[Prevalence of adenovirus infection and the dominant serotype among patients with acute gastroenteritis in Tehran between May 2008 and May 2009]

Adenoviruses are double-stranded DNA and non-enveloped viruses. It causes different diseases in human through respiratory, urinary and gastrointestinal tracts. Interestingly, more than fifty serologic types of human adenovirus were distinguished and just serotypes 40 and 41 cause gastroenteritis in human. The purpose of this study was to evaluate the prevalence of adenovirus infection in patients with acute gastroenteritis in the population of Tehran. Between May 2008 and May 2009, 293 stool samples were collected from patients with acute gastroenteritis. After DNA extraction, PCR procedures were performed, using designed primers. Positive adenoviruses samples were analyzed by the software and their serotypes were determined. 6 positive samples of 293 patients recruited to the hospital were children less than 5 years old. Additionally, they were diagnosed as serotype 41 of adenoviruses F group. According to our results, serotype 41 of adenovirus was an important cause of gastroenteritis in less than 5 years old children in population of Tehran

Survey on childhood solid malignant tumors in cases admitted to Mofid pediatric hospital from 1996-2010: a single-center study

As children comprise a considerable proportion of our population, the importance of local epidemiologic research and geographic and racial differences can't be disputed on childhood malignancies. In this descriptive retrospective study, we extensively reviewed the medical records of patients younger than 15 years of age, diagnosed with solid malignant tumors, from 1996 to 2010, using the last version of International Classification of Childhood Cancers. In our study the order of incidence of solid malignancies was relatively similar to the other national studies, with lymphomas and Central Nervous System [CNS] tumors as the most common, followed by Sympathetic Nervous System [SNS] tumors, soft tissue sarcomas and renal tumors. The peak age of diagnosis was between 1 and 4 years old. In our study, the overall male to female ratio was 1.38, with a trend towards male dominance in the older age groups. We also observed a disturbing trend of childhood solid malignancies. The total number of cases almost doubled from 2009[54[6.9%]] to 2010[96[12.2%]] .This trend was particularly detected in CNS and SNS tumors. Further analysis showed that malignant CNS tumors had played a more pronounced role in this change. Changes in trends of some tumor categories have illustrated a desperate need to further research in regional and national levels. Also the gathered data can be used to make more accurate programs for a better control of cancer and to help policymakers to allocate more evidence-based resource for hospitals

Prevalence of sapovirus infection among infant and adult patients with acute gastroenteritis in Tehran, Iran

This study investigated the prevalence of sapovirus infections in patient with acute gastroenteritis in Tehran, Iran. Sapovirus, a member of the family Caliciviridae is one of the major causative agents of viral gastroenteritis affecting both children and adult individuals. There isn't enough data about prevalence and genotypes of sapovirus infection in Tehran, the capital city of Iran. A total of 42 fecal samples were collected from patients with acute gastroenteritis from May to July 2009. RT nested- PCR was performed for screening. To genotype the sapovirus isolates, some positive samples were subjected to phylogenetic analysis by sequencing of fragments of viral capsid gene region. Sapovirus was detected in 5 of 42 stool specimens from patients with acute gastroenteritis. Saporvirus detected in this study was clustered into only one distinct genogroup I/2. Sapovirus GI/2 was predominant. Our results show that among the studied viruses responsible for this disease, sapovirus was a major viral isolate virus

Immunohistochemical detection of p53 protein expression as a prognostic factor in wilms tumor

Histological typing, especially the evidence of anaplasia and stage of the tumor are two major prognostic indicators in Wilms tumor, but some genetic factors have recently been noted. Mutations in TP53, which is a tumor suppressor gene, have been demonstrated to be associated with poor prognosis in some malignancies. There are also few studies which have confirmed the correlation between p53 protein overexpression and advanced course in Wilms tumor. This study was conducted to determine the correlation p53 immunoexpression and prognosis and outcome of Wilms tumor. The overexpression of p53 in 44 specimens of children [26 boys and 18 girls] with Wilms tumor [median age, 36 months; range, 4 to 96 months] was assessed in Mofid Children's Hospital, Tehran, Iran. The overexpression of p53 was determined by immunohistochemistry with antihuman p53 antibody. A positive immunostaining for p53 was detected in 24 of the 44 cases [54.7%]. The grade of the tumor and anaplasia were associated with p53 positivity, but there was no association of p53 with the tumor stage. In comparison to p53 negatives, week-moderate and high p53-expressing tumors had significantly decreased the overall survival [hazard ratio, 3.75 and 8.61; P=.05 and P=.01, respectively]. Overexpression of p53 protein in Wilms tumor is an indicator of poor pro gnosis, because it is correlated with unfavorable histology tumors and a shorter survival period

Can we rely on frozen sections of a rectal biopsy for one-stage trans-anal pull-through operation in Hirschsprung's disease?

