Background: Intrauterine infections (TORCH) lead to the involvement of various organs of the body of the fetus, including the eye. The aim of this study was to determine the frequency and clinical ...response of eye lesions to specific drugs, in infants with confirmed TORCH induced ocular lesions. Methods: This historical cohort study from 2011 to 2017, had done in Pediatrics and Ophthalmology Department of Rasoul Akram Hospital, Tehran, Iran. Cases included; 78 infants with confirmed intrauterine infection (TORCH) with ophthalmologic disorders (glaucoma, cataract, and retinitis), 3 cases died (without any treatment). The cases with incomplete diagnosis, no treatment or without follow-up excluded from study. Out of 74 children with confirmed TORCH induced ophthalmologic disorders, finally 37 children (25 cytomegalovirus, 12 toxoplasma) were treated with specific drugs, and clinical response to treatment was followed-up to 1 year by ophthalmologic examination. Results: From 12 cases with ophthalmologic disorders due to congenital toxoplasmosis, 5 cases had full treatment, 4 cases had complete response. One case had not any improvement. From 25 cases with congenital cytomegalovirus (CMV), 18 patients continued treatment, 9 cases with complete clinical response, 9 cases had not response to antiviral treatment, indeed most non responder cases had central nervous system involvement from birth. The best response observed in CMV infected cases accompanied with sensory hearing loss (without CNS involvement). Conclusion: Good clinical response of ophthalmic diseases in 80% of congenital toxoplasma; and 50% of congenital cytomegalovirus infected cases. Probably with initial diagnosis and rapid treatment of cases with TORCH induced ophthalmic disorders (especially cases without CNS involvement) it would lead to stopping ocular lesions.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
High resistance to common antibiotics has become a huge global dilemma in eradicating Helicobacter Pylori infection in both children and adults. The great concern is about the resistance to different ...classes of antibiotics especially Clarithromycin because of its widespread use.
The present survey aimed to assess the resistance rate to Clarithromycin in Helicobacter Pylori isolated in patients aged less than 15 years as compared to patients older than 15 years of age.
In this cross-sectional study, total 72 patients with upper gastrointestinal symptoms requiring diagnostic endoscopy referred to Rasoul-e-Akram Hospital in Tehran during one year (August 2015 to August 2016). Helicobacter Pylori infection was diagnosed in patients using the Rapid Urease Test. The antibiotics resistance was detected in genomes using the real-time polymerase chain reaction (PCR) on 23S rRNA gene.
In total 72 patients, 36 cases aged less than or equal to 15 years and 36 patients were older than 15 years. Of all patients in this study, 17 cases were detected with gene mutations or polymorphisms related to resistance to Clarithromycin. Overall prevalence rate of resistance was reported 23.61%. Three polymorphisms on 23S rRNA gene including A2142G, A2142C, and A2143G were revealed in 47.1%, 5.9%, and 47.1% of patients, respectively. The bacterial resistance to Clarithromycin was observed more prevalent in patients that aged older than 15 years compared to patients younger than 15 years of age. Also, frequent consumption of any type of antibiotics was significantly associated with the higher resistance of bacterium to Clarithromycin.
The results of our study regarding the resistance of Helicobacter Pylori to Clarithromycin were similar to findings of other studies around the world. But, the Clarithromycin resistance rate was reported higher in patients older than 15 years of age and those patients who repeatedly received different types of antibiotics regardless of their age. Of all mutations in bacterial genome, the prominent mutations responsible for bacterial resistance to Clarithromycin included A2142C, A2142G, and A2143G nucleotide polymorphism on 23S rRNA gene.
