Evaluation of QT dispersion in children with breath-holding spells

Background: Breath holding spells (BHS), as sudden and reflexive phenomena, are common in infancy and early childhood. Long QT syndrome (LQTS) and sudden abnormalities of rhythm should be considered in the differential diagnoses of BHS. The aim of this study was to evaluate the QT dispersion (QTd) in children with BHS. Materials and Methods: This cross-sectional study was performed on 56 children with BHS and 56 healthy children. After recording ECG, QTd and corrected QT dispersion (QTcd) were evaluated in the patients. Results: Among 112 children, 51 cases (45.5%) were male and the rest female. There was no statistically significant difference in mean age of the children between the two groups (P=0.99). In the case and control groups, cyanotic (83.9%), the most common type of BHS, was often repeated once a week (35.7%). The mean and SD of QTd and QTcd in the case and control groups were 61.6±22.5, 47.1±18.8 and 104.2±29.6, 71.9±18.2, respectively. These values in the control group were less than the case group (P<0.001). Conclusion: According to the results of this study, the frequencies of QTd and QTcd in children with BHS are more than those in the healthy children. Therefore, ECG and LQTS in these children allow for more precise evaluation of BHS and they should be considered in early assessment of the patients

Perforated acute appendicitis in a pre-term neonate

Acute appendicitis is a common occurrence in childhood, but this diagnosis is considered rarely in differential diagnosis of acute abdomen in the neonatal period because its occurrence is very rare in neonates. We report a 20-day- old afghan female baby that was admitted to neonatal intensive care unit, because of irritability and abdominal distension. Complete ultrasound of abdomen and pelvis was normal. In plain Radiographs of chest and abdomen with the exception of Air-filled stomach and intestine, there was no abnormality. Due to the lack of improvement and severe abdominal distension, she was transmitted to the operating room and Surgical exploration revealed perforated appendix. Appendicitis should be considered in the differential diagnosis for a neonate with abdominal distension and bilious vomiting and needs strong clinical suspicion. © 2013, Iranian Red Crescent Medical Journal