Pseudotumor Cerebri after Kidney Transplantation

<p><strong><em>Background and Objectives</em></strong><strong>:</strong> Pseudotumor cerebri is defined by the increase of intracranial pressure. It has different atiologies but, many of its causes are idiopathic and typically present on young obese females. Cerebrospinal fluid (CSF) analysis was normal in this case study and there was no evidence of intracranial mass, venous sinus thrombosis, or obstruction in CSF stream.</p><p>In this study, we have reported a case of Pseudotumor cerebri presented 7 years after a successful kidney transplant, under treatment by Cyclosporine, Methylprednisolon and Azathioprine(AZT).</p><p><strong><em>Case Report</em></strong><strong>:</strong> The patient was a 17-year old obese female with a body mass index of 30kg/m2 having Pseudotumor cerebri 7 years after a successful kidney transplant. Brain imaging like CT scan & MRA (Magnetic Resonance Angiography) were normal. CSF analysis was normal, but the increase in CSF pressure had been detected. Repetitive lumber punctures was performed with simultaneous Acetazolamid administration. But her headaches were treated even after the continuation of Cyclosporine and Methylprednisolon, anemia, and renal failure. For patients with kidney transplant and headaches, it is necessary to rule out Pseudotumor cerebri as a differential diagnosis. Neurotoxicity of Cyclosporine is not rare and we have to pay close attention to neurologic side effect of this drug as well. After diagnosing Pseudotumor cerebri in such patients, it is necessary to limit the progression of symptoms and avoid the decrease in patient 's visual acuity.</p&gt

Relationship between antimicrobial therapy and scar formation in urinary tract infection in children

Background: Urinary infection is known as one of the most common bacterial infection in children. Punctual diagnosis and treatment along with the diagnosis of risk factors and long-term follow-up of the patients suffering from urinary infection are the most important factors in order to prevent scar formation in kidneys. This study was carried out in order to analyze time difference among symptoms onset and the start of urinary infection treatment and it has relation with scar formation in kidneys. Methods: This study was done by (Historical cohort ) method on 120 patients they were divided into 2 groups of 60. The treatment was started on time for the first group but for the second with delay. All of the patient suffered from urinary infection and they were DMSA scaned after six months. The scar formation amount in kidneys was compared in two groups and the results were analyzed by SPSS software. Finding: The result showed that 75% of the girls and 25% of the boys out of 120 infected children, suffered from urinary infection. No obvious relation between the scar formation appearance, parents social level and children genders was found. A meaningful relation was found between treatment delay and scar formation in kidney due to urinary infection (RR= 3, CI = 1.4–6.5). The Minimum And Maximum delay time in this treatment were 1 and 21 days respectively. The average of delay time between symptoms onset and treatment start has been 4.8 days. Based on this research, the delay time in treatment more than 6 days may cause kidney scar formation twice as much (RR=2.15, CI=1.1- 4.6). Conclusion: Scar formation risk increase with delay in antimicrobial therapy in UTI. It is strongly recommended to diagnose and begin the treatment as soon as possible to prevent kidney damage properly

Hemolytic Uremic Syndrome; Report of a Case With late Recovery Of Renal Function

Background and ObjectiveHemolytic uremic syndrome (HUS) is characterized by triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. It is more common in children younger than the age of 4 years and is the most common cause of acute renal failure in many parts of the world in this range of age. The classic form of the disease occurs after an episode of acute diarrhea which may lead to chronic renal failure in 9% of cases. Here in we report a case of HUS with recovery of renal function after 15 months of dialysis. Case report A 12 year old boy was admitted with major clinical symptoms including acute bloody diarrhea, followed by acute renal failure, thrombocytopenia and severe microangiopathic hemolytic anemia. Peripheral blood smear showed probability of HUS. Peritoneal dialysis was started and later followed by hemodialysis. Eventually after 15 months of dialysis he obtained normal renal function and now after 3 years he is in good health with normal renal function.Conclusion: Recovery of renal function in HUS is possible even after a prolonged period of renal failure.Keywords: Hemolytic-uremic syndrome, Children, Child, Late recovery

Pseudotumor Cerebri after Kidney Transplantation

AbstractBackground and Objectives: Pseudotumor cerebri is defined by the increase of intracranial pressure. It has different atiologies but, many of its causes are idiopathic and typically present on young obese females. Cerebrospinal fluid (CSF) analysis was normal in this case study and there was no evidence of intracranial mass, venous sinus thrombosis, or obstruction in CSF stream.In this study, we have reported a case of Pseudotumor cerebri presented 7 years after a successful kidney transplant, under treatment by Cyclosporine, Methylprednisolon and Azathioprine(AZT).Case Report: The patient was a 17-year old obese female with a body mass index of 30kg/m2 having Pseudotumor cerebri 7 years after a successful kidney transplant. Brain imaging like CT scan & MRA (Magnetic Resonance Angiography) were normal. CSF analysis was normal, but the increase in CSF pressure had been detected. Repetitive lumber punctures was performed with simultaneous Acetazolamid administration. But her headaches were treated even after the continuation of Cyclosporine and Methylprednisolon, anemia, and renal failure. For patients with kidney transplant and headaches, it is necessary to rule out Pseudotumor cerebri as a differential diagnosis. Neurotoxicity of Cyclosporine is not rare and we have to pay close attention to neurologic side effect of this drug as well. After diagnosing Pseudotumor cerebri in such patients, it is necessary to limit the progression of symptoms and avoid the decrease in patient 's visual acuity.Keywords: Pseudotumor Cerebri; Neurotoxicity; Cyclosporin

