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Autoimmune encephalitis is an inflammatory condition caused by different factors, including viral infections, diagnosed after ruling out other causes of encephalitis. The current study reported novel autoimmune encephalitis in an 11-year-old girl who presented with seizures, cognitive dysfunction, and neurological impairments. During the admission, the researchers observed high levels of anti-N-methyl-D-aspartate receptor (NMDAR) antibodies in the cerebrospinal fluid (CSF). Besides, she had positive anti-COVID-19IgG. Therefore, the diagnosis of COVID-19-induced autoimmune encephalitis was specific. The patient received anti-epileptic, anti-viral drugs, IVIG, and rituximab and was discharged with remission. The case diagnosis was made by anti-NMDAR antibodies, which highlights the importance of this diagnostic tool. Similar cases have been reported earlier, but the point of this case was her younger age compared to the previous cases and her developing neurological deficit before COVID-19 presentations.
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BACKGROUND: An electroencephalogram (EEG) is a test that measures the brain's electrical activity. Here we decided to evaluate and compare the effectiveness of two drugs, hydrate, and nasal dexmedetomidine, in creating sedation during EEG in children. METHODS: This clinical trial was performed in 2020-2022 on 65 children that were candidates for sedation for EEG with the Iranian Registry of Clinical Trials (IRCT) code IRCT20210614051574N8 (https://www.irct.ir/trial/61860). Pediatrics were randomized into two groups. Children in the first group received intranasal dexmedetomidine at a dose of 2-3 µg/kg 10 minutes before the procedure. The second group received 5% chloral hydrate syrup at a dose of 50-100 mg/kg orally 10 minutes before the procedure. For each patient, sleep onset latency and sleep duration were also measured. It should be noted that the patient's level of consciousness and sleepiness were checked by AVPU (alert, verbal, pain, unresponsive) criteria. RESULTS: There was no significant difference between the two groups regarding the mean sleep onset latency (P = 0.59), sleep duration (P = 0.12), heart rate (P = 0.30), respiratory rate (P = 0.26), and SPO2 (P = 0.27). Analysis of covariance by adjusting for age and sex in both groups showed that the mean sleep duration (P = 0.04) and heart rate (P = 0.03) in the oral chloral hydrate group were significantly higher than in the nasal dexmedetomidine group. But the mean of other variables was not significantly different between the two groups (P>0.05). CONCLUSION: The mean sleep duration and heart rate were significantly lower in the intranasal dexmedetomidine group compared to the oral chloral hydrate group.
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BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the common gastrointestinal diseases with various side effects. Proton pump inhibitor (PPI) drugs are widely used for their treatment and long-term ingestion, which results in an electrolyte imbalance. This study investigates the changes in serum magnesium, calcium, sodium, and potassium after long-term use of omeprazole in children. MATERIALS AND METHODS: This cross-sectional study was conducted in 2016-2017 on 97 children and adolescents, aged 1-15 years, with GERD, in Isfahan, Iran. Enrolled were patients visiting a referral pediatric gastroenterology clinic (Imam Hossein and Amin Hospitals) examined by an academic pediatric gastroenterologist. Before and 4 weeks after omeprazole administration, clinical manifestations including lethargy, muscle spasm, dyspnea, nausea, vomiting, abnormal heartbeat and deep tendon reflexes, and Chvostek and Trousseau signs were recorded in a data-gathering form. In addition, fasting serum magnesium, calcium, sodium, and potassium were measured. RESULTS: The McNemar test results showed that omeprazole can reduce sodium, calcium, and magnesium levels statistically significantly (P < 0.05), but potassium levels do not have a meaningful reduction (P > 0.05). CONCLUSION: Consumption of omeprazole might cause asymptomatic hypomagnesemia, hypocalcemia, and hypernatremia in children. Such side effects should be considered in the follow-up of children under treatment with this medication.
