Diagnostic Value of Ultrasound Findings in Mesenteric Lymphadenitis in Children with Acute Abdominal Pain

Backgrounds/Objective: The aim of this study was to compare abdominal sonographic features of patients with mesenteric lymphadenitis versus sonographic features of the asymptomatic children, in order to identify diagnost ic criteria for mesenteric lymphadenitis. Patients and Methods: Ultrasound data from 113 children with acute abdominal pain whose suspected sonographic diagnosis was mesenteric adenitis or ileitis was inspected in a child hospital in March 2004 to March 2005. The fina l diagnoses were established after patient management and follow-up. As for the control group, a hundred asymptomatic children were referred from health centers or kindergartens.

Results: No para-aortic lymphadenopathy was found in any of the subjects from the study and the control groups. The number of enlarge d mesenteric lymph nodes observed in symptomatic children was significantly greater than the figure in asymptomatic children (P 0.0001). The highest rate of sensitivity was seen with the presence of RLQ lymphadenopathy (94.7%) and the highest rate of specifici ty was seen with the presence of lymphadenopathy in two or three areas of LUQ or mi d-abdomen together; lymphadenopathies larger than 6mm in RLQ; presence of more than 4 lymph nodes (with any size) in a sonographic image from RLQ; or thickening of terminal il eum more than 8mm (92%-100%) in the diagnosis
of mesenteric lymphadenitis. Conclusion: In children with acute abdominal pain due to causes such as appendicitis which cannot be confirmed by ultrasound and the f indings consist of only enlarged mesenteric lymph nodes (≥4mm) and/or mural thickening of the terminal ileum ( ≥8mm), the probable diagnosis would be mesenteric adenitis-ileitis and surgery is not required; but close observation is recommended.

 

 

بررسي هيپوگناديسم در بيماران مبتلا به تالاسمي ماژور

شماره نود و يك ، سال چهل و نهم
بهار 1385

دكتر رضا رجبيان¹، دكتر رباب ابوترابي²، دكتر شكوفه بنكداران³، دكتر زهرا بديعي⁴،

دكتر محمد خواجه دلوئي⁵

تاريخ دريافت: 11/3/84 - تاريخ پذيرش: 24/1/84

خلاصه

مقدمه: گرچه درمان هاي جديد باعث طولاني شدن عمر و بهبود كيفيت زندگي بيماران مبتلا به تالاسمي شده است ولي هنوز مشكلات زيادي از جمله عوارض اندوكرين و به خصوص هيپوگناديسم در اين بيماران شايع است که به علت رسوب آهن در سلولهای گنادتروپ هيپوفيز ذکر گرديده است. هدف از اين مطالعه بررسي شيوع و شناسايي عوامل د خيل در ايجاد هيپوگناديسم در بيماران مبتلا به تالاسمي ماژور مي باشد.

روش کار: در اين مطالعه توصيفی 47 بيمار تالاسمي ماژور با سن بالاتر از 14 سال که در سال 1383 به بيمارستان دکتر شيخ مراجعه کرده بودند مورد مطالعه قرار گرفتند، جهت بررسی هيپوگناديسم. ميزانFSH, LH و استراديول در زنان و در مردان ميزان تستوسترون اندازه گيري و رابطه آنها با متغيرهائي شامل شروع و طول مدت دريافت ترانسفوزيون خون و طول مدت و دوز دسفرال دريافتي، سطح فريتين و يافته هاي باليني مربوط بررسی گرديد. مشخصات فردی، نتايج آزمايشگاهی در پرسشنامه ای ثبت گرديد. اطلاعات جمع آوری شده با استفاده از آمار توصيفی و آزمونهای تی و من ويتنی پردازش شد.

نتايج: ميانگين وزن اين بيماران 4/8±5/42 كيلوگرم و ميانگين قدي اين بيماران 2/10 ±151 سانتيمتر بود. فراواني كوتاهي قد و كم وزني1/68% و فراواني هيپوگناديسم در اين بيماران 8/63% بود. شيوع هيپوگناديسم هيپوگنادوتروفيك در جنس مذكر بيشتر بود (025/0=p) اما رابطه معني داري بين هيپوگناديسم با طول مدت ترانسفوزيون خون، زمان شروع و دوزدسفرال دريافتي و سطح فرتين وجود نداشت.

