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Background: The clinical implication of abnormal liver functional tests (LFTs) is not well studied in children with congenital heart diseases (CHDs). We aimed to screen LFTs in children with CHDs. Methods: LFTs including liver enzymes (AST, ALT and ALP), as well as direct bilirubin (DB), total bilirubin and albumin were measured in 80 children with CHDs. Results: Ventricular septal defect (VSD), tetralogy of Fallot (TOF), atrial septa defect (ASD), congestive heart failure (CHF) and Patent ductus arteriosus (PDA) accounted for 45 (67.4%), 3 (3.8%), 25 (20%), 2 (2.5%) and 5 (6.2%) of our patients, respectively. Abnormally elevated ALT, AST, ALP, DB, TB and reduced total protein were identified in 3 (3.8%), 21 (26.2%), 6 (7.6%), 10 (12.5%), 7 (8.8%) and 43 (53.8%), respectively. There was no significant difference in LFTs among various CHDs except for AST (P = 0.04). The mean level of AST was significantly lower in children with VSD (31.4 ±10.7 IU/l) than those of TOF (48.3 ±22.8 IU/l, P = 0.03) and ASD (36.8 ±9.8 IU/l, P = 0.03). Conclusion: Considering the respectively high incidence of abnormal LFTs in children with CHDs, it is advisable to regularly monitor these tests to timely manage any progressions toward congestive or ischaemic hepatitis. Keywords congenital heart disease, ventricular septal defect, heart failure, ischaemic hepatitis

Background In most term neonates, the ductus arteriosus closes functionally on the first day of life, and a permanently open ductus arteriosus is abnormal. Objectives To evaluate the effect of oral acetaminophen on patent arterial duct (PDA) closure in premature infants less than 32 weeks. Methods This randomized clinical trial was performed on 140 preterm neonates with gestational age less than 32 weeks and birth weight less than 1,500 g, admitted to the neonatal intensive care unit of Ali Enbe Abitalib Hospital in Zahedan between 2019 and 2021. The neonates were randomly divided into two groups, with and without acetaminophen administration. In the intervention group, acetaminophen drops were started during the first 24 hours after birth and were administered for five days. In both groups, echocardiography was performed five days after birth. Finally, the data were analyzed in SPSS software. Results About 140 neonates with gestational age of ≤32 weeks and weight at birth ≤1,500 g were admitted for the study. The neonates were equally divided into two groups and acetaminophen medication assigned for one of the groups. Of the 70 neonates who did not receive acetaminophen administration, 75.7% had PDA closure spontaneously; this pattern was 94.3% in patients who had treatment with acetaminophen. This effect of treatment was significant (X2=9.468, p=0.002). Conclusion The study showed significant improvement in PDA in neonates receiving paracetamol. This can have a significant impact on the treatment approach to preterm neonates.

Objectives: Infant screening for congenital heart disease (CHD) includes a straightforward bedside test called pulse oximetry. Low degrees of oxygen in the blood can be an indication of a critical CHD. The aim of the present study was to evaluate the role of pulse oximetry in the early detection of asymptomatic CHD in new borns before discharge from Hospital. Methodology: This cross-sectional study conducted on 3151 term neonates first stage of SPO2 was performed 2-12 hours after birth. If SPO2 was < 95%, premeasured within the first 12 to 24 hours of life. If the neonates maintained their SPO2

