Relationship between para clinical findings of first seizure and one year recurrence ra te in children admitted at shaheed Sadoughi hospital-Yazd

Seizure is the most common pediatric neurology problem that occurs in 10% of children. The purpose of this study was to determine the recurrence rate of seizures after one year and its relationship with paraclinical findings of the first attack. In a historical cohort analytic study, 131 children with first seizure admitted to Shaheed Sadoughi Hospital between March 2004 to August 2005 were evaluated for recurrence rate during one year and its relationship with serum levels of sodium, potassium, glucose, calcium, Hb, MCV and PMN during the first attack. 79.4% of cases were in febrile seizure group and 20.6% in first unprovoked seizure group [FUS].Of the total, 27.84% of patients had seizure recurrence [27.9% in febrile and 25.9% in afebrile group]. Mean survival recurrence rate was 10.11 +/- 0.32 SD months [10.25 +/- 0.33 SD months in febrile group and 9.57 +/- 0.83 SD months in FUS]. Survival analysis showed that seizures recurred later in older patients. Younger age and lower Hb levels in the febrile seizure group and lower MCV in the FUS group were associated with an increased risk of recurrence. In this study, anemia and microcytic RBC were risk factors for seizure recurrence. Therefore, more studies should be done so as to decrease seizure recurrence by treating and preventing anemia

[ role of C-reactive protein in diagnosis of neonatal early-onset sepsis]

Bacterial sepsis is one of the most common diagnostic challenges in newborn medicine and is considered as a leading cause of neonatal mortality and morbidity. To study the role of C-reactive protein [CRP] in diagnosis of neonatal early-onset sepsis. This was a cross-sectional analytical study in which 100 newborn babies admitted to NICU were investigated. C-reactive protein was measured before and 24 hours after the beginning of therapy. Continuation or cessation of antibiotic treatment depended upon the result of CRP and blood culture. The data were analyzed statistically using chi-square and fisher exact tests. Sensitivity of the first measurement of CRP compared with the result of blood culture was unmeasurable, but the negative predictive value was 97%. The sensitivity of CRP in second measurement and the negative predictive value were 100%. Our findings revealed that the first CRP result bear little sensitivity in diagnosing sepsis, however, the second CRP result produced higher sensitivity and negative predictive value [100%] for detection of early-onset sepsis. CRP negativity 24 hours after the onset of symptoms could rule out the presence of sepsis with further antibiotic cessation. On the other hand, a positive CRP with sensitivity of 100% is suggestive of sepsis

[Statistical study of laboratory diagnostic tests of streptococcus pyogens]

Bacteria of species Streptococcus pyogenes are a human pathogen, causing serious invasive infections. The culture method remains the standard way for its isolation and identification. Due to the accessible facilities, medical laboratories employ different methods in this way. In present study the most common methods have been statistically interpreted. A total of 159 beta-hemolytic streptococci isolated from different samples were tested for hemolysis potency, sensitivity to bacitracin [BC] or sulfametoxazole/trimethoprim [SXT] and Voges-proskauer [V.P]. Based on L-pyrrolidonyl-beta-naphthylamide [PYR] test, the positive predicted value [ppv], negative predicted value [npv] and sensitivity [sen] of each test were calculated. The ppv, npv and sen. of beta-hemolysis on sheep blood agar [SBA] for identification of S. pyogenes were 75, 89 and 89% respectively. It was 76, 89 and 53% for banked human blood [BHB]. For BC test the above mentioned criteria were 52, 70 and 89% and also for VP test 57, 89, and 94%. Finally SXT test with 49, 47 and 63% demonstrated the least practical identification value. The PYR test is considered the most reliable biochemical test for identification of S. pyogenes among other beta hemolytic streptococci. If it is not available, combining of hemolysis >/= 3mm with BC >/= 10mm has presumptive identification value of 89%. It was realized that the hemolytic activity of this bacterial species on BHB is documented and equal to a potent hemolysis on SBA. The VP test with 89% value is a suitable test to rule out its presence; but the accuracy of SXT test result is limited

[Failure to thrive in under-two-year-old-children and the probable factors involved]

Failure to thrive [FTT] has bad consequences in the first year of life because of maximum of brain growth is at this time and the failure can cause mental retardation and decrease in IQ. Considering that identifying factors contributing to FIT is regarded at first level prevention, a cross- sectional study for identification of causing factors was performed. In this study, 400 children under two years referring to Azadshahr clinic for routine visits were randomly selected. A questionnaire was completed for each child by asking their mothers on their records. Gomez definition was used to evaluate each child for FTT. Out of 400 children, 103 [25.7%] had FTT. FTT did not have remarkable difference between boys and girls. Our results showed that low birth weight, family bigness, maternal age, onset of solid foods, taking ferrous sulfate and the way of starting solid foods were statistically associated with FTT. Although FTT was higher in children of higher educated mothers, in those who did not receive A+D vitamin, in low socioeconomic status families, in unwanted children, in children of mothers observing less than 3 years between pregnancies and in those who suffered a special clinical disorder in the past two months, the correlation was not statistically significant. According to results, attention to factors affecting children growth and educating health staff and their families can help solve our today's community problem

[Severe Combined Immune Deficiency Syndrome [SCIDS] associated with Coarctation of Aorta and Patent Ductus Arteriosus: a case report]

A 25-month old male baby was brought to the emergency room with a clinical picture of septic shock. He had the history of hospitalization during the neonatal period because of pneumonia and heart failure. At that time coarctation of aorta and patent ductus arteriosus was diagnosed. Later in life he had frequently pneumonia, gastroenteritis, urinary tract infection, otitis media, recurrent sepsis, chronic oropharyngeal candidasis, local abscess at the site of BCG vaccination, and multiple draining lymphadenopathies in the left axilla, supraclavicular [the same side of BCG vaccination] and sub mundibular areas. Prolonged mumps parotitis, multiple sores in his mouth and anal area and abscesses in this region. At 5 months of age he underwent the surgical operation for correction of coarctation. Finally, with the diagnosis of [SCID], he was receiving intravenous immune globulin monthly. The results of all tests, particularly cultures were negative. Despite therapeutic measures the patient expired . We suspected viremia as the likely cause of his problem. The most interesting finding in this case was the unusual association between the SCID and the coarctation of the aorta and patent ductus arteriosus[PDA], as far as we are aware, a similar case is not reported in the literature as yet