1
|
Jafari M, Pourroshani B, Eftekhari K, Malekiantaghi A, Ashournia P, Shafiei A. Effect of Combination Montelukast and Nasal Mometasone on Childhood Adenoid Hypertrophy. Iran J Otorhinolaryngol 2024; 36:391-397. [PMID: 38476566 PMCID: PMC10925965 DOI: 10.22038/ijorl.2024.73906.3490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/14/2024] [Indexed: 03/14/2024]
Abstract
Introduction Adenoid hypertrophy is a common childhood disease; its standard treatment is adenoidectomy. The desire for medical management is increasing due to fewer complications and more convenience. The present study investigated the effect of adding oral montelukast to mometasone nasal spray in treating adenoid hypertrophy. Materials and Methods This was a randomized, double-blind, placebo-controlled study conducted at a referral teaching hospital (Tehran, Iran) from September 2020 to September 2021. Children aged 2 to 14 years with clinical and radiological findings of adenoid hypertrophy were enrolled. Patients were randomly divided into two groups: mometasone nasal spray with oral montelukast (case group) or mometasone with placebo (control group). Then, the clinical scores were compared before and two months after the intervention. Results Ninety-six patients completed the study [62.5% male (n=60)]. Of these, 51 were in the case and 45 in the control group. The clinical score in each group decreased significantly after the intervention (P<0.001), but the decrease in clinical score in the case group was not significantly different from the control (p=0.576). Conclusion The results showed that the combination therapy with mometasone and montelukast has the same efficacy as mometasone and placebo in treating adenoid hypertrophy. Adding montelukast to mometasone has no additional effect.
Collapse
Affiliation(s)
- Mohsen Jafari
- Division of Infectious Diseases, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Pourroshani
- Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Division of Gastroenterology, Department of Pediatric, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Armen Malekiantaghi
- Division of Gastroenterology, Department of Pediatrics, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Ashournia
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shafiei
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Jafari M, Sobhani M, Eftekhari K, Malekiantaghi A, Gharagozlou M, Shafiei A. The Effect of Oral Montelukast in Controlling Asthma Attacks in Children: A Randomized Double-blind Placebo Control Study. Iran J Allergy Asthma Immunol 2023; 22:413-419. [PMID: 38085143 DOI: 10.18502/ijaai.v22i5.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/20/2023] [Indexed: 12/18/2023]
Abstract
Oral Montelukast is recommended as maintenance therapy for persistent asthma, but there is controversy regarding its effectiveness in controlling asthma attacks. The present study was conducted to investigate the clinical efficacy of oral Montelukast for asthma attacks in children. This study was conducted as a double-blind placebo-controlled clinical trial on 80 children aged 1-14 years with asthma who were admitted to the emergency department of Bahrami Children's Hospital (Tehran, Iran) during one year. Patients were randomly divided into case and control groups. In addition to the standard asthma attack treatment, Montelukast was prescribed in the case group and placebo in the control group for one week. Patients were evaluated in terms of asthma attack severity score and oxygen saturation percentage (SpO2) in room air as primary outcomes 1, 4, 8, 24 and 48 hours after admission. In the first 48 hours, there was no significant difference in the score of asthma attack severity and SpO2 between the case and control groups. There was no significant difference between the groups in terms of length of hospitalization or number of admissions to the intensive care unit. None of the patients were re-hospitalized after discharge. The results of this study showed that the use of Montelukast along with the standard treatment of asthma attacks in children has no added benefit.
Collapse
Affiliation(s)
- Mohsen Jafari
- Division of Infectious Diseases, Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Masoomeh Sobhani
- Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kambiz Eftekhari
- Division of Gastroenterology, Department of Pediatrics, Pediatric Gastroenterology and Hepatology Research Center, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Armen Malekiantaghi
- Division of Gastroenterology, Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Gharagozlou
- Department of Allergy and Clinical Immunology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alireza Shafiei
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Shabani‐Mirzaee H, Sayarifard F, Malekiantaghi A, Eftekhari K. Acute infantile liver failure syndrome type 2 in a 2.5-year-old boy: A case report. Clin Case Rep 2023; 11:e7892. [PMID: 37692149 PMCID: PMC10485241 DOI: 10.1002/ccr3.7892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023] Open
Abstract
Key Clinical Message Infantile liver failure type 2 is described as repeated attacks of liver dysfunction with remission. This syndrome should be considered in the differential diagnosis of any child with symptoms of recurrent hepatic encephalopathy. Abstract Infantile liver failure syndrome 2 is described as recurrent attacks of liver dysfunction. ILFS2 should be included in the differential diagnosis of children with frequent and acute liver failure. We present a 2.5-year-old boy with clinical manifestation of acute liver failure. In past, he had two similar attacks.
Collapse
Affiliation(s)
- Hosein Shabani‐Mirzaee
- Department of Pediatric EndocrinologyBahrami Children's HospitalTehran University of Medical SciencesTehranIran
| | - Fatemeh Sayarifard
- Department of Pediatric EndocrinologyChildren's Medical Hospital CenterTehran University of Medical SciencesTehranIran
| | - Armen Malekiantaghi
- Department of Pediatric EndocrinologyBahrami Children's HospitalTehran University of Medical SciencesTehranIran
| | - Kambiz Eftekhari
- Pediatric Department, Pediatric Gastroenterology and Hepatology Research CenterBahrami Children's HospitalTehran University of Medical SciencesTehranIran
| |
Collapse
|
4
|
Malekiantaghi A, Shabani‐Mirzaee H, Ehsani M, Eftekhari K. Anabolic-androgenic anabolic steroids as a probable risk factor for hepatoblastoma in infants. Clin Case Rep 2023; 11:e7676. [PMID: 37434955 PMCID: PMC10332254 DOI: 10.1002/ccr3.7676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
Key Clinical Message The etiology of hepatoblastoma (HB) is still unknown; several risk factors have been identified. The only risk factor for the development of HB in presented case was the child's father using anabolic androgenic steroids. It may be a risk factor for developing HB in their children. Abstract HB is the most common primary liver cancer in children. Its etiology is still unclear. The patient's father's use of androgenic anabolic steroids could be a risk factor for developing HB in his child. A 14-month-old girl was hospitalized with intermittent fever, severe abdominal distention, and anorexia. On initial examination, she was cachectic and pale. There were two hemangioma-like skin lesions in the back. Huge hepatomegaly was found and the ultrasound showed a hepatic hemangioma. The possibility of malignancy was considered due to the severe enlargement of the liver and the increased levels of the alpha-fetoprotein. An abdominopelvic CT scan was performed and finally, the diagnosis of HB was confirmed by pathology. There was no history of congenital anomalies or risk factors for HB.Also we did not find any risk factors in the mother's history either. The only positive finding in the father's history was the use of anabolic steroids for bodybuilding. Anabolic-androgenic anabolic steroids may be one of the possible causes of HB in children.