Background: Celiac disease is a hereditary digestive disease in children associated with an autoimmune disorder of the small intestine. This study aimed to study aortic stiffness in children with celiac disease compared with controls and assess the effects of a gluten-free diet on aortic stiffness parameters. Methods: This case-control study was conducted on 114 children with celiac disease and 57 healthy volunteers. Children with celiac disease comprised three groups: Gluten-free diet (GFD)-responsive, GFD-nonresponsive, and newly diagnosed. Systolic and diastolic diameters of the ascending aorta were recorded by M-mode echocardiography. Data were analyzed using SPSS 20. Study data had free distribution and nonparametric tests were applied for the analysis. The tests were Mann-Whitney U and Kruskal-Wallis with P value < 0.05as the significance level. Results: Aortic strain (11.15 ± 7.47 vs. 13.78 ± 6.95, P = 0.002) and aortic distensibility (6.98 ± 5.03 vs. 8.33 ± 5.13, P = 0.037) were lower in celiac disease (CD) while pressure strain elastic modulus (410.60 ± 247.45 vs. 330.71 ± 216.94, P = 0.012) and aortic strain β index (1.79 ± 0.62 vs. 1.44 ± 0.51, P < 0.001) were higher. The aortic strain significantly differed between control and response to GFD (P = 0.026), control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.003), and no response to GFD and new diagnosis (P < 0.001) groups. The aortic strain β index differed significantly between control and response to GFD (P ≤ 0.001), control and new diagnosis (P < 0.001), response to GFD and no response to GFD (P = 0.035), response to GFD and new diagnosis (P = 0.002), and no response to GFD and new diagnosis (P < 0.001) groups. Aortic distensibility significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Pressure strain elastic modulus significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Conclusions: The present study concluded that the elasticity parameters will change due to celiac disease. Gluten-free diet had no significant effect on aortic stiffing measures except the ASβ index.

Background: Poisoning is a critical global health problem, especially among children. This study aimed to assess the epidemiological features, clinical signs, and risk factors of childhood poisoning in the southeastern region of Iran. Patients and Methods: This cross-sectional study was conducted on 636 children and adolescents admitted to the Emergency Department of Ali Ebne Abitaleb Teaching Hospital in Zahedan, Iran, within 2014 to 2020. The collected data were clinical symptoms at the time of admission, socioeconomic and demographic determinants, poisoning agents, admission to the pediatric intensive care unit (PICU), using antidote, hospital stay in days, discharge status from the hospital, self-poisoning, gender, and place of residency. The data were analyzed using SPSS software (version 18). Mean and standard deviation, Pearson and chi-square were used to assess the association between two specific categorical variables, and the level of significance was considered 0.05. Results: Opium was the most common poisoning agent with the age of 8 years and femalepriority. Among poisoned subjects by chemical agents, the highlighted symptoms were respiratory distress, decreased peripheral oxygen saturation (SPO2), nausea and vomiting, fever, and a decrease in heart rate in the given order. Among poisoned subjects by medicinal agents with a decrease in SPO2, a decrease in consciousness and blood pressure was common. More frequent symptoms in children poisoned by opium were a decrease in SPO2, myosis, a decrease in heart rate, a decrease in respiratory rate, seizures, and nausea and vomiting. The factors, including antidote, gender, place of residency, poisoning by accidental events, admission to PICU, and days stayed in the hospital, were the significant factors in poisoning. Conclusions: Poisoning by opium agents was more common than other agents in Iran in lower age groups. Poisoned children by opium agents had severe symptoms with higher frequency than other agents. Antidote, gender, place of residency, poisoning by accidental events, admission to PICU, and days stayed in the hospital were significant factors in agent poisoning.

A temperature-related seizure is a febrile seizure that affects the QT interval. The purpose of this study was to evaluate the changes in the QT interval caused by febrile convulsion compared with healthy children. Method This case-control study considered the distribution of 180 children equally shared between patients and controls. The study was conducted at the "Ali Ebne Abi Talib" Hospital in Zahedan, Iran. The disease diagnosed and confirmed based on standard definitions of febrile convulsion. QT interval measured by ECG and interpreted by a pediatric cardiologist and collected data were analyzed with SPSS 19 considering 0.05 as significant error. Results Among the ECG parameters, HR, R in aVL, S in V3, LVM, QTd, QTc and QTcd were significantly different in children with febrile convulsion compared to the peers. From those who had abnormal QTd, FC children were more frequented but not significant (CHI SQUARE=1.053, p=0.248), when children with FC were more in abnormality regarding QTc (CHI SQUARE=13.032, p24 months (p>0.05). LVM had the highest value in the age group of >24 months significantly (CHI SQUARE= 52.674, P0.05). Conclusion From the study concluded that dispersion corrected QT, corrected QT and dispersion QT changed significantly in children with febrile convulsion in comparing with the healthy children but with constant values in children with FC in different age groups.

