Search

Introduction: Constipation is a frequent complication in paediatrics. Most of the constipation is functional. Functional constipation constitutes 25% of visits in paediatric gastroenterology clinics. Two studies were published regarding aggregation or clustering of functional constipation. Only one of these research projects was about a paediatric population. Aim: To elucidate the cluster pattern of constipation among the families of children with constipation. Material and methods: This case-control study was carried out on the families of 37 children < 18 years old with chronic functional constipation and the families of 37 healthy children as controls. Cases were enrolled in the study according to Rome III criteria for constipation. The control group was selected from children < 18 years old who visited the well baby clinic of the university. Parents and siblings were evaluated regarding constipation. Rome II and III were used for evaluation of constipation for adults and children, respectively. Data was analysed using SPSS (Chicago, IL, USA). The χ2 and t-test were used for comparison. Results: Physical activity and vegetable consumption were seen more frequently in the control group compared to the cases, but these differences were statistically insignificant. Constipation in mothers was significantly higher in the case group compared to the control group (p = 0.015). There was no significant difference between the two groups regarding exercise and vegetable consumption. Conclusions: The frequency of constipation among mothers was significantly higher in the case group compared to the control group. Another study is recommended in a larger population for evaluation of genetic background, diet, physical activity, and familial clustering among mothers of children with constipation. [ABSTRACT FROM AUTHOR]

Background: Training of pediatric residents is a dynamic process which should be changed as the nature and epidemiology of pediatric diseases change. In this study, we compared the training program of the pediatric residents with the disorders of the pediatric patients who had referred to pediatric offices. Methods: The study was conducted in pediatric offices in Shiraz, South of Iran. The main complaints of all the patients who were referred to these offices in the first 3 days of the four seasons of the year were recorded. Finally, descriptive statistics was used to determine the frequency of different complaints among these patients. Results: There are 58 Pediatrics offices in Shiraz and 37 offices completed the questioners (64%). The most frequent complaints of the patients were related to infections, especially respiratory and gastrointestinal ones. Nutritional and growth problems were other frequent complaints. Nonetheless, a high number of the patients were referred due to skin, eye, or ear problems or for check up of the baby. Conclusion: There is an important training-practice problem in the curriculum of pediatric residents. Thus, we suggest decreasing the periods of inpatient subspecialty training and increasing the period of outpatient dermatology, ophthalmology, otolaryngology, and well-baby clinics. [ABSTRACT FROM AUTHOR]

Two trials were conducted to evaluate the withdrawal or reduction of vitamin premix from diets of finisher period (29 to 42 days of age) on broiler performance and immunocompetence. Trial 1 was conducted as a completely randomized design with 4 treatments of 6 replicates and 5 chicks in each battery cage system. Trial 2 was conducted with 4 treatments of 6 replicates and 18 chicks in pen floor system. The diets were formulated based on wheat and barley, and dietary treatments were: T1 = based diet without vitamin premix, T2= based diet with 33.33% vitamin premix, T3 = based diet 66.66% vitamin premix, T4 = based diet 100% vitamin premix (Control Group). On day 34, two birds from each replicate were selected and antibody responses to inoculated sheep red blood cells were determined. The cell-mediated immunity was determined via phytohemagglutinin (PHA) and dinitrochlorobenzene (DNCB). Results of trial 1 showed that there were no significant differences in the bird's performance with reduction or withdrawal of vitamin premix from diets in 29-35 days among the experimental groups, but in 36-42 days of age, the performance of the group of the birds fed with diet without vitamin premix (T1) was significantly lower than other groups (P < 0.05). Results of trial 2 showed that vitamin premix reduction and withdrawal from 29 d of age did not impair body weight, feed intake and feed conversion ratio during the final period of broilers (29-42d). The results of two trials demonstrated that immunocompetence response was not affected by treatments in finisher period. The results of the present study indicated that in the battery cage system it's possible to reduce dietary vitamin premix during finisher period but withdrawal can negatively affect performance of broilers. While in the floor system it is possible to withdraw vitamin supplements from finisher diets. [ABSTRACT FROM AUTHOR]

