Evaluation of Lipid Profile Changes in Pediatric Patients with Acute Mononucleosis / 감염과화학요법

BACKGROUND: Acute Epstein-Barr virus (EBV) infection could lead to atherogenic lipid profile changes in adults; while there is no evidence about the children with Infectious mononucleosis (IM). The aim of this study was to evaluate the lipid profile of the children in acute phase of mononucleosis and two months after the recovery. MATERIALS AND METHODS: From 2010 through 2012, 36 children with IM aged 1-10 years were enrolled in a prospective cross-sectional study. Fasting serum total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglyceride level were measured during acute phase of the disease and after 2 months of the recovery. RESULTS: From 36 patients enrolled, 25 (69.4%) cases were male and the mean age of the patients was 4.1 ± 2.0 years. The mean of the total cholesterol level in the acute phase and 2 months after the recovery were149.5 ± 35.3 mg/dL and 145.7±30.6, respectively (P = 0.38). However, the serum level of HDL cholesterol in patients after 2 months of recovery was significantly increased (37.9 ± 9.3 mg/dL vs. 28.5 ± 10.6 mg/dL, P <0.001). The mean value of serum LDL cholesterol was significantly reduced, two months after recovery (81.4 ± 19.5 mg/dL, vs. 92.6 ± 28.8 mg/dL, P = 0.009). Furthermore, the serum triglyceride level was significantly reduced after the recovery (108.7 ± 36.9 mg/dL) compared with the acute phase (163.8 ± 114.3 mg/dL) (P = 0.004). CONCLUSION: EBV infection in children could change lipid profile which is partially restored 2 months after the recovery.

Clinical findings and initial treatment response of patients with visceral Leishmaniasis admitted in Ali asghar children hospital from 1976 to 2010 in Tehran, Iran

Background:Visceral Leishmaniasis[VL] is a spreading potentially fatal zoonosis in Iran mimicking many other diseases in infancy which differs from VL in some other regions in terms of it's clinical characteristics and response to therapy; earlier and better management is quite effective for life saving. Patients and Methods: All cases with final diagnosis of VL, 2months to 12 years who were discharged from Ali Asghar children hospital from 1976 to 2010 were enrolled in this descriptive-analytic retrospective study; demographic, clinical, paraclinical parameters as well data concerning initial response to treatment were gathered and analyzed by appropriate statistical methods by SPSS software. Results: 58 patients with final diagnosis of Kala azar were admitted in Ali asghar children hospital from 1976 to 2010.36 cases[62%] were male; mean age of patients was 30 months[SD=24.98]; Most cases had been admitted in spring [21cases, 36%] and winter[18cases, 31%], 43% were living in Tehran and around Tehran.Fever was the most common symptom and observed in 54 cases[93.1%]followed by splenomegaly, hepatomegaly, pallor and cough. There was a significant association between fever onset until admission and presence of splenomegaly[P value=0.015], weigh loss[P vaue=0.025]and pallor[0.029].Most cases[93%] had been treated by Glucantime; mostly with doses less than 20 mg/kg/day and there was no significant difference regarding initial response[stopping fever] between those who got final dosages less than or equal to 20mg/kg/day and those who received higher doses. Conclusion: Comparing to previous studies, there were some differences concerning presenting symptoms and signs on admission probably due to late diagnosis of VL in recently infected areas. Glucantime still has good effect for VL in Iran and it's lower doses might also be effective for treatment although follow up studies are needed. Keywords: Kala azar, children, Iran, Leishmania infantum

Epidemiology of nosocomial infections in a pediatric intensive care unit [PICU]

Nosocomial infections [NI] are major concerns in the management of patients in hospitals and are growing problem in developing and developed countries because of increased mortality and morbidity rates and corresponding costs. This cross sectional study was carried out on all patients hospitalized for more than 48 hours in pediatric intensive care unit [PICU] of Rasul Akram hospital in Tehran Nosocomial infection was defined according to the criteria of National Nosocomial Infections Surveillance [NNIS] System. During the study period, 102 patients were hospitalized of whom 15 [14.7%] proved to have NI. The mean duration of PICU stay was 16.1 days for NI group and 8.9 days for non-NI group [p<0.05]. Mortality rate was significantly higher among NI group [40%] when compared with non-NI group [11.5%] [OR=5.13 95% CI:1.29-20.60, p<0.05]. Age under 2 years was a risk factor for NI [OR=4.44, 95% CI:1.23-16.67]. The most common causative organisms for nosocomial infections in PICU were coagulase-negative staphylococci [CONS], followed by Klebsiella and Pseudomonas aeruginosa. Pneumonia was the most common nosocomial infection followed by urinary tract infection and sepsis. The calculated NI rate in our study [14.7%] is higher than usual rates reported from PICU in other societies. Meanwhile, long stay in PICU and age less than 2 years are the main risk factor for NI and subjects with NI are 5.13 times more likely to die