سیدعلی نقی کاظمی

Chronic abdominal pain or recurrent abdominal pain is defined as abdominal pain that occurs in at least three episodes, lasting for a minimum of three consecutive months, and is severe enough to adversely affect the child's normal functioning. Abdominal pain can be a challenging complaint for many specialists because, at the same time, it can indicate a completely benign finding, it can also indicate the presence of an acute and malignant pathology. At this stage, the most important action of the treating physician is to diagnose the disease as organic or functional. The present study was conducted to evaluate the diagnostic performance of upper gastrointestinal endoscopy in diagnosing organic causes of chronic abdominal pain in children and investigating the correlation between clinical symptoms and pathological findings of endoscopy in children aged 3 to 12 years with chronic abdominal pain. 

The present study was conducted as a cross-sectional study on 100 children with chronic abdominal pain without pathological cause who visited the pediatric clinic of Ayatollah Mousavi Hospital in Zanjan, from April to December 2021. At first, after taking the initial history and examining the clinical symptoms of the patient, diagnostic and paraclinical tests were performed to determine the cause of chronic abdominal pain. If the cause of the pain was diagnosed using clinical and paraclinical examinations, the patient was excluded from the study and treated accordingly. Then, the children who could not find a specific cause for their pain were referred to a pediatric gastroenterology specialist for endoscopy. After a complete examination and observation of the upper gastrointestinal tract, a pathology sample was also prepared for all patients, and endoscopic, pathological, demographic, and clinical findings were recorded for all patients. Finally, the data was statistically analyzed by SPSS version 26 software using Chi-2 statistical tests, Fisher's exact test, t-test, and Mann-Whitney.

The mean ± standard deviation of the children's age was 8±2.66 years. 63% of the children were girls and 37% were boys. The most common complaints in children after abdominal pain were vomiting (19%) nausea (14%) and non-response to outpatient treatment (8%). The most common accompanying symptoms besides abdominal pain included nausea, vomiting, tooth decay, and constipation. Endoscopic findings were normal in only two patients with abdominal pain, and in 98% there was at least one organic lesion. The most common findings in pathology examination were GERD I at 48%, Small sliding hiatal hernia at 37%, and GERD II at 24% respectively.

Our findings indicated that most cases of chronic abdominal pain in children had an organic origin, and it was better to conduct further investigations to identify the cause of the pain. The most common pathological findings in these children were GERD I, II, and sliding hiatal hernia. Clinical manifestations of the disease, diverse clinical symptoms, paraclinical findings, initial tests, and mucosal biopsy results can help diagnose the cause of chronic pain. By finding the cause of the pain, effective actions can be taken to control the pain of these children

  Despite frequent vaccination, Pertussis is still relatively common in the world. The prevalence of this disease has been reported differently in different parts of the world. The aim of this study was to investigate clinical and pediatric findings and compare them with the results of nasopharyngeal culture in suspected Pertussis patients in Zanjan province. In this cross-sectional study, records of all patients referred to Zanjan health center during 2011-2015 with suspected Pertussis were evaluated. Data were collected from questionnaires and analyzed by SPSS v16 software using frequency distribution, chi-square and chi-square test.
Findings: Of the 243 patients examined, 17 (7%) patients were positive for nasopharyngeal culture. Eight of them were male and 9 were females. The highest number of cases was in winter (9 cases). We found cough in all cases and post coughing vomiting in 15 cases . Of the 17 positive cultured patients, 11 patients were below 6 months (before completing three doses of vaccine).
Discussion & In this study, the positive nasopharyngeal culture was similar to most of the national’s studies but was less than that of other countries.

There are many accredited free open access journals in medical subjects. We do not know how much researchers in this country are aware of them. The aim of this study is to learn about the knowledge of faculty members of Zanjan University of Medical Science about such journals. This is a descriptive cross- sectional study. The questionnaires were made after a pilot study to check the validity of the questions. Of 189 faculty members 95 filled out the questionnaires. Data were analyzed using the Chi-Square testes. The frequencies and the means were also calculated. 34. 7% of the participants were familiar with free open access journals، but most of them were unaware of the following points: validity of articles، suitability of reviewers، copyright declaration، and financial resources. However، most faculty members believed that free electronic information sources provide the opportunity for high citation. There are high impact factor journals which are widely available and publish articles earlier than others. Most of the participants believed that two important benefits of e-journals are easy accessibility and being free of charge. Most participants of our study were not fully familiar with free open access journals. It is recommended that faculty members be made more aware of such journals.

