Comparison of the Voiding Cystourethrogram Results One and Three weeks after the First Urinary Tract Infection in 1-Month to 15-Year-Old Children

Introduction: To determine whether the timing of voiding cystoureterogram (VCUG) in the first or the third week after a diagnosis of urinary tract infection (UTI) is important in the diagnosis and severity of VUR.Materials and Methods: In this case-control study, 72 children between 1 month and 15 years old diagnosed with their first episode of UTI were investigated over one year. The study population was divided into 2 groups of 36, early (VCUG in the first week after UTI) and late (VCUG 3 weeks after UTI), and compared the severity and incidence of reflux in both groups.Results: The prevalence of VUR was 66.6%. Twenty-two cases in the first group (61%) and 26 cases in the second group (72.2%) presented with VUR. The peak age of the disease in both groups was 1-3 years with a female predominance. The most common germ detected was E-Coli and the most common presentations were fever (87.5%) and dysuria (26.3%).Conclusions: As VUR following UTI is very common in children and is one of the most important risk factors of early hypertension and chronic renal failure, early diagnosis by VCUG seems to be useful in all UTI patients before discharge. Keywords: Urinary Tract Infection; Vesico-Ureteral Reflux; VCUG; Child

Prevalence and association of human papillomavirus, Epstein-Barr virus and Merkel Cell polyomavirus with neoplastic esophageal lesions in northern Iran

Background: Studies concerning on esophageal squamous cell carcinoma (ESCC) etiological factors have been done for several decades, however, results reported from various investigations were not consistent. The present investigation aimed to explore the presence of 3 oncogenic viruses, human papilloma virus (HPV), Epstein-Barr virus (EBV) and Merkel cell polyomavirus (MCPyV) in the neoplastic and non- neoplastic esophageal lesions collected from Mazandaran, a high risk area of Iran. Methods: In total, 168 esophageal specimens (100 with ESCC confirmed diagnosis and 68 without esophageal malignancy) were analyzed for HPV, EBV and MCPyV by Real Time PCR. Results: HPV DNA was detected in 27 out of the 100 neoplastic esophageal lesions (27.0%) and 28 out of the 68 samples from non-neoplastic group (41.2%). EBV DNA was detected in esophageal specimens of 10 out of the 100 neoplastic cases (10%) and 3 out of the 68 samples in non- neoplastic group (4.4%). MCPyV DNA was detected in esophageal specimens of 30 out of the 100 neoplastic cases (30.0%) and 24 out of the 68 samples in non- neoplastic group (35.3%). There was no statistically significant difference in HPV (p=0.066), EBV (p=0.143) and MCPyV (p=0.471) DNA positivity between neoplastic and non-neoplastic groups. Conclusions: This study showed that HPV, EBV and MCPyV can be detected in both neoplastic and non-neoplastic esophageal tissues and weakens the hypothesis of the pathogenic role of these viruses in esophageal malignant transformation

Medical Interns’ Achieving Rate of Learning Minimums in Common Pediatric Illnesses in Isfahan University of Medical Sciences

Introduction: The purpose of medical education is to acquire knowledge, perspective and skills necessary for patient treatment, and focus on assessment as a tool for quality assurance in educational programs is one of the important traits of medical education. The purpose of this study was to investigate the achieving rate of learning minimums in common pediatric illnesses among medical interns of Isfahan University of Medical Sciences. Methods: This descriptive, cross-sectional study was conducted in 2014-15 academic year. Research population included the medical interns of Isfahan University of Medical Sciences who were selected through convenience sampling (census) (n=84). Data were collected using 8-station objective structured clinical examination. Views of medical education and pediatrics experts were used to confirm content and face validity. Reliability coefficient of the examination was calculated using Cronbach’s alpha of 0.86. A checklist (total score=20) was used to assess each station. Data were analyzed using descriptive statistics. Results: Mean scores of achieving rate of learning minimums in common illnesses were as follows in each station: ear checkup (13.64±1.96), common cold (16.60±2.62), diarrhea and vomiting (15.56±4.22), croup (9.28±2.07), acute seizure (15.96±2.42), history taking of seizure (14.88±2.81), interpretation of growth chart (13.60±3.17) and history taking in underweight child (8.76±3.25). Conclusion: Interns’ achieving rate of learning minimums in common pediatric illnesses was acceptable in four stations, less than expected in two stations and unacceptable in two other stations. Considering the importance of the issue, it is therefore recommended to revisit the duration and methods of ambulatory trainings in pediatrics internship programs

The efficacy of low and moderate dosage of diazepam on sleep bruxism in children: A randomized placebo-controlled clinical trial

