فهرست مطالب

Journal of Comprehensive Pediatrics
Volume:5 Issue: 3, Aug 2014

  • تاریخ انتشار: 1393/08/29
  • تعداد عناوین: 9
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  • Francesco Vierucci *, Andrea Azzarelli, Rossana Gualtierotti, Raffaele Domenici Page 1
  • Mohammad Reza Esmaeilidooki *, Leila Moslemi, Atena Rezai, Morteza Safari Tirtashi, Majid Sharbatdaran, Ali Bijani, Mehri Njafi Sani, Hassan Karami, Mohammad Pornasrollah Page 3
    Background
    Epidemiology of hepatitis A virus (HAV) is changing over time. Giving awareness of this issue can be developed as a plan to prevent complications of the disease; it is especially very helpful in high risk children, such as those with chronic liver disease.
    Objectives
    The current study aimed to investigate the seroprevalenceof anti-HAV antibodies in children with and without chronic liver diseases during two different periods.Patients and
    Methods
    Two studies were conducted on anti-HAV seroprevalence antibodies in children aged one to fifteen years who were referred to Amirkola Children’s Hospital (Babol, North of Iran). The first study was conducted on 73 patients with chronic liver disease (CLD) in 2006, and the second study on 180 cases without it (NCLD) in 2011. Blood samples were collected from children and the sera were evaluated for anti-HAV antibodies via ELISA assay by Dia. Pro kit.
    Results
    Seroprevalence of HAV was 17.8% and 10% in the first and second study, respectively. There was no significant difference in age, sex, and place of residence between anti-HAV negative and positive subjects in the studies.
    Conclusions
    It appears that anti-HAV antibody seroprevalence has declined among children below 15 years with and without chronic liver disease, and it is likely that more children would be susceptible to HAV infection. Therefore, it is important to employ preventative strategies against HAV in chronic liver diseases.
    Keywords: Hepatitis A Virus_Child_Chronic Liver Diseases
  • Mohammad Hadi Imanieh, Seyed Mohsen Dehghani *, Amin Masjedi, Abbas Rezaianzadeh, Mahmood Haghighat Page 4
    Background
    Helicobacter pylori infection is a common infection that affects human beings. This infection also affects children. Different diagnostic methods such as serology, stool antigen detection, rapid urease test and histology are used to detect this microorganism.
    Objectives
    The aim of this study was to determine the correlation between serology and histology/rapid urease test.Patients and
    Methods
    In this study, two groups (case and control) were selected and matched for age and sex. The case group comprised of 77 children with confirmed H. pylori infection, as they had positive rapid urease test and histology results. The control group included 77 healthy children. Both case and control groups were checked serologically for detection of anti H. pylori IgM, IgG and IgA antibody titers. Receiver operating characteristic (ROC)-analysis software was used for data analysis.
    Results
    Amongst the case group 54.6% were female and 45.4% were male. The most common complaints were abdominal pain (96%) and anorexia (82%). Using ROC-analysis method three cut-off points for IgG, IgM and IgA were obtained. These points were 3.3 U/ML for IgA, 6.4 U/ML for IgM and 9.9 U/ML for IgG. Considering cut-off points for each antibody, higher levels were considered as positive and lower levels as negative. Antibody titers were compared with gold standard methods including histologic and rapid urease tests. IgA level had a sensitivity of 64%, specificity of 58%, accuracy of 59.3%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgM level had a sensitivity of 76%, specificity of 36.1%, accuracy of 74.2%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgG level had a sensitivity of 58.6%, specificity of 61.3%, accuracy of 60.6%, positive predictive value of 36.9% and negative predictive value of 79.3%.
    Conclusions
    Therefore, these antibodies have a relatively high negative predictive value and a low positive predictive value. Thus, their negative results are more valuable. The most sensitive antibody is IgM and most specific antibody is IgG. However, the performances of all serological tests for H. pylori are poor in children and these tests should not be used for diagnosis of H. pylori infection and treatment decisions for the pediatric age group.
    Keywords: Helicobacter pylori, Serology, Children
  • Saleheh Ala, Mahmood Haghighat, Seyed Mohsen Dehghani, Karmella Kamali, Hassan Bazmamoun* Page 5
    Introduction
    Congenital microgastria is an extremely rare anomaly, which is due to failure of gastric development, and causes a tubular stomach with reduced capacity. It is almost always associated with other congenital anomalies.
    Case Presentation
    The patient was a two-month-old boy with microgastria in association with gastroesophageal reflux, tracheomalacia, and limb defect.
    Discussion
    Most cases of congenital microgastria are associated with other anomalies such as VACTERL. We concluded that upper gastrointestinal contrast studies should be done in patients with frequent vomiting and other multiple anomalies.
    Keywords: Congenital Microgastria, Gastroesophageal Reflux, Congenital Tracheomalacia, Tracheomalacia, Limb Defect
  • Mahsa Motavaf, Majid Sadeghizadeh* Page 6
    Context: Prenatal testing aims to identify fetal chromosomal and genetic disorders prior to delivery. Current invasive procedures such as amniocentesis and chorionic villus sampling (CVS) pose a risk to mother and fetus and such diagnostic procedures are available only to high-risk pregnancies, which limits aneuploidy detection rate. The identification of cell-free fetal DNA (cffDNA) in maternal circulation has made noninvasive prenatal testing (NIPT) possible. This review seeks to highlight the necessity of investing in NIPT and briefly summarizes the technical aspects of the NIPT and application of this method in clinical practice.Evidence Acquisition: PubMed, OVID, SCOPUS, and the Cochrane database were searched for relevant articles published between 1995 and 2014, using appropriate keywords including prenatal screening, noninvasive testing, prenatal diagnosis, cell free fetal DNA, maternal circulation, chromosomal aneuploidies, trisomy, and sex determination. Results were restricted to systematic reviews, randomized clinical trials, meta-analysis, and observational studies.
