Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years

 How to cite this article: Sadeghzadeh M, Khoshnevis P, Mahboubi E. Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years. Iran J Child Neurol Autumn 2012; 6(4):27-31.Abstract Objective: Febrile seizure is one of the most common neurological conditions of childhood. Several theories, such as iron deficiency anemia have been proposed as the pathogenesis of this condition. The aim of this study was to find the association between iron deficiency anemia and febrile seizures in children aged 6 months to 3 years admitted in Valie Asr hospital in Zanjan. Materials &Methods Hemoglobin (Hb), mean corpuscular volume (MCV), serum iron (SI), total iron binding capacity (TIBC) and SI/TIBC ratio were assessed in one hundred children with febrile seizures and compared to the values of one hundred healthy children presenting in a heath care center in the same period as the control group. Results A total of 6% of cases had iron deficiency anemia which was similar to the control group. In the case group SI/TIBC ratio below 12% was seen in 58% of children which was significantly higher than that of the control group (29%). Conclusion The results of this study suggest that although anemia was not common among febrile seizure patients, iron deficiency was more frequent in these patients. ReferencesBidabadi E, Mashouf M.. Association between iron deficiency anemia and first febrile convulsion: A case-control study. Seizure. 2009 Jan;18(5):347-51.Sadeghzadeh M, Khoshnevisasl P, Moussavinassab N, Koosha A, Norouzi M. The Relation Between Serum Zinc Level and Febrile Seizures in Children Admitted to Zanjan Valie-Asr Hospital. J Zanjan Uni Med Sci. 2011;19(74):17-24.Kumari PL, Nair MK, Nair SM, Kailas L, Geetha S. Iron deficiency as a risk factor for simple febrile seizures-a case control study. Indian Pediatr. 2012 Jan;49(1):17-9.Pisacane A, Sansone R, Impagliazzo N, Coppola A, Rolando P, D'Apuzzo A, Tregrossi C. Iron deficiency anaemia and febrile convulsions: case-control study in children under 2 years. BMJ. 1996 Aug;313(7053):343.Yadav D, Chandra J. Iron deficiency: beyond anemia. Indian J Pediatr. 2011 Jan;78(1):65-72.Sherjil A, us Saeed Z, Shehzad S, Amjad R. Iron deficiency anaemia-a risk factor for febrile seizures in children. J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3):71-3.Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL. Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav. 2001 Jul-Aug;69(3-4):409-18.Beard JL, Chen Q, Connor J, Jones BC. Altered monoamine metabolism in caudate-putamen of iron-deficient rats. Pharmacol Biochem Behav. 1994 Jul;48(3):621-4.Chen Q, Beard JL, Jones BC. Abnormal rat brain monoamine metabolism in iron deficiency anemia. J Nutr Biochem. 1995;6(9):486-93.Youdim MB, Ben-Shachar D, Yehuda S. Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. Am J Clin Nutr. 1989 Sep;50(3 Suppl):607-15.Felt BT, Beard JL, Schallert T, Shao J, Aldridge JW, Connor JR et al. Persistent12.  neurochemical and behavioral abnormalities in adulthood despite early iron supplementation for perinatal iron deficiency anemia in rats. Brain Behav Res. 2006 Aug;171(2):261-70.Beard JL, Felt B, Schallert T, Burhans M, Connor JR, Georgieff MK. Moderate iron deficiency in infancy: biology and behavior in young rats. Behav Brain Res. 2006 Jun 30;170(2):224-32.Beard JL, Connor JR. Iron status and neural functioning. Ann Rev Nutr. 2003;23:41-58.Johnston MV. Iron deficiency, febrile seizures and brain development. Indian Pediatr. 2012;49(16):13-4.Lozoff B, Georgieff MK. Iron deficiency and brain development. Semin Pediatr Neurol. 2006 Sep;13(3):158-65.Idro R, Gwer S, Williams TN, Otieno T, Uyoga S, Fegan G et al. Iron deficiency and acute seizures: results from children living in rural Kenya and a meta-analysis. PLoS One. 2010 Nov 16;5(11):e14001Salehi Omran MR, Tamaddoni A, Nasehi MM, Babazadeh H, Alizadeh navaei R. Iron status in febrile seizure: a case-control study. Iran J Child Neurol. 2009;3(3):39-42Momen AA, Hakimzadeh M. Case-control study of the relationship between anemia and febrile convulsion in children between 9 months to 5 years of age. Sci Med J Ahwaz Uni Med Sci. 2003;1(4):54-50.19. Stoltzfus RJ, Mullany L, Black RE(2004). Iron deficiency anaemia. In: Ezzati M, Lopez AD, Rodgers A, et al. editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization; 2004. p. 163-209.Brotanek JM, Halterman JS, Auinger P, Flores G, Weitzman M. Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children. Arch Pediatr Adolesc Med. 2005 Nov;159(11):1038-42.Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C et al. The association between iron deficiency and febrile seizures in childhood. Clin Pediatr (Phila). 2009 May;48(4):420-6.Daoud AS, Batieha A, Abu-Ekteish F, Gharaibeh N, Ajlouni S, Hijazi S. Iron status: a possible risk factor for the first febrile seizure. Epilepsia. 2002 Jul;43(7):740-3.Naveed-ur-Rehman, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak. 2005 Jun;15(6):338-40.Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian Pediatr. 2010 May;47(5):437-9.Ozaydin E, Arhan E, Cetinkaya B, Ozdel S, Değerliyurt A, Güven A et al. Differences in iron deficiency anemia and mean platelet volume between children with simple and complex febrile seizures. Seizure. 2012 Apr;21(3):211-4.Abdurrahman KN, Al-atrushi AM. The association between iron deficiency anemia and first febrile seizure: a case-control study. Duhok Med J. 2010;4(1):60-6. Amirsalari S, Keihani doust ZT, Ahmadi M, Sabouri A, Kavemanesh Z, Afsharpeyman SH et al. Relationship between iron deficiency anemia and febrile seizures. Iran J Child Neurol. 2010;4(1):27-30. Kobrinsky NL, Yager JY, Cheang MS, Yatscoff RW, Tenenbein M. Does iron deficiency raise the seizure threshold? J Child Neurol. 1995 Mar;10(2):105-9.Abbaskhanian A,Vahidshahi k, Parvinnejad N. The association between iron deficiency and the first episode of febrile seizure. J Babol Uni Med Sci.2009;11(3):32-6.

