Journal of Comprehensive Pediatrics
Volume:2 Issue: 2, Dec 2010

The aim of this study is to review the existing literature about early childhood caries and the role of pediatricians in regards to prevention of this condition. Early childhood caries is a multi-factorial disease and several factors are implicated in its establishment. Control of this disease is very difficult and affected children have diminished oral health-related quality of life. Taking all evidence together, we propose that physicians and specially pediatricians have an important task to help parents in preventing early childhood caries by delivering suitable and organized information

Human brucellosis caused by organisms of the genus Brucella, continues to be a major public health problem worldwide. The aim of the study was to evaluate the clinical features and treatment in children with Brucellosis. We retrospectively evaluated the records of 45 children with brucellosis. In this study there were 31 males (68.8%) and 11 females (24.4%). Only 16.3% (8/42) of the patients were less than 5 years, 24% (12/42) were older than 5 years but ≤10 years and 59.7% (22/42) were older than 10 years but ≤15 years. Twenty eight of the children lived in rural areas and the remaining lived in urban areas. Ingestion of unpasteurized milk was reported in 24 (53.3%), contact with animal in 15 (33.3%), while 19 (42.2%) appeared to have no history of exposure to either. The most common symptom in 32 children was high grade fever reaching 39.5 °C, four had chills; intermittent and night fever was observed in 10 children. Sweating was complained in 76.4%; and arthralgia or arthritis involved mainly the knees and hips in 30 (83%) children. Sacroileitis was seen in 2 children (4.8%). Antibiotic treatment lasted for 28 days on average. There were no complications or relapses, except one and the final outcomes were excellent. In the present study we attempted to evaluate the clinical and laboratory findings, treatment modalities and final outcome of brucellosis in children. It seems that better socioeconomic conditions and standards of living results in milder illness with no complications and better response to treatment.

A mortality rate of four million children from Acute Respiratory Infections (ARI) is reported for developing countries. This study aimed to clarify viral etiologies, clinical manifestations, and other contributing factors (e.g. age, sex, seasonal distribution) of ARIs in referrals to Masih Daneshvari hospital, the research center for pediatric respiratory diseases in Iran.. Clinical samples, including nasopharyngeal swabs and nasal washings, were collected from 50 exacerbated asthma cases between October 2007 and September 2008. The specimens were collected from children aged less than 17 years old who were admitted to Masih Daneshvari Hospital, NRITLD, Tehran. Diagnosis was performed by nested or Real time PCR on specimens using DNA and RNA extracted with Invite Spin DNA and Invite Spin RNA Mini Kits, respectively.. The 50 participating patients included 14 girls and 36 boys. The most common age group was 6-11 years, followed by 1-6 years. Cough and wheezing were the most commonly reported symptoms and signs, respectively. Rhinovirus was the most common causative agent. The most common season for infection was autumn, followed by winter, with a total rate of 78% under the category “cold season.”. Considering the small sample size, it would be advisable to perform a multidisciplinary survey over the country to obtain sufficient data to generalize the results and to help the health care system make suitable decisions regarding viral infection prevention and control, especially for respiratory tract infections.

This cross- sectional study was designed for determining the monthly serial serum ferritin levels and adequacy of Desferrioxamine usage in β-thalassemia major patients for roughly estimated outcome of compliance by subcutaneous Desferrioxamine chelation therapy.. In this study, 243 patients suffering from β-thalassemia major who had referred to the Thalassemia center affiliated to Ahvaz Jundishapur of Medical Sciences University, were investigated carefully and assessed for monthly serial serum ferritin levels. They received regular blood transfusions and follow ups were done in one year (Sept 1998 - Sept 1999). Ferritin levels were measured by IRMA technique. Patients with a high serum ferritin level due to false positive causes were excluded from this study. Iron chelating treatment was started when serum ferritin levels was about 1000-1500 µg/lit. This usually occurred after the first 10-20 transfusions (nearly 3 years of age). It was prescribed for regular daily adjusted dosage (subcutaneous, 25-50 mg/kg/24hr) over 8-12 hrs for administration at home. It was infused via a thin needle inserted subcutaneously and connected by an infusion line to a portable battery electrical infusion device. In selected heavily iron-load subjects, it was given via IV route in dose of 50 mg/kg/24hr, by short hospital admissions.. Compliance adherence was observed only in 46 patients (18.2%, first group) with desirable serum ferritin levels less than 2000 µg/lit. Improved compliance adhesion was achieved in 78 patients (31.3%, second group) with unsatisfactory serum ferritin levels between 2000- 4000 µg/lit. Even though in this group the compliance adherence could be improved by close surveillance of Desferrioxamine infusions and intimate scrutiny by psychology intervention and social workers activity. In 119 patients (48.8%, third group) compliance was not achieved with serum ferritin levels more than 4000 µg/lit and more. These high risk patients were kept under evaluation by medical care through IV Desferrioxamine infusion and other medical treatments as needed and collaboration of social worker and psychology intervention.. Compliance adherence was achieved only in 18.2% of patients (first group) and compliance adherence was improved by close surveillance of Desferrioxamine infusions and psychology intervention and social workers activity in 31.3% (second group). Despite every day encouragement, compliance was not achieved in 48.8% (third group). Overall outcome was poor.

