The Effect of Adding Honey to Zinc in the Treatment of Diarrhea in Children / 가정의학회지

Background@#Honey has been used in medicine since ancient times. Limited reports are available to indicate its antibacterial, antiviral, and antidiarrheal properties. This study aimed to determine the effect of honey on acute diarrhea in children. @*Methods@#This randomized clinical trial included 80 children with acute diarrhea. Forty children received honey and zinc gluconate (trial group) and 40 received only zinc gluconate (control group). After treatment, vomiting/diarrhea duration, the recovery time, and the duration of hospitalization were compared between the groups. @*Results@#Among the 40 children in the trial group, 19 were male and 21 were female. In the control group, 25 children were male and 15 female (P=0.26). After initiating treatment, the duration of diarrhea, recovery time, and the duration of hospitalization was significantly shorter in the trial group than in the control group (P<0.05). @*Conclusion@#This study showed that honey with zinc gluconate reduces the duration of diarrhea, accelerates the recovery time, and shortens the duration of hospitalization.

Association between vitamin D and urinary tract infection in children / 소아과

PURPOSE: The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children. METHODS: In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed and compared between both groups. RESULTS: Among 70 children with UTI (case group), 5 children (7.2%) were male and 65 (92.8%) were female. Among the healthy children (control group), 9 (12.8%) and 61 children (87.2%) were male and female, respectively (P=0.39). The mean±standard deviation of age in the case and control groups were 53.2±35.6 and 36.1±60.2 months, respectively (P=0.24). The mean level of serum 25(OH)D in the case group was significantly higher than that of the control group (20.4±8.6 ng/mL vs. 16.9±7.4 ng/mL, P=0.01). CONCLUSION: This study showed that there was a relationship between serum 25(OH)D levels and UTI in children. It seems that 25(OH)D plays a role in the pathogenesis of UTI.

[Serum zinc concentrations in children with acute bloody and watery Diarrhoea]

Objectives: The role of zinc in the pathogenesis of diarrhoea is controversial. This study was conducted to compare serum zinc levels in children with acute diarrhoea to those found in healthy children

Methods: This case-control study was carried out at the Qazvin Children's Hospital in Qazvin, Iran, between July 2012 and January 2013. A total of 60 children with acute diarrhoea [12 children with bloody diarrhoea and 48 children with watery diarrhoea] and 60 healthy children were included. Zinc levels for all subjects were measured using a flame atomic absorption spectrophotometer and data were analysed and compared between groups

Results: Mean serum zinc levels in the patients with acute bloody diarrhoea, acute watery diarrhoea and the control group were 74.1 +/- 23.7 microg/dL, 169.4 +/- 62.7 microg/dL and 190.1 +/- 18.0 microg/dL, respectively [P = 0.01]. Hypozincaemia was observed in 50.0% of children with acute bloody diarrhoea and 12.5% of those with acute watery diarrhoea. None of the patients in the control group had hypozincaemia [P = 0.01]

Conclusion: Children with acute bloody diarrhoea had significantly reduced serum zinc levels in comparison to healthy children. However, a study with a larger sample size is needed to examine the significance of this trend

Are Clinical, Laboratory, and Imaging Markers Suitable Predictors of Vesicoureteral Reflux in Children With Their First Febrile Urinary Tract Infection?

PURPOSE: This study was conducted to determine the predictive value of clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux in children with their first febrile urinary tract infection. MATERIALS AND METHODS: One hundred fifty-three children with their first febrile urinary tract infection were divided into two groups according to the results of voiding cystourethrography: 60 children with vesicoureteral reflux and 93 children without. The sensitivity, specificity, positive and negative predictive value, likelihood ratio (positive and negative), and accuracy of the clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux were determined. RESULTS: Of the 153 children with febrile urinary tract infection, 60 patients (39.2%) had vesicoureteral reflux. There were significant differences between the two groups regarding fever>38degrees C, suprapubic pain, C-reactive protein quantitative level, number of red blood cells in the urine, and results of renal ultrasound and dimercaptosuccinic acid renal scanning (p38.2degrees C and dimercaptosuccinic acid renal scanning and vesicoureteral reflux. Also, there were significant positive correlations between the erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound and high-grade vesicoureteral reflux. CONCLUSIONS: This study revealed fever>38.2degrees C and dimercaptosuccinic acid renal scanning as the best predictive markers for vesicoureteral reflux in children with their first febrile urinary tract infection. In addition, erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound are the best predictive markers for high-grade vesicoureteral reflux.