Objectives: To compare conventional echocardiography, aortic elasticity and lipid profiles in overweight or obese children with healthy controls. Methodology: This case control study was conducted on 49 obese or overweight children aged 4 to 16 years, equally matched in age and sex of control that were normal regarding body mass index. Echocardiography and aortic elasticity findings measured for both groups and lipid profiles measured for overweight or obese children only. Data analyzed by SPSS 20 considering 0.05 as significant level. Results: Most of the echocardiography findings such as LVDS(P130. Those who had abnormal LDL (>130) had lower value of AOS (p=0.017). Systolic BP was correlated with AD (p=0.007), Diastolic BP with AS beta Index (p=0.006), AoD with AS (p=0.002), with AD (p

Epilepsy and febrile convulsion are the most common neurological diseases with significant effect on cardiac functions. This study aimed to evaluate electrocardiography parameters alterations in epilepsy and febrile convulsion children compared with controls. In this comparison study, 270 children analyzed who shared equally in epilepsy, febrile convulsion, and healthy that aged from 0.5 to 5 years. The participants were collected from Ali ibn Abi Talib Hospital of Zahedan, Iran. Epilepsy confirmed based on definition of having at least two unprovoked seizures in 24 hours. Febrile convulsion was confirmed based on its definition by the International League against Epilepsy. Healthy children selected from those referred to the hospital with fever and without any underline diseases. Electrocardiography was performed by a pediatric cardiologist. Data were analyzed using SPSS 19 with p

Febrile convulsion (FC) is a seizure associated with body temperature that leads to electrocardiography changes. This article aimed to study electrocardiographic changes in children with FC as compared with healthy children. In this case–control study, 90 children aged 6 to 60 months were matched with equal healthy ones in “Ali Ebne Abi Talib” hospital in Zahedan, Iran. FC was confirmed by a neurologist based on its definition by the International League Against Epilepsy. Electrocardiogram (ECG) was captured by a pediatric cardiologist. Data were analyzed using SPSS 19. Sex distribution in groups was similar (p = 0.232). QT correction (QTc) was normal in 97.8 and 76.7% of controls and FC children, respectively (p 24 months, respectively (p

Cardiovascular diseases are the most common illness that needs special medical care in thalassemia particularly in children and adolescents. We aimed to compare aortic stiffness in thalassemia major and healthy children. The study included 65 asymptomatic thalassemia major 6 to 19-year–old children without known history of heart disease and 65 age- and sex-matched healthy controls. Arterial stiffness indices determined using two-dimensional (2D) and Doppler echocardiography. Data were analyzed by SPSS 20.0 with 0.05 as significant error. From the study, results showed that systolic (p = 0.009) and diastolic (p

