estimation of steroid responsiveness of idiopathic nephrotic syndrome in Iranian children

Idiopathic Nephrotic syndrome [INS] is the most common form of nephrotic syndrome [NS] in children with the potential of progression to end stage renal disease [ESRD]. INS is steroid-responsive in most children, but not all patients respond to it. The aim of this study was to determine the rate of steroid responsiveness in children with INS that referred to Children's Medical Center since 1995 to 2007. In as a cross sectional study, the medical records of all children with INS aged 1 to 15 years who were referred to our referral hospital was reviewed. All patients with onset of disease less than 1 year of age, spontaneous remission, secondary forms of NS associated with systemic diseases, and follow up duration of less than 12 months were excluded from the study. Patients were categorized into 6 groups: Group 1 needed biopsy prior to any treatment, group 2 non-relapsing NS, group 3 infrequently relapsing NS, Group 4 frequently relapsing NS, group 5 steroid dependent NS and group 6 steroid resistant NS. A total of 238 patients were enrolled in the study. Kidney biopsy was performed in 79 cases. Minimal change lesion [MCL] was the most common [36.7%] pathological diagnosis. Steroid responsiveness was found in 81.5% of all cases including: 96% of MCL [consisting of biopsy proven cases and presumed ones], 32% of focal and segmental glomerulosclerosis, 73% of diffuse mesangial proliferation and 58% of membranoproliferative glomerulonephritis patients. During minimal follow up period of 12 months, there were 194 patients in remission, 32 patients with active NS, and 12 patients in ESRD. Our study results showed that 81.5% of all patients, 96.2% of MCL and 32% of FSGS patients initially responded to steroid therapy

[ relation between serum cobalamine, folate, photostress recovery time and age related exudative macular degeneration]

Several studies have reported high prevalence of severe lack of cobalamine and Folate in aged people. The most important causes are: malnutrition, atrophic gastritis and drug use. Age related macular degeneration [ARMD] is a primary degenerative disorder of central retinal area with loss of visual acuity. Recent studies have shown a significant relationship between age related macular degeneration and lack of plasma level of Folate, red blood cells and cobalamine. This study was caried out to investigate the relationship between age related macular degeneration and plasma Folate, Cobalamine and photostress recovery time, in elderly population. This case - control study was done on 124 elderly population. The participants were collected from by cluster sampling in mashhad located in the Noth - East of Iran during 2006. The patients underwent eye examination including indirect ophthalmoscopy. Slit lamp examination and photostress recovery time for age related macular degeneration by an ophthalmologist. After blood sampling, plasma Folate, serum Cobalamine, were determined by RIA method [DRG kit]. The Mean +/- SD of cobalamin and folate in age related macular degeneration patients was 298.848 +/- 288.66 pg/ml and 5.543 +/- 3.58 ng/ml and in normal group was 310.775 +/- 531.38 pg/ml and 5.365 +/- 3.52 ng/ml. There was no significant difference between age related macular degeneration patients and control group. Photostress recovery time was significantly increased in patients with age related macular degeneration [P<0.05]. There was no significant relationship between photostress recovery time and Cobalamine and folate level. This study showed that serum cobalamin and folate non significantly is decreased in age related maucular degeneration patients, with increasing photostress recovery time, we can use this screening test for the dignosis of age related macular degeneration