Ataei N, Safaian B, Madani A, Esfahani St, Ataei F,
Volume 67, Issue 2 (5 2009)
Abstract
Background: Early diagnosis of renal parenchymal involvement in children with acute
pyelonephritis (APN) using isotope scan and early treatment may decrease or prevent
development of renal parenchymal lesions. We designed this study to assess the
diagnostic value of certain biologic parameters in children with first- episode of acute
pyelonephritis (APN) documented by 99m Tc-dimercaptosuccinic acid (DMSA)
scintigraphy.
Methods: We compared the laboratory findings of leukocyte count, erythrocyte
sedimentation rate (ESR) and serum C-reactive protein (CRP) levels with the results of
the DMSA scans obtained within three days of admission. One hundred-two children (93
girls and 9 boys aged 1 month–12 years (mean 2.85±2.92 years) were enrolled in the
study. Of these patients, 203 renal units, were investigated using scintigraphy. Voiding
cystourethrography (VCUG) was performed in 98 children (195 renal unit) when urine
culture became negative.
Results: In all children one or both of kidneys had parenchymal involvement on
scintigraphy. Changes on the DMSA scan were found in 178(88%) renal units during the
acute phase. The extent of changes in DMSA scan were mild in 113/178(55.7%) renal
units, moderate in 40/178(19.7%) and severe in 25/178(12.3%). When inflammatory
markers were correlated with the development of the severe renal lesions, as assessed
with DMSA scan, a highly significant correlation with both ESR (p=0.007) and leukocyte
counts (p=0.02) were found.
conclusions: We conclude that the incidence of renal parenchymal involvement in
Iranian children with APN is very high. Although increased ESR and leucocytosis may
be valuable markers for determination of severe renal parenchymal involvement, but
these parameters and also CRP, were inadequate in distinguishing mild to moderate
renal parenchymal involvement.
B Safaian, S Shokri, S Mohamadian, F Cheraghali, L Joibari, S Aryan Nejad, T Ramim,
Volume 71, Issue 2 (5 2013)
Abstract
Background: Serum estradiol level is a controversial prognostic factor in the outcome of labial adhesion. The aim of this study was to evaluate serum estradiol levels and topical estrogen response in patients with labial adhesion.
Methods: A prospective interventional study was conducted among girls with labial adhesion that referred to Pediatrics clinic in Taleghani University Hospital, Gorgan city, Iran in 2011. One hundred patients entered the study. The diagnosis was conducted by clinical examination of vestibule area. Inclusion criteria were, three months to eight years old prepuberty girls, no ambiguous genitalia, lack of vulvovaginitis symptoms, labial adhesion more than twenty five percent, no history of previous topical estrogen treatment since two weeks ago and previous incomplete treatment. The patients who did not use proper amount and duration of drug and also with adverse drug reactions during treatment period were excluded from the study.
Results: The maximum frequency of labial adhesion was in the group of less than one year old. The minimum frequency of labial adhesion was in the 7-8 years old group. Eighty six patients had complete or partial remission. No evidence of an improvement was observed in fourteen children. Severity of adhesions did not worsen in our patients. Serum estradiol levels were lower in patients who had a positive response to treatment. There were significant differences in serum estradiol levels between full or relative improvement with no improvement groups (P=0.044).
Conclusion: Findings of this study showed that the labial adhesion patients with low serum estradiol level had better treatment response after using topical estrogen.
