Iranian Journal of Pediatrics
Year:2002 | Volume:12 | Issue:1|Papers Count:14

Complete Blood Count (CBC) is one of the most frequently requested laboratory tests by clinicians. This simple test delivers important information on hemoglobin, hematocrit, different blood cells (red and white blood cells, platelets) as well as their number and morphology. Provided that an experienced and responsible examiner with good knowledge of the patient's history performs the test, this test can be of great importance in diagnosing, typing and evaluating the etiology of hematological and many other diseases. Ignores the examiner sources of error, the test can be the cause of an awkward misleading for the clinician.

To investigate the effect of iron therapy on breath holding spells, in a clinical trial 41 children were given ferrous sulfate solution orally in a dosage of 6 mg/kg per day for 3 months. At the end of this period 28 patients had taken the medication regularly. 21 (75%) of children showed no more spells, 4 (14%) responded moderately (more than 50 % reduction in attacks/month), and 3 (11%) poorly (less than 50% reduction in attacks/month) to the therapy. Results of this study confirm that iron therapy is effective in the treatment of breath holding spells.

In a retrospective study 42 Kawasaki Patients from 3 teaching hospitals in Tehran were evaluated for clinical and laboratory findings. Age peak was found to be 2-3 years whereas that of 18 months is given in other references. A sex ratio of 1.8 males to 1 female was found versus 1.5 to 1 female in other studies. Arthritis, uveitis, and meningitis were rare findings in our patients in contrast to other references

A retrospective study of cholelithiasis in a teaching children's hospital in Tehran in the last 10 years showed that 11 children aged 2-14 (mean 9) years, 4 boys and 7 girls, were admitted with pain in right upper quadrant (72%) and vomiting (54%). The most frequently encountered etiologic factor was major thalassemia (3 cases). Wilson's disease, adiposity, infectious bowel disease, chronic hepatitis and cephterixon pseudolithiasis were responsible for the 5 other cases, in the remaining 3 cases the etiology was idiopathic. The observed complications consisted of occlusive jaundice (2 cases), acute cholecystitis and acute pancreatitis (1 case each). The gallstones were black pigmented (4 cases), cholesterol (1 case) and calcium bicarbonate (1 case) stones.

To evaluate the effect of oral baclofen in spastic cerebral palsy (cp), we studied 40 children with different clinical types of spastic cp. Half of these children served as control group and the others received oral baclofen. All of them were treated with physiotherapy under equal conditions for 6 weeks.We used two methods, modified Ashworth scale and range of motion for evaluation. At the end of therapy we found a significant improvement in the baclofen group compared to control group.As a result of this study, we recommend a combination of oral baclofen and physiotherapy in the treatment of the children with spastic cerebral palsy.

The main goal of this paper is to show the way of approaching to and management of pediatric urticaria. At first the definition as well as different types and pathogenesis of the disease is discussed. A complete history and exact physical examination is always helpful. A complete history should consist of a) whether the urticaria is related to a special time of the year (season), place (immediate home or work environment) or activity (ingestion of foods or drugs, physical activity, etc.); 2) a detailed review of all home remedies and prescriptions.Several simple provocative tests are available. Routine skin testing with scratch of intradermal antigens is usually not very helpful in most cases of chronic urticaria, selective laboratory and x-ray examinations based upon individualized findings may be necessary in these patients.The most important aspect of the therapy is elimination of the etiologic agent. In acute severe urticaria administration of epinephrine, antihistamines and systemic corticosteroids is necessary. In acute mild to moderate or a chronic urticaria, the first choice in medication is H1 antihistamines. If there is little or no response, the dose should be increased and/or H2 antihistamines administered. Ketotifen has been successfully used in many cases of urticaria. Tricyclic antidepressants such as doxepin and propranolol may be used when there is a stress component. In refractory cases dietary intervention, development of tolerance, calcium channel antagonist, a trial of anti-infectives or antimalarial therapy may be helpful.

A retrospective analysis of neonatal mortality rates in a period of 3 years was conducted in a NICU in Tehran. A total of 484 newborns were admitted in the said period of time. The overall mortality rate was 38.4%. This intolerable high rate of mortality seems to a nonstandard distribution of patients and improperly managed care organizations.

A 4.5-year old boy is presented with a left posterosuperior lateral neck mass, which was noticed since 2 years prior to admission. 3 antibiotic courses had brought no improvement. The two masses measured 3x4 and 2x2 cm located in the left posterior auricular area and anterosuperior border of the sternocleidomastoid muscle respectively, were mobile, non-adhesive with slight tenderness and without any inflammatory signs.In surgical investigation the parapharyngeal deep neck space was invaded by a yellowish-white tumor with its "worm-like" projections extended into jugular foramen superiorly, lateral oropharyngeal wall medially and supraclavicular area inferiorly.A total resection of the tumor was possible. Pathology showed a plexiform neurofibroma. The patient was discharged after 5 days in good general condition.

500 newborn infants with prolonged icterus in Kashan were scanned for congenital malfunction of the thyroid gland. 5 newborns (3 boys, 2 girls) were found to be congenitally hypothyroid. 3 cases had transient hypothyroidism. As a routine scanning for hypothyroidism in Iran is not being performed, evaluation of thyroid function in neonates with prolonged jaundice seems to be mandatory in order to be able to begin the treatment of the disease as early as possible.

The study population consisted of 500 healthy newly born babies admitted to the newborn nursery of Shari'ati Hospital in Tehran. All infants were icteric and their birth weight was 1500gr or more. None of the infants had been exposed to phototherapy or has had blood exchange transfusion before measurement. All measurements were obtained within the first two weeks of life.The investigation showed that a caudal progress of icterus corresponds to an increasing serum bilirubin concentration. Significant linear correlation (r=0.808) existed between yellow color of the skin and serum bilirubin concentration, furthermore, the relationship did not depend on age, sex, birth weight of infants and the rate of serum bilirubin rise.