The Effect of Adding Honey to Zinc in the Treatment of Diarrhea in Children / 가정의학회지

Background@#Honey has been used in medicine since ancient times. Limited reports are available to indicate its antibacterial, antiviral, and antidiarrheal properties. This study aimed to determine the effect of honey on acute diarrhea in children. @*Methods@#This randomized clinical trial included 80 children with acute diarrhea. Forty children received honey and zinc gluconate (trial group) and 40 received only zinc gluconate (control group). After treatment, vomiting/diarrhea duration, the recovery time, and the duration of hospitalization were compared between the groups. @*Results@#Among the 40 children in the trial group, 19 were male and 21 were female. In the control group, 25 children were male and 15 female (P=0.26). After initiating treatment, the duration of diarrhea, recovery time, and the duration of hospitalization was significantly shorter in the trial group than in the control group (P<0.05). @*Conclusion@#This study showed that honey with zinc gluconate reduces the duration of diarrhea, accelerates the recovery time, and shortens the duration of hospitalization.

Association between vitamin D and urinary tract infection in children / 소아과

PURPOSE: The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children. METHODS: In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed and compared between both groups. RESULTS: Among 70 children with UTI (case group), 5 children (7.2%) were male and 65 (92.8%) were female. Among the healthy children (control group), 9 (12.8%) and 61 children (87.2%) were male and female, respectively (P=0.39). The mean±standard deviation of age in the case and control groups were 53.2±35.6 and 36.1±60.2 months, respectively (P=0.24). The mean level of serum 25(OH)D in the case group was significantly higher than that of the control group (20.4±8.6 ng/mL vs. 16.9±7.4 ng/mL, P=0.01). CONCLUSION: This study showed that there was a relationship between serum 25(OH)D levels and UTI in children. It seems that 25(OH)D plays a role in the pathogenesis of UTI.

Treatment outcome of neurogenic bladder dysfunction in children; a five-year experience

A neurogenic bladder is one which functions abnormally due to disorders of sacral nerves that control the bladder's ability to fill, store and empty urine. Abnormal bladder function can cause the bladder to be underactive or overactive. This study was planned to evaluate the treatment outcome of our patients with neurogenic bladder dysfunction [NGBD]. Thirty three patients who have been treated for NGBD were evaluated. Diagnosis was confirmed by voiding-cysto-urethrography [VCUG] and urodynamic study. The patients were treated medically and all had clean intermittent catheterization [CIC]. Data regarding age, sex, clinical and paraclinical findings, sonography, imagings, renal scan, associated anomalies, treatment and outcomes were collected and entered in SPSS software version 18 and analyzed by descriptive statistical. Totally 33 patients aged three days to four years [mean 6.8 months] were included in this study. There were 20 [61%] males and 13 [39%] females. Mean follow-up period was 3.4 +/- 1.2 years [1.5 months to 5 years]. Eighty two precent cases had bilatral and 18% unilatral hydronephrosis and bilatral vesicouretral reflux [VUR] existed in 67% and unilatral in 33% of the patients. Treatment consisted of antibiotherapy and CIC in all patients, which was only in 33% of the cases succesful. The most common associated anomaly was meningomyelocle in 8 patients. Vesicostomy was performed in 22 [67%] cases. Kidney scan showed scar in 10 patients at follow-up study. Complete continence on follow-up was achieved in 24 [71%] patients, and it was improved in 6 [18%] cases. Mortality rate was 9% [3 cases]. Cure rate was 85% in urinary tract infection, 82.7% in hydronephrosis, 80% in VUR and 86.5% in kidney function. Anticholinergic medications was not effective in all our patients. We believe that permanent vesicostomy is an effective and acceptable surgical intervention for protection of upper urinary tract decompression, especially in those who do not respond to medical treatment and have high risk position

sensitivity of ultrasonography in detecting renal cortical defects in pyelonephritic patients with or without vesicoureteral reflux

