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The article in the Current Journal of Neurology discusses a rare case of polyneuritis cranialis in a 9-year-old boy, presenting with ocular, speech, and swallowing problems. The boy had lower motor neuron facial palsy involving multiple cranial nerves, with symptoms appearing after a flu-like illness and bloody diarrhea. The patient responded well to intravenous immunoglobulin treatment, showing full recovery. The article highlights the importance of considering post-infectious cranial polyneuropathy in cases of multiple cranial nerve involvement, emphasizing the need for early diagnosis and intervention for optimal outcomes. [Extracted from the article]

Background: Guillain-Barre syndrome (GBS) is a post-infectious immune-mediated peripheral neuropathy, progressing bilaterally and often symmetrically and affecting sensory and motor function. Most cases completely recover, but around 20% of cases may lead to complications, incomplete recovery, or even death. Objectives: This study aims to assess the prognosis of GBS in pediatric patients and possible associated conditions regarding recovery or prognosis. Methods: We investigated 71 cases of GBS admitted to Mofid Pediatric Hospital from March 2014 to March 2017. Demographic, clinical, and laboratory data were retrospectively recorded and analyzed. Two follow-up visits were performed after 1 to 3 and 5 to 8 years from onset, according to the GBS Disability Scale, and recovery of motor function was assessed during patients' visits to the clinic. Results: We found 35 male and 36 female subjects with an average age of 6.17 ± 3.82 (range 0.9 up to 15 years old); cases were mostly presented with myalgia and weakness (78.9%) followed by headache, found in 5 patients (7%). Around 84.5% of patients had an upper respiratory infection as their antecedent infection. Fifteen cases of autonomic dysfunction were observed, and 15 patients had cranial nerve involvement. Most cases had the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) form of GBS on electrophysiologic tests. Analysis showed onlyaxonal involvement was significantly correlated with poor prognosis (P-value<0.05), and other variables were not significantly correlated. Conclusions: Compared to the current literature, we found fewer autonomic dysfunctions, cranial neuropathies, and a smaller percentage of AIDPs in our data. Altogether, the axonal form of GBS is reported as a predictor of an unfavorable prognosis in GBS patients. [ABSTRACT FROM AUTHOR]

Introduction: Hydronephrosis, a condition that is mostly congenital, is considered as the most common type of pediatric urinary tract disorder. The aim of this study was the evaluation of the prognosis and outcomes of hydronephrosis in cases of congenital hydronephrosis.Methods: In a cross-sectional study, run in a tertiary clinic of pediatric nephrology, from 2015 to 2020, patients with fetal hydronephrosis were selected. Ultrasonography, urinalysis and kidney function tests were ordered for all patients and in the presence of hydronephrosis, repeated ultrasonography, voiding cystourethrography and dimercaptosuccinic acid scan were performed. In cases with evidence of obstruction, a diethylenetriamine pentaacetic acid scan and relative surgical procedures were performed.Results: Among 141 cases, mean age was 8 ± 1.4 years and 80.9% were male. Partial or complete obstruction in the right and left kidney was found in 16.3 and 24.8% of patients, respectively. The degree of hydronephrosis was mild in 46.1%, moderate in 39%, and severe in 9.2% of the patients. At the last follow-up period, hydronephrosis recovered in 46% of the patients, while 54% experienced persistence or exacerbation of the disease. Meanwhile, 7.1% of patients showed neurogenic bladder, 19.1% urinary tract infection and 22.7% urinary stones.Conclusion: Our study revealed that fetal hydronephrosis ends in complete recovery following birth in 46% of the cases. However, in cases experiencing persistent or exacerbating hydronephrosis, optimized treatment and/or surgical intervention are required.  DOI: 10.52547/ijkd.6516. [ABSTRACT FROM AUTHOR]

