Iranian Journal of Pediatrics
Year:2003 | Volume:13 | Issue:2|Papers Count:12

Thyroid hormones have critical role in growth and development. Many factors including anti-convulsant drugs affect thyroid hormones. Anti-convulsant drugs are used commonly in children due to high prevalence of seizure disorders in this age group. In order to evaluate thyroid function tests correctly in these children understanding of drug effects is necessary.In this study, thyroid function tests of 55 anti convulsant drugs recipients with mean age of 8.88±3.9 year are compared with tests of age and sex matched control group including 42 non drug recipient normal children. Hypothalamic-pituitary axis was assessed with TRH test in 19 patients.Serum T4 level of patients were significantly lower than those of control group (p=0.005). Serum levels of TSH, T3, T3RU and FT4I had no significant difference between the two groups and all of the patients were clinically euthyroid. Hypothalamic-pituitary axis was intact in all of TRH tested patients.In children receiving anticonvulsant drugs the serum TSH level is a good indicator of true thyroid function rather than T4 level.

Typhoid fever (enteric fever) is one of the most important infectious diseases in developing countries which is also frequently seen in Iran. The main route of transmission is via consumption of contaminated food and water and contaminated hands. The most definite method of diagnosis is blood, urine, bone marrow and stool cultures. In some cases, due to antibiotic abuse, cultures may be negative; in such cases, Widal test can be the simplest diagnostic test. The degree of positivity of the Widal test depends on environmental conditions. Therefore, in countries like Iran, it is necessary to determine the basal antibody titer so that it can be used as a reference value. This study was performed in 2002-2003 on 1745 healthy primary school children who were selected from the 19 areas of Tehran. Anti O antibody was negative (≤1/20) in 1710 cases (98%) and positive (>1/20) in the remaining 2%. Anti H antibody titer was less than 1/20 in 1718 cases (98.5%) and more than 1/20 in the remaining 1.5% of cases.

Two hundred mothers, who had children in the age of vaccination, were interviewed to measure their degree of awareness of the civil vaccination program. There was a significant and direct relation between the degree of education and awareness of civil vaccination program (p<0.05). Nevertheless, mother's awareness of vaccination program in spite of increased level of their education is not satisfying. Health centers were the main source of information for mothers in this regard.

This study is designed to determine the injury rate in Iranian Shotokan karate championships in children and adolescent age groups.All of the injuries were recorded in national competition in 2004. Details of ages, weight, year of karate experience and kind and location of injuries were obtained.Thirty injuries were recorded in this competition. The overall rate of injury was 0.25 per bout and 0.29 per competitor. Fourteen (43.7%) injuries were to the limbs, 31.3% to the head and neck and 25% to the trunk. Only four competitors were unable to continue fighting as a result of their injuries, one of them due to fracture.

The tooth eruption is clearly quite complex, and many different mechanisms are undoubtedly involved. Low birth weight (LBW) infants (birth weight 2500 g or less) are prone to many serious medical problems during the neonatal period which may affect the development of oral tissues. This cohort study evaluated the eruption pattern of primary teeth in 26 LBW infants and 26 normal birth weight infants. Wilcoxon rank sum test and student t-tests were used for comparison of two groups. Initial eruption sequence in both groups was the same, with the two lower central incisors erupting first.

Since 1950 with the extensive use of antibiotics in medicine and agriculture industries, resistant organisms are growing. The rapid evolution of resistance has limited the duration of the effectiveness of specific agents against certain pathogens. It urges us to expand our knowledge of antibiotic resistance of different organisms in order to maximize continued efficacy of the antibiotic.Usage of appropriate antibiotic in every region depends on the results of antibiotic resistance of organisms in that region. In this article the results of 320 cases of positive culture and their antibiogram, from children admitted to pediatric and neonatal ward in Imam Khomeini hospital in 1381 is reported.Commonest organisms in blood culture were Staphylococcus epidermidis (25%), in CSF: Staphylococcus Aureus (30%) and Staphylococcus epidermidis (30%), in urine: E.coli (60%) and in secretions Staphylococcus aureus (35%). Unfortunately because of irrational antibiotic usage, resistance to ampicillin (60-95%) and co-trimoxazole (55-100%) was very high. Also resistance to some other antibiotics was high.

Neonatal hypocalcaemia is common. The etiology is probably multifactorial. This retrospective case- series study evaluated early and late neonatal hypocalcaemia in 796 neonates. 267 of neonates were hypocalcemic. We found significant statistical relationships between early and late onset hypocalcemia and asphyxia, (p=0.043, p=0.027), prematurity (p=0.004, p=0.040), cold seasons (late onset: p= 0.010), diabetic mother (p=0.0392). There was no significant relationship between hypocalcaemia and weight or sex in neonates and pregnancies.

Facial nerve palsy, a very rare complication of Kawasaki syndrome, has been reported in only 25 patents. None of the 25 previous reported cases with this complication was treated with IVIG. We treated a 24-month-old boy with bilateral coronary artery aneurysms due to Kawasaki syndrome. In our patient, whom we treated with Aspirin and IVIG, duration of disease was 7-9 days. He developed marked unilateral peripheral facial nerve palsy on day 3 of illness. This treatment led to complete resolution of facial nerve palsy within 48 hours. Review of pervious cases demonstrates that children with Kawasaki–associated facial nerve palsy have more than twice the risk for coronary artery aneurysm (52% vs 25%) as that of children without facial nerve palsy.Unexplained facial nerve palsy in young children with a prolonged febrile illness should provoke consideration of Kawasaki syndrome and Echocardiography to exclude coronary artery aneurysms. Although facial nerve palsy appears likely to be resolved in all patients surviving the acute phase of Kawasaki syndrome, treatment with IVIG appears to shorten considerably the time for full recovery and provides an important clue to the mechanism of neurological injury in this illness.

Holt-Oram syndrome (HOS) is an autosomal dominant disorder, characterised by congenital heart and upper limb malformations. It is a rare disorder, however, there are several groups working on this syndrome worldwide since the genes involved in this syndrome are important to study on the cardiogenesis and development of hand.Although genetically heterogeneous, HOS is frequently linked to the TBX5 gene. To review the molecular genetics of HOS, this article has been written to highlight the importance of this syndrome and have more attention of pediatricians, cardiologists, heart surgeons, orthopedists and geneticists

After about two centuries from the famous monograph written by Jean-Marc Gaspard (French physician) and about six decades after the first descriptions of autism published by Dr. Leo Kanner, autistic children have a yet unexplored, strange world full of mysteries not only for the parents but also for the physicians involved in the management of these children. The mean age of diagnosis of a child with autistic spectrum disorder is as late as six years even in well-developed European countries.Pediatricians are the first who visit these children and they are also actively involved in their health care. What is the actual role of a pediatrician in a logical and practical approach to the problem? And also how could we promote early diagnosis?In the following review article, I am going to answer these questions, mainly by introducing a new checklist for early diagnosis as well as a guide for further requesting paraclinical examinations for the children with autistic spectrum disorders.