Poisoning in children and adolescents in Kermanshah city, Iran.

BACKGROUND: Poisoning among children and adolescents is a public health problem worldwide. To take preventive measures, the pattern of this problem should be determined. This study aimed to describe the demographic characteristics of poisoning in children and to investigate the relationship between the types of poisoning and demographic factors in children in Kermanshah province. METHODS: This cross-sectional, descriptive-analytical study was conducted on 250 children and adolescents under 18 years of age who were referred to Mohammad Kermanshahi Pediatric Hospital in Kermanshah province due to poisoning during 2019-2022. The demographic and epidemiological data of patients were extracted from their medical files and analyzed. RESULTS: Out of 250 cases of poisoning, 173 (69.2%) cases were unintentional, 96 (55.5%) of whom were boys. Further, 77 (30.8%) cases of poisoning were intentional, of whom 49 (63.6%) were girls. There was a significant difference between gender and intentional and unintentional poisonings (p-value = 0.005). The median age of unintentional poisoning was 3 (IQR = 2.5) and that of intentional poisoning was 14 (IQR = 2). Most cases of poisoning were in cities, 145 (83.8%) of them were unintentional and 66 (85.7%) were intentional. Most cases of intentional and unintentional poisonings occurred in spring 2017 (35.1%) and autumn 2016 (34.6%), respectively. The most common causes of poisoning were narcotics (n = 36, 34.3%) and drugs (n = 35, 33.3%) in the age group 0-3 years and drugs (n = 46, 66.9) in the age group 11-18 years. CONCLUSIONS: The most common causes of poisoning were narcotics and drugs in children and drugs in adolescents. To prevent poisoning in children, parents are required to increase their knowledge of the safe storage of narcotics and drugs, such as not storing methadone in a water bottle. Targeted evaluation and preventive measures are also needed in adolescent poisoning.

Survey of the effect of biotin on glycemic control and plasma lipid concentrations in type 1 diabetic patients in kermanshah in iran (2008-2009).

OBJECTIVE: Diabetes mellitus is the most common chronic endocrine disease worldwide. Intensive glycemic control plays an important role in decreasing morbidity and mortality rate of the disease. Preclinical studies have shown that biotin has an essential role in regulating blood glucose and serum lipid metabolism. This study aims to evaluate the effect of biotin on glycemic control and plasma lipids concentrations in type 1diabetic patients. METHODS: This randomized double-blind placebo-controlled clinical trial study was conducted 70 type 1 diabetic patients with an age range 5-25 years old with poorly controlled (glycosylated hemoglobin ≥8%). Subjects were randomly allocated into two groups. In the intervention group biotin (40 microgram/kg) was administered plus daily insulin, while the control group received placebo plus daily insulin regimen for three months. Laboratory tests including glycosylated hemoglobin (HbA1c), fasting blood sugar and plasma lipids were measured at the base and after 3 months. RESULTS: In this study, seventy patients were evaluated, 35 were allocated to each group. There were no statistically significant differences between age, gender, duration of diabetes, BMI and BP between the two groups (p>0.05). HbA1c in the intervention (biotin) group was 9.84±1.80 at base and after 3 months treatment, it declined to 8.88±1.73 (p<0.001). In the control group HbA1c at base was 9.39±1.58, after 3 months it increased to10.11± 1.68. There were statistically significant differences in the mean of HbA1c in both the biotin and the control groups (p<0.001). FBS in the biotin group at base was 275±65.76 mg/dl and after 3 months it had reduced to 226± 41.31 (p<0.001). There were statistically significant differences in the mean of total cholesterol, low density lipoprotein cholesterol and triglyceride between the two groups at the end of 3 months (p<0.05). CONCLUSION: Results of this study showed that biotin administration as an adjuvant in addition to insulin regimen can improve glycemic management and decrease plasma lipids concentrations in poorly controlled type 1 diabetic patients.

Effect of White Plastic Cover around the Phototherapy Unit on Hyperbilirubinemia in Full Term Neonates.

OBJECTIVE: Jaundice is a common problem in neonatal period. Phototherapy is the most common treatment for neonatal jaundice. The purpose of this study was to determine the effect of adding white plastic cover around the phototherapy unit on hyperbilirubinemia in full term neonates with jaundice. METHODS: In this randomized controlled trial, over 12 months (October 2009 - September 2010), 182 term neonates with uncomplicated jaundice, admitted to neonatal unit of Imam Reza Hospital (AS) in Kermanshah province of Iran, were selected. They were randomized in two groups. Control group received conventional phototherapy without cover around the apparatus and covered group received conventional phototherapy with plastic cover around the unit. After enrolment, total serum bilirubin was measured every 12 hours. Phototherapy was continued until the total serum bilirubin decreased to or less than 12.5 mg/dl. FINDINGS: There were no significant differences between the two groups for gestational age, birth weight, postnatal age, weight (at admission), serum level of hemoglobin, hematocrit and reticulocyte count. Total serum bilirubin in covered group, during the first 48 hours of treatment, declined significantly than in control group (P. value=0.003). The cover around the phototherapy unit not only did not increase the side effects of phototherapy, but also had a positive impact in reducing duration of jaundice (P. value <0.0001) and duration of hospitalization (P. value <0.0001). CONCLUSION: The study results showed that using white plastic cover around the phototherapy unit can increase the therapeutic effect of phototherapy.

Tuberculin Reactivity in School Age Children; Five-year Follow-up in Iran.

OBJECTIVE: Tuberculosis (TB) is an important infectious disease worldwide. Tuberculin skin test (TST) is the standard test for diagnosis of tuberculosis infection; Bacillus Calmette-Guerin (BCG) vaccination at birth has effects on this test. The aim of this study was to determine the prevalence of positive TST cases among 7- to 11-year-old primary school children and also to follow test-positive individuals for a five-year period. METHODS: TST was performed on 10.184 children aged 7-11 years sampled by cluster random method in Kermanshah, West Iran. Those who had a positive test result (i.e. an induration of ≥15 mm following 72 hours of injecting 0.1 ml of 5 tuberculin units of purified protein derivative from Mycobacterium tuberculosis) were followed for five years to determine the presence of active TB. Also tuberculin positive rates at cut-off points of 10 mm and ≥15 mm for boys and girls and at different ages were derived and compared using the chi-squared test. FINDINGS: Of 10.184 studied subjects, 830 (8.15%) cases showed positive TST. This rate was 8.7% in boys and 7.8% in girls (P=0.1). A significant linear trend was found between the tuberculin positive rates and age at all cut-off points (P<0.001). No active TB was detected during 5-year follow-up. CONCLUSION: The rate of positive TST cases in primary school children in Kermanshah, Iran was 8.15% with no new cases of active tuberculosis detection within five-year follow-up.