Shiraz Emedical Journal
Volume:8 Issue: 1, Jan 2007

To estimate the frequency of enuresis in 5-10 year old Tafila children and to examine the factors associated with it. Across sectional study done in Tafila at Prince Zeid Hospital pediatric clinic for children 5-10 year old visiting it through asking the parents of 1000 children of whom 700 children completed the questionnaire which included items about age, sex, frequency of daytime and nighttime bed wetting, family history, strategies taken by parents to solve the problem and some socio-demographic factors associated with enuresis from January 2005- January 2006. Frequency tables and descriptive statistics were analyzed using the SPSS for Windows version 10 software program. The response rate to the questionnaire was 70%(700/1000).The frequency of enuresis was 8.8%,mostly wetting >3 nights/wk 25(40.3%), male: female ratio was 1.58:1, Poor economic status of the family and low maternal education are important factors in enuretic children, and children concern to solve the problem is better than the parents(62.9%)vs.(37.1%). The frequency of enuresis among Tafila children is 8.8% and is associated mostly with male gender, positive family history, poor socio- economic status, mother education and poor parents concern.

Hepatitis C virus (HCV) infection is an increasing problem, with millions people all over the world being infected. It is accepted as a significant public health problem with several life altering complications, especially hepatocellular carcinoma. The correlation between HCV infection and non – Hodgkin’s lymphoma is no doubt at present. However, the reports on the correlation between HCV infection and Hodgkin’s lymphoma are still controversy. The correlation between this virus infection and development of Hodgkin’s lymphoma is of interest. Here, the author performs an appraisal on the seroprevalence of HCV among patients with Hodgkin’s lymphoma comparing with healthy control subjects. Risk analysis was performed. According to the literature review, 3 reports were recruited. According to the metanalysis, 184 cases and 904 healthy subjects were investigated for HCV seroprevalence. The overall Anti HCV seropositive rate in the patients (3/184) and healthy subjects (6/904) are 1.6 % and 0.7 %, respectively. The odds ratio is 2.5. According to this study, it could be seen that having Anti HCV seropositive is a weak risk for Hodgkin’s lymphoma.

One of the etiological causes of nonulcer dyspepsia (NUD) is H. pylori infection. The role of H. pylori infection in dyspepsia and its accompaniment with hormonal disorders remain controversial. We studied the association between existence of H. pylori and variation of Colecystokinin (CCK) and gastrin in NUD patients. One hundred consecutive out patients with NUD that referred to Taleghani Hospital in Tehran from May 2002 to January 2003 were studied. Demographic and clinical examinations were fulfilled and basal serum gastrin and CCK level and IgG anti H. pylori were measured. After through endoscopic evaluation, gastric mucosal biopsies were taken from all patients for investigation of H. pylori (Rapid urease test (R.U.T), direct exam and IgG Anti H. pylori tests) and histological assessment. 100 NUD patients including 48 (48%) male and 52(52%) female were studied. 11 patients were smoker. Fullness (62%) was the predominant symptoms in them. 59% of patients complained of abdominal pain, 57% of early satiety, 42% of anorexia, 17% of dysphagia, 46% of nausea and 20% of vomiting. 78 (78%) of patients were H. Pylori positiveIn H. pylori positive group, the mean± SD of CCK was 1.06± 0.40 and gastrin was 6.68 ± 7.82. In H. pylori negative group the mean ± SD of CCK was 0.92 ± 0.31 and gastrin 8.20 ± 12.58. There was no significant difference in gastrin and CCK serum level between H. pylori positive and H. pylori negative in nonulcer dyspeptic patients. According to high frequency of H. pylori in NUD patients, the investigation of patients for the presence of H. pylori in patients is recommended. We didn’t find any relation between H. pylori infection and the serum level of gastrin and CCK in NUD patients

Th1 cytokines are required for host antiviral immune responses. However little is known about the production and progression of cytokines in hepatitis C virus (HCV) infected patients. The aim of this study was to assess the serum levels of Th1 cytokines and also their association with inflammatory indicators in HCV-infected and normal individuals. Fifty four HCV-infected patients along with thirty one healthy controls were selected using the sequential sampling method. Serum levels of interleukine-2 (IL-2), interferon-gamma (IFN-γ) and tumor necrosis factor-alfa (TNF-α) was determined in all the precipitants by enzyme-linked immunosorbent assay (ELISA). Moreover serum levels of alanine aminotransferase (ALT), aspartat aminotransferase (AST), alkaline phosphatase (ALP), C-reactive protein (CRP) and rheumatoid factor (RF) were also determined in both patient and control groups. The results showed that serum levels of IFN-γ, TNF-α and IL-2 were higher in HCV-infected patients than controls group but the difference was significant only for TNF-α (p<0.05). A positive correlation was found between the serum level of TNF-α and IL-2 in patient group (p<0.05). TNF-α is the main mediator of the acute inflammatory responses to microbial infections and in our study serum level of TNF-α in HCV-infected patients was higher than healthy subjects. Positive correlation of serum TNF-α and IL-2 levels in HCV-infected patients may contribute to the role of innate immunity in stimulating the adaptive immune responses, thus suggests role of TNF-α in antibody production.

