Alireza Nateghian , Soudabeh Hoseini, Mohsen Sadeghi, Zahraa Behnamfar,
Volume 1, Issue 2 (8-2015)
Abstract
Background and Objective: Typhoid fever is still a major health problem for which there are limited options for the diagnosis. Current diagnostic methods are time consuming with undesirable sensitivity. Among newer diagnostic methods, PCR is attractive and could be potentially very helpful in developing countries where systemic salmonella infections are endemic among children but needs to be investigated.
Methods: We performed a cohort study in Aliasghar Children Hospital, a teaching hospital in Tehran, between May 2012 and July 2013 to include suspicious systemic salmonella infections. Clinical and laboratory findings as well as clinical courses were followed on daily basis. Overall, 45 patients assigned into 3 groups were included into the study. For each case all appropriate cultures as well as Widal agglutination test and a blood sample for PCR of salmonella were submitted after taking informed consent from parents.
Results: Twenty one (46.7%) boys and 24 (53.3%) girls with ages ranging from 1 month of age to 17 years (mean 4.5 years) diagnosed for typhoid fever. About 88.9% of the patients had diarrhea, 84.4% had fever, 66.7% had vomiting, 28.9% had abdominal pain, 15.6% had nausea, 11.1% had rash and 2.2% had constipation. Eighteen (40%) patients have received antibiotic treatment before coming to the hospital. Group I consisted of 18(41%) patients, group II consisted of 27 patients with positive Widal test of these, one was blood and stool cultures positive however PCR in blood was negative in this group. Group III represented 2 patients with positive blood and stool cultures. In one case PCR in blood was positive. In another patient Widal test was negative despite positive blood culture and PCR in a leukemic kids who passed away.
Conclusion: In our setting the role of conventional PCR in blood samples of kids with suspicious systemic salmonella infections was not clearly determined. Larger sample size, preferably in a multicenter study, and using more sophisticated methods of blood cultures and novel techniques to increase the availability of organism for DNA detection is needed before determination of its role in both groups with no prior antibiotic therapy and cases with previous history of antibiotic administration.
Fariba Jahangiri, Mahnaz Sadeghian , Hadi Ahmadi Amoli, Shirin Sayyahfar,
Volume 2, Issue 1 (1-2016)
Abstract
Background and Objective: In the present study, the diagnostic agreement between surgical and pathological findings of appendicitis in children was tested. The aim was to assess the association between patient body mass index (BMI) and this diagnostic agreement.
Methods: This cross-sectional study was carried out on 121 consecutive children aged less than 15 years suspected to acute appendicitis that were candidate for appendectomy in surgery ward of Ali-Asghar hospital between 2006 and 2011. The patients’ characteristics were collected from hospital recorded files.
Results: Assessment of surgical and pathological findings showed a good agreement between the two procedures with an agreement value of 0.69. The overall prevalence of obesity in those with and without pathological appendicitis was 8.7% and 21.5% with a significant difference between them (p= 0.012). Also, the mean BMI in patients with surgical appendicitis was 19.6 ± 4.9 kg/m2 and in those with normal appendix was 20.9 ± 4.8 kg/m2 that was significantly lower in former group (p= 0.041).Thus, the mean BMI in patients with appendicitis diagnosed surgically or pathologically was lower than those with normal appendix.
Conclusion: Obesity is more common in children with normal appendix surgically and/or pathologically. Thus, the over diagnosis of appendicitis is higher in obese children
Mahnaz Sadeghian, Meysam Babbagei, Hasan Otukesh, Shahrbanoo Nakhaei, Shirin Sayyahfar, Niloofar Khosravi,
Volume 2, Issue 2 (5-2016)
Abstract
Background and Objective: Given the widespread use of paraffin in the treatment of constipation in chil-dren and the possibility of long duration of drug use and the risk of drug leakage, the risk of urinary infection in these patients is considerable. The aim of this study was to determine the association between leakage of paraf-fin and the presence or exacerbation of the urinary infection and repeated attacks of urinary tract infection in children with chronic functional constipation.
Methods: In this cohort study, 80 consecutive children aged 3 to 17 with the diagnosis of chronic constipa-tion according to the Rome III criteria that received paraffin (5 to 15ml/kg/day) or polyethylene glycol (1.5grams/kg/day) treatment schedule were studied and the presence of urinary tract infection in the patients was analyzed.
Results: There was also no difference between paraffin group and polyethylene glycol group in terms of the prevalence of urine incontinence (17.5% versus 25.0%, p=0.293) and fecal incontinence (17.5% versus 12.1%, p=0.378). In total, positive urinary culture was found in one child (2.5%) in paraffin group and in two children (5.0%) in polyethylene glycol group without significant difference (p=0.500).