Collapse
Affiliation(s)
- Armen Malekiantaghi
- Pediatric Gastroenterology, Pediatric DepartmentTehran University of Medical Sciences, Bahrami Children's HospitalTehranIran
| | - Hosein Shabani‐Mirzaee
- Pediatric Endocrinology and Metabolism, Pediatric departmentTehran University of Medical Sciences, Bahrami Children's HospitalTehranIran
| | - MohammadAli Ehsani
- Pediatric Hematology and Oncology, Department of Pediatric Hematology and OncologyTehran University of Medical Sciences, Bahrami Children's HospitalTehranIran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology, Pediatric Gastroenterology and Hepatology Research Center, Pediatric DepartmentTehran University of Medical Sciences, Bahrami Children's HospitalTehranIran
| |
Collapse
|
5
|
Khosroshahi N, Rezaei D, Emami F, Eftekhari K. Risk factors for mortality in fulminant acute necrotizing encephalopathy following influenza A in an adolescent boy. Clin Case Rep 2023; 11:e7253. [PMID: 37102104 PMCID: PMC10123315 DOI: 10.1002/ccr3.7253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/28/2023] Open
Abstract
Acknowledging the risk factors of mortality and morbidity of each disease is effective for its final outcome. Recognizing these cases can have the value of preventing the occurrence of unfortunate events, such as not recommending the use diclofenac in an influenza epidemic.
Collapse
Affiliation(s)
- Nahideh Khosroshahi
- Associate professor of pediatric neurology, Department of Pediatric Neurology, Bahrami Children's HospitalTehran University of Medical SciencesTehranIran
| | - Darya Rezaei
- Medical Student, Department of Pediatric Neurology, Faculty of Medicine, Bahrami Children's HospitalTehran University of Medical SciencesTehranIran
| | - Farnoosh Emami
- Medical Student, Department of Pediatric Neurology, Faculty of Medicine, Bahrami Children's HospitalTehran University of Medical SciencesTehranIran
| | - Kambiz Eftekhari
- Associate Professor of Pediatric Gastroenterology, Pediatric gastroenterology and hapatology research centerTehran University of Medical Sciences, Pediatric department, Bahrami children's HospitalTehranIran
| |
Collapse
|
6
|
Akhijahani RF, Farahmand F, Rahmani P, Motamed F, Eftekhari K, da Silva Magalhães EI, Sohouli MH. Effectiveness of sucralfate in preventing esophageal stricture in children after ingestion of caustic agents. Eur J Pediatr 2023:10.1007/s00431-023-04924-2. [PMID: 36935468 DOI: 10.1007/s00431-023-04924-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/16/2023] [Accepted: 03/04/2023] [Indexed: 03/21/2023]
Abstract
Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. The role of sucralfate in preventing stricture caused by caustic agents is controversial, and limited studies have been conducted in this field. We aimed to investigate the effect of sucralfate on preventing esophageal stricture in children. Sixty children with mean age of 36.69 ± 20.50 months and grade II B esophageal burns due to ingestion of caustic agents were enrolled in the study. In the intervention group, in addition to the usual treatment, sucralfate was administered orally at a dose of 80 mg/kg every 2 h for 3 days. For the control group, only the usual treatment was prescribed. Stricture development was compared between groups based on endoscopic and radiologic findings. Of the 60 patients enrolled in the study, 53 were examined. The incidence of esophageal stricture in the intervention group was significantly lower than in the control group (37% versus 67%, P-value = 0.042). In addition, the odds of esophageal stricture after sucralfate intervention was significantly reduced after adjustment for potential confounders (OR = 0.198, P-value = 0.031). Conclusions: The results of this study showed that sucralfate may reduce the development of esophageal stricture in children when used to manage IIB esophageal burns due to ingestion of caustic agents. What is Known: • Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. • The role of sucralfate in preventing stricture caused by caustic agents is controversial and limited studies have been conducted in this field. What is New: • It seems that sucralfate significantly reduces the incidence of esophageal stricture following the ingestion of caustic agents in children compared to the control group. • We believe that the prognosis may be improved and the risk of stricture formation may be reduced with high doses of sucralfate therapy in grade IIB esophageal injury.
Collapse
Affiliation(s)
- Roghayeh Faraji Akhijahani
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Farahmand
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Rahmani
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Motamed
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, São Luís - MA, Centro, Brazil
| | - Mohammad Hassan Sohouli
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
Shabani-Mirzaee H, Haghshenas Z, Malekiantaghi A, Vigeh M, Mahdavi F, Eftekhari K. The effect of oral probiotics on glycated haemoglobin levels in children with type 1 diabetes mellitus - a randomized clinical trial. Pediatr Endocrinol Diabetes Metab 2023; 29:128-133. [PMID: 38031828 PMCID: PMC10679923 DOI: 10.5114/pedm.2023.132025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/08/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Proper control of blood glucose in children with type 1 diabetes has a direct effect on their metabolism and quality of life by reducing the risk of complications. The use of probiotics may have a beneficial effect on glucose levels. PURPOSE The aim of this study was to evaluate the effect of oral consumption of probiotics on glycosylated haemoglobin in children with type 1 diabetes. MATERIAL AND METHODS In this single-blind randomized controlled clinical trial, 52 children with type 1 diabetes were studied. We created 2 groups of 26 individuals each. The probiotic group received a daily probiotic capsule for 90 days, in addition to routine insulin therapy. The control group received only insulin therapy. Blood samples were taken to measure HbA1c, fasting plasma glucose, and lipid profiles at the beginning and end of the trial. RESULTS The study showed that HbA1c was high in both groups, but this increase was lower in the probiotic group than in the control group. This difference was not statistically significant. The mean level of fasting plasma glucose in the probiotic group was significantly reduced compared to the control group (p = 0.016). CONCLUSIONS According to the results of our study, consumption of oral probiotics has no significant effect on HbA1c levels in children with type 1 diabetes mellitus.
