Search

Background: Polycystic ovarian syndrome (PCOS) is defined by excessive production and/or secretion of androgenic hormones in women. This disease has a complicated nature, so its control is difficult and challenging. Therefore, many women use complementary therapies to support medical treatment, one of which is the consumption of mint plants. Objective: This study aimed to characterize the chemical composition of peppermint (Mentha piperita L.) and spearmint (Mentha spicata L.) oils, to assess the binding of constituents of the oils to the androgen receptor as well as their pharmacokinetic features. Methods: The essential oils were isolated by water distillation and then analyzed using GC-MS and GCFID. Thereafter, in silico binding studies were performed between the main volatile constituents and human androgen receptors using Autodock Vina. Besides, the pharmacokinetic properties of the selected compounds were evaluated using SwissADME. Results: GC analyses showed the presence of 19 and 23 constituents out of the total components (accounting for 94.7% and 97.6%, respectively), with carvone (73.0%), and menthone (33.1%) and menthol (29.3%) as the major compounds in spearmint and peppermint oils, respectively. Moreover, molecular docking studies revealed that carvone has the lowest binding energy to the androgen receptor. On the other hand, all tested compounds finally exhibited favorable pharmacokinetic parameters. Conclusion: The present study virtually indicated that the main volatile constituent in the spearmint oil, i.e., carvone, could probably cause a beneficial effect on PCOS.

Objectives: Postnatal evaluation of vesicoureteral reflux (VUR) remains controversial in patients with antenatal hydronephrosis (HN). The objective of this study was to identify the significance of mild postnatal HN as a marker of VUR and its severity. Materials and Methods: Sonographic findings of 248 children (351 kidneys) with persistent postnatal HN were evaluated for the incidence and severity of primary VUR. Results: The majority of patients had mild (67.8%) HN, followed by moderate (27.6%) and severe (4.6%) HN. VUR was identified in 14.7% of patients with mild HN, 18.5% of patients with moderate HN, and 18.7% of patients with severe HN. About 11.44% of patients with mild HN had low-grade VUR, followed by moderate (45.71 %) and severe grades (42.85%). Conclusion: A large number (89%) of patients with mild HN had moderate to severe VUR. In this cohort, renal sonography was not a reliable method for the prediction of VUR and its severity in patients with mild postnatal HN. However, it was reliable for high grades of VUR. These results are limited due to the study design and the inability to generalize these findings. These results should be replicated across other multiple clinics, thereby recruiting more variety of patients, to validate these study recommendations.

Introduction: The vesicoureteral reflux (VUR) is among the most common congenital disorder of urinary system. There are several surgical methods to manage this disease. In this study we aimed to assess and compare the result of the two common surgical techniques including Cohen and Gil-Vernet methods of in children with VUR.Method and materials: In this retrospective study, we gathered the record of all patients who underwent Cohen or Gil-Vernet surgeries during 2010-2017. We recruited all the infants and patients until age of 15 years who had moderate and high grade VUR in voiding cystourethrogram (VCUG). We gathered and compared information regarding the grade of VUR, the number of breaks through urinary tract infection (UTI), kidney parenchymal scars and the side effects of surgery between two methods. Results: In this study we recruited 89 patients with mean age of 66.56 ± 31.51months. Of all patients, 18 cases underwent Cohen surgery and for 71 patients Gil-Vernet was performed. All the patients showed improvement regarding the grade of reflux according to VCUG (p:.001). The incidence rate of UTI was decreased in both groups (p:0.001). The clinical profile of the study participants was improved in both group and there was not any difference between two surgical modalities in this respect. The mean follow-up time was 59.11 ± 23.4 months.Conclusion: Both Cohen or Gil-Vernet surgeries were effective methods for treating VUR. Also, there was not any significant difference between two surgical techniques.

