فهرست مطالب niloufar amini

There are limited data on severe cutaneous adverse reactions (SCARs) associated with antiepileptic medications. The current study aims to investigate the clinical and epidemiological characteristics of antiepileptic medication-induced SCARs in hospitalized children.

The current five-year retrospective study was conducted at Isfahan University of Medical Sciences, Iran. This study included all children with a definite diagnosis of SCARs secondary to the use of antiepileptic medications based on the world health organization (WHO) definition. In our study SCARs were categorized into three fields: Hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).

Among 259 children with SCARs induced by antiepileptic medications, 199 (76.83%), 42 (16.22%), and 18 (6.95%) had hypersensitivity syndrome, DRESS, and SJS/TEN, respectively. Phenobarbital was the most common offending drug in all types of SCARs. The multinomial logistic regression model revealed that lymphadenopathy increased the occurrence of DRESS by 35 times compared to hypersensitivity syndrome (P < 0.001). Girls were at risk of SJS/TEN approximately 6 times more than boys (P = 0.027). Age (P = 0.021), weight (P = 0.036), and mucosal involvement (P < 0.001) affected the hospitalization duration in children with SCARs related to antiepileptic medication.

There are some similarities and differences in the clinical and epidemiological features of Iranian children suffering from antiepileptic medication-induced SCARs.

  The prevalence of congenital anomaly of kidney and urinary tract (CAKUT) and related chronic kidney disease (CKD) may be increased in countries with higher rate of consanguineous marriage. Therefore, we evaluated the prevalence of CKD by biochemical and kidney ultrasound measurements in the firstgrade pupils.

This cross -sectional study was carried on children aged 6 to 7 years. Urine analysis, serum creatinine, urine microalbumin to creatinine ratio and kidney ultrasound have been evaluated for participants.

653 children were recruited to the study. Stage 1 and stage 2 systolic hypertension have been found in 6.5 and 1%, respectively. The percentage of stage 1 and stage 2 diastolic hypertension were 1.3 and 0.3%, respectively. Both weight Z-score and waist Z-score had positive correlation with systolic and diastolic blood pressure. Microalbuminuria (in 2.5%) did not have any correlation with the following factors: hypertension, body mass index, microscopic hematuria, glomerular filtration rate, kidney sonographic abnormalities or kidney parenchymal thickness and family history of kidney transplantation. GFR less than 90 mL/ min /1.73 m2 has been detected in 1.8% of the students. Only 1.7% had urine RBC more than 5 in each high-power field (hpf). Approximately 1.5% had anatomical abnormality of kidney and urinary tract (hydronephrosis or hydroureter).

  Considering the higher prevalence of elevated blood pressure and microalbuminuria in Iranian children, a CKD screening program based on evaluating microalbuminuria and blood pressure measurement is needed. However, irrespective of high prevalence of consanguineous marriage in Iran, using kidney ultrasound as a screening tool has not been recommended.

The prevalence of eosinophilic esophagitis (EoE) has increased in recent decades. Recent studies have found that the prevalence of EoE in patients with celiac disease (CD) is much higher compared with the general population. In this study, the prevalence of EoE in children with CD was calculated and their clinical symptoms, endoscopic and histopathological findings were compared.
This was a retrospective study conducted on the data records of the patients diagnosed with celiac disease during 2012-2020, and registered at Imam Hossein Children’s Hospital and the Institute of the Celiac Association in Isfahan, Iran. Clinical findings, endoscopic reports, serological and histopathological data of the patients were recorded and analyzed.
A total of 80 children with CD were included in the study. The mean age of the patients with CD and EoE (n=8) was 7.75± 3.99 years, and in children with CD alone (n=72), the mean age was 7.85± 3.83. The most common clinical findings were abdominal pain, anorexia, diarrhea and constipation. There were no significant differences in the symptoms of either group. The most common endoscopic view was duodenal scalloping and esophagitis; and 50% of EoE patients had a normal endoscopic view of the esophagus. With regards to serological findings, the level of TTG-IgA (U/ml) in the CD and EoE group was higher than the CD group (183.73 ± 101.54 vs. 117.07 ± 95.34 U/ml); however, no statistically significant difference was observed.
Our study found that the prevalence of EoE in children with CD appears to be higher than in previous studies.  We have also shown that the presence of EoE cannot be detected solely based on clinical and even endoscopic results.  Therefore, an esophageal biopsy is recommended in celiac patients.

Urticaria is an inflammatory skin disorder lasting for six weeks or longer. Nowadays, the role of vitamin D in inflammatory disease such as urticaria is a matter of great interest. The aim of this study was to investigate the relationship between vitamin D and chronic urticaria.

In this cross-sectional study, 40 patients with chronic urticaria and 40 healthy individuals aged 18 to 60 years were studied during the years 2017-2018 in Alzahra hospital, Isfahan, Iran. In all cases, vitamin D levels were measured using high-performance liquid chromatography (HPLC) method. Levels of 25-hydroxyvitamin D less than 20 ng/ml were considered as deficiency and levels of 20-30 ng/ml were considered as insufficiency. Data were analyzed with appropriate statistical tests.

The mean serum vitamin D level was 21.6 ng/ml in the patients group and 30.8 ng/ml in the control group. In the patient group 42.5%, and in the control group 22.5%, had vitamin D level of less than 20 ng/ml, and in the patient group 42.5%, and in the control group 25%, had vitamin D level of between 20-30 ng/ml. Therefore, the prevalence of vitamin D deficiency and insufficiency in patients and in the control group was 85% and 47.5%, respectively.

This study shows that vitamin D deficiency is more common in people with chronic urticaria than in normal population. However, finding a cause-and-effect relationship between chronic urticaria and vitamin D requires more extensive studies.