Serum interleukin-1beta and tumor necrosis factor-alpha in febrile seizures: is there a link? / 소아과

PURPOSE: Febrile seizures are induced by fever and are the most common type of seizures in children. Although numerous studies have been performed on febrile seizures, their pathophysiology remains unclear. Recent studies have shown that cytokines may play a role in the pathogenesis of febrile seizures. The present study was conducted to identify potential links between serum interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and febrile seizures. METHODS: Ninety-two patients with simple or complex febrile seizures (46 patients per seizure type), and 46 controls with comparable age, sex, and severity of temperature were enrolled. RESULTS: The median concentrations of serum IL-1beta in the simple, complex febrile seizure, and control groups were 0.05, 0.1, and 0.67 pg/mL, respectively (P=0.001). Moreover, the median concentrations of TNF-alpha in the simple, complex febrile seizure, and control groups were 2.5, 1, and 61.5 pg/mL, respectively (P=0.001). Furthermore, there were significant differences between the case groups in serum IL-1beta and TNF-alpha levels (P<0.05). CONCLUSION: Unlike previous studies, our study does not support the hypothesis that increased IL-1beta and TNF-alpha production is involved in the pathogenesis of febrile seizures.

Serum levels of interleukin-6 and interleukin-8 as diagnostic markers of acute pyelonephritis in children / 소아과

PURPOSE: Early diagnosis and treatment of acute pyelonephritis in children is of special importance in order to prevent serious complications. This study was conducted to determine the diagnostic value of serum interleukin (IL)-6 and IL-8 in children with acute pyelonephritis. METHODS: Eighty-seven patients between 1 month to 12 years old with urinary tract infection (UTI) were divided into 2 groups based on the result of 99m-technetium dimercapto-succinic acid renal scan: acute pyelonephritis (n=37) and lower UTI (n=50) groups. White blood cell (WBC) count, neutrophil (Neutl) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, platelet count, and serum IL-6 and IL-8 concentrations of both groups were measured and compared. RESULTS: There was a significant difference between two groups regarding WBC count, Neutl count, ESR, and CRP concentration (P<0.05). In addition, the difference between the two groups regarding serum IL-6 and IL-8 concentrations was not significant (IL-6, 60 and 35.4 pg/mL and IL-8, 404 and 617 pg/mL, respectively). The sensitivity and specificity of serum IL-6 and IL-8 for diagnosis of acute pyelonephritis were 73%, 42% and 78%, 32%, respectively. Sensitivity, specificity, negative and positive predictive values of serum IL-6 and IL-8 were less than those of acute phase serum reactants such as CRP. CONCLUSION: This study showed that there was no significant difference between acute pyelonephritis and lower UTI groups regarding serum IL-6 and IL-8 levels. Therefore, despite confirming results of previous studies, it seems that IL-6 and IL-8 are not suitable markers for differentiating between acute pyelonephritis and lower UTI.

Lack of correlation between plasma neuropeptide Y and typical and atypical febrile seizures

It is known that neuropeptide Y which is widely distributed throughout the central nervous system is able to prevent seizures in animals. There are limited studies about the role of neuropeptide Y in febrile seizures. This study was conducted to evaluate the association between plasma neuropeptide Y level and febrile seizures in children. Seventy six patients with typical and atypical febrile seizures [each group 38 patients] and 38 sex and age matched control subjects were enrolled. The mean plasma levels of neuropeptide Y in typical and atypical febrile seizures were 90.60 +/- 28.01 and 97.34 +/- 41.27 pmol/l respectively. This value in control group was 88.94 +/- 32.66 pmol/l. There was no significant differences between groups regarding plasma neuropeptide Y level [P=0.532]. Also, there was no significant difference in comparison with case groups [P=0.40]. This study revealed that there is no association between plasma neuropeptide Y and febrile seizures

When is the best time for voiding cystourethrogram in urinary tract infection of children?

This study was conducted to investigate whether the length of the interval between a urinary tract infection and the performance of the voiding cystourethrogram influences the presence or severity of vesicoureteral reflux [VUR]. In this study 161 children with first episode of urinary tract infection were evaluated. Depending on time of performance of voiding cystourethrogram [VCUG], patients divided into two groups: early [within the first 7 days following treatment] and late [during second week or thereafter of the start of treatment]. The prevalence and severity of vesicoureteral reflux in both groups were compared. Out of 161patients, the early and late groups consisted of 75 and 86 patients, respectively. The prevalence of vesicouretral reflux in the early and late groups was 25.3% and 30.2%, respectively. No significant difference was observed between two groups regarding prevalence [P=0.598] and severity [P=0.379] of vesicoureteral reflux. This study showed that the prevalence and severity of VUR is not affected by timing of VCUG. Therefore, it is recommended that in children with urinary tract infection, VCUG should be done following negative urine culture as soon as possible.

