effect of serum levels of vitamin C on asthmatic children: a systematic review

Introduction: Asthma is a chronic inflammatory airway disorder that is distinguished by coughing, wheezing, and dyspnea. It is the most common chronic disease among children. Epidemiological trials have suggested that there may be a correlation between vitamin C intake and the incidence of asthma. Specifically, according to these studies, a rapid increase in the occurrence of asthma may be caused by a decreased intake of dietary antioxidants and various vitamins such as vitamin C. A systematic review was performed to determine the role that vitamin C, in terms of both dietary intake and serum levels, had on asthma in children

Methods: PubMed and Scopus databases were searched for studies that provide information on the effects of vitamin C on asthma in children aged between 1 and 17 years. The inclusion criteria specified that the studies involved needed to be cohort and case series involving at least ten patients. Exclusion criteria were non-English articles, case reports, and articles involving children who were aged below or above the age 1 and 17 respectively

Result: A total of 13 studies involving 6503 patients met the inclusion criteria. Dietary vitamin C intake was lower in people with asthma than in those without asthma. Lower quantity dietary intakes and serum levels of vitamin C were also associated with increased incidents of asthma

Conclusion: According to the extracted data, a relatively low dietary intake of vitamin C is associated with an increased risk of asthma and wheezing. Moreover, asthmatic patients who consumed vitamin C exhibited an improvement in their diseases

Clinical aspects of patients with febrile convulsion: a survey in Mashhad

Febrile seizures [FS] happen in 2-5% of children aged 6 months to 5 years. Several studies have confirmed that between 2 to 7% of children with FS, develop epilepsy later in life. This study was performed to evaluate the clinical aspects of patients with febrile seizure in our region. This is a retrospective descriptive cross- sectional study that was performed in the pediatric ward of Ghaem hospital in Mashhad, Iran from Sep. 2004 to March 2005. 68 patients aged 6 months to 5 years were evaluated. Most patients were male and aged between 1 to 3 years. 25% had a past history of febrile seizures. Upper respiratory tract infections and gastroenteritis were among the most common causes of febrile seizures, respectively. Simple febrile seizures were seen in 64.7% of the cases. Most of such patients had body temperature above 38.5[degree]c at the time of seizure occurrence. Febrile seizures were more frequently seen in boys aged 1 to 3 years. It most commonly occurred following an upper respiratory tract infection and due to rise in body temperature above 38.5[degree]c

ABO hemolytic disease leading to hyperbilirubinemia in term newborns: value of immunohematological tests

ABO hemolytic disease of the newborn is most common cause of neonatal jaundice; previous studies have shown a poor correlation between serologic tests and clinical course in affected infants. The aim of this study was to identify the value of direct and indirect Coombs' immunohematological tests, to identify the incidence of hemolytic disease in newborns [ABO-HDN]. This two-year retrospective study of 1800 jaundiced term-neonates studied 355 cases due to ABO incompatibility divided into two groups: with and without hemolytic disease. Relation of laboratory parameters and immunohematological tests to severity of disease were studied. We did not analyze the maternal antibody titer or elusion test, and this was a limitation of the study. In this study, 355 [19.7%] of all jaundiced newborn infants were ABO incompatibles; 98 [27.6%] of the newborns who had ABO incompatibility showed ABO-HDN [5.4% of total icteric patients]. The positive direct antiglobulin [direct Coombs' test] and indirect antiglobulin [indirect Coombs' test] were diagnostic in 18.2% and 25.5% respectively in affected infants. The overall prevalence of immunohematological tests associated with ABO-HDN was 43.7%. There was significant correlation between positive antiglobulin tests and severity of jaundice [P=0.000]; also there was a significant difference between indirect and direct Coombs' test and severity of jaundice [P= 0.002]. The antiglobulin tests, namely the indirect Coombs' [IC] test and direct Coombs' [DC] test are very useful to detect the newborns liable to serious jaundice

Postdural puncture headache: incidence and risk factors in children following intrathecal chemotherapy

To evaluate the incidence and risk factors of development of postdural puncture headache in children who had intrathecal chemotherapy injection. Two-hundred eighty patients [mean age, 7.23 +/- 3.92 years] who had intrathecal chemotherapy injection were studied prospectively during 2008-2009 in the pediatric ward of Dr. Sheikh hospital in Mashhad. Patients who had lumbar puncture for their chemotherapy drug injections were assessed daily for four days to detect postdural puncture headache. There were 172 [61, 4%] male patients and the remainder were female. Postdural puncture headache was detected in 41 patients [14.6%]. The body mass index did not show any significant difference between the two groups. Lumbar puncture [LP] attempts had a significant association with postdural puncture headache. The size and shape of the needle did not have a significant association with postdural puncture headache. LP attempts have a significant relationship with postdural puncture headache