نتيجه گيري : عوارض اندوكرين بيماري تالاسمي متفاوت مي باشد و با توجه به يافته هاي فوق به نظر مي رسد عوامل ديگري غير از افزايش تجمع آهن در ايجاد عارضه هيپوگناديسم د خالت داشته باشد.

واژه های كليدي : تالاسمي ماژور، هيپوگناديسم، عوارض آندوکرين

 

Spring 2004; 47(83):79-89

QUANTITATIVE ASSESSMENT OF CARDIAC FUNCTION IN CHILDREN WITH BETA- THALASSEMIA MAJOR, USING THE DOPPLER MYOCARDIAL PERFORMANCE INDEX

MOTTAGHI MOGHADDAM H.,ALIZADEH B.,BANIHASHEM A.,AFZALNIA S

Introduction: Cardiac disease and early death due to myocardial injuries because of Iron overload and hemosiderosis are still the major problems in the management of patients with beta-thalassemia major (BTM). Valuable echocardiographic techniques have been limited in early detection of cardiac dysfunction in these patients. A new Doppler index combining systolic and diastolic time intervals (the Tei index) has been reported to be useful for assessment of global ventricular function in many cardiac diseases. The purpose of this study was to assess global ventricular function in children with BTM using Tei index and also to determine its correlation with hematologic parameters.
Material and Methods: This analytic cross sectional study was performed on 59 patient with Beta-Thalassemia Major during Jan.2003 until Feb.2004 in hematologic clinics of Imam Reza and Dr. Sheikh Hospitals. Complete physical examination and Doppler Echocardiographic study was done for all the patients and patients Tei indexes were compared with normal values in other studies statistically.
Results: The mean Tei index of left ventricule (LV) and right ventricule (RV) was 0.35±0.11 (mean±SD) and 0.28±0.12 (mean±SD) respectively. There was a significant difference between both right and left ventricular Tei index in-patients with BTM and healthy children. There was also a significant correlation between mean blood transfused volume per year and Tei index in both right (PV? 0.05) and left ventricule (PV? 0.05). We also find a significant difference between two groups of thalassemic patients according to their mean pre-transfused Hgb per year (Hgb? 9 g/dl and Hgb >9 g/lit) for left ventricular Tei index.
Conclusion: The Tei index is a simple, feasible and reproducible measure of global cardiac function in-patients with BTM with early myocardial dysfunction.

 

 

Summer 2001; 44(72):7-13

COMPARING THE EFFECT OF SECNIDAZOLE AND METRONIDAZOLE FOR THE TREATMENT OF GIARDIASIS IN CHILDREN

MODARRESI A.R.,FATTA A

Giardiasis is one of the most common intestinal parasitic infection among children. It is a world wide and an important disease in Iran.
Abdominal pain, bloat, chronic or intermitant diarrhea and steaturrhea which cause malabsorption are the main clinical signs.
The etilogic agent is Giardia lamblia which is found in the, form of trophozoite (pathogenic form) and cyst (infective form).
In order to evaluate the efficacy of secnidazole (a new drug) and comparing with the effect of metronidazole, a study was undertaken over a 15 months period on 83 patients suffering from giardiasis in Imam Reza Hospital. After completing a questionnaire for each patient, the patients were treated with secnidazole (30 mg/kg single dose) and metronidazole (15 mg/kg tid for 7 days) randomly. Two weeks after the end of the treatment, direct and, formol ether faecal examination was performed on 3 consecutive days for each child.
Examinations showed that secnidazole is effective in 94.4% and metronidazole is effective in 80% of infected children (P<0.05). Since secnidazole had milder side effects and was more effective than metronidazol, and can be used in single dose, it can be concluded as a better drug than metronidazole for treatment of giardiasis in children

Keyword:Giardia lamblia, Secnidazole, Metronidazole, Treatment, Side effects