Prognosis and Complications of Attempted Suicidal Hanging

Background: Hanging is a form of strangulation, in which the body is suspended through the neck and the weight of the body acts as a constricting force. This study assessed various factors on the outcome of hanging and identification of prognostic factors related to the outcomes.Methods: Ninety-nine hanging victims from 1995 to 2015 in Iran were evaluated; then, variables such as the cause of death, distribution of mortality, duration of hospitalization, substance abuse consumption, respiratory distress, and cerebral edema were studied in these people. Finally, the data were analyzed.Results: Major cases of suicide by hanging were men. In connection with prognosis, about 12% of the deaths occurred in men and about 21% were represented in women. More importantly, in the matter of suspension, the model was largely incomplete to complete. Also, the outcomes of pulmonary stress and cerebral edema were recognized in association with the type of hanging and mortality prognosis.Conclusion: Only two risk factors, including loss of consciousness at the time of entry into the medical center, as well as the complete suspension, would be predictive operations of death and unsuccessful revival

Bilateral Ptosis as the First Presentation of Guillain-Barre Syndrome

How to Cite This Article: Talebian A, Soltani B, Talebian M. Bilateral Ptosis as the First Presentation of Guillain-Barre Syndrome. Iran J Child Neurol. Winter 2016; 10(1):70-72.AbstractObjectiveGuillain-Barre syndrome (GBS) is the most common cause of acute weakness in children. It has multiple variant forms with different presentations. A rare initial sign is ptosis. In this study, we present a 10-year-old girl with bilateral ptosis without opthalmoplegia followed by a weakness in extremities with a favourable response to intravenous immunoglobulin. Due to the patient’s initial eyelid levators, myasthenia gravis was ruled out by a Tensilon test and electrophysiological studies. Our report highlights the possibility of GBS as a cause of isolated ptosis, especially in cases without ophthalmoplegia

Causes and Associated Factors of Headaches among 5 to 15-year-old Children Referred to a Neurology Clinic in Kashan, Iran

How to Cite This Article: Talebian A, Soltani B, Haji Rezaei M. Causes and Associated Factors of Headaches among 5 to 15-year-old ChildrenReferred to a Neurology Clinic in Kashan, Iran. Iran J Child Neurol. 2015 Winter;9(1):71-75.AbstractObjectiveHeadaches are common neurologic problems for children and adolescents. They are divided into two types: primary and secondary. Primary headaches include migraines and tension-type as well as comprise the majority of headaches. We detect the causes of headaches and their associations with demographic variables among children and adolescents.Materials & MethodsThis cross-sectional study was performed on 5–15 year-old children with headaches from March 2010 to April 2012 who presented at a pediatric neurology clinic in Kashan, Iran. Diagnosis of headaches was done in accordance with the International Classification of Headache Disorders. Data regarding the type of headache, age, gender, pain severity, aura, family history, and sleep disorder were collected.ResultsOne hundred fourteen children (44 male and 70 female) with headaches were enrolled in the study. The types of headaches were comprised as follows: 67 cases of migraines, 38 cases of tension-type headaches, 2 cases of cluster headaches, and 7 cases of secondary headaches. Pulsating headaches, family history of headaches, insomnia, and pain severity had higher prevalence in migrainous patients.ConclusionPhysicians should extend their information gathering about primary and secondary headaches. Sleep disturbances and a family history of headaches were the most important factors associated with migraine headaches.ReferencesCuvellier JC, Donnet A, Guegan-Massardier E, Nachit-Ouinekh F, Parain D, Vallee L. Treatment of primary headache in children: a multicenter hospital-based study in France. J Headache Pain 2009; 10: 447-53.Lateef TM, Merikangas KR, He J, Kalaydjian A, Khoromi S, Knight E, et al. Headache in a national sample of American children: prevalence and comorbidity. J Child Neurol 2009; 24: 536-43.Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trondelag Health Study (Head-HUNT-Youth), a large populationbased epidemiological study. Cephalalgia 2004; 24: 373- 9.Isik U, Topuzoglu A, Ay P, Ersu RH, Arman AR, Onsuz MF, et al. The prevalence of headache and its association with socioeconomic status among schoolchildren in istanbul, Turkey. Headache 2009; 49: 697-703.Abu-Arafeh I, Macleod S. Serious neurological disorders in children with chronic headache. Arch Dis Child 2005; 90: 937-40.Lewis DW. Headaches in children and adolescents. Am Fam Physician 2002; 65: 625-32.The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004; 24 Suppl 1: 9-160.Tavasoli A, Aghamohammadpoor M, Taghibeigi M. Migraine and Tension-Type Headache in Children and Adolescents Presenting to Neurology Clinics. Iran J Pediatr 2013; 23: 536-540.Bruni O, Fabrizi P, Ottaviano S, Cortesi F, Giannotti F, Guidetti V. Prevalence of sleep disorders in childhood and adolescence with headache: a case-control study. Cephalalgia 1997; 17: 492-8.Isik U, Ersu RH, Ay P, Save D, Arman AR, Karakoc F, et al. Prevalence of headache and its association with sleep disorders in children. Pediatr Neurol 2007; 36: 146-51.Miller VA, Palermo TM, Powers SW, Scher MS, Hershey AD. Migraine headaches and sleep disturbances in children. Headache 2003; 43: 362-8.Lewis DW, Ashwal S, Dahl G, Dorbad D, Hirtz D, Prensky A, et al. Practice parameter: evaluation of children and adolescents with recurrent headaches: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002; 59: 490-8.Lewis DW,Koch T. Headache evaluation in children and adolescents: when to worry? When to scan? Pediatr Ann 2010; 39: 399-406.Hershey AD, Powers SW, Bentti AL, Degrauw TJ. Effectiveness of amitriptyline in the prophylactic management of childhood headaches. Headache 2000; 40: 539-49.Donald W. Headache in children and adolescent. Am Fam Physician 2002; 65: 625-33.Kroner-Herwig B, Gassmann J. Headache disorders in children and adolescents: their association with psychological, behavioral, and socio-environmental factors. Headache 2012; 52: 1387-401.Wober-Bingol C, Wober C, Wagner-Ennsgraber C, Zebenholzer K, Vesely C, Geldner J, et al. IHS criteria and gender: a study on migraine and tension-type headache in children and adolescents. Cephalalgia 1996; 16: 107-12.Abu-Arafeh I,Russel G. Prevalence of headache and migraine in schoolchildren. British medical journal 1994; 308: 765-9.Ayatollahi SM,Khosravi A. Prevalence of migraine and tension-type headache in primary-school children in Shiraz. East Mediterr Health J 2006; 12: 809-17.Fallahzadeh H,Alihaydari M. Prevalence of migraine and tension-type headache among school children in Yazd,Iran. J Pediatr Neurosci 2011; 6: 106-9.Russell MB, Iselius L, Ostergaard S, Olesen J. Inheritance of chronic tension-type headache investigated by complex segregation analysis. Hum Genet 1998; 102: 138-40.Stewart WF, Linet MS, Celentano DD, Van Natta M, Ziegler D. Age and sex specific incidence rates of migraine with and without visual aura. Am J Epidemiol 1991; 134: 1111-20