Collapse
Affiliation(s)
- Hosein Shabani-Mirzaee
- Department of Pediatric Endocrinology, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Haghshenas
- Department of Pediatric Endocrinology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Vigeh
- Maternal-Fetal Medicine Research Center, Tehran University of Medical Sciences, Iran
| | - Fazeleh Mahdavi
- Department of Pediatric Endocrinology, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatrics, Tehran University of Medical Sciences, Iran
- Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Iran
| |
Collapse
|
8
|
Malekiantaghi A, AsnaAshari K, Shabani-Mirzaee H, Vigeh M, Sadatinezhad M, Eftekhari K. Evaluation of the risk of malnutrition in hospitalized children by PYMS, STAMP, and STRONGkids tools and comparison with their anthropometric indices: a cross-sectional study. BMC Nutr 2022; 8:33. [PMID: 35449119 PMCID: PMC9027700 DOI: 10.1186/s40795-022-00525-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Malnutrition is a determining factor of pediatric mortality and morbidity, especially in low and middle-income countries. Hospitalized children are at a higher risk of malnutrition. Several malnutrition screening tools have been used, among which STAMP, PYMS, and STRONGkids are valid tools with high sensitivity and specificity. The aim of this study was to compare these screening tools to find the best ones in identifying the risk of malnutrition in hospitalized children. Methods This is a cross-sectional study performed on hospitalized children aged 1 to 16 years. The questionnaires of PYMS, STAMP, STRONGkids malnutrition risk assessment tools were filled. The weight for height and BMI for age Z-scores were calculated. The data were analyzed by SPSS. Sensitivity, specificity, positive predictive value, and negative predictive values of the risk scores based on weight for height and BMI for age Z-scores were calculated. Results Ninety-three patients with a mean age of 5.53 ± 3.9 years were included. The frequency of malnutrition was reported as 26% and 39% according to weight for height and BMI for age Z-scores, respectively. A significant relationship was found between PYMS and Weight for height Z-score (P-value < 0.001), and BMI for age Z-score (P-value < 0.001). Moreover, STRONGkids was found to be associated with weight for height Z-score (P-value: 0.017). Conclusion The PYMS is a practical and beneficial tool in early identifying the risk of severe malnutrition in hospitalized patients. It is a suitable method for patients in our settings. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00525-8.
Collapse
Affiliation(s)
- Armen Malekiantaghi
- Pediatric department, Pediatric Gastroenterology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kosar AsnaAshari
- Pediatric department, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Shabani-Mirzaee
- Pediatric department, Pediatric Endocrinology and Metabolism, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Vigeh
- Maternal-Fetal Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Sadatinezhad
- Pediatric department, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatric department, Pediatric Gastroenterology and Hepatology Research Center, Bahrami Children Hospital, Tehran University of Medical Sciences, Kiaee Street, 1641744991, Tehran, Iran.
| |
Collapse
|
9
|
Mirlohi SH, Eftekhari K, Shirzadi R, Fateh A, Masoumi M, Modaresi M. The Value of Sputum Polymerase Chain Reaction for Detection of Nontuberculous Mycobacteria in Cystic Fibrosis Patients with Negative Nontuberculous Mycobacteria Sputum Culture. Med J Islam Repub Iran 2022; 36:7. [PMID: 35999933 PMCID: PMC9386751 DOI: 10.47176/mjiri.36.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/12/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Cystic Fibrosis (CF) is a life-threatening autosomal recessive disease. The purpose of this study was to evaluate the value of Polymerase Chain Reaction (PCR) in CF patients with Nontuberculous Mycobacteria (NTM) negative sputum culture.
Methods: This is a descriptive cross-sectional study. The population included all children with CF, aged between 5 - 18 years old, with an NTM negative sputum culture. The patient's sputum samples were sent for smear and culture of NTM, RFLP PCR, and PCR sequence.
Results: In total, 57 CF patients with negative NTM sputum culture were enrolled. Nine patients (15.78%) had positive sputum PCR for NTM. Among these strains, Mycobacterium simiae was the most common one with 5 cases (8.77% of total positive cases). Conclusion: PCR can be used as an alternative diagnostic method for NTM in CF patients with negative NTM sputum culture, always under clinical suspicion of the disease.
Collapse
Affiliation(s)
- Seyed Hossein Mirlohi
- Pediatric Respiratory and Sleep Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Department of Pediatrics, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rohola Shirzadi
- Pediatric Respiratory and Sleep Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Morteza Masoumi
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammadreza Modaresi
- Pediatric Respiratory and Sleep Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Dr Mohammadreza Modaresi,
| |
Collapse
|
10
|
Sadeghi P, Salari K, Ziaee V, Rezaei N, Eftekhari K. Serological Screening of Celiac Disease in Patients with Juvenile Idiopathic Arthritis. Arch Iran Med 2021; 24:783-785. [PMID: 34816702 DOI: 10.34172/aim.2021.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 01/24/2021] [Indexed: 05/20/2023]
Abstract
There is a possible association between celiac disease (CD) and juvenile idiopathic arthritis (JIA). Our aim was to evaluate the serological incidence of CD in patients with JIA. Children under 16 years of age with JIA who did not respond adequately to routine treatment, who referred to the pediatric centers of Tehran University of Medical Sciences (2017-2019), were enrolled in this study. Manifestations of CD were also evaluated. CD-related serological screening tests were measured. Seventy-eight patients were enrolled in the study. Their mean age was 7.9±3.9 (1.6-16) years. Three patients with oligoarticular JIA had Anti-TTG-Ab levels above normal (prevalence=3.8%). None of them had symptoms of CD. There were no significant statistical differences in terms of growth disorders, sex distribution, and different subtypes of JIA (P value ˃ 0.05) between the groups (sero-positive vs. sero-negative). In one case, CD was confirmed by pathology and the gluten-free diet was recommended. The absence of CD symptoms in patients with JIA does not rule out concomitant CD.
