[Study of the final height in children with constitutional short stature]

Short stature is one of the common problems in children. One of the common forms of short stature is Constitutional. Usually early diagnosis and treatment is worthwhile. We studied children with Constitutional short stature who came to the outpatient clinic of Pediatric Endocrinology in Loghman hospital between 2002 and 2008. Their final height has evaluated after puberty. SDS for the first and final height of the patients and their parents' height was calculated. Forty-nine patients [35 boys and 14 girls] were studied. Mean chronological age at the time of referral was 13.4 +/- 1.4 years, mean delay of the bone age 2.6 +/- 1.4 years, mean height 141.9 +/- 7.5 cm, mean SDS of the first height -2.6910.69, mean parental height 163.8 +/- 3.9 cm and SDS for parental height was -0.85 +/- 0.47. Mean age at the time of evaluating final height was 18.7 +/- 0.5 years and mean SDS for the final height was -1.23 +/- 0.89 cm. All patients in our study reached their excepted final height. In this study final height of 9 patients [18.4%] was over 2 standard deviation lower than the mean of the community. Although, all of the patients reached to the normal range of final height, it was in the lower limit of the range. It seems medical interventions could be implemented for patients, whose first height was much lower than the mean

[Practical hospital disaster planning]

Considering the importance of emergency medical practice as a therapeutic specialty taking into account our country's being the fourth Asian country in regard to frequency of Natural disasters and 10th country in the world, an emergency reaction program has been prepared and executed in one of referral hospitals in Tehran. In the current study a formerly prepared procedure used in European hospitals is taken as the base on which the study is conducted. The modes are then modified as dictated by climatic, cultural and clinical conditions of Iran. An aerial map of Imam Hossein Hospital is used to depict the positions of field units and command centers when it's partially dilapidated. Necessary training based on this procedure was provided to the staff and the program was followed to the practice phase and a maneuver was then conducted. The program should be prepared in such a way to constitute immediate establishment of crisis committee comprised of: 1] head of the hospital, 2] Para clinic unit [including laboratory, Radiology and blook bank], 3] nursing unit [triage, coordination], 4] guarding unit and sentinels, 5] dispatching and discharging unit, 6] psychiatric and social work unit, 7] freezers and refrigeration unit, 8] emergency evacuation unit, 9] installations and maintenance unit, 10] logistics and transport unit, 11] communication unit, 12] public relations and media unit, 13] reception unit, 14] bio Nucleuchemical unit, 15] specialized units. Each unit is headed by a director for whom 3 surrogates should be designated who would immediately take the director's place if and when necessary. After preparing such plan extensive and comprehensive training should be given to hospital staff or whoever which would be engaged in such reaction. Eventually the readiness of the staff should be evaluated through simulated situations and maneuvers. It's hoped that god willing we could reduce losses caused by Natural disasters in the future

[ study of patients admitted with serum sickness in Mofid Children Hospital from [April 2005 to September 2007]]

Serum sickness is a type III hypersensitivity reaction mediated by immune complex deposition with subsequent complement activation, small vessel vasculitis, and tissue inflammation. Disease is caused by exposure to foreign proteins, equine diphtheria antitoxin. However, sporadic cases of serum sickness from non-protein antibiotics such as penicillins continue to occur. A retrospective chart review was conducted in 28 children who were admitted because of serum sickness in Mofid Children Hospital since April 2005 to September 2007. Of 28 cases included in our study, 17 were male and 11 female. 24 of the 28 cases [86%] aged less than five years old. In 25 of the 28 patients [89%], the onset of symptoms occurred 1-3 weeks after administration of the inciting antigen, in two patients less than one week, and in one patient more than three weeks. Associated symptoms included arthritis 36%, subjective fever 75%, arthralgia 85%, skin rash and angioedema 100% were observed during admission. Furazolidone was the most common cause of disease in this study. The incidence of serum sickness is decreasing as a result of public health vaccination programs that have decreased the need for specific antitoxins. However, currently, non-protein drugs such as furazolidone are the most common causes of serum sickness-like reactions