Abhimanyu Sharma; Meera Sikka; Sunil Gomber; Satendra Sharma
Abstract
Background & Objectives: In sepsis, enhanced fibrin formation, impaired fibrin degradation, and intravascular fibrin deposition lead to a prothrombotic state. The current study aimed at measuring various coagulation parameters to predict an early marker for disseminated intravascular coagulation ...
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Background & Objectives: In sepsis, enhanced fibrin formation, impaired fibrin degradation, and intravascular fibrin deposition lead to a prothrombotic state. The current study aimed at measuring various coagulation parameters to predict an early marker for disseminated intravascular coagulation (DIC). Methods: The current prospective study was conducted from January 2012 to April 2013 on 50 children aged 1-10 years with clinically suspected sepsis referred to the Department of Pediatrics of a tertiary care center in New Delhi, India. Patients were evaluated in accordance with criteria for acute infection (i e, symptoms less than seven days) confirmed in all patients in the laboratory. Patients receiving antibiotics 24-48 hours preceding the admission were excluded from study. Prothrombin time, activated partial thromboplastin time, plasma fibrinogen, and D-dimer were measured at the time of admission in 50 patients and 50 controls. Results: D-dimer was positive in 36 (72%) patients and negative in all controls. The difference was statistically significant (P <0.01). Plasma fibrinogen was significantly (P <0.01) higher in patients compared with the controls. It was decreased in 6% and increased in 8% of the patients, and normal in all controls. PT and APTT were significantly (P <0.01) higher in patients compared with the controls. Conclusion: Though none of the current study patients developed overt disseminated intravascular coagulation, the high positivity for D-dimer suggested that it should be measured in children with sepsis for early identification of DIC. This can aid better management as additional coagulation based therapy such as recombinant anti-thrombin and thrombomodulin may help to improve prognosis.
Biology & Genetic
Alireza Abdollahi; Hana Saffar
Volume 11, Issue 2 , April 2016, , Pages 89-96
Abstract
It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started ...
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It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions. Timing of virological testing is also important. Infants infected at or around delivery may take short time to have detectable virus. Therefore, sensitivity of virological tests is lower at birth. In utero HIV infection, HIV DNA or RNA can be detected within 48 h of birth and in infants with peripartum acquisition it needs one to two weeks. Finally it is emphasized that all laboratories performing HIV tests should follow available services provided by WHO or CDC for quality assurance programs. Both clinicians and staffs providing laboratory services need regular communications, well-defined SOPs and nationally validated algorithms for optimal use of laboratory tests. Every country should use assays that have been validated by national reference laboratory.
Abolfazl Khoshdel; Ebrahim Saedi Dezaki; Froozan Ganji; Roya Habibian; Reza Imani; Elham Taheri; Azar Nikkhah
Volume 9, Issue 1 , January 2014, , Pages 23-27
Abstract
Background and Objectives: An increasing number of tularemia was reported in all over the world. This infection is characterized by different clinical syndromes that can be considered in differential diagnosis of infectious disease. Despite effective antibiotics against Francisella tularensis, ...
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Background and Objectives: An increasing number of tularemia was reported in all over the world. This infection is characterized by different clinical syndromes that can be considered in differential diagnosis of infectious disease. Despite effective antibiotics against Francisella tularensis, this infection is still as one of the agent of mortality and disability among infectious disease.The aim of this study was investigation of seroepidemiological of F. tuleransis among children between 2-18 years old in a risky zone in Iran.
Methods: This cross-sectional, laboratory-based study in two distinct villages Saragha seyed and Khoye in Chaharmahal va bakhtiari Province involved 183 children, adolescents who had no sign and symptom of disease and were screened for tularemia immunoglobulins G (IgG), using the ELISA-based quantitative assay.
Results: In general, from 183 children 11 persons (6%) were seropositive, compared with 172 persons (94%) were seronegative.
Conclusion: According to the high prevalence of antibodies against F. tularensis in this study, this infection must be considered as differential diagnosis of infectious disease in suspect patients.