role of zinc sulfate in acute bronchiolitis in patients aged 2 to 23 months

Evaluating the effect of zinc sulfate in improving the clinical manifestations of acute bronchiolitis in children younger than 2 years. This was a double blind pilot trial on 50 patients aged 2 to 23 months at Ghaem and Dr. Sheikh Hospitals in Mashhad from January 2008 to March 2009. Patients were randomly divided into two groups: a case group received oral zinc sulfate and to the control group was given placebo. Mean age of case group was 168.0 +/- 108.6 days and control group 169.2 +/- 90.4 days [P=0.98] with male predominance in both groups. At first there was no statistically significant difference between the two groups in reducing the symptoms. But 24 hours after treating, improvement of some important manifestations including tachypnea, subcostal and intercostal retraction, wheezing and cyanosis revealed statistically significant difference in control group in comparison with case group [P=0.04]. Zinc sulfate has no benefit in improving clinical manifestations of acute bronchiolitis

comparison between traditional yogurt and probiotic yogurt in non-inflammatory acute gastroenteritis

To compare the traditional yogurt and probiotic yogurt in improving acute noninflammatory gastroenteritis. A double blinded case-control clinical trial, performed in 100 patients aged 6 months to 12 years of age from October 2008 to September 2009 in Ghaem and Dr. Sheikh Hospitals in Mashhad, Iran. The patients were assigned to the following groups: the case group received a probiotic yoghurt and the control group received the ordinary yogurt. There were statistically significant differences between the case and control groups in reducing frequency of diarrhea in the first [p= 0.000], second [p=0.013], third [p=0.028], and fourth [p=0.022], therapy. Also, there was a significant difference [p=0.000] in discontinuation of diarrhea between the case and control groups. Acute non- inflammatory gastroenteritis improvement is accelerated by probiotic yogurt consumption

Role of intravenous extra fluid therapy in icteric neonates receiving phototherapy

To evaluate the role of intravenous extra fluid therapy in accelerating the reduction of jaundice in newborns who received phototherapy. This study was performed on 100 terms, jaundiced neonates who had a total bilirubin of 18mg/dl or more in the Pediatrics Ward of Ghaem Hospital, Mashhad, Iran from October 2007 to April 2008. The patients were randomly divided into 2 equal groups; group I [case group] were given extra parenteral fluid besides breast feeding, and group II [control group] received only breast milk. The rate of bilirubin decrement, length of hospital stay, and rate of blood exchange were compared. The rate of serum bilirubin decrease per hour in the first 12 hours after admission in group I [0.41mg/dl [95%CI 0.1] versus 0.38mg/dl in group II [95% CI 0.3], [p=0.22]]. It was 0.4lmg/dl for group I [95% CI 0.0001], and 0.21mg/dl [95%CI 0.06] for group II in the second 12 hours [p=0.02]. After 24 hours, it was 0.38mg/dl in group I [95% CI 0.0001], and 0.29mg/dl in group II [95% CI=0.09] [p=0.037]. The mean hospital stay was 68.5 hours in group I, and 67.4 hours in group II [p=0.95]. Additional parenteral fluid therapy in icteric newborns can accelerate reduction in serum bilirubin levels in the first 24 hours

10 year survey of neonatal kidney mass in north-east of Iran [Khorasn]

Although abdominal mass in neonates is not common, it is very critical to detect it promptly. 2/3 of neonatal abdominal masses belong to kidney. Correct diagnosis and immediate appropriate management can prevent morbidity and mortality. This study pays special attention to incidence, associated anomalies and mortality rate in those neonates who suffered from palpable kidney mass. During a period of 10 years 48250 neonates were examined for abdominal mass by neonatalogists or pediatric residents. Sonography in suspected cases of abdominal mass was performed to confirm the diagnosis. In all cases of neonatal death, autopsy was performed. Thirty out of 48250 neonates had abdominal mass presenting as nephromegaly [1/1600]. Polycystic kidneys [PCK] were the most common cause of renal enlargement followed by multicystic kidney disease [MCK] and hydronephrosis. It was revealed that renal mass contained most of abdominal mass in our study and mortality [73%] was higher than other reports. Also, we found that PCK was the most common abdominal mass in our cases. Lung hypoplasia was the most common cause of death in PCK cases

