[Evaluation of discontinuation of antibacterial prophylaxis in children with vesicoureteral reflux]

Vesicoureteral reflex is the most important factor in urinary tract infection. For prevention of urinary tract infection [UTI] in children with vesicoureteral reflux [VUR], prophylactic antibiotics are used, but maybe accompany with uncompliance of the parents and also it must use for long time. So, this study aimed at comporison of evaluation of discontinuation of antibacterial prophylaxis in children with VUR. This semi experimental study was done in 54 children with low grade VUR [1, 2] and higher than 5 years old. None of them have had any episode of UTI since last year. They were divided in two groups, continue and discontinue of prophylactic drugs and were followed for at least one year. Then the risk and episode of recurrent UTI were compared in 2 groups. The data were analyzed by SPSS and P<0.05 was determined as significant. Mean age of patients were 7.8 +/- 2.5 years. Forty two [77.8%] children were girls and others [22.2%] were boys. Five episode of UTI were diagnosed in first group and 7 episodes for second group [P>0.05]. Also the risk of recurrent UTI was 1.5 time in girls. According to this study, discontinuing of prophylactic drug in children with grade I and grade II of VUR and after 5 years old is safe and there isn't increased risk of recurrent UTI

Response to hepatitis B virus vaccination in haemodialysis patients with and without hepatitis C infection

The aim of this study was to determine the efficacy of hepatitis B virus [HBV] vaccination and the response to vaccine in individuals on haemodialysis with and without HCV infection. From April 2000 to September 2003 all haemodialysis patients referred to the haemodialysis department in a Babol hospital received 4 microg vaccine intramuscularly at 0, 1, and 6 months. All were negative for HBV infection markers [HBcAb, HBsAg and HBsAb]. Of 62 patients, 53 [85.5%] responded to vaccination and 26 [49.1%] were high responders. All individuals with HCV infection responded to vaccination. Duration of haemodialysis had no effect on response to vaccination

etiologies of hydronephrosis in neonates

Hydronephrosis is defined as abnormal dilation of pyelocaliceal system. There is a controversy about the etiologies and follow up in antenatal and neonatal hydronephrosis. This study was done to determine the etiologies of hydronephrosis in neonates who were born with this disorder. This study was carried out on all neonates who were referred to nephrology department and clinic of Amirkola children hospital, Babol Medical University from 1998 to 2004. In whom it was diagnosed hydronephrosis before or after birth; VCUG [voiding cystourethrography], IVP [Intravenous pyelography] and/or DTPA [diethylene triamine-pentaacetic acid] were used as needed. Then all data were evaluated according to their etiologies. Of 42 neonates, 38 [90%] were male and 4[10%] were female. Twenty-four [57%] and 17 [40%] patients had UPJO [ureteropelvic junction obstruction] and VUR [vesicouretral reflux], respectively. Twenty-six [62%] had been diagnosed before birth. The most common causes of admission were prenatal diagnosis [57%] and UTI [24%]. Among 54 hydronephrotic kidneys unites in 42 neonates, 30 [55.5%], 23 [42.5%] and 1 had VUR, UPJO and UVJO respectively. The most common cause of hydronephrosis in neonates was UPJO, It is needed to give more attention to male neonates who showed higher prevalence of hydronephrosis and also early prenatal sonographic diagnosis

Biliary pseudolithiasis during ceftriaxone therapy in children

Ceftriaxone is almost widely used in the treatment of pediatric infection and this is accompanied by some complications. The aim of this study was to determine the incidence of abnormal ultrasonography findings of gallbladder [pseudolithiasis or sludge] during ceftriaxon therapy and its relation to fasting, sex and G6PD deficiency. This quasi-experimental survey was done in Amirkola Children's Hospital, Babol, Iran. First ultrasonography was done before initiation of ceftriaxone therapy and it was repeated 24-48 hours after therapy and in the 5th, 7th, 10th and 14th day after the treatment. If abnormal finding was seen, ultrasonography was done weekly in the first two weeks until the side effect disappeared. Data was collected and analyzed by SPSS software. Of all 108 patients, who were between 3 months to 10 years old, 20 cases had abnormal findings in gallbladder [2 sludges and 18 pseudolithiases]. Length of fasting before ceftriaxone therapy had a positive relation with possibility of stone formation [p<0.005], but age, sex, duration of therapy and G6PD deficiency were not related [p>0.05]. In four cases pseudolithiasis was formed after only 1-2 doses of ceftriaxone. Shortest and longest periods of resolution of complications were 1 and 17 days respectively after formation. Incidence of pseudolithiasis or sludge formation during ceftriaxone therapy was 18.5% and fasting had a great effect on these complications

[ comparison between the effect of oral and intravenous prednisolone in prevention of acute rejection during the first two weeks of renal transplantation]

Induction of anti rejection therapy in renal transplanted patients is performed in various forms and there is a great difference in steroid administration. The aim of this study was to compare the effect of oral and intravenous prednisolone [Methyl prednisolone] in prevention of rejection during first two weeks of hospitalization. In this clinical trial study during one year in a randomized trial, 60 patients in two groups [31 for parenteral route and 29 for oral route] were studied for rate of rejection. Also, according to gender, age [less or more than 35 years old], clinical manifestations, time of rejection [first or second week] and the results of isotope scan [DTPA], the findings were assessed. It was found eight cases of rejection in oral group and six cases in parenteral, one without any significant difference. Also, there was no significant difference between two groups for other parameters. The only meaningful difference was for isotope scan that was true for all rejections of the parenteral group but in only 25% of rejections of the oral group, it showed the problem [p=0.049]. In short term, there is no significant difference between two methods. But because sample size was small, this study should be repeated with larger one

[Escherichia coli and drug sensitivity in children with urinary tract infection]

Introduction: Urinary tract infection [UTI] is the most common bacterial infection in children. By the age of seven years, 8.4% of girls and 1.7% of boys had at least one episode of UTI. With suitable treatment, risks of complications are decreased. E.coli is the most common cause of UTI, but sensitivity of this microorganism is different in the world

Objective: Therefore this study has been done to determine the sensitivity of E.coli to drugs in this area

Materials and Methods: In this study, all children over one month old with UTI that were admitted in AmirkolaChildren Hospital were evaluated, and the resistance of E.coli to common drugs that were used for treatment of UTI were evaluated

Results: E.coli infected 59.5% of children, 41% of boys and 68% of girls with. The most resistance to Ampicilin was 96% and the least resistance to ceftriaxon was 6%. Eighty-one percent infected with E.coli were resistant to co-trimoxazol

Conclusion: According to this study, resistance of E.coli to the most drugs that were used for treatment of UTI was different in comparison to other area which requires attention