There are inconsistencies regarding the association of blood lead level (BLL) in opium addicts with severe abdominal pain. In present study, we aimed to assess BLL in opium addicts presented with severe abdominal pain. This cross-sectional study was conducted on 60 opium-addicted individuals admitted to our rehabilitation center in Zabol city during February-October 2016. BLL was measured using potentiometric-stripping analysis (PSA) method. Statistical analysis was conducted in SPSS 20 software. From 60 addicts re-cruited, 47 (78.3%) were males. The mean age was 40.3±18.1 years old. The mean BLL was 43.1±117.4 µg/ dl. Considering a threshold of 18 µg/dl, 22 (37.6%) of the addicts had elevated BLL. The mean BLL in addicts with oral, inhalation and mixed method of consumptions were 54.9±1.5 µg/dl, 47.4±9.2 µg/dl, and 10.1±95 µg/dl respectively (P=0.5). No differences were found regarding the mean BLL among different age groups or between different genders. Furthermore, there were no significant difference in neither hematological pa-rameters or liver enzyme in addicts with normal and elevated BLL. The BLL was not of significant difference in addicts with different methods of opium usage and severe abdominal pain. It is recommended to investigate the effects of factors such as the duration of opium usage and the concentration of lead in opium to influ-ence BLL., Postoje nedosljednosti u vezi povezanosti razine olova u krvi (OUK) u ovisnika o opijumu s jakim bolovima na području abdomena. U ovome radu nam je bio cilj odrediti OUK u ovisnika o opijumu s jakim bolovima u trbuhu. Provedeno je presječno instraživanje na 60 ovisnika o opijumu primljenih u naš rehabilit-acijski centar u gradu Zabol od veljače do listopada 2016. OUK je mjereno metodom potenciometrijske strip-ing analize. Statističke analize su učinjene programom SPSS 20. Od ispitanih 60 ovisnika, 47 (78,3 %) su bili muškarci. Srednja dob je bila 40.3 ± 18.1 godina. Srednja vrijednost OUK je bila 43.1 ± 117.4 μg/DL. S obzirom na prag od 18 μg/DL, 22 (37,6 %) ovisnika imalo je povišeno OUK. Srednje vrijednosti OUK u ovisnika koji su sredstvo konzumirali peroralno, inhalacijski i mješano su iznosile 54.9 ± 1,5 μg/DL, 47.4 ± 9,2 μg/DL i 10.1 ± 95 μg/DL (P = 0,5). Nisu pronađene značajne razlike srednje vrijednosti OUK među različitim dobnim skupinama ili između spolova. Nadalje, nije bilo značajne razlike ni u hematološkim parametrima ili jetrenim enzimima u ovisnika s normalnim i povišenim OUK. OUK se nije značajno razlikovalo u ovisnika s različitim načinima konzu-miranja droge i jakim bolovima u trbuhu. Preporuča se istražiti kako čimbenici kao što su trajanje konzumacije opijuma i koncentracija olova u opijum utječu na razinu OUK.

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 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

Objective: Cardiovascular changes are related to some of epilepsy disorders such as seizures and breath holding. The study objective was to evaluate ECG findings in breath-holding and febrile convulsion compared to healthy individuals. Methodology: This Cross-sectional study was conducted on 270 children of 90 with febrile convulsion, 90 with breath-holding patients and 90 healthy children in 2019. Electrocardiography parameters of; QT interval, dispersion QT, corrected QT and dispersion QTc measured for participants. Consent form was asked to be signed by the parents before the study execution. Data analysis done by SPSS 20.0 considering 0.05 as significant error. Results: Females were 46(51.1%), 38(42.2%) and 35(38.9%) in control, febrile convulsion and breath holding, respectively. QTc was normal in 97.8%, 76.7% and 71.1% of controls, febrile convulsion and breath holding respectively. A significant association observed between QTc measures in different groups (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 Respiratory Distress (RD) is a life-threatening respiratory failure. This study aimed to evaluate the diagnostic value of N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) in distinguishing respiratory and heart diseases in neonates. Materials and Methods Hundred fifty neonates aged 2-3 days randomly collected from those who hospitalized in the related ward of the Ali Ebne Abitaleb Hospital, Zahedan, Iran. After sampling 2ml blood from venipuncture by trained nurse in the related ward separated serums performed in a laboratory. Then, 250 μl of the patients’ serum was isolated to assess NT- pro-BNP level using ELISA kit (USA). Data were analyzed using SPSS software version 20.0 with considering of P< 0.05. Results Mean of NT-pro-BNP in respiratory, Acyanotic, cyanotic and controls were 386.22±208.82, 384.83±183.74, 372.23±143.04, and 161.70-± 121.2, respectively. Weight, height and head circumference had different mean ranks for respiratory, Acyanotic, cyanotic and healthy groups, respectively (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

