Iranian Journal of Pediatrics
Volume:14 Issue: 1, 2004

Background: The rhesus blood group antigen system is important in transfusion and clinical medicine، being involved in hemolytic disease of the newborn، transfusion reactions and autoimmune hemolytic anemia. Despite the widespread use of rhesus immunoglobulin prophylaxis in rhesus D (RhD)-negative mothers، rhesus immunization still occurs. Knowledge of the RhD status of the fetus is important in the clinical management، because no further diagnosis or therapeutic procedures are necessary if the fetus is RhD-negative. RhD antigen can be detected using a sensitive PCR-based assay. It was shown that RhD negative individuals lack the RhD gene. Methods: We obtained 5ml blood samples from thirty eight RhD positive and negative blood donors، as controls and forty chorionic villus samples (CVS) from pregnant women at 8 to 12 weeks of gestation. DNA was extracted from CVS by standard salting out and blood DNA was extracted by boiling procedure. DNA amplification (heminested-PCR) was carried out with appropriate primers. Results: PCR products were analyzed on an agarose gel. RhD gene determined in all CV samples.

Background: Hepatitis C virus (HCV) is a hepatotrop virus which causes chronic hepatitis and some important complications such as hepatocellular carcinoma (H.C.C). In patients، one of important ways for spreading of this virus is blood products and blood transfusion. In Iran، the donor’s blood in Blood Transfusion Organization has been screened for HCV scince 1996. We decided to determine the frequency of this disease in patients who received blood products before 1996 due to an acute illness (not persons who repeatedly received blood products due to a chronic disease). Methods: This case-control study includes 200 patients (100 cases and 100 controls) between 7-18 years of age، referred to the pediatrics clinic of Amircola Hospital in Babol in 2003. The first 2cc of venous blood sample from each person in two groups was prepared and screened for HCV antibody by Eliza method and then the positive ones were examined by PCR method. Exclusion criteria in our study were age less than 7 and greater than 18 years، immunocompromised patients، who received multiple blood transfusions for their chronic disease and also patients who received blood products after 1996. Results: In case group، 2 persons (2%) were HCV antibody positive in one of whom (1%)، this was confirmed by PCR method، but in control group there was no infected person (P=0.5).In conclusion، infectivity to hepatitis C virus in persons who received blood products for acute illness before 1996 was more than in control group but the difference between the two groups was not significant statistically (P=0.5). Conclusion: It seems to be necessary to conduct a larger study and a special attention for infectivity of HCV in these persons.

Background: Sodium valporate is one of the drugs that has been proved effective in adults. To compare the effectiveness and safety of sodium valportate and propranolol in childhood migraine، this study was designed. Materials and Methods: An open labeled crossover clinical trial was carried out having a 4 week medication free baseline phase، an eight week treatment phase for each drug and a 4 week wash out period before crossing over. Forty eight patients were randomized to sodium valporate or propranolol (1:1 ratio) treatment group. Results: The response to treatment was evaluated on the basis of frequency and severity of migraine attacks. Sixty percent of valporate treated patients and seventy eight precent of propranolol treated ones showed 50% or greater reduction in headache frequencies from the baseline phase. Thirthy one percent of valporate and 50% of propranolol treated group revealed at least one grade improvement in functional restriction. McNemar statistical analysis didn''t show remarkable difference between groups concerning both frequency and severity. No serious side effect was seen during treatment. Conclusion: sodium valporate was generally well tolerated in this study and showed favorable efficacy in childhood migraine.

Background: Although، the high efficacy of Apgar score to find the neonates who have respiratory distress، a low number of Apgar score couldn’t determine asphyxia definitely، and other factors could reduce it، too. Methods: This case control study was carried out in Mirza Koochak Khan hospital. Arterial blood gas in the first hour and Apgar score in minute 5 were evaluated in subjects (half of them had an Apgar score below 7 and the rest were 7 or over). Furthermore، the kind of delivery، gravidity، gender and gestational age were investigated. Results: All of neonates were divided into two groups based on Apgar score (below 7 or over). Each group consisting of 100 newborns. We found a significant association between Apgar score and ABG in the first hour of life (pH and BE being the most important factors of ABG). In this study a positive effect was shown in male gender، the Cesarean delivery and gestational age over 37w on the association between Apgar score and ABG. conclusion: According to an association between Apgar score and ABG، ABG is recommended as a routine procedure in neonates with a low Apgar