Background: Hyponatremia/water intoxication has been considered a rare but serious complication of desmopressin (DDAVP) for the treatment of primary monosymptomatic nocturnal enuresis (PMNE). Objectives: This study aimed to identify the incidence and risk factors of serum sodium (Na) alterations in children with PMNE treated with oral or intranasal DDAVP. Methods: A total of 201 patients with PMNE were evaluated in 2 groups using intranasal (n = 127) or oral DDAVP (n = 74) for approximately 6 months. Treatment efficacy was defined as a more than 50% decrease in wet nights after 1 month of treatment. Serum Na was measured before, during, and after treatment in all patients. Predisposing factors of serum Na disturbance were evaluated concomitantly. Results: The mean age of patients was 8.8 ± 2.6 (5 - 17.5) years, and males outnumbered females (M/F = 1.68). Treatment efficacy was 100% in 93 (46.2%), and > 90% in 157 (78.1%) cases. Oral DDAVP had significantly more therapeutic effects than intranasal treatment (P = 0.024). However, serum Na had no significant difference between the 2 groups (P = 0.52). Hyponatremia occurred in 7 (3.5%) patients (3 in oral treatment and 4 in intranasal treatment; P = 0.73) with no significant correlation to age, gender, body weight, frequency of enuresis, and initial serum Na. However, decreased serum Na > 5 mEq/L was a significant risk factor for the prediction of hyponatremia in our patients (P < 0.001). Conclusions: Oral DDAVP had more therapeutic effects than intranasal treatment for the treatment of PMNE. Serum Na had no significant alteration in both oral and intranasal treatments, and hyponatremia was a rare complication of DDAVP, which occurred significantly in children with a > 5-mEq/L decrease of initial serum Na concentration. As a suggestion, monitoring serum Na is not an essential follow-up in asymptomatic patients in DDAVP treatment.

Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (PConclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.

Vesicoureteral reflux (VUR) is the most common congenital urinary tract abnormality in children. The objective of this study was to evaluate the diagnostic value of urine neutrophil gelatinase-associated lipocalin (NGAL) in children with primary vesicoureteral reflux (VUR). A total of 69 patients were evaluated in 2 groups with (32) and without (37) VUR. Patients with secondary VUR, infectious or inflammatory disorders, obstructive uropathies, and acute or chronic kidney disease were excluded. Urine NGAL level was measured by ELISA kit. Mean age of children with VUR was 36.84 ± 28.16, compared to those without VUR 32.32 ± 29.08, with no significant difference (p = 0.51). Mean urine NGAL (p = 0.012) and urine NGAL/Cr (p = 0.003) were higher in patients with VUR. In addition, urine NGAL/Cr increased significantly in patients with decreased parenchymal function, compared to those with normal DMSA scan. Using the cutoff value of 0.888, urine NGAL had 84% sensitivity and 81% specificity for diagnosis of VUR. Based on AUC (0.86), urine NGAL had acceptable diagnostic accuracy in children with VUR. The results of this study support the evidence that urine NGAL/Cr is a sensitive, specific and accurate biomarker for diagnosis of children with primary VUR.

Background: Hypertension (HTN) is a significant public health problem worldwide. Early diagnosis of HTN and its related risk factors has been considered as one of the main requirements of general healthcare in children. Objectives: This study aimed to examine the nomograms of normal systolic and diastolic blood pressure (BP) and the prevalence of asymptomatic HTN and pre-HTN in a population of school-aged children. Methods: Systolic and diastolic BP, height, and weight were measured in 5811 healthy school-aged children (2904 males and 2907 females) during healthcare visits. HTN was defined as systolic or diastolic BP ≥ 95th percentile for age, gender, and height of the screened population on ≥ 3 occasions. Pre-HTN was considered as systolic or diastolic BP between 90 - 95 percentile. Results: HTN and pre-HTN were detected in 8.4% and 7.8% of the children, respectively. The prevalence of HTN was 8.6% among the males and 8.2% among the females. Systolic HTN and pre-HTN were detected in 5.8 and 6.4% of the cases compared to diastolic HTN and pre-HTN observed in 5.9 and 6.1% of the participants, respectively. In addition, HTN was detected in 27.9% of children with obesity. Conclusions: According to the high incidence of asymptomatic HTN and pre-HTN in asymptomatic children, it is recommended to perform routine BP measurement during medical care visits of all healthy school children and to prevent and treat obesity in childhood.

