Iranian Journal of Pediatrics
Volume:12 Issue: 2, 2002

To prevent new stone formation in patients with urolithiasis we treated 48 children with documented diagnosis of urolithiasis by polycitra-k (Potassium citrate+citric acid) solution. Duration of the treatment was 12-54 months (Mean 24 months). In 38 (82.6%) patients complete remission and in 6 children (13%) partial remission of stone formation was observed, in 2 patients (4.3%) this prophylaxis was not effective. This study and previous controlled studies show that medical prevention of urolithiasis with polycitra-k is safe and effective.

Osteogenesis Imperfecta is a heterogeneous genetical disorder and is inherited as an autosomal dominant or autosomal recessive trait. The primary defect lies in the mutation of genes that encode type 1 collagen. Organs bearing connective tissue such as bone, sclera, inner ear, skin, ligaments, tendons, and fasciae are involved. With respect to clinical, biochemical and inheritance characteristics, this disorder is divided into 4 groups (OI I, OI II, OI III and OI IV). The clinical feature consists of mainly fragile bones with or without sclera and deafness. In report an 8-year old boy is presented with a pedigree suggesting an autosomal recessive type of inheritance in whom with respect to clinical feature, Osteogenesis type IIB is diagnosed.

Cardiac siderosis from transfused iron remained, despite iron chelation therapy with desferioxamine (DFO), the major cause of death in Thalassemia major. In a retrospective study, we reviewed 67 patients with Thalassemia major and the same number of non-thalassemic children and analyzed factors affecting cardiac involvement. Ejection fraction (EF) and shortening fraction (SF) of Thalassemic group was lower than that of non-thalassemic and difference was significant (P<0.001). In Thalassemic patients there was inverse relationship between serum ferritin and cardiac OF and SF. Patients with optimal compliance had lower serum ferritin (P<0.001). 16 patients showed some kind of cardiac involvement. Older (P<0.001), had lower SF (P<0.05) and late onset of DFO therapy (P<0.001). We concluded that patients with Thalassemia major, despite iron chelation therapy with DFO, had weaker cardiac performance compared to non-thalassemic children. In these patients cardiac complications occurred in older age group with late onset of DFO treatment. Echocardiographic measurement of SF has prognostic value.

1- A survey of the causes of mortality in newborns and children under 5 years of age during 10 years (1988-1997) in northern Iran (Regions eastern and western bandpey, gatab and kolagarmahalleh in province babol) revealed following Average incidence of mortality in newborns and children under 5 years of age was 10.5 and 4 per thousand respectively. The most frequently encountered causes of death in children under 5 years of age were congenital anomalies (20.2%), infections (16.8%), prematurity (16.4%), accidents (14.5%), intrapartum asphyxia (5.8%), jaundice (3.8%), and meconium aspiration (2.4%).

Several etiologies are responsible for submental masses. In a patient with submental mass, missing any other clinical finding of the disease, the result of excisional biopsy was reported as “Leishmaniasis”, despite the fact that Leishmaniasis can rarely manifest itself as a submental mass. After diagnosis was established, we referred the patient to “Infectious disease department” for more evaluation and treatment.

The pathogens in urine specimens of 90 pediatric patients with urinary tract infection were isolated and their resistance to antibiotics in antibiogram determined. The most common pathogen was found to be E coli (In 77.7% of specimens). The most effective antibiotics were i.v amikacin (Sensitivity in 91.5% of cases) and oral nalidixic acid (In 76.9% of specimens) whereas ampicillin was the most ineffective antibiotic (Resistance in 87.5% of specimens). Therapy in urinary tract infections is commonly started with ampicillin and gentamicin. Considering that 39.5% of pathogens isolated in our study were resistant to both of thee antibiotics, preparation of antibiograms to find the most effective antibacterial in all cases of urinary tract infection is highly recommended.

Neonatal septicemia is a common cause of infant mortality in developing countries. In a descriptive-sectional study we cultured blood specimens of 620 newborns with a suspected diagnosis of septicemia. The isolated germs were treated for antibiotic sensitivity in agar plates. 16.8% of 104 cultures showed growth of bacteria. The isolated germs consisted of pseudomonas 26.9%, klebsiella 25%, staphylococcus aureus 14.4%, Escherichia coli 13.5%, staphylococcus epidermidis 7.7% and miscellaneous 9.6%. Low birth weight infant were most endangered cases. Gram negative and gram-positive bacteria showed highest sensitivity to ciprofloxacin and ceftizoxime respectively.

This retrospective study includes 400 children (70.3% boys and 29.7% girls) under 12 years of age, referred to the emergency room of Sina hospital in Tehran during the years 1993-1998. Clinical signs consisted of headache (81.7%), hematoma (64%), lethargy (47%), and vomiting (27.5%). A positive radiographic lesion was found in only 10% of the cases. The causes of trauma were: Head injury (82.5%), spinal column injury (7.5%), brain tumor (1.75%), high intracranial pressure (1.75%), and congenital anomalies of the central nervous system (Hydrocephaly, meningocele, etc) (3%). 80% of the patients came into emergency room in the first 48 hours after the accident. The most frequent neurologic sequelae consisted of post-traumatic syndrome, retrospective and prospective insomnia and seizures. The highest mortality rate was seen in the age group under 3 years and over 10 years. There was a significant relation between the indication for surgery and Glasgow coma staging.

Cutaneous disorders are the most common manifestation of HIV infection in both children and adults. The spectrum of these manifestations includes infections, neoplasm, drug reactions, nonspecific exanthemas and skin changes associated with nutritional deficits. Mucocutaneous candidiasis, herpetic gingivostomatitis and severe bacteriemia.