Collapse
Affiliation(s)
- Payman Sadeghi
- Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Rheumatology Iranian Society
| | - Kobra Salari
- Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Ziaee
- Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Rheumatology Iranian Society
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Ataee P, Badiee H, Mohammadzadeh S, Moradveisi B, Roshani D, Nasiri R, Eskandarifar A, Malekiantaghi A, Eftekhari K. The Relationship Between Obsessive-Compulsive Disorders and Childhood Chronic Functional Constipation. ACTA 2021. [DOI: 10.18502/acta.v59i8.7257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Chronic constipation is one of the most common problems in children. It can cause anxiety and psychological problems in patients and parents. The purpose of this study was to investigate the relationship between obsessive-compulsive disorders (OCD) in children with chronic functional constipation. This is a case-control study performed at the gastroenterology clinic of Besat Hospital Sanandaj for one year. The children aged 7-14-year-old with chronic functional constipation were selected as a case group, and the healthy children were recruited as a control group, who referred for growth control. Then, the Maudsley questionnaire for obsessive-compulsive disorders was completed by a trained assistant. With this questionnaire, the presence or absence of OCD and its type can be determined. Forty-three children were selected as the case group and sixty-seven children as the control group. The mean age of the case and control group was 9.3±1.5 and 8.8±1.6 years, respectively. Based on the results, there was a significant difference between the groups in terms of checking, cleaning, slowness, doubting, and total obsessive score (P˂0.05). Therefore, all five types of obsessive-compulsive disorder in the case group were greater than the control group. Obsessive-compulsive disorders were more common in children with functional constipation, and the total obsessive score in these children than the healthy children was a significant difference.
Collapse
|
12
|
Paknejad MS, Eftekhari K, Rahimi R, Vigeh M, Naghizadeh A, Karimi M. Myrtle (Myrtus communis L.) fruit syrup for gastroesophageal reflux disease in children: A double-blind randomized clinical trial. Phytother Res 2021; 35:6369-6376. [PMID: 34533246 DOI: 10.1002/ptr.7288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 07/10/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022]
Abstract
This double-blind study was designed to evaluate the efficacy of a syrup made from Myrtus communis L. fruit on children with gastroesophageal reflux disease. Children aged 1-7 years old, diagnosed with gastroesophageal reflux disease (GERD), were randomly allocated to either intervention group (omeprazole and "myrtle fruit syrup") or control group (omeprazole and placebo syrup). GERD symptom questionnaire for young children (GSQ-YC) was filled out for each patient at zeroth and eighth week, and also 4 weeks after cessation of intervention. No statistically significant difference between two groups in terms of GERD score was reported neither in 8th nor in 12th week assessments. During the 4 weeks of the drug-free period, patients in myrtle group did not experience a large shift in GERD score, while patients in placebo syrup group experienced an increase of as much as 19.4. However, this difference was not statistically significant, although it could be significant clinically. For achieving more conclusive results, more studies are needed. The symptom "refusal to eat" in the intervention group was less than in placebo group after 8 weeks (p = .018) and at the end of the study (p = .042). So myrtle fruit syrup may be considered for children with low appetite.
Collapse
Affiliation(s)
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roja Rahimi
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Vigeh
- Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Environmental Health, Juntendo University, Tokyo, Japan
| | - Ayeh Naghizadeh
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Kaveh M, Nazarirad A, Noemi Diaz D, Eshghi T, Eftekhari K. Non-Surgical Causes of Bilious Vomiting in Neonates Admitted in a Tertiary Center. ACTA 2021. [DOI: 10.18502/acta.v59i5.6666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Bilious vomiting is highly suggestive of an acute and emergent condition among neonates. The aim of this study was to investigate the non-surgical causes of bilious vomiting in neonates admitted to a tertiary center and to compare them with the surgical causes. This cross-sectional study was performed on 80 infants with bilious vomiting who were admitted at the neonatal intensive care unit of a pediatric tertiary center over two years. The demographic characteristics, clinical symptoms and signs, diagnostic assessments, and therapeutic approaches were recorded. The mean age of neonates was 9.07±8.84 days, and 55% of them were males. The most common final diagnosis was: Necrotizing Enterocolitis (NEC), duodenal atresia, Hirschsprung’s disease, gastroesophageal reflux disease (GERD), volvulus, sepsis, meconium plug, isolated mal-rotation, metabolic abnormalities, imperforate anus, and Ladd’s bands, respectively. Abnormal findings in ultrasound and X-rays were detected in 35% and 46.3%, respectively. About half of the affected neonates were treated non-surgically. Overall, 17.5% of the patients died. Most deaths were seen in infants with NEC. Using multivariable logistic regression analysis, the presence of NEC as an underlying etiology was the only predictor of neonatal death in neonates with bilious vomiting (OR=12.455, 95%CI: 1.365-113.618, P=0.025). The most common cause of bilious vomiting was NEC, followed by duodenal atresia. Half of the neonates with bilious vomiting were treated medically without operation.
Collapse
|
14
|
Kamali Aghdam M, Bakhtiari H, Diaz DN, Eftekhari K. Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0040-1716393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractThe main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.