effect of clofibrate on hyperbilirubinemia of term neonates

Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78 +/- 2.38 and 20.52 +/- 2.44 mg/dl, respectively [P=0.69]. The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20 +/- 2.20, 14.70 +/- 2.06, 10.72 +/- 2.40 and 8.90 +/- 0.83 mg/dl, respectively. These values in control group were 18.26 +/- 2.42, 15.36 +/- 2.59, 12.29 +/- 2.28 and 10.23 +/- 1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours [P=0.019] and 48 hours after treatment [P=0.005]. In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment

case-control study of the association between serum copper level and febrile seizures in children

Febrile seizures are the most common cause of seizure in children. Identification of risk factors is very important. This study was conducted to determine the association between the serum copper level and simple febrile seizure in children. In this study, 30 children with simple febrile seizures [case group] were compared with 30 children with febrile illness without seizures [control group] regarding serum copper level. This study was conducted in Qazvin children's hospital [Qazvin, Iran]. The mean serum copper levels in the case and control groups were 141.41 +/- 30.90 and 129.43 +/- 18.97 mcg/dl, respectively. This difference was not significant statistically. This study revealed that there is no association between serum copper levels and febrile seizures. It seems that copper deficiency is not a risk factor for febrile seizures in children

Can urinary nitrite results be used to conduct antimicrobial option for urinary tract infection in children?

This study was performed to determine the relationship between urinary nitrite results and bacterial resistance to antimicrobial drugs in urinary tract infection of children. In a cross-section study 119 children younger than 12 years with urinary tract infection were evaluated in Qazvin children's hospital. Patients were divided into negative and positive nitrite groups depending on urinary nitrite test result. Rates of antibiotic resistance in the two groups were compared. Sixty seven patients were in the negative nitrite group and 52 in the positive nitrite group. Resistance rates to ceftriaxone, trimethoprim sulfamethoxazole, ampicillin, gentamicin, amikacin, nalidixic acid, cephalothin and nitrofurantoin in the nitrite negative group were 7.5%, 31.3%, 50.7%, 11.9%, 9%,3%, 14.9%, and 11.9%, respectively. these values in the nitrite positive groups were 21.2%, 28.8%, 63.5%, 7.7%, 5.8%, 1.9%, 9.6%, and 3.8%, respectively [P>0.05]. This study showed that there is no correlation between urinary nitrite results and bacterial resistance to antimicrobial drugs. Therefore, it seems that physicians should not adjust antibiotic therapy for UTI based on nitrite results

Serum immunoglobulin levels in splenectomized and nonsplenectomized patients with major beta-thalassemia

Thalassemia is a common disease in many countries, in which several complications such as infections can occur. Although aberration in the function of the immune system could be a reason for such complication, a little is known about the status of humoral immune system in major beta thalassemia. In this study we measured serum immunoglobulins level in a group of patients with major beta thalassemia. Ninety nine patients with major beta thalassemia were enrolled in this study divided into two groups of splenctomized and not splenctomized patients. Serum IgG, IgM and IgA levels of these patients were measured and analyzed. Serum mean levels of IgG and IgM in patients of all ages in both groups were normal. The mean serum IgA level in the group of not splenectomized patients aged less than five years as well as in the splenectomized patients aged more than twenty years was increased. However, it was normal in other age groups. Although this study could not show any defect in the humoral immune system, evaluation of immunoglobulins could be useful to understand the relmarkable high rate of infection in the patients with major beta thalassemia

Serum thyroid hormone levels in epileptic children receiving anticonvulsive drugs

The aim of this study was to investigate serum thyroid hormone levels in epileptic children receiving anticonvulsive drugs. In this case- control study, 30 epileptic children who were receiving anticonvulsive drugs [case group] were compared with 30 healthy children [control group]. This study was carried out in the Qazvin Children's Hospital [Qazvin, Iran] from October to December 2007. Both groups were matched for age and sex. Thyroid hormone levels were measured using a radioimmunoassay and immunoradiometric assay. Data were analyzed using Chi-square and Student's t-tests. The mean serum T3 and T4 levels in the case group were 2.36 +/- 0.73 nmol/L and 95.96 +/- 27.01 nmol/L, respectively, and the corresponding values in the control group were 1.88 +/- 0.93 nmol/L and 147.46 +/- 35.77 nmol/L, respectively. The mean serum thyroid-stimulating hormone [TSH] levels in the case and control groups were 2.73 +/- 0.73 mIU/mL and 2.49 +/- 2.17mIU/mL, respectively. This study revealed that long-term consumption of anticonvulsive drugs resulted in a decline in serum T4 levels and an increase in serum T3 levels, but had no effect on TSH levels

Comparison of 16S rDNA-PCR amplification and culture of cerebrospinal fluid for diagnosis of bacterial meningitis

