Gastroenteritis Related Seizure with or without Fever: Comparison Clinical Features and Serum Sodium Level

Objective: To investigate the clinical characteristics and serum sodium level in children with gastroenteritis related seizure with or without fever. Methods: 165 patients aged 6-60 months with gastroenteritis related seizure were studied. Demographic, seizure and gastroenteritis characteristics and laboratory findings were recorded.Results: Among the 165 children 47.3% were female and 52.7% were. Vomiting was 2.7±2.6 and 3.9±1.9 times in febrile and afebrile group. Duration of diarrhea was 1.8±1.8 day and 2.1±1.3 day in febrile and afebrile group (p=0.014). 36% in febrile group and 6.4% in afebrile group experienced seizure within the first 24 hours of gastroenteritis (p<0.001). Seizure in 99.1% in febrile and 93.6% in afebrile group was generalized (p>0.05). Seizure was more than 5 minutes in 51.4% in febrile and 57.4% in afebrile group (p>0.05). Drowsiness after seizure was seen in 72.9% and 60% in febrile and afebrile group (p>0.05). The serum level of sodium was 137.6±3.98 mEq/L and 138.5±3.78 mEq/L in febrile and afebrile group (p>0.05). 26.3% in febrile group and 8.5% in afebrile group had hyponatremia (p=0.012). There was no difference in seizure duration between hyponatremic patients and others (p>0.05). Conclusion: Type, duration of seizure and drowsiness after seizure had not any difference in febrile and afebrile cases. Vomiting and duration of diarrhea before admission was lower in febrile group. Seizure within the first 24 of gastroenteritis was higher in febrile group. Mild hyponatremia in febrile group was higher than afebrile group. No difference in duration of seizure was detected between hyponatremic patients and others

Nutritional Risk Assessment in Children with Cancer: A Longitudinal Study in North East of Iran

Background Children with cancer are in risk of malnutrition. Nutritional risk assessmentis more importance in developing countries. The aim of present study was to investigate the nutritional risk in admitted children with cancer. Materials and Methods One hundred admitted children newly diagnosed with cancer were studied at the time of admission, after 3 and 6 months.Demographic characteristics and anthropometrics indexes were recorded via standard and calibrated tools. Nutritional risk assessed according to modified Screening Tool for Assessment of Malnutrition in Pediatrics (STAMP).Statistical analysis was performed using SPSS software (version 16.0). Results Of the 100 children 55 patients (55%) were female. The average age was 3.46±3.3 years. Hematologic tumors constituted 73.5% of patient. All patients were in nutritional risk. There was no patient with low nutritional risk during study; 17 patients (17%), 53 patients (56.4%), and 41 patients (43.6%) diagnosed with medium nutritional risk at the time of admission, after 3 and 6 months, respectively; 83 patients (83%), 41 patients (43.6%), and 40 patients (43%) diagnosed with high nutritional risk at the time of admission, after 3 and 6 months, respectively. Difference was significant (

The Effect of Rosa damascena on Children’s Enuresis: A Randomized Pilot Study

Background and Aim: Enuresis is one of the common problems among children. The present pilot study was conducted to investigate the effect of Rosa damascene on nocturnal enuresis in children. Materials and Methods: A randomized pilot study was performed from April 2017 to March 2018. The study participants were 40 children aged between 5-12 years with nocturnal enuresis. They were randomly divided to intervention and control groups using block randomization. The intervention group received R. damascena petals under the brand name Gole-Ghand (Barij- essence, Iran) as 5 cc orally, every 8 hours for one month. The control group received desmopressin as nasal spray (Sina Darou, Iran) 1-2 puffs for one month (maximum 20 mg daily). The primary outcome was complete or partial improvement in enuresis. The secondary outcome was frequency of side effects in patients. Results: Twenty-two out of 39 patients 22 (56.4%) were male and 17 patients (43.6%) were female with the average age of 7.3±1.86 years. There was no noticeable distinction between the groups in age, sex, urbanity, history of treatment, and primary or secondary enuresis (p>0.05). Complete improvement was observed in 14 patients (70%) in the control group. Partial improvement was observed in four patients (20%) in the control group and in six patients (31.5%) in the intervention group (p:0.001). No side effect was reported during the study in the intervention group. Conclusion: Based on the results of this pilot study, the use of R. damascena may lead to partial improvement against enuresis in some children. Further studies are required to evaluate this hypothesis