Introduction: Influenza-related viral myositis is observed mostly in children with influenza, and the disease is more common in influenza type B. The aim of the present study was to evaluate the ...prevalence, and clinical and laboratory features of acute viral myositis in children with influenza in 2019 and 2020. Methods: This retrospective cross-sectional study was performed in Ali Asghar Hospital, from December 2019 to February 2020. Children aged 2-14 years with symptoms of acute onset of fever, along with the symptoms of influenza with or without muscle pain who referred to the emergency department of Hazrat Ali Asghar Children's Hospital, were included in the study. The data were collected and analyzed by Statistical Package for the Social Sciences (SPSS) version 22. Results: Out of the 105 participants in this study, 62 (59%) were male and the rest were female. The average age of the patients was 5.34 years (SD = 2.63). Clinical signs of lower limb pain, myalgia, lameness, weakness, and lethargy were significantly more common in patients with myositis (P-value < 0.05). In-vitro examination demonstrated that creatine phosphokinase (CPK), aspartate aminotransferase (AST), and aAlanine aminotransferease (ALT) levels were significantly higher in patients with myositis. Conclusion: Based on the present results, the clinical symptoms in patients are quite clear, and based on the symptoms, it is possible to diagnose and treat myositis without relying on laboratory findings; due to the self-limitation of this complication and lack of the need for complex treatments in case of early diagnosis, physicians can diagnose and treat many cases, depending on the clinical symptoms and the accuracy of the examination.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
4.
Risk factors of renal scars in children with acute pyelonephritis Ehsanipour, Fahimeh; Gharouni, Minoo; Rafati, Ali Hoseinpoor ...
The Brazilian journal of infectious diseases,
January-February 2012, 2012 Jan-Feb, 2012-01-00, 20120101, 2012-01-01, Volume:
16, Issue:
1
Journal Article
Peer reviewed
Open access
The aim of this study was to determine the association between previously documented risk factors such as recurrent pyelonephritis with the incidence of renal scarring after acute pyelonephritis in ...children.
Children with acute pyelonephritis who were admitted to the Department of Pediatrics of a teaching hospital during 2007–2009 were enrolled in this study. DMSA scans were obtained 4–6 months after the last episode of pyelonephritis in all patients.
A total of 80 children with acute pyelonephritis were enrolled in this study. Most of them were girls (77.5%), with a median age of 12 months. Nearly half of the children (n=44; 55%) had one or more renal scars. The distribution of gender, CRP level and leukocytosis did not differ significantly regardingthe absence or presence of renal scars (p>0.05). Most of the scars occurred in children who had presented with bilateral pyelonephritis (69.4% vs. 18.2%, p=0.001). Most of the patients with renal scars had a positive history of vesicoureteral reflux (VUR) (75% vs.13.6%, p=0.001). The significant roles of recurrent pyelonephritis and presence of VUR were further confirmed by multivariate analysis.
According to our findings, presence of VUR and recurrent pyelonephritis are independently associated with a higher incidence of renal scarring.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
OBJECTIVE: The aim of this study was to determine the association between previously documented risk factors such as recurrent pyelonephritis with the incidence of renal scarring after acute ...pyelonephritis in children. MATERIAL AND METHODS: Children with acute pyelonephritis who were admitted to the Department of Pediatrics of a teaching hospital during 2007-2009 were enrolled in this study. DMSA scans were obtained 4-6 months after the last episode of pyelonephritis in all patients. RESULTS: A total of 80 children with acute pyelonephritis were enrolled in this study. Most of them were girls (77.5%), with a median age of 12 months. Nearly half of the children (n = 44; 55%) had one or more renal scars. The distribution of gender, CRP level and leukocytosis did not differ significantly regardingthe absence or presence of renal scars (p > 0.05). Most of the scars occurred in children who had presented with bilateral pyelonephritis (69.4% vs. 18.2%, p = 0.001). Most of the patients with renal scars had a positive history of vesicoureteral reflux (VUR) (75% vs.13.6%, p = 0.001). The significant roles of recurrent pyelonephritis and presence of VUR were further confirmed by multivariate analysis. CONCLUSIONS: According to our findings, presence of VUR and recurrent pyelonephritis are independently associated with a higher incidence of renal scarring.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective:
To evaluate the role of ID in the pathogenesis of FS.
Methods:
In this case-control study (2014-2016), 70 children were studied, 35 children with FS and 35 (controls)children with febrile ...diseases without convulsion (The mean age of cases was 2.191 ± 0946
vs
. 1.93 ± 1.433 years in controls). Serum ferritin was estimated by the EIAS test. Data were compared between 2 groups, The ROC (receiver-operating-characteristic) curve was illustrated. The sensitivity, specificity, PPV, and NPV of the test, were calculated.