Objectives Spinal cord tumors are rare in children, mostly presented with unspecific symptoms that might pose a problem due to their possible malignancy and further complications. However, there are limited data on spinal cord lesions in Iran. This study aimed to present a series of 37 cases of primary spinal tumors treated at the same institution and briefly review their pathology, symptoms, and site of occurrence. Materials & Methods In this study, 37 cases of spinal cord tumors and masses were selected within March 2007-2017, excluding spinal dysraphism. The data on age, gender, clinical presentation, location of the mass, and pathology were retrospectively collected. Results The mean age at diagnosis was 5 years and 8 months (standard deviation: 4.1 years). Moreover, 21 and 16 cases were male and female, respectively (male-to-female ratio: 1.31). Pathological findings included 9 neuroepitheliomas (i.e., 6 neuroblastoma, 2 ganglioneuroma, and 1 ganglioneuroblastoma/ganglioneuroma), 4 ependymomas, 3 primitive neuroectodermal tumors, 3 glial tumors, 4 neurodevelopmental tumors, 3 lymphomas, 1 hemangiopericytoma, and 1 neurofibroma. In addition, 26 (74.2%), 14 (40%), 6 (16.6%), and 4 (11.4%) patients had motor symptoms, pain, sensory symptoms, and urinary symptoms, respectively. The most common location of occurrence was the lumbosacral region. Conclusion In conclusion, while differing in pathological composition and location of tumors in comparison to other papers, this study presents possible presentations and/or expected pathologies in pediatric spinal cord tumors. [ABSTRACT FROM AUTHOR]

Introduction: Abdominal pain, in particular appendicitis, is a common cause of emergency department visits in children. Therefore, early diagnosis is very important. There are different scoring systems for the diagnosis of appendicitis. This study is the first study to evaluate the performance and accuracy of pediatric appendicitis score (PAS) in Iranian children with abdominal pain in emergency departments. Methods: This is a cross-sectional study of children under 18 years with suspected appendicitis who were referred to the emergency medicine department of hospitals affiliated to SBMU during 2015. Acute appendicitis was determined according to pathological findings, and final PAS scores were calculated for all children. With statistical analysis, comparison between two groups was calculated and the diagnostic accuracy of PAS score was estimated. Results: 88 children with mean age of 10.5 ± 3 were studied. According to clinical examination 58 of the children were suspected to have acute appendicitis and 30 others were healthy. In current study, the diagnostic accuracy and precision of PAS at cutoff of 5.5 in patients younger than 18 years admitted to the emergency department with suspected acute appendicitis was 91% and 92%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 93.88%, 86.21% and 92%, 89.29%, respectively. Conclusions: The results of current study showed that PAS has high diagnostic predictive value for the diagnosis of acute appendicitis in children under 18 years and due to the advantages listed for this score, its use is recommended for children in emergencies. [ABSTRACT FROM AUTHOR]

Introduction: Renal diseases can be asymptomatic even in progressive disorders; therefore, detecting urine and ultrasound abnormalities may help facilitate early diagnosis and prevention of renal diseases. This study was conducted to investigate random urine parameters and urinary system ultrasonography findings in 7-11 year-old students. Materials and Methods: Healthy students from Tehran and Qom, Iran were enrolled in a prospective descriptive study and their sex, age, weight, height, and BMI were measured. Then, a fresh clean urine sample was collected and ultrasonography of the urinary tract was done. The urine specimen was tested for urine Ca/Cr, urine oxalate/Cr, and urine citrate/Cr. Results: Of 932 students, 47.9% were female and 52.1% were male. The age range of the students was 7-11 years with a mean age of9.08 years. A history of renal disease and UTI was positive in 1.1% and 9.9% of the students, respectively. Ultrasound was normal in78% and abnormal in 22% of the students. Abnormal findings included hydronephrosis in 1.1%, fullness of the urinary tract in 0.1%, urinary system duplication in 3%, urolithiases in 0.7%, decreased kidney size in 0.4%, increased bladder thickness in 8.9%, and other abnormal findings in 7.8% of the subjects. Abnormal urine findings included hypercalciuria, in 10.9%, urine hyperuricosuria in 5.4%, urine hyperoxaluria in 12.8%, and hypocitraturia in 96.9% of the students. Conclusions: According to the results, nephrolithiasis may be due to hyperoxaluria, hypercalciuria, and hyperuricosuria in a normal population. Genetics and nutrition are more important risk factors. Therefore, some nutritional interventions for decreasing urine oxalate, calcium, and uric acid may be beneficial. [ABSTRACT FROM AUTHOR]