Serum Level of Vitamin D and Febrile Seizure? A Clinical Study

Objective:To evaluate the serum level of vitamin D in children aged six to 60 months with febrile seizure and febrile children without the seizureMaterials & MethodsFebrile children aged six to 60 months with or without seizure were studied. Demographic characteristics, serum level of vitamin D, and other laboratory findings were recorded.ResultsAmong the 104 children, 51 patients had fever without a seizure and 53 patients had a febrile seizure. The mean subjects’ age was significantly more in the febrile seizure group compared to the without seizure group (16.26 ± 11.87 versus 26.36 ± 14.11 months, p = 0.001). The mean serum level of vitamin D in the with and withouts eizure groups was 41.92 ± 22.42 and 48.41 ± 15.25 microgram perd eciliter, respectively (p = 0.08). There was no significant correlation between serum level of vitamin D and seizure occurrence (p = 0.07).The mean serum sodium and potassium levels, and platelet count were significantly lower in the febrile seizure group compared to the without seizure group (p < 0.05). There were no significant differences between the two groups regarding hemoglobin, blood sugar, creatinine, blood urea nitrogen, calcium, alkaline phosphatase levels, and white blood cell count (p > 0.05).ConclusionThe serum level of vitamin D in febrile children with or without seizure was normal. The serum level of vitamin D was lower inp atients with the seizure but not statistically significant. More clinical studies are needed to evaluate the relationship between febrile seizurea nd the serum level of vitamin D

Different effect of green tea consumption on salivary antioxidant status in light versus heavy smokers

Objectives Oxidative stress consequent to cigarette smoking may alter the salivary antioxidant defense system and lead to oral cancer. Green tea, with antioxidant properties, interacts with saliva upon entering the mouth. This experimental study explored the preventive effect of green tea on cigarette smoke-induced oxidative damage over 3 weeks.Methods In this clinical trial study sixty volunteer healthy male smokers (light and heavy) and non-smokers were selected according to the inclusion criteria. Participants of each three groups were instructed to drink 4g of green tea (prepared with 300 ml hot water) daily, for three weeks. Total antioxidant capacity of saliva was measured at baseline, after 7 days, and after 21 days in each group. Repeated measure ANOVA with Bonferroni adjustment was performed for statistical analysis.Results Non-smokers had a higher amount of salivary total antioxidant capacity at baseline (p<0.001). After 7days of green tea consumption total antioxidant capacity of non-smokers and light smokers showed no statistical difference (p=0.075), this trend continued until 21 days. In the heavy smokers total antioxidant capacity was still different from the other two groups (p<0.001). However, the maximum positive alteration of salivary total antioxidant capacity from day zero to day 21 occurred in the heavy smoker group (p< 0.001).Conclusion Although findings support the role of green tea drinking in reducing oxidative damage in saliva of both groups of smokers, heavy smokers showed the most significant change in total antioxidant capacity levels over three weeks

Review of Oral and Dental Consideration in the Patients with Head and Neck Radiotherapy and Chemotherapy

Objectives Aggressive cancer therapy places patients at a greater risk for oral complications. Cancer patients suffer from oral toxic effects secondary to antineoplastic therapy (radiotherapy and chemotherapy). The aim of this review is management of the head and neck   cancer patients that specifically emphasizes the prevention and treatment of oral and   dental complications associated with cancer therapy.Methods In this narrative review article, the specialized databases such as PubMed, PubMed Central, MEDLINE, EBSCO, Science Direct, Scopus from 2008 to 2018 were used to find relevant documents by using Mesh terms: Chemotherapy, Radiotherapy, oral consideration, head and neck.Results The data were categorized in: Complications of head and neck radiotherapy and its management (Xerostomia,  Oral Infection, Oral Mucositis, Osteoradionecrosis), Complications of head and neck chemotherapy and its management (Mucosal toxicity, Dental alterations, Neurological disorders, Salivary alterations, Dysgeusia, Infections, Bleeding tendency, Osteonecrosis of the jaws due to bisphosphonates).Conclusion In order to minimize   morbidity in the head and neck cancer patients, it is recommended for consulting to   dental health care providers   before, during and after cancer therapy

Evaluation and Comparison of Choroidal Thickness in Patients with Behçet Disease with versus without Ocular Involvement