Molecular identification and evaluation of antibiotic resistance of coagulase negative Staphylococcus isolated from Neonatal Sepsis hospitalized at Gharazi Hospital in Sirjan, Kerman

Background and aims: Sepsis is one of the serious infectious diseases in the neonates and infants that is potentially life threatening. The aim of the current study was to identify coagulase negative Staphylococcus and their antibiotic resistance patterns in Neonatal Sepsis in the neonates and infants hospitalized at Ghrazi Hospital, Sirjan. Methods: In the cross-sectional study, 140 blood samples were obtained from neonates and infants hospitalized in a period of time from June to November 2015 in the Sirjan, Kerman and then evaluated based on many items such as: BC(blood culture)/sex/age/admission date/weight/type of birth/admission ward/clinical findings/predisposing factors. All of these informations were acquired from patients profile. All of the isolated S. epidermidis strains were confirmed by PCR. Antibiotic susceptibility test was performed by disk diffusion method. Results: of 140 blood samples, 10 CoNS strains were isolated. Evaluation of EDTA tube and molecular identification confirmed that 6 isolates were S. epidermidis. The results of disk diffusion test showed that most of them were susceptible to vancomycin and novobiocin and the most of them were resistance to cefixime, ceftriaxone and Cephalexin. In the work, half of strains (50%) were resistance to oxacillin. So, they were methicillin resistance S. epidermidis (MRSE). Conclusion: Coagulase negative Staphylococcus (S. epidermidis) is most common cause of sepsis. The specificity and sensitivity of PCR for detection of this strains in the emergency condition was useful

The Relationship between Osteogenesis Imperfecta and Spinal Muscular Atrophy

ObjectiveA 4-month-old female with osteogenesis imperfecta (OI) type II was admitted in PICU of our center due to severe respiratory distress and fever with a diagnosis of severe pneumonia, and mechanical ventilation was initiated. Due to severe hypotonia, NCV and EMG were performed, and spinal muscular atrophy (SMA) type I was diagnosed.Keywords: Osteogenesis imperfecta; spinal muscular atrophy; hypotoni

A Study on Causes and Types of Abnormal Increase in Infants’ Head Circumference in Kashan/Iran