Juvenile dermatomyositis; clinical and laboratory assays

Juvenile dermatomyoistis [JDMS] involves children rarely. Our purpose of this study is to detect clinical and laboratory aspects of this disorder and its treatment in Khorasan Province. A 10-years retrospective study performed on medical records of all patients with JDMS in a medical center in Mashhad. Data was analyzed with statistical measures including SPSS and Excel. 18 patients had DJMS during 10 years. There was a female to male predominance [1.25/1]. The mean age of patients was 12.1 years. Muscular weakness was the most common presenting symptom. Skin involvement including heliotrope rash and Gottron papules were detected in most patients. Elevated muscular enzymes were an important finding in many cases. EMG, and muscle biopsy in those cases performed, showed abnormal results. Seventeen [94.5%] of patients responded to oral prednisolon therapy. According to clinical manifestations and laboratory findings, in particular muscular enzyme assays, a timely diagnosis and treatment with oral prednisolon can improve the disease dramatically and reduce morbidity and mortality rates as well

Association of the expression of IL-4 and IL-13 genes, IL-4 and IgE serum levels with allergic asthma

Immune and inflammatory responses mediated by cytokines, play important roles in the pathophysiology of asthma. These responses are associated with overexpression of Th2 cytokines such as IL-4 and IL-13. These two cytokines use common receptors for signaling that lead to identical immunological effects and regulation of the Th1/Th2 balance. The aim of this study was to determine whether patients with allergic asthma display overexpression of IL-4 and IL-13 genes. Using RT-PCR, we examined the expression of IL-4 and IL-13 genes in twenty asthmatic cases and twenty normal individuals. Total levels of serum IgE and IL-4 were also determined by ELISA method. Expression of IL-13 gene in 70% of patients with allergic asthma was higher than controls [P=0.01]. There was no correlation between the expression of IL-13 gene and total level of serum IgE [P=0.07]. Expression of IL-4 gene was detected in 30% of the patients and none of the normal individuals as determined by RT-PCR [P=0.01]. Mean of serum IgE levels in patients and controls were 84.9 IU/ml and 62.2 IU/ml, respectively. Level of serum IgE was more than 100 IU/ml in 30% of patients [P=0.03]. Mean of serum IL-4 levels in patients and controls were 15.73 pg/ml and 13.07 pg/ml, respectively. There was a relation between levels of serum IgE and IL-4 in 73% of cases. The results showed that there was a correlation between the expression of IL-4 gene and the level of serum IL-4. Levels of serum IgE and IL-4 were considerably higher in asthmatics than nonasthmatic controls

Maternal and other risk factors including bovine IgG in developing infantile colic

Infantile colic is one of the most current problems in the first few months of life. It is suggested that organic or psychologic and behavioral factors can predispose to involve this disorder. Here, we have studied the role of some maternal risk factors including bovine IgG levels in breast milk for appearing the colic in young babies. This retrospective study was performed on 50 infants as case group and 30 infants aged 3 weeks to 3 months who had normal growth and development as control group for one year in Mashad. Data was analyzed with Pearson Chi-Square and Fisher's exact tests. Most colicky infants were male [62% vs 38% female]. They were mainly symptomatic at neonatal period. In 64% of cases, it occurred in the first offspring. Infantile colic was more common in babies who delivered normally than by cesarean section and in mothers aged 20-30 years. According to our finding, there was no relationship between bovine IgG in breast milk and infantile colic. It revealed that anxious pregnant women had more colicky babies and paternal smoking seemed to develop colic in young infants. In order to reduce the occurrence of colic in infants, primigravid mothers aged 20-30 years should have a stressfree environment especially during pregnancy and no smoking exposure in this period

Predictive factors of pediatric intractable seizures

This study was performed in children aged <15 years, at the Pediatric Neurology Clinic of Imam Reza Hospital affiliated to Mashhad University of Medical Sciences. The objective of this study was to recognize the main predisposing factors that result in uncontrolled seizures in patients so that we can start the treatment accurately. There were two groups of patients; group I, consisted of 51 patients, with minimum refractory seizures of one episode per month while taking at least two antieplieptic drugs, and group II, comprised of 80 well-controlled patients chosen at random, who had no fit within 6 months after starting the treatment. Factors affecting the occurrence of refractory seizures included age <1 year, multiple seizures before starting the treatment, male gender, myoclonic seizures, neurologic defects, neonatal and daily seizures, and first abnormal electroencephalogram and brain computerized tomo-graphy scan. There are several factors that can predict development of uncontrolled seizures. Knowledge of these factors helps us to discriminate our patients and pay more attention to those at risk of developing uncontrolled seizures

Bacterial parotiditis in two neonates

The authors report two cases of neonatal parotitis which is a rare infection in newborns and has been reported less than 120 times in world literature. Neonatal bacterial parotitis is commonly represented with fever and swelling and erythema in the preauricular area. The treatment requires appropriate use of antibiotics for 7-1 0 days. Our patients were a 16 day old boy who was presented with fever, poor feeding, swelling, redness, induration and tenderness of left preauricuiar region and a 10 day old girl who admitted due to fever, restlessness, swelling and erythema of left external auricular region. Both of them were treated successfully with parenteral antibiotics for 7 days which were followed by oral antibiotics