory techniques, PCR methods could be very attractive due to their general good sensitivity, specificity; meanwhile they can usually be done in a relatively short time but the problem of availability, cost and limited experience of physicians needs attention and more studies. In this article we tried to review the most current evidences on this matter.

Drug induced acute tubulointerstitial nephritis is a rare condition in children. We report a case of 10-year-old boy who developed nonsteroidal anti-inflammatory drugs (NSAIDs) and aminoglycoside associated tubulointerstitial nephritis. Laboratory studies revealed increased levels of creatinine and decreased glomerular filtration rate. Tubulointerstitial nephritis was diagnosed by renal biopsy. The treatment consisted of acute kidney injury management with a short period of corticosteroids. Renal function recovered after corticosteroid therapy. At last, full recovery occurred.

The science of neonates in the world doesn’t  have an old background and it is about 70 years that  has become separated from pediatric medicine(1,2) ;but  this science has had a lot of improvements during these years .Despite incredible advances in the care of premature infants, today’s scientists are facing many unresolved issues, including limits of viability, cost of care, quality of life for intensive care “graduates” (into their adult lives), and an ever-increasing battle against opportunistic nosocomial microorganisms.(6,7).Currently in our country there aren’t  enough pediatricians for the treatment of the hospitalized infants in NICU and also lack of primary services and equipment’s( specially the primary services) will increase the death rates and morbidity among the infants .In our country there are plenty of NICUs that don’t  have enough pediatricians to diagnose the disease,  or  to  treat  infants.  In some cases, there are plenty of equipment but some pediatricians because of their lack of knowledge don’t know how to use them; so they will be referred to other NICUs. So the main purpose of executing this model is to assimilate neonatal intensive care services according to the services performed in the central units till they become autonomous in their neonatal staff tools and equipments and in their scientific diagnosis and treatments.This is the first time that this project is going to be executed under the command of the head of the University of Medical Sciences and Health Services’ and its main purpose is to reduce the death rates among infants and also reduce the dispatching progressfrom local units to the center units.The main purpose of this project is to decrease the mortality, morbidity and   referral of neonates to other centers that are more equipped. In this project the neonatal specialists that are reside in the central NICU are going to consult and help the pediatricians in local NICU who have problems in detecting the diagnosis and treating infants.

This will be done by presenting a plan to the Central NICU, offering a plan  to the local NICU (how to communicate and inspect – how to admit a patient from local units to the central units – educating the local personnel including pediatricians and nurses), launching the comprehensive project of central NICU, conducting a survey on the number and function of nursing system and pediatricians, personal tutoring in the field of communications and supervising the local NICU and pediatricians tutoring in theory and practical methods .

The main purpose is to reduce the death rates among infants and also to decrease the dispatching progress from the local units to the center units. We can use the proficiency of the central NICU for the local ones till they become independent from other systems, and by performing this project we can reduce the rate of mortality, morbidity, mental retardation and the side effects during hospitalizations and so it will be more cost effective for the government as well.