A Study on Causes and Types of Abnormal Increase in Infants’ Head Circumference in Kashan/Iran

How to Cite This Article: Talebian A, Soltani B, Moravveji AR, Salamati L, Davami M. A Study on Causes and Types of Abnormal Increase in infants’ Head Circumference in Kashan/Iran. Iran J Child Neurol. 2013 Summer; 7(3): 28- 33. ObjectiveHead circumference is a valuable index of brain growth and its disturbances can indicate different disorders of nervous system. Abnormal increased head circumference (macrocephaly) is common and observed in about 2% of infants. In this study, the causes and clinical types of abnormal increase in infants’ head circumference were investigated in Kashan, Iran.Materials & MethodsThis cross-sectional study was performed on 90 infants less than 2 years of age with abnormal increase in head circumference in Kashan, during 2009- 2011. The data were collected by history taking, physical examination, growth chart, and imaging.Results65 (72%) cases out of 90 infants were male and 25 ( 28%) cases were female. Fifty-three (58.8%) cases had familial megalencephaly, 30 (33.4%) had hydrocephalus, and other causes were observed in 7 (7.8%) cases. Eighty-three percent of Infants with familial megalencephaly and 50% with hydrocephalus had normal fontanels. In 90.6% of cases withfamilial megalencephaly, family history for large head was positive. Motor development was normal in 100% of cases with familial megalencephaly and 76.7% of hydrocephalic infants.Conclusion Familial megalencephaly was the most common cause of macrocephaly in the studied infants, and most of them had normal physical examination and development, so, parental head circumferences should be considered in the interpretation of infant’s head circumference and in cases of abnormal physical examination or development, other diagnostic modalities, including brain imaging should be done. References1. Lunde A, Melve KK, Gjessing HK, Skjaerven R, Irgens LM. 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Comparison between the efficacy of photodynamic therapy and topical paromomycin in the treatment of old world cutaneous leishmaniasis: A placebo-controlled, randomized clinical trial

<b>Background: </b> The optimal treatment for cutaneous leishmaniasis (CL) is not known. Topical paromomycin is one of the many drugs that have been suggested for the treatment of CL caused by Leishmania major. Recently, topical photodynamic therapy (PDT) has been reported to be effective in the treatment of CL. This study aimed to compare the parasitological and clinical efficacy of PDT versus topical paromomycin in patients with old world CL caused by <i> L. major</i> in Iran. <b> Materials and Methods:</b> In this trial, sixty patients with the clinical and parasitological diagnosis of CL were recruited and were randomly divided into three treatment groups with twenty subjects in each group. Group 1 was treated with weekly topical PDT and groups 2 and 3 received twice daily topical paromomycin and placebo, respectively. The duration of treatment was four weeks for all groups. These groups were followed up for 2 months after the end of treatment. <b> Results: </b> 57 patients with 95 lesions completed the study. At the end of the study, complete improvement was seen in 29 of 31 (93.5&#x0025;), 14 of 34 (41.2&#x0025;) and 4 of 30 (13.3&#x0025;) of the lesions in group 1, 2 and 3 respectively (<i> P</i> &#60; 0.001). At the same time point, 100&#x0025;, 64.7 and 20&#x0025; of the lesions had parasitological cure in group 1, 2 and 3, respectively (<i> P</i> &#60; 0.001). <b> Conclusion: </b> Topical PDT can be used safely as a rapid and highly effective alternative choice for treatment of old world CL in the selected patients