Early and Late Outcome of Premature Newborns with History of Neonatal Intensive Care Units Admission at 6 Years Old in Zanjan, Northwestern Iran

How to Cite This Article: Sadeghzadeh M, Khoshnevisasl P, Parvaneh M, Mousavinasab N. Early and Late outcome of Premature Newborns with history of NICU Admission at 6 years old in Zanjan, Iran. Iran J Child Neurol. Spring 2016; 10(2):67-73.ObjectivePremature birth is an important factor for mortality and morbidity of neonates. This study was designed to evaluate the outcome of preterm neonates who needed neonatal intensive care (NICU) hospitalization after 6 yr at their entrance to the school.Materials & MethodsThis cross sectional study was conducted on premature neonates consecutively hospitalized in NICU of Valie Asr Hospital (the Academic Pediatric Hospital, Zanjan, Northwestern Iran) from September 2001 to September 2003. All children with a history of prematurity and NICU treatment were evaluated at their entrance to the school. Demographic findings, clinical examinations, IQ test, hearing and visual acuity exams were recorded.ResultsFrom 179 neonates, 78 (43.6%) survived and were discharged from hospital. Fifty-four of them were available and entered first grade in primary school. Only one case had severe mental retardation. One case had severe retinopathy of prematurity (ROP). Hearing abnormality was not detected in any case. There was no significant relation between IQ score, visual as well as hearing findings and gestational age.ConclusionWe did not find significant disability in the outcome of surviving infants. This could be explained by the high mortality rate of neonates during hospitalization. References1. Fakher M, Shaaban W, Abdel Monein A, Hassan Z, Moustafa Fikry M. Statistical Study of Preterm Infants Admitted to NICU in Fawzy Moaz Hospital For Children. Alex J Pediatr 2005; 19 (1):155-8.2. Fauth de Araújo B, Zatti H, Madi JM, Coelho MB, Olmi FB, Canabarro CT. Analysis of neonatal morbidity and mortality in late-preterm newborn infants. Jornal de Pediatria 2012 ; 88 (3): 259-266.3. Stephens BE, Vohr BR. Neurodevelopmental outcome of the premature infant. Pediatr Clin North Am 2009; 56 (3):631-46.4. Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA, Buzas JS. Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009. Pediatrics 2012;129 (6): 1019-26.5. Melamed N, Klinger G, Tenenbaum-Gavish K, Herscovici T, Linder N, Hod M, Yogev Y, Short-term Neonatal Outcome in Low-Risk, Spontaneous, Singleton, Late Preterm Deliveries. Obstetr Gynecol 2009 ; 114 ( 2): 253-260.6. Larroque B, Ancel PY, Marret S, Marchand L, AndréM, Arnaud C, Pierrat V, RozéJC, Messer J, Thiriez G, Burguet A, Picaud JC, Bréart G, Kaminski M, EPIPAGE Study group. Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet 2008; 371(9615): 813.7. Sajedi F, Vameghi R, Mohseni Bandpei MA, Alizad V, Hemmati Gorgani S, Shahshahani Pour S. Motor developmental delay in 7500 iranian infants: prevalence and risk factors. Iran J Child Neurol 2009; 3(3):43-50.8. Allen MC. Neurodevelopmental outcomes of preterm infants. Curr Opin Neurol 2008 ;21(2):123-8.9. Beaino G, Khoshnood B, Kaminski M, Marret S, Pierrat V, Vieux R, Thiriez G, Matis J, Picaud JC, RozéJC, Alberge C, Larroque B, Bréart G, Ancel PY, EPIPAGE Study Group. Predictors of the risk of cognitive deficiency in very preterm infants: the EPIPAGE prospective cohort. Acta Paediatr 2011;100 (3): 370.10. Mikkola K, Ritari N, Tommiska V, Salokorpi T,Lehtonen L, Tammela O, Pa¨a¨kko¨nen L, Olsen P, Korkman M, Fellman V, for the Finnish ELBW Cohort Study Group. Neurodevelopmental Outcome at 5 Years of Age of a National Cohort of Extremely Low Birth Weight Infants Who Were Born in 1996–1997. Pediatrics 2005;116:1391.11. Mercier CE, Dunn MS, Ferrelli KR, Howard DB, Soll RF. Neurodevelopmental Outcome of Extremely Low Birth Weight Infants from the Vermont Oxford Network: 1998–2003. Neonatology 2010; 97: 329–338.12. Neubauer AP, Voss W, Kattner E. Outcome of extremely low birth weight survivors at school age: the influence of perinatal parameters on neurodevelopment. Eur J Pediatr 2008; 167(1):87-95.13. