A case report: An atypical Kawasaki syndrome following aseptic meningitis in a 9-month old infant

چکیده: مقدمه: بیماری کاوازاکی، التهاب عروق (Vasculitis) حاد و وسیع در اعضای مختلف بدن می باشد. سن شیوع بیماری کاوازاکی بین 1 تا 5 سالگی است و زمانی که خارج از این محدوده باشد، تشخیص آن دشوار و شانس عوارض بیماری بخصوص عوارض قلبی افزایش می یابد. معرفی بیمار: شیرخوار 9 ماهه ای بود که با علایم مننژیت در بخش اطفال بیمارستان هاجر شهرکرد بستری و پس از دریافت درمان دارویی و بهبود علایم، مجدداً در روز هشتم بستری دچار تب بالا، فارنژیت و اسهال و بی قراری گردید. در معاینه بیمار کنژنکتیویت غیر چرکی دو طرفه، ترک خوردگی لب ها، لنفادنوپاتی و دیگر علایم تیپیک کاوازاکی را نداشته ولی قلب تاکی کارد و سرعت سدیمانتاسیون اریتروسپتی (ESR) بیمار نیز افزایش یافت. کودک با تشخیص بیماری کاوازاکی آتیپیک تحت درمان ایمونوگلوبولین وریدی قرار گرفت، پس از 24 ساعت تب بیمار کاهش و علایم بالینی وی بهبود یافت. ESR بیمار ده روز پس از ترخیص mm/hr10 گزارش گردید. نتیجه گیری: بر اساس این گزارش بالینی در زمان ابتلا به مننژیت باکتریال اگر مجدداً بیمار دچار تب بالا و افزایش ESR گردید باید بیماری کاوازاکی، علاوه بر دیگرعوارض مننژیت مد نظر باشد

Correlation of transcutaneous and serum bilirubin levels in infants with neonatal jaundice hospitalized in Hajar Hospital in Shahrekord

Background and Aim: Bilirubin level measurement through BiliCheck device can be a useful method in diagnosing neonatal jaundice due to no need for frequent blood-taking. Thus, the present study aimed to compare serum and transcutaneous bilirubin levels in infants with neonatal jaundice hospitalized in Hajar Hospital in Shahrekord. Materials and Methods: In this descriptive-correlation study, 417 infants with neonatal jaundice were examined. A questionnaire including demographic information (age and weight of infant at the time of reception, weight at the time of birth, age of pregnancy, and infant sex) was completed. As the infants were hospitalized, the blood-taking were done to control serum bilirubin based on the routine stages of the unit and transcutaneous Bilirubin level was controlled by BiliCheck device and the data were recorded. Pearson coefficient and independent t-test statistical analysis were used through SPSS software. Results: From the total of 417 infants under this study, 322 infants were term and 95 infants were preterm. 51.3% were male and 48.7% were female. Weight average of term infants was 3081467.88 and in the preterm infants, it was 2335572.44 gram. The results indicated the linear coefficient was direct and meaningful between the serum and transcutaneous bilirubin levels in term and preterm infants. ‍Conclusion: The findings suggested that mean difference of bilirubin levels on these two methods of measurement in term infants in different days were meaningful while there is no significant mean difference in preterm infants indicating the efficacy of this device in measuring bilirubin levels in preterm infants

Evaluation of congenital hypothyroidism screening program in urban and rural health centers in Chaharamahal and Bakhtiari

زمینه و هدف: تشخیص و درمان زودرس کم کاری تیروئید در پیشگیری از عقب ماندگی ذهنی ضروری است. این مطالعه به منظور ارزیابی برنامه غربالگری کم کاری تیروئید نوزادی در استان چهارمحال وبختیاری انجام شده است. روش بررسی: مطالعه حاضر از نوع توصیفی- مقطعی در سال 1388 بر روی 100 نوزاد متولد شده انجام شد. داده ها با کمک چک لیست محقق ساخته مبتنی بر دستورالعمل کشوری در خصوص غربالگری تیروئید جمع آوری و در نرم افزارSPSS تحلیل شد. یافته ها: 23 کارکنان از علایم کم کاری تیروئیدی مادرزادی آگاهی خوب و 73 آگاهی متوسط داشتند و تقریباً 79 فعالیت های نمونه گیری در مراکز خیلی خوب انجام می شد. نتیجه گیری: با توجه به یافته های حاصل در 80 مراکز وضعیت خیلی خوب بود. آموزش و نظارت مستمر بر کارکنان ، ارسال دستورالعمل و کتابچه به مراکزی که در این زمینه دچار کمبود هستند، توصیه می گردد