Conclusion: The occurrence of urinary tract infection is expected in 3.75% of children with chronic func-tional constipation treated with paraffin or polyethylene glycol. The types of treatment including paraffin or polyethylene glycol do not increase the risk for urinary tract infection in these children
Zohreh Kalbassi, Ladan Afsharkhas, Mahnaz Sadeghian, Niloofar Khosravi,
Volume 2, Issue 2 (5-2016)
Abstract
Background and Objective: Headache in children and adolescents is among the most common complaints that can cause impairment in their function. The current study is designed to evaluate the frequency and type of headaches and use of analgesics in a sample of female high school students in Tehran.
Methods: Three hundred female high school students were included in the study during September 2011 to April 2012. All students were examined about headache. If students had positive history of headache, the second step of examination and physical exams were considered. Frequency and types of headaches and analgesic con-sumption were recorded. The effect of headache on daily function of students was evaluated by MIDAS scale. Data were analyzed using SPSS software version 14.
Results: Two hundred seventeen students (72.3%) had headaches. Among them, 86 (39.6%) people experi-enced tension type headaches and 68 (31.3%) migraine type headaches. Mean frequency of headache was 6.6 ± 4.8 episodes per month. Mean MIDAS score was 35.3±5.85 in migraine type headaches and 13.4% of cases had severe disability in daily activities due to headaches. One hundred seventy nine (82.5%) used analgesics for their headaches.
Conclusion: According to high prevalence of headache in female students of Tehran, disabilities in daily ac-tivities due to migraine headache and also large amount use of analgesic in them, a screening of female students for headache and appropriate management is recommended
Ahmad Bahrami, Gholamreza Bayazian, Omid Momeni, Arezoo Mansoori, Safoora Hajisadeghi,
Volume 3, Issue 3 (8-2017)
Abstract
Background and Objectives: Nocturnal snoring and open mouth breathing in children is one of the common causes of referrals to pediatricians. The two most common reasons of this problem are adenotonsillar hypertrophy and allergic rhinitis. Based on the findings, there is still no significant relationship between these two diseases. Therefore, the aim of this study was to determine the frequency of adenoid hypertrophy and allergic rhinitis in children with mouth breathing complaints who referred to the allergy or ENT clinic of Ali Asghar Hospital in Tehran during 2015-2016.
Methods: The population included all children between the ages of 4 and 12 years with symptoms of mouth breathing and nocturnal snoring referred to Allergy clinic of Ali Asghar Hospital during 2015-2016. These patients were examined by allergy sub-specialist in terms of atopy, allergic rhinitis, and allergy tests history. Patients were also examined by hospital otolaryngologist and otolaryngologist and the severity of tonsil hypertrophy and conchae was found. A checklist of the patient gender and age, age of the first allergic rhinitis symptoms, clinical signs at referral time, the severity and frequency of allergic rhinitis symptoms, other diseases, selected therapies by doctor, is also completed by researcher. Allergic rhinitis symptoms and adenoid hypertrophy symptoms and severity of asthma, duration of allergic rhinitis symptoms, quality of life, parent's history of smoking in children, and parent's history of snoring were also included in.
Results: 104 children at mean age of 6.35 ± 2.65 years were enrolled. Of these, 54.8% were male. Only 17.3% of children had adenoid hypertrophy, and other children had seasonal or perennial allergic rhinitis, or had both of them. The highest prevalence of nasal congestion symptoms was 92.3% and rhinorrhea was 79.8%. Mite allergy was 28.8%, weeds mixtures allergy 26.0%, pollen trees allergy 15.4%, dog and cat's hair allergy in 8.7%, and food allergies in 2.9% of children. The frequency of rhinorrhea, nasal congestion, sneezing, nasal itching, tearing and itching eyes, pulmonary allergy, asthma, gastro esophageal reflux and mites, weeds mixtures, pollen trees, dogs and cats hair allergies was significantly more (p<0.05) in children with allergic rhinitis. However, the frequency of otitis media in children with adenoid hypertrophy was significantly higher than in children with allergic rhinitis (p<0.05).
Conclusion: It can be concluded that the prevalence of allergic rhinitis which responds to avoidance of specific allergen and intranasal corticosteroid in children who referred with mouth breathing complaints is much higher than adenoid hypertrophy with no response to pharmacological therapy, and in case of proper diagnosis and treatment, a few children will ultimately require surgery. Therefore, considering the appropriate strategies and planning for early diagnosis and treatment of these patients, can reduce the need for surgery, its complications for patients.
