Estudo sero-epidemiológico de helicobacter pylori em vacas da província de Shahrekord

Helicobacter pylori (H. pylori) is a common infection in developing countries, causing chronic gastritis, peptic ulcer disease, gastric malignancies. Its main transmission methods include human-human transmission, especially in early childhood, environmental (water supply and hygiene) and zoonotic factors. Some researchers have suggested that pigs, cats, and dogs are infected with Helicobacter and sheep is suggested as an important animal reservoir of H. pylori, causing infection in shepherds. Accordingly, cowherds might also be prone to H. pylori infection, while studies have scarcely addressed this issue. Thus, we aimed to investigate the prevalence of H. pylori infection in cowherds of Shahrekord province. In this cross-sectional study, conducted from June to October 2016, 80 cowherds with at least three days a week involvement with cows were compared with a matched control group from their neighbors with no direct contact with cows. Demographic information, including age, sex, job experience, educational level, number of family members, history of cancer or peptic ulcer, gastric symptoms, including epigastric pain, nausea/vomiting, and heartburn were collected. One blood sample was taken from all participants for ELISA measurement of H. pylori. Mean±SD age of participants was 35.8±14.3 (P>0.05). Serum examination of H. pylori showed positive IgG in 89 participants (55.6%), which was 57.5% in the case group and 53.8% in the control group (P>0.05). The prevalence of gastric symptoms was not statistically significant different between the groups and there was also no association between presence of H. pylori and gastric symptoms or demographic variables, including age, sex, job, educational level, marital status, and number of family members (P>0.05). Cowherds have the same prevalence of H. pylori infection than the control group that suggests that cows are not a potential zoonotic factor for H. pylori infection in cowherds.Helicobacter pylori (H. pylori) es una infección común en los países en vías de desarrollo, que causa gastritis crónica, enfermedad de úlcera péptica y neoplasias gástricas. Sus principales métodos de transmisión incluyen la transmisión humano-humano, especialmente en la primera infancia, los factores ambientales (suministro de agua e higiene) y zoonóticos. Algunos investigadores han sugerido que los cerdos, gatos y perros están infectados con Helicobacter y se sugiere la presencia de ovejas como un importante reservorio animal de H. pylori, que causa infección en los pastores. En consecuencia, los pastos de ganado también podrían ser propensos a la infección por H. pylori, mientras que los estudios apenas han abordado este problema. Por lo tanto, el objetivo fue investigar la prevalencia de la infección por H. pylori en los pastos de vacas de la provincia de Shahrekord. En este estudio transversal, realizado de junio a octubre de 2016, se compararon 80 rebaños de ganado con al menos tres días a la semana de participación con vacas con un grupo de control pareado de sus vecinos sin contacto directo con las vacas. Se recopiló información demográfica, incluyendo edad, sexo, experiencia laboral, nivel educativo, número de miembros de la familia, antecedentes de cáncer o úlcera péptica, síntomas gástricos, incluido dolor epigástrico, náuseas / vómitos y acidez estomacal. Se tomó una muestra de sangre de todos los participantes para la medición ELISA de H. pylori. La edad media ± desviación estándar de los participantes fue de 35.8 ± 14.3 (P> 0.05). El examen sérico de H. pylori mostró IgG positiva en 89 participantes (55,6%), que fue del 57,5% en el grupo de casos y del 53,8% en el grupo control (P> 0,05). La prevalencia de síntomas gástricos no fue estadísticamente significativa diferente entre los grupos y tampoco hubo asociación entre la presencia de H. pylori y los síntomas gástricos o variables demográficas, incluyendo edad, sexo, empleo, nivel educativo, estado civil y número de miembros de la familia. (P> 0.05). Los pastos de vacas tienen la misma prevalencia de infección por H. pylori que el grupo de control que sugiere que las vacas no son un factor zoonótico potencial para la infección por H. pylori en los pastos de vacuno.Helicobacter pylori (H. pylori) é uma infecção comum em países em desenvolvimento, causando gastrite crônica, úlcera péptica, neoplasias gástricas. Seus principais métodos de transmissão incluem a transmissão humano-humana, especialmente na infância, fatores ambientais (abastecimento de água e higiene) e zoonóticos. Alguns pesquisadores sugeriram que porcos, gatos e cães são infectados com Helicobacter e que ovinos são sugeridos como um importante reservatório animal de H. pylori, causando infecção em pastores. Conseqüentemente, os pastores de vacas também podem ser propensos à infecção por H. pylori, enquanto os estudos mal abordaram essa questão. Assim, nosso objetivo foi investigar a prevalência da infecção por H. pylori em vacas da província de Shahrekord. Neste estudo transversal, conduzido de junho a outubro de 2016, 80 vacas com pelo menos três dias por semana de envolvimento com vacas foram comparados com um grupo controle pareado de seus vizinhos sem contato direto com vacas. Informações demográficas, incluindo idade, sexo, experiência de trabalho, nível educacional, número de membros da família, história de câncer ou úlcera péptica, sintomas gástricos, incluindo dor epigástrica, náusea / vômito e azia foram coletados. Uma amostra de sangue foi coletada de todos os participantes para a medição de ELISA do H. pylori. A idade média ± DP dos participantes foi de 35,8 ± 14,3 anos (P> 0,05). O exame sérico de H. pylori mostrou IgG positiva em 89 participantes (55,6%), que foi de 57,5% no grupo caso e 53,8% no grupo controle (P> 0,05). A prevalência de sintomas gástricos não foi estatisticamente significativa entre os grupos e também não houve associação entre a presença de H. pylori e sintomas gástricos ou variáveis demográficas, incluindo idade, sexo, emprego, nível educacional, estado civil e número de membros da família. (P> 0,05). Cowherds têm a mesma prevalência de infecção por H. pylori do que o grupo controle, o que sugere que as vacas não são um potencial fator zoonótico para infecção por H. pylori em vacas