PURPOSE: Early diagnosis and management of diabetic nephropathy (DN) might prevent or delay its progression to end-stage renal disease. The purpose of this study was to investigate whether changes in the duplex Doppler resistivity index (RI) are useful for the early identification of renal involvement in children and adolescents with insulin-dependent diabetes mellitus and associated conditions. MATERIALS AND METHODS: A total of 49 diabetic patients (two groups: 21 with DN and 28 without DN) were included in this study. DN was defined as 30–300 mg/l of albumin excretion in a random urine sample. The RI of the main renal arteries and their intrarenal branches (arcuate, interlobar) were evaluated with duplex Doppler ultrasound and correlated with age, renal length, duration of diabetes, and laboratory examinations. RESULTS: The mean age did not significantly differ between the two groups. The patients with DN had a significantly longer duration of type 1 diabetes (p = 0.02). The majority of patients (90.5%) had mild renal involvement with microalbuminuria and normal renal function. The mean RI was normal in both groups of patients, with no significant difference between the two groups. CONCLUSION: The RI did not increase in the early clinical stage of DN and was not a reliable marker for the screening of DN in patients with type 1 diabetes mellitus.

Pro-inflammatory cytokines have been suggested in the pathogenesis of idiopathic nephrotic syndrome (INS), with conflicting results. This study was performed to identify alteration of different serum interleukins (ILs) in children with INS, and their predictive value in response to steroid treatment. Three groups of children (27; steroid-sensitive INS, 21; steroid-resistant INS, and 19 healthy controls) with normal serum C3, negative serologic tests of hepatitis B virus (HBV), hepatitis C virus (HCV), human immune deficiency virus (HIV), and parasitic infections were included in this study. Serum concentrations of IL-1β, IL-2, IL-6, IL-8, IL-13, and IL-18 were measured, using quantitative colorimetric sandwich ELISA kits. Children with secondary nephrotic syndrome, inflammations, systemic disorders, and chronic kidney disease were excluded. The serum concentration of all ILs; except IL-13 and IL-18; was significantly higher in children with INS, compared with the healthy controls. Serum IL-2 had the highest sensitivity of (95.24%) in patients with INS. All of the serum ILs had acceptable accuracy in children with INS, compared with the control group. The serum concentration of IL-1β, IL-6, and IL-8 was significantly higher in children with steroid-sensitive nephrotic syndrome (SSNS), compared with steroid-resistant nephrotic syndrome (SRNS). All of these ILs had acceptable accuracy for the prediction of steroid response in patients with INS. Our findings suggested the pathogenic role of pro-inflammatory cytokines in children with INS, of which IL-1β, IL-6, and IL-8 were accurate biomarkers for the prediction of steroid response in these patients.

Vesicoureteral reflux (VUR) is the most common risk factor of urinary tract infection in children. Currently, diagnosis of VUR depends on invasive imaging studies, with a high radiologic burden. Therefore, different biomarkers have been introduced for the evaluation of these patients. The objective of this study was to identify alteration of urinary interleukins (ILs) excretion in children with primary VUR and renal parenchymal damage, for further clinical application.Urinary concentrations of IL-1α, IL-1β, IL-6, and IL-8 were evaluated in 34 children with VUR (cases) and 36 without VUR (control), during 2018-2019. Urinary concentrations of IL-1, IL-1, IL-6 and IL-8 were measured, using polyclonal antibody ELISA kit, and standardized to urine creatinine (Cr). Patients with infectious or inflammatory disorders, urolithiasis, immune deficiency, acute or chronic kidney disease, and secondary VUR were excluded from the study.Mean age of cases (36.00 ± 27.66) had no significant difference with the control (32.86±29.31) group (p=0.44). The majority of patients had moderate VUR (58.8%), followed by severe (35.3%) and mild (5.9%) grades. Urinary concentration of all ILs/Cr were significantly higher in patients with VUR, compared with those without VUR. There was no significant correlation between urine ILs/Cr with age, gender, serum electrolytes, urine specific gravity, renal ultrasound, laterality or severity of VUR, and DMSA renal scan. All urine ILs/Cr had acceptable sensitivity and accuracy for workup of children with primary VUR.Urine IL-1α, IL-1β, IL-6 and IL-8/Cr were sensitive and accurate additionary screening biomarkers in children with primary VUR.

