Electrocardiographic Changes in Children With Acute Opioid Poisoning: A Cross-Sectional Study.

OBJECTIVES: Opioid poisoning in children is a common pediatric emergency in Iran. The emergence and spread of new synthetic opioids have come up with new consequences in case of toxicity. In this study, we aimed to evaluate electrocardiographic changes in children with acute opiate poisoning. METHODS: This cross-sectional study was performed on all children with opioid poisoning admitted to the emergency ward of Vali-e-Asr Hospital, Birjand, Iran, from December 2015 to February 2017. Data (demographics, manifestations, clinical course, and outcome) were collected using a predesigned checklist. An electrocardiogram (ECG) was obtained and evaluated for arrhythmias, corrected QT interval (QTc), and other ECG indices. Data were analyzed using SPSS version 21. A value of P less than 0.05 was considered statistically significant. RESULTS: A total of 85 children were enrolled in this study. Most of them were male (51.8%). The mean age of the patients was 3.46 ± 3.36 years. Among these children, 38.8% were poisoned with synthetic opioids (methadone). Mean QTc length was 399 ± 24 milliseconds in nonsynthetic opioid poisoning and 407 ± 66 milliseconds in methadone poisoning, and it was prolonged (>450 milliseconds) in 3.5% of cases. Other ECG changes were limited to 1 U wave formation (1.2%) that was detected in a patient with methadone poisoning. CONCLUSIONS: Electrocardiogram changes due to acute opioid toxicity in children are not common, although in the case of methadone poisoning, long QT interval and associated arrhythmias should be anticipated. Moreover, because of life-threatening effects of opioids such as respiratory insufficiency and decreased consciousness, it is necessary to be prepared for these conditions.

Lipid Profiles and Prevalence of Dyslipidemia in Eastern Iranian Adolescents, Birjand, 2012.

BACKGROUND: Cardiovascular risk factors begin in childhood and adolescence. This study aimed at assessing serum lipids and prevalence of Dyslipidemia in 11-18 year old students of Birjand. METHODS: The present cross-sectional, descriptive, and analytical study was done on 2,643 middle and high school students of Birjand aged 11-18 years (1,396 girls and 1,247 boys). Blood samples were collected for the measurement of blood lipids, including Cholesterol, Triglyceride, HDL, and LDL after a 12-hour fasting period. The defined borderline and abnormal values stated in 2011 by the American Academy of Child, was used. RESULTS: According to our results, it is concluded that: (i) 34.3% (31.3% girls and 37.6% boys) of adolescents had at least one dyslipidemia. (ii) 24.7% of the individuals had HDL lower than 40, where 14% of them TG≥130, 6.1% of cases TC≥200, and 3.5% of cases LDL≥130. Lipid disorder within low HDL type and hypertriglyceridemia were significantly higher in boys (P<0.05) than girls. Hypercholesterolemia and hypertriglyceridemia in the age group of 11-14 years and low HDL in the age group of 15-18 years showed the highest values (P<0.05). CONCLUSION: Adolescents of Birjand have high prevalence of dyslipidemia. Preventive measures are recommended to improve lifestyle, including healthy nutrition, encouraging adolescents to exercise, and more mobility.

The relationship between serum lipids and obesity among elementary school in Birjand: a case control study.