The frequency and risk factors of Helicobacter pylori in children of 6 years old from Shahrekord in 2006

چکیده: زمینه و هدف: هلیکوباکتر پیلوری یکی از عفونت های شایع در انسان است که در ایجاد گاستریت حاد و مزمن، زخم پیتیک و سرطان معده نقش دارد. شیوع عفونت در کودکی 10 تا 80 درصد بوده و بیشترین شیوع در کشورهای در حال توسعه می باشد. هدف از این مطالعه، تعیین میزان آلودگی به هلیکوباکتر پیلوری در کودکان شش ساله شهرکرد و عوامل موثر بر آن بوده است. روش بررسی: در این مطالعه توصیفی – تحلیلی تعداد 215 نفر از کودکان 6 ساله مراجعه کننده برای طرح سنجش کودکان بدو ورود به دبستان شهرکرد وارد مطالعه شدند. نمونه مدفوع جمع آوری و با استفاده از روش ELISA از نظر آنتی ژن هلیکوباکترپیلوری بررسی گردید. داده ها با استفاده از آزمون های آماری کای دو و رگرسیون لجستیک مورد تجزیه و تحلیل قرار گرفتند. یافته ها: بر اساس نتایج 3/23 (50 مورد) از نمونه ها از نظر آنتی ژن هلیکوباکترپیلوری مثبت بودند. شیوع عفونت هلیکوباکترپیلوری رابطه معنی داری با جنس، مصرف سیگار والدین، درد شکم، رشد، تهوع، بی اشتهایی، زخم معده و یا اثنی عشر در والدین و سابقه استفاده از شیر مادر نداشت. ولی با تحصیلات والدین و سابقه سرطان معده در فامیل درجه اول رابطه معنی داری وجود داشت (05/0