Collapse
Affiliation(s)
- Mojtaba Kamali Aghdam
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hassan Bakhtiari
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Diana Noemi Diaz
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kambiz Eftekhari
- Department of Pediatrics, Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Bahrami Children's Hospital, Tehran, Iran
| |
Collapse
|
15
|
Kamali Aghdam M, Jafari N, Eftekhari K. Novel coronavirus in a 15-day-old neonate with clinical signs of sepsis, a case report. Infect Dis (Lond) 2020; 52:427-429. [PMID: 32233816 PMCID: PMC7157949 DOI: 10.1080/23744235.2020.1747634] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: Novel coronavirus or coronavirus disease (COVID-19) can affect all age groups. The clinical course of the disease in children and infants is milder than in adults. It should be noted that, although typical symptoms may be present in children, non-specific symptoms could be noted in the neonate. The disease is rare in the neonate, so, its suspicion in this group can help to make a quick diagnose.Case report: A 15-day-old neonate was admitted with fever, lethargy, cutaneous mottling, and respiratory distress without cough. His mother had symptoms of Novel coronavirus. So Reverse-Transcription Polymerase Chain Reaction (RT-PCR) assay was done for the neonate and showed to be positive. The newborn was isolated and subjected to supportive care. Antibiotic and antiviral treatment was initiated. Eventually, the baby was discharged in good general condition.Conclusion: When a newborn presents with non-specific symptoms of infection with an added history of COVID-19 in his/her parents, it indicates the need for PCR testing for Novel coronavirus.
Collapse
Affiliation(s)
- Mojtaba Kamali Aghdam
- Pediatric Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nahid Jafari
- Neonatology Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kambiz Eftekhari
- Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Habibi Zoham M, Zafar F, Malekiantaghi A, Ettehadi R, Jazayeri SB, Eftekhari K. Evaluation of the Efficacy of Probiotics in the Treatment of Infantile Colic; a Randomized, Double Blind; Placebo Controlled Trial. ACTA 2020. [DOI: 10.18502/acta.v57i7.2325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The infantile colic is one of the most common complaints in the infancy; however, limited therapeutic approaches are described in the literature. Recently probiotics have been suggested as a potential strategy in the treatment of infantile colic. We conducted this study to investigate the efficacy of probiotics in relieving colic symptoms in Iranian infants. This double-blind clinical trial was performed among 70 infants aged 3 to 16 weeks with the presumed diagnosis of infantile colic according to Wessel criteria who were breastfed or formula fed. They were assigned at random to receive Pedilact® (Bifidobacterium infantis, Lactobacillus reuteri, and Lactobacillus rhamnosus) (N=33) or placebo (N=32). Demographic data were recorded in the questionnaires at the beginning of the study. The number of daily episodes of crying and fussiness, number of weekly crying days, and duration of crying were separately analyzed on 7, 21, and 30th days of investigation. Baseline demographic data showed no statistically significant difference between intervention and placebo groups. Infants given Pedilact® showed a significant reduction in daily episodes of crying, duration of crying, and the weekly number of crying days at the end of the treatment period compared with those receiving placebo (P=0.000). On 21th day of the study, daily episodes of fuss and crying (P=0.032) and duration of crying reduced significantly in the intervention group in comparison to the placebo group (P=0.000). Administration of Pedilact® drop significantly improved colic symptoms by reducing crying and fussing times in breastfed or formula fed in Iranian infants with colic.
© 2019 Tehran University of Medical Sciences. All rights reserved.
Acta Med Iran 2019;57(7):405-411.
Collapse
|
17
|
Nasiri R, Ataee P, Abdi A, Moradi G, Moradveisi B, Eftekhari K. Evaluation of the Relationship Between Childhood Asthma and Helicobacter pylori Sero-Prevalence. ACTA 2019. [DOI: 10.18502/acta.v57i5.1865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In recent years, the prevalence of asthma and allergic rhinitis has increased in developed countries. Helicobacter pylori (H. pylori) infection can exacerbate asthma. The purpose of this study was to investigate the relationship between asthma and H. pylori seroprevalence in children. In this cross-sectional study, 100 children aged 5-15 years hospitalized in Besat hospital in Sanandaj were investigated from 2015 to 2016. Fifty children with asthma were considered as the case group and 50 non-asthmatic children as the control group. The questionnaires were completed, including demographic information, history of asthma, exposure to cigarette smoke, and family history of gastric and duodenal ulcers. Blood samples were collected from the children, and the serum level of specific antibodies (IgG) of H. pylori was measured. There were 42 and 31 boys in the case and control group, respectively. The mean age in the case group was 8.12±2.29 and in the control group was 8.9±2.52 years. In the case group, 48% were exposed to cigarette smoke and in the control group, 18%. There was a statistically significant difference between the groups in terms of gender and exposure to cigarette smoke (P=0.001 and P=0.013, respectively). There was no significant difference between the case and control groups in terms of H. pylori seroprevalence. (P=0.211). There was no significant association between asthma and H. pylori seroprevalence. (P=0.22). According to our study, there no correlation between childhood asthma and H. pylori seroprevalence.
© 2019 Tehran University of Medical Sciences. All rights reserved.
Acta Med Iran 2019;57(5):299-302.
Collapse
|
18
|
Motamed F, Fallahi G, Ahmadi F, Bazvand F, Ahmadi M, Eftekhari K, Rezaei N. Gastroesophageal Variceal Bleeding as a Complication of Cystic Fibrosis in a 3-Month-Old Patient. Acta Med Iran 2016; 54:220-221. [PMID: 27107529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 06/05/2023] Open
Abstract
Cystic fibrosis (CF) is a hereditary disease of mucous and sweat glands, which affects the respiratory and gastrointestinal systems. Herein, we describe a 3-month-old girl with a history of recurrent episodes of urinary tract infections that required hospitalization. She was referred to our center at the age of three months, with massive gastroesophageal variceal bleeding. In physical examination, she had clubbing, hepatosplenomegaly, and mild ascites. Laboratory studies revealed high serum levels of liver enzymes and low level of Albumin. As of suspicious to CF, sweat tests were performed twice which confirmed the diagnosis of CF. Gastrointestinal bleeding due to gastroesophageal varices is a rare complication of CF, which could result as a consequence of hepatobiliary involvement of disease. Early diagnosis of CF could prevent severe complications and even death in this group of patients.