Thromboembolism is a rare complication of primary nephortic syndrome. Both venous and arterial thrombosis might occur in steroid responsive and steroid resistant nephrotic syndrome. This is the report of an infant with nephrotic syndrome and renovascular hypertension, complicated with asymptomatic intracardiac thrombus and managed appropriately with medical treatment.

Introduction: Idiopathic nephrotic syndrome has been considered a cell-mediated immunity disorder with T cell dysfunction. Objectives: The purpose of this study was to investigate immunologic dysfunction in children with steroid-sensitive nephrotic syndrome (SSNS) by evaluating serum interleukin-18 (IL-18). Patients and Methods: A total of 30 children with SSNS (n=20 males, n=10 females), aged 1–11 years were enrolled in this study. All of them were treated with steroids at the time of study. Serum IL-18 was compared during both active and remission phases of nephrotic syndrome. In addition, correlation between serum IL-18 with urine protein and serum biochemical variables was evaluated. Results: Mean serum IL-18 was higher in the active phase, and decreased significantly poststeroid treatment (4.87±1.43 ng/L versus 2.39± 0.94 ng/L; P=0.01). It had no correlation with other variables. Conclusion: According to increased serum IL-18 level, dysregulation of type-1 and type-2 mediated immune reactions is suggested in children with SSNS.

There is little information about the clinicopathological correlations of focal segmental glomerulosclerosis (FSGS) in children. Renal biopsies of 46 patients with primary FSGS were reviewed between 1994 and 2015. Clinical and laboratory findings were evaluated at the time of renal biopsy. Totally, not otherwise specified (NOS) was the most common pathologic variant in 38 patients. There was no correlation between age, gender, serum protein, urine protein, hematuria, and steroid response with five distinct pathologic variants and histopathologic lesions. Hgb level had a negative correlation to the glomerular hyalinosis, mesengial hypercellularity, mesengial deposition, and glomerular volume. Renal dysfunction and blood pressure had a significant positive association with the extent of tubular atrophy, interstitial fibrosis, synechiae in Bowman capsule, arteriolar hyalinosis, mononuclear infiltration, atherosclerosis, glomerular hyalinosis, mesengial hypercellularity, mesengial deposition, and glomerular sclerosis. In conclusion, serum creatinine and blood pressure were the significant predictors of histopathologic lesions in children with primary FSGS.

Alkaptonuria (ALK) is a rare genetic disorder, characterized by binding of ochronotic pigment to the connective tissues in different tissues. This is the first report of a child presented with primary distal renal tubular acidosis associated with ALK. Both disorders were managed by their specific medical treatments, with no further complication.