Early and accurate diagnosis of bacterial meningitis is of critical concern. Optimum and rapid laboratory facilities are not routinely available for detecting the etiologic agents of meningitis. The objective of this study was to compare polymerase chain reaction [PCR] assay with culture for detection of bacteria in central nervous system [CNS] samples from patients suspected to have meningitis. One-hundred CSF samples were obtained and divided into two parts. One part of samples was used for standard bacterial culture and gram staining. The remaining was used for DNA extraction. PCR assay was performed with universal primers for 16S rDNA gene of bacteria. Performance characteristics of the test were determined. The PCR method was able to detect bacteria in all 36 culture-positive and in 38 of 64 culture-negative cases showing sensitivity and specificity of 100% and 40.6% respectively. Positive predictive value was 48.6% and negative predictive value 100%, however, Kappa coefficient showed the correlation of the 2 methods to be at 0.33. There are advantages and disadvantages in performance characteristics of the conventional CSF culture and universal CSF 16S rDNA PCR. Therefore, it is recommended to use both methods in clinical practice, particularly in suspicious contaminated samples, with presumable presence of fastidious or slow growing bacteria because of antibiotic consumption

Zinc and copper status in children with beta-thalassemia major

There are some reports in which a condition of zinc deficiency and its associated outcomes with a change in concentration of serum copper among the thalassemic patients has been highlighted. The aim of this prospective study was to determine the serum zinc and copper levels in children with beta-thalassemia major. In this cross sectional study all children under 12 years affected by beta thalassemia major [40 patients] were evaluated for serum zinc and copper levels in Qazvin thalassemia center [Qazvin, Iran] in 2007. Serum measurements for zinc and copper were performed by atomic absorption spectrophotometer. The mean concentrations of serum zinc and copper levels were 67.35 +/- 20.38 and 152.42 +/- 24.17 micro g/dl respectively. Twenty-six [65%] of thalassemic patients had zinc concentration under 70 micro g/dl [hypozincemia]. None of the thalassemic children had copper deficiency. No significant correlation between serum zinc level with age, weight, height, body mass index, duration of blood transfusion, desferrioxamine dose and ferritin level was observed in thalassemic patients [P=0.3]. This study revealed that hypozincemia is common in thalassemic patients, but in contrast, there is no copper deficiency. Further evaluation in this regard is recommended

[Comparison of 16S rDNA-PCR amplification and culture of cerebrospinal fluid for diagnosis of bacterial meningitis]

Early and accurate diagnosis of bacterial meningitis is critical concern. Optimum and rapid laboratory facilities are not routinely available for detecting the etiologic agents of meningitis. The objective of this study was the comparison of polymerase chain reaction [PCR] assay with culture, for the detection of bacteria in CSF samples from patients suspected of meningitis in Hospitals of Qazvin. 100 CSF samples were obtained and divided in two parts. One part of samples was used for standard bacterial culture and gram staining. The remaining was used for DNA extraction. A PCR assay was performed with universal primers for 16S rDNA gene of bacteria. Performance characteristics of the test were determined. The PCR method was able to detect bacteria in 36 cultures [..] positive and in 38 of 64 cultures were negative cases, showing sensitivity, Specificity of 100% and 40.6% respectively. Positive predictive value [PPV] was 48.6% and its negative predictive value [NPV] was 100%, however, Kappa coefficient showed the correlation of 2 methods to be at 0.33. There are advantages and disadvantages in performance characteristics of the conventional CSF culture and universal CSF 16S rDNA PCR. Therefore, it is recommended to use both methods in clinical practices, particularly in suspicious contaminated samples, with presumable presence of fastidious or slow growing bacteria and antibiotic consumption

Comparison of procalcitonin and C-reactive protein tests in children with urinary tract infection

Urinary tracet infection [UTI] is a common discase in children. The distinction between upper and lower UTI in children is associated with some ambiguities. The objective of this study was to determine the sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] of procalcitonin [PCT] compared to C-reactive protein [CRP] in predicting renal involvement. Serum concentrations of PCT and CRP in blood samples of 111 children with UTI were measured. Renal parenchymal involvement was evaluated with 99mTc-dimercaptosuccinic acid [DMSA] scintigraphy. Sensitivity, specificity, PPV and NPV were determined. Out of 111 children, 52 [46.8%] were shown to have acute renal involvement, 23 [20.7%] lower UTI, and 36 [32.5%] refused to be examined by DMSA renal scan. PCT was positive in 36 [69.2%] patients with upper UTI and 12 [52.2%] with lower UTI. The sensitivity, specificity, PPV and NPV obtained for PCT and CRP were 70.6, 45.5, 75, 40% and 96.2, 4.3, 69.4,; and 33.3%, respectively. No significant correlation was found between renal parenchymal involvement and serum levels of PCT and CRP. However, the results demonstrated that the PCT was a better diagnostic test compared to CRP