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Background Cardiovascular complications are continuing to be a major cause of morbidity and mortality in diabetes mellitus type I (DMTI). The study aimed to evaluate the rate of changes in ECG parameters in children with DMTI compared with healthy children. Materials and Methods This case-control study was performed on 140 participants which consisted of 70 patients with DMTI (case group) matched in sex and age with 70 healthy ones (control group) in two centers in collaboration with Ali Asghar Hospital, Zahedan, Iran, between March 2017 and April 2018. Electrocardiography was performed in all participants (patients and healthy), and heart rate, QT (start of the Q wave and the end of the T wave) QTc interval (QT/√ RR), QTd (dispersion between maximum and minimum of QT), and QTcd (dispersion between maximum and minimum of QTc) were measured. Duration of diabetic and level of HbA1c were obtained for patients and the effects of these parameters on ECGs were investigated. Results Height, weight and heart rate were higher in the patients (P1 was higher in case (6.16±3.23) compared to the control group (4.33± 2.22) (P1c normality states did not change the length of these parameters in diabetic patients. Conclusion Based on the results, QT, QTd, QTc and QTcd were higher in patients with DMTI. Diabetic time duration and HbA1c states did not change the ECG parameters in diabetic patients.

Background Epilepsy is one of the most common neurological diseases. Over the last decades the hypothesis of cardiovascular effects from sudden seizure has been raised, and cardiac rhythm and ECG changes in these patients have been highlighted. The study aimed to evaluate the electrocardiography findings in children with epilepsy compared with healthy children. Materials and Methods In this case-control study, 90 patients aged between 6 months and 18 years who were matched with equal number of healthy children who referred to pediatric ward the of 'Ali Ebne Abi Talib' hospital in Zahedan, Iran. The study was performed in multicenter of Neurology and Cardiology centers. In the patients, the epilepsy was confirmed by a unique pediatric neurologist based on the definition of having at least two unprovoked seizures in 24 hours. ECG was captured from all participants by a pediatric cardiologist. Results In patients, 45.6% (n= 41) were females and in healthy 51.1% (n= 46) were females. Mean age of participants was similar in patients and healthy children (p=0.060). ECG findings such as QT min (p=0.001), R-R interval (p Conclusion Based on the results, QTc, QTd, QTcd were prolonged in patients with epilepsy and, R in V5 was higher in male patients. To prevent abnormality rhythm in epilepsy, it is needed to evaluate QT to recognize the autonomic changes.

Background: Conventional echocardiography and tissue Doppler imaging have been highlighted to diagnose diastolic and systolic heart dysfunction. We aimed to compare tissue Doppler imaging with conventional echocardiography to diagnose heart dysfunctions in diabetes mellitus type 1 (DMT1) patients. Materials and Methods: This case-control study was conducted in the Ali Asghar Clinic, Zahedan, Iran. The study lasted from 2017 to 2018 on 140 participants aged from 4-18 years, and consisted of 70 patients with DMT1, and 70 children who referred to hospital for checkup as control group. The participants went under tissue Doppler imaging andconventional echocardiography (M mode and 2D) by an invariable cardiologist. The 5 ml blood samples were taken to test blood leptin and ferritin. The data were analyzed using SPSS software (version 18.0). Results: Conventional findings such as left and right deceleration time, left, and right peak E velocity, left ejection time, left Myocardial performance index and TDI findings such as left, and right ET’, right S’, right E’, left MPI’, right MPI’, and left E/E’ were different in patients and the control group (p

Background Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and a chronic inflammatory condition caused by immune pathology in the small intestines in genetically susceptible individuals. This study aimed to determine the efficacy of gluten free diet on cardiac functions using conventional and Doppler tissue echocardiography (DTE) in children with CD compared to controls. Materials and Methods This case-control study was conducted on 107 children with CD and 45 healthy children. The study was performed in the Ali Ebne Abi Talib hospital, affiliated to Zahedan University of Medical Sciences, Zahedan (ZaUMS), Iran. After considering exclusion criteria, participants underwent echocardiography. Data were analyzed through SPSS software version 20.0. Results: Results showed that tTG-IgA was different in participants. Left MPI was different in control-positive (p

