International Journal of Children and Adolescents
Volume:6 Issue: 1, Feb 2020

Sleep is a transient altered level of consciousness, relative suspension of sensory perceptions and inactivation of voluntary muscles during rest.It has important role in the quality of life. Some chronic diseases such as Diabetes mellitus type 1(T1D)are accompanied with sleep disturbances which may lead to poor glycemic control.Our study was conducted to investigate sleep disorders in children with type 1 diabetes.

This cross-sectional study was conducted on 104 children with T1D referred to the endocrinology clinic from October 2018 to March 2019 in Ali Asghar Children Hospital. Patientchr(chr('39')39chr('39'))s characteristics including age, sex, weight and height were recorded in the data collection form. For each patient, questionnaire was filled out by the researcher with Children Sleep Habit Questionnaire (CSHQ).The collected data were analyzed with SPSS.

In this cross-sectional study, 104 diabetic patients aged 2-17 years were enrolled. Sleep disorders had high prevalence of 94 percent.There was significant relationship between  age and sleep disturbances(pvalue=0.003).Some common abnormal items included need to parents’ attendance for sleep in 44(42%), bad mood in the morning in 35(33.5%), afraid of sleep in darkness in 29(28%), afraid of sleep alone in 25 (24%),sleep in others’ beds in 20 (19%), avoidance to go to bed in 16(15.5%),try to not start sleep in  11(10.5%) and awake with others’ force in 10(9.5%)cases was seen.

Prevalence of sleep disorders in T1D ,irrespective to gender or BMI,is high. Preventing sleep disorders with an emphasis on screening for this problems in T1D patients and education for sleep hygiene is necessary.

Considering that prevoius investigation has included more adult age range, this study aimed to evaluate the agreement between TST and Quantiferon in kidney disease children who are candidate for immunosuppressive medications.

In this cross sectional study, 31 children with renal disease including nephrotic syndrome and renal transplant candidates nominated for immunosuppressive drugs were evaluated from the point of LTBI. These children underwere TST and QFT. Physical examination and chest x-ray was conducted in all patients who were positive for QFT or TST to rule out active TB. Finally, the data were entered into statistical software SPSS v. 16 and were analyzed.

In this study, 31 children including 17 (54.8%) new case of nephrotic syndrome and 14 (45.2%) kidney transplant candidates with a mean age of 6.86 (SD= 4) years were evaluated from whom 10 (32.3%) were female and 21 (67.7%) were male. The average duration of nephrotic syndrome was 1.3(SD= 12.12) weeks. The average duration of ESRD in children undergoing kidney transplantation was 6.35 (SD= 2.83) years and the average duration of dialysis was 1.72 (SD= 1.25) years. QFT test was negative in all patients in both groups and PPD test was positive in 1 (5.9%) patients with nephrotic syndrome; the difference was not statistically significant (p Value = 0.35).

QFT test has a high negative predictive value as well as a high diagnostic accuracy compared with TST and thus QFT and TST have a similar diagnostic performance to assess TB, however due to lower cost-benefit of TST, this test is more preferred to QFT.

Pericardial effusion, once common among dialysis patients, has become a rare entity in recent years. Due to its low incidence, its recognition has gained importance among internists, cardiologists, and nephrologists. It can be seen in pre-dialysis patients and in dialysis patients who are on hemodialysis or peritoneal dialysis.

A retrospective study was performed. The subjects consisted of all hospital admissions of the patients suffering from ESRD and pericardial effusion within a 5-year period. The clinical manifestations at admission, echocardiography and treatment modalities of the patients were recorded.

We reported 8 cases of dialysis- associated pericarditis, their presenting manifestations, and the literature review. The traditional findings of acute pericarditis such as chest pain, fever and leukocytosis were uncommon among the patients. Muffled cardiac sounds have a relatively high incidence and should be emphasized on auscultation of patients under dialysis. Not infrequently, it might be complicated by pre-tamponade or tamponade requiring pericardiocentesis or pericardial surgery.

Dialysis- associated pericardial effusion is a treatable, but not always a preventable condition. Timely recognition of its presence and its efficient management suggest essential elements of successful treatment.

Familial hypercholesterolemia (FH) is a hereditary dislipidemia. Patients present with extremely high level of low-density lipoprotein cholesterol (LDL-C), which is due to mutation in the gene of LDL receptor. Homozygous patients (HoFH) whose incidence is 1 in 1.000.000 are at high risk of premature aortic valve stenosis, and coronary artery atherosclerosis. In homozygous individuals cardiovascular complications can occur in childhood. The current study presented a 12-y-old boy with HoFH who suffered from mild aortic stenosis, and right coronary artery atherosclerosis. The patient underwent a successful coronary artery stenting, and was discharged with pharmacologic therapy.