BACKGROUND: Childhood obesity could induce some risk factors for cardiovascular disease (CVD) including serum lipid abnormalities, hypertension, and atherosclerosis. The present study aimed to comparison the lipid profile in normal children with cases having overweight, obesity and central obesity. METHODS: In this case control study, which was conducted 2013, serum lipids for three groups of children including cases with overweight (Body mass index (BMI): 85-95th percentiles to age and sex and waist circumference (WC) <90th percentile to age and sex = Case group1), central obesity without general obesity (BMI <85th percentiles and WC ≥ percentile 90 = Case group 2) and central obesity with general obesity (BMI ≥95th percentile and WC ≥ percentile 90 = Case group 3) were compared with control group (BMI < 85th percentiles WC <90th percentile). Data were analyzed using software SPSS-16 by chi-square and ANOVA tests at significance level α=0.05. RESULTS: Each group consisted of 100 individuals. The highest mean of serum lipids and the highest extent of dyslipidemia existed in the children having central obesity along with general obesity. So that 49%, 28%, and 38% students of this group show hypertriglyceridemia, hypercholesterolemia, and low high-density lipoprotein cholesterol (HDL-C). Odd ratio of hypertriglyceridemia, hypercholesterolemia and low HDL-c, in children with at least one abnormal index (BMI and /or WC) compared with control group were 3.73 (95% CI: 1.98, 6.99), 1.37 (95% CI: 1.71, 2.65) and 2.98 (95% CI: 1.51, 5.87), respectively. CONCLUSIONS: With regard to the relationship between central obesity and adverse changes in lipid profiles, the screening children for central obesity to prevention of cardiovascular disease are recommended.

Prevalence of abdominal obesity in adolescents 2012, birjand, East of iran.

BACKGROUND: Prevalence of obesity in children has been increased during recent decades all over the world. Obesity, particularly, abdominal obesity (AO) is associated with the risk of metabolic syndrome and cardiovascular disease. This study aimed to assess obesity and central obesity within students aged 11-18 of Birjand city. METHODS: This cross-sectional and descriptive- analytical study was conducted on 2458 secondary and high school students, including 1345 girls (54.8%) and 1113 boys (45.2%), who had been selected from Birjand Middle and high schools through multiple-cluster sampling in 2012. For determination of AO, waist circumference and the percentage 90 or more regarding age and sex were used. The obtained data were analyzed by using statistical t-tests and χ(2) at the significant level P < 0.05. RESULTS: Among the studied students, average 16.3% (20% of boys and 13.2% of girls) had AO. The obtained data about these two groups shows statistical significant difference of P < 0.001. Chance of AO in boys was 1.6 times greater than that of girls. Odds ratio (OR) = 1.6 (confidence interval [CI]: 1.3-2.1). It was 1.9 times more about under 15-year-old than over 15 aged subjects. OR = 1.9 (CI: 1.5-2.4). CONCLUSIONS: Regarding high prevalence of AO in Birjand adolescents, it is recommended that adolescents and their families should be warned for long-term outcomes of obesity on quality-of-life. Periodic studies are suggested for awareness of obesity trends in the coming years.

Prevalence of overweight, obesity and central obesity among elementary school children in Birjand, east of Iran, 2012.

BACKGROUND: Prevalence of obesity in children has been increasing during recent decades all over the world. Obesity, particularly central obesity, is associated with metabolic syndrome and cardiovascular diseases. The present study aimed to assess obesity and central obesity in 6-11 year old Birjand elementary school children, East of Iran. METHODS: This cross-sectional study was conducted on 1541 elementary school children, i.e. 851 girls and 690 boys, selected from Birjand elementary schools through multiple-cluster sampling in 2012. In order to determine overweight and obesity the percentile of CDC was used, so that, 85-95th percentile were taken as overweight and >95th percentile was defined as obese with respect to age and sex. For determination of central obesity, waist circumference and the ≥90th percentile were used regarding age and sex. The obtained data was analyzed by means of SPSS software (V: 15) using t and chi-square statistical tests at the 0.05 significant level. RESULTS: Out of the studied children, 9.6% (11% of boys and 8.3% of girls) were overweight and 9.2% of children (i.e. 10.9% of boys and 7.9% of girls) were obese. About 15.7% of children (i.e. 20.3% of boys and 12% of girls) had central obesity. CONCLUSIONS: Regarding high prevalence of obesity, central obesity, and overweight in Birjand elementary school children, it is recommended that families should be provided with necessary information with respect to correcting life-style and preventing obesity in children.