Acute Kidney Injury in Children with Acute Gastroenteritis

Introduction: This study was done in Children’s Medical Center Hospital affiliated with Tehran University of medical science, Tehran, Iran.Materials and Methods: The patients were 140 children who were admitted for gastroenteritis and we detected acute kidney injury in them. All of the patients were admitted and managed in the Emergency Department, and were evaluated for symptoms of AKI including dehydration, renal function tests, electrolytes, and urine output.Results: The median age of the children with gastroenteritis and AKI was 2.5 years (ranging from 2 months to 12 years) and 78.6% of them were male. Acute kidney injury (AKI) was present in 116 (82.9%) patients at admission with 53 (37.8%) patients in the “failure” category (RIFLE). Twelve children had anuria and 54 patients had oliguria. At presentation, 24 patients (15%) had serum BUN levels between 30-75 and creatinine levels in the range of 0.9-2.1mg/dl. One patient had HUS that was excluded from this study. Seventy-six children had symptoms of severe dehydration and metabolic acidosis. After adequate fluid therapy, 30 children had polyuria of 6.4 (range 4-9) cc/kg/min. Twenty-three patients (16.4%) had hyponatremia and 41 patients (29.2%) had hypernatremia. Nine children (6.4%) suffered from hypokalemia. Some children had received ORS at home. All of them were managed in the emergency ward and discharged with normal GFR without any electrolyte abnormalities. The patients were fallowed for 3-6 months and all of them had normal renal function at the end of the study.Conclusions: Early diagnosis and urgent management of gastroenteritis and dehydration can prevent AKI.Keywords: Acute Kidney Injury; Child; Gastroenteritis

The effect of canola oil compared with sesame and sesame-canola oil on cardiometabolic biomarkers in patients with type 2 diabetes: Design and research protocol of a randomized, triple-blind, three-way, crossover clinical trial

BACKGROUND: Both canola and sesame oils consumption have been associated with favorable effects on cardio-metabolic biomarkers. However, to the best of our knowledge, no study has compared their effects on cardiovascular risk factors. The present study aimed to assess the effect of canola, sesame, and sesame-canola oils consumption on cardio-metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM‎). METHODS: This study was a randomized, triple-blind, three-way, crossover clinical trial. The study participants included 102 individuals with T2DM‎. Their spouses were also included in the study. The participants were entered into a 4-week run-in period. After that, their regular dietary oil was replaced with canola, sesame, or sesame-canola oils (a blend of sesame and canola oils) in three 9-week phases, which were separated by two 4-week washout periods (sunflower oil was consumed during the run-in and the washout periods). Dietary, physical activity, blood pressure, and anthropometric measurements were assessed at the beginning, middle (week 4-5), and end of each treatment phase. Blood samples were taken at the beginning and at the end of each phase. Serum, plasma, buffy coat, and whole blood samples were extracted and kept at-80 ºC for further analysis. Serum fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol‎ (HDL-C)‎, and low-density lipoprotein cholesterol (LDL-C) were selected as the primary outcomes. RESULTS: 102 participants with T2DM were randomly assigned to one of the 6 rolling methods. Through them, 93 individuals (91.2%) completely participated in all phases. CONCLUSION: The present study will provide an exceptional opportunity to examine the effect of canola, sesame, and sesame-canola oil on cardio-metabolic markers in adults with and without T2DM‎. This trial will also provide a good medium for the investigation of gene-dietary oils interaction in the future

Comparison of Common Monogenic Defects in a Large Predominantly Antibody Deficiency Cohort

Background: Predominantly antibody deficiencies (PADs) are the most common primary immunodeficiencies, characterized by hypogammaglobulinemia and inability to generate effective antibody responses. Objective: We intended to report most common monogenic PADs and to investigate how patients with PAD who were primarily diagnosed as suffering from agammaglobulinemia, hyper-IgM (HIgM) syndrome, and common variable immunodeficiency (CVID) have different clinical and immunological findings. Methods: Stepwise next-generation sequencing and Sanger sequencing were performed for confirmation of the mutations in the patients clinically diagnosed as suffering from agammaglobulinemia, HIgM syndrome, and CVID. Results: Among 550 registered patients, the predominant genetic defects associated with agammaglobulinemia (48 Bruton's tyrosine kinase [BTK] and 6 μ heavy chain deficiencies), HIgM syndrome (21 CD40 ligand and 7 activation-induced cytidine deaminase deficiencies), and CVID (17 lipopolysaccharides-responsive beige-like anchor deficiency and 12 atypical Immunodeficiency, Centromeric instability, and Facial dysmorphism syndromes) were identified. Clinical disease severity was significantly higher in patients with μ heavy chain and CD40 ligand mutations compared with patients with BTK (P = .003) and activation-induced cytidine deaminase (P = .009) mutations. Paralysis following live polio vaccination was considerably higher in patients with μ heavy chain deficiency compared with BTK deficiency (P < .001). We found a genotype-phenotype correlation among patients with BTK mutations regarding clinical manifestation of meningitis and chronic diarrhea. Surprisingly, we noticed that first presentations in most patients with Immunodeficiency, Centromeric instability, and Facial dysmorphism were respiratory complications (P = .008), whereas first presentations in patients with lipopolysaccharides-responsive beige-like anchor deficiency were nonrespiratory complications (P = .008). Conclusions: This study highlights similarities and differences in the clinical and genetic spectrum of the most common PAD-associated gene defects. This comprehensive comparison will facilitate clinical decision making, and improve prognosis and targeted treatment

Comparison of Common Monogenic Defects in a Large Predominantly Antibody Deficiency Cohort

Predominantly antibody deficiencies (PADs) are the most common primary immunodeficiencies, characterized by hypogammaglobulinemia and inability to generate effective antibody responses