[ frequency of recurrence of urinary tract infection [UTI] in 1- month to 12-year-old children without congenital abnormalities referred to Arak Amir Kabir hospital]

Urinary Tract Infection [UTI] is one of the most common diseases of childhood which may cause serious morbidity. We evaluated recurrence rate of UTI in children without congenital abnormalities who were at the age of 1 month to 12 years old. This cross-sectional study was carried out for three months after the termination of the treatment in order to determine the rate of recurrence and re-infection in children [sex segregationation] at the age of 1 month to 6 years and 6 to 12 years who did not have any anatomical or functional urinary abnormalities at Arak Amir kabir Hospital. In total, 250 patients [224 girls and 26 boys] were evaluated. 17 girls had recurrences, of whom, 2 cases [11.7%] were under 1 year old, 14 cases [82.2%] had 1 to 6 years old and 1 case [5.8%] was in the 6 to 12 years old group. In the first month there was no relapse and most recurrences occurred through the third month [65%]. All recurrences were symptomatic. Due to low rate of recurrence of urinary infection in our study group, repeated cultures and prophylactic treatments is not recommended in children and infants without underlying congenital renal abnormalities. In such cases, UTI can be prevented by effective trainings

[Studying the epidemiology of traumatic patients referring to Valie-Asr hospital in Arak]

Nowadays, trauma has considered as one of the important cause of mortality and disability in different countries. Due to identify the importance of this problem spread, it is vital to plan some strategies in each region in order to prevent and decrease trauma. Therefore, the aim of this study was the epidemiological assessment of traumatic patients referring to Arak Valie-Asr Hospital in 2006. In this cross-sectional and descriptive study, the data of 813 traumatic patients, who were admitted to the Arak Valie-Asr Hospital in 2006, were extracted by hospital trauma database. The data were such as: demographic variables, location of trauma and its type, type of trauma [blunt or penetrating], smoking or taking drugs, using safety belt in car accidents, and how to transfer patients to the hospital. According to the findings: the most common cause of trauma was car accidents [351, 43%] followed by occupational accidents [171.21%]; 74% of patients were males; 53% were between 20-44 age-group and 64% didn't get diploma. Most of traumas have occurred outside of the town [704, 87%]; 609 patients [69%] had been transferred to the hospital by people; about 693 [85%] of traumas were blunt type. In car accidents, 16 patients [5%] were smoking and 6 patients [2%] using narcotics. Only 64 patients [18%] had used safety belt. The agents of accidents were as follow: about 57% car vehicle [200]; 18% human [65] and also 25% objects and obstacles [86]. The present findings showed like other studies, the most common cause of trauma in the mentioned hospital was car accidents and most young meals are at high risk. The second cause was occupational accidents. Traumas and accidents injuries are one of the serious challenges of public health. Hence, training and developing culture for the use of safety belt, helmet and also safety measures at work could be the most important preventive factors

[Comparing the sacral ratio in children with various degrees of vesicoureteral reflux with children without reflux]

Children with reflux who fail prophylaxis management or reflux which do not resolve spontanously are candidates for sugery. Delay in surgery increases the development of new renal scars. Finding a modal factor for prediction of reflux resolution likelihood can decrease complications of treatments. Regarding that sacral bone anomalies have a direct influence on the final function of urinary and bowel systems, this study is done to investigate the relationship between sacral ratio and reflux. This is a case-control study. The case group included 76 children under 9 years old refered to Vali-e-Asr and Amir kabir hospitals clinics with urinary tract infection and according to VCUG results, children with III, IV and V grade VUR entered the study. The control group included 76 children with previous urinary tract infection and normal VCUG. Sacral ratio in the two groups was measured and was compared by student T, Chi2 and Mann Whitney tests. The case group included 24 males and 52 females with average age of 2.7 years old and the control group included 23 males and 53 females with the average age of 3 years. The percent of sacral ratio abnormality were 40% and 23.7% in the case and control groups respectively, which was significantly different [p=0.001]. The difference between the mean sacral ratio in case group with the value of 80% and the control group with the value of 84% was not different. The ratio distribution pattern in the two groups was not different. The percent of sacral ratio abnormality in children with vesicoureteral reflux were more than children without reflux

Evaluation the causes of hydronephrosis in children under 12 years old with UTI or failure to thrive, visiting Amir Kabir hospital of Arak, November 2004 to August 2005

