Clinical Manifestations and Treatment Response of Eosinophilic Gastrointestinal Diseases in children: A 5-year Study in an Iranian Referral Hospital

Background: Eosinophilic gastrointestinal disorders (EGIDs) are a group of uncommon inflammatory diseases. In this study, we aimed to evaluate the prevalence of EGIDs, clinical manifestation and their response to treatment in a Children Medical Center in Iran.Method: Between 2011 and 2016, all patients, aged <18 years old, who had pathology-confirmed diagnosis of EGIDs and underwent endoscopy in our center, were included in the study. Patient demographics, clinical presentation, laboratory data, radiologic findings, endoscopic findings, histological findings and the results of treatment were retrieved from the participants’ medical records.Results: The prevalence of EGIDs in children in the gastrointestinal unit of our hospital during these years was reported as 5 per 1000 children. The most reported clinical symptoms in patients with EoE were nausea (75%), vomiting (69%), and epigastric pain (62.5% each). All of the patients had a hypoallergenic diet. Seventy-five percent of the patients used fluticasone spray.  The most frequent symptom in the patients with EoC was rectal bleeding (100%), followed by diarrhea (73%), irritability (23%), and loss of weight gain (18%). All of the patients had a hypoallergenic diet. Twenty-seven percent of the patients used Neocate milk and the use of cetirizine and ketotifen were reported in 18% of patients. EoGE was reported in only two patients (mean age: 10.25 years).Conclusion: During the 5-year period, most cases of EGIDs were related to EoC and EoE, and all cases improved in response to treatment. The hypoallergenic diet was identified as a common effective treatment for the studied patients

on The Study of Herbal Combination Effect of Securigera Securidaca, Vaccinium Arctostaphylos, Citrullus Colocynthis and Coriandrium Sativum on Triglyceride of Pre-Diabetic Elderlies

Background: Increasing blood sugar and hyperlipidemia in could deteriorate the late complications in diabetic patients. Hence, this study aimed to evaluate the herbal combination effects of Securigera securidaca, Vaccinium Arctostaphylos, Citrullus Colocynthis and Coriandrum sativum on triglyceride level in pre-diabetic elderlies. Materials and Methods: In a single-blind randomized controlled trial study, 60 pre-diabetic individuals aged between 60 to 70 years with a triglyceride level of 180-250 mg/dl were selected. They were divided into two groups (drug and placebo) randomly. The drug group received a diet including 500 mg capsules of herbal blend once daily, and the placebo group received diet including placebo capsules (500 mg flour) in the same period. The serum triglyceride level was evaluated after 30 days in both groups. Finally, the SPSS software version 18 was used for data analysis. Results: The mean triglyceride level, between before the intervention and afterward were not significantly different, and the mean changes in triglyceride level in total showed no significant differences as well. Likewise, the comparison between the mean triglyceride level before and after the intervention, independently in drug group or placebo revealed no statically significant differences. Conclusion: There is no adequate evidence for the efficiency of this 30-day period intervention of herbal blend. Therefore it is recommended to perform further studies using different drug dosage and period of consumption to get more conclusive results about the potential effectiveness of these herbal medications on elderly’s triglyceride level

Evaluation of the Effect of Intravenous Ondansetron versus Placebo before Anesthesia on Vomiting after Endoscopy and Colonoscopy Procedures

Background: Vomiting is a common complication after endoscopic procedures in children. Different medications could be administered to control vomiting after endoscopy. The goal of this study is to evaluate anti-emetic effects of ondansetron in children who undergo endoscopic procedures.Methods: In this clinical randomized trial, 198 children (103 female/95 male) were randomly assigned into one of the following two studied groups. Case group (G1): Fentanyl 1 µg/kg + propofol 2.5 mg/kg + ondansetron 0.15 mg/kg and control group (G2): Fentanyl 1 µg/kg + propofol 2.5 mg/kg + 2 cc normal saline.Results: The mean age was 6.3 ± 3.5 years (6.2 ± 3.6 years in G1 vs. 6.4 ± 3.5 years in G2). The most common cause of endoscopy procedure in both groups was hematochezia. Vomiting, recovery time, Paediatric Anesthesia Emergence Delirium (PAED), and Aldrete scores were compared. Rate of vomiting after recovery and Aldrete score were significantly different between the two groups.Conclusions:Ondansetron is effective in controlling vomiting after colonoscopy and upper gastrointestinal endoscopic procedures. Also, patients in intervention group experienced better recovery time

Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections : An updated systematic review

Peer reviewedPublisher PD

The study of upper gastrointestinal endoscopy in patients with inflammatory bowel disease and ulcerative colitis