Clinical features and outcome of Guillain-Barré syndrome in children

 Background: Considering the fact that there are no reports about the clinical presentations and outcome of Guillain-Barré syndrome (GBS) in our region, we aimed to report some mentioned findings in children diagnosed with GBS in Isfahan, Iran. Materials and Methods: In this retrospective study, pediatric patients diagnosed with GBS were enrolled.The following information were extracted from the medical files of patients; age, gender, early signs and symptoms of GBS, neurological features, sensory and motor and autonomic involvements, sphincter dysfunction, bulbar muscle involvement, respiratory failure, cranial nerve paralysis, delay time from onset to definite diagnosis and management of GBS and the outcome. Results: During this study, 57 children with GBS aged 1-13 years were evaluated. Frequency of GBS was significantly higher in boys than in girls (38.6% vs. 61.4%, P=0.01, OR=0.39). The most common clinical presentations were distal lower limb weakness (92.11%), reduced deep tendon reflex (DTR ) (82.46%) and neuropathic pain (75.44%). 92.9% of patients had complete recovery. Conclusion: The findings of this study indicated that distal lower limb weakness, reduced deep tendon reflex and neuropathic pain are the main clinical presentation in children with GBS but in some patients DTR may be normal or even exaggerated in early stage of disease. This finding suggests that revising the diagnostic criteria for GBS may be necessary. Most of our patients had complete recovery. The only death was due to autonomic involvement

Therapeutic Effects of Adrenocorticotropic Hormone ACTH in Children with Severely Intractable Seizure

How to Cite This Article: Nasiri J, Sarajan A, Salari M, Sedghi M. Therapeutic Effects of Adrenocorticotropic Hormone ACTH in Children withSeverely Intractable Seizure. Iran J Child Neurol. Summer 2017; 11(3):19-26.AbstractObjectiveTreatment of intractable seizures other than spasms is difficult and controversial.There are few studies on efficacy of adrenocorticotropic hormone (ACTH) in treatment of patients with intractable seizure.Materials & MethodsTwenty-five patients with intractable seizure other than spasm including 14 boys and 11 girls with median age of 58 months referred to university clinics of Pediatric Neurology in Isfahan, Iran, during 2014-2015 were prospectively investigated. ACTH was administrated according to our protocol. All cases were followed regularly and assessed for response to treatment and probable side effects, 3 wk after beginning of ACTH therapy and three months after the ACTH therapy. EEG finding were recorded before and three months after the end of ACTH therapy. Statistical analysis using Freidman test and Wilcoxon signed – rank test were performed in order to compare seizure frequency and EEG changes, respectively.ResultsMean A significant reduction (>80%) in seizure frequency in 11 cases (44%) and moderate reduction (50%-80%) in 7 (28%) after 3 wk of ACTH therapy.Despite initial positive response, recurrence of seizure was observed in 7 out of 18 cases with favorable initial response within 3 months after ACTH therapy cessation. The comparison of EEG finding before and 3 months after ACTH therapy using Wilcoxon signed – rank test showed  significant differences.ConclusionACTH therapy may be useful in treatment of children with intractable seizures who are resistant to usual antiepileptic drugs. However further studies should be performed to determine the long-term efficacy of ACTH in treatment of intractable seizure.References1. Dunin-Wąsowicz D, Mazurkiewicz-Bełdzińska M, Steinborn B, Wheless J, Jóźwiak S. Treatment of pediatric epilepsy in Poland. Eur J Paediatr Neurol 2015;19(3):320-6.2. Oka E, Ohtsuka Y, Yoshinaga H, Murakami N, Kobayashi K, Ogino T. Prevalence of Childhood Epilepsy and Distribution of Epileptic Syndromes: A Population-based Survey in Okayama, Japan. Epilepsia 2006;47(3):626-30.3. Beleza P. Refractory epilepsy: a clinically oriented review. Eur Neurol 2009; 62(2):65-71.4. Pentella K, Bachman D, Sandman CA. Trial of an ACTH4-9 Analogue (ORG 2766) in children with intractable seizures. Neuropediatrics 1982;13(2):59-62.5. Snead OC, Benton JW, Myers GJ. ACTH and prednisone in childhood seizure disorders. Neurology 1983;33(8):966-70.6. Okumura A, Tsuji T, Kato T, Natsume J, Negoro T, Watanabe K. ACTH therapy for generalized seizures other than spasms. Seizure 2006;15(7):469-75.7. Verhelst H, Boon P, Buyse G, Ceulemans B, D’Hooghe M, De Meirleir L, et al. Steroids in intractable childhood epilepsy: clinical experience and review of the literature. Seizure 2005;14(6):412-21.8. Oguni H, Funatsuka M, Sasaki K, Nakajima T, Yoshii K, Nishimura T, et al. Effect of ACTH therapy for epileptic spasms without hypsarrhythmia. Epilepsia 2005;46(5):709-15.9. Haberlandt E, Weger C, Sigl SB, Rauchenzauner M, Scholl-Bürgi S, Rostásy K, et al. Adrenocorticotropic hormone versus pulsatile dexamethasone in the treatment of infantile epilepsy syndromes. Pediatr Neurol 2010;42(1):21-7.10. Inutsuka M, Kobayashi K, Oka M, Hattori J, Ohtsuka Y. Treatment of epilepsy with electrical status epilepticus during slow sleep and its related disorders. Brain Dev 2006;28(5):281-6.11. Fujii A, Oguni H, Hirano Y, Osawa M. Atypical benign partial epilepsy: recognition can prevent pseudocatastrophe. Pediatr Neurol 2010;43(6):411-9.12. Inui T, Kobayashi T, Kobayashi S, Sato R, Endo W, Kikuchi A, et al. Efficacy of long term weekly ACTH therapy for intractable epilepsy. Brain Dev 2015;37(4):449-54.13. Kalra V, Sharma S, Arya R. ACTH therapy in refractory generalized epilepsy. Indian J Pediatr 2009;76(1):91-3.14. Kurian M, Korff CM. Steroids in pediatric epilepsy: infantile spasms and beyond. Epileptologie 2011; 28(1):15-20.15. Rogawski MA, DS R. Neurosteroids and infantile spasms: The deoxycorticosterone hypothesis. In: JMR PAS, editor. International Review of Neurobiology Volume 49: Academic Press; 2002. p. 199-219.16. Snead OC. How does ACTH work against infantile spasms? Bedside to bench. Ann Neurol 2001;49(3):288-9.17. Jacobson L, Sapolsky R. The Role of the Hippocampus in Feedback Regulation of the Hypothalamic-Pituitary- Adrenocortical Axis. Endocr Rev 1991;12(2):118-34.18. Sinclair DB. Prednisone therapy in pediatric epilepsy. Pediatr Neurol 2003;28(3):194-8