Collapse
Affiliation(s)
- Farzaneh Motamed
- Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamhossein Fallahi
- Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Ahmadi
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bazvand
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maedeh Ahmadi
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Eftekhari
- Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Medicine, Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.AND Universal Scientific Education and Research Network (USERN), Tehran, Iran
| |
Collapse
|
19
|
Kamali Aghdam M, Davari K, Eftekhari K. Recurrent Epistaxis and Bleeding as the Initial Manifestation of Brucellosis. Acta Med Iran 2016; 54:218-219. [PMID: 27107528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 06/05/2023] Open
Abstract
Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas.
Collapse
Affiliation(s)
- Mojtaba Kamali Aghdam
- Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kambiz Davari
- Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kambiz Eftekhari
- Department of Pediatric, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
20
|
Eftekhari K, Vahedi Z, Kamali Aghdam M, Noemi Diaz D. A Randomized Double-Blind Placebo-Controlled Trial of Lactobacillus reuteri for Chronic Functional Abdominal Pain in Children. Iran J Pediatr 2015; 25:e2616. [PMID: 26635937 PMCID: PMC4662837 DOI: 10.5812/ijp.2616] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/11/2015] [Accepted: 08/22/2015] [Indexed: 12/23/2022]
Abstract
Background: Functional abdominal pain (FAP) is one of the most common diseases, and large percentages of children suffer from it. Objectives: The purpose of the study was to evaluate the effect of Lactobacillus reuteri in treatment of children with functional abdominal pain. Patients and Methods: This study was a randomized double-blind placebo-controlled trial. Children aged 4 to 16 years with chronic functional abdominal pain (based on Rome III criteria) were enrolled in the study. They were randomly divided into two groups, one receiving probiotic and the other placebo. Results: Forty children received probiotic and forty others placebo. There were no significant differences in age, weight, sex, location of pain, associated symptoms, frequency and intensity of pain between the groups. The severity and frequency of abdominal pain in the first month compared to baseline was significantly less and at the end of the second month, there was no significant difference between both groups compared to the end of the first month. Conclusions: This study showed that the severity of pain was significantly reduced in both groups. There was no significant difference in pain scores between them. The effect of probiotic and placebo can probably be attributed to psychological effect of the drugs.
Collapse
Affiliation(s)
- Kambiz Eftekhari
- Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Kambiz Eftekhari, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2173013000, Fax: +98-2177568809, E-mail:
| | - Zahra Vahedi
- Department of Pediatrics, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran
| | - Mojtaba Kamali Aghdam
- Department of Pediatrics, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran
| | - Diana Noemi Diaz
- Department of Pediatrics, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran
| |
Collapse
|
21
|
Farahmand F, Khotaie G, Eftekhari K, Sabbaghian M. Fulminant hepatitis with HHV-6 in a childhood patient. J PEDIAT INF DIS-GER 2015. [DOI: 10.3233/jpi-2010-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Fatemeh Farahmand
- Department of Gastroenterology, Children’s Medical Center Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ghamar Khotaie
- Department of Infectious Disease, Children’s Medical Center Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Kambiz Eftekhari
- Department of Gastroenterology, Children’s Medical Center Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mozhgan Sabbaghian
- Department of Gastroenterology, Children’s Medical Center Hospital, Tehran University of Medical Science, Tehran, Iran
| |
Collapse
|
22
|
Moghaddam HM, Badiei Z, Eftekhari K, Shakeri R, Farhangi H. Prevalence of Pulmonary Hypertension in Patients with Thalassemia Intermedia in 2009: a single center's experience. Electron Physician 2015; 7:1102-7. [PMID: 26388975 PMCID: PMC4574695 DOI: 10.14661/2015.1102-1107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/28/2015] [Indexed: 01/09/2023] Open
Abstract
Background: There are various clinical symptoms of thalassemia intermedia, and they lie roughly between those of major and minor forms of the disease. Patients with thalassemia intermedia occasionally require blood transfusions. This renders them susceptible to pulmonary arterial hypertension (PAH) syndrome, which is one of the most significant complications in patients with thalassemia intermedia. PAH is more common in in thalassemia intermedia than in thalassemia major, and it may cause cardiac complications in patients who are older than 30. The objective of this study was to estimate the prevalence of PAH in thalassemia intermedia patients so that they can be referred expeditiously for treatment, thereby preventing the complications that occur later. Methods: This cross sectional study was conducted under the supervision of hematology department of Mashhad Medical University. Forty-one patients with thalassemia intermedia were examined at the Sarvar Thalassemia and Hemophilia Clinic of Mashhad. Electrocardiography, chest radiography, and echocardiography tests were performed for all of the patients by the same pediatric cardiologist. The data were processed by SPSS software, version 11.5, and the results were analyzed using chi-squared, Student’s t, and Mann-Whitney tests. Results: The mean age of the patients was 21.93±8.34. They had been under pediatric heart specialists’ constant examination and treatment since their childhood when they were diagnosed with TI, and continue to receive regular follow-up care. The prevalence of pulmonary hypertension was 24% in our study population. In patients with thalassemia intermedia, the left ventricular (LV) mass indices were about 3–5 times higher than would be expected in a normal population. Patients with higher LV mass indices have a greater risk of developing pulmonary hypertension, and those with serum ferritin levels below 1000 ng/ml are less susceptible to diastolic dysfunction. Conclusion: Pulmonary hypertension is common in patients with thalassemia intermedia. Irregular chelation therapy or absence of this treatment might lead to diastolic dysfunction, and serum ferritin levels below 1000 ng/ml could be an important factor in preventing the development of diastolic dysfunction or slowing down its progression.