Purpose: To assess the subfoveal choroidal thickness (SFCT) in patients with Behçet disease (BD) and compare the SFCT in patients with and without ocular BD (OBD) and between patients with active and quiescent phases of the Behçet’s posterior uveitis. Method: This prospective cross-sectional study was conducted on patients with BD (n = 51) between October 2016 and October 2018. Complete ocular examinations including slit lamp biomicroscopy and fundus examination with dilated pupils were performed for all patients. The SFCT values were compared between patients with and without OBD. Enhanced depth imaging optical coherence tomography (EDI–OCT) was done to measure the SFCT, and wide field fundus fluorescein angiography (WF–FAG) was performed to evaluate the ocular involvement and determine the active or quiescent phases of the Behçet’s posterior uveitis. The correlation between the changes of SFCT and the WF-FAG scores was assessed. Results: One hundred and two eyes of 51 patients with BD, aged 29 to 52 years were studied. Of these, 23 patients were male. The mean age ± standard deviation in patients with OBD and patients without ocular involvement was 38.71 ± 7.8 and 36.22 ± 10.59 years (P = 0.259) respectively. The mean SFCT in patients with OBD was significantly greater than in patients without OBD (364.17 ± 93.34 vs 320.43 ± 56.70 μm; P = 0.008). The difference of mean SFCT between the active compared to quiescent phase was not statistically significant when only WF-FAG criteria were considered for activity (368.12 ± 104.591 vs 354.57 ± 58.701 μm, P = 0.579). However, when the disease activity was considered based on both WF-FAG and ocular exam findings, SFCT in the active group was higher than the inactive group (393.04 ± 94.88 vs 351.65 ± 58.63 μm, P = 0.060). This difference did not reach statistical significance, but it was clinically relevant. Conclusion: Choroidal thickness was significantly increased in BD patients with ocular involvement; therefore, EDI-OCT could be a noninvasive test for evaluation of ocular involvement in patients with BD. The increased SFCT was not an indicative of activity in OBD; however, it could predict possible ocular involvement throughout the disease course

Recurrent Seizure during Hospitalization in Children with the First Febrile Seizure: Incidence and Risk Factors

Background: The present study aimed at evaluating the demographic and laboratory factors associated with the recurrent seizure during hospitalization in the children with the first febrile seizure.Methods: This cohort study was performed in Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran, from 2018 to 2019. Totally 483 admitted children aged 6-60 months with the first febrile seizure were included. The repetition of seizure during hospitalization was considered as incidence of recurrent seizure.Results: Among 483 children with the first febrile seizure, recurrent seizure occurred in 57 patients (11.8%). The serum level of potassium, magnesium and calcium in children with recurrent seizure significantly was lower in comparison to the patients without repeated seizure. Complex seizure was the major risk factor for recurrent seizure (relative risk: 377.74, p=0.001). The risk of recurrent seizure decreased with the increase of serum level of potassium, calcium and magnesium. The risk of recurrent seizure increased with the increase of body temperature but not significantly.Conclusion: The incidence rate of recurrent seizure in children with the first febrile seizure was 118 cases per 1000 population. Complex seizure was the main risk factor for the seizure recurrence. Higher serum levels of potassium, calcium and magnesium may decrease the risk of recurrent seizure

Comparison of Verbal Explanations, Graphics, and Film Presentations for Increasing Parental Satisfaction with Lumbar Puncture Performance in Children with Febrile Seizure

AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted on the children with febrile seizures referred to the Emergency and Pediatric Wards of hospitals affiliated with Mashhad University of Medical Sciences. They were LP candidates; nonetheless, their parents did not consent to the performance of this procedure. The children were randomly assigned to three groups. In the first group, videos of the location and method of LP were presented to the parents. The second group received this information via posters, and the parents in the third group were given a verbal explanation. Results: The children included 49 (4.54%) females with a mean age of 15 months. There was a significant relationship between the reason for parental refusal of LP and their final satisfaction (P=0.022). There was a significant relationship between parents' satisfaction with the performance of LP and their education (P=0.029). The film method had the lowest chance of success, and the verbal explanation method enjoyed the most remarkable success in enhancing parental satisfaction (P= 0.013).Conclusion: Although the use of posters and videos was less effective than verbal explanation, it increased the satisfaction of LP in some parents. In fact, it is more beneficial to try to alter parental misperceptions of LP in non-emergency situations

The Relationship between Chronic Constipation and Urinary Tract Infection in Children: A Case-Control Clinical Study

Background Urinary tract infection (UTI) is one of the most common bacterial infections in children, if not diagnosed leads to serious complications such as hypertension, chronic renal failure and renal scar. Constipation is one of the main risk factors for recurrent UTI. The aim of present study was to investigate the relationship between chronic constipation and urinary tract infection in children. Materials and Methods In this case-control study 105 patients with functional chronic constipation as case group, compared with 104 children without chronic constipation as control. The control group was matched according to gender and age. The prevalence of UTI in children with and without constipation as well as their improvement was compared after treatment. Results The prevalence of UTI in case and control groups was 13.3% and 6.7%, respectively (P=0.17). The prevalence of UTI in case group decreased to 3.8% after treatment of constipation. Escherichia coli (E coli) was the most commonly isolated organism in both groups. Conclusion Results of present study showed that despite of no significant urinary tract infection incidence between children with constipation and those without constipation, the constipation should still be considered as a predisposing risk factor for the UTI occurrence