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Background: Hypothyroidism can play an important role in the development of non-alcoholic fatty liver disease (NAFLD). This study compared the thyroid function tests in overweight and obese children and adolescents with and without NAFLD. Methods: This case-control study was conducted on 100 children and adolescents aged 4-18 years who referred to the endocrinology clinic of Amirkola Children's Hospital, Babol, Iran in 2021. 42 obese and overweight children with NAFLD were considered as case group and 56 persons without NAFLD as control group. They were selected after physical examination and body mass index (BMI) assessment. Then, TSH, T4, FBS, lipid profile, 25(OH) vit D3 (VD), AST and ALT levels were measured. Abdominal ultrasound was performed to survey fatty liver. T-test and Chi-score were used for analysis and p< 0.05 was considered significant. Results: The mean age in both group was 11.63±2.55 and 10.07±2.61 years, respectively (P=0.004). Hypothyroidism was not seen in the groups. Two groups in terms of mean TSH (P=0.92), T4 (P=0.87), FBS (P=0.33), cholesterol (P=0.44), LDL (P=0.35), VD (P=0.07) had no significant difference. However, difference was found between the two groups in terms of the mean level of AST (P=0.003), ALT (P=0.001), TG (P=0.02), HDL (P=0.01) and BMI (P

Background: The growth and development of children affect biochemical variables. This population-based study was designed to evaluate the reference interval for alkaline phosphatase (ALP) routinely measured in the clinical laboratory. Methods: For this examination, 873 cases were selected among the healthy children and adolescents aged 1-18 years who referred to the endocrinology clinic of Amirkola Children's Hospital for growth evaluation. After overnight fasting, early morning blood samples were obtained to measure the ALP level and other biochemical parameters using an automatic biochemical analyzer. Subjects were categorized by age, sex, and body mass index (BMI) values. The age groups were categorized as follows: 1-4 years, 5-8 years, 9-13 years, and 14-18 years. Results: There was a significant difference among the age and sex categories; on the contrary, there was no meaningful variation between the two groups categorized by BMI. The reference range for ALP was 474.14-517.71 U/L for children aged 1-4 years, 273.47-871.44 U/L for 5-8 years, 215.04-893.69 U/L for 9-13 years, and 228.9-739.22 U/L for 14-18 years. Also, significant positive correlation was found between ALP with length (P=0.000, r=0.134), weight (=0.04, r=0.073), phosphorus (P) (P=0.001, r=0.122), and alanine aminotransferase (SGPT) (P=0.000, r=0.142) respectively. Conclusion: This project's data established a reference interval for ALP in healthy children and adolescents, which will prepare a basis for diagnosis and monitoring liver- or bone-related disorders.

Background: The New coronavirus (SARS COV-2) can cause acute respiratory disease and also multiorgan dysfunction. There is insufficient data about kidney involvement in children. So, this study was done on children with COVID-19 to evaluate nephrological involvement. Methods: All children with confirmed or suspected COVID-19 who were admitted in Children Hospital .were enrolled. They were admitted in hospital from March 2020 to July 2020. Serum Blood Urea Nitrogen (BUN), creatinine, sodium, potassium, calcium and urinalysis were evaluated. Also, glomerular filtration rate (GFR) was calculated by Schertz's formula. All patients were evaluated by chest x-ray and/or computerized tomography scanning (CTS). The data were analyzed by SPSS software and P value less than 0.05 was determined as significant. Results: Forty-seven children with confirmed or suspected COVID-19 were enrolled to this study. At admission, 23.4% and 27.7% of children with COVID-19 had abnormal increase in serum BUN and creatinine, respectively. Also 78.8% and 25.5% of children had GFR less than 90 and 60 ml/min /1.732, respectively. Additionally, 13/47 (27.7%) of children had abnormal urine analysis (microscopic hematuria and/or proteinuria). There wasn’t a significant relationship between pulmonary lesions and abnormal reduction of GFR (P

Background: Congenital hypothyroidism (CH) is one of the most common endocrine diseases and one of the major causes of mental retardation in children. So we aimed to evaluate the developmental outcome of children with CH. Methods: This case-control study was performed on two 3-6-year-old groups of 100 patients. The case group was children with CH, referred to Endocrine Clinic of Amirkola Childrenchr('39')s Hospital (2011-2017) and the control group was healthy children and normal from other states. The Denver developmental screening test-II (DDST_II) was used to assess the developmental factors and disorders in four areas of gross motor, fine motor, personal-social and language. Data were analyzed by SPSS 21 using descriptive statistics, t-test and chi-square, and a p