Short-term side effects of low dose valproate monotherapy in epileptic children: a prospective study

Objectives: Considering the common use of valproate among children, we investigated short-term side-effects of low dose valproate monotherapy in epileptic children.Materials and Methods: In this prospective study, 209 epileptic children (48.3% male, mean age: 7.02 ± 3.13 years) on low therapeutic dose of valproate monotherapy (20-30 mg/Kg/daily) were enrolled and side-effects were evaluated through frequent clinical visits and laboratory tests during 6 months.Results: Weight gain was reported in 53.1% of patients. Decreased appetite was seen in 11% of patients, more frequent in younger cases (P=0.006). Abdominal pain, nausea/vomiting, diarrhea, and constipation were reported in 16.3%, 2.4%, 1.4%, and 1% of patients, respectively. Headache, tremor, dizziness, abnormal color vision, myoclonus, and bruxism were seen in 5.7%, 1.4%, 1%, 1%, 1%, and 0.5% of patients, respectively. Enuresis, hair loss, and skin rash were reported in 8.1%, 6.7%, and 0.5% of patients, respectively. Thrombocytopenia, impaired liver function tests, and leukopenia occurred in 1%, 1%, and 0.5% of patients, respectively.Conclusions: low dose valproate monotherapy may cause numerous side-effects, mostly not life-threatening and requiring no action. Besides more reported complications, we observed decreased appetite (among younger patients), enuresis, and abnormal color vision which have been briefly discussed in the literature and need to be addressed more

Empathy in Iranian medical students: A preliminary psychometric analysis and differences by gender and year of medical school

