[Evaluation of prevalence and risk factors for hepatitis E in pediatric patients in Tabriz children hospital]

Background and Objectives: Hepatitis E is usually self-limited, but may be associated with high mortality in some situations. Hepatitis E virus [HEV] has a fecal-oral transmission cycle and is transmitted through environmental contamination, mainly water. Previous studies have shown that, HEV is responsible for more than 50% of acute hepatitis cases in young patients in developing countries. This study was aimed to determine the prevalence of anti-HEV antibodies among pediatric patients in Tabriz Children Hospital

Materials and Methods: The study was a cross sectional and descriptive-analytical survey on the children who had been referred to clinic of Tabriz children hospital. For each patient, demographic data including age, sex, area of residence, method of sewage and waste disposal and type of water supply, history of animal contact, history of surgery, blood transfusion and parent's addiction were recorded in questionnaires. Serum levels of specific anti-HEV IgG antibody were measured. The relationshiop between seropositivity and demographic characteristics was investigated

Results: A total of 252 children aged 2-16 years were studied. In 9 patients [3.6%], the sample was positive for anti-HEV IgG antibody consisting of 5 boys [2%] and 4 girls [1.6%]. There was no significant statistic relationship between our demographic characteristics and seropositivity

Conclusion: This study revealed 3.6% seropositivity for anti HEV antibody in children living in Tabriz. According to the present study, the prevalence of HEV is considerable in Iran. Thus HEV study is strongly recommended in the approach to all clinical hepatitis cases

Probiotics for the treatment of pediatric helicobacter pylori infection: a randomized double blind clinical trial

Helicobacter pylori is recognized as a major etiological factor in the pathogenesis of gastritis and peptic ulcer disease. H. Pylori eradication has a failure rate of more than 30% in pediatric patients, particularly because of poor compliance, antibiotic resistance and occurrence of side-effects. This study was aimed to determine whether adding the probiotics to a standard anti-H. pylori regimen could minimize the gastrointestinal side-effect prevalence and improve the eradication rate. Double-blind randomized placebo controlled study conducted at Children's Medical Center in Tehran, Iran. Sixty six H. pylori positive children were treated with a triple drug treatment protocol [omeprazole+amoxycillin+furazolidon] and randomly allocated to receive either probiotic or placebo. All patients underwent esophagogastroduodenoscopy. H. pylori infection was diagnosed by either rapid urease test [RUT] or histology. H. pylori status was assessed after 4-8 weeks of the completion of treatment with stool H. pylori antigen test. The side effects of the treatment were determined in each group. Mean age of patients was 9.09 [range 3-14] years, 44 [65.7%] patients were boys [sex ratio 2:1]. All 66 patients completed the course of treatment and follow-up. The rate of H. pylori eradication was significantly higher in probiotic group [P=0.04]. In probiotic supplemented children there was a lower rate of nausea/vomiting [P=0.02] and diarrhea [P=0.039] during treatment. This study showed that probiotics have positive effect on the eradication of H. pylori infection. Adjuvant therapy with probiotic is recommended in order to reduce the frequency of antibiotic induced side-effects during treatment with antibiotics

Stroke in a child with type IV hereditary sensory autonomic neuropathy: a coincidence or complication?

Hereditary sensory autonomic neuropathy Type IV is a rare autosomal recessive disorder characterized by congenital insensitivity to pain and generalized anhidrosis and resulting in recurrent hyperpyrexia, self-mutilation behavior. The clinical presentation of a child with this rare disease complicated with stroke is described