Effect of vitamin E and metformin on fatty liver disease in obese children- randomized clinical trial

We evaluated the effect of vitamin E and metformin on fatty liver disease in obese children. This interventional study has been done on 119 children with Non-alcoholic fatty liver disease [based on sonography results]. Patients were divided into four treatment groups; they received metformin 1gr daily [age< 12 years], metformin 1.5 gr daily [age> 12 years], vitamin E 800 U daily and vitamin E 400 U daily. Liver sonography was performed for patients for two periods of two months. This trial was registered in Iranian Registry of Clinical Trials [IRCT], No.IRCT2013021012421N1 The study group comprised 119 individuals [62 females, 57 males]. The mean age was 10 +/- 3.19 yr. There was no significant difference in terms of sex and BMI between the groups. Overall liver sonography showed normal liver in 66 patients [55.46%], 66.63% after two months and 33.37% after four months. After two months, the most therapeutic response observed in the group which received vitamin E 800 u daily [48.1%] and the least therapeutic response was in the group which received vitamin E 400 u daily [14.3%]. After four months, the greater response was seen in vitamin E 400 u daily group [45.8%] and the least response in the metformin 1 gram daily group [19%]. In comparison with metformin, vitamin E is more influential in remission; however both are efficient in treatment of fatty liver. Vitamin E 400 u daily responses better in four-month treatment

Comparison of the frequency and complications of inappropriate antidiuretic hormone secretion in patients with septic and aseptic meningitis

Due to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion [SIADH]. This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic meningitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006. This descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information [age, gender, type of meningitis, serum sodium and potassium, urine specific gravity [USG], blood sugar, blood urea nitrogen, serum creatinin, hydration condition] was collected from patients' records. Data was analyzed using Mann-Whitney and Kappa [2] tests. Out of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases [34.5%] suffered from SIADH. It was more frequent among 1-2 year old children. According to this research, SIADH was diagnosed in 57% of the 121 patients with hyponatremia, 58.7% of the 167 patients with USG> 1.004, 74% of the 93 patients with serum osmolity <280 mOs/l and 100% of the patients with BUN <10 mg%. Due to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH

Urinary calcium excretion in healthy children living in Kashan/ Iran

Urinary calcium excretion is different in various geographical regions. Therefore, we decided to evaluate the urinary calcium excretion in pediatric inhabitants of residential districts in the Desert of Iran and to determine the frequency of hypercalciuria. This study was carried out from 2004 to 2005 on healthy children aged 7-12 years in Kashan [Central Desert of Iran]. By proportional cluster sampling 95 rural and 305 urban cases were selected. The second non fasting morning urine sample was collected for measuring sodium, creatinine and calcium. Children whose urine calcium to creatinine ratio was more than 0.2 and urine sodium more than 200 meq/l were considered as hypercalciuric and hypernatriuric. Water samples were collected by health worker from 9 regions of the city and 9 villages for chemical analysis. The differences between frequencies were assessed by chi square test. P values less than 0.05 were considered significant. A total of 362 [175 females, 187 males] with a mean age of 9.5 [ +/- 1.4] years were studied. Mean urinary calcium/creatinine concentration ratio was 0.2 [ +/- 0.17]. The 95th percentile value for urine calcium/creatinine concentration was 0.53 and prevalence of hypercalciuria was found as 37.8%. The contents of water were similar in Kashan city and the villages, only the mean of total water density was higher in water supply of the city [P<0.05]. By regression analysis we found only direct but weak correlation between urine calcium and urine sodium excretion [r=0.37, P=0.0001]. Urinary calcium excretion is high in desert of Kashan; thus it is important to conduct more studies to determine the risk factors and its untoward effect such as nephrolithiasis