Collapse
Affiliation(s)
- Hassan Mottaghi Moghaddam
- Associate Professor of Pediatric Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Badiei
- Associate Professor of Pediatric Hematology & Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kambiz Eftekhari
- Assistant Professor of Pediatric Gastroenterology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shakeri
- Fellow of Pediatric Cardiology, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Farhangi
- Assistant Professor of Pediatric Hematology & Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
23
|
Abstract
Atresia of the colon is a rare anomaly with an incidence of between 1:20,000 and 1:66,000 live births being reported. Hirschsprung's disease association with Colonic atresia is usually diagnosed after several failures of intestinal anastomoses. We herein report one of the first patients in the literature diagnosed before a therapeutic challenge. A 2-day-old female was admitted with severe abdominal distention, bilious vomiting and failure to pass meconium. A distended abdomen accompanied by hypoactive bowel sounds was also observed. Abdominal X-ray revealed increased intestinal gas, mainly in the colon. Type IIIa atresia of the colon at the level of the splenic flexure was found at laparotomy. A temporary double-barrel colostomy was completed, and she was discharged from hospital on the tenth day after operation without any complications. At the age of 3 months, due to the aspect of the distal colon, a rectal biopsy was performed and aganglionosis was confirmed. The combination of intestinal aganglionosis and colonic atresia is extremely rare. The concomitance of colonic atresia and aganglionosis is calculated to be in 1 in 10 million live births. Wilson, et al. claims that 80 percent of infants with colonic atresia have associated gastrointestinal anomalies. These defects include rotation and fixation anomalies. However, aganglionosis and intestinal neuronal dysplasia should be taken into account as well. When both diseases are combined, the etiology is still uncertain and several etiologies have been suggested. The association should be suspected in all cases of colonic atresia and rectal biopsies are advocated at the primary operation in patients with atresia of the colon.
Collapse
Affiliation(s)
- Diana N Diaz
- Department of Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Kambiz Eftekhari
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Najafi M, Sadjadei N, Eftekhari K, Khodadad A, Motamed F, Fallahi GH, Farahmand F. Prevalence of Celiac Disease in Children with Autoimmune Hepatitis and vice versa. Iran J Pediatr 2014; 24:723-8. [PMID: 26019778 PMCID: PMC4442834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/22/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Celiac disease is an autoimmune disorder in which the risk of autoimmune liver disease is high. Autoimmune hepatitis is a chronic and progressive entity and the risk of its being associated with other autoimmune disorders such as celiac disease is high also. The aim of this study was to determine the prevalence of celiac disease in patients with autoimmune hepatitis and vice versa. METHODS In a cross-sectional study children with autoimmune hepatitis underwent serological screening and endoscopy for celiac disease. In patients with celiac disease, serum aminotransferases were measured and, if abnormal, autoantibodies related to autoimmune hepatitis were checked and needle liver biopsy was performed. FINDINGS Of the 96 patients, 64 had autoimmune hepatitis and 32 celiac disease. Among patients with autoimmune hepatitis only three (4.7%) were compatible with celiac disease. In the group of patients with celiac disease, autoimmune hepatitis was confirmed in four (12.5%) cases. We consider important to state that 3.1% of this group had celiac hepatitis. CONCLUSION Autoimmune liver disease is sometimes associated with latent celiac disease. Serological screening for celiac disease should be routinely done in patients with abnormal serum aminotransferases, particularly those with chronic liver disease. On the other hand, celiac disease is often accompanied by other autoimmune diseases, including autoimmune hepatitis.
Collapse
Affiliation(s)
- Mehri Najafi
- Department of Pediatrics,,Children’s Medical Center, Pediatrics Center of Excellence
| | - Nooshin Sadjadei
- Department of Pediatric, Jondi Shapoor University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Eftekhari
- Department of Pediatrics,,Bahrami Hospital, Tehran University of Medical Sciences, Tehran,Corresponding Author; Address: Department of Pediatric, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran, E-mail:
| | - Ahmad Khodadad
- Department of Pediatrics,,Children’s Medical Center, Pediatrics Center of Excellence
| | - Farzaneh Motamed
- Department of Pediatrics,,Children’s Medical Center, Pediatrics Center of Excellence
| | | | - Fatemeh Farahmand
- Department of Pediatrics,,Children’s Medical Center, Pediatrics Center of Excellence
| |
Collapse
|
25
|
Najafi M, Kiani MA, Eftekhari K, Aghamohammadi A. Recurrent Gallbladder Hydrops and Sclerosing Cholangitis in 11-Year-Old Male with Hyper IgM Syndrome. Iran J Pediatr 2013; 23:705-6. [PMID: 24910752 PMCID: PMC4025131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 03/09/2013] [Indexed: 11/01/2022]
Affiliation(s)
- Mehri Najafi
- Department of Pediatrics, Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Mohammad-Ali Kiani
- Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kambiz Eftekhari
- Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran,Corresponding Author:Address: Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. E-mail:
| | - Asghar Aghamohammadi
- Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran,Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
26
|
Motamed F, Eftekhari K, Kiani MA, Rabbani A. Ovarian Cyst Enlargement in a 14 Year Old Female with Persistent Ascities, Severe Hypothyroidism and Elevated Serum CA-125 Level. Iran Red Crescent Med J 2012; 14:379-81. [PMID: 22924118 PMCID: PMC3420030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 10/17/2011] [Indexed: 11/24/2022]
Abstract
A 14 year old female complained of abdominal pain and distention with vomiting. The physical exam showed thyroid enlargement and ascites. The imaging evaluation demonstrated a large ovarian cyst. Laboratory tests depicted hypothyroidism and marked elevation of Carbohydrate antigen 125 (CA-125) levels. As the bone age was 10 years, more retarded than the chronological age, Van Wyk and Grumbach syndrome was suspected. Treatment with thyroid hormone was initiated and the condition improved dramatically with disappearance of symptoms and signs 5 weeks later.
