Predisposing factors for nephrolithiasis and nephrocalcinosis in cystic fibrosis

Cystic fibrosis [CF] is characterized by chronic pulmonary disease, insufficient pancreatic and digestive function, and abnormal sweat concentration. There is controversy about predisposing factors of nephrolithiasis and nephrocalcinosis in patients with cystic fibrosis. We assessed the results of metabolic evaluation in patients with cystic fibrosis and its correlation with nephrocalcinosis. Forty five CF patients, mean age 47.1 months, were enrolled in the study. No one had past history of nephrolithiasis and/or nephrocalcinosis. The records were reviewed for clinical characteristics and all patients underwent metabolic evaluation including serum electrolyte measurements and spot urine analysis. Ultrasonography was performed in all patients to detect nephrocalcinosis and urolithiasis. Nephrocalcinosis was found in 5 [11%] patients. No patient had clinical symptoms of nephrolithiasis and/or micro/macroscopic hematuria. Metabolic evaluation of the CF patients versus normal reference values showed decreased serum uric acid in 48.8%, elevated serum phosphate in 24.4%, and urine oxalate excretion in 51%. Metabolic evaluation of the nephrocalcinosis positive patients versus nephrocalcinosis negative group showed no statistical difference in serum electrolytes. The mean value of urine calcium excretion was lower in patients with nephrocalcinosis [P=0.001]. Despite lack of any significant correlation, higher numerical hyperoxaluria was observed in patients with severe steatorrhea. There was no statistical correlation between steatorrhea and urine calcium as well as oxalate excretion. Hypocalciuria in the nephrocalcinotic CF patients may be seen. It can be hypothesized that hypocalciuria may be due to a primary defect in renal calcium metabolism in CF patients

[ comparative study of serum zinc level between asthmatic and control group]

During the past decade Asthma have been increased worldwide. Free radicals have been proposed to be responsible or the pathogenesis of many diseases because of their harmful effects on the cells and tissues. There are some defense mechanisms in the organism to avoid the harmful effects of free radicals. The most important antioxidants are glutathione peroxidase and superoxide dismutase. Glutathione peroxidase has selenium and superoxide dismutase system has zinc in their structures which diminish the harmful effects of oxygen free radicals. This research was done to analyze the relation between serum zinc concentrations as antioxidant in children asthma. This was a case study. We made comparison between 80 asthmatic patients. Who attended the pediatric allergy outpatients clinics and 80 control group children who attended the pediatric outpatient clinic for the complaints of non specific non-chronic disorders [acute upper respiratory system infection, urinary tract infection e.t.c] without any of history of atopy. None of the patients in the study used systemic or inhaled steroids and nonsterioidal anti inflammatory for the last 2 weeks. The serum zinc was measured with manual calorimetric method and then the results were compared. In this study the overage age in case group was [6.07 +/- 2.07 yrs] and in control group was [5.25 +/- 3.44 yrs]. Therefore, no significant difference was detected. In view of gender both groups were totally identical. Mean serum zinc in patients was 93.93 +/- 25.58 mg/dl and in controls was 97.18 +/- 23.59 mg/dl; With no statistical difference [P>0.05]. It was not approved that serum zinc concentrations were lower in the asthmatic patients than normal individuals

[Diagnostic accuracy of polyclonal stool antigen for detection of helicobacter pylori infection in children]

Helicobacter pylori infection has various clinical features. One of the most common presentations of this infection is upper abdominal pain. Complications such as gastritis, gastric ulcer, gastric carcinoma and MALT lymphoma mandate early diagnosis of H.P infection by a low cost and non invasive manner. The aim of this study was to evaluate the diagnostic role of H.P stool antigen detection as a simple and non invasive method for diagnosis of this infection. Upper endoscopy with gastric biopsy was done on all patients between 6 months to 18 years old with upper abdominal pain. Stool test was done by polyclonal anti-h.p antibody. Results of stool Test were compared with results of RUT and histologic examination Overall 110 patients [57 boys, 53 girls] were studied, 32 patients were Helicobacter pylori positive and 78 patients were Helicobacter pylori negative based on RUT and histologic examination. Stool antigen testing was positive for 39 patients. Sensitivity and specificity of stool Ag were 100% and 91% respectively Stool Ag test has high sensitivity and negatity predictive value for diagnosis of Helicobacter pylori infection

Cryptosporidium infection in pediatric patients with lymphohematopoietic malignancies

Cryptosporidium parvum is a common protozoan pathogen with worldwide distribution. It localizes on the intestinal cells and prolonged diarrhea in immunocompromised patients. The aim of this study was to estimate the prevalence and the clinical features of enteric cryptosporidiosis in pediatric patients with lymphohematopoietic malignancies. in this cross-sectional study stool samples were collected from 100 children [67 boys, 33girls] with lymphohematopoietic malignancies who underwent chemotherapy between the ages of 6 months and 17 years [mean age 7.5 years]. All of the specimens were examined for the oocysts of C. parvum by modified Ziehl Neelsen [MZN] staining technique and coproantigens of C. parvum by EL IS A. Cryptosporidium infection was detected in 22 patients. 16 [72.7%] of the infected patients were male and 6 [27.3] female. 7 [31.8%] patients were <5 years, 8 [36.4%] 5-10 years and 7 [31.8] >10 years old. Parasites were detected in 19/85 [86.4%] patients with ALL, 2 of 5 [9.1%] with AML, and 1 of 10 [4.5%] with NHL. Clinical symptoms were found in 11 [50%] of the patients. We found longer duration of chemotherapy in patients who were positive for Cryptosporidium infection [Mean=2067 days] in comparison to negative group [Mean=258.5 days] [ANOVA, f=2.82, P=0.04]. The incidence of Cryptosporidium infection was 22% among pediatric patients with lymphohematopoietic malignancies. We recommend evaluation of these patients with at least two different diagnostic methods in order to prevent possible life threatening outcomes