Introduction: Addiction imposes a large medical, social and economic burden on societies. Currently, there is no effective treatment for addiction. Our struggle to decipher the different mechanisms involved in addiction requires a proper understanding of the brain regions which promote this devastating behavior. Previous studies have shown a pivotal role for insula in cigarette smoking. In this study we investigated the change in opium consumption after CVA. Methods: This study took place in three referral academic hospitals affiliated to Tehran University of Medical Sciences. Patients who suffered a CVA and were addicted to opium were recruited during their hospitalization or visit to the neurology clinic in this study. Age, sex and the route and mean amount of opium use of each patient before CVA and 1, 3 and 6 months post-CVA was asked using a questionnaire. The patients were divided into three groups based on the location of brain ischemia (insula, basal ganglia and non-insula non-basal ganglia group). Results: Seventy five percent of the patients with ischemia of the insula changed the route or amount of opium use after CVA and 37.5% of them stopped opium use after CVA. These values were significantly higher than patients with non-insula non-basal ganglia ischemia (p values 0.005 and 0.03 for change in route or amount and stopping opium use, respectively). This was not true in patients with ischemia of the basal ganglia. Younger patients were more likely to change the route or amount of opium use and stop opium use after CVA (p values 0.002 and 0.026, respectively). Discussion: The results of the present study indicate a possible role for the insula in opium addiction, especially in younger individuals. [ABSTRACT FROM AUTHOR]

Background: COVID-19 infection and its neurological manifestations were seen in children although less common than adults. The aim of this study was to determine the frequency of different types of neurologic findings of hospitalized children with COVID-19. Methods: This retrospective study was performed on hospitalized pediatric patients aged ≤ 18 years with confirmed SARS-CoV-2 at Children's Medical Center Hospital. Neurological manifestations were defined as the presence of any of the following symptoms: seizure, altered mental status, behavioral/personality change, ataxia, stroke, muscle weakness, smell and taste dysfunctions, and focal neurological disorders. Results: Fifty-four children with COVID-19 were admitted and their mean age was 6.94 ± 4.06 years. Thirty-four of them (63%) were male. The most frequent neurological manifestation was seizure (19 [45%]) followed by muscle weakness (11 [26%]), loss of consciousness (10 [23%]), and focal neurological disorders (10 [23%]). Other neurological manifestations consisted of headache (n = 7), movement disorders (n = 6), behavioral/personality change (n = 5), ataxia (n = 3), and stroke (n = 3). Twenty-nine percent of our patients had leukocytosis. A neutrophil count above 70% was seen in 31% of participants. Among our patients, 81% had a positive reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2. Conclusion: During the current pandemic outbreak, hospitalized children with COVID-19 should be evaluated for neurological signs because it is common among them and should not be under-estimated. [ABSTRACT FROM AUTHOR]

Introduction. Assessment of the hemodialysis adequacy is one of the key factors in evaluating health service system. This would provide a good background for effective future planning by healthcare authorities. In this study, we aimed to evaluate the hemodialysis adequacy in Iran. Materials and Methods. One hundred and twenty-seven hemodialysis centers affiliated to 30 medical universities in Iran participated in this cross-sectional multicenter national study. All demographic data as well as hemodialysis prescription data, including blood flow rate, length of the hemodialysis session, hemodialysis membrane type, and composition of the dialysis solution were recorded for each patient. In addition, urea reduction ratio and Kt/V were calculated to determine the hemodialysis adequacy. Results. A total of 4004 patients were included in this study, 2345 men (58.6%) and 1659 women (41.4%). Bicarbonate-based solutions and low-flux membranes were prescribed for 77.0% and 97.6% of the patients, respectively. The mean blood flow rate was 242.9 ± 39.2 mL/min. The mean length of hemodialysis session was 229.2 ± 22.2 minutes. The mean urea reduction ratio and Kt/V were calculated to be 61.0 ± 11.8% and 1.2 ± 0.4, respectively. A Kt/V less than 1.2 and a urea reduction ratio less than 65% were found in 56.7%, and 65.2% of the hemodialysis patients, respectively. Conclusions. This study showed a substantial inadequate hemodialysis in Iran as compared with the Kidney Disease Outcomes Quality Initiative guidelines. Considering the impact of dialysis adequacy on quality of life and survival rates, as well as healthcare costs, rigorous attempts to achieve the desired goals are necessary. [ABSTRACT FROM AUTHOR]