Acute Kidney Injury in Children with Acute Gastroenteritis

Introduction: This study was done in Children’s Medical Center Hospital affiliated with Tehran University of medical science, Tehran, Iran.Materials and Methods: The patients were 140 children who were admitted for gastroenteritis and we detected acute kidney injury in them. All of the patients were admitted and managed in the Emergency Department, and were evaluated for symptoms of AKI including dehydration, renal function tests, electrolytes, and urine output.Results: The median age of the children with gastroenteritis and AKI was 2.5 years (ranging from 2 months to 12 years) and 78.6% of them were male. Acute kidney injury (AKI) was present in 116 (82.9%) patients at admission with 53 (37.8%) patients in the “failure” category (RIFLE). Twelve children had anuria and 54 patients had oliguria. At presentation, 24 patients (15%) had serum BUN levels between 30-75 and creatinine levels in the range of 0.9-2.1mg/dl. One patient had HUS that was excluded from this study. Seventy-six children had symptoms of severe dehydration and metabolic acidosis. After adequate fluid therapy, 30 children had polyuria of 6.4 (range 4-9) cc/kg/min. Twenty-three patients (16.4%) had hyponatremia and 41 patients (29.2%) had hypernatremia. Nine children (6.4%) suffered from hypokalemia. Some children had received ORS at home. All of them were managed in the emergency ward and discharged with normal GFR without any electrolyte abnormalities. The patients were fallowed for 3-6 months and all of them had normal renal function at the end of the study.Conclusions: Early diagnosis and urgent management of gastroenteritis and dehydration can prevent AKI.Keywords: Acute Kidney Injury; Child; Gastroenteritis

Can Children Enhance Their Family’s Health Knowledge? An Infectious Disease Prevention Program

Objective: The purpose of this study is to propose an innovative method of knowledge transfer that aims to improve health literacy about pediatric infectious diseases prevention in families. Children have an appreciable role in this scheme. Methods: This study is a before and after trial that has been conducted in Hamedan in 2009. After changing seven infectious disease topics into childish poems, we selected five kindergartens randomly and taught these poetries to the children. Teaching process held after a pretest containing 24 questions that examined 103 of parents about mentioned topics. The same post-test was given after 4 months of teaching process. Findings: The mean of correct answers to the pretest was 59.22% comparable with 81.00% for post-test (P<0.00). Gender and knowledge degree could not change the results significantly. Assuming one’s correct answers to the questions as his/her Knowledge Mark, the mean of this variable increased to 5.32 by this method. Conclusion: This cost-effective and joyful method had successful results in promoting health knowledge. Children are able to play an active role in family’s health situation. Learning within family atmosphere without any obligations makes our scheme a solution for paving the knowledge transferring way

Incidence of diarrhoeagenic Escherichia coli isolated from young children with diarrhoea in the west of Iran

Diarrhoeagenic Escherichia coli (DEC) represents a main group of enteric pathogens that cause human diarrhoea. Because it is not simply distinguished from normal flora by simple laboratory methods, modern molecular diagnostic assays are necessary. Although it is neither necessary nor applicable to perform PCR for all patients, it is of many advantages to verify the prevalence of DEC in different areas by this method. Knowing the prevalence of DEC in an area, we can focus on few pathogens and narrow our antimicrobial treatment. The aim of this study is to evaluate the contribution of the different DEC categories in children diarrhoea in the west of Iran.The stool specimens of 251 children with diarrhoea were collected from June to September 2007. Polymerase chain reaction (PCR) was performed to determine the presence of enteropathogenic (EPEC), enterotoxigenic (ETEC), entero-invasive (EIEC), Shiga toxin-producing (STEC) and entero-aggregative (EAEC) strains. ETEC strains were isolated from 13 and EAEC strains from 16 children. STEC was detected in 7 children, and no EIEC was isolated. Finally, EPEC strains were isolated in 41 cases. EAEC and EPEC are the most frequent DECs in children less than 10 years of age in West of Iran