Se realizaron dos pruebas para evaluar la retirada o reducción de la premezcla vitamínica de las dietas del período de finalización (29 a 42 días de edad) en el comportamiento e inmunocompetencia de pollos de ceba. La prueba 1 se llevó a cabo como un diseño completamente aleatorizado con 4 tratamientos de 6 réplicas y 5 pollitos en cada sistema de jaula de batería. La prueba 2 se condujo con 4 tratamientos de 6 réplicas y 18 pollitos en un sistema de pollera con piso. Las dietas fueron formuladas con trigo y cebada y los tratamientos dietéticos fueron: T1 – dieta base sin premezcla de vitaminas, T2 dieta base 33.33% premezcla de vitaminas, T3 = dieta base 66.66% premezcla de vitaminas, T4 = dieta base 100% premezcla de vitaminas (Grupo control). El día 34, se seleccionaron dos pollitos de cada réplica y se determinaron las respuestas de anticuerpos a las células rojas de sangre de oveja inoculadas. Se estableció inmunidad por mediación de las células vía fitohemaglutin (FHG) y dinitroclorobenzeno (DNCB). Los resultados de la prueba 1 mostraron que no hubo diferencias significativas en el comportamiento de las aves con la reducción o eliminación de la premezcla de vitaminas de las dietas a los 29-35 días entre los grupos experimentales, pero a los 36-42 días de edad, el comportamiento del grupo de aves alimentado sin premezcla de vitaminas (T1) fue significativamente inferior que en los otros grupos (P < 0.05). Los resultados de la prueba 2 mostraron que la reducción de la premezcla vitamínica y su eliminación a partir de 29 días de edad no perjudicó el peso corporal, el consumo de alimentos y la proporción de conversión de alimentos durante el período final de los pollos de ceba (29 a 42 días). Los resultados de las dos pruebas demostraron que la respuesta de la inmunocompetencia no fue afectada por los tratamientos en el período de finalización. Los resultados indicaron que en el sistema de jaula de baterías es posible reducir la premezcla de vitaminas dietética durante el período de finalización, pero su retirada puede afectar negativamente el comportamiento de los pollos de ceba mientras que en el sistema de piso es posible retirar los suplementos de vitaminas de las dietas de finalización. [ABSTRACT FROM AUTHOR]

Background: Nowadays, the introduction of the so-called 'diabetes technology' (either hardware/device or software) to different aspects of day-to-day living in patients with diabetes aims to improve blood glucose control and thus, various lifestyle features. Since medical nutrition therapy has long been considered as the corn stone of chronic management of the disease, the coordination of vast context of diabetes education/training, particularly in the area of carbohydrate counting regarding insulin regimen, is of great concern. On the other hand, as many other food cultures, Iranian food culture consist of a set of traditional dietary patterns and food consumption habit, depending on the country natural environment and available food items. Objective: The study was aimed to develop "the Comprehensive Mobile Application (App) of Advanced Carbohydrate Counting and Diet- and Insulin-Regimen Planning" to help type 1 diabetic patients improving their health status. Material and Methods: The programming language of Kotlin, JavaScript, Node JS, and HTML5 was used for the mobile app development. Results and Conclusion: The app was developed with the following abilities: 1) Educate users on different aspects of disease control (including, updated general treatment guidelines on physical activity, medical nutrition and insulin therapy, stress management; and the patient's specific goals and dietary needs), 2) Perform advanced carbohydrate counting utilizing both picture-represented and kitchen-scale of carbohydrate foods as well as traditional Iranian foods, 3) Recommend the patient's specific insulin dose (either short- or rapid-acting), based on the carbohydrate content of the selected meal or the selected amount of Iranian foods, 4) Recommend the personalized insulin dose needed for decreasing the high blood glucose levels, and 5) Perform both 3 and 4 simultaneously to recommend the insulin dosage required for covering the carbohydrate content of selected meal and lowering high blood glucose. [ABSTRACT FROM AUTHOR]

The article discusses medications available to treat diabetes mellitus for children suffering from chronic endocrine disorders. Topics include survey conducted to find methods of alternative treatment, study conducted in Shiraz, Iran where patients enrolled for educational program for management of diabetes, and herbal method was the preferred method of use.

Background: Osteogenesis imperfecta (OI) is a group of connective tissue disorder caused by mutations of genes involved in the production of collagen and its supporting proteins. Although the majority of reported OI variants are in COL1A1 and COL1A2 genes, recent reports have shown problems in other non-collagenous genes involved in the post translational modifications, folding and transport, transcription and proliferation of osteoblasts, bone mineralization, and cell signaling. Up to now, 17 types of OI have been reported in which types I to IV are the most frequent cases with autosomal dominant pattern of inheritance. Case Presentation: Here we report an 8- year- old boy with OI who has had multiple fractures since birth and now he is wheelchair-dependent. To identify genetic cause of OI in our patient, whole exome sequencing (WES) was carried out and it revealed a novel deleterious homozygote splice acceptor site mutation (c.1257-2A > G, IVS7-2A > G) in FKBP10 gene in the patient. Then, the identified mutation was confirmed using Sanger sequencing in the proband as homozygous and in his parents as heterozygous, indicating its autosomal recessive pattern of inheritance. In addition, we performed RT-PCR on RNA transcripts originated from skin fibroblast of the proband to analyze the functional effect of the mutation on splicing pattern of FKBP10 gene and it showed skipping of the exon 8 of this gene. Moreover, Real-Time PCR was carried out to quantify the expression level of FKBP10 in the proband and his family members in which it revealed nearly the full decrease in the level of FKBP10 expression in the proband and around 75% decrease in its level in the carriers of the mutation, strongly suggesting the pathogenicity of the mutation. Conclusions: Our study identified, for the first time, a private pathogenic splice site mutation in FKBP10 gene and further prove the involvement of this gene in the rare cases of autosomal recessive OI type XI with distinguished clinical manifestations. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 14 year old girl with diabetes mellitus type 1, who developed generalized edema and pericardial effusion a few days after initiation of insulin therapy. The patient showed no cardiovascular manifestation hence no treatment was prescribed. The case presents a rare case of complication of insulin therapy.