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010;126(3):443-56.14. Khan MR, Maheshwari pK, Shamim H, Ahmed S, Ali SR. Morbidity pattern of sick hospitalized preterm infants in Karachi, Pakistan. J Pak Med Assoc 2012; 62 (4): 386- 388.15. Navaei F, Aliabady B, Moghtaderi J, Moghtaderi M, Kelishadi R. Early outcome of preterm infants with birth weight of 1500 g or less and gestational age of 30 weeks or less in Isfahan city, Iran. World J Pediatr 2010; 6 ( 3): 228-232.16. Arafa MA, Alshehri MA, Predictors of neonatal mortality in the intensive care unit in Abha, Saudi Arabia. Saudi Med J 2003; 24 (12): 1374-1376.17. Atalay D, Salihoğlu Ö, Can E, Beşkardeş A, Hatipoğlu S. Short-Term Outcomes of Very Low Birth Weight Infants Born at a Tertiary Care Hospital, Istanbul, Turkey. Iran J Pediatr 2013; 23(2): 205-211.18. Mathews TJ, MacDorman MF. Infant Mortality Statistics From the 2007 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports. 2011;59(6).19. Natarajan G, Shankaran S, Laptook AR, Pappas A, Bann CM, McDonald SA, et al. Apgar scores at 10 min and outcomes at 6-7 years following hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 2013 ;98(6):F473-9.20. Tommiska V – Heinonenk Ikonen S – pokelu ML-Renlund M/Virtanen M-fellman V. A national short –term followup study of extremely LBW infants born in Finland in 1996-1997. Pediatrics 2001; 107 (1):1-9.21. Ahmadpour M, Zahedpasha Y, Khafri S, Pishnamazi N. Short-term outcome of premature neonates admitted to NICU & newborn services at Amirkola children hospital in 2010. IJN 2012; 3( 3,4): 10.22. Calisici E, Eras Z, Oncel MY, Oguz SS, Gokce IK, Dilmen U. Neurodevelopmental outcomes of premature infants with severe intraventricular hemorrhage. J Matern Fetal Neonatal Med 2014 ; 14:1-6.23. Santos IS, Matijasevich A, Domingues MR, Barros AJD, Victora CG, Barros FC. Late preterm birth is a risk factor for growth faltering in early childhood: a cohort study; BMC Pediatrics 2009; 9:71.24. Leversen KT, Sommerfelt K, Rønnestad A, Kaaresen PI, Farstad T, Skranes J, et al. Prediction of neurodevelopmental and sensory outcome at 5 years in Norwegian children born extremely preterm. Pediatrics 2011;127(3):e630.25. Christian P, Murray-Kolb LE, Tielsch JM, Katz J, LeClerq SC, Khatry SK. Associations between preterm birth, small-for gestational age, and neonatal morbidity and cognitive function among school-age children in Nepal. BMC Pediatrics 2014;14:58.26. Synnes AR, Anson S, Arkesteijn A, Butt A, Grunau RE, Rogers M, Whitfield MF. School entry age outcomes for infants with birth weight≤800 grams. J Pediatr. 2010;157(6):989.27. van Baar AL, Vermaas J, Knots E, de Kleine MJ, Soons P. Functioning at school age of moderately preterm children born at 32 to 36 weeks’ gestational age. Pediatrics 2009; 124(1): 251.28. Johnson S, Fawke J, Hennessy E, Rowell V, Thomas S, Wolke D, Marlow N. Neurodevelopmental disability through 11 years of age in children born before 26 weeks of gestation. Pediatrics 2009;124(2):e249.29. Kerstjens JM, de Winter AF, Bocca-Tjeertes IF, ten Vergert EM, Reijneveld SA, Bos AF. Developmental delay in moderately preterm-born children at school entry. J Pediatr 2011; 159(1):92.30. Soleimani F, Kazemnejad A,Vameghi R. Risk factor profiles of adverse neuromotor outcome in infants. Iran J Child Neurol 2010; 4 (4): 25-31