AimThis study was conducted to evaluate the effect of prebiotics on some common clinical ailments in healthy term infants. MethodsSixty healthy-term, breastfed (BF) infants were included. Along with these infants, 120 healthy-term formula-fed infants were randomly assigned to either the prebiotic formula (PF, n = 60) or regular formula (RF, n = 60) groups. Ready-to-use prebiotic-supplemented formula containing galacto-oligosaccharides and polydextrose (ratio 1:1) was used. ResultsAt 2 months of age, PF infants demonstrated significantly higher weight gain than BF and RF. At 6 months of age, bodyweight was significantly higher in the RF group compared to BF and PF groups (P < 0.05). Similar results were seen at 8, 10 and 12 months of age. At 10 months of age, the duration of diarrhoea was significantly shorter in PF-fed compared to the RF (P = 0.03) group. A significant difference was found between PF and RF (P < 0.0001) and BF and RF groups (P = 0.002) for diarrhoea duration. Means of constipation episodes per year were 0.03 0.18, 0.433 +/- 0.77 and 0.1 +/- 0.30 for the BF, RF and PF groups, respectively, with significant difference found between BF and RF (P = 0.006) and PF and RF (P = 0.02). The means of episodes of respiratory tract infections per year for BF, RF and PF groups were 1 +/- 0.69, 1.6 +/- 0.88 and 1 +/- 0.58, respectively (P = 0.01). ConclusionPrebiotic-supplemented and regular formula were similar to breast milk regarding prophylactic effects for diarrhoea, constipation and respiratory tract infections in the first year of life. Prebiotic-supplemented formula may be an appropriate substitution for breast milk when breast milk in unavailable.

Background Cystic Fibrosis (CF) is the most prevalent autosomal recessive disorder in the West, caused by mutation in Cystic Fibrosis transmembrane conductance regulator (CFTR) gene. This study focused on detecting three mutations in exon 4, 7, 10, and 17b of CFTR gene in CF patients among Baluch tribes settled in Zahedan, the district of Sistan and Baluchistan County, southeast of Iran. Due to the cultural and religious isolation and sectarian conditions of Baluch tribe members in Sistan and Baluchistan, also as a result of endogamous marriages, the present paper focused on these Baluch patients and was conducted in order to provide further effective diagnostic and medical care services. Methods Blood samples were collected from nine unrelated patients who were the only ones suffering from CF on the date and in the geographical site of the research registered in pediatric respiratory sections of Zahedan hospitals. All these patients had a CF clinical history and positive sweat test. The genomic DNA was extracted using salting-out method. The PCR primers were designed; PCR amplifications were carried out with the corresponding annealing temperature and run-in gel electrophoresis. The sequencing was performed via Sanger dideoxy method. Results Following the base wise alignment, CTT deletion occurred in exon 10, exactly located in F508del region, in samples number 2, 3, and 4. Conclusion Due to the cultural and geographical isolation of Baluch tribes in Sistan and Baluchistan County of Iran, F508del mutation could be identified in their population.

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: 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 Patent ductus arteriosus is an open channel between the aorta and pulmonary artery. The study aimed to evaluate the clinical course of patent ductus arteriosus after discharge and comparing in therapies technique. Materials and Methods This cross-sectional and inferential- descriptive study was performed in the hospitals of city of Zahedan-Iran in the period of one decade from 2005 to 2015. The study populations were all patients with patent ductus arteriosus (PDA) and these patients followed for at least one year after discharge from the hospitals due to the treatment with one of the Video-assisted thoracoscopic surgery (VATS), Amplatzer, surgery and medical techniques. 144 patients were assessed and the results of echocardiographic findings recorded in pre-determined data collection form and analyzed using SPSS version 15.0. Results No residuals for VATS treatment after hospital discharge, but in the Amplatzer the rate of residual was 13.3% when the higher rate of 20% was for surgery. The highest rate of residual for PDA closure was 23.5% in medical treatment. In the treatment methods comparison analysis in respect to the size left atrium-to-aorta (LA / AO) changes from one month to one year observed a significant difference in the methods of VATS, Amplatzer and Surgery in which illustrate the left heart cavities that represent a great relief due to passing time occurred. Conclusion From the study concluded that in the methods of VATS, Amplatzer and surgery a closed PDA needs time to become normal left chambers by changes in LA / AO, but in the medical method, not observed any changes in LA / AO. The results showed any residual due to VATS method after discharge from hospital, but surgeryandAmplatzerhad very low rates.