Background Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and characterized by a wide range of clinical manifestations. The study aimed to compare Doppler tissue echocardiography findings between children with celiac disease and healthy children. Materials and Methods This case-control study was performed on 186 celiac and healthy children aged 6- 19 years. Celiac diagnosed by clinical findings and laboratory's tests (tTGIgA) confirmed by intestinal biopsy. Controls consisted of voluntary individuals free of any diseases. Echocardiography performed on participants. Data analyzed utilizing SPSS software version 20.0. Results Left Peak A, left S', right ICT', right IRT', right S', EF, FS, left ET', left IRT', right E'/A' left S' were higher in case when Right ET was lower. Patients with left S' < 8 were lower in left A', higher in right ICT', lower level in right S', higher in left E/E'. Patients with Left E/E' ≥9, were higher in Left Peak E velocity, lower in IVSD, higher in right E/E’, lower in left S' and lower in left E’ (P

Background 25-hydroxy vitamin D [25(OH) VitD] deficiency is a highly prevalent condition, present in approximately 30% to 50% of the general population. A growing body of data suggests that low 25(OH) VitD levels may adversely affect cardiovascular health. The present study aimed to measure the serum levels of 25(OH) Vit D in Congenital heart disease (CHD) children compared to healthy children. Materials and Methods A case-control study performed on 270 children who equally distributed in case and controls and selected randomly from those who referred to the Ali Asghar Clinic and Ali Ebne Abi Talib Hospital in Zahedan, Iran, in the year of 2017. In patients, CHD diagnosed based on echocardiographic and clinical tests by pediatric cardiologist, Serum 25(OH) Vit D measured by monoby kit made of Italy. Results The level of 25(OH) Vit D serum means were lower in case (31.68±17.37) compared to controls (42.20±14.31) significantly (P

Background Regarding abnormalities in thalassemia major (TM) patients and the effects of leptin and ferritin on heart, aimed to investigate the possible relationship between leptin, ferritin and cardiac involvement in TM patients compared to controls. Materials and Methods In total 141 individuals entered to the present case-control study that consisted of 66 TM patients matched in age and sex with 75 healthy controls. The case group selected from those patients attending to the clinic of Ali Asghar Hospital, Zahedan-Iran. From participants, 5ml blood takes by a nurse and was isolated from serum samples in order to analyze ferritin and leptin levels. Major proceedings in patients were checking medical history, physical examination, chest X-ray and Electrocardiogram (ECG) that performed before echocardiography by unique cardiologist. The participants subjected to conventional examination for both right and left heart functions. Results Leptin level (p=0.026), height, weight and body mass index (BMI) were lower in patients (p

Background: Children with congenital heart disease (CHD) are prone to malnutrition and growth retardation. This study aimed to compare growth status between children with CHD and healthy children. Materials and Methods: This case–control study included 310 children with CHD and 300 healthy children matched in age and gender. CHD patients grouped according to cardiac diagnosis: group 1 (n=5), cyanotic patients with pulmonary hypertension; group 2 (n=22), cyanotic patients without pulmonary hypertension; group 3 (n=43), Acyanotic patients with pulmonary hypertension; and group 4 (n=240), Acyanotic patients without pulmonary hypertension. Anthropometric measurements of weight (Kg), height (cm), and head circumference (cm) were measured and recorded for both case and control groups. Descriptive and analytical statistics were performed using the by SPSS version 21.0. Results: Weight and head circumference were significantly lower in CHD children compared to healthy children (p