The presence of renal scarring has been documented in 5% to 15% of febrile urinary tract infections. The main aim of this study was to compare the value of renal ultrasonography and cortical scintigraphy with technetium-99m dimercaptosuccinic acid [DMSA] in detecting renal cortical defects in acute pyelonephritis. Between June 2003 and February 2012 a prospective cohort study of patients aged 1 month to 14 years of age was conducted. Pediatric patients with documented urinary tract infections were evaluated with renal ultrasonography, voiding cystoureterography [VCUG] and DMSA scintigraphy. Statistical test was two-tailed and was considered significant when P< 0.05. The results of DMSA scans showed 70.2% of cases as being abnormal. Renal ultrasonographies were reported to be normal in 72.45 and showed mild hydronephrosis in 37.7% of cases, moderate to severe hydronephrosis in 40.62%, stone formation in 13.66% and scar formation or decreased cortical thickness in 8.2%. There was a significant difference in ultrasonography reports between patients with normal and abnormal DMSA scans [P< 0.012] but there was no significant difference in detection of scar formation between DMSA scan results and those of ultrasonography in our patients. Among patients with severe abnormalities on DMSA scintigraphy the percent of cases with vesicoureteral reflux was significantly higher than those with normal scans or mild to moderate changes on DMSA scintigraphy. [46.3% vs 26.9%]. We concluded that ultrasonography is a sensitive method for detection of renal cortical defects and ultrasonography can also predict the presence of vesicoureteral reflux in pyelonephritic patients

case-control study of the association between serum copper level and febrile seizures in children

Febrile seizures are the most common cause of seizure in children. Identification of risk factors is very important. This study was conducted to determine the association between the serum copper level and simple febrile seizure in children. In this study, 30 children with simple febrile seizures [case group] were compared with 30 children with febrile illness without seizures [control group] regarding serum copper level. This study was conducted in Qazvin children's hospital [Qazvin, Iran]. The mean serum copper levels in the case and control groups were 141.41 +/- 30.90 and 129.43 +/- 18.97 mcg/dl, respectively. This difference was not significant statistically. This study revealed that there is no association between serum copper levels and febrile seizures. It seems that copper deficiency is not a risk factor for febrile seizures in children

Serum thyroid hormone levels in epileptic children receiving anticonvulsive drugs

The aim of this study was to investigate serum thyroid hormone levels in epileptic children receiving anticonvulsive drugs. In this case- control study, 30 epileptic children who were receiving anticonvulsive drugs [case group] were compared with 30 healthy children [control group]. This study was carried out in the Qazvin Children's Hospital [Qazvin, Iran] from October to December 2007. Both groups were matched for age and sex. Thyroid hormone levels were measured using a radioimmunoassay and immunoradiometric assay. Data were analyzed using Chi-square and Student's t-tests. The mean serum T3 and T4 levels in the case group were 2.36 +/- 0.73 nmol/L and 95.96 +/- 27.01 nmol/L, respectively, and the corresponding values in the control group were 1.88 +/- 0.93 nmol/L and 147.46 +/- 35.77 nmol/L, respectively. The mean serum thyroid-stimulating hormone [TSH] levels in the case and control groups were 2.73 +/- 0.73 mIU/mL and 2.49 +/- 2.17mIU/mL, respectively. This study revealed that long-term consumption of anticonvulsive drugs resulted in a decline in serum T4 levels and an increase in serum T3 levels, but had no effect on TSH levels

Diaper type as a risk factor in urinary tract infection of children

Urinary tract is one of the most common sources of infection in children under the age of two years. Many known and unknown risk factors predispose to this important disease in children. This study was conducted to determine whether using a specific type of diaper plays a role in urinary tract infection [UTI] in girls under the age of 2 years. This case control study was performed in hospitalized children; girls with their first urinary tract infection were selected as cases, and those admitted for other reasons comprised the control group. Two groups were matched for age [ +/- 1 month], and other known risk factors for UTI. Type of diapers [superabsorbent, standard disposable and washable cotton], used for these children during six months, from October 2007 to March 2008, were compared in both I groups. 59 matched pair infant girls less than 2 years were selected. It was revealed that in cases with UTI superabsorbent diapers were used more frequently than in controls [Odds ratio =3.29, P-value=0.005] There were no significant differences in other factors like number of diapers used per day, the time between defecation and diaper change, mothers' educational level, level of family income and mother's occupation. The use of superabsorbent diapers could be a risk factor for urinary tract infection in infant girls

