Combination of citicoline and physiotherapy in children with cerebral palsy

The most common cause of physical disability in children is cerebral palsy. This study was aimed to evaluate the effect of citicoline in combination to physiotherapy versus physiotherapy alone, to improve the functional outcome in pediatric cerebral palsy. The clinical trial was performed on 50 pediatric patients aged 18-75 months with spastic diplegia or quadriplegic cerebral palsy. Patients were assessed in two groups: case group, under treatment, using injection of citicoline [10 mg/kg] every other day for 3 months and physiotherapy. Gross motor function classification system [GMFCS] levels were assessed in all patients before and after treatment. Patient's mean age was 38.7 +/- 17.2 months, and 52% were girls. Differences in the frequency of GMFCS levels between groups were not statistically significant, before [P = 0.09] and after [P = 0.47] treatment. In case group improving in GMFCS, level was occurred in 9/11 with level 2 to level 1, 3/5 with level 3 to other levels and 3/7 with level 4 to other levels. In the control group improving in GMFCS, level was occurred in 3/9 with level 2 to level 1, 3/10 with level 3 to other levels, and 2/4 with level 4 other levels. GMFCS level in 64% of cases was improved, whereas in control group, 32% was improved [P = 0.02]. Results demonstrated that citicoline in combination to physiotherapy appears to be a promising agent to improve gross motor function in patients with cerebral palsy versus physiotherapy alone. Although, further studies are need to be done

effect of Ramadan fasting on biochemical substances relating to the renal and bone function of fasting pregnant women, 2011-2012

The effect of fluid and food restrictions on biochemical substances relating to the renal and bone function of pregnant women is not well defined. The purpose of this study is to evaluate the effects of fluid and food restriction on the following substances in pregnant fasting women during Ramadan: blood urea nitrogen [BUN], creatinine [Cr], calcium [Ca], phosphorus [P], and alkaline phosphates [ALP]. Thirty fasting pregnant women voluntarily participated in this prospective descriptive study. The serum levels of BUN, Cr, P, and ALP were measured at the baseline, and on the 7th, 14th, and 28th days of Ramadan; the measurements were also performed 2 weeks after this month. The statistical significance was defined as P<0.05 and the analyses were performed using SPSS version 11.5. As to the results of the present study, the weight and body mass index [BMI] of women didn't change during the experiment. BUN and Cr increased significantly by the 2nd week of Ramadan; however, no differences were observed between BUN and Cr values at the end of Ramadan and two weeks after it [P>0.05]; also, Cr didn't change during Ramadan and 2 weeks after it [P>0.05]. Moreover, no differences in P and ALP levels were noticed between the end of Ramadan and two weeks after it [P>0.05]. According to this study, there is no sufficient evidence regarding the adverse effects of Ramadan fasting on biochemical substances relating to the renal and bone function of pregnant fasting women

Prevalence and severity of anemia in pediatric hemodialysis patients

To determine the prevalence and severity of anemia, and to identify independent predictors for anemia in children on hemodialysis. We conducted this cross sectional study on 25 children aged 7?20 years receiving hemodialysis from September 2005 to January 2006 in Isfahan University of Medical Sciences, Isfahan, Iran. A total of 22 [82%] patients had hemoglobin [Hb] level of <11 g/dL [anemia] and 12 [48%] patients had Hb values <8 g/dL [severe anemia]. The mean age was 15.5 +/- 3.7 years. Mean time on hemodialysis was 20.44 +/- 15.25 months. Anemia was more common and severe among children who were on dialysis <6 months. There was an inverse relation between severity of anemia and duration of hemodialysis [r=-0.465, p=0.019]. Nearly all patients were treated with recombinant human erythropoietin [rHuEPO]. Children with severe anemia received a slightly higher dose of erythropoietin [r=0.202 p=0.09]. There was a correlation between serum albumin and Hb level [r=0.511, p=0.01]. Intact parathyroid hormone [iPTH] levels were >200 pg/mL in 16 patients [66%] and >400 pg/mL in 9 patients [37.5%]. There was a reverse correlation between iPTH level >200 pg/mL and Hb level [r=-0.505, p=0.046]. The prevalence of anemia in our study appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients who were on dialysis <6 months and with low albumin and severe hyperparathyroidism

Impact of maternal ramadan fasting on growth parameters in exclusively breast-fed infants

There are many advantages of breast milk for infants. The impact of Ramadan fasting of breast-feeding mothers on their exclusively breast-fed infants' growth is still not clear. The objective of this study is to determine the impact of maternal Ramadan fasting on growth parameters of exclusively breast-fed infants. This cohort study was conducted during Ramadan and five months after Ramadan on 116 healthy, exclusively breast-fed infants aged 15 days to 6 months. 36 infants, whose mothers fasted throughout Ramadan [case group] and 80 infants, whose mothers did not fast [control group], were enrolled in the study. All infants underwent periodic physical examinations, twice in Ramadan, 3 times in the second month and twice monthly in the next 4 months. The data analyses were done using a repeated measure analysis of variance. Statistical significance was defined as P<0.05. Analyses were performed using SPSS statistical package and repeated measures ANOVA. All growth parameters increased during the study period [P< 0.05], rate of increase being the same for both groups [P>0.05]. There is obvious increasing trend for all growth parameters; this trend depends on age and is almost similar for both groups. Ramadan fasting by breast-feeding mothers did not adversely affect the growth parameters of exclusively breast-fed infants in short-term

Prevalence and severity of anemia in pediatric hemodialysis patients; a single center study

To determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis and to identify independent predictor for anemia in children on hemodialysis. A cross sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7?20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan, Iran. A total of 22 [82%] patients had hemoglobin level of<11 g/dL [anemic] and 12[48%] patients had hemoglobin values<8 g/dL [severe anemia]. The mean age for these patients was 15.5 +/- 3.7 years and the mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was a inverse relation between severity of anemia and duration of hemodialysis [p=0.019, r=-0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P=0.09, r=0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [p=0.023]. There was a correlation between serum albumin and hemoglobin level [r=0.511, P=0.01]. Parathyroid hormone [PTH] levels was>200 pg/ml in 16 patients [66%] and>400 pg/ml in 9 patients [37.5%]. There was a reverse correlation between PTH level>200 pg/ml and hemoglobin level [r=-0.505, P=0.046]. The prevalence of anemia in children on hemodialysis in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months], low albumin and severe hyperparathyroidism

Prevalence and severity of anemia in pediatric hemodialysis patients, a single center study

This study was conducted to determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis, and to identify independent predictors of anemia in children on hemodialysis. This cross-sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7+20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan. A total of 22 [88%] patients had hemoglobin levels of <11 g/dL [anemic] and 12 patients [48%] had hemoglobin levels of <8 g/dL [severe anemia]. The mean age of these patients was 15.5 +/- 3.7 years. Mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was an inverse relationship between the severity of anemia and duration of hemodialysis [P = 0.019, r = - 0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P = 0.09, r = 0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [P = 0.023]. There was a correlation between serum albumin and hemoglobin level [r = 0.511, P = 0.01]. Intact PTH levels were >200 pg/ml in 16 patients [66%] and >400 pg/ml in 9 patients [37. 5%]. There was a reverse correlation between intact PTH level >200 pg/ml and hemoglobin level [r = -0.505, P = 0.046]. The prevalence of anemia in hemodialysis children in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months] and in those with low albumin and severe hyperparathyroidism