Background N-terminal pro–B-type natriuretic peptide (NT-proBNP) is a marker to evaluate the cardiac involvement in thalassemia. We aimed to evaluate conventional and tissue Doppler echocardiography findings and its relation to plasma NT-pro BNP, Ferritin and Iron levels in beta-thalassemia patients. Materials and Methods This study performed on 164 participants equal of major beta- thalassemia patients (n=82), and controls (82 healthy children with normal cardiovascular status). The patients collected from outpatients after applied exclusion criteria. Blood samples were taken from participants in fasting to measure NT- pro BNP, Ferritin and Iron serum. Participants were under echocardiography by Pediatric cardiologist. The level of error considered as 0.05 for data analysis by SPSS version 20.0. Results NT- pro BNP, Iron, Ferritin, left S', left A', right A', EF, FS, left and right A/A'; right and left MPI were significantly different in patients group (P

Background Urinary tract infection (UTI), are the most frequent and serious infection in childhood around the world. The present study aimed to evaluate antibiotic sensitivity of urinary tract pathogens among children in Zahedan, South East Iran. Materials and Methods This cross-sectional study analyzed 396 patients aged 1-18 years with positive urine and suspected UTI. Gender and age of children, kind of isolated bacteria in urine culture, susceptibility and resistance of these bacteria to current antibiotics were studied. Bacterial growth for more than 105 CFU/ml was considered as positive. Data analyzed by SPSS version 21.0. Results The most common age of urinary tract infection were < 1 year and 1-7 years for boys and girls, respectively, and the variation of sex distribution was significant in different age groups (P = 0.003). The most prevalent cause of UTI was Escherichia coli(E.coli) (77%), in total ages and both gender, afterward was Enterobacter (8.1%) and Klebsiella (7.1%). E.coli sepsis was highly sensitive to nitrofurantoin (74.7%), ciprofloxacin (72.5%), and amikacin (64.6%), both highly resistant to trimethoprim and sulfametoxazole (74.8%), ampicillin (66.9%), and nalidixic acid(51.1%); and its resistance to ceftriaxone was increasing. Conclusion In this study resulted that E. coli was the first responsible pathogen in proven culture of UTI in children, which was increased in resistance to popular antibiotics like Ampicillin, Sulfamethoxazole-trimethoprimand Nalidixic acid. In several countries, emphasize the need for local population specific surveillance for guiding empirical therapy for UTI in children.

Background: Dilated cardiomyopathy (DCM) is revealed with the left ventricular dilatation and systolic dysfunction. This study was performed to determine the level of Calcitonin Gene Related Peptide (CGRP) and Brain Natriuretic Peptide (BNP) in children with dilated cardiomyopathy and controls and comparison of these two biomarkers in patients. Materials and Methods: This case-control study was performed from April 2014 to March 2015 on patients with DCM. The levels of BNP and CGRP were measured by ELISA and final amounts of biomarkers were compared with echocardiographic finding.37 DCM patients compared with 30 healthy children selected randomly from those who referred to the hospital for routine checkup. Results: In this study the mean age was 10.567± 5.50 and 12.135 ± 4.626 years for controls and cases, respectively (P=0.321). The majority of echocardiography indices in the left and right heart had different means in case and controls (P

Background Heart failure is a major cause of death in thalassemia. The study aimed to determine the diagnostic value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP), to early diagnose the cardiac involvement in beta- thalassemia major patients. Materials and Methods 80 thalassemia patients aged 7 to 18 years old (patients group), and 80 healthy age and gender matched controls were enrolled in the case-control study. Patients were selected from those attending to the clinic of Aliasghar hospital, Zahedan-Iran. They were subjected to echo-Doppler tissue and conventional examination for both right and left heart function. Data were analysis using SPSS 18.0 software. Results NT-pro BNP increased in patients compared the controls (P

