Blood pressure percentiles by age and height for children and adolescents in Tehran, Iran.

To construct reference percentiles for blood pressure (BP) by sex, age and height for the first time in Iran, we used data on 16 972 healthy children, aged 1 month to 18 years, collected during 2000-2010 in Tehran. BP in this population rose steadily with age and height following a very similar trend in both genders up to the age of 14. Systolic BP (SBP) rise was more prominent in younger ages, and after puberty (15-18 years) was greater in boys compared with girls, while the rise in diastolic BP (DBP) was slightly higher in girls. Iranian norms, compared with 'Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents' (US-4th-Report) and the 'German BP Percentiles by Age and Height for Children and Adolescents' (KiGGS), showed a similar pattern of differences for both genders. For example, for Tehrani boys up to 6 years old whose heights were equal to 50th percentile of stature-for-age as well as length-for-age growth charts, the differences in 95th percentile for SBPs compared with the US-4th-report varied from 2-21 mm Hg while compared with KiGGS, maximum of differences was 9 mm Hg. For boys 7-15 years of age, ours were slightly higher than both. For ages of 16 and 17 years, we yielded figures lower than US-4th-report (2 mm Hg) but higher than KiGGS (3 mm Hg). Iranian 95th percentile for DBPs was lower than US-4th-report and KiGGS (1-11 mm Hg). Considering the differences with US-4th-report and KiGSS standards, the references presented in this study should rather be applied in Iranian population.

Incidence of urinary tract infection in neonates with septicemia: a prospective study.

AIM: The aim of this study was to investigate the incidence and clinical course of urinary tract infection (UTI) in neonates with septicemia and also determine the most common UTI manifestations in hospitalized neonates. METHODS: A cross-sectional study was carried out on consecutive febrile infants aged 1 to 56 days that were hospitalized in the neonatal intensive care unit. In all neonates with positive urine culture, scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA) and ultrasonography (US) were performed. Voiding cystourethrography was performed in the course of the illness, generally within 5-7 days of hospitalization. RESULTS: Positive blood culture was detected only in 9% of patients. However, 5% of them had positive urine culture. Positive abnormal US findings were present in two of five (40%) and vesicoureteral reflux (VUR) was present in one of five (20%) of infants with positive urine culture. CONCLUSION: DMSA scan revealed renal parenchymal abnormalities in 3 of 5 (60%) neonates with urosepsis. The incidence of UTI in neonates with septicemia is low. All neonates with sepsis and positive urine culture should undergo a screening renal scintigraphy and cystogram for identifying renal parenchymal involvement and urinary tract abnormalities.

Incidence of urinary tract infection in neonates with septicemia: a prospective study.

AIM: The aim of this study was to investigate the incidence and clinical course of urinary tract infection (UTI) in neonates with septicemia and also determine the most common UTI manifestations in hospitalized neonates. METHODS: A cross-sectional study was conducted on consecutive febrile infants aged 1 to 56 days that were hospitalized in the neonatal intensive care unit. In all neonates with positive urine culture, scintigraphy with technetium-99m -labeled dimercaptosuccinic acid (DMSA) and ultrasonography (US) were done. Voiding cystourethrography was performed in the course of the illness, generally within 5-7 days of hospitalization. RESULTS: Positive blood culture was detected only in 9% of patients. However, 5% of them had positive urine culture. Positive Abnormal US findings were present in 2 of 5 (40%) and vesicoureteral reflux (VUR) was present in 1 of 5 (20%) of infants with positive urine culture. CONCLUSION: DMSA scan revealed renal parenchymal abnormalities in 3 of 5 (60%) neonates with urosepsis. The incidence of UTI in neonates with septicemia is low. All neonates with sepsis and positive urine culture should undergo a screening renal scintigraphy and cystogram for identifying renal parenchymal involvement and urinary tract abnormalities.

Ultrasonographic diagnosis of urinary tract anomalies in neonates: a study among Iranian children.

AIM: The incidence of urinary tract anomalies varies in different population and depends on several factors such as underlying etiologies. The goal of this study was to investigate the incidence of abnormal urinary tract ultrasound findings in children with different etiologies. METHODS: In a case-series study, 100 neonates who were hospitalized in the Children's Hospital Medical Center with the different etiologies such as sepsis, icter, seizure, and respiratory distress were included. In all neonates, ultrasound study was performed by using 3.5-7.5 MHz probe and neonates with the diagnosis of urinary tract infection underwent DMSA scan and voiding cystourethrogram (VCUG). RESULTS: The mean age of neonates was 10.15+/-7.45 days and 56% of patients were male. The most frequent etiologies led to hospitalization were icter (37%), sepsis (35%), and infectious respiratory distress (10%). Abnormal sonographic findings were found in 5% of patients. The frequency of urinary tract anomalies in neonates with sepsis was higher than non-septic group (14.29% versus 0.0%, P=0.008). CONCLUSION: The incidence of urinary tract anomalies which detected by sonography in our population is higher than other reported studies and has strong relationship with the occurrence of neonatal sepsis.

The relation of body mass index and blood pressure in Iranian children and adolescents aged 7-18 years old.

BACKGROUND: The obesity and hypertension are the major risk factors of several life threatening diseases. The present study was aimed to investigate the relation between body mass index (BMI) the validated index of adiposity and different aspect of blood pressure (BP). METHODS: Systolic and diastolic blood pressures and also weight and height of 7 to 18 years old children and adolescent collected in 2002 and 2004 respectively. Data was consisted of 14865 schoolchildren and adolescents from representative sample of country. BMI was classified according to CDC 2000 standards into normal (BMI<85th percentile), at risk of overweight (BMI≥85th and <95th percentile) and overweight (BMI≥95th percentile). Then, age-sex specific prevalence of being overweight was derived. ANOVA was used to investigate the effect of BMI on systolic blood pressure and diastolic blood pressure and mean arterial pressure of participants. RESULTS: Mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly increased with BMI (P< 0.0001) and age groups (P< 0.0001), and was significantly (P< 0.0001) higher in boys than girls especially in older ages. (P< 0.0001, interaction of age and BMI level). The proportion of being overweight was significantly higher in boys than girls was (7.4% vs. 3.6%; P< 0.0001). CONCLUSION: There is an association between BP and BMI in children and adolescence. SBP, DBP and MAP are associated with rise in BMI and age, which was lower in girls. This data can provide basics for public health policy makers and primary prevention policies in the country.