Caspian Journal of Pediatrics
Volume:5 Issue: 1, Mar 2019

“Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections”, or PANDAS, is a syndrome characterized by acute-onset obsessive-compulsive disorder (OCD) and/or tics accompanied by the neuropsychiatric symptoms. This case is reported because of its rarity.

A 6.5-year-old boy with swollen tonsils, high-grade fever and rash was admitted to Amirkola Children’s Hospital, Northern Iran. Thereafter he got involved with tachycardia, hypotension, suppurative conjunctivitis and swelling of extensor surfaces of extremities. In addition, after the onset of fever, he had some neuropsychiatric problems such as social isolation, irritability, aggression, oppositional behavior, behavioral regress, unusual sound production, repeated vilifications, loss of appetite and handwriting deterioration. He was treated with intravenous immunoglobulin (IVIG). The patient was discharged from the hospital in a good condition.

The medical treatment of underlying disease leads to remarkable patient's neuropsychological and OCD symptoms. PANDAS should be diagnosed in the streptococcal infections associated with abrupt behavioral symptoms and treated with IVIG and antibiotics.

Osteogenesis imperfecta (OI) is a group of genetic disorders characterized by significant variation, which is due to qualitative or quantitative defects in the production of collagen. The prevalence of cardiovascular abnormalities in OI patients is unknown. This study aimed at investigating cardiac involvement in OI children using Echocardiography.

This cross-sectional research was performed on 65 patients diagnosed with OI in a children’s hospital in Tehran, Iran, from 2011 to 2012. The classification of OI was based on the Sillence criteria. A consultation with a skilled pediatric cardiologist was scheduled for the subjects, and echocardiography was carried out, using the Samsung HS70 ultrasonography machine (Medison Co., Seoul; South Korea). Data analysis was done using SPSS-22, chi-square and t-tests. The exact P-values were determined and P-values <0.05 were regarded significant.

Sixty percent of patients were male and 40% were female, with an average age of 6.95±4.36 years (ranged from 2 months to 17 years), respectively. Based on the Sillence classification, 20% of the cases were categorized in subtype I, 47.7% in subtype III, and 32.3% in subtype IV. The prevalence of aortic root dilatation, mitral valve prolapse (MVP), mitral regurgitation (MR) and tricuspid regurgitation (TR) were 13.8%, 15.38%, 7.6% and 15.38%, respectively. The MVP and female gender showed a significant relationship, whereas there was no relationship between MVP and patients’ subgroups.

Due to the significance of cardiac involvement in OI, echocardiography is recommended for all children with OI.

Pediatric poisoning is a common and predictable cause of morbidity worldwide. It is necessary to determine the pattern of this problem in order to take preventive measures. The aim of this study was to determine the epidemiological and clinical pattern of children poisoning.

This cross-sectional, descriptive-analytical study was carried out on 408 children hospitalized due to poisoning in Amirkola Children’s Hospital from 2008 to 2013. The hospital information system was used to recognize children with a definite diagnosis of poisoning. Individual and epidemiological information of the participants was extracted from their medical records and analyzed.

Out of 408 poisoning cases, 97% of cases were unintentional, 55.4% of subjects were male, and the mean age of the children was 36.27±2.8 months. Totally, 56.6% of the children were residing in urban areas (P=0.004), and most cases (56.12%) suffered from medication poisoning. Moreover, 30.4% of them had no abnormal clinical manifestations, and the most common manifestation was loss of consciousness (29%). Besides, 61% of medical measures taken included the prevention of gastrointestinal absorption of the poison. The mean hospital stay duration was 2.7±2.1 days, and the consequence of poisoning was treatment and discharge in 68.3% of the cases and 1 death (0.2%).

The most common cause of pediatric poisoning was medications. In order to prevent poisoning in children, it is necessary to inform parents and other carers about the proper storage and use of medications, and in case of poisoning, urgent referral of the child to the centers.

Different dietary practices are applied worldwide to treat diarrheal diseases. The aim of this study was to assess the mothers’ knowledge and perception about childhood diarrhea and the way they manage it with diet.

This cross-sectional study was conducted on mothers who had at least one child (6 to 60 months) with diarrhea and needed home management. They were selected by multistage cluster sampling from health centers affiliated to Shahid Beheshti University of Medical Sciences. The data were collected using socio-demographic characteristics and the knowledge about the mothers’ behavior related to nutritional factors during diarrhea questionnaires. The total knowledge score was 39. The classification of low, medium, high and excellent the knowledge scores was less than 20, 20-25, 25-31 and above 31, respectively. The data analysis using SPSS-18. P-value <0.05 was considered as significant level.

The mean age of the mothers was 29.1 ± 4.9% years. The highest incidence of diarrhea was seen in children aged 6-24 months (52.2%). Acute diarrhea (duration < 14 days) was predominant (n = 379, 94.75%), while only 21 (5.25%) of the children reported persistent diarrhea (duration ≥14 days). The mean score of the mothers’ knowledge was 23.75±4.41, ranging from 10 to 39. The mothers' knowledge score was significantly correlated with their education levels (p<0.001).

The mothers had little information on nutritional management of diarrhea. Therefore, the healthcare providers have a crucial role in increasing the mothers’ awareness of appropriate and optimal use of a specific diet to control diarrhea.