The Incidence of Renal Scarring and its Related Factors in Children with First Pyelonephritis

Introduction:Urinary tract infection (UTI) is common in children. UTIs are important in view of the morbidity and risk of scarring. Several factors have been reported to be responsible for progression to scarring. The aim of this study was to determine the incidence of scar and its related factors. Materials and Methods:In this study, 26 males and 77 females (3 months - 12 years) with first pyelonephritis were evaluated. All patients underwent ultrasound, cystourethrography, and Dimercaptosuccinic acid scan. A follow-up scan was performed 6 months later. Age, gender, organism, presence, and grade of vesicoureteral reflux (VUR), delay in treatment, total white blood cell counts (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels on admission were recorded. Logistic regression analysis was used to evaluate the association between the variables and scar.Results:Of 103 patients, 47.6% had VUR. Scar was detected in 38.8%. There were significant associations between delay in treatment (p=0.0001), grade of VUR (p=0.03) and elevated ESR (p= 0.006), CRP (p=0.002) and WBC (p=o.oo5) with scar. No association was established with age, sex, VUR, and organism. On multivariate analysis, delay in treatment was independently associated with scar.Conclusions:We found that the grade of VUR, delay in treatment, and increased ESR, CRP and WBC were important factors related to scar. Keywords: Child; Pyelonephritis; Renal Scar

Dipstick Urinalysis Screening of Healthy Neonates

Renal disease may accidentally be discovered during urinalysis. This study was conducted to examine the usefulness of dipstick urinalysis screening in healthy neonates for the diagnosis of underlying renal disease and to study the magnitude of abnormal urinalysis in apparently healthy neonates. Methods: In this descriptive study, voided urine samples were obtained from 400 apparently healthy neonates and tested using urine dipstick. The reaction of dipstick strip was read visually by a trained nurse. In cases with an abnormal urine analysis, a second screen test was performed within a week, and for those with persistent abnormalities, complete diagnostic tests were done. Results: On the first urinalysis, 375 (94%) subjects were normal and 25 (6%) had abnormalities: 23 had proteinuria (5.75%), one was blood positive (0.25%), and one was both protein and blood positive (0.25%). Male neonates had a higher proportion of proteinuria than female neonates (p=0.038). In the second examination, proteinuria was found in five (1.25%) neonates, but the proportion of other abnormalities did not change. In follow-up investigations, ureteropelvic junction obstruction and vesicoureteral reflux were recognized in two infants who had blood-positive or combined blood- and protein-positive results on their first tests. Conclusion: The findings of this study show that dipstick test during neonatal period could be used for early diagnosis of renal diseases

Health-related Quality of life and its related factors in patients undergoing Coronary angioplasty, Zanjan, northwest Iran

Background: The quality of life of patients after percutaneous coronary interventions (PCI) is definitely not clear. The aim of this study was to evaluate the health-related quality of life (HRQL) and related factors in patients undergoing angioplasty. Methods: This analytical cross-sectional study was performed on patients with coronary artery disease who underwent PCI and had a history of hospitalization in Zanjan, Iran in 2020.  920 patients based on specific inclusion and exclusion criteria were included by census method.The study tool was a 36-item Short Form Health Survey questionnaire)SF-36). Mann-Whitney U test and Kruskal-Wallis tests were used to data analysis in SPSS 19 with a significance level of 5%. Results: In total, 70%(644people) were female, 86% (791) angina, 34.2% (315) Myocardial infarction. median (IQR) of age, Physical Component Summary(PCS), and Mental component summary (MCS) were 60 (15), 65.78(9.48), 64.18 (7.68), respectively. Multivariate linear regression showed that PCI type (B=-2.52, p=0.013) and age (B= -0.21,p<0.001) had a negative effect  and education level(B=3.15, p=0.002), income(B=1.34, p=0.002), angina(B=1.27, p=0.02)  and number of drugs(B=0.609, p<0.001)  had a positive effect on PCS. Also, PCI type (B=-3.024, p=0.001), age(B=-0.123, p<0.001), diabetes(B=-1.19, p=0.008), blood pressure(B=-0.728, p=0.05)  and duration of disease(B=-0.309, p=0.022)  had a negative effect and education, income(B=2.57, p=0.022), number of drugs(B=0.615, p<0.001)  had a positive effect on MCS. Conclusion: Age, type of PCI, diabetes, blood pressure, level of education, income were the most important factors related to HRQL of cardiovascular patients undergoing coronary angioplasty. Therefore, to improve the HLQL, these factors must be considered