ABSTRACT
Background: We sought to determine the clinical characteristics of pediatric esophagitis in southern Iran
Methods: This cross-sectional study was conducted over a 4-year period, from 2005 to 2009, in Nemazee Hospital, a tertiary healthcare center in Shiraz, southern Iran. We consecutively included all pediatric patients [<18 years] who underwent endoscopy in our center and had pathology-confirmed diagnosis of esophagitis. Data regarding the patients' demographic characteristics, comorbidities, and clinical findings were recorded using a questionnaire. All the patients underwent upper gastrointestinal endoscopy and biopsy of the esophagus, and the findings were recorded in the questionnaire
Results: We studied 125 children, comprising 61 [48.8%] girls and 64 [51.2%] boys at a mean age of 6.6 +/- 5.5 years. Repeated vomiting was the prominent symptom in our series, with it being reported by 75 [60%] patients, followed by fever in 35 [28%]. Erythema [33.6%], esophageal ulcer [11.2%], and whitish patch [8.0%] were the most common endoscopic findings, while reflux esophagitis [32.8%], chronic [6.4%] and acute esophagitis [5.6%], and candida esophagitis [5.6%] were the most common histological diagnoses. Only one [0.8%] patient was diagnosed as having eosinophilic esophagitis, aspergillosis, and graft versushost disease
Conclusion: Reflux was the most common cause of esophagitis in the pediatric population of southern Iran. Contrary to previous reports, the prevalence of eosinophilic esophagitis was far less than that estimated, while the prevalence of opportunistic infections was higher secondary to post-liver transplantation immunosuppression
ABSTRACT
This study aimed to determine the common etiologies and characteristics of lower gastrointestinal [GI] bleeding in children from Southern Iran. This five-year prospective cross-sectional study was performed from March 2006 to March 2011 in Nemazee Hospital. All pediatric patients [<18 years of age] who referred to our center with gross lower GI bleeding or two consecutive positive occult blood tests with at least a one-week interval were included in the study. Patients were categorized as neonates, infants, children and adolescents and the findings were reported separately in each group. Each patient underwent a colonoscopy and several mucosal biopsies were taken. Demographic and clinical information as well as colonoscopy and pathology findings were reported. Overall, we included 363 pediatric patients with a mean age of 71.9 +/- 58.4 months [range: 1-216 months]. There were 215 [59.2%] boys and 148 [40.8%] girls. The most common colonoscopy findings were sigmoid colon polyp in 91 [25.1%] patients followed by descending colon petechia in 78 [21.5%] patients, whitish rectal lesions in 45 [12.4%] patients, and sigmoid and rectal ulcers in 37 [10.2%] patients. Biopsy samples were non-specific in 96 [26.4%] patients. The most common pathological findings were juvenile polyp in 84 [23.1%] followed by lymphoid nodular hyperplasia in 55 [15.2%] and solitary rectal ulcers in 25 [6.9%] patients. We found that lower GI bleeding was more common among 2-10 year-old children and was rarely encountered in neonates. Hematochezia was the most common form of presentation followed by bloody diarrhea and occult blood. The most common colonoscopy finding was sigmoid colon polyp and the most common pathological finding was juvenile polyp.
ABSTRACT
In medicine, especially in the field of pediatrics, it is necessary to perform regular epidemiologic studies in each geographic region. We designed this study in Nemazee Hospital, Shiraz [the major referral pediatric center in Southern Iran], to determine the disease spectrum, the mortality and also the rate of matching final diagnosis with the initial impression in pediatric wards. All children older than 1 month [2731] who were admitted in Nemazee Hospital [except for surgical wards], from November 2005 to October 2006, were studied through questionnaire interviewing on admission and were followed till discharge or expire time. In some instances that final diagnosis or cause of death was unclear; we followed them through their files in clinics up to 1 year. Among 3057 admissions [related to 2731 patients], 56.8% were males [male to female ratio: 1.31]. Patients' age was 31 days to 25 years [mean: 5.16 years, SD: 4.98 years] and the significant portion was less than 2 years [1210= 44.2%]. Admission duration varied from 1 to 62 days [mean: 5 days, SD: 5.13 days]. The most common diseases were seizure disorder [315=11.1%], pneumonia [235=7.7%], febrile convulsion [136=4.79%] and gastroenteritis [128=4.18%]. 17.93% of admissions came out of Pars Province [18 Provinces] with digestive system [19.1%], infectious [18.5%] and nervous system diseases [15.0%] as the most frequent referred patients. In 90.6% of admissions final diagnosis was clarified in the hospital [ranged from 86.45% in infectious ward to 93.4% in cardiology ward] [P=0.01]. The total mortality rate was 5.30%; this rate was 9.49% for patients younger than 1 year and 5.0% in older patients [P<0.001]. The most common age of admission in pediatric wards was less than one year. The most common diseases were seizure disorder, pneumonia and gastroenteritis. Congenital heart disease, sepsis and pneumonia were the most common diseases leading to death