Background: It has been well documented that effective empathic communication in the context of patient care is associated with improved health care outcomes. However, the emphasis given to empathy in medical education in Iran is limited, and the state of such teaching is unknown in many countries. Aims: To determine the psychometric properties of an Iranian translation of the Jefferson Scale of Physician Empathy (JSPE) among medical students, and to examine the differences on mean empathy scores by gender and the different years of medical school. Method: A cross-sectional study was conducted among medical students. Data analysis was based on 181 questionnaires. Principal component analysis (PCA) with Varimax rotation was used to identify the number and composition of components constituting the developed constructs. Results: The PCA yielded three factors: Compassionate care, perspective-taking, and the ability to walk in the patient's shoes. No statistically significant differences in the empathy means scores were found by gender and the different years of medical school. Conclusions: The Persian version of JSPE is a psychometrically sound instrument to measure empathy. Cultural backgrounds and pedagogical practice may influence medical students' attitudes towards empathy. Some recommendations are made, and the study limitations are discussed

Neurodevelopmental Outcomes of Infants with Benign Enlargement of the Subarachnoid Space

  ObjectiveBenign enlargement of the subarachnoid space (BESS) is the most common cause of macrocephaly in infants. This study aimed to evaluate the neurodevelopmental outcomes in infants with BESS. Materials & Methods In this follow-up study, all records of infants diagnosed with BESS in 2012-2016 were assessed. A clinical follow-up examination was carried out at 6, 12, 18, and 24 months of age to assess the macrocephaly outcomes. Denver Developmental Screening Test-II (DDST-II) was used for evaluating the psychomotor development of infants at 24 months of age. All data were entered in SPSS Version 13, and descriptive statistics were measured. Results Out of 32 infants included in this study, 28 (87.5%) were boys. Five cases of prematurity history (15.6%), and 23 cases of macrocephaly in the family (71.9%) were recorded. The mean age of BESS diagnosis was 6.8 months (SD=3.2). subdural hematoma was reported in one infant (3.1%). Also, 28 infants showed macrocephaly at 18 months of age (83.3%). Seven patients had developmental delay, according to DDST-II (22%). The mean head circumference at birth and six months of age was significantly greater in infants with developmental delay compared to those with normal development. There was a significant difference between the mean head circumference at birth (P=0.05) and the mean head circumference at six months of age (P=0.02). Conclusion Developmental delay is frequent in BESS infants, especially those with macrocephaly at birth and six months of age, and requires medical attentio

Infantile Neuroaxonal Dystrophy in Two Cases: Siblings with Different Presentations

  Infantile neuroaxonal dystrophy (INAD) is a rare recessive neurodegenerative disorder manifested by symptoms, including hypotonia, extrapyramidal signs, spastic tetraplegia, vision problems, cerebellar ataxia, cognitive complications, and dementia, before the age of three. Various reports evaluated the relationship with the incidence of INAD and different mutations in the PLA2G6 gene. We describe cases of two children with INAD whose diagnoses were challenging due to misleading findings and had a mutation in the position C.2370 T>G (p. Y790X) in the PLA2G6 gene based on NM_001349864 which has been reported previously

The effect of Ramadan fasting on serum leptin, neuropeptide Y and insulin in pregnant women

Background: Many pregnant Muslim women choose to fast during Ramadan every year worldwide. This study aimed to examine the effect of Ramadan fasting on serum leptin, neuropeptide Y and insulin in pregnant women and find whether fasting during pregnancy could have a negative effect on the health of mothers and fetuses. Methods: This cross-sectional study was conducted on 39 healthy volunteer fasting pregnant women. Serum leptin, neuropeptide Y, insulin levels, body mass index and weight were measured five times on 0, 7th, 14th and 28th days of Ramadan and on the 14th day post-Ramadan. The data were analyzed by SPSS software (version 11.5) using repeated measures ANOVA to find whether any changes occurred in the variables of interest during the study, and Pearson correlation coefficient was used to examine the relations among the variables. Results: A significant change in fasting blood sugar, neuropeptide Y and leptin was observed during the study (p0.05). Conclusion: The result of this study revealed the important role of leptin and neuropeptide Y in the long term regulation of energy balance in pregnant women with chronic diurnal fasting, and it further revealed that Ramadan fasting did not significantly change the serum insulin level