Summary Background Hematuria, either macroscopic or microscopic, is an incidental finding of multiple nephrologic or urologic disorders. Disturbances of urine inhibitors or promotors have been suggested as the potential causes of isolated idiopathic hematuria in children and its recurrence. Meanwhile, appropriate treatment of these risk factors might improve secondary asymptomatic or macroscopic hematuria. Objectives The aim of this study was to identify contribution of urinary biochemical abnormalities in children with isolated idiopathic hematuria. Methods About 522 children with isolated hematuria were evaluated in a prospective cross-sectional study. Data such as clinical manifestations, family history, laboratory examinations, structural anomalies, and urine biochemistry were obtained. Patients with nephrolithiasis, nephrocalcinosis, tubulointerstitial disorder, genitourinary abnormality, urinary tract infection, and glomerular disorder were excluded from the study. Variables such as calcium, citrate, oxalate, phosphate, uric acid, cystine, and magnesium were measured in 24-h urine collection. In addition, serum levels of electrolytes, urea, creatinine, parathyroid hormone, and bicarbonate were identified. Results Mean age at diagnosis was 5.9 years, and females outnumbered males (2/1). Of those, 88.5% had microscopic hematuria, and 12.6% experienced episodes of gross hematuria. Abdominal pain was the most common clinical manifestations. Urinary tract infection occurred in 30% of cases. Totally, 94% of patients had single or multiple metabolic abnormalities in 24-h urine excretion including hypocitraturia, 60.7%; hypomagnesuria, 58.2%; hyperuricosuria, 35.8%; hypercalciuria, 33.7%; hyperoxaluria, 33.7%; and cystinuria, 0.76%, respectively. About 8% of cases had mixed urine metabolic disturbances. Most patients had mild hematuria (red blood cell 30/hpf), with no statistical correlation to urine metabolic abnormalities. About 80% of patients had a history of nephrolithiasis in their relatives. Discussion Decreased urinary inhibitor concentration followed by increased stimulator concentration were the most common abnormalities in patients with idiopathic hematuria. Accordingly, measurement of urinary biochemical concentration is highly recommended in children with isolated hematuria. In addition, investigating the therapeutic effect of potassium citrate supplements is highly recommended in these patients to prevent future stone formation and treatment of hematuria. Variables No (%) Female (%) FH of NL (%) Gross hematuria (%) Hypocitraturia 60.7 70.9 (p 66.6 (p = 0.9) 80.1 (p = 0.9) 11 (p = 0.9) Hypomagnesuria 58.2 64.9 (p = 0.008) 71.1 (p = 0.005) 81.3 (p = 0.5) 10.5 (p = 0.98) Hyperuricosuria 35.8 39.6 (p = 0.12) 61.2 (p = 0.77) 84 (p = 0.11) 10.2 (p = 0.47) Hypercalciuria 33.7 28.5 (p = 0.2) 65.8 (p = 0.9) 83.6 (p = 0.26) 10.4 (p = 0.66) Hyperoxaluria 24.9 27.1 (p = 0.3) 70.8 (p = 0.2) 78.5 (p = 0.5) 11.5 (p = 0.68) FH, familial history; NL, nephrolithiasis.

Background and objectives Accurate diagnosis of acute pyelonephritis (APN) is clinically challenging in young children. The evaluation methods for APN and its major risk factor, vesicoureteral reflux (VUR), have been revised in recent years. The aim of this study was to evaluate the value of different radiologic investigations in children experiencing the first episode of APN. Materials and methods This study included 425 children of 2–12 months of age (17.5% male, 82.5% female) with APN. APN was defined as a positive urine culture associated with focal or diffuse decreased cortical uptake and preservation of renal contour indicated by DMSA renal scan. Results The mean age at diagnosis was 39.2 ± 1.56 months. The following signs were observed in the patients: fever ≥ 38.5 °C, 66.8%; positive CRP, 85.4%; ESR > 25, 78.6%; and leukocytosis > 13,000/mm 3 , 53.4%. Pyelocalyceal fullness and increased parenchymal echogenicity were the most common renal ultrasonography findings, and ultrasonography had 34% sensitivity and 53% specificity for these two findings. DMSA scan and ultrasound findings of APN were not significantly correlated ( P = .112). VUR was found in 42.2% of patients. DMSA scanning was not reliable for the diagnosis of VUR ( P = .956), with 42% sensitivity and specificity. VUR was identified in 42.7% of patients by ultrasound ( P = .001), and the diagnostic rate was related to the VUR severity. Ultrasound had 42.7% sensitivity and 27% specificity for the diagnosis of VUR. Conclusion Determination of inflammatory markers is recommenced for the evaluation of children with APN. In addition, normal ultrasound is a valuable imaging tool for excluding high grade VUR.

Objectives: Septicemia is an important cause of acute kidney injury (AKI) in neonates admitted to neonatal intensive care units. The aim of this study was to identify the predictive factors for AKI in neonates with culture-proven septicemia. Methods: Medical records of 138 newborns with septicemia were evaluated in 2 groups with (n, 65) and without (n, 73) AKI. Results: The mean age at diagnosis of AKI was 11.31 ± 9.92 days. AKI was more common in neonates with lower gestational age, birth weight, age, blood pressure, platelet count, and serum pH at admission. Moreover, AKI was associated with an increased incidence of intubation at birth, inotrope treatment, shock, disseminated intravascular coagulation (DIC), mechanical ventilation, and morality. Gestational age, initial serum pH, and DIC were the only independent predictors of AKI in the multivariate analysis. In addition, serum pH at admission was the most accurate laboratory marker for the prediction of AKI with 83% sensitivity and 60% specificity. Conclusions: Monitoring of renal function is highly recommended in low-birth-weight infants with severe septicemia.