Background: Sleep bruxism (SB) in children is commonly a self-limited problem; however, therapy of the condition may be needed to improve sleep quality of parents and children. Benzodiazepines have some success in controlling adult bruxism. The objective of this study was to evaluate the effect and the safety of a short course of diazepam on controlling SB in healthy children. Materials and Methods: In this double-blind, randomized placebo-controlled clinical trial, 109 children with SB were randomly assigned to three groups, receiving low or moderate dose of diazepam or placebo for 2 weeks. For children aged 2–8 years, the dose of 2.5 and 5 mg was considered as low and moderate dose consequently. In children >8 years, the doses were doubled. The severity of SB was evaluated at the beginning and also 2, 8, and 12 weeks thereafter. Data were collected by a questionnaire completed by parents including frequency of SB per week and per night and duration of each SB, as bruxism severity score (BSS). A mixed-model ANOVA was used to assess the differences of mean BSS between different groups and measurement times. Results: From 109 children recruited, 90 completed the study. After 2 weeks of intervention, the mean BSS decreased significantly in all groups (P = 0.0001), but it was not significantly different between groups in any of follow-ups (P = 0.554). Next-day sleepiness was assessed at week 2 of the study and was significantly higher in the groups using diazepam (P = 0.026). Conclusion: Short course of diazepam was not more effective than placebo for long-term control of SB in children

Association of serum 25-hydroxyvitamin D Levels and liver enzymes in a nationally representative sample of iranian adolescents: The childhood and adolescence surveillance and prevention of adult noncommunicable disease study

Background: Hypovitaminosis D is highly prevalent and has several adverse health effects. This study aims to assess the relationship of serum concentrations of 25-hydroxyvitamin D (25[OH] D) and liver enzymes in adolescents. Methods: This population-based cross-sectional survey was conducted among a nationally representative multistage sample of 1095 adolescents (52% boys), aged 10–18 years, living in different provinces of Iran. Serum 25(OH)D concentration 40 U/L was considered as high level. To determine the association between serum 25(OH)D categories and elevated levels of liver enzymes, multiple regression models and linear regression analysis were applied, after adjustment for potential confounders. Odds ratios (95% confidence interval) of serum 25(OH)D and elevated liver enzymes were assessed by logistic regression analysis. Results: Higher rates of Vitamin D deficiency were documented among individuals with increased levels of liver enzymes. Compared to boys, median of 25(OH)D was lower in girls with elevated levels of liver function tests (12.75 vs. 25.60 ng/mL for ALT and 13 vs. 14.10 ng/mL for AST), with marginally significant gender differences regarding AST. Conclusions: We found a relatively high frequency of hypovitaminosis D among adolescents with abnormal liver function. Further prospective studies are needed to examine these associations from early life

Probiotic or Conventional Yogurt for Treating Antibiotic-associated Diarrhea: A Clinical Trial Study

Background The popularity of probiotics is on the rise. Despite the beneficial effects of antibiotics, gastrointestinal health is at risk of diarrhea. This study aimed to investigate whether probiotic yogurt is of capability to prevent the incidence of diarrhea versus conventional yogurt. Materials and Methods This controlled, randomized, double-blind trial was designed to recruit 48 hospitalized children, whose treatments included different types of antibiotics. They were subsequently assigned into a 1:1 ratio into groups A and B at random. The first group was instructed to consume probiotic yogurt (Bifidobacterium strains and Lactobacillus acidophilus), while the second were on conventional yogurt (placebo containing Streptococcus thermophiles and Lactobacillus bulgaricus) at least for 7 days. The incidence of diarrhea, its onset and duration were compared between the two groups. Results The findings indicated that there was no statistically significant difference between the experimental and control groups (p > 0.05). No significant decrease was observed in the incidence of diarrhea between the groups following adjustment for negative C-reactive protein (CRP) (p > 0.05). Conclusion According to the results, the consumption of yogurt, either probiotic or conventional, reduced the incidence, duration, and onset of antibiotic-associated diarrhea in pediatric population. This study showed no significantly better performance for probiotic yogurt than conventional yogurt

Are non-high–density lipoprotein fractions associated with pediatric metabolic syndrome? The CASPIAN-V study

Abstract Background Non-high-density lipoprotein cholesterol (non-HDL-C) is considered as a valuable predictor for dyslipidemia and subclinical atherosclerosis which can be an appropriate index for identifying individuals with metabolic syndrome (MetS). Objective To evaluate the association between non-HDL-C MetS and determine the optimal cut-points of non-HDL-C fractions for identifying MetS in Iranian children and adolescents. Methods This nationwide study was conducted in the framework of the fifth survey of a national school-based surveillance program on children and adolescents aged 7–18 years. MetS was defined by the Adult Treatment Panel III (ATP III) criteria modified for the pediatric age group. The analysis of receiver operating characteristic (ROC) curve was applied to determine the optimal cut-points of non-HDL-C, difference between non-HDL-C and LDL-C (Diff-C) and triglycerides (TG) to HDL-C ratio (TG/HDL-C) for the prediction of MetS. Results Overall, the study participants consisted of 3843 students (52.3% boys) with mean (±SD) age of 12.28 (3.1) years. The odds of high LDL-C, low HDL-C and MetS were increased in subjects with higher non-HDL-C, Diff-C and TG/HDL-C (P < 0.05). Non-HDL-C, Diff-C and TG/HDL-C cut-off points for predicting MetS were 120.5 mg/dl (sensitivity: 44%, specificity: 73%), 19.9 mg/dl (sensitivity: 85%, specificity: 75%) and 2.53 (sensitivity: 82%, specificity: 79%), respectively. Conclusions This study revealed a strong association between surrogates for serum lipid profile including non-HDL-C, TG/HDL-C and Diff-C and pediatric MetS. Our findings suggest that age- and gender-specific reference values of these markers were appropriate for both risk classification and long-term control of cardiovascular events in clinical assessments