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.

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

Objectives: Sodium disorders are one of the most important electrolyte disturbances in children admitted to intensive care unit (ICU). The purpose of this study was to determine the frequency of electrolyte disturbances and the associated factors in pediatric intensive care unit (PICU) patients. Methods: All patients hospitalized in PICU of Ali Ebne Abi Talib Hospital during a year since October 2015 considered for the study. Electrolyte disturbances involving; sodium, potassium, calcium and magnesium were identified in PICU. Statistical tests were determined at 5% error level. Results: The prevalence of sodium, calcium and magnesium abnormalities was not significantly different in gender of patients (P > 0.05), but, the prevalence of hypokalemia (9.5% versus 1.7%) and hyperkalemia (37.8% vs. 31.3%) were higher in girls compared with boys. (P = 0.021). The rate of hyponatremia (29.3% vs. 13.1%) and hypernatremia (18.3% vs. 15.9%) in children who had died were significantly higher than in alive children. (P = 0.013). The prevalence of all electrolyte disorders was not significantly different from those of diuretics consumption (P > 0.05). Hyperkalemia though (41% versus 27.3%) was significantly higher in children with diuretic use than in other children. (P = 0.022). The frequency of electrolytes abnormalities in children was not significantly different between diseases (P > 0.05). Conclusions: The study concluded that the frequency of electrolytes was significantly different in deceased children compared to alive children. However, hyperkalemia was significantly higher in children with diuretic use than in other children. Therefore, it is much necessary to measure these electrolytes in course of hospitalization.

Background Different genetic and epigenetic variations are implicated in congenital heart diseases (CHDs). GATA4 and DNMT1 genes play an important role in embryonic heart development. We aim to investigate the correlation between rs4841587 in GATA4 and rs6999593 in DNMT1 genes with susceptibility and severity of symptoms in ventricular septal defects (VSDs) and tetralogy of fallot (TF) diseases in the southeast of Iran. Materials This case-control study was evaluated 200 children diagnosed with VSDs or TF as well as 200 healthy controls. SNPs genotyping were performed using T-ARMS-PCR. Odds ratio (OR) and 95% confidence interval (CI), as well as Chi-square, was used to assess the strength of the association. Results TT genotype at rs4841587 in GATA4 was associated with the susceptibility of CHDs (OR = 2.02, 95% CI = 1.06–3.83, P = .031). Rs4841587 was related with VSDs under the dominant model (GT + TT vs. GG: OR = 1.70, 95% CI = 1.08–2.65, P = .020). However, no significant differences were observed in genotype frequencies between TF cases and controls at this position. AG genotype at rs6999593 in DNMT1 was strongly correlated with the risk of CHDs (OR = 2.27, 95% CI = 1.43–3.60, P = .000). Significant differences also were found between AG genotype with VSDs (OR = 2.12, 95% CI = 1.19–3.77, P = .011) and TF (OR = 2.58, 95% CI = 1.19–5.57, P = .016). Conclusions rs4841587 and rs6999593 can be proposed as a significant marker for CHDs. Rs4841587 T/G polymorphism correlated with the susceptibility and severity of symptoms in VSDs. Moreover, rs6999593 A/G affects the susceptibility of VSDs and TF, in the southeast of Iran. However, further investigations are necessary to confirm these results.

