Incomplete and atypical presentation of kawasaki disease: a report of five cases

Kawasaki disease [KD] is an acute febrile vasculitis mainly affecting children, with two types of presentation, namely, typical and atypical. It is the most critical cause of coronary artery complications and if not treated on time and appropriately, complications may occur in up to 25% of the patients will get. This study reports five rare cases of incomplete KD Who has been admitted with diagnosis of Bacterial Meningitis, Staphylococcal Septic Arthritis, Herpetic Gingivostomatitis, Viral Hepatitis and prolonged Fever. Since there was no response to treatment, with impression of Atypical Kawasaki patient has been evaluated and treated. Atypical presentation of the disease led to misdiagnosis and prolonged process of diagnosis. Due to the increasing number of atypical Kawasaki cases and the probability of coronary artery disorder, it is recommended that atypical Kawasaki be considered in the differential diagnosis of the disease in the patients with fever of over five days without any clinical cause

[Evaluating the clinical and paraclinical aspects of Kawasaki patients referred to Bandar-Abbas children hospital during 2008-2011]

Kawasaki disease [KD], a systemic vasculitis of unknown etiology with an increasing incidence in childhood, can be the leading cause of the acquired heart diseases. This study aimed to describe the demographics and clinical features of KD patients referred to Bandar-Abbas children hospital. This descriptive case series study was performed on 83 KD patients referred to Bandar-Abbas children hospital during 2008-2011. Diagnostic criteria were fever, skin rash, bilateral noninfectious conjunctivitis, erythema and desquamation of extremities and alterations in the mouth and pharyngeal mucosa. Age, sex, clinical and paraclinical changes of the patients as well as the seasonal prevalence of the disease were evaluated. Among 83 cases, 60 [72.3%] were male and 23 [27.7%] female and. The age range was from 3 months to 13 years. The KD disease occurred more frequently in spring and winter. Fever was seen in 100%, extremity involvement in 54.1% [45], conjunctivitis in 46.1% [39], skin rash in 55.4% [46], and neck lymphadenopathy in 25.3% [21] of the cases. Moreover, the laboratory findings included leukocytosis in 80%, thrombocytosis in 43.6%, abnormal ESR in 73.6% and cardiac sequelae in 11% of the cases. To prevent cardiac sequelae of KD disease, diagnostic work up is suggested in children with prolonged fever unresponsive to antibiotics

Strongyloides stercoralis: the most prevalent parasitic cause of eosinophilia in Gilan province, northern Iran

Eosinophilia occurs in a wide variety of situations such as parasitic infections, allergic disorders, and malignancies. Most cases of eosinophilia of parasitic origin, especially those with a tissue migration life cycles consists of human infections by helminth parasites. The aim of present study was to determine the parasitic causes of eosinophilia in patients in a major endemic area of human fascioliasis in Gilan Province, northern part of Iran. One hundred and fifty patients presenting with an elevated eosinophilia attending infectious disease clinics with or without clinical symptoms, were examined. After clinical history evaluation and physical examination, coprological examinations were performed using the formalin-ether and the Kato-Katz techniques for detection of Fasciola sp. and intestinal parasites. Forty two percent of patients were infected with S. stercoralis, nine [6%] were found to be infected with Fasciola sp. while only a single patient [0.7%] were infected by Ttrichostrongylus sp. Local clinicians in Gilan may consider eosinophilia as a suggestive indication for diagnosis of human fascioliasis, especially when microscopic stool and/or serological tests are negative. Based on the results, local physicians should consider S. stercoralis as the potential causes of eosinophilia in patients with elevated eosinophilia

Analgesic effect of alcoholic datura stramonium L. seed extract on streptozotocine-induced diabetic male rats

Hyperalgesia and allodynia are two of the most critcal debilitating symptoms in patients with diabetes mellitus. In this study, the threshold of the acute and chronic pain was measured using formalin and hot plate tests in male rats. In another experiments, we studied the anti-hyperalgesic effect of alcoholic Datura seed extract in diabetic rats. The aim of this study was to investigate the effect of alcoholic Datura stramonium seed extract on hyperalgesia induced by diabetic mellitus. Experimental animals were made diabetic [n=12-15] using a single dose of streptozotocin [STZ, 60 mg/kg, i.p]. After 30 days their pain threshold in each test group was compared with control group [n=12-15]. Our statistical data analysis showed that the acute and chronic pains arising from formalin and hot plate tests were markedly augmented due to diabeties mellitus. In additional experiments we assessed the acute and chronic pain in groups 1-control+extract [n=12-15] and 2-diabetic+extract [n=12-15]. The extract was administered for 30 days every other day. The results showed that the extract [over than 50 mg/kg/BW] could significantly diminish the augmented acute pain in hot plate and formalin tests. In contrast, chronic formalin pain did not change by the extract in dosage of 50 mg/kg/BW and over. The acute pain in hot plate and first phase of formalin tests were significantly augmented due to diabetes mellitus. Also, it was shown that the Datura seed extract could have diminished the augmented acute pain in both tests, but chronic formalin pain could not be influenced by doses of the extract higher than 50 mg/kg/BW