Distal renal tubular acidosis and its relationship with hearing loss in children: preliminary report

In autosomal recessive distal renal tubular acidosis [DRTA], a substantial fraction of the patients have progressive bilateral sensorineural hearing loss. This coexistence is due to the mutations of a gene expressed both in the kidney and in the cochlea. The aim of this study was to assess the correlation between hearing loss and DRTA. In this study, 51 children diagnosed with renal tubular acidosis were evaluated. Diagnosis of DRTA was based on clinical manifestations and detection of normal anion gap metabolic acidosis, urine pH higher than 5.5, and positive urinary anion gap. Audiometry was performed in children with DRTA and sequencing of the ATP6V1B1 gene was done for those with sensorineural hearing loss. Twenty-seven patients [52.9%] had DRTA, of whom 51.9% were younger than 1 year old, 55.6% were boys, and 44.4% were girls. Eleven patients [40.7%] had bilateral sensorineural hearing loss, consisting of 5 of 15 boys [33.3%] and 6 of 12 girls [50.0%]. There was no correlation between hearing loss and gender. Three patients with hearing loss had mutation in the ATP6V1B1 gene [11.1% of patients with DRTA and 27.3% of patients with DRTA and hearing loss]. This study indicated that a significant percentage of the children with DRTA had sensorineural hearing loss and mutation in ATP6V1B1 gene. It is recommended to investigate hearing impairment in all children with DRTA

Diagnostic potential of urinary tumor necrosis factor-alpha in children with acute pyelonephritis

Tumor necrosis factor-alpha [TNF-alpha] is an important mediator of the inflammatory response in serious bacterial infections. The aim of this study was to evaluate the potential of urinary TNF-alpha for diagnosis of acute pyelonephritis in children. This study was conducted from March 2006 to December 2007 on children with confirmed diagnosis of acute pyelonephritis. They all had positive renal scintigraphy scans for pyelonephritis and leukocyturia. The ratios of urinary TNF-alpha to urine creatinine level were determined and compared in patients before and after antibiotic therapy. Eighty-two children [13 boys and 69 girls] with acute pyelonephritis were evaluated. The mean pretreatment ratio of urinary TNF-alpha to urinary creatinine level was higher than that 3 days after starting on empirical treatment [P = .03]. The sensitivity of this parameter was 91% for diagnosis of acute pyelonephritis when compared with demercaptosuccinic acid renal scintigraphy as gold standard. Based on our findings in children, the level of urinary TNF-alpha-creatinine ratio is acute increased in pyelonephritis and it decreases after appropriate therapy with a high sensitivity for early diagnosis of the disease. Further research is warranted for shedding light on the potential diagnostic role of urinary TNF-alpha in pyelonephritis in children

Urinary lnterleukin-8 in acute pyelonephritis of children: a before-after study

The aim of this study was to assess urinary interleukin-8 [IL-8] levels in pyelonephritis and its relation with the clinical course of the infection and of inflammatory changes detected by renal scintigraphy. In this quasi-experimental before-after study, we evaluated 91 children aged 1 to 144 months [mean 34.4 +/- 35.2 months] with pyelonephritis. Inflammatory markers including erythrocyte sedimentation rate, C-reactive protein, leukocyte count, and urinary IL-8, together with the results of ultrasonography, voiding cystourethrography, and dimercaptosuccinic acid renal scintigraphy were evaluated in these children. The ratios of urinary IL-8 to creatinine [IL-8/C] before and after the treatment were compared with each other. Urinary IL-8/C levels were significantly higher after the empirical treatment in comparison with those before the treatment [0.19 +/- 0.21 versus 0.51 +/- 0.53, P < .001]. No correlation was found between the urinary IL-8 levels and leukocyturia, urine culture results, other inflammatory markers, or findings of imaging examinations. We found high urinary IL-8 levels in children with pyelonephritis. We also documented its increasing after the treatment. We conclude that evaluation of urinary IL-8 can be a noninvasive test for diagnosis of upper urinary tract infection and its response to treatment