Background: Because of the importance of thyroid function and its effect on different organs, such as the heart, this study was aimed to evaluate the effect of levothyroxine on cardiac function in children with subclinical hypothyroidism. Methods: This quasi-experimental study was performed on children aged 4-12 years old with diagnosis of subclinical hypothyroidism in Amirkola Children's Hospital during 2018-2019. Cardiac functional parameters, including ejection fraction (EF), fractional shortening (FS), ratio of early filling velocity to early diastolic mitral annulus velocity (E/E'), myocardial performance index (MPI), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD), were measured by echocardiography at baseline and 6 months after levothyroxine treatment. Results: Out of the 30 subjects, 19 (63.3%) were boys and 11 (36.7%) were girls. The mean age was 6.60±2.13 years old. The mean EF index was 63.13±3.01 percent before treatment, which increased to 69.07±4.50 percent after treatment (p

Background: Type I diabetes mellitus (T1DM) with growing frequency which is considered as a world health threatening problem is an autoimmune disease with insulinupenia. Considering the relationship between the incidence of T1DM and environmental factors, the aim of this study was to assess seasonal incidence of T1DM and its association with birth season. Methods: This cross-sectional study was conducted on 112 diabetic patients (66 males, 46 females) less than 18 years, referred to Pediatric Endocrine Clinic (Amirkola Children's Hospital) during 2011-2017. All the needed information was extracted from the patient's files and asking questions of their parents. Data were collected in a checklist. Comparison between different seasons and age groups was done by Pearson's chi-square test. Data were analyzed using SPSS 19 and p£0.05 was considered significant level. Results: The mean age of the patients during diagnosis of T1DM was 7.34±3.70 years. The incidence of T1DM was significantly increased in the cold seasons (especially winter) (P

Background: Type 1 diabetes mellitus (T1DM) as an autoimmune disorder is associated with other autoimmune diseases such as autoimmune thyroid (AIT) disease. The aim of this study was to determine the prevalence of AIT in children who were referred to Amirkola Endocrine Clinic (north of Iran). Methods: This cross-sectional study was carried out on 100 diabetic children aged 1-15 years during 2008-2013, who were referred to the pediatric endocrine clinic. Serum levels of anti-thyroid peroxidase (Anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies and Thyrotropin Stimulating Hormone (TSH) were measured by Immune Chemiluminescence assay, and demographic information was obtained from patients'medical records. The collected data were analyzed using SPSS 18. Results: AIT was found in 13% of patients (8% female and 5% male). Significant levels were found for Anti-TPO (3%), anti-Tg (2%), and both antibodies (8%) in patients with AIT. Thyroid dysfunction was observed in 8 of 13 patients with AIT versus 2 of 87 patients without AIT (P

Tacrolimus is a main drug for induction and maintenance immunosuppression for patients with kidney transplants in many centers. One of important side effect of drug is post-transplant diabetes mellitus. Of course, diabetes ketoacidosis (DKA) is rare. In this report, a 12-year-old girl with DKA was presented after 45 days of kidney transplantation.

Background: Diabetic ketoacidosis (DKA) is the final consequence and life-threatening complication of severe insulin deficiency in type 1 diabetes with occurrence of 20-40%. The aim of this study was to investigate the incidence and predisposing factors of DKA and its consequences. Methods: This retrospective study was performed on 128 diabetic patients in Amirkola Children’s Hospital in 2005-2013. Patients' data were recorded in a predetermined questionnaire. The data were analyzed using SPSS.18. Results: Of all 128 hospitalized diabetic patients, 103 patients (80.5%) were referred for the first time and 25 (19.5%) patients were previously treated with insulin. Of total 128 patients, 71 (55.5%) had some degree of ketoacidosis that severe ketoacidosis was the most common form (in 36 cases; 50.7%). Among patients with the diagnosis of ketoacidosis (71 patients), 54 patients (76%) presented with DKA as the first symptom of diabetes. Generally, the predisposing factors of ketoacidosis were seen in 39 (54.9%) patients, which were due to infections and insulin therapy discontinuation in 27 (69.23%) and 12 (30.76%) of them, respectively. In patients with previous diagnosis of diabetes mellitus and history of admission with diabetic ketoacidosis, 70.58% had previous treatment cessation. Conclusions: In the current study, the incidence of ketoacidosis was high (55.5%). This subject seems to be related to lack of information about diabetes mellitus among population who require the universal education. On the other hand, in respect to high incidence of DKA among patients with cessation of previous insulin treatment, rigorous and complete training of them is critical.