[An assessment of Toxoplasmosis antibodies seropositivity in children suffering Autism]

Background: Toxoplasma gondii, is a mandatory intracellular protozoa, that many people worldwide are infected with. In children, the infection enters central nervous system and leads to inflammation of the gray matter. Autism, is a complex developmental disorder, altering social communication, with unknown origin. Neuropathologi-cal changes in autism are the same as those occurred in brain toxoplasmosis

The objective of this survey was to evaluate positive serology of toxoplasma gondii, in autistic children

Methods: This case-control study was done on 3-12 years old children, referring to the neurology and psychiatry sub-special clinics of Baqiyatallah hospital and also autistic children of Omid-e Asr and Navid-e Asr general rehabilitation centers in Tehran, Iran. The study performed at 2012-2013. Forty autistic children were placed in the case group and 40 children, suffering from no neuropsychiatric disease or other ones, were placed in the control group. A folder, containing demographic data, type of the disorder, onset of diagnosis and child characteristics at birth, such as time of birth [preterm/ term] fulfilled for each child. Sampling was done with 5 ml blood, for determining IgM and IgG antibody levels against toxoplasma gondii, using ELISA method. Data analyzed by the software SPSS ver. 17 and descriptive and analytic analysis were done, using central and dispersion indexes and also chi-Square test

Results: The autistic group contained 34 boys and 6 girls [85 and 15 percent respectively], with the average age of 6 [+/-2.71] years old [minimum of 2.33 and maximum of 12]. The average age at the time of diagnosis was 4.01 [+/-1.87] years old. 87. The non-autistic group contained 17 boys and 23 girls [42.5 and 57.5 percent respectively], with the average age of 5.67 [+/-3.09] years old [minimum of two and maximum of 12]. IgM and IgG serology of all autistic children were negative, while in non-autistic group, 2.5 percent (1 child) were positive and 97.5 percent [39 ones] were negative. There were no statistically significant difference among these two groups according to the serology results. [P=0.31]

Conclusion: There was no statistically significant difference in comparing positive serology of toxoplasmosis, between the two groups. However, to obtain a perfect result, a larger sample size are required

Thyroid function test in pre-term neonates during the first five weeks of life

Congenital hypothyroidism [CHT] is one of the most common congenital endocrinal disorders. The prevalence of CHT is estimated about 1 in 3,000 newborns. The prevalence, etiology and associated disorders of abnormal thyroid screening tests are reported in different ranges. In this study, we assessed the pre-term newborns for CHT and associated factors that influence thyroid function. One hundred newborns with the gestational age fewer than 35 weeks were investigated. Baseline serum thyroid stimulating hormone [TSH] and free thyroxin [FT4] levels were measured during the first 5 days of life and were repeated during the first 5 weeks. We analyzed the effects of demographic factors and the presence of respiratory distress syndrome on the alteration of thyroid function tests during the first 5 weeks of life. The mean gestational age [GA] at delivery was 32.35 +/- 1.97 [range 28 to 35] weeks. CHT was observed in 13[13%] preterm infants. GA was the only factor which affect the FT4 changes over the two weeks follow-up [P < 0.001, b: -2.783, Power: 70.2%] although the differences between baseline and follow-up amount of TSH were not significantly influenced by GA [P = 0.062, power: 46%]. However, the adjusted TSH and FT4 serum level changes during follow-up were significantly different between two groups [between CHT and normal, P = 0.006, 0.000, respectively]. It seems that thyroid function tests should be repeated in preterm infants, especially for patients with lower gestational age, to confirm the diagnosis of CHT. Also, CHT should be considered among the newborns that are affected by RDS.

Magnetic resonance imaging findings in epileptic children and its relation to clinical and demographic findings

Epilepsy is an important disease with a cumulative incidence of 3% all over the life and more than half of them are started from childhood. In this study we surveyed magnetic resonance imaging [MRI] findings in epileptic children and its relation with clinical and demographic findings in order to find better diagnostic and treatment modalities for these children in the future. In this cross sectional study, we investigated consecutively all 1 to 15-year-old epileptic children who referred to the pediatric neurology outpatient clinic from 2004 to 2010. Two hundred children were enrolled for investigation. There were 85 [42.5%] girls and 115 [57.7%] boys, aged 1 to 15-year-old [7.7 +/- 4]. 196 [98%] of the children had abnormal electroencephalography [EEG]. Abnormal MRI was seen in 57 [28.5%] patients and consisted of brain atrophy [10%], increasing white matter signal intensity in T2-weighted images [8%], benign cysts [5%], brain tumors [4%] and vascular abnormalities [1.5%]. Abnormal MRI findings had significant relation with abnormal EEG, age, positive family history for epilepsy, dysmorphic appearance, and abnormal physical exam. Considering 98% EEG abnormalities in these epileptic children, benign nature of MRI findings in most of our cases, the high price of MRI and the small minority of patients who benefit from active intervention as a result of MRI, we suggest to use EEG for confirmation of epilepsy and perform MRI for patient with abnormal physical exams, focal neurologic deficits or focal EEG abnormalities