Evaluation of Aseptic Meningitis Following Measles-Mumps-Rubella Vaccine in Children Admitted due to Febrile Convulsion

Background Febrile convulsion (FC) is the most common neurological problem in children which can occur in 2 to 5% of this population. The most important issue is to identify the cause of fever and rule out bacterial meningitis. The purpose of this study was to evaluate the association of aseptic meningitis due to Measles-Mumps-Rubella (MMR) vaccine in admitted children with febrile convulsion. Materials and Methods This study was a retrospective cross-sectional. Children aged 6 months to 5 years old with FC that admitted to Mousavi Hospital in Zanjan, Iran, during one year (from 2016 to 2017) were enrolled. The demographic information of patients and laboratory parameters of meningitis in their CSF fluid were recorded in a researcher made questionnaire. Results A total of 275 children were admitted due to FC. Of these children, 36.3% had respiratory infections, 33.8% nonspecific febrile infections, 16% gastroenteritis, 5.8% urinary tract infection, 5.1% acute otitis media and 2.2% meningitis. All cases of meningitis were aseptic without evidence of bacterial compromise. There was a significant relationship between the age of febrile convulsion and meningitis (P=0.012). The age of children with meningitis were between 385 to 395 days (equivalent one year and 20- 30 days), which coincide with 20 to 30 days after receiving the MMR vaccine. Conclusion In the study, all cases of meningitis occurred 20 to 30 days after the MMR vaccine at one year of age. It is strongly suspected the association between aseptic meningitis and the MMR vaccine. LP is recommended in children with febrile convulsions in this age range

