Résumé
Puberty is a critical time between childhood and adulthood. Puberty onset is determined by the appearance of breast buds in girls. Many studies have been reported that the mean age of breast development is decreasing. The aim of this study was to provide updated data on the pubertal development of girls and to evaluate precocious puberty in our population. This cross sectional study was conducted in 6 to 16 years old school girls during 2009 to 2010 in Qazvin. 2240 healthy girls from all geographical regions with every socioeconomic status were selected by a stratified multistage cluster design to obtain representative sample of population. A questionnaire including demographic data, anthropometric measurements, secondary sexual characteristics, menarche status and its onset was filled out for every participant. Secondary sexual characteristics including breast development [B1-5] and pubic hair [PH 1-5] were evaluated according to Marshal and Tanner recommendation. The mean +/- SD of height, weight, and BMI of participants was 139.7 +/- 14.5, 36.1 +/- 12.9 and 17.9 +/- 3.7 respectively. The mean age [10th - 90th percentile] of B2 and PH[2] were 9.71[7.67 - 11.4] and 9.82 years [7.84 - 11.42] respectively. Mean age of menstruation was 12.52 years. The mean BMI was significantly higher in pubertal females comparing to prepubertal girls [p <0.001]. Average duration of puberty [the time from initiation of puberty to menarche] was 2.81. The mean age of pubertal onset in girls living in Qazvin is 9.71 years. Menarche occurs at mean age of 12.52 and onset of puberty earlier than 6.24 years will be precocious. We found that girls in Qazvin had a slightly earlier age of initiation of puberty and of menarche in comparison with other studies in Iran
Résumé
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