BackgroundCongenital heart diseases (CHD) are the most common congenital anomaly in children and also the leading cause of mortality from congenital anomalies. Various factors including smoking, drinking alcohol and addiction play role in development of congenital heart diseases. This study was conducted with the aim of investigation of the prevalence of addiction in parents of children with congenital heart disease compared with healthy children.Materials and MethodsThis was a case-control study conducted on 320 children with congenital heart disease aged 6 months to 16 years and 320 healthy children as control group. Children referring to Ali Asghar hospital or who were hospitalized in Imam Ali Hospital were included in the study and their demographic characteristics and their parents were collected. Data were analyzed using SPSS 20.ResultsAverage age of diseased and healthy children was 4.08 ± 4.11 and 3.59 ± 2.36, respectively. The rate of addiction of father, mother and parents of children with congenital heart disease was higher than those of children in control group. The most common congenital heart disease was ventricular septal defect (VSD).ConclusionIn overall, this study showed addiction rate of parents in children with congenital heart disease was higher.

BackgroundLife expectancy has increased in congenital heart diseases (CHD) patients and the interest has risen considering the quality of life (QOL). The study aimed to compare patients and proxy-parents reports on CHD children' QOL.Materials and MethodsThis cross-sectional study performed on 165 CHD patients aged 2-18 years during 2016 using Pediatric Quality of Life 3.0 (PedsQL™ 3.0) inventory. PedsQL™ 3.0 has same dimensions with different question for various age groups. The internal consistency of the inventory scales and subscales was assessed by means of Cronbach’s alpha. Scales with reliability ≥ 0.70 were recommended.ResultsThe overall mean score of QOL was significantly higher in parents’ perceived (51.78±10.87) compared to children’s perceived (48.61±11.25) (t= -2.615, P=0.009). The anxiety was significantly higher (56.23 ±17.93 vs. 47.31± 17.96) in parents’ perceived compared to children (t= -2.281, P=0.025). The cognition has been perceived significantly better by children than parents’ (51.22±15.76 vs. 41.53± 13.15). Children with simple diseases had higher score of quality of life (53.09±13.44) compared with those children with complex diseases (42.73±18.23) (t=2.786, P=0.007) for 2-4 years age in parents' perceived. The mean scores in heart problem scale were 46.74±13.64 and 61.14±18.17 and for the communication scale were 28.49±13.87 and 41.77±20.23 for pre and post operated children respectively for the age group of 5-7 years in parents' perceived.ConclusionResulted no impacts by two clinical (types of diseases and operation) factors on CHD patients' Health-related quality of life (HRQOL). Therefore should be considered more clinical factors to detect the gap in QOL in CHDs.

BackgroundAutomatic release of urine at any time of a day during sleep beyond the age of five years defined enuresis as a health disorders in children. The etiology of enuresis is still not clearly understood. Body Mass Index (BMI) is an indicator to evaluate the growth trend of individuals in a population for any specific age group. Evaluation of obesity in children is important and provides an opportunity to identify the problem and prevent disease progression. The purpose of this study was to determine the prevalence of enuresis and the association with BMI.Materials and MethodsThe study was a cross-sectional survey based on specific age group population to determine the prevalence of enuresis conducted on the schoolchildren in Zahedan, Iran during December 2015 and February 2016. A random, multistage sample of 2,000 students was taken from fifty schools in five districts of Zahedan city and filled out some easy questions such as age and gender along with measuring weight and height. Body Mass Index categorized after calculation accordance with the formulae of BMI= Height (kg) / Weight (m) 2. The classification of BMI was accordance with percentiles of underweight in less than the 5th percentile, healthy level from the 5th to less than 85th percentile, overweight from the 85th to less than the 97th percentile and obese equal to or greater than the 97th percentile.ResultsThe prevalence of enuresis was 17.18% for boys and 11.82% for girls, and the overall prevalence was 140 in 1000. Enuresis and non- enuresis population were different in mean of BMI (15.51±3.92 versus 17.69±5.11), so that this differential were statistically significant (P