Hydronephrosis in infancy and childhood is a frequent urinary malformation. We were unable to find any reports concerning rate and causes of hydronephrosis in Iranian children; therefore, we decided to evaluate it, in under 12 years old children. This was a descriptive study done in a 9-month period starting from Novemger 2004. All children under 12 years old who had visited Amir Kabir hospital of Arak for UTI or FTT were enlisted and an ultrasonography was requested. If hydronephrosis was detected, then a VCUG was performed. For those with normal VCUG results, if hydronephrosis persisted in the follow up sonography, the next step was an IVP or DTPA scan. 65 patients [39 girls and 26 boys] were evaluated for hydronephrosis. 18.5% presented with FTT, 75.4% with UTI and 6.1% with FTT+UTI. The most prevalent causes of hydronephrosis were VUR [40%] and UPJO [23.5%]. Grade I hydronephrosis was the most prevalent form [65%], however when VUR was present, it was mostly grades III or IV [27% and 19% respectively]. 70% of girls and 31% of boys had VUR and the average age at the time of diagnosis was 2-3 years. Vesicouretero reflux and UPJO are tlie most prevalent causes of hydronephrosis and must be evaluated in children with hydronephrosis

Evaluating the effects of prostatan as an adjunct drug in treatment of benign prostatic hyperplasia

Benign Prostatic Hyperplasia [BPH] is the most common benign tumor in men. Due to the side effects of chemical drugs, phytotherapy has become a treatment method in BPH since 1990s. Prostatan is a plant extract widely available hi Iran. In this study, we evaluated the therapeutic effects of Prostatan drop in combination with Prazosin in alleviating BPH symptoms. In a single blind randomized clinical trial, 66 men over 50 years with BPH symptoms who were visited in Vali-e-Asr hospital of Arak were randomly divided in two groups and treated with either Prostatan [40 drop,TDS] plus Prazosin [ling, BD] or Prazosin [Img, BD] alone. AUA symptom score, PSA [prostate-specific antigen] levels, Prostate volume, post voidal residue [PVR] by sonograms and uroflowmetry results were determined before and 12 weeks after treatment. Data was analyzed by T and Man-Whithey u tests. Before treatment there were no significant differences hi age, PSA, PVR, AUA symptom score, Prostate volume and uroflowmetry between the two groups. After treatment the mean of PSA levels, Prostate volume and PVR did not differ between the two groups. In the Prostatan plus Prazosin group, the mean of AUA symptom score was 3.3 less [p<0.0001] and the mean of maximal urine flow rate was 2.7 ml/s more than the Prazosin group [p<0.0001]. Regarding results, it seems that adding Prostatan to Prazosin against Prazosin alone enhances its effects on controlling BPH symptoms and increases urine flow rates

[ effectiveness of Hydrochlorothiazide on preventing recurrent urinary tract infection in idiopathic hypercalciuric children]

Idiopathic hypercalciuria [IH] has been recognized as a common disorder in childhood and is an important and common factor in formation of renal stones. Recurrent urinary tract infection is a clinical presentation of hypercalciuria. Regarding that Hydrochlorothiazide is effective in hypercalciuria treatment, therefore in this study we assessed the efficacy of Hydrochlorothiazide in preventing recurrent UTI in hypercalciuric girl patients. This research was a single blind randomized clinical trial. 100, 1 to 12 years old girls, who were followed by pediatric nephrology outpatient clinic in Vali-Asr and Amir Kabir hospitals, with the diagnosis of idiopathic hypercalciuria and at least two urinary tract infections in year, were included in study. Patients were randomly divided into two equal group. First group received a general preventive treatment consisted of a liberal fluid, urination every 2 hours, reducing dietary salt intake, washing genitalia from front to back, wearing cotton loose underwear and complete urination. In second group, in addition to the general treatment, Hydrochlorothiazide was used with initial dose of 1mg/kg/day in a morning dosage. Then, urinary tract infection recurrence in two groups was assessed by student T test. All patients who received Hydrochlorothiazide were normocalciuric. In each group, incidence of UTI non recurrence was 34% [17 cases], that was not significantly different. This study rejected the presence of hypercalciuria treatment effect in preventing recurrent urinary infection. Therefore, the association between UTI and IH needs to be closely studied with the attention to eliminate confounding factors