Clinical evaluation of disc battery ingestion in children

The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. We reviewed the medical records of children admitted to Mofid Children's Hospital due to disc battery ingestion from January 2006 to January 2010. Clear history, clinical symptoms and results of imaging studies revealed diagnosis of disc battery ingestion in suspected patients. The clinical data reviewed included age, gender, clinical manifestation, radiologic findings, location of disc battery, duration of ingestion, endoscopic results and surgical treatment. We found 22 cases [11 males and 11 females] of disc battery ingestion with a mean age of 4.3 years [range: 9 months to 12 years]. Common symptoms were vomiting, cough, dysphagia, and dyspnea. The mean duration of ingestion was 2.7 days [4 hours to 1.5 months]. A total of 19 patients had histories of disc battery ingestion, but three cases referred with the above symptoms, and the batteries were accidentally found by x-ray. Only three cases had batteries impacted in the esophagus. Twelve batteries were removed endoscopically, 6 batteries spontaneously passed through the gastrointestinal [GI] tract within 5 to 7 days, and 4 patients underwent surgery due to complications: 3 due to tracheo-esophageal fistula [TEF] and 1 due to intestinal perforation. There was no mortality in our study. Most cases of disc battery ingestion run uneventful courses, but some may be complicated. If the battery lodges in the esophagus, emergency endoscopic management is necessary. However, once in the stomach, it will usually pass through the GI tract

Evaluation of the nutritional status in children admitted to the neurology ward of Mofid children's hospital

Malnutrition is commonly considered as an important risk factor that can produce a negative influence on the prognosis of patients with chronic neurological diseases. We aimed to evaluate the nutritional status of patients admitted to the neurology ward of Mofid Children's hospital via subjective and objective methods. 61 children [2-6 years of age] who were consecutively hospitalized at the neurology ward between January and March 2008 underwent objective [weight, height, mid upper arm circumference - MUAC- and triceps skinfold thickness-TSF] and subjective nutritional assessment. The result showed that 42.6%, 37.7% and 25.9% of patients were consecutively wasted, underweight and stunted. The z- Scores for TSF and MUAC were below -1 in 32.7% and 41.8% of the patients, consecutively. According to subjective Assessments [SGNA], 52.7% were malnourished. The prevalence of malnutrition was not significantly different between sex or diagnosis groups. Malnutrition is of high prevalence in patients with neurologic diseases. Regular assessment and timely nutritional support may improve the situation

Helicobacter pylori infection; in cases with and with out subjective halitosis

In most individuals H. Pylori is acquired early in the life [before 5 years]. H. Pylori infection is more common in the third world countries, where about 90% of adults may be infected. Helicobacter pylori is one of the suspected causes of halitosis in children. To evaluate the relationship of helicobacter pylori and halitosis. 33 patients with chief complaint of halitosis included in our study. Halitosis was evaluated as a subjective symptom in this study. Careful history was obtained. All patients underwent physical examination in order to rule out sinusitis, otitis, and possible cause of halitosis. 67 patients without halitosis were selected as control group. All patients were aged 4-17 years old. Urea Breath Test was done for all patients. UBT has >95% sensitivity and specifity for diagnosis of H.pylori infection. Chi-square test and Yate's corrected x[2] was used to analyzes finding. Epi-info ver 6 were used. In the case groups 7 patients had H. pylori infection and 26 patients had not. In the control group 18 patients had H.pylori infection and 49 patients had not halitosis [P=0.53]. There is no significant differences between case and control group. In this study we did not find relationship between H.pylori infection and halitosis

External hemorrhoids in children

Hemorrhoids in children are not common. The most common cause of hemorrhoids in the young children is portal hypertension. A 3 year old boy with history of hematemsis and external hemorrhoids is being reported. Patient had associated varices for which he was put on proparnolol

Peutz-Jeghers syndrome in a girl with chronic abdominal pain

It is a report of a seven years old girl with Peutz-Jeghers syndrome. Mode of presentation, various investigations, pattern of family history and management aspect are reported