Collapse
Affiliation(s)
- F Motamed
- Department of Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - K Eftekhari
- Department of Pediatrics, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M A Kiani
- Department of Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Mohammad Ali Kiani, MD, Department of Gastroenterology, Children's Medical Center Hospital, Dr Gharib St, Keshavarz Blvd, Tehran, Iran. Tel.: +98-21-66924545, Fax: +98-21-66924545, E-mail:
| | - A Rabbani
- Department of Endocrinology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
27
|
Farahmand F, Eftekhari K, Modarresi V, Najafi-Sani M, Khodadad A, Motamed F. Comparing Oral Route Paraffin Oil versus Rectal Route for Disimpaction in Children with Chronic Constipation; a Randomized Control Trial. Iran J Pediatr 2010; 20:291-6. [PMID: 23056719 PMCID: PMC3446033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/18/2009] [Accepted: 02/10/2010] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Functional constipation is a common and challenging problem in pediatrics. Fecal disimpaction prior to maintenance therapy is recommended to ensure successful treatment. The aim of this study was to compare the efficacy and patient's compliance of the two methods of paraffin oil administration (oral and rectal route) with the purpose of disimpaction in treatment of children with functional constipation. METHODS A total of 80 children (49 males and 31 females) aged 1-12 years, with functional constipation according to Rome III criteria, whose rectal examination confirmed fecal impaction were divided into two groups randomly. Group I received 3 ml/kg/day paraffin oil orally and group II received 3ml/kg/day paraffin oil rectally during 3 consequent days. Successful treatment was defined as no detectable fecal impaction in rectal examination after at most 72 hours. Patient compliance and family satisfaction also was evaluated using a scored questionnaire. FINDINGS Response to the treatment in both groups was with 92.5% and 82.5% in group I and II, respectively. So, there was no significant difference between the two methods of therapy. Family satisfying and compliance were obviously more achieved in group 1 (87.5% vs 57.5%) than in Group 2 (P<0.001). No parents in group I complained about type of treatment while 12.5% of parents in group II were unsatisfied with the mode of paraffin oil administration. The most common side effect of paraffin oil in both groups was anal oil seepage (27.5%). Nausea and abdominal pain were more common side effects in group 1 and 2 respectively. CONCLUSION It seems that using paraffin oil per oral route in comparison with rectal route could be a preferred option for disimpaction in children causing less anxiety to the family.
Collapse
Affiliation(s)
- Fatemeh Farahmand
- Department of Pediatrics, Faculty of medicine, Tehran University of Medical Sciences, Tehran, IR Iran,Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran
| | - Kambiz Eftekhari
- Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran
| | - Vajiheh Modarresi
- Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran,Corresponding Author:Address: Division of Pediatric Gastroenterology, Children's Medical Center, Dr. Gharib St, Keshavarz Blvd, Tehran, IR Iran. E-mail:
| | - Mehri Najafi-Sani
- Department of Pediatrics, Faculty of medicine, Tehran University of Medical Sciences, Tehran, IR Iran,Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran
| | - Ahmad Khodadad
- Department of Pediatrics, Faculty of medicine, Tehran University of Medical Sciences, Tehran, IR Iran,Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran
| | - Farzaneh Motamed
- Department of Pediatrics, Faculty of medicine, Tehran University of Medical Sciences, Tehran, IR Iran,Pediatrics Center of Excellence, Children's Medical Center, Tehran, IR Iran
| |
Collapse
|
28
|
Motamed F, Modaresi V, Eftekhari K. Familial achalasia, a case report. Iran J Pediatr 2010; 20:233-6. [PMID: 23056711 PMCID: PMC3446026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Revised: 09/24/2009] [Accepted: 11/05/2009] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although achalasia is a relatively rare disease in pediatric age group, it must be considered for differential diagnosis of esophageal disorders in children with positive family history even in the absence of typical clinical manifestations. CASE PRESENTATION A 5-month old boy was hospitalized for cough and mild respiratory distress. Because of positive history of achalasia in his mother, achalasia was detected in esophgagography. Pneumatic dilation through endoscopy was successful. A 12-month follow-up revealed no problem. CONCLUSION Achalasia must be considered for differential diagnosis in children with positive family history of achalasia even in the absence of typical clinical manifestations. An autosomal recessive mode of inheritance is probable. We suggest further researches and genetic studies to establish the pattern of inheritance.
Collapse
Affiliation(s)
| | - Vajiheh Modaresi
- Corresponding Author:Address: Pediatric Gastroenterology Division, Children's Medical Center, Dr Gharib St., Keshavarz Blvd, Tehran, IR Iran. E-mail:
| | | |
Collapse
|
29
|
Fallahi G, Najafi M, Farhmand F, Bazvand F, Ahmadi M, Ahmadi F, Eftekhari K, Khodad A, Motamed F, Khatami G, Aghamohammadi A, Rezaei N. The clinical and laboratory manifestations of Iranian patients with cystic fibrosis. Turk J Pediatr 2010; 52:132-138. [PMID: 20560247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Cystic fibrosis (CF) is a hereditary disease, characterized by chronic pulmonary disease, pancreatic insufficiency and abnormal electrolytes in the sweat. In order to evaluate the clinical manifestations and laboratory findings of Iranian children with CF during a 10-year period, 243 CF patients, with a median age of 5 months, were investigated in this study. The most common manifestations were gastrointestinal disorders and respiratory manifestations. Cough was the most common symptom, followed by malnutrition, diarrhea, respiratory distress, and vomiting. The frequency of these findings after treatment was significantly decreased in comparison with the period before diagnosis. During the mean follow-up of 40.9 months, seven cases died due to severe infections. Cystic fibrosis as a common genetic disorder should be considered in any child with recurrent gastrointestinal and respiratory manifestations, since delayed diagnosis could lead to severe complications and even death in this group of patients.
Collapse
Affiliation(s)
- Gholamhossein Fallahi
- Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran, Iran
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Tabatabaie P, Fallahi GH, Farahmand F, Eftekhari K, Ahmadi M, Ahmadi F, Bazvand F, Rezaei N. Congenital choledochal cyst in an infant with cystic fibrosis. Ann Hepatol 2009; 8:156-7. [PMID: 19502662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Congenital choledochal cyst is malformation of the biliary ductal system, which rarely occur. We describe here a 4-month old boy, who was referred to our center with respiratory distress and low level consciousness. In physical examination, a mass was detected in right upper quadrant of abdomen. Sonographic examination indicated a cystic structure representing the choledochal cyst. Further evaluation confirmed the diagnosis of cystic fibrosis in this patient. Although choledochal cyst is considered as a rare disease, it is the most frequent malformation of the extrahepatic biliary ducts, which easily could be misdiagnosed.
Collapse
Affiliation(s)
- Parviz Tabatabaie
- Center of Excellence for Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Baker J, Schulz S, Beilhack A, Eftekhari K, Negrin R. Murine CIK cells show tumor specific cytolysis in CD107a based degranulation analysis. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|