Iranian Journal of Pediatrics
Volume:11 Issue: 1, 2001

To assess the outcome of high-risk pregnancies as an indicator for the referral in the network system, a retrospective, descriptive study was conducted by reviewing the records of 206 pregnant women who were referred by primary health workers (Behvarzes) of 10 different villages in Kerman to more advanced centers during the years 1990-1995. In addition to reviewing the records, the subjects were interviewed when necessary. The most common reasons for referral were edema, hypertension, history of abortion, and previous neonatal death, inappropriate weight gain of the mother and vaginal bleeding. Among the referrals, preterm delivery rate was 9%. There were 7 cases of stillbirth and 9 cases of neonatal death. Therefore, the neonatal mortality rate and perinatal mortality rate were 43.7 and 77.7% 100 live birth respectively. In 90% of case, behvarz followed the protocols to refer the patients but only 29% of the cases followed the referral path correctly and the remaining 71% went directly to the urban centers. In 1.5% of cases the referral forms were returned to the health houses from rural health centers but none from urban centers. It is concluded that firstly, the high-risk pregnancy was over-diagnosed by behvarz and secondly, the referral does not go the right way in the network system and it needs lot of efforts to be improved

Helicobacter Pylori is one of the known causes of upper gastrointestinal tract diseases in adults, but this causative relationship in children is under investigation. In this cross-sectional prospective research, we studied the clinical and laboratory aspects of H.pylori infection in children who underwent esophagogastroduodenoscopy from November 1996-January 1998 in Qa’em hospital, Mashhad. Of 59 patients (33 females, 23 males) aged 9.2±2.96 years, 24 were found to be culture positive for H.pylori. The common complaint was abdominal pain (83.1%). Endoscopic findings consisted of gastritis (76.3%), duodenitis (67.8%), esophagitis (59.3%), nodular hyperplasia (13.6%), duodenal ulcer (11.9%), gastric ulcer (5.1%) and erosive gastritis (8.5%) which were culture positive in 42, 40, 40, 75, 57, 0 and 60% respectively

specimens of infectious material obtained from 12 cases of chronic granulomatous disease (10 boys and 2 girls) aged 3-6 years were examined for bacteriologic findings. 48% of the cultures were negative for bacteria, in the remaining 52% bacteria were isolated in the following incidence: Salmonella sp 10.5%, Klebsiella sp 10.5%, staph aureus 9.52%, E.coli 7.52%, aspergillus fumigatus 4.52%, strep pneumoniae, a-hemolytic streptococci, mycobacterium tuberculosis and candida albicans each 2.52%, staph epidermidis, actinomyces, pseudomonas aeroginosa and enterococcus sp each 1.52%

isolates from children (0-12 years old) with acute diarrhea were examined for the susceptibility of antibiotics. The results were as follows: 100% of salmonella spp were sensitive ciprofloxacin and ceftizoxime. 93% showed resistance to ampicillin, 62% to tetracycline, 54% to amoxicillin, and 54% to co-trimoxazole. The selective antibiotics for salmonella spp were ciprofloxacin, ceftizoxime, chloramphenicol, and gentamicin. 92% showed resistance to co-trimoxazole, 90% to tetracycline, 42% to ampicillin, and 21% to amoxicillin. For campylobacter spp the selective antibiotics were ceftizoxime with 85% and ciprofloxacin with 65% respectively. 80% showed resistance to chloramphenicol, 87% to tetracycline, 60% to gentamicin and 40% to furazolidone

We studied 320,000 school children aged 6-20 years in province Zanjan during 3 years (1991-1993) to determine the prevalence rate of Rheumatic heart disease (RHD). The examination method was uniform and performed by a uniformly trained and instructed medical staff. All suspected cases of RHD were referred to Zanjan heart center where then underwent a complete cardiovascular examination. A heart disease was suspected only in 0.25% of the examined children. In 37% of them the suspicion was not confirmed, 7% had mitral valve prolapse, 15% (Females 10%, males 19%) had innocent heart murmur and 41% revealed to have a Rheumatic or congenital heart disease. The rate of RHD was 0.36 cases per 1000 children. The most common RHD consisted to MR 35.8%, MR/MS 17.9%, MS 16.4%, MS/AI 7.5% and AS/AI 7.5%. Unexpectedly, the prevalence rate of Rheumatic fever/Rheumatic heart disease in this study was, compared with that of other socio-economically comparable countries, lower (0.36 per 1000). This may be caused by prevalence of young age groups in this study. The rate of MR, the most common sequela of ARF, was the highest finding in this study. The rate of MS, a late sequela of ARF, was 16.4% in this study. So, according to slow progress of RF sequel and with respect to the fact that 20% of ARF attacks are silent, it should be expected that several cases of MVP worsen to MR as the age progresses. Therefore, public should be made aware of the benefits of early-onset treatment of pharyngitis, medical staff treat pharyngitis and/or RF/RHD properly and care for prophylaxis of bacterial endocarditis

In a retrospective study of 28449 deliveries in a period of 5 years (1993-1997) in the nurseries of the 2 major teaching hospitals of the Tehran university of medical sciences we found 67 cases of neural tube defect (NTD), I.e. 2.4 per 1000 deliveries. Spina bifida (56.5% of NTD cases) was the most frequent anomaly. In 95.5% of NTD cases, mothers had no history of giving birth to a child with NTD. Hydrocephaly was the most common anomaly associated with NTD

Surgeons require determining urea and creatinine in patients undergoing surgery routinely as these parameters allow a judgment on the function of the kidneys. It is suggested that a normal urea level of blood is always associated with a normal value of creatinine in the same patient and, therefore, determination of urea alone suffices for this judgment. This spares collection of large volumes of blood sample for manual determination of creatinine, particularly in children and newborns. In this survey we analyzed the results of urea and creatinine estimation in blood samples of 1315 persons. In 95% of persons with a blood urea level of lower than 25 mg/dl and 99.8% havinglower than 20 mg/dl, the serum creatinine level was lower than 1 mg/dl. This confirms the suggestion that a person with a normal blood urea level will have a normal creatinine level too and an estimation of both of them is an unnecessary burden for the patient and the laboratory as well

Cardiovascular diseases represent an important public health problem in adults. It is known that they are based on atherosclerotic process and this is mostly caused by hyperlipidemia, cholesterolemia being the most hazardous one. This starts early in childhood. Therefore, detection and management of hyperlipidemia in children is of great importance for the prevention of cardiovascular disease in later life. In this article we present 2 rare cases of primary hyperlipidemia, 2 boys of 2.5 and 8.5 years of age, of consanguineous parents, showing recurrent abdominal pain and xanthomas as main clinical signs