ObjectiveThis study aimed to assess Brain Natriuretic Peptide in early diagnose of cardiac function in children with Congenital Heart Diseases.MethodologyThis study was performed on children with CHD and healthy. Severity of heart failure modified Ross classification system was used for grouping patients in four classes. For all participants, height, weight and head circumference were measured. From participants 3 cc blood samples was taken and after separation, the plasma placed at temperature of -80 c. After collecting all samples they were in testing using an ELISA BNP kit. For 50 children in control group statistical methods used to generate RV and PA pressure randomly. The data were analyzed using SPSS for Windows, Version, 15.0 (Chicago,SPSS Inc. USA) with 0.05 for the level of significant. ResultsBNP, RV pressure, PA pressure, HB and O2 saturation had different means in cyanotic, Acyanotic and and control significantly. BNP, RV, PA , HB and O2Sat had different means in case and control significantly. , RV, HB and O2 saturation had different means significantly acordance with the sevirity of disease.BNP had correlation with PA and PA had correlation with Qp/Qs ratio ,Rp/Rs ratio , RV and O2Sat significantly .ConclusionAt the end from the results of the study concluded that BNP levels in children with chd increased. in patients with pulmonary hypertension , with increasing the level of pulmonary hypertension the BNP will increase. BNP increasing had high association with the severity of heart failure.

Background Oral cleft is the most common orofacial congenital anomaly among live births. This anomaly at birth is one of the main causes of children disability and mortality. Congenital heart disease (CHD) is one of the most common anomalies in oral clefts. This study aimed to assess the incidence of congenital heart diseases anomalies in newborns with oral clefts. Materials and Methods This study performed on 48,692 live born to estimate incidence of oral clefts from 1 st December 2013 to 31 th November 2015 from three general hospitals in Zahedan, The capital city of the Sistan & Baluchestan province, Iran. All oral cleft patients were under echocardiography to diagnosis the incidence of CHD as associated anomaly. The collected data were processed using SPSS-16. Results The results of the analysis showed that the incidence of cleft lip was higher in boys than girls, while the cleft palate was higher in girls. Lip/palate cleft was higher for boys. Oral clefts patients accounted of 102 (0.2%) with incidence rate of 2.095 per 1000 lives. Of 102 patients 19 (18.62%), 39(35.24%) and 44(43.14%) were oral lip, oral palate and both respectively. The incidence of CHD in patients with oral clefts was 26.5%, while the incidences for cleft lip, cleft palate and both were 15.79%, 20.51%, and 36.36% respectively. Conclusion From the study concluded that the rate of CHD among children with oral clefts was high compared with the healthy children. Strongly is suggested the echocardiography for these patients to have early diagnostic of CHD to manage any life-threatening.

Background The prevalence of celiac disease (CD) is remarkably varied in Down syndrome(DS)patientscompared with other diseases. This study aimed to assess celiac disease prevalence in Down syndrome children with and without congenital heart defects (CHD) and its comparison with controls. Materials and Methods This case-control study was performed at a single center on 132 participants in three groups. Clinical and genetic tests were performed on all patients suspected with Down syndrome to confirm their diseases. After that in patients with confirmed Down syndrome echocardiography was carried out to diagnosis of CHD. Healthy children selected randomly among those who referred to the center for annual check-up. Statistical evaluation was done using SPSS-16. Results For the factors of age, weight, height and Body Mass Index (BMI) not observed significant differences between three groups of participants, but it would be observed statistically differences for the variable of tTG- IgA. For variables of weight, tTG- IgA and BMI was observed statistically different in the case and controls. The status of tTG- IgA (normal or 20) had significant correlation with three groups of controls, Down syndrome with and without CHD. The status of tTG- IgA also had significant correlation with groups of case and controls. In comparison of tTG- IgA in DS patients with and without CHD, no significant differences were observed. Conclusion The prevalence of CD in DS patients was higher compared the controls population; and in DS patients with CHD was higher compared the DS patients without CHD.