Successful results after one-stage trans-anal pull-through [OSTAPT] operation for Hirschsprung's disease [HD] depend on accurate identification of the aganglionic segment in intra-operative frozen section [FS]. Misinterpretation of the findings of the rectal biopsy is an anxiety-evoking pitfall for the surgeon. This study aims to describe our experiences in comparing results of FS and permanent Section [PS] rectal biopsies in children with HD who were candidates for OSTAPT in a single-step operation. Subjects under the age of 14 years, admitted from March 2000 to July 2008 in a university-affiliated children's hospital for open rectal biopsy to diagnose HD were included in the study. All biopsies were taken 2-3 cm above the dentate line. 210 specimens of full-thickness rectal biopsy were obtained for both frozen section and permanent biopsy from all patients, examined by two well experienced pediatric pathologists for ascertaining the presence of ganglion cells, and the results were compared. Analysis was performed by SPSS Software version 11.5. Two-hundred one infants and children underwent FS rectal biopsy to exclude HD. Positive results were seen in 63.8% of the specimens examined as PS and in 58.3% of FS samples. 93.9% of positive results in FS studies were confirmed by PS studies. 6.1% of FS reports were false positive and 21.7% were false negative [P<0.001]. The sensitivity of FS was 85.8% and specificity 90.2%. Positive predictive value [PPV] was 93.9% and negative predictive value [NPV] was 78.3% in FS studies [P<0.001]. The accuracy of FS was 80.4%. Although FS of the rectal biopsy is useful in defining the aganglionic segment during operation, according to this study, it cannot be used as the sole base for performing primary pull-through operation before the results of the permanent section are on hand

[Prevalence of norovirus infection and determination of the dominant genogroup in children with acute gastroenteritis in Tehran, 2008-2009]

One of the most important pathogens responsible for acute gastroenteritis is Human Norovirus [NoV], causing >85% of all nonbacterial outbreaks of gastroenteritis reported in Europe. NoVs are members of the Family Caliciviridae. There are three infectious genogroups; genogroups I and II are recognized as the major cause of NoVs infections in humans. The aim of this study was to determine the rate of pediatric diarrhea caused by NoVs infection in children under 10 years with acute gastroenteritis admitted in Mofid Children's Hospital. During May 2008 to May 2009 we collected 204 stool samples from children under 10 years with acute gastroenteritis. RNA was extracted and RT-PCR was performed using specific primers. Using these primers we could distinguish between genogroup I and II of NoVs. Stool samples of 23 children [11.3%] were positive for NoVs RNA and 6 positive samples belonged to genogroup I [26%], 74% belonged to the genogroup II. The mean age of NoVs infected patients was 4 +/- 2.8 years. The results revealed the role of NoVs as one of the viral agents responsible for gastroenteritis in children. It also demonstrates the predominance of genogroup II of Norovirus

Blood pressure screening in school-aged children in Tehran

Hypertension is one of the most common diseases in the world and a major risk factor for cardiovascular, renal, and neurologic diseases. It seems that hypertension and overweight in children are a growing epidemic. The aim of this study was to investigate the prevalence of hypertension in school-aged children in Tehran. In a cross-sectional study, blood pressure and anthropometric measurements were performed on school-aged children in Tehran from 2008 to 2009. Children aged 7 to 11 years from 5 public schools in Tehran were included. Blood pressure, weight, and height measurement were performed at the school. At each screening, 3 seated blood pressure, weight, and height measurements were made and at least after 3 minutes of rest and choosing proper cuff, blood pressure was measured by a pediatric nephrologist and a pediatric assistant. A total of 425 school-aged children were included. Twenty-four percent of the primary school children had hypertension and 12% were shown to be overweight. Hypertension was more common in students of the north of Tehran in comparison to other geographic parts of Tehran. There was a significant difference in the prevalence of hypertension between girl students of north of Tehran and girls of the other parts of Tehran. We concluded that hypertension is a common problem in school-aged children. Our study re-emphasized the need for prevention and control of high blood pressure in children to manage the global diseases burden due to hypertension