Nephropathy is one of the risky complications of Type I diabetes mellitus that could lead to end stage renal disease. Persistent microalbuminuria i.e. small amounts of urinary albumin excretion (UAE), is the best predictor of high risk of developing diabetic nephropathy. Early diagnosis of microabminuria and evaluation of patients with this, regarding the presence of comorbid associations are effective strategies for reduction of diabetic mortality and morbidity. The present study carried out because the great variability in prevalence of nephropathy depends on geographic area and different population and little is known about the prevalence of nephropathy and its preceding morbidity in our community. To determine the frequency of microabumnuria in children and adolescents with insulin dependent diabetes mellitus. Subjects and In a cross sectional study frequency of microalbuminaria was investigated in 39 children and adolescents with IDDM which were selected by simple convenient sampling. Data were analyzed by descriptive inferential method (distribution, frequency rate, mean, standard deviation, t test and χ2 test) using SPSS. P value < 0.05 was considered significant. from a total 39 patients with 5 years duration of diabetes 9(23.1%) patients were microalbuminuric and 30 (76.9%) of them normoalbumminuric. The mean duration of diabetes was 7.88±2.7 year in microalbuminuric patients and in normoalbuminoric patients was 7±2.5 year, The age of patients was 16.06± 2.3 year in miroalbuminuric group and in normoalbumiric patients it was 13.87± 3.41 year (p=0.01). In microalbuminric patients systolic blood pressure and diastolic blood pressure were 10.51± 0.98 mm Hg and 6.9±1.8 mm Hg respectively. In normoalbuminuric patients systolic blood pressure was 10.26±1.31 mmHg and diastolic pressure 7.1 ± 0.75 mmHg. In patients with microalbuminuria the mean of HbA1c value was 8.44±2.08 and in normoalbuminuric patients it was 8.62±1.88. Findings also, showed no association between miroalbuminuria with total cholesterol, HDL LDL and triglyceride. In our study the mean age of patients in microalbuminuric and normoalbuminuric groups was significantly different, so this could be related to ethnic difference in different populations. Based on data obtained, absence of relationship between microalbuminuria and variables may be due to low numbers of samples, also the frequency rate of microalbuminuria in our patients was higher that many other studies. So, we can say this study can be perceived as a pilot study and we suggest doing study on more numbers of patients who are attending in different clinics of diabetes and as a national study.

A 55-year-old man with severe right-sided empyema was admitted to our hospital. Six days before this admission, he had undergone upper GI endoscopy in another center to remove a retained chicken bone in lower esophagus and despite documented thoracic esophageal perforation, treatment was surprisingly delayed. The perforation was closed with primary sutures and reinforced with intercostal muscle flap wrap and pleural patch. Esophagography performed 3 weeks after the operation showed a well-healed esophagus without stenosis or leakage. We conclude that regardless of the time interval between the injury and the operation, reinforced primary repair is recommended for non-malignant thoracic esophageal perforation and provide a one-stage operation with preservation of the native esophagus. As far as we know, this type of procedure (with regard to its underlying infected body region and considerable controversy in delayed esophageal perforation management) has not been previously performed in Iran.

Acute cholecystitis is rare in pediatric age group and usually is not diagnosed. Recent reports of pediatric acute cholecystitis are increasing which can be because of more clinical suspiciousness or increased long term TPN usage. This article reports a three year old boy, a six year old girl and a seven year old girl with acute cholecystitis which referred to primary care because of chills, fever, vomiting and generalized abdominal tenderness. With impression of acute peritonitis, these patients were operated and acute acalculous cholecystitis was the diagnosis. Culture of billiary secretions of them was positive for Salmonella Typhi.

Non-occlusive mesenteric ischemia (NOMI) has been defined as diffuse intestinal ischemia that often results in intestinal gangrene in the presence of a patent arterial trunk with vasospasm. A few cases of severe acute pancreatitis have been reported to be complicated by NOMI. Here we report a case of acute hemorrhagic biliary pancreatitis with intestinal gangrene due to NOMI. Clinicians who manage acute pancreatitis should consider NOMI as one of the severe complications of this condition.