Due to the lack of adequate effectiveness of synthetic drugs and the replacement of fluids and electrolytes in the treatment of acute gastroenteritis in children, the use of herbal and complementary medicine has received special attention today. The aim of this clinical trial study was to evaluate the effect of green tea consumption in improving pediatric viral gastroenteritis.

This study was performed as a randomized clinical trial in which a group of children aged 2 to 17 years suffered from diarrhea and had not been treated within 48 hours of the clinical appearance were randomly assigned to receive green tea leaf extract (GTE) tablet on the first day of the week and irrigation solutions in other days of the week; or receiving only irrigation solutions on all days of the week as the control. Treatment (prescribing the tablets) was continued until a Bristol Stool Scale of 3 or 4 was obtained.

The complete and partial improvement was revealed in 63.2% and 31.6% respectively in the GTE group while only in 15.8% and 57.9% respectively in control group indicating a significant difference (p <0.001). The increase in the number of tablets led to higher improvement rate in response to GTE prescription. The mean hospital stay in GTE and control groups was also 1.66 ± 0.63 days and 3.36 ± 0.4 days indicated shorter hospitalization in former group (p < 0.001).

the use of GTE leads to effectively improve the diarrhea as well as to reduce the hospital stay in children suffering viral gastroenteritis.

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The aim of this study was to determine of diagnostic value of albumin, anti-thrombin Ш, and fibrinogen factors in the diagnosis of pulmonary embolism compared to lung perfusion scan in patients with nephrotic syndrome referred to Hazrat Ali Asghar hospital of Tehran city (Iran) in 2018-2019. 

This study was cross sectional study that was carried out on 30 patients with nephrotic syndrome referred to Hazrat Ali Asghar hospital of Tehran city (Iran) in 2018-2019. Initially, lung perfusion scan as gold standard was performed for all patients, then, albumin, anti-thrombin Ш, and fibrinogen factors as screening tests were checked for these patients. After data collection, the data were entered into the STATA14 software, then, determined and compared the sensitivity, specificity, positive predictive value, predictive value and ROC curve level of these screening tests with the results of the lung perfusion. The significance level was considered < 0.05. 

The mean (SD) age of the patients under study was 6.22 (3.50), also 70% (21 cases) were boy and 30% (9) were girl. The results of lung perfusion scan showed that 23.3% (7 cases) of patients with nephrotic syndrome have pulmonary embolism. The results of analytical analyzes also showed that sensitivity, specificity, positive predictive value and negative predictive value for albumin were 100, 21.74, 28, 100% respectively, for anti-thrombin Ш were 100, 52.17, 38.88 and 100% , for fibrinogen were 100, 56.52, 41.17 and 100% respectively. Also, the area under the ROC curve for albumin, anti-thrombin Ш, and fibrinogen were 0.6087, 0.7609, and 0.7826, respectively.

The present study showed that fibrinogen screening test had the highest diagnostic value in comparison with other screening tests of albumin and anti-thrombin Ш in detection of pulmonary embolism in patients with nephrotic syndrome. However, given the low sample size, more studies are recommended in this area.

Asthma is one of the most common chronic diseases all over the world, which impacts socioeconomics of families and health care systems. We aimed to investigate the economic burden of pediatric asthmain Iran and to examine its variability depending on asthma severity.

In a descriptive-analytical study 141 pediatric asthmatic patients, who referred to pediatric referral centers in Tehran , included from September 2018 to September 2019 . in an interview with parents we evaluated direct medical costs of asthma including physician fees, admission fees, medication costs and direct nonmedical costs including transportation,hoteling and others. Data were statistically analyzed for finding association between the costs and disease severity (3 groups of mild, moderate and severe were defined)

75 patients (65.8%) were male and 39 patients (34.2%) were female with the age range of 1-16 yr old were included. We found the mean annual cost per child was approximately 205 dollars . In this study, 83% of costs were related to direct medical costs, 69% of which were hospitalization costs Direct non-medical costs were estimate 17% including 51 %transportation costs and 49% hoteling costs. Also, 37% of the patients had severe disease severity, with the majority of the costs being allocated to the patients in this group

Since there is a close correlation between the costs and the severity of the disease, there is also a significant increase in costs If the disease is not controlled, it can be concluded that early diagnosis and control of the disease can have a significant role in reducing costs.