Contact tracing of a 15-year-old girl with smear-negative pulmonary tuberculosis in Tehran

Early detection of tuberculosis [TB] cases and supervised treatment are vital for control of the disease. To assess TB transmission from a sputum smear-negative pulmonary TB case, the contacts of a 15-year-old Iranian girl diagnosed with smear-negative TB in 2010 were traced. In all, 52 classmates and close friends and 15 school staff were screened by tuberculin skin test and chest X-ray. Those with a positive skin test or abnormal chest X-ray were further evaluated by chest spiral computed tomography [CT] scan and triple gastric washing. All classmates and close friends were Iranian and female. Of the 52 girls, 17 [32%] had latent infection [either positive skin test or abnormal chest X-ray] and 3 [5.7%] had active TB [abnormal CT or positive culture additional to positive skin test or abnormal X-ray]. None of the staff had abnormal findings. Contact tracing should be considered for contacts of all children with symptomatic pulmonary TB, even those who are smear-negative

[Caries status in asthmatic children receiving anti-asthma inhalers]

Asthma is known as a probable risk factor for dental caries; however there is some controversy in this issue. Present study is designated to evaluate the caries status in asthmatics compared to non asthmatic controls. In addition probable factors and co-varieties associated with dental health were also investigated. Forty five asthmatics and 46 healthy controls aged 6 to 12, entered this case-control study. There was a history of asthmatic drugs for at least one year including inhalators of beta-agonist, Corticosteroid or both. DMFS Index recorded according to visual- tactile method. Stimulated saliva was obtained and microbial count performed as CFU/ml for S. Mutans and Lacto Bacilli. Data analysis performed according to t-test, Mann-Whitney, Kendall's Rank Correlation and Ridge Regression. Mean DMFS Index was 3.98 +/- 2.53 in asthmatics and 4.3 +/- 2.81 in healthy controls. The difference was not significant caries. Final Ridge Regression showed significant correlation between drug regimen and caries [P=0.001, r=0.76]. Those received beta agonist along with protective corticosteroid had significantly less caries compare to beta agonist alone [P<0.001]. S. Mutans count revealed significantly higher in controls. Lactobacilli count was not significantly different. DMFS index was not significantly different. Inhaled corticosteroids in asthmatics leads to better control of disease process, and reduce dental caries maybe because of reduced beta 2-agonist consumption as a potent xerostomic

[Abdominal mass in a 14-year-old girl with cystic fibrosis]

Cystic fibrosis is an inherited multi-system disease, characterized by respiratory and digestive system disorders. We describe a 14-year-old cystic fibrosis patient with chronic abdominal pain and a right lower quadrant mass. Diagnostic laparotomy was performed and pathological results revealed the etiology of mass as phelgman. In patients with cystic fibrosis, a lower quadrant mass may be difficult diagnostic problem Most frequently, it is due to a distal intestinal obstruction syndrome, but the possibility of intussusceptions and appendiceal abscess should also be considered. It seems that finding the cause of an abdominal mass in cystic fibrosis patients needs a closer attention

Impact of anti-tuberculosis therapy on plasma zinc status in childhood tuberculosis

This study compared plasma zinc levels in 15 children with active pulmonary tuberculosis, 15 malnourished children and 15 healthy children. Mean plasma zinc concentrations in children with tuberculosis [71.7 microg/dL] were not significantly different than the other 2 groups [72.5 and 76.9 microg/dL]. The zinc status of the children with tuberculosis was evaluated after 2 months and 4 months of DOTS therapy. The serum zinc level during anti-tuberculosis therapy decreased after 1 month and then recovered to the initial level after 4 months of treatment

Primary and acquired drug resistance in childhood tuberculosis

This study determined the resistance pattern of Mycobacterium tuberculosis to 4 first-line anti-tuberculosis drugs in children with pulmonary tuberculosis at the Iranian National Research Institute of Tuberculosis and Lung Diseases from 1999 to 2004. There were 350 children with positive cultures over the study period: 7 [2%] were resistant to at least one of the 4 anti-tuberculosis drugs. Primary resistance was detected in 4 cases and secondary resistance in 3 cases. Most cases [6] were among Afghan refugees. Resistance to rifampicin both in primary and secondary resistances was high, showing that children in the Islamic Republic of Iran face the threat of drug-resistant tuberculosis transmission

[Efficacy and safety of inhaled steroid in children with asthma: a comparison of fluticasone propionate with beclomethasone]

Inhaled corticosteroids are indicated in children who have more than mild persistent asthma. Fluticasone propionate is a newer corticosteroid agent with more potency compared with previous generations. However, still few dose ranging studies have investigated optimal dosing of inhaled corticosteroids particularly in children regarding the tolerability and safety of the drug. The primary purpose of this study is to compare and evaluate the efficacy and safety of Fluticasone to Beclomethosone in the treatment of childhood asthma that is unresponsive to non-steroidal medications and also in persistent, moderate and severe asthma. 70 children, aged 6 to 14 years, were enrolled in the open randomized trial of parallel group design. 52 children with moderate, severe or persistent asthma received Fluticasone 100microg twice daily for 12 weeks compared with 18 asthmatic children on Beclomethasone 200microg daily. The outcome was assessed by data on questionnaires, changes in clinical symptoms, results of peak flowmetery [PEFR]. More over safety was assessed by 24 hour urinary cortisol measuring at the beginning of the study and comparison of the data with urinary cortisol at the end of 12 weeks. Of 70 children, 13 [18.6%] had a history of contact with pets during their life. At the beginning of the study in Beclomethasone group the following signs and symptoms were found: cough 88.9%, post exercise cough 88.9%, dyspnea 66.7% and wheeze 72.2%; however, these figures were as follow in Fluticasone group: 75%, 76.9%, 46.2%, and 59.6%, respectively. After 3 months of therapy they have been changed as follow 16.7%, 11.1%, 11.1% and 16.7%, respectively, in Beclomethasone group and 15.4%, 11.1%, 1.9% and 3.8%, respectively, in Fluticasone group. Data showed a better improvement in clinical signs of patients with Fluticasone [p<0.05]. Pulmonary function test revealed a better lung function in Fluticasone group [p<0.05]. In addition 24 hour urinary cortisol level were measured at the beginning and after 12 weeks of therapy and it was within normal range for both drugs. Fluticasone was associated with better improvement in lung function and controlled asthma symptoms much better than Beclomethasone, therefore, it is efficient in the treatment of persistent, moderate and severe asthma in children