زمینه و هدف: در بررسی های تشخیصی بیماری های التهابی روده، یکی از موارد تشخیصی انجام آندوسکوپی فوقانی است که علاوه بر تأیید تشخیص، در افتراق کولیت های نامشخص نیز کمک کننده است. هدف از این مطالعه بررسی لزوم انجام آندوسکوپی فوقانی در بیماران مبتلا به التهاب روده بوده است. روش بررسی: در این مطالعه توصیفی- تحلیلی تعداد 30 کودک در بیمارستان مرکز طبی به صورت سرشماری از مهر 1388 تا اسفند 1389 که به عنوان بیماری کرون و کولیت اولسراتیو به تشخیص قطعی رسیدند؛ تحت انجام آندوسکوپی فوقانی قرار گرفتند و داده ها با استفاده از نرم افزارSPSS و آزمون آماری t-test تجزیه و تحلیل شدند. یافته ها: از30 کودک با تشخیص بیماری التهابی روده، تعداد 15 بیمار دچار کرون و مابقی کولیت اولسراتیو داشتند. نتایج مطالعه حاضر حاکی از درگیری ماکروسکوپی مری در 93 بیماران، درگیری معده در 87 و درگیری دئودنوم در 26 بیماران با تشخیص کرون بود. در بیماران کولیت اولسراتیو درگیری مری 80، معده 66 و دئودنوم 20 بود. از نظر میکروسکوپی در بیماران کرون درگیری مری 94، درگیری معده 80 و در نهایت درگیری دئودنوم 47 مشاهده شد. در بیماران کولیت اولسراتیو از نظر میکروسکوپی 94 درگیری مری، 87 درگیری معده و 67 درگیری دئودنوم داشتند. نتیجه گیری: با توجه به درصد قابل توجه درگیری دستگاه گوارش فوقانی در بیماران با بیماری التهابی روده، انجام آندوسکوپی در تمام بیماران جدا از نوع و محل درگیری و بررسی هیستوپاتولوژیک کاری منطقی و لازم بنظر می رسد

Systemic Amyloidosis in a Teenage Boy With Inflammatory Bowel Disease

Systemic amyloidosis is a very rare complication of inflammatory bowel disease (IBD). The reported cases of secondary amyloidosis in children with IBD are much fewer than those reported in adults. Herein, a teenage boy with Crohn’s disease is presented who developed nephrotic syndrome due to renal involvement secondary to amyloidosis, whereas the patient was under treatment with corticosteroid and 6-mercaptopurine. To our best knowledge, this is the first reported case of secondary amyloidosis in a teenage Iranian boy with Crohn’s disease

Prevalence of Attention Deficit Hyperactivity Disorder in Pediatrics Patients Newly Diagnosed with Gastroesophageal Reflux Disease

Background: Gastroesophageal reflux disease (GERD) is associated with a number of comorbidities in pediatrics. However, its association with attention deficit hyperactivity disorder (ADHD) has not been reported. The aim of the present study was to investigate the prevalence of ADHD in pediatric patients newly diagnosed with GERD. Materials and Methods: Sixty newly-diagnosed treatment naive GERD patients and sixty healthy controls aging between 5 to 12 years referring to the Children and Adolescent’s medical center, Tehran, Iran were recruited in a case-control study during the year 2015. Then patients were evaluated for ADHD by a psychiatrist according to the DSM-IV criteria. The revised Conners' Parent Rating Scale (CPRS-R) was used for assessment of the symptoms of ADHD. To screen for psychiatry disorders other than ADHD, the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) questionnaire was used. Logistic regression analysis was used for modeling the association between GERD and ADHD in the study sample. Results: The mean age of GERD patients was 5.77±2.27 and for non-GERD controls was 6.03±2.52 (P= 0.543). Thirty-three out of 60 (55%) GERD patients and 37 out of 60(61.66%) non-GERD controls were male (P: 0.579). Prevalence of ADHD was 33.60 (55%) in GERD patients and 10.60 (16.66%) in non-GERD (

Clinical Manifestations and Treatment Response of Eosinophilic Gastrointestinal Diseases in children: A 5-year Study in an Iranian Referral Hospital

Background: Eosinophilic gastrointestinal disorders (EGIDs) are a group of uncommon inflammatory diseases. In this study, we aimed to evaluate the prevalence of EGIDs, clinical manifestation and their response to treatment in a Children Medical Center in Iran. Method: Between 2011 and 2016, all patients, aged <18 years old, who had pathology confirmed diagnosis of EGIDs and underwent endoscopy in our center, were included in the study. Patient demographics, clinical presentation, laboratory data, radiologic findings, endoscopic findings, histological findings and the results of treatment were retrieved from the participants' medical records. Results: The prevalence of EGIDs in children in the gastrointestinal unit of our hospital during these years was reported as 5 per 1000 children. The most reported clinical symptoms in patients with EoE were nausea (75%), vomiting (69%), and epigastric pain (62.5% each). All of the patients had a hypoallergenic diet. Seventy-five percent of the patients used fluticasone spray. The most frequent symptom in the patients with EoC was rectal bleeding (100%), followed by diarrhea (73%), irritability (23%), and loss of weight gain (18%). All of the patients had a hypoallergenic diet. Twenty-seven percent of the patients used Neocate milk and the use of cetirizine and ketotifen were reported in 18% of patients. EoGE was reported in only two patients (mean age: 10.25 years). Conclusion: During the 5-year period, most cases of EGIDs were related to EoC and EoE, and all cases improved in response to treatment. The hypoallergenic diet was identified as a common effective treatment for the studied patients

Familial achalasia, a case report

Background: Although achalasia is a relatively rare disease in pediatric age group, it must be considered for differential diagnosis of esophageal disorders in children with positive family history even in the absence of typical clinical manifestations. Case Presentation: A 5-month old boy was hospitalized for cough and mild respiratory distress. Because of positive history of achalasia in his mother, achalasia was detected in esophgagography. Pneumatic dilation through endoscopy was successful. A 12-month follow-up revealed no problem. Conclusion: Achalasia must be considered for differential diagnosis in children with positive family history of achalasia even in the absence of typical clinical manifestations. An autosomal recessive mode of inheritance is probable. We suggest further researches and genetic studies to establish the pattern of inheritance