Detection of anti-platelet glycoprotein antibodies Using MAIPA method

AITP mostly occur in children accompanied by variable clinical sings including petechiae, purpura, ecchymosis and severe bleeding. This study has determined and characterized the anti-platelet glycoproteins in children with ITP. The aim of this study was to determinate anti-platelet glycoproteins [GPs] using MAIPA method. During 18 months 38 children with clinical signs of AITP were studied in Mofid children hospital. To determine anti-platelet antibodies by ELISA technique, washed O negative platelets were used as a source of platelet antigens. MAIPA method was used to detect antibodies against individual platelet membrane glycoprotein. The anti-platelet antibodies level above mean+ 3SD of control group was assumed as positive. The results indicated that the platelet count ranges was between 2×109/L and 95×109/L. 63.5 % out of 38 patients were anti-platelet antibodies positive with ELISA method. The correlation between the above patients with anti-platelet antibody positive and clinical signs was 0.4. Results for determination of antibody against platelet GPIIb/IIIa, GPIb/IX and GPIa/IIa using MAIPA method were 44%, 51% and 25% respectively. In conclusion the preference of MAIPA method is the detection of very small amount of antibody. Since MAIPA is the specific method for the detection of antibody against glycoprotein antigens, it has the advantage of differentiating immune and non-immune thrombocytopenia

Autosomal recessive chronic granulomatous disease, IgA deficiency and refractory autoimmune thrombocytopenia responding to anti-CD20 monoclonal antibody

Immunodeficiency and autoimmune disease may occur concomitantly in the same individual. Some of the immunodeficiency syndromes, especially humoral defects are associated with autoimmune disorders. Hematological manifestations such as thrombocytopenia and hemolytic anemia are the most common presentations. Persistent antigen stimulation due to an inherent defect in the ability of the immune system to eradicate pathogens is the primary cause leading to autoimmunity in patients with primary immunodeficiency states. We describe a 10 year old Iranian girl with chronic granulomatous disease -the autosomal recessive type with mutation of NCF1 gene P47- associated with selective IgA deficiency, refractory immune thrombocytopenia that showed an excellent response to Rituximab [Anti-CD20 monoclonal antibody]. Patients with primary immunodeficiencies may have variable autoimmune manifestations. So for early detection and appropriate treatment, autoimmune diseases should always be suspected in such patients

Subcutaneous fat necrosis of the newborn complicated with hypercalcaemia

Subcutaneous fat necrosis of the newborn [SCFN] is an unusual disorder which occurs in term or post-term newborns due to perinatal stress. SCFN appears by firm nodules over the trunk, arm, buttock, thigh and cheeks in the first several weeks of life. Prevalence of SCFN is unknown. Race and sex do not play a role in this condition Hypocalcaemia and rarely hypercalcaemia are considered as major causes of morbidity and mortality in cases of SCFN. We report a case of SCFN in a two month male infant complicated with hypercalcemia and hyperuricemia

[Antibiotic susceptibility patterns in H. influenzae type B isolated from healthy children oropharynx in day care centers of Tehran]

Haemophilus influenzae type b [Hib] is a most frequent cause of invasive diseases such as meningitis, septic arthritis and pneumonia in children under 5 years old. Asymptomatic oropharyngeal colonization is an origin of distribution of microorganism to others and probable bacteremia in the same child. The aim of this study was to determine antibiotic susceptibility of Hib in Tehran day care centers. Hib was isolated from oropharynx of 1000 children visiting 25 day care centers selected randomly in different parts of Tehran city during second half of year 2005. For antibiotic susceptibility determination we used disk diffusion test. Ampicillin resistance was 32.3% and Beta lactamase production was seen in 23.6%. Cephalosporins resistance except for cefixime was between 10% to 20% and in cefixime was 58.8%. Rifampin resistance was 17.6%. Resistance to studied macrolids including azythromycin and clarythromycin was 19.6% and 35.3%. On the base of high antibiotic resistance to Hib in our study and other similar studies in Iran, we recommend to use optimal effective and proper antibiotics to decrease the high rate of antibiotics resistance to Hib colonization and its invasive diseases