    Results
    The importance of prenatal diagnosis and risks associated with current invasive techniques makes NIPT research morally and commercially beneficial. The outstanding advantages of NIPT over current prenatal diagnosis techniques include increasing detection rate, enabling earlier diagnosis, and eliminating iatrogenic fetal loss and risk to the mother due to invasive procedures. At present, two major techniques for isolating cffDNA, namely digital PCR and massively parallel sequencing (MPS), have enabled the successful implementation of NIPT into clinical practice such as fetal sex determination, RhD genotyping, and fetal chromosomal aneuploidy detection.
    Conclusions
    The advent of new NIPT using cffDNA has been regarded as a revolution in prenatal testing and has attracted significant commercial interest in the field. It is not overoptimistic to predict that NIPT will supplement or replace existing screening and diagnostic tools.
    Keywords: Noninvasive, Genetic Testing, Prenatal Diagnosis, Cell, Free System, Fetus, DNA, Chromosomes, Aneuploidy
  • Gholamreza Soleimani*, Elham Shafighi Shahri, Somayeh Rashidi, Zahra Salari, Alireza Ansari Moghadam Page 7
    Background
    Bronchiolitis is the most common lower respiratory tract infection in infants, which is often due to respiratory syncytial virus. The treatment is supportive; therefore, epidemiology, clinical, laboratory, and radiologic findings can help to prevent inappropriate use of antibiotics.
    Objectives
    The aim of this study was to evaluate the clinical, and laboratory characteristics of bronchiolitis in hospitalized children.Patients and
    Methods
    In this cross-sectional study, we recruited 117 patients with the bronchiolitis who with one to 24 months old who were hospitalized in Ali-Ebne Abitaleb Hospital of Zahedan, Iran, from December 1, 2011 to December 1, 2013. The participants were included according to the clinical diagnostic criteria. We tried to select the patients from the same demographic characteristics and health condition. Based on exclusion criteria, 17 patients were excluded from the study. Demographic, radiologic, and laboratory data were recorded in separate data forms were analyzed by SPSS 21.
    Results
    A total of 117 patients were recruited, 57% were male and 43% female. The most common age at disease onset was one to six months old. Winter was the most common season for bronchiolitis. The most common clinical signs were cough, wheezing, rhinorrhea, fever, and dyspnea, consecutively. In radiologic studies, hyperinflation was the most prevalent finding. Leukocytosis was seen in 67% of patients.
    Conclusions
    We can prevent inappropriate use of antibiotics in bronchiolitis with early diagnosis and supportive measures. Moreover, we obtain symptoms of bronchiolitis in southeastern Iran.
    Keywords: Bronchiolitis, Pneumonia, Wheezing
  • Board and Committees
    Page 8
  • Shivanand Kattimani*, Siddharth Sarkar, Balaji Bharadwaj, Vengadavaradan Ashvini, Subramanian Mahadevan Page 9
    Background
    Symptoms of autism spectrum disorders (ASD) are commonly observed in children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). These symptoms might underlie social and functional impairment in such children. The existing classification systems do not allow for diagnosing both conditions in children.
    Objectives
    This study aimed to assess the presence of ASD in a hospital-based sample of children diagnosed with ADHD and to find the utility of Modified Checklist for Autism in Toddlers (MCHAT) through using parent recall in predicting development of ASD.Patients and
    Methods
    A total of 50 children with a diagnosis of ADHD, who attended the Child Guidance Clinic of a tertiary care hospital in Southern India, were recruited through simple random sampling from July to December 2012. These children were assessed for current ASD using Childhood Autism Rating Scale (CARS) and MCHAT based on parents recall. To test the diagnostic accuracy of MCHAT in early detection of ASD (index test), CARS was used as a reference test. OpenEpi 3.01 software was used for computing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.
    Results
    Among 50 children, 30 (60%) had scores over the cutoff point of 33 on CARS while 38 (76%) had scored over the cutoff point on MCHAT, qualifying for presence of ASD. Moreover, presence of ASD was associated with older age (P = 0.035), greater risk of medical comorbidities (P = 0.022), lower social quotient on Vineland Social Maturity Scale (VSMS) (P = 0.001), and poorer global functioning according to Children’s Global Assessment Scale (CGAS) (P = 0.002). Using CARS as Gold Standard, the sensitivity and specificity of MCHAT in predicting ASD were 86.7% and 40.0%, respectively. The PPV and NPV of MCHAT in detecting ASD were respectively 68.4% and 66.7%.
    Conclusions
    ASD is present in considerable proportion of children diagnosed with ADHD. MCHAT could be a useful instrument for early detection of children at risk of developing ASD.
    Keywords: Child Development Disorders, Pervasive, Early Diagnosis, Autistic Disorder