Background: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. Objective: AKI is a serious condition in critically ill patients. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of AKI in the Pediatric Intensive Care Unit (PICU). Materials and Methods: This prospective observational study was conducted in the PICU of a hospital in the South-east Area of Iran (Zahedan City), to study the clinico-etiological profile of AKI (defined according to the AKI network criteria). Over a period of 20 months from April 2012 to December 2014, 303 children were included in the study. Both the groups of patients, those who developed AKI and those who did not develop AKI, were then followed during the course of their hospital stay. Results: There were 303 cases included in the study, with the incidence rate of AKI of 14.9% in PICU. The most common PICU admission diagnoses in AKI were neurologic 85 (%28.05), followed by heart diseases 52 (17.18%) and 31 (10.23%) for respiratory diseases. AKI was 43.5 and 5.4 times more prevalent in renal and endocrine patients compared to those with heart disease respectively. The mortality rate was estimated to be higher in patients with AKI compared to their counterparts (40% vs. 17.8%). Chance of death increased in patients with AKI (odds ratio = 3.04). Conclusion: AKI is a serious problem, but its true incidence is unknown. Understanding the epidemiology of AKI by using of standard definition help us to find high-risk children that are the first step to improve outcomes. The future multiple-center study may benefit by better identifying risk factors and early detection of AKI by using biomarkers novel to prevent the developing of AKI.

Background: Dilated cardiomyopathy (DCM) is revealed with the left ventricular dilatation and systolic dysfunction. Objective: This study was performed to determine the level of calcitonin gene-related peptide (CGRP) and brain natriuretic peptide (BNP) in children with DCM and controls and comparison of these two biomarkers in patients. Materials and Methods: This study was performed from April 2014 to March 2015 on patients with DCM. The levels of BNP and CGRP were measured by ELISA, and final amounts of biomarkers were compared with the echocardiographic finding. Results: In this study, the mean age was 10.567 ± 5.50 and 12.135 ± 4.626 years for controls and cases, respectively (P = 0.321). The majority of echocardiographic indices in the left and right heart had different means in cases and controls (P < 0.05). Means of BNP were 213.814 ± 309.601 and 2.76 ± 1.013 for case and control, respectively (P < 0.001). Means of CGRP were 2.278 ± 1.586 and 1.488 ± 0.501 for cases and controls, respectively, (P = 0.001). In the patients group, however, no significant relationship was observed between CGRP level and Ross classification but observed a direct relationship of Ross classification with BNP (χ2 = 15.845, P < 0.05). Conclusions: The present research was performed on DCM patients and showed that most echocardiographic parameters, mean of CGRP and mean of BNP increased in patients compared to healthy children. The severity of illness based on the Ross classification showed significant and positive correlation with BNP level but not with CGRP. Probably, it could be concluded that BNP would be a better biomarker in DCM patients.

Background: Urinary tract infection (UTI) is the most common bacterial infections in children. This studyaimed to investigate the oxidative and antioxidate status of plasma in patients with UTI and to compare them with those of the controls. Methods: This case–control study of 50–75 children in the given order was performed in 2013 at the Pediatric Clinic of infections in Zahedan Hospital of Ali Ibn Abi Talib. The antioxidative status of plasma were evaluated by measuring the total antioxidant capacity (TAC) The oxidative status of samples was assessed by measuring the total peroxide and the oxidative stress index (OSI) levels. The means of the parameters were compared and the relationship among them was determined. Data were analyzed using SPSS 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). Student's t -test and Mann–Whitney U-test were applied in various situations of our questions; 95% confidence interval was considered for the level of significance. Results: The results showed that total oxidant serum status in UTI patients was higher compared to controls when total antioxidant serum was lower. The balance of oxidant-antioxidant serum was in favor of oxidant serum and this term was confirmed by OSI. Conclusion: Our results showed that the plasma levels of TAC in patients with UTI were decreased compared to controls, and oxidant-antioxidant balance and OSI caused increased OS in patients.