Indranil Chakrabarti; Nilanjana Ghosh
Volume 6, Issue 3 , June 2011, , Pages 153-157
Abstract
Giant cell glioblastoma is an extremely rare variant of Glioblastoma (WHO grade IV) which is characterized by a predominance of bizarre, multinucleated giant cells. These tumors comprise of 0.8% of brain tumors and up to 5% of glioblastomas. In pediatric age group, these tumors are still uncommon with ...
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Giant cell glioblastoma is an extremely rare variant of Glioblastoma (WHO grade IV) which is characterized by a predominance of bizarre, multinucleated giant cells. These tumors comprise of 0.8% of brain tumors and up to 5% of glioblastomas. In pediatric age group, these tumors are still uncommon with only around 53 published cases since 1952. Here, we report a case of a 12-year old female patient who presented in outpatient clinic with a short period history of headache and seizures. A CT scan showed a large right sided frontal space occupying lesion with areas of calcification. The patient was operated and subsequent histopathology revealed a high-grade astrocytic tumor with increased cellularity, atypical mitosis, bizarre multinucleated giant cells along with large areas of ischemic necrosis and calcification. A diagnosis of Giant cell glioblastoma (WHO Grade IV) was made. The patient was symptomatically well at 3-month follow-up.
Alireza Nateghian; Gholamreza Irajian; Fatemeh Faraji
Volume 6, Issue 2 , April 2011, , Pages 79-85
Abstract
Background and Objectives: The aim of the study was to determine the role and characteristics of nosocomial and community acquired Staphylococcus sepsis in admitted children in tertiary centers in Iran. Patients and Methods: A cross sectional descriptive-analytic study was performed since March ...
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Background and Objectives: The aim of the study was to determine the role and characteristics of nosocomial and community acquired Staphylococcus sepsis in admitted children in tertiary centers in Iran. Patients and Methods: A cross sectional descriptive-analytic study was performed since March 2008 to March 2009 in which all blood cultures from various admitted patients were checked for Staphylococcu aurues in Aliasghar Children Hospital, Tehran, Iran. Upon diagnosis by appropriate microbiologic tests, antimicrobial testing was done according to CLSI methods. Results: Overall, 2647 blood culture samples from 5197 admitted children were sent from which, 25 cases of S. aurues septicemia were isolated; the rate was 4.8 in 1000 admissions;1.3 in 1000 admissions were nosocomial and 3.5 in 1000 admissions were community acquired sepsis. Ten cases were neonates and remainder was older. Eighteen cases were CA and 28% were NI septicemia with mean age of 38.8 months and 8.2 months, respectively. Mean duration of admission in NI group was 20.5 days, however it was 12.6 days in CA group; they also had higher mortality rate. Conclusion: The rate of Staphylococcus sepsis in this study was higher than developed countries for both CA and NI cases, both groups had high rate of resistance. Although most cases were CA in which significant proportion had underlying malignancy, NI group had a longer duration of admission and mortality.
Ahmad Talebian; Zarichehr Vakili; Safar Ali Talar; Seyede Mahbobeh Kazemi; Gholam Abbas Mousavi
Volume 4, Issue 4 , September 2009, , Pages 157-160
Abstract
Background and Objectives: Febrile convulsion is one of the most common types of seizure in childhood. Its pathogenesis is unknown, so studying its cause is valuable. The purpose of this study was to determine the serum level of zinc and magnesium in children withfebrileconvulsion (F.C) ...
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Background and Objectives: Febrile convulsion is one of the most common types of seizure in childhood. Its pathogenesis is unknown, so studying its cause is valuable. The purpose of this study was to determine the serum level of zinc and magnesium in children withfebrileconvulsion (F.C) (3 months to 6 years age). Patients and Methods: In this analytical case-control study, serum level of zinc and magnesium in 60 children with F.C in Shahid Beheshty Hospital of Kashan, center of Iran, was determined. The control group was composed of febrile children with no seizure. All children in both groups were 3 months to 6 yr of age and had not any background of disorders. Serum level of zinc & magnesium was determined by biochemical methods in all groups. Finally, the data were analyzed by SPSS and t test. Results: The mean serum level of zinc and magnesium in case group, was lower than that of zinc & magnesium in control group (P<0.05). There was no relationship between sex, type and time of seizure with serum level of zinc or magnesium in children in case group. Conclusion: There was a relationship between serum level of zinc & magnesium and the presence of F.C in children. So, it is suggested to use supplements of zinc and magnesium in diet of affected children for prophylaxis of febrile seizure recurrences.
