Thyroid Function in Epileptic Children who Receive Carbamazepine, Primidone, Phenobarbital and Valproic Acid

ObjectiveIn this study, we investigated the changes of the serum levels of thyroidhormones including Thyroxine (T4), Triiodothyronine (T3), T3 resin uptake andThyroid stimulating hormone (TSH) in epileptic children during treatment withanti-epileptic drugs (AEDs) including carbamazepine (CBZ), primidone (PRM),phenobarbital and valproic acid (VPA).Materials and MethodsThis study consisted of four case-series comparisons, was conducted on 115epileptic children (37 girls and 78 boys with an age range between 2 monthsand 15 years, mean: 62.06 ± 44.97 months). These children were divided into4 groups who took either phenobarbital (n=29), PRM (n=28), CBZ (n=29), orVPA (n=29) for 3 months. Thyroid hormone levels (T3, T3 resin uptake, T4 andTSH) were measured at the beginning and three months after starting the study.ResultsAt first, all patients were euthyroid and there were no clinical or laboratoryfindings suggestive of hypothyroidism. Regarding thyroid hormones before andafter the administration of phenobarbital, carbamazepine, valproic acid andprimidone, there were no significant changes in serum T3, T4, T3 resin uptakeand TSH levels.ConclusionOur findings showed that short term therapy with phenobarbital, carbamazepine,valproic acid and primidone had no effect on thyroid function etsts.Key words: Anti-epileptic drugs; Thyroid hormones; Epileptic children.  

Magnetic Resonance Imaging Findings in Epileptic Children and Its Relation to Clinical and Demographic Findings

Epilepsy is an important disease with a cumulative incidence of 3% all over the life and more than half of them are started from childhood. In this study we surveyed magnetic resonance imaging (MRI) findings in epileptic children and its relation with clinical and demographic findings in order to find better diagnostic and treatment modalities for these children in the future. In this cross sectional study, we investigated consecutively all 1 to 15-year-old epileptic children who referred to the pediatric neurology outpatient clinic from 2004 to 2010. Two hundred children were enrolled for investigation. There were 85 (42.5%) girls and 115 (57.7%) boys, aged 1 to 15-year-old (7.7±4). 196 (98%) of the children had abnormal electroencephalography (EEG). Abnormal MRI was seen in 57 (28.5%) patients and consisted of brain atrophy (10%), increasing white matter signal intensity in T2-weighted images (8%), benign cysts (5%), brain tumors (4%) and vascular abnormalities (1.5%). Abnormal MRI findings had significant relation with abnormal EEG, age, positive family history for epilepsy, dysmorphic appearance, and abnormal physical exam. Considering 98% EEG abnormalities in these epileptic children, benign nature of MRI findings in most of our cases, the high price of MRI and the small minority of patients who benefit from active intervention as a result of MRI, we suggest to use EEG for confirmation of epilepsy and perform MRI for patient with abnormal physical exams, focal neurologic deficits or focal EEG abnormalities

Leukocyte Adhesion Deficiency: Report of Two Family Related Newborn Infants

"nLeukocyte adhesion deficiency type 1 (LAD 1) is an autosomal recessive hereditary disorder resulting from deficiency of CD18, characterized by recurrent bacterial infections. We report two consanguineous patients with Leukocyte adhesion deficiency type 1( LAD1). These two infant boy patients were referred to us, within a short period of time, with the complaints of recurrent infections at the age of 38 and 75 days -old, respectively. Parents of two patients were first cousins and their grandmothers also were first cousins. The history of delayed umbilical cord separation was shown in both patients. Patient 1 had history of omphalitis, conjunctivitis, skin lesion of groin area and abscess formation of vaccination site, and had infective wound of eye-lid at the last admission. Patient 2 had history of omphalitis and soft tissue infection of right wrist at the last admission. Laboratory findings showed marked leukocytosis and low CD18 levels (6.6% in Patient 1 and 2.4 % in Patient 2). In Patient 1 recurrent infections were treated with antibiotic regimens and received bone marrow transplantation but Patient 2 died because of septicemia, generalized edema, ascites and progression to acute renal failure at 4 months of age. Due to considerable rate of consanguineous marriages in parents of Leukocyte adhesion deficiency patients, sequence analysis especially for prenatal diagnosis in subsequent pregnancies and genetic counseling is recommended

Tehran University of Medical Sciences: Participation in Twenty Five Percent of Pediatric Science Production in Iran

Objective: Scientific articles are indicators of research interests and efforts in every country. The aim of our study was to compare the scientific output between universities of medical sciences in Iran on pediatrics in the Pubmed database. Methods: In a descriptive study, we searched in Pubmed in order to assess the Iranian pediatrics publications with these words: "(Pediatric [*MeSH] OR Neonate [MeSH] OR Newborn[MeSH] OR Infant [MeSH] OR Child [MeSH] OR Children [MeSH] OR Adolescent[MeSH] OR Adolescence [MeSH])" AND (Iran [*AD] OR Iranian [AD] OR Persian [AD]). The identified articles were published May 1957 to December 2007 and we selected all articles from universities of medical sciences in Iran. We extracted year of publication, affiliation of authors and impact factor from hard copy of articles. Findings: From 819 papers published, 565 were authored by members of universities of medical sciences. Tehran University of Medical Sciences with 142 articles (17.3% of all, 25.1% from publications of universities of medical sciences) held the first place, Shiraz University of Medical Sciences with 116 (14.2% of all, 20.5% from publications of universities of medical sciences) the second place and Shaheed Beheshti University of Medical Sciences with 88 (10.7% of all, 15.5% from publications of universities of medical sciences) the third place. Regarding Impact Factors (IF) Tehran, Shaheed Beheshti and Shiraz Universities of Medical Sciences with 153, 93 and 81 were in the first, second and third place, respectively. Conclusion: Tehran University of Medical Sciences had twenty five percent of pediatric science production in Iran. This university had published higher number of papers on pediatrics among universities of medical sciences in Iran