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Background: Fecal calprotectin (FC) is suggested as a novel biomarker for the diagnosis of gastrointestinal (GI) diseases; however, few studies have investigated its diagnostic value for Helicobacter pylori (H. pylori). Therefore, the current study evaluated the level of FC and its diagnostic value in patients with H. Pylori and its related conditions including gastritis and duodenitis. Methods: In this case-control study, 120 children with upper GI symptoms, who were indicated to undergo upper GI endoscopic examination, were consecutively included. Patients were categorized into different groups based on their endoscopic findings including H. pylori, gastritis, duodenitis or normal. Results: Patients with gastritis (P = 0.014) and those with duodenitis (P < 001) had significantly higher FC. The level of FC was higher in patients with H. pylori but this difference was marginally significant (P = 0.054). The level of FC had poor ability to diagnose the presence of H. pylori (P = 0.054) and gastritis (area under the curve, AUC = 0.639, P = 0.014). However, it had acceptable power to diagnose patients with or duodenitis (AUC = 0.718, P < 0.001). The sensitivity and specificity of FC for diagnosis of gastritis were 64 and 65 percent (cut-off = 45.2 µg/g), and for duodenitis were 77 and 61 percent (cut-off = 46.2 µg/g), respectively. Conclusions: FC can be considered as an objective and diagnostic tool for duodenitis. However, due to the low sensitivity and specificity, it is suggested to consider it as an objective supplementary test beside other established diagnostic modalities. [ABSTRACT FROM AUTHOR]

Abstract Background Adverse reactions induced by BCG vaccination are rare, disseminated mycobacterial BCG infection in particular, which is often fatal and results from impaired immunity. The aim of this study is to determine the nature of the immunodeficiences in patients with disseminated BCG infection in northwest region of Iran. Materials and methods Through 2 years all infants with BCG adenitis or other complications of this vaccine that had suspicious BCG infection were referred to children's hospital and health centers of Tabriz. Evaluation of immune system and in some cases genetic survey was performed in infants with evidence of histopathologic demonstration of acid-fast bacilli. Then frequency of infants who had disseminated BCG infection with immunodeficiency was defined. Results From 48 selected infants with complications of BCG vaccine in the range of 2 to 62 months, 28 infants (58.3%) were male and 20 infants (41.7%) were female. Disseminated BCG infection was diagnosed in 11 cases, almost all of whom had immunodeficiency as follows: Seven cases had severe combined immunodeficiency and one cases had chronic granulomatous disease. MSMD in two cases and IL12 R deficiency in another one was diagnosed. Overall, the mortality rate was 72.8% (8 cases) which 7 cases of them were SCID and another one CGD Consanguineous was found in more than half (7 cases) of patients and family history of disseminated BCG infection or immunodeficiency was found in nearly one third (3 cases) of patients. Discussion BCG vaccine is administered world wide to prevent tuberculosis and is considered to have excellent safety profile. However in some immunodeficient patients it can cause severe and fatal complications, like in our region, where all cases of disseminated BCG infection with severe immunodeficiency died. Conclusion BCG vaccination is necessary in some countries such as Iran, so it seems that development of a more safer vaccine and change of vaccine program in the families with history of inherited immunodeficiency can be identifies such high risk infants and prophylaxis of severe complications or dead in such patients.

Abstract Aim To identify personality dimensions of mothers with a constipated child and compare it with those mothers of children without defecation problems. Methods We compared mothers of 150 children with functional constipation to mothers of 150 children with no such a problem attending to pediatric hospital of Tabriz University of medical sciences. Personality dimensions were evaluated by NEO five factor inventory after excluding any psychiatric disorders by an interview. Results Mean age (SD) was 28.8(18.6) months in constipated children and 20.0(19.3) months in controls, 54.6% of constipated children and 56.7% of controls were male. Mean age (SD) was 30.9(7.1) years in mothers of children with functional constipation and 30.1(7.6) years in controls. Mothers of children with functional constipation scored lower in neuroticism and scored higher in extraversion, conscientiousness and agreeableness. Conscientiousness was the dominant dimension of personality in both groups. Conclusion Our results suggest the maternal personality as a factor to directly influence toileting behavior of their children resulting in functional constipation.