How to Cite This Article: Talebian A, Soltani B, Moravveji AR, Salamati L, Davami M. A Study on Causes and Types of Abnormal Increase in infants’ Head Circumference in Kashan/Iran. Iran J Child Neurol. 2013 Summer; 7(3): 28- 33. ObjectiveHead circumference is a valuable index of brain growth and its disturbances can indicate different disorders of nervous system. Abnormal increased head circumference (macrocephaly) is common and observed in about 2% of infants. In this study, the causes and clinical types of abnormal increase in infants’ head circumference were investigated in Kashan, Iran.Materials & MethodsThis cross-sectional study was performed on 90 infants less than 2 years of age with abnormal increase in head circumference in Kashan, during 2009- 2011. The data were collected by history taking, physical examination, growth chart, and imaging.Results65 (72%) cases out of 90 infants were male and 25 ( 28%) cases were female. Fifty-three (58.8%) cases had familial megalencephaly, 30 (33.4%) had hydrocephalus, and other causes were observed in 7 (7.8%) cases. Eighty-three percent of Infants with familial megalencephaly and 50% with hydrocephalus had normal fontanels. In 90.6% of cases withfamilial megalencephaly, family history for large head was positive. Motor development was normal in 100% of cases with familial megalencephaly and 76.7% of hydrocephalic infants.Conclusion Familial megalencephaly was the most common cause of macrocephaly in the studied infants, and most of them had normal physical examination and development, so, parental head circumferences should be considered in the interpretation of infant’s head circumference and in cases of abnormal physical examination or development, other diagnostic modalities, including brain imaging should be done. References1. Lunde A, Melve KK, Gjessing HK, Skjaerven R, Irgens LM. Genetic and environmental influences on birth weight, Birth length, Head circumference, and gestational age by use of population-based parentoffspring data. American J Epidemiol 2007;165(7):734-41.2. Sankaran S, Das A, Bauer CR, Bada HS, Lester B, Wright LL, et al. Association between patterns of maternal substance use and infant birth weight, length and head circumference.Pediatrics 2004;114(2):e226-34.3. Demestre Guasch X, Raspall Torrent F, Vila Ceren C, Sala Castellvi P, Elizari Saco MJ, Martinez-Nadal S, et al. Influence of socioeconomic factors on weight, length and head circumference measurements in newborns from 35 to 42 weeks gestational. An Pediatr (Barc) 2009;70(3):241-52.4. Fenichel, GM. Disorders of cranial volume and shape. In: Clinical Pediatric Neurology: A Signs and Symptoms Approach, 6th ed. Philadelphia: Elsevier Saunders; 2009.p. 368.5. Kinsman SL, , Johnston MV. Hydrocephalus. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA: Elsevier/Saunders, Philadelphia; 2011. p. 2008-11.6. Nard, JA. Abnormal head size and shape. In: Gartner JC,Zitelli BJ, editors. Common and Chronic Symptoms in Pediatrics. St. Louis: Mosby; 1997.7. Menkes JH, Sarnat HB, Flores-Sarnat L. Malformations of the central nervous system. In: Menkes JH, Sarnat HB, Maria BL, editors. Child Neurology. 7th ed. Philadelphia:  Lippincott Williams & Wilkins; 2006. p. 284.8. Williams CA, Dagli A, Battaglia A. Genetic disorders associated with macrocephaly. Am J Med Genet A 2008;146A(15):2023-37.9. Varma R, Williams SD, Wessel HB. Neurology. In: Zitelli BJ, Davis HW, edtors. Atlas of Pediatric Physical Diagnosis. 5th ed. Philadelphia: Mosby Elsevier; 2007. p. 563.10. Rekate HL. Hydrocephalus in children. In: Winn HR, Youmans JR, editors. Youmans Neurological Surgery. 5th ed. St Louis: Saunders. 2003. 3387-404.11. Gupta SN, Belay B. Intracranial incidental findings on brain MR images in a pediatric neurology practice: a retrospective study. J Neurol Sci 2008;264(1-2):34-7.12. Alper G, Ekinci G, Yilmaz Y, Arikan C, Telyar G, Erzen C. Magnetic resonance imaging characteristics of benign macrocephaly in children. J Child Neurol 1999;14(10):678-82.13. Smith R, Leonidas JC, Maytal J. The value of head ultrasound in infants with macrocephaly. Pediatr Radiol 1998;28(3):143-6.14. Day RE, Schutt WH. Normal children with large heads benign familial megalencephaly. Arch Dis Child 1979;54(7):512-7.15. Kumar R. External hydrocephalus in small children. Childs Nerv Syst 2006;22(10):1237-41.16. Rollins JD, Collins JS, Holden KR. United states head circumference growth reference charts: birth to 21 years. J Pediatr 2010;156(6):907-13.17. Medina LS, Frawley K, Zurakowski D, Buttros D, DeGrauw AJ, Crone KR. Children with macrocrania: Clinical and imaging predictors of disorders requiring surgery. AJNR Am J Neuroradiol 2001;22(3):564-70.18. Lorber J, Priestly BL. Children with large heads: a practical approach to diagnosis in 557 children, with special reference to 109 children with megalencephaly. Dev Med Child Neurol 1981;23(4):494-504.19. Zahl SM, Wester K. Routine measurement of head circumference as a tool for detecting intracranial expansion in infants: what is the gain? A nationwide survey. Pediatrics 2008;121(3):e416-20.20. Alvarez LA, Maytal J, Shinnar S. Idiopathic external hydrocephalus: natural history and relationship to benignfamilial macrocephaly. Pediatrics 1986;77(6):901-7.21. Yew AY, Maher CO, Muraszko KM, garton HJ. Longterm health status in benign external hydrocephalus. Pediatr Neurosurg 2011;47(1):1-6.22. Muenchberger H, Assad N, Joy P, Brunsdon R, Shores EA. Idiopathic macrocephaly in the infant: long-term neurological and neuropsychological outcome. Childs Nerv Syst 2006;22(10):1242-48