Clinical and Epidemiologic Findings of Pertussis Suspected Patients Referred to Zanjan Health Centers in 2011-2012

Introduction: Despite frequent vaccination, Pertussis is still relatively common in the world. The prevalence of this disease has been reported differently in different parts of the world. The aim of this study was to investigate clinical and pediatric findings and compare them with the results of nasopharyngeal culture in suspected Pertussis patients in Zanjan province. Materials and Methods: In this cross-sectional study, records of all patients referred to Zanjan health center during 2011-2015 with suspected Pertussis were evaluated. Data were collected from questionnaires and analyzed by SPSS v16 software using frequency distribution, chi-square and chi-square test. Findings: Of the 243 patients examined, 17 (7%) patients were positive for nasopharyngeal culture. Eight of them were male and 9 were females. The highest number of cases was in winter (9 cases). We found cough in all cases and post coughing vomiting in 15 cases . Of the 17 positive cultured patients, 11 patients were below 6 months (before completing three doses of vaccine). Discussion & Conclusion: In this study, the positive nasopharyngeal culture was similar to most of the national’s studies but was less than that of other countries

Age at Menarche and its Related Factors among School Girls, in Zanjan, Iran

BackgroundThere are differences in the age at menarche in different countries and it seems that in recent decades gradually the age of puberty is declining. The aim of the present study was to determine the age at menarche and its related factors in school girls in Zanjan city, Iran.Materials and MethodsThis cross-sectional study was conducted on 1,500 healthy school girls between 6-17 years old who were selected on the basis of a multistage probability sampling. Age at menarche, birth weight, family size, Body Mass Index (BMI), fast food consumption, and physical activity, were recorded. Data were analyzed using SPSS version 16.0.ResultsOut of 1,500 students, 273 girls (18.2%) had experienced menarche with a mean age of 12.6±1.6 (95% confidence interval [C]: 12.4-12.8), and a median age of 13 years. The prevalence of early menarche, was 10.3%, (95% CI: 6.6%-14.1%). A significant association between menarche and BMI, frequency of fast food consumption and birth rank was observed; however, we didn’t find a significant association between physical activity (P>0.05) and birth weight (P>0.05) with menarche. ConclusionThe mean age of menarche in our study was 12.6±1.6 years old, similar to other studies in Iran, and it was significantly associated with higher BMI

A report of high triglyceride level in cord blood of Iranian newborns

Background: Since cord blood triglyceride level have been reported very different in recent articles, the purpose of this study is determination of triglyceride level in cord blood of Iranian newborns and compare it with other reports. Methods: In this study, cord blood of 174 healthy term newborn infants (97 girls, 77 boys) born from healthy mothers have been used. Triglyceride level has been measured by calorie metric method Statistical analysis was performed by independent t test, Mann-Whitney regression test and Spearman correlation coefficient method using SPSS 16 .0 software (SPSS, USA). Results: The mean of cord blood triglyceride was 1.37 ΁ 4.81 mg /dl and there was no statistical difference between two sexes. There was not exist linear relationship between triglyceride and weight, height, head circumference, body mass index and sex of the babies .In 8.6% of our new born infants, triglyceride levels were more than 95th percentile of triglyceride level reported in Iranian population. In 33.9% of our cases, triglyceride levels were more than 95 th percentile of triglyceride level reported in the Nelson text book of Pediatrics. In this study, the 95th percentile of triglyceride level in cord blood was 132.5 mg /dl. Conclusion: The mean and 95 th percentiles of triglyceride levels in cord blood of our newborn infants were higher than other reports. We recommend that larger studies should be conducted in this area to establish preventive ways for increasing epidemic of the metabolic syndrome