Objectives: Calprotectin is released from neutrophils and monocytes during the inflammatory process. Recently, an increasing number of studies has postulated some possible diagnostic roles of fecal calprotectin (FC), including the inflammatory bowel disease (IBD). Considering that mesenteric lymphadenopathy is due to the inflammation of lymph nodes, it can be assumed that FC can be used as an early diagnostic tool for mesenteric lymphadenopathy. Thus, the aim of this study was to evaluate the association between FC and mesenteric lymphadenopathy in children. Materials and Methods: Children with abdominal pain admitted to Tabriz Pediatric Hospital were included in this cross-sectional, case-control study during one year. Patients were allocated to two groups based on ultrasonography (US). The case group consisted of children with mesenteric lymphadenopathy revealed by the US while the control group included children without mesenteric lymphadenopathy. Finally, the demographic data and FC concentration, along with other routine laboratory tests were assessed in both groups. Results: Overall, 119 children were included of whom, 47 and 71 children were in the control and case groups, respectively. The median FC of the case and control groups was 50 and 46.7 µg/g ranging from 6.5-1800 and 5-1000 µg/g, respectively, demonstrating a significant difference between the groups (P = 0.001). The optimal cutoff point of FC was 46.7 µg/g for the diagnosis of mesenteric lymphadenopathy with 61.1% sensitivity and 78.7% specificity. Conclusions: The results of this study revealed that the level of FC in the case group was significantly higher compared to the control group. Therefore, the FC concentration could be the most useful method for the diagnosis of mesenteric lymphadenopathy. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to investigate the correlation of genotype-phenotype in patients with cystic fibrosis (CF) in the Azeri-Turkish population, Iran. Materials and Methods: In this descriptive-analytical study which was conducted according to Registry Center of Cystic Fibrosis, 206 patients with CF were investigated from 2001 to 2017. The data included clinical, laboratory, and genetic results. Descriptive statistics, chi-square test, and independent t test were applied using SPSS version 21.0. The odds ratio with 95% confidence interval and P < 0.05 were considered significant. Results: Thirty-one variants and 47 genotypes were observed. The ?F508 genotype (the most common genotype), especially homozygous and compound heterozygous genotypes were significantly different from other genotypes for chronic sinopulmonary disease, gastrointestinal and nutritional abnormalities, and salt loss syndromes, with a higher sweat test measures, higher mortality rate, and complications. Conclusions: Except for ?F508, the rest of mutations were the same, and milder clinical course, and most mutations belonged to this group. The challenge in cystic fibrosis consists of no detected mutations and high heterogeneity of cystic fibrosis transmembrane conductance regulator (CFTR) mutations. [ABSTRACT FROM AUTHOR]

Background. Henoch-Schönlein purpura (HSP) is a multisystem, small vessel, leucocytoclastic vasculitis. It is predominantly a childhood vasculitis, rarely reported in adults. Studies have shown that several different genetic factors such as genes involved in inflammatory system and renin-angiotensin system (RAS) are important in the pathogenesis of Henoch-Schönlein purpura. Objectives. The purpose of this study was to evaluate the independent effect of 3 gene polymorphisms including CCL2-2518 C/T, VEGF-634G/C and ACE(I/D) with HSP disease and their possible joint interactions in developing the disease. Material and methods. In this case-control study 47 HSP cases and 74 unrelated healthy controls were enrolled for evaluation. All individuals were genotyped for CCL2-2518C/T, VEGF-634G/C and ACE(I/D) gene polymorphisms. The possible association of these polymorphisms with susceptibility to develop HSP disease independently and in different joint combinations was evaluated. Results. The frequencies of TT genotype and T allele of CCL2-2518C/T gene polymorphism and CC genotype and C allele of VEGF-634G/C gene polymorphism were significantly high in HSP children (p-values = 0.005 and = 0.007 respectively). Interestingly, studying the joint interaction of these 2 genotypes (CC genotype of VEGF G-634C and TT genotype of CCL2 C-2518T) in this cohort showed a more significant effect in the development of the disease (p < 0.000, OR = 6.009). The frequency of TT genotype of CCL2 gene when combined with II genotype of ACE gene in HSP children was significantly higher (p < 0.000, OR = 4.213). Conclusions. The results of this pilot study provide evidence of the possible gene-gene interaction effects of CCL2, VEGF and ACE genes in developing HSP disease. [ABSTRACT FROM AUTHOR]