Background: Rubella is an infectious disease with few clinical symptoms which is hardly diagnosed. Specially in the first trimester of pregnancy، it may causes the congenital rubella syndrome، that is one of the major cause of neonatal mortality، and permanent disabilities in children. Methods: The research is prospective cross sectional with the aim of immunological status of rubella in Tehran. Multi stage sampling was done. Results: Our subjects were 975 female(56.77%) and 720 male(43.3%) with mean age 9.171.55 yr. Five hundred twenty five subjects (31.5%) were immunized against rubella، and 1140 subjects have no antibody titer against rubella. Five hundred forty one (32.5%) cases had history of rubella vaccination. Among vaccinated children، 205 subjects (38%) were seropositive، while in non-vaccinated children 328 subjects (29.2%) were seropositive. Conclusion: Immunity of rubella vaccine is not long term. Therefore، rubella vaccination in infancy، do not reduce congenital rubella. It seems that the best strategy to avoid congenital rubella syndrome is girl vaccination before marriage.

Background: Infestation of the gastrointestinal tract with parasites is one of the commonest causes of the digestive tract syndromes especially in developing countries. The aim of present study to determine the incidence of parasitic infestation in the stool specimens in pediatric age group. Methods: Stool specimens of all the children referred to Children''s Medical Center in Tehran، regardless of their clinical complaint، in the last 13 years، are examined microscopically. Findings: 14.27% of 64196 specimens were positive regarding parasites، isolated Giardia lamblia being 7.54%. Positive stool specimens of boys related to girls were more frequent. Conclusion: The incidence of infestation with Giardia is remarkable and regarding the possible complications of infestation، more intensive hygienic teaching of the public is recommended to prevent the expansion of the infestation.

Background: Helicobacter pylori (H.Pylori) is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD). Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2%) had pathologic defect in endoscopy and 57 patients (82.6%) had gastrointestinal symptoms. Prevalence of H pylori positive was 21.7% (15 patients). H pylori was positive in 21% patients with gastrointestinal symptoms. Conclusion: Chronic renal failure and dialysis had no effect on prevalence of H pylori.

Hearing is a key sense in human communication development and communication is the basic need for learning Speech is the best way of communication and speech development is impeded by hearing loss. Hearing loss compromises optimal development and personal achievement because language and communication serve as the foundations for learning and also normal child development delay in the acquisition of these skills affect literacy academic achievement and personal and social development. The studies show that auditory deprivation specially in critical period of the brain development (first year of life) results in considerable changes in cochlear nuclei of the brain stem Therefore، early detection of hearing loss in children has been a long standing clinical priority in audiology. In this article we have reviewed 60 years effort for early detection of hearing loss and finally. emphasiz that the basic assumption of new born hearing screening is early intervention. Early detection followed by early intervention will result in near normal speech achievement in these children which meaiis personal and social independence in life. In other words early intervention maximizes the benefits the child the family and the society will receive.

Background: Menkes kinky Hair syndrome is a sex-liked recessive hereditary disorder whit severe mental and growth retardation، developmental delay، convulsion، cerebral degeneration، hypotonia، abnormal and light-colored hair، depigmented skin with a dark patchy pattern due to disseminated vasculopathy. Patients usually die during the first or the early months of the second year of life. In this syndrome، there is a cellular copper transport defect that leads to decreased levels of cupper in plasma and other tissues such as brain and liver as well as a decline in the activity of copper containing enzymes. Case report: In this article، a seven months old boy suffering from failure to thrive، microcephaly and convulsions due to this syndrome is presented.

Background: Brain and spinal cord tumors are the most frequent neoplasms after leukemia in children. Brain stem glioma is responsible for 10-20% of brain tumors in this group and often found in pons presenting with cerebellar signs, cranial nerve palsies, pyramidal signs and eventually increased intracranial pressure Case Report: In this article we reported an 11 year old girl affected with brain stem tumor with signs of headache, dizziness, vomiting and ataxia. Strabismus due to palsy of sixth cranial nerve, and dysarthria was observed. Conclusion: Children complaining of vomiting, headache and dizziness for a long time must be assessed for brain tumor in posterior fossa that sometimes may lead to increased intracranial pressure. An exact neurological examination can be worth guide to diagnosis.