Frequency of celiac disease in children with type 1 diabetes

Background and aims: Occurrence of celiac and diabetes is accompanied by numerous complications in children and if diagnoses do not occur promptly, celiac disease complications including gastrointestinal disorders, loss of appetite and damage caused by hypoproteinemia, and most importantly, growth disorder occurs in diabetic children. This study was aimed to compare the frequency of celiac disease in children with diabetes aged under 15 years and the controls of the same age referring to the clinics affiliated with Shahrekord University of Medical Sciences. Methods: In this case-control study, using convenience sampling, 42 patients with diabetes and 43 patients without diabetes admitted for gastrointestinal diseases were assigned as cases and controls, respectively. The description of all patients was provided, and physical examinations and serologic tests were conducted on them. If the serologic tests tTGA-IgA and tTGA-IgG were positive, the intestinal biopsy was taken. The data were analyzed by descriptive statistics and t-test, chi-square, and Mann–Whitney test in SPSS. Results: The mean serum levels of tTGA-IgA and tTGA-IgG were significantly higher in the case group than the control group (P<0.05). There were significant differences in weight gain between the cases and the controls (P=0.017). The frequency of celiac disease was 15% (n: 6) in children with diabetes with a significant difference from the controls (P=0.02). Conclusion: In this study, the frequency of celiac disease was higher in children with diabetes than children without. Therefore, in the study area, routine screening for celiac disease is helpful in reducing possible disorders and complications in diabetic children

Molecular pathology of 6 novel GJB2 allelic variants detected in familial and sporadic Iranian non syndromic hearing loss cases

Background: Mutations of GJB2 gene encoding connexion 26 are the most common cause of hearing loss in many populations. A very wide spectrum of GJB2 gene mutations associated with hearing loss have been detected but pathogenic role has been tested only for a part of them. In this study, we have provided genetic evidence on the pathogenicity of our previously reported novel GJB2 allelic variants. Methods: The pathogenic role of GJB2 allelic variants were assessed using co segregation of each allelic variant with hearing loss in family members, absence of the allelic variants in control populations, coexistence with a second GJB2 mutation, nature of the amino acid substitution and evolutionary conservation of the appropriate amino acid. Results: The GJB2 allelic variants including 363delC, 327delGGinsA, H16R and G200R have been co segregated with autosomal recessive non syndromic hearing loss in five families and are not found in control subjects. The G130V and K102Q were found in heterozygous state in two deaf individuals. G130V results in an exchange a residue highly conserved among all the connexins but was found with a rate of 1% in control subjects and K102Q results in an exchange a residue not conserved among all the connexins and not identified in control subjects. Conclusion: We conclude that, 363delC, 327delGGinsA, H16R and G200R may be pathogenic. However, the pathogenicity and inheritance of K102Q and G130V can not be assessed clearly and remains to be identified

First Detection of Leishmania major DNA in Sergentomyia (Spelaeomyia) darlingi from Cutaneous Leishmaniasis Foci in Mali

Leishmania major complex is the main causative agent of zoonotic cutaneous leishmaniasis (ZCL) in the Old World. Phlebotomus papatasi and Phlebotomus duboscqi are recognized vectors of L. major complex in Northern and Southern Sahara, respectively. In Mali, ZCL due to L. major is an emerging public health problem, with several cases reported from different parts of the country. The main objective of the present study was to identify the vectors of Leishmania major in the Bandiagara area, in Mali. Methodology/Principal Findings: An entomological survey was carried out in the ZCL foci of Bandiagara area. Sandflies were collected using CDC miniature light traps and sticky papers. In the field, live female Phlebotomine sandflies were identified and examined for the presence of promastigotes. The remaining sandflies were identified morphologically and tested for Leishmania by PCR in the ITS2 gene. The source of blood meal of the engorged females was determined using the cyt-b sequence. Out of the 3,259 collected sandflies, 1,324 were identified morphologically, and consisted of 20 species, of which four belonged to the genus Phlebotomus and 16 to the genus Sergentomyia. Leishmania major DNA was detected by PCR in 7 of the 446 females (1.6%), specifically 2 out of 115 Phlebotomus duboscqi specimens, and 5 from 198 Sergentomyia darlingi specimens. Human DNA was detected in one blood-fed female S. darlingi positive for L. major DNA. Conclusion: Our data suggest the possible involvement of P. duboscqi and potentially S. darlingi in the transmission of ZCL in Mali

Comparison of amoxicillin and metronidazole effect on three-drug regimen for the treatment of Helicobacter pylori infection in children

Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1-15-year-old children. This clinical trial was conducted on 82 patients aged 1-15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord. Group 1 was administered with clarithromycin, amoxicillin, and omeprazole (CAO), and Group 2 with, clarithromycin, metronidazole, and omeprazole (CMO). One month after completion of the treatment, stool antigen test was used to study the eradication of H. pylori. Data were analyzed using SPSS software by Chi-square test. Three of the 82 patients were excluded from the study because of side effects caused by drugs. Nearly 87.2% of the patients in CAO-Treated group and 92.5% in CMO-Treated group had response to treatment. There was no significant difference in eradication rate between the two regimens (P = 0.43). The two regimens displayed no superiority over each other for eradicating H. pylori infection and response rate to treatment in children aged 1-15 years