Tehran University Medical Journal

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Background: Cardiotoxicity of anthracyclines (ANTs) in medium and high doses (more than 350 mg/m2) has been already known but it is still unclear whether or not minimal doses (lower than 350 mg/m2) can also affect cardiac function. The goal of this study was to assess the cardiotoxicity of ANTs in children under minimal doses and evaluation the association of this toxicity with probable risk factors such as age at beginning of regimen, gender or type of malignancy. Methods: In a prospective study 50 children suffering from different malignancies ad-mitted in pediatric oncology department of Besat Hospital of Sanandaj City in 2010 to 2012, under ANTs regimen (Daunorubicin, Doxorubicin) in doses lower than 350 mg/m2 were followed by serial echocardiography for 1-3 years. The deviation from normal values of echocardiographic parameters was measured for all patients in this period and even one parameter's deviation was considered as cardiac dysfunction and ANTs cardi-otoxicity. The association of this toxicity and probable risk factors was analyzed by proper statistical methods in SPSS 18th version. Results: In 22% of patients, mostly children older than 11, at least one of echocardio-graphic parameters including: ejection fraction (EF), left ventricular end systolic diame-ter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular mass (LVM) and left ventricular posterior wall diameter (LVPWD) changed during our follow up. The most important risk factor for cardiotoxicity in this study was age at beginning of ANTs regimen. Acute myeloid leukemia (AML) had the most abnormal values among all types of malignancies. In this study there was no statistically significant as-sociation between cardiotoxicity and gender or duration of follow up. Conclusion: Anthracyclines even in doses lower than 350 mg/m2 can induce cardiac dysfunction and alter echocardiographic parameters, although these changes are not always accompanied by clinical signs or symptoms as they were in this study. So long term echocardiographic follow up and cardioprotective techniques are recommended in prescription any doses of these cardiotoxic drugs.

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Enuresis is the inability to control urination during sleep. It is one of the most common childhood urologic disorders. Nocturnal enuresis refers to the occurrence of involuntary voiding at night after 5 years. Persistent nocturia can decrease self-esteem, increase anxiety and other emotional problems in children. The aim of this study is to evaluate the factors affecting nocturia amongst school-aged children. Methods: This cross- sectional study was conducted on 200 children over a period of 3 months from 21 April to 22 July 2014 (. Subjects of this study included 200 children (100 boy and 100 girl) aged 6 to 12 years that referred to the urology clinic. Following the written consent, patients under study were divided into two groups according to gender. A questionnaire concerning the personal data was completed for each patient. Questionnaires were completed by interviewing parents. Results: Our investigation revealed that 32% of children had nocturnal enuresis. The Chi-square test demonstrated significant differences between the case and control groups in terms of gender (P= 0.002), positive family history (P= 0.004), deep sleep (P= 0.005) and high fluid intake (P= 0.00). Significant differences were not observed among enuretic children with parents' education level, income, number of family members, birth order, history of injury and hospitalization, birth of a new baby, moving house, problems at school and home, snoring, mouth breathing, urinary tract infections, constipation (P> 0.05). Conclusion: In order to control enuresis it seems essential to provide information about nocturia and its etiologic factors to the children and their parents by the physician.

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Background: Urinary tract infection is a common infectious disease in children and associated with the risk for renal scarring and long-term complications, usually consists of pyelonephritis and may cause complications such as scars in kidney, hypertension and renal failure. Some studies demonstrated association between urinary tract infection and electrolyte disturbances such as hyponatremia. The present study has been designed for assessment of association between urinary tract infection and hyponatremia in children.

Methods: This is a descriptive, cross-sectional study has been conducted on 120 children have referred to the Golestan Hospital, Ahvaz Jundishapur University of Medical Science from 21 March 2011 until 20 March 2013. A total of 120 children who were aged 6 months to 12 years and had febrile urinary tract infection. The study population and were classified into two group of sixty children: hyponatremic and nonhyponatremic. We compared the laboratory findings in two groups with each other. The data included serum sodiom level, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ddimercaptosuccinic acid (DMSA) scan results collected from children with febrile urinary tract infections admitted in pediatric ward. Data analysis was performed using descriptive statistics, chi-square and independent T-test with SPSS software, ver. 20 (IBM, Armonk, NY, USA).

Results: In this study, 120 patients, 104 females (86.7%) and 16 males (13.3%) aged six months to 12 years were evaluated. All the patients were studied in terms of positive DMSA Scan. In the first group (hyponatremic) 31, and the second group (without hyponatremia) 13 patients were identified. There was a significant association between hyponatremia and WBC count, ESR, CRP, duration of fever and abnormal DMSA scan. Conclusion: We conclude that there is significant association between hyponatremia and severity of urinary tract infection in children.