Clinicopathologic findings in 35 children with Wilson disease

Wilson disease is a rare autosomal recessive disorder of copper metabolism. Wilson disease is the most common metabolic cause of fulminant hepatic failure in children over the age years. The aim of this study was to find the major clinical and pathologic findings of Wilson disease in children in Tehran. This retrospective study was carried out in the Mofid children's hospital. Thirty five patients suffering from Wilson disease were studied. Ceruloplasmin level below 20 mg/dl and urinary copper excretion level above 100 micro g/24hr were considered as the inclusion criteria. Of the patients, 20 cases were males and 15 were females with average age of 9 years. The most patients were in 8-9 and 10-11 years age group with 37% and 20%, respectively. Hepatic invoIvement was confirmed in 100% of patients. Jaundice was seen in 20 patients [57%], abdominal enlargement together in 20 patients [57%], and encephalopathy in 9 patients [26%]. Serum copper was reduced in 100% and low-serum ceroluplasmin in 100%, increased urinary copper excretion in%97, increased AST and ALT in 100%, increased PT was in 94% patients, anemia was found in 100%, leucopenia in 14%, and thrombocytopenia was seen in 71% of patients. In this study, 37% of patients had neurological symptoms such as tremor, ataxia, difficulty in speech and delayed education. 32 patients had undergone ophthalmic examination and 62% showed KF ring in their ophtalmoscopy. According to this study, hepatic and neurologic involvement is the most consistent finding in the Wilson disease. Most patient were in the age's group of 8-9 and 10-11

Study of the risk factors related with helicobacter pylori infections in children with peptic ulcer disease

Helicobacter pylori is the cause of peptic ulcer and gastroduodenal disease in children and adults. The prevalence of H-pylori infection has increased during past decade. Most of evidence has shown the patients got infected child hood. This study was carried out for recognizing the risk factors of H-pylori in children with gastrointestinal problems who had undergon evaluation endoscopy in Mofid Children Hospital. In this case control study, the number of patients infection and control were 47 in each group. The patient and control groups were matched for age and sex. Demographic variable were registered in information forms. Positive urease test was considered as a patient and negative urease test was considered as control group. All of the risk factors for H-pylori infection were evaluated for both groups and CI in the samples was evaluated with 95% estimation. The number of family members were 4.1 +/- 1.2 in the control group and 5.7 +/- 1.2 in the patients group. Attitude were higher in the patients group toward low consumption of fruit, vegetables, liquid vegetables, seed oil, smoking in family, low level education of parents, blood group A and parents dyspepsia. In the all risk factors CI>1.0 and P<0.05. The consumption of fruit, vegetables, liquid vegetable, seed oil, and negative history of smoking are the reasons for decreasing H-pylori infection in the children and adults

Role of anorectal manometry to improve the results of biopsy in diagnosis of chronic constipation

Most pediatric constipation cases may be treated with an adequate diet and moderate use of laxatives and enemas. A significant proportion of patients, however, does not show improvement with these therapeutic measures. In these cases, it is necessary to establish the differential diagnosis between functional and structural constipation. The objective of this study was to compare the result of two methods of evaluation, manometry before biopsy and biopsy alone. This cross sectional study was carried out in the children with chronic constipation that were referred to Mofid Children Hospital and underwent rectal manometry from 2002-2006. Chi-square test was used for the analysis. From 347 patients who underwent anorectal manometry, 134 patients had evidence that indicated neurologic abnormality and hirschprung disease. From these patients, based on parental agreement, biopsy were obtained from 69 patients. Histopathologic study was performed on 69 samples, and 57[82.6%] specimens had evidence of neuroanatomic abnormality as a cause of the disease. From the 423 biopsy that were obtained from rectal wall without previous anortectal manometry, only 125[29.55%] patients had pathological evidence of structural abnormalities due to Hirschprung disease. From all the biopsy [480], only 57[11.87%] patients had anorectal manometry. Based on there results of anorectal manometry they underwent biopsy. Performing anorectal manometry as a first step to approach constipation could increase specifity of biopsy in contrast to performing biopsy without anorectal manometry. Due to some limitation, we did not obtain biopsy from patients whose manometry was normal