Recurrent henoch-schonlein purpura in familial Mediterranean fever

Familial Mediterranean fever [FMF] is a relatively rare disorder, characterized by recurrent self-limited attacks of fever and polyserositis. Diagnosis is made by clinical features, gene identification on chromosome 16 and clinical response to specific treatment. Different types of vasculitis have been reported in FMF. Henoch-Schönlein purpura [HSP] is one of them, usually with a benign clinical course. Repeated attacks of HSP have been rarely reported in FMF. This is the report of a 7-year-old girl who presented initially with recurrent fever and abdominal pain. After the primary diagnosis of FMF and appropriate treatment, she experienced two documented repeated attacks of HSP with severe renal involvement [crescentic glomerulonephritis] and protracted abdominal pain in the second one. Glomerulonephritis was controlled by methyl-prednisolone pulse therapy plus oral corticosteroid and azathioprine, but abdominal pain was resistant to steroids and revealed completely by intravenous immunoglobulin [IVIg] administration. In conclusion, it is suggested to consider the recurrence of HSP in cases with FMF to prevent irreversible renal complications. IVIg seems to be a good choice for the management of intractable abdominal pain of HSP

Bacteriologic study of blood culture in children and neonates with bacterimia and septicemia

The use of antibiotics for life threatening infections depends on periodic study of resistance patterns among isolated organisms in various settings and age groups especially in the era of increasing resistance. This study was performed to determine the microbiological characteristics of blood stream isolates in the neonates and children as a high risk population at a community hospital located in the southern Tehran. All neonates and children up to 12 years of age admitted with presumptive diagnosis of sepsis or bacteremia were enrolled to this cross sectional, descriptive study. Blood cultures were monitored on a daily basis and suspicious samples were further subcultured in appropriate media; using the usual differential techniques and antimicrobial sensitivity tests. Results were recorded and expressed as percentages using excel software. One hundred and seven positive blood cultures were identified among 500 enrolled patients. Positive blood cultures were more common in the neonates than children [56 vs 51]. Gram positive organisms were more common than gram negative ones [61% vs 39%] with coagulase negative staphylocoscci [CONS] as the most common isolate in gram positive and Ecoli as the most prevalent gram negative organism. Apart from vancomycin, first generation of cephalosporins showed the best activity against CONS, however aminoglycosides showed promising for gram negative organisms. It was concluded that type of organisms and their sensitivity patterns are quite different in our community hospitals versus referral centers, still similar to other general children hospitals albeit with higher resistance rates

[Intestinal obstruction among Iranian children]

Intestinal obstruction is one of the important diseases in children that need to be diagnosed and treated appropriately to prevent complications. The present study was conducted to identify the most common causes of intestinal obstruction, age and sex prevalence, complications and associated anomalies in Iranian children. One hundred children aged under 12 years old with manifestation such as vomiting, abdominal pain, no fecal and gas passage and abdominal distention indicative of intestinal obstruction were studied. Different etiologies of obstruction were documented by of radiologic procedures or during surgery. Sixty and three patients were less than 1 month, 27 between 1-12 months and 10 had 1-12 years. Most of the patients [73] were male. The most common causes were Hirschprung disease, invagination and imperforated anus with relatively equal prevalence. The most common age of hirschprung disease and imperforated anus was in neonatal period. Invagination was more prevalent during infancy. Intestinal perforation occured in 6 patients, mostly in small bowel atresia obstruction. Hirschprung disease and imperforated anus were most common causes of mortality. Associated anomalies were cardiovascular, urologic, genital and gastrointestinal abnormalities, especially in imperforated anus and hirschprung disease. The results of this study are largely confirming the findings of previous similar studies in other countries

Pheochromocytoma and renal agenesis

Pheochromocytomas are cathecolamine producing tumor arising from chromaffin cells of adrenal medulla and extra adrenal tissues. This is a report of a boy presented with headache and hypertension. In radiologic exams, an adrenal mass detected in the left side, with no renal tissue on that side. It was reported an adrenal pheochromocytoma in histopathology. Renal agenesis confirmed during surgery. All of the patients symptoms alleviated after the resection of tumor

Determination of birth indices in healthy neonates

Determination of birth indices is essential for primary supportive care, evaluation of perinatal anomalies, determination amount of difference from standard values and for further follow up. In this study using a multicentre sampling, a number of 2832 healthy neonates selected. Mean and percentile values of four main birth indices; weight, height, head and chest circumference are presented. In this study, males outnumbered the females [50.8% vs. 49.2%]. Mean [ +/- SD] weight, height, head and chest circumferences were 3231.70 gr [ +/- 3.92] 49.77 cm [ +/- 1.76], 35.03 cm [ +/- 1.27] and 33.34 cm [ +/- 1.56], respectively. Weight, height and head circumference had significant statistical differences in male and female. Chest circumference had difference in gender groups, but it seemed to be clinically not significant [mean difference= 0.416]. Birth weight in both genders plus height and chest circumference in girls were significantly lower than NCHS standard values. But, head circumference was more. Height and chest circumference of males had no statistically difference