Isolation of mycobacterium and other microorganism from skin infectious in children during Bam earthquake

The Bam earthquake in southeastern Iran turned an ancient city to dust, killing thousands and destroying 80% of all infrastructures. More than 30,000 people died and It left some 100,000 people homeless. Direct contact with polluted water increases the risk of infection, particularly wound infections, cellulitis, dermatitis, conjunctivitis, and ear, nose and throat infections. The prevalence of NTM [non-tuberculosis mycobacteria] is difficult to obtain. The aim of this study was isolation of bacteria and mycobacterial agents, especially atypical species from dermal lesions of children in Bam earthquake. In this descriptive study, 88 children settled in camps in 2004 were enrolled. Samples from dermal lesions of children were obtained and transported with middle brook 7H9 and Brain Heart [BH] media to laboratory for isolation of mycobacterial agents and other bacteria. For isolation of mycobacterium, after decontamination and acid-fast staining, they had been cultured in Lewenstein-Jensen medium. Having isolated mycobacteria by differential tests their antibiotic resistance and susceptibility were studied. Meanwhile, other bacteria were identified by staining and culturing in standard media. The study population included 32 girls and 56 boys. Of 88 samples, 3 mycobacteria were isolated [3.4%] of which 2 were M. chelonae [rapidly growing] and 1 was M. scrofulaceum [slowly growing]. The most common isolated bacteria were E.coli [41%] and Coagulase negative staphylococcous [38%].Infectious disease epidemics may play a role in the post disaster period. Since atypical mycobacteria exist in soil, and some cases were reported from Iran, isolation of these microorganisms is of utmost importance especially in children after a disaster such as earthquake

Generalized myelolipoma

Myelolipoma is a benign tumor originating from hematopoietic and adipose tissue. This tumor usually develops in the adrenal gland, but rare presentations of extraadrenal myelolipoma are also reported, which usually arise from the presacral region. Herein, we present a 6-year-old girl with myelolipoma with generalized involvement of her abdomen, pelvis, chest, and retroorbital region

Interleukins 1 and 6 in children with acute pyelonephritis

Renal infection and scarring are the leading causes of end stage renal disease [ESRD] in some parts of the world [e.g. Iran]. Urinary interleukins [IL] 1 and 6 have been reported to be high in acute pyelonephritis in previous studies. This study was performed to determine the relation between IL 1 and 6 levels in the presence of acute pyelonephritis and the relation between the amount of these cytokines and the severity of pyelonephritis by dimercaptosuccinic acid [DMSA] scan. Children ages 1 month to 12 years who were admitted to the nephrology ward of Mofid Children's Hospital for pyelonephritis from January to July 2004 were enrolled in the study. Interleukins 1 and 6 and creatinine were measured in 80 random urine samples of 37 patients [81%female] with acute pyelonephritis and 43 healthy children [81% female]. Urinary cytokines were measured by Enzyme Linked Immunosorbent Assay [ELISA] and creatinine by spectrophotometry methods and recorded in microgram per mg of creatinine. Pyelonephritis was confirmed by positive urine culture and/or DMSA scan in all patients using SPECT apparatus. Data were analyzed by paired student t test and differences considered significant if p<0.05. Mean interleukin 1/creatinine [IL 1/Cr] ratio in patients with pyelonephritis was 0.70 +/- 0.96 [range 0.02-5.08] and in healthy children was 0.04 +/- 0.12 [range 0-0.51]. Mean interleukin 6/creatinine [IL 6/Cr] ratio in patients with pyelonephritis was 4.80 +/- 10.06 [range 0.01-44.74] and in healthy children was 0.15 +/- 0.37 [range 0-2.32]. There were significantly higher levels of urinary IL-1 and IL-6 in children with pyelonephritis than healthy children, but we didn't find any significant relationship between urinary interleukin levels and other parameters such as pyuria, ESR, CRP and different grades of renal involvement in DMSA scans