The effects of slow and quick freezing methods on microstructure, drip loss, proximate composition and sensory properties of Nile Tilapia (Oreochromis niloticus) fillets

The aim of this study was to investigate the effects of slow and quick freezing on the changes in sensory properties, drip loss, microstructure and proximate compositions of Nile Tilapia (Oreochromis niloticus) fillets. For this reason, skined off and deboned tilapia fillets were frozen by slow and quick freezing methods. The samples were packed and stored at -18 ° C for six months. Proximate composition, drip loss, and sensory evaluation of the samples were determined on a montly basis. Microstructure of the samples was studied using Scanning Electron Microscopy (SEM) every second month. Results indicated that fresh tilapia fillets had 1/30, 18/70, 1/85, 79/12 percentage of fat, protein, ash and moisture contents, respectively. The amounts of proximate compositions were changed during the storageperiod. Quick frozen samples had significantly lower changes than slow frozen samples. The percentage of the drip in the slow frozen samples was significantly higher than quick frozen samples. SEM micrographs were also showed that the changes in the microstructure of the samples were different in the slow and frozen samples. Slow freezing method resulted in the higher damage in the microstructure of the samples than quick freezing method. Sensory evaluation of the samples indicated a better acceptability for the quick frozen samples than that for slow frozen sample

Survey of Factors that Affect the Arteriovenous Fistulas Survival in Semnan and Mahdishahr, Iran

Background: First step in chronic dialysis is establishing a suitable dialysis access. Arteriovenous fistula (AVF) has been known as the gold standard for hemodialysis; and due to complex interaction of factors that affect thesurvival time of fistula, we decided to evaluate survival time and affective factors among the dialysis patients.Methods: In a historical cohort study, we analyzed 52 patients of the Semnan and Mahdishahr Dialysis Centers. The data recorded by history taking and physical examination.Results: The survival of fistula was 83%, 80%, 67%, and 40% after 1, 3, 5, and 10 years respectively. Our results showed that the survival time of fistula was higher among patients with left-side AVFs. Factors such asage, gender, underlying disease, dialysis session per week, the time that patients started dialysis after installing fistula and fistula infection did not statistical significant affect the survival time.Conclusions: The survival time of AVF among dialysis patients of Semnan and Mahdishahr is satisfying, and installing the fistula in left hand lead to higher survival

Incidence and Risk Factors of Neural Tube Defects in Kashan, Central Iran

How to Cite This Article: Talebian A, Soltani B, Sehat M, Zahedi A, Noorian A, Talebian M. Incidence and Risk Factors of Neural Tube Defects in Kashan, Central Iran. Iran J Child Neurol. Summer 2015;9(3):50-56.AbstractObjectiveNeural tube defects (NTDs) are the most common congenital defects of centralnervous system due to neural tube closure deficit during the third and fourthweeks of gestational age. Our study was performed to detect the incidence andrisk factors of NTDs in Kashan, center of Iran.Material & MethodsThis case-control study was done on all pregnancies with NTD affectedneonates (n=91) and 209 pregnancies with normal neonates from February2007 to December 2012 in three hospitals in Kashan, center of Iran. Annual andthe mean incidence of NTDs were calculated. Risk factors including neonatalgender, maternal age, gravidity, maternal abortion history, maternal gestationaldiabetes (GDM), folic acid use, familial marriage, maternal body mass index(BMI), birth season and family history of NTDs were evaluated by interviewwith mothers. Univariate and multivariate logistic regression were used toanalyze the risk factors.ResultsThe mean incidence of NTDs was 2.33 per 1000 births. The multivariate analysisindicated that maternal history of abortion (OR: 4.9, CI: 1.9-12.8), and maternal obesity (OR: 5.4, CI: 1.3-21.8) were significantly associated with NTDs.ConclusionMaternal history of abortion and BMI were the major risk factors of NTDs