Results:
Serum ferritin levels had no significant difference between the 2 groups. The ferritin level (36ng/ml) had 74.3% sensitivity, 20% specificity, 56% PPV, and 52% NPV, with a Positive likelihood Ratio being 1.3 and a Negative likelihood Ratio: 0.93 to discriminate the 2 groups.
Conclusion:
Here the ferritin level (cut-off=36ng/ml) has an acceptable sensitivity (74.3%) but poor specificity (20%) and just 56% PPV and 52% NPV to differentiate the FS cases from non-convulsive febrile children. Although a different cut-off value 21.50 ng/ml provides 91% sensitivity and very low specificity . This lower threshold cut-off might have clinically relevant outcomes in FS children if considering the other comorbidities. In our opinion, ID could not lead to FS in all children, but in some cases, with a genetic basis; ID raises the threshold for seizures. The ferritin levels as an acute phase reactant are acceptable in every febrile case. The ferritin base level in each child (case /control) before infection was unknown, but in the present study, both groups were febrile in contrast to previous studies in which ferritin levels were compared with afebrile children. Due to the high prevalence of ID (26%), especially in the young Iranian population, adding iron to the diet might help decrease FS in susceptible cases. We recommend in the future study the FS cases selected with known iron levels before convulsion.
Introduction:
The sacral bone anomalies have an important effect on urinary and gastrointestinal tract and sacral ratio was defined as an indicator for estimating the anorectal abnormalities in ...children. This study was carried out for determining the association between sacral ratio and Urinary Tract Infections (UTI) among children.
Material and Methods:
In a cross sectional study, 100 children under 15 years with proven febrile UTI were referred to a referral children center considering the presence and grading of VUR according to VCUG enrolled in this study.
Sacral ratio was measured for all cases and the data were compared by student T test, Chi 2 and Mann Whitney tests. SPSS 16.0 software was used for data analysis. P values less than 0.05 were considered significant.
Results:
41 boys and 59 girls with mean age 4.8 years were enrolled in this study. The average range of sacral ratio was 0.82. There was no staistical difference between two different genders and ages (
p
> 0.05).
The values of SR in patients with VUR were lower than patients without VUR(
P
˂0.05) but there was no statistically significant difference between both bilateral and unilateral VUR and SR (
p
> 0.05).
Conclusion:
The risk of sacral bone abnormality in patients with VUR is more than patients without VUR. Therefore, in patients with UTI and low SR simultaneously, tighter evaluation for VUR and treatment should be considered.
Delay in diagnosis and treatment of acute appendicitis (AA) results in an increased rate of perforation, postoperative morbidity, mortality and hospital length of stay. Several biochemical parameters ...including white blood cell (WBC) count, C-reactive protein (CRP), interleukin-6 (IL6) and Procalcitonin (PCT) have been used to further improve the clinical diagnosis of AA. The aim of this study was to assess the value of procalcitonin as a predictor of diagnosis and severity of appendicitis in order to improve the clinical decision making, since other studies have been unable to demonstrate a diagnostic value for PCT elevation in acute appendicitis.
One-hundred patients who underwent open appendectomy, including 75 men and 25 women with a mean age of 28 years were included in this study. Procalcitonin values were measured by an immunofluorescent method). Serum PCT>0.5 ng/ml was considered positive. The PCT serum values were measured in four different categories, including ˂0.5ng/ml, 0.5-2 ng/ml, 2-10ng/ml and more than 10ng/ml.
The sensitivity and specificity of PCT level measurement for acute appendicitis diagnosis were 44% and 100% respectively. The value of PCT increased with the severity of appendicitis and also with the presence of peritonitis and infection, at the site of surgery.
Procalcitonin measurement cannot be used as a diagnostic test for adult patients with acute appendicitis and its routine use in such patients is not cost effective and conclusive. Procalcitonin values can be used as a prognostic marker and predictor of infectious complications following surgery and it can help to carry out timely surgical intervention which is highly recommended in patients with PCT values more than 0.5ng/ml.
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