Thyroid function in epileptic children who receive carbamazepine, primidone, phenobarbital and valproic acid

In this study, we investigated the changes of the serum levels of thyroidhormones including Thyroxine [T4], Triiodothyronine [T3], T3 resin uptake andThyroid stimulating hormone [TSH] in epileptic children during treatment withanti-epileptic drugs [AEDs] including carbamazepine [CBZ], primidone [PRM],phenobarbital and valproic acid [VPA]. This study consisted of four case-series comparisons, was conducted on 115epileptic children [37 girls and 78 boys with an age range between 2 months and 15 years, mean: 62.06 A +/- 44.97 months]. These children were divided into4 groups who took either phenobarbital [n=29], PRM [n=28], CBZ [n=29], or VPA [n=29] for 3 months. Thyroid hormone levels [T3, T3 resin uptake, T4 and TSH] were measured at the beginning and three months after starting the study. At first, all patients were euthyroid and there were no clinical or laboratory findings suggestive of hypothyroidism. Regarding thyroid hormones before and after the administration of phenobarbital, carbamazepine, valproic acid and primidone, there were no significant changes in serum T3, T4, T3 resin uptake and TSH levels. Our findings showed that short term therapy with phenobarbital, carbamazepine, valproic acid and primidone had no effect on thyroid function tests

Prevalence of readmission for hyperbilirubinemia in healthy newborns

The aim of this study was estimation of prevalence of jaundice readmission and observes neonatal jaundice risk factors in singleton infant with birth weight more than 2500 gr. This study was done among women who delivered a normal singleton infant with birth weight of >/= 2500 gr in Najmieh Hospital, Tehran, from 2004-2005. Maternal age, race, blood group and Rh, drug consumption during pregnancy, oxytocin consumption during labour, rupture of membranes together with neonatal sex, weight, maturity, gravity and length of nursery stay were recorded. The infants were followed during neonatal period to see if they were readmitted, and the reason of admission. The prevalence of readmission for neonatal jaundice was assessed and the risk factors for neonatal jaundice were compared between the icteric and non-icteric babies. The prevalence of readmission because of jaundice was 12.6%. The maternal data recorded from all mother-baby pairs were not significantly different except for maternal race, Rh group and drug consumption during pregnancy. Arab mothers compared with other race groups had more icteric babies [P=0.001]. Rh-negative mothers had more icteric infants [17.9%] compared with Rh-positive mothers [12%] [P=0.01]. Premature infants were hospitalized significantly more than mature babies [20.3% versus 12.1%, P=0.04]. The length of primary nursery stay differed significantly between two groups [mean [SD] 27 [9.8] hours for icterics versus 30 [2.5] hours for non-icterics, P < 0.001]. The mean age of readmission was fifth postnatal day. We conclude that infants, especially infants of Arab or negative Rh group mothers and premature babies, discharged early from the nursery should be advised to visit a pediatrician within the next 48-72 hours of birth to avoid complications of severe jaundice

[Frequency of multiple pregnancy and its complications in three educational hospitals, Tehran]

Multiple pregnancies are high-risk pregnancies since they are associated with increased perinatal and maternal problems. The aim of our study was to determine the frequency of multiple pregnancies and their maternal and perinatal complications. In a cross-sectional study we assessed 94 multiple pregnancies and 199 neonates in three educational hospitals [Baqiyatollah, Najmie and Mahdie] in Tehran in the first half of 2006. The information was collected from hospital registries of mothers and their neonates. Of 4584 deliveries, 84 [1.8%] were twins, 9 [0.19%] were triplets and 1 [0.02%] was quadruplets. 59 [62.7%] mothers had preterm labor and 14 [14.8%] had pre-eclampsia. We found discordant birth weigh>/=20% in 24 [25.4%] and Twin-to-Twin Transfusion in 3 [3.1%] mothers. 174 [87.4%] neonates were admitted in neonatal intensive care unit or pediatric department. The frequency of mortality and respiratory distress in neonates was 27 [13.5%] and 107 [53.7%], respectively. 39 [19.5%] of neonates had Apgar scores<7 and seizure was not observed in neonates. 65 [32.6%] neonates were normal weight [>2500 gram], 104 [52.4%] low birth weight, 21 [10.5%] very low birth weight and 9 [4.5%] extremely low birth weight. Hypocalcaemia, hypoglycemia and anemia was detected in 45 [22.6%], 24 [12%] and 48 [24.1%] neonates respectively. Regard to increasing the prevalence of multiple pregnancies, better use of infertility modalities, early diagnosis of the multiple pregnancies, prevention of preterm birth, close fetal surveillance, atraumatic labor and delivery can improve maternal and perinatal outcome