Adenovirus is the leading etiological agent among the causes of acute diarrhea in infants and young children and the second cause of diarrhea in children by age of 4 years. However, there isnt an accurate statistic for the frequency of adenovirus diarrhea in our area. So we decided to perform a study on the incidence of adenovirus in acute diarrhea.. In this study, the incidence of adenovirus infection was studied in 200 children less than six years of age who were suffering from acute gastroenteritis between March 2008 and July 2009 in Mashhad, Iran. Adenovirus antigen was detected by Latex Agglutination Test (Rotascreen) method.. Adenovirus was detected in 2% of the stool samples that were collected from children. The frequency of adenovirus infection was significantly higher among patients 12-24 months of age (75%) than children of more than 30 months (25%) old. The highest rate of adenovirus antigen detection was observed among 12-24 months of age group. The peak incidence was in winter and autumn.. Adenovirus is an important and common agent in causing gastroenteritis in children less than 6 years of age. Adenovirus is more dangerous than rotavirus; there is no need to use antibiotics for treating these children. We should recognize the agent in order to cure the patients with conservative actions.

Urinary tract infection is a common clinical problem in children under 8 weeks of ages. Studies in this area indicate that the first sign of bacterial infection in neonates may be icterus. Our goal in this study is to determine the relationship between urinary tract infection and icterus in neonates admitted because of this condition. This is a prospective study conducted on neonates less than 4 weeks of age who were hospitalized because of neonatal icterus in Milad Hospital. Urinary Tract Infection (UTI) is defined as any number of pathogens found to grow on culture medium obtained by suprapubic puncture. Other information including birth weight and laboratory results are recorded on designed question sheets. Sixteen cases out of 90 cases had urinary tract infection (18%).The prevalence of UTI in neonates with more than 7 days of age (27.2%) was significantly more than its prevalence in neonates within their first week of age (14.2%). Urinalysis (U/A) in 5 cases of urinary tract infection (38%) was abnormal. Meanwhile 73% with urinary tract infection (12 cases) at the time of admission did not show any sign except icterus. About 18% of the icteric neonates have urinary tract infections. Therefore it is recommended to investigate UTI (as a part of study) in icteric babies, even in the absence of any other marker.

Respiratory tract infection is one of the important causes of deaths in children especially in developing countries. The most common viral respiratory tract infections are Respiratory Syncitial Virus (RSV), Adenovirus and Influenza viruses. Our objective was to identify the frequency of Adenovirus, RSV, and Influenza viruses in patients with acute respiratory tract infection in a teaching hospital.. A prospective cross sectional study was carried out during 12 months on 160 children of up to 14 years of age. The nasopharyngeal secretions were analyzed with chromatography method.. A total of 160 patients with upper respiratory tract infection with a mean age of 61.5 months were evaluated; 57.5% were boys and 42.5% were girls. Influenza A virus, RSV, and Adenovirus were detected in 7 cases (4.4%), 9 cases (5.7%), and 10 cases (6.3%), respectively. Sore throat in RSV infection, cough, petechiae on palate and vomiting in Influenza infection and cervical adenopathy in Adenovirus infection were more prevalent.. Adenovirus was the most prevalent virus. We need a more sensitive test to detect viruses properly as a cause of upper respiratory tract infection in children..