Sheila Kianifar; Abdolreza Malek; Mohammad Ali kiani; Hamid Reza Goldouzi
Abstract
Erythema nodosum (EN) is a condition in which the skin suffers from oval-shaped and tender erythematous patches, mostly on the anterior region of the leg and sometimes other parts of the body, including the arms and affects subcutaneous adipose tissue. These patches are self-limiting and usually heal ...
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Erythema nodosum (EN) is a condition in which the skin suffers from oval-shaped and tender erythematous patches, mostly on the anterior region of the leg and sometimes other parts of the body, including the arms and affects subcutaneous adipose tissue. These patches are self-limiting and usually heal on their own within one to two weeks. This is a case report of a patient who is a 14-year-old boy complained of oval-shaped tender erythematous lesions on the legs of both legs and referred and was hospitalized 5 days ago. The patient continued to complain of pain in both thighs when standing and sitting. The patient developed a high fever upon admission. There was no history of the disease while we were taking his history. All laboratory tests were performed and rheumatic diseases and possible malignancies were evaluated and rejected. The patient was treated with the anti- naproxen, an inflammatory drug, and then the patient’s pain and fever decreased. However, the patient suffered from multiple ulcerative lesions in the mouth on the final day of hospitalization. Infectious counseling was performed and he was discharged with a diagnosis of EN in the context of oral herpes. Two days after discharge, the patient suffered from hematochezia. Consequently, he was hospitalized and underwent colonoscopy, which showed multiple mucosal lesions in the esophagus and duodenum, and a sample was sent for pathology. The test result showed Crohn’s disease, and the patient was treated immediately.
Elhan Bakhtiari; Farhad Heydarian; Mohammad Ali kiani; Zahra Askari; Mohammad Heidarian
Abstract
Objective: The aim of present study was evaluation and comparison of the white blood cell, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in febrile children with or without convulsion. Methods: Three hundred sixty eight febrile children aged 6-60 months with or without convulsion ...
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Objective: The aim of present study was evaluation and comparison of the white blood cell, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in febrile children with or without convulsion. Methods: Three hundred sixty eight febrile children aged 6-60 months with or without convulsion were studied. Demographic, white blood cell (WBC), ESR and CRP were compared and analyzed. Results: There was 368 children (184 patients with febrile convulsion as case group and 184 febrile patients without convulsion as control group), with the average age of 26.6±14.4 months and 17.71±15.4 months respectively (p=0.001). In case group 59.78% and in control group 43.48% were male (p=0.002). There was no significant difference between groups regarding WBC, ESR and CRP. There was significant relationship between leukocytosis and convulsion in patients with longer than 15 minutes convulsion (p=0.03). There was not any significant relationship between febrile convulsion patients according to type, duration and frequency of convulsion in ESR and CRP. Conclusion: Leukocytosis and elevated ESR and CRP in patients with febrile convulsion can represent underlying etiology of the fever and it may not be due to convulsion itself. But in longer than 15 minutes convulsion, it can lead to leukocytosis itself.
Elaheh Heidari; Maryam Emadzadeh; Ezzat Khodashenas; Farideh Najm Sarvari; Hamid Ahanchian; Amin Heidari; Mahdi Mottaghi
Abstract
Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: ...
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Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: This systematic review was conducted via searching in databases such as PubMed, Scopus, Web of Science, and Cochrane Library until August 2019. Randomized clinical trials regarding the effects of systemic corticosteroids on children with bronchiolitis aged less than two years were evaluated in the retrieved studies. The quality of the studies was assessed based on the Jadad scale. Result: Three studies were included in this systematic review. In two studies, dexamethasone versus placebo were used, and in one study, prednisolone was applied. In one study, use of dexamethasone versus placebo resulted in the faster resolution of respiratory distress, shorter duration of respiratory distress syndrome, reduced oxygen therapy time, and reduced length of hospital stay. In another study, children receiving treatment with dexamethasone had no significant difference in the clinical score, respiratory rate, and pulmonary function compared to the control group. In another study, use of prednisolone within two weeks led to the partial improvement of rhinitis, wheezing, breathing problems, nocturnal respiratory symptoms, and coughing. However, no significant difference was observed between the prednisolone treatment and control groups after 12 months.Conclusion: Despite the improvements in respiratory symptoms, evidence is scarce regarding the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years. Therefore, well-designed randomized clinical trials on large sample sizes are required in this regard.
Maryam Khalesi; Farhad Heydarian; Seyed Javad Sayedi; Shima Badzai; Elahe Heidari
Abstract
Convulsion with mild gastroenteritis is an afebrile seizure associated with viral gastroenteritis in a healthy child without fever, dehydration, electrolyte imbalance, meningitis, or encephalitis. Convulsion with mild gastroenteritis is more common in children aged 1 to 2 years. Usually, Convulsions ...
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Convulsion with mild gastroenteritis is an afebrile seizure associated with viral gastroenteritis in a healthy child without fever, dehydration, electrolyte imbalance, meningitis, or encephalitis. Convulsion with mild gastroenteritis is more common in children aged 1 to 2 years. Usually, Convulsions are brief generalized tonic colonic type. Most convulsions occur within first 24 hours of illness onset. Rotaviral gastroenteritis is known as the most common type of gastroenteritis associated with Convulsion. Laboratory investigations are normal. Also EEG and neuroimaging are usually normal. Long term antiepileptic treatment is not necessary. It is usually a benign condition with good prognosis and no risk for developing epilepsy in future. Considering this etiology of seizure could prevent supernumerary evaluations and long-term antiepileptic treatment.
Mohammad Faraji-rad; Hadi Tohidi; Elnaz Faraji-rad
Abstract
This study aimed to assess the efficacy of magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) in localizing epileptic foci in children with temporal lobe epilepsy (TLE). This prospective study was conducted on 12 patients including five males and seven females aged ...
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This study aimed to assess the efficacy of magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) in localizing epileptic foci in children with temporal lobe epilepsy (TLE). This prospective study was conducted on 12 patients including five males and seven females aged between 2 and 16 years old with a clinical diagnosis of TLE. All the patients underwent high-resolution MRI and if no abnormality was identified, SPECT was used for further assessment. In all the patients, visual inspection identified unilateral mesial temporal sclerosis, and the patients underwent craniotomy and lesionectomy.According to the results, eight patients were categorized in class I and two cases were classifies as class II, and all the patients survived. About 25% of the patients showed adequate memory function on the non-operated temporal lobe, and general intelligence quotient increased by 10% in 50% of the patients.According to the results, in patients with clinically suspected TLE, MRI alone is not able to localize the epileptic foci correctly, and SPECT can be helpful to localize these lesions.