Introduction: Different biomarkers have been investigated for prognosis of patients with nephrotic syndrome. Qualitative and quantitative changes have been reported in platelets in these patients. Objectives: The aim of this study was to identify platelet abnormalities and their prognostic value of steroid response in children with idiopathic nephrotic syndrome. Patients and Methods: Platelet counts and indices (mean platelet volume [MPV], platelet distribution width [PDW] and platelet larger cell ratio [PLCR]) were evaluated and compared in 122 children with active nephrotic syndrome (64%; steroid resistant and 36%; steroid sensitive). Results: Mean age at diagnosis was 55 months (6 to169 months), and males outnumbered females (1.7/1). Steroid resistant patients had significantly higher platelet counts and lower PLCR, compared to steroid sensitive group. Regarding area under the ROC curve, low MPV, high PDW and low PLCR showed relatively acceptable correlation with steroid resistance. Conclusion: Increased platelet counts in addition to low PLCR are the suggestive indicators of steroid resistance in children with idiopathic nephrotic syndrome.

Salvia genus is one of the largest genera of the Lamiaceae family. Its species have been used for a wide variety of disorders in the local traditional medicine systems. Therefore, the genus has been the subject of several phytochemical and biological studies. The aim of the study was to identify the major antioxidant compound(s) from the methanol extract of Salvia verticillata using activity-guided fractionation. The crude extract showed strong antioxidant activities in DPPH and β-carotene/linoleic acid tests. The ethyl acetate fraction also exhibited a potent free radical scavenging activity compared to the other fractions. Further fractionation and purification of the ethyl acetate fraction using chromatography methods yielded a compound with high antioxidant capacity. The isolated active compound was determined as chrysoeriol. It showed a dose-dependent free radical scavenging activity with an IC50 (DPPH scavenging) value of 93.32 (80.23 – 108.57) mM.

Background: The accurate diagnosis and management of febrile urinary tract infection (UTI) is a clinical challenge in the absence of specific clinical and laboratory findings in infants and young children. Objectives: The aim of this study was to identify and compare the diagnostic and therapeutic implications of recently introduced cytokines for the diagnosis of acute pyelonephritis (APN). Methods: This multicenter prospective study was performed on 37 (female/male = 6.5:1) children with symptomatic culture-proven APN and 37 (female/male = 1.6/1) age-matched febrile children without UTIs as the control group. Urine samples were obtained before antibiotic treatment in both groups and 3 - 4 days after treatment in the UTI group, and evaluated for interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF) using an ELISA immunoassay kit. Results: Mean urinary IL-1α, IL-4, IL-6, and IL-8 concentrations significantly increased in the acute phase of APN compared to the control group, and decreased following antibiotic treatment. Conclusions: We recommend routine urinalysis and urine culture for the diagnosis of children with APN. Urinary IL-4 was a relatively good cytokine for the prediction and treatment-monitoring of children with acute febrile UTI.

Renal involvement is a rare complication of β-thalassemia. Both tubular and glomerular dysfunction might occur in these patients. The aim of this study was to evaluate and compare kidney function in the major, intermedia, and minor variants of β-thalassemia.Renal tubular and glomerular function of 72 patients with β-thalassemia (25 major, 23 intermedia, and 24 minor) were evaluated. Patients older than 40 years and those with chronic kidney disease, diabetes mellitus, congestive heart failure, associated infections, congenital anomalies of the kidney and urinary tract were excluded. Blood and urine samples were collected electrolytes and markers of kidney function.Mean age at the time of study was significantly higher in the minor group. The majority of patients with thalassemia major were males. Hematuria and pyuria occurred in 4% to 8% of the patients. Serum level of all variables were within normal limits, with no significant difference between the three groups. Glomerular filtration rate was nonsignificantly higher in the major and intermedia groups, compared to the minor variant. A significantly lower urine phosphorus and uric acid excretion was noted with the minor variant. Urine phosphorus and uric acid excretion increased more frequently in the major and intermedia groups.Tubular and glomerular functions appear to be well preserved in all variants of β-thalassemia.