Alireza Nateghian; Joan L. Robinson; Simin Rezaii; Mahnaz Kefayati; Naser Rakhshani; Safa Sianati
Volume 2, Issue 1 , January 2007, , Pages 23-28
Abstract
Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged ...
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Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged from 5 pediatric teaching hospitals in Tehran from 1991 to 2004 with a diagnosis of typhoid fever. The Widal test was performed on 58 children with confirmed and 40 children with probable typhoid fever and as control groups, 40 febrile children admitted with infections other than typhoid fever, and 40 afebrile children admitted for elective surgery. Results: For the confirmed cases of typhoid fever, 33 (57%) were male and the mean age was 7.5 ± 3.5 years. Fever was present in 56 cases (97%) and the mean duration of fever before admission was 14 ± 8 days. Other symptoms included tachycardia (60%), anorexia (60%), vomiting (60%), diarrhea (57%), abdominal pain (48%), and headache (34%). Hepatomegaly was present in 55% of cases, splenomegaly in 44%, and Rose spots in 14% of them. Positive cultures were from blood (45/58), stool (18/58), and bone marrow (12/17) with 4 cases having only positive bone marrow cultures. Positive titers of at least 1:40 for anti “O” and/or anti “H” agglutinins were found in 78% of confirmed cases, 65% of possible cases, 12.5% of febrile controls, and no afebrile controls. Conclusion: The Widal test remains a useful test for diagnosis of typhoid fever in developing countries where blood cultures may not be available or may be negative because of prior antibiotic therapy. A titer of at least 1:40 for anti “O” and/or anti “H” agglutinin should be considered a positive titer in Iranian children.
Mitra Mehrazma1; Soraya Salehi; Shokrollah Yousefi; Selaheddin Delshad; Ahmad Jalilvand; Alireza Hasanpour
Volume 1, Issue 4 , September 2006, , Pages 155-160
Abstract
Background and Objective: Mediastinal masses in children are a heterogenous group of asymptomatic potentially life-threatening congenital, infectious, or neoplastic lesions that present complex diagnostic and therapeutic dilemmas. Materials and Methods: The clinical and laboratory features of 65 patients ...
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Background and Objective: Mediastinal masses in children are a heterogenous group of asymptomatic potentially life-threatening congenital, infectious, or neoplastic lesions that present complex diagnostic and therapeutic dilemmas. Materials and Methods: The clinical and laboratory features of 65 patients who had open biopsies in Ali-Asghar hospital over 11 years were reviewed. Results: Seventy-two percent of cases were male and 28% were female. The age varied between 2.5 months and 19 years. Eighty-four percent of lesions were malignant and 16% were benign. Neurogenic tumors were the most common (36.9%). In order of frequency the following lesions were the most common neuroblastoma (mostly in posterior mediastinum), Hodgkin’s and non-Hodgkin’s lymphoma (mostly in middle mediastinum), and malignant small round cell tumor (mostly in chest wall). Most patients were presented by fever (21.5%), dyspnea (20%) and cough (12%), especially in Hodgkin’s and non-Hodgkin’s lymphoma. Lymphadenopathy (29.2%) and hepatosplenomegaly (13.8%) were the most frequent clinical signs. Laboratory examination revealed anemia (29%), leukocytosis (35%), and high sedimentation rate (21.5%). Conclusion: The clinical presentation and laboratory findings of mediastinal and chest wall masses are often non-specific and are variable, but according to their clinical data (i.e. age) and location, only few important diagnoses should be considered.
