Cytomegalovirus colitis in a 10 year-old girl after kidney transplantation

Cytomegalovirus is an important infection in kidney Transplantation. Isolation of the CMV virus or detection of its proteins or nucleic acid in any body fluid or tissue specimen is defined as [CMV infection]. A 10-year-old girl was admitted frequently for vomiting and colicky watery diarrhea starting one month after renal transplantation from a non-relative living donor. Cr, BUN, serum electrolytes and also liver function tests were normal. Anti CMV IgM titer was negative before and after transplantation. On colonoscopy large aphthous like lesions were detected in the colon. CMV PCR of the lesion was strongly positive [>2000 copies/ml]. The patient received Ganciclovir. Usually CMV infected patients present with renal dysfunction after renal transplantation but other organ involvements must not be ignored. We report a patient presenting only with intestinal signs and symptoms of CMV infection

Comprehensive assessment of the relative frequency of sleep disorders in migraine and non migraine in 6- to 14-year-old children

Headaches are common during childhood. In addition, sleep disorders are common problems in children, too. Although it is commonly thought that headache and sleep problems are related, there is not enough evidence to confirm this relationship. Finding evident relations between these problems would help practitioners a lot to make earlier diagnosis and plan treatment modalities for both problems as soon as possible. This study aimed to assess the relative frequency of sleep disorders in migraine and non migraine children. In a cross sectional study, 148 children were enrolled in migraine [60] and non migraine [88] groups. They were aged 6 to 14 years. Migraine group consisted of patients who had definite migraine according to HIS [International Headache Society] criteria. Ten sleep problems [snoring, nightmares, sleep walking, sleep talking, bedtime struggle, bruxism, sweating during sleep, excessive daytime sleepiness, insomnia in early or mid night and sleep apnea] were compared between 2 groups. Fisher exact and chi square tests were used for making comparisons. We found relationships between night sleep and daytime headaches. Some of these relationships were easy to explain but for some others, finding complicated explanations are necessary. Our findings showed that bruxism, sleep walking, early and midnight insomnia was significantly higher in migraine children. There was a common etiology for headache and sleep disorders. Also, parents and migraine children were well familiar with the effect of relaxation on decreasing migraine episodes. They provided appropriate facilities for night sleep for this reason. We found relationships between night sleep and daytime headaches. Some of these relationships were easy to explain but for some others, finding complicated explanations are necessary

[ comparative study of eradication of H. pylori infection in dyspepsy patients using a low dose and a high dose triple therapy with clarithromycin, amoxicillin and Omeprazole]

Helicobacter Pylori is a major cause of diseases of the upper gastrointestinal tract. Having considered the high prevalence of the infection, an ideal regimen has been a matter of debate by the scientists for many years. This study evaluates the efficacy of the more tolerable regimens in the eradication of the bacteria and the effect of the treatment on the gastric symptoms. This parallel randomized control trial study included 560 patients with dyspepsia admitted to Imam Reza Hospital, Kermanshah University of Medical Sciences between 2006-2007. Patients who were identified with dyspepsia based on Rome II and were candidate for endoscopy were examined for H. pylori infection through rapid urease test and histology. Those proven positive were assigned at random to one of the two groups of high dose [Omeprazole 20mg, Clarithromycin 500 mg, and Amoxicillin 1000 mg] and low dose [Omeprazole 20 mg, Clarithoromycin 250 mg, Amoxicillin 500 mg] treatment regimens. They all went under treatment every 12 hours for a period of seven days. 4 weeks after the therapy, eradication success rate and gastric symptoms were evaluated using the same protocol. Side effects were recorded through a questionnaire. From the total of 560, 480 were proven positive for H. pylori [85.7%]. Eradication success rate was the same for the two groups [87.5%]. History of pyrosis before the treatment was statistically associated with eradication failure at the end of the treatment. Symptoms such as pyroisis were significantly reduced. General well being was also improved but the improvement was not statistically significant. Mild side effects were observed in 11% of high and 8% of low dose treatment regimens. However they were well tolerated and did not result in drug withdrawal. Eradiation success rate of one-week low dose treatment regimen was within the acceptable level. Eradication also reduced pyrosis episodes. Symptoms were improved even when the therapy did not result in eradication