Juvenile dermatomyositis (JDM) is a rare autoimmune disease characterized by proximal muscle weakness, skin lesions, gastro intestinal, pulmonary, cardiac and small nerve damage. Renal involvement has been rarely reported in JDM. This is the report of a 7-year-old boy presented with nephrotic syndrome (NS) and subsequent renal failure. Clinical manifestations of JDM appeared gradually. Renal manifestations could be considered as a rare initial presentation of JDM.

This study was aimed to analyze and identify the antioxidant constituents of the essential oil of Bunium persicum (Apiaceae) fruit. The essential oil was obtained by hydrodistillation and analyses by GC-FID and GC-MS. The essential oil was tested for antioxidant capacity in DPPH radical scavenging and linoleic acid/β-carotene assays. The TLC-bioautography method based on DPPH radical assay and GC analyses were carried out to characterize the major antioxidant compounds in the essential oil. GC analyses showed the presence of sixteen compounds with p-cymene (31.1%), cuminaldehyde (22.2%), and γ-terpinene (11.4%) as the main components in the essential oil. The oil exhibited good radical scavenging [IC50 (DPPH·) = 4.47 (3.96 - 5.05) mg/mL] and antilipid peroxidation [IC50 (β-carotene bleaching) = 0.22 (0.16 - 0.31) mg/mL] activities. The TLC tests resulted in identification of cuminaldehyde, p-cymene-7-ol, and cuminyl acetate as the main constituents of the active oil fraction.

Vesicoureteral reflux (VUR) is one of the most important causes of urinary tract infection and renal failure in children. It is a potentially self-limited disease. The aim of this study was to evaluate the clinical course and significant factors in children with primary VUR. The medical charts of 125 infants and children (27.2 % males, 72.8% females) with all grades of primary VUR were retrospectively reviewed. Mean age at diagnosis was 22.3 ± 22.9 months. 52% of patients had bilateral VUR. Mild reflux (Grade I, II) was the most common initial grade. 53.6% of patients achieved spontaneous resolution. 30.1% of patients had decreased renal function on initial DMSA renal scan, significantly in males and severe VUR. Reflux nephropathy occurred in 17.6% of patients, especially in renal damage and male sex. No significant association was observed between recurrent urinary tract infection with the severity of VUR, and the presence of renal damage at admission. Age at diagnosis, gender, grade, laterality, the absence of recurrent urinary tract infection and renal damage had a significant correlation between spontaneous VUR resolution. Spontaneous resolution of primary VUR occurred significantly in female patients, age ≤ 30 months at diagnosis, mild-to-moderate VUR, unilateral reflux, the absence of recurrent urinary tract infection, and renal damage.

Idiopathic nephrotic syndrome (INS) is a common chronic illness in childhood and is initially treated with corticosteroids. Recent reports indicate that the incidence of steroid resistance and focal segmental glomerulosclerosis is on the rise. However, these reports involved different ethnic populations. The purpose of this study was to compare the characteristics of INS in Iranian children in different periods.A retrospective chart review of children admitted with the diagnosis of new-onset INS was performed. Patients were divided into two groups based on date of presentation periods of 1991 to 2002 and 2005 to 2012. Steroid resistance was defined as persistent proteinuria (2+ and more) within 8 weeks of oral corticosteroid treatment.A total of 238 children included in this study (119 in each group). There was an insignificant decrease in the frequency of steroid resistance, along with an insignificant change in histopathology towards focal segmental glomerulosclerosis.These findings indicate that in contrast to other reports of INS from various ethnic compositions, a tendency to steroid resistance is still arguable in the population of Iranian children.