Evaluation of laboratory findings in children with wilson's disease in Emam Khomeini hospital during 1994-2003

Wilson's disease is a rare but treatable condition with variable clinical presentations. Its diagnosis depends on a combination of clinical and laboratory findings. We evaluated the clinical and laboratory findings in children with Wilson's disease [WD]. Twenty-seven children [4-14 years, 59.2% male, 40.7% female] with confirmed WD were evaluated between 1994 and 2003 at Imam Khomeini Hospital. Seventeen patients [64%] presented with liver abnormalities, 3[11%] with neurological features, 3[11%] with fulminant hepatic failure and 4[14%] were asymptomatic siblings of patients with WD. The presence of Kayser Fleischer rings, high urine copper excretion, low ceruloplasmin level, and elevated liver copper concentration were detected in 51.8%, 77.7%, 92.5% and 72.7% of patients respectively. We emphasize on clinical findings together with one or more laboratory findings as a diagnostic guide in WD and also recommend evaluation of serum ceruloplasmin level and 24 hour urine copper excretion particularly when liver biopsy may not be obtained

Evaluation of triple and quadruple regimens in eradication of helicobacterpylori infection in pediatric patients inEmam Khomeini hospital in 2002-2003: a randomized clinical trial

Triple therapy with a proton pump inhibitor, clarithromycin and amoxicillin and quadruple therapy with a proton pump inhibitor, bismuth citrate, metronidazole and amoxicillin have been proposed in Maastricht 2000 as the optimal treatment of Helicobacterpylori infection. We aimed to compare these two regimens in Iranian pediatric patients.Arandomized clinical trial in Emam Khomeini Hospital between 1381 and 1382 was done. Patients with confirmed H. pylori infection by histology were divided in to two groups in a randomized 1:1 scheme.Triple regimen group: Clarithromycin 15 mg/kg/d, Amoxicillin 50 mg/kg/d and Omeprazole 1 mg/kg/day for 10 days.Quadruple regimen group: Omeprazole 1 mg/kg/d, Amoxicillin 50 mg/kg/day, Met-ronidazole 20 mg/kg/day and Bismuth citrate 8 mg/kg for 10 days. The eradication was assessed by c-urea breath test 4 weeks after the end of treatment and by perprotocol analysis.In our study, 100 patients [50 in each group] were found and the eradication rates in the triple and quadruple group were 92% and 84% respectively [p= 0.046].According to our results, we recommend triple therapy as first-line treatment in Iranian pediatric patients and quadruple therapy as a second line regimen