The article discusses a study assessing the function general physicians (GP) of emergency departments (ED) of general hospitals in answering telephone consultations (TC) using a questionnaire. Findings revealed that 80 percent of physicians of EDs answered TC inappropriately, indicating that ED physicians do not believe in the importance of TC.

Introduction and Aim: The aim of this study was to evaluate nutritional status in children without prior hospital admission or evidence of chronic disease.Subjects and Methods: The current study is a cross-sectional and observational study which was conducted for assessing the nutritional status of children. In this study, consecutive sampling was used, with a sample size about 400 children aged 6 months to 18 years at first hospital admission. All subjects were hospitalized consecutively in the Pediatric Emergency Department of the Nemazee Teaching Hospital of Shiraz University of Medical Sciences (Shiraz, Islamic Republic of Iran). All children with evidence or history of chronic diseases such as liver cirrhosis, microcephaly, macrocephaly due to congenital infection or abnormal skull shape, patients with muscular or neurological problem, with prolonged steroid usage, nephrotic syndrome, cardiac problem, and protein loosing enteropathy were excluded from the study. The duration of the study was six months, starting from January 2016.Results: In the current study, 430 (225 boys and 175 girls) cases were included. Mean age was 5.39 (SEM 0.23) for boys and 5.78 (SEM 0.38) for girls. According to H/A criteria (current height/ideal height), 194 (48.5%) patients were stunted, 75 (18.8%) were mild, 49 (12.3%) were moderate and 70 (17.5%) were severe. According to W/A data (current weight/ideal weight), 188 (47%) of the patients studied were malnourished. Of these cases, 118 (29.5%) had mild malnutrition; 54 (13.5%), moderate; and 16 (4%), severe. According to body mass index (BMI), 40 (10%) patients were overweight, four (16%) were obese, and four (1%) were severe obese. In relation to middle upper arm circumference (MUAC), 56 (14%) patients were malnourished, 33 (8.3%) were at risk, 14 (3.5%) presented moderate malnutrition, and 9 (2.3%), severe malnutrition.Conclusion: Prevalence of malnutrition among children without prior admission was 48.5% (according to H/A). According to W/A, 47% of children had different degrees of malnutrition. [ABSTRACT FROM AUTHOR]

Bruck syndrome is an autosomal recessive syndrome consisting of bone fragility and congenital joint contractures. According to the genotype, it has been classified into types 1 and 2. Recently, mutations in FKBP10, localised to chromosome 17q21, have been identified in some patients of Bruck syndrome. Twenty-seven patients of this syndrome have been reported so far. We present a new patient of this syndrome, with frequent fractures, congenital joint contractures, kyphoscoliosis, bilateral clubfoot, and pectus carinatum. The clinical and genetic features of all previously reported cases are also reviewed.

Objective: To determine the epidemiology of acute childhood poisoning in Shiraz, southern Iran., Methods: This was a prospective cross-sectional descriptive study, being performed in Nemazee and Dastgheib Hospitals affiliated with Shiraz University of Medical Sciences. The study included pediatric patients (<18 years) referred to our centers due to acute poisoning. Demographic and etiological factors were prospectively recorded and analyzed., Results: A total of 773 patients with mean age of 3.86 ± 1.5 years were recruited in the study. The most common group which included 352 (45.5%) patients, aged between 8 months and 5 years followed by 330 (42.6%) cases aged from 12-18 years. In majority of cases, poisoning was due to opium in 222 (23.5%) followed by analgesics in 181 (19.1%), which mostly included acetaminophen in 75(7.9%), anti-depressants in 170 (17.9%), anti-hypertensive drugs in 65 (6.8%) and hydrocarbons in 60 (6.3%). There were 260 (33.7%) boys and 513 (66.3%) girls. The poisoning occurred inadvertently in 387 (50.1%) cases while 298 (38.5%) patients committed suicide. Most cases (255 patients; 32.9%) were asymptomatic at presentation., Conclusion: Our study substantiated the following findings: A) Alarmingly, opium is the most common cause of acute childhood poisoning in our area. B) Easy access to toxic material is the most common risk factor for acute childhood poisoning. C) Female predominance of acute childhood poisoning accompanied by high rate of suicidal attempts shows that psychiatric problems, especially depression is most common among young girls.