Isolation and Characterization of Crude Oil Degrading Bacillus Spp.

Today, application of microorganisms for removing crude oil pollution from contaminated sites as bioremediation studies, was considered by scientists because other methods such as surfactant washing and incineration lead to production of more toxic compounds and they are non-economic. Fifteen crude oil degrading Bacillus   spp. were isolated from contaminated sites. Two isolated showed best growth in liquid media with 1-3% (v/v) crude oil and mineral salt medium, then studied for enzymatic activities on tested media. The results showed maximal increase in optical densities and total viable count concomitant with decrease in pH on fifth day of experimental period for bacillus S6. Typical generation time on mineral salt with 1% crude oil is varying between 18-20h, 25-26h respectively for bacillus S6 and S35. Total protein was monitored at determined time intervals as biodegradation indices. Increasing of protein concentration during the incubation period reveals that isolated bacillus can degrade crude oil and increase microbial biomass. These bacillus spp. reduced surface tension from 60 (mN/m) to 31 and 38 (mN/m), It means that these bacillus spp. can produce sufficient surfactant and have good potential of emulsification capacity. The results demonstrated that these bacillus spp. can utilize crude oil as a carbon and energy source

Spontaneous Resolution of Vesicoureteral Reflux (VUR) in Iranian Children, a Single Center Experience in 533 Cases

Background and ObjectivesExperience with vesicoureteral reflux (VUR) differs in different centers and there are lots of controversies surrounding this issue. The aim of this study was to evaluate Spontaneous resolution and prognosis of the disease among Iranian children.MethodsIn this case series study, 1278 children with urinary tract infection and visited at pediatric nephrology clinic in Tehran, Iran during 1999-2007 were studied. Primary VUR was found in 533 Patients. Following the diagnosis, the patients received prophylactic antibiotic and were annually followed with radionucleo cystography (RNC). Patients underwent surgery in case the medical treatment failed (breakthrough infection) or new renal scar formation.Results533 patients with VUR were studied. Patients’ mean age with VUR was 3.7±2.4 years (range: 2 days to 18 years old). During an average follow-up duration of 3.3+2.2 years, spontaneous resolution was observed in 40% of 279 patients who had follow-up RNCs. The mean interval between VUR diagnosis and spontaneous resolution was 1.5+ 1 years (range: 2 months to 6 years). The resolution rate was decreased with increment of reflux grade so that for grades I to V, VUR was resolved in 63%, 57%, 27%, 22% and 10% of the cases, respectively. Anti reflux surgery was performed in 27(10%) of patients during follow-up.ConclusionBased on the excellent results obtained from clinical therapy using low dose antibiotics, it is recommended that VUR grades 1 to 4 be managed medically with low-dose oral antibiotic prophylaxis and close follow-ups.Keywords: Urinary Tract Infection; Vesico-Ureteral Reflux; Spontaneous Resolution; Child

Investigation of Exon 1 in FXN Gene in Patients with Clinical Symptomatic of Friedreich Ataxia

Background and Objectives: Friedreich’s ataxia (FRDA) is an autosomal recessive disorder that is typically associated with dysarthria, muscle weakness, spasticity in the lower limbs, scoliosis, bladder dysfunction, absent lower limb reflexes, and loss of position and vibration sense. Approximately two-thirds of these patients suffer from cardiomyopathy and more than 30% have diabetes mellitus. Individuals with FRDA have identifiable mutations in the FXN gene . The most common type of mutation which is observed on both alleles in more than 98% of patients is an expansion of a GAA triplet-repeat in intron of FXN gene. Approximately 2% of individuals with FRDA are compound heterozygotes, who have a GAA expansion in the disease-causing range in one FXN allele and an inactivating FXN mutation in another allele . Aim of the present study was to investigate exon 1 in FRDA gene in patients with clinical symptoms of Friedreich’s Ataxia that have not GAA triplet-repeat expansion in intron 1 of FXN gene.   Methods: In this study , exon 1 in 5 patients suspected of FRDA analyzed using PCR and sequencing.   Results : An A to G transition at nucleotide number 815284, in exon 1 was observed in all patients.   Conclusion: The results of this study showed that disease-causing homozygous mutations could be because of consanguinity marriage in Iran. Therefore, sequencing of all exons of the gene is necessary