Benzodiazepines are used for prophylaxis of febrile seizures. This study compares the effectiveness of intermittent Nitrazepam versus Diazepam therapy in preventing the recurrence of febrile seizures. This prospective randomized controlled trial was performed on neurologically normal children aged from 6 months to 3 years with a history of febrile seizures without history of prescribed antiepileptic drugs and family history of epilepsy. The patients were randomly prescribed oral nitrazepam (36 cases) or diazepam (37 cases) at the beginning of febrile disease. They were advised to use the medication within the first 48 hours of the onset of fever. All patients were followed for 9 months since the last seizure. Recurrence of seizures occurred in 4 (10. 8 %) patients of diazepam group، but it was not observed in any patients of the nitrazepam group. Age، sex، weight، height، grade of fever at the beginning of febrile seizure، seizure duration and hemoglobin level did not reveal a significant difference between the two groups of patients، and likewise، these variables did not show any statistically significant difference among patients with or without recurrence. Intermittent nitrazepam therapy for febrile seizure seems clinically advantageous in comparison to diazepam. To obtain more precise clinical and statistical results، further research is recommended.

Inadequate vitamin D (insufficiency and deficiency) has been reported as one of the most important factors that might contribute to the increased occurrence of pediatric LRTI. This study was carried out to find the rate of vitamin D deficiency in children with acute lower respiratory infections.

This case- control study was implemented on 2 to 60- month- old children diagnosed with LRI (Lower Respiratory Infection) or without LRI admitted to the pediatric ward of Mousavi Hospital in Zanjan. Both groups were similar in age and gender. Serum 25 (OH) D levels were determined by direct enzyme-linked immunosorbent assay. Data were analyzed with version 16 of SPSS.

The mean vitamin D level for the entire LRI group was79/87 mmol/l and 67/35mmol/l for the control group. There was not any significant difference between the two groups. 12 patients had vitamin D deficiency. 36 had insufficient and 34 had sufficient vitamin D levels. Regarding these findings، there was not any significant difference between the case and control groups too.

In this study no relationship was observed between vitamin D level and LRI in case and control groups despite high levels of inadequate vitamin D (insufficiency and deficiency) in both groups.

Resistin is a novel adipokine which may play a role in insulin resistance. In this study we aimed to determine the cord blood resistin, leptin, insulin and maternal serum resistin levels during pregnancy; and to investigate correlation between these metabolic hormones; and also to evaluate their association with newborn growth indices.

This study was conducted on 80 newborns and their mothers in Mousavi Hospital Zanjan, Iran in 2009. Newborn growth indices including birth weight, height, body mass index (BMI), Ponderal index, Homeostatic Model assessment (HOMA-IR) and their mothers’ BMI were determined. Resistin, leptin and insulin levels were measured by ELISA.

In this study, cord blood resistin levels were higher than serum resistin levels of pregnant mothers (10.77±1.53 vs. 7.91± 5.71 ng/ml). Moreover, serum resistin levels of mothers’ did not exhibit any correlation with cord blood resistin, leptin and insulin levels, as well as neonatal anthropometric indices. Meanwhile, there was no significant correlation between cord resistin levels, insulin resistance, fat percentage and newborn growth factors. Cord resistin levels were positively correlated with cord blood leptin levels (r=0.222; p=0.048). Also, there was a significant positive correlation between cord blood leptin and neonatal BMI (r=0.223; p=0.047), Ponderal index (r=0.212; p=0.058), HOMA-IR (r=0.426; p=0.052) and fat percentage (r=0.247; p=0.014).

On the basis of the findings, increased cord blood resistin levels may indirectly influence fetal growth through leptin or other cytokine levels. Though, further researches are needed to confirm this matter.

Chronic use of antiepileptic drugs may influence the bones and their mineral metabolism due to deficiency of vitamin D3. In this study we investigated the effect of high dose vitamin D3 on bones and their mineral metabolism. Fifty six children older that 3 years old who were affected by epilepsy and had taken the antiepileptic drugs at least for 6 months were included in the study. Levels of alkaline phosphatase (ALP), calcium, phosphorus and vitamin D3 was measured. The patients were divided into three groups one group was provided with 1peril of 50000 units of vitamin D and the other two groups took 2 and 3 perils of vitamin D. Two months after prescription, serum level of the above parameters were measured and compared with the results before vitamin D prescription. After prescription of vitamin D3, decrease of ALP (p<0/001), increase of calcium (p=0/01) and increase level of vitamin D3 in serum (p<0/001) was observed. The highest increase in the serum level of vitamin D3 was observed in the group which had received 3 perils of vitamin D (p<0/0001). Decrease in the serum level of vitamin D3 following long term use of antiepileptic drugs and its increase as a result of vitamin D supplementation suggests that this method of therapy can prevent the skeletal abnormalities due to side effects of these drugs.