BackgroundDiabetes type I (DTI) is one of the most common endocrine disorders during childhood and adolescents in which has strong impact on physical and emotional development of individuals with family members. We aimed to evaluate of stress, anxiety and depression in parents with DTI child compared with parents with healthy child.Materials and MethodsIn this case – control study, 60 parents of patients with type 1 diabetes, who had referred to the endocrine clinic of Ali Asghar hospital in Zahedan city and the same number of parents with healthy children, who had referred to the hospital for their children's routine checkup, as control group (n=60), were studied. Depression, anxiety and stress was measurement by Depression Anxiety Stress Scale 42 (DASS). Data were analyzed using SPSS-16.ResultsMean age of children was 6.3 ± 3.6 years. In this study, the score and rate of depression in parents of children with diabetes type I was 21.4 ± 13.8 and 75.4%, respectively. The scores of depression, anxiety and stress in parents of children with DTI were 21.4 + 13.8, 18.8 + 11.3 and 27.1 + 11.5 respectively. Also, the scores of depression, anxiety and stress in parents with healthy children were 14.8 ± 11.3, 8.7 ± 6.9 and 15.8 ± 9.3, respectively; and these scores was significantly lower in control group (P0.05).ConclusionDiabetes in children is a stressful event that can affect the public health of parents. Parents of children who diagnosed with DTI, are at risk for experiencing anxiety, depression and stress.

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.

Women experience several problems during the childbirth process which always remain with them throughout their lives. These problems affect the health of the mother and the child, the emotional relationship between them, the sexual activity and the desire to have her next child in the future. This qualitative study is designed to explore the experiences of primiparous women about natural childbirth problems. This qualitative study is conducted on primiparous women who referred to the health center of Imam Javad in Zahedan. The sample selection is based on objective; the data are collected using semi-structured interviews with 18 primiparous mothers who had healthy natural childbirth. The data are collected through an interview that is done in the first visit within 72 hours after the childbirth, and the data are analyzed through content analysis. After analysis of the data, four themes associated with the problem of the first natural childbirth are extracted. The first is the fear and stress of the labor pain that most participants expressed as the major problem of natural childbirth. The second theme is lack of awareness and lack of information about the process of labor and the delivery room environment; this means that participants of this study are mostly unfamiliar with the process of labor and the delivery room environment and this leads to their fear and pain. The other two themes are the need for protection and support of the mothers by the midwives, their family and their friends. Based on the results of this study, the problems of human resources are stated as being more serious than the problems regarding the environment and modern equipment. This leads to the increase of attention of the midwives and other medical staff on psychological and spiritual needs of mothers and supporting them during the labor in addition to the physical health of the mother and the fetus. In this regard, childbirth classes are recommended in outlining the stages of childbirth to improve the experience of primiparous women regarding natural childbirth.

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 respiratory distress (ARD) is a critical respiratory failure due to lung injury of neonates leading to the clinical appearance of poor lung compliance. The aimed of the study was to evaluate the diagnostic values in differentiating respiratory from heart diseases with using of N-terminal pro brain natriuretic peptide (NT-pro BNP) and Atrial natriuretic peptide(ANP) in neonates. Material and Methods: Ninety neonates randomly collected from those who hospitalized in the neonate ward of the Ali Ebne abitalib Hospital, Zahedan, Iran .After taking blood samples ANP and NT pro Brian Natriuretic peptide using ELISA kit were measured. The separated serum was kept in -20 °C until BNP measurement. 250 μl of the patients’ serum was isolated to assess pro BNP level using ELISA kit (USA). Data were analyzed using SPSS- 20 with considering of P< 0.05. Results: NT pro-BNP level had the highest in cardiac patients and followed by respiratory. The level of NT pro-BNP for control neonates had the lowest. These levels had significant variation (P

Background: It is suggested that constipation could be due to celiac disease (CD); therefore, this study aimed to determine the prevalence of positive tissue transglutaminase (tTG) IgA test among children with functional constipation (FC). Methods: In this case-control study, 182 consecutive patients with FC who fulfilled the Rome III criteria as cases were compared with 240 healthy children as the control group in terms of suspicious CD by measuring the serum tTG IgA level. Results: There was a significant difference in favor of the case group in terms of serum tTG IgA levels (P = 0.000). The probability of having CD would change based on belonging to each group (case/control odds ratio [OR] = 0.222). Conclusion: With respect to these data, tTG IgA level was observed to be significantly higher in patients relative to healthy children; therefore, it is recommended that patients be screened for CD through the tTG IgA.

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.