New treatment protocol for primary nocturnal enuresis in children according to ultrasound bladder measurements

To evaluate the response rate of various modalities of therapy in primary nocturnal enuretic children according to the ultrasound bladder volume and wall thickness index [BVWI] measurements. From February 2006 to November 2007, a total of 31 children, aged 6-12 years old were enrolled in a clinical trial. Based on BVWI they were divided into 3 groups as follows: Group 1 [BVWI <70%] was treated with oral desmopressin and oxybutynin; Group 2 [BVWI 70% to <130%] was treated with oral desmopressin. Group 3 [BVWI >130%] was treated with oral desmopressin accompanied by double-voiding technique and scheduled voiding. All of them were treated for 3 months. Significant reductions in mean bed-wetting frequency before and after first treatment cycle were observed in all groups [p<0.05]. The complete response rate was 70% in Group 1, 25% in Group 2, and 20% in Group 3. Overall, the complete and partial response rate was 9/10 [90%] children in Group 1, 13/16 [81%] in Group 2, and 3/5 [60%] in Group 3. Bedwetting frequency significantly decreased at the first and second treatment cycles in Group 2 [p<0.05] for each pair wise comparison. The proposed treatment representation according to ultrasound BVWI measurements achieves favorable response rates in children with PNE. We suggest that this treatment should be used to develop the management of enuresis in children

Prevalence and severity of anemia in pediatric hemodialysis patients

To determine the prevalence and severity of anemia, and to identify independent predictors for anemia in children on hemodialysis. We conducted this cross sectional study on 25 children aged 7?20 years receiving hemodialysis from September 2005 to January 2006 in Isfahan University of Medical Sciences, Isfahan, Iran. A total of 22 [82%] patients had hemoglobin [Hb] level of <11 g/dL [anemia] and 12 [48%] patients had Hb values <8 g/dL [severe anemia]. The mean age was 15.5 +/- 3.7 years. Mean time on hemodialysis was 20.44 +/- 15.25 months. Anemia was more common and severe among children who were on dialysis <6 months. There was an inverse relation between severity of anemia and duration of hemodialysis [r=-0.465, p=0.019]. Nearly all patients were treated with recombinant human erythropoietin [rHuEPO]. Children with severe anemia received a slightly higher dose of erythropoietin [r=0.202 p=0.09]. There was a correlation between serum albumin and Hb level [r=0.511, p=0.01]. Intact parathyroid hormone [iPTH] levels were >200 pg/mL in 16 patients [66%] and >400 pg/mL in 9 patients [37.5%]. There was a reverse correlation between iPTH level >200 pg/mL and Hb level [r=-0.505, p=0.046]. The prevalence of anemia in our study appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients who were on dialysis <6 months and with low albumin and severe hyperparathyroidism

Prevalence and severity of anemia in pediatric hemodialysis patients; a single center study

To determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis and to identify independent predictor for anemia in children on hemodialysis. A cross sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7?20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan, Iran. A total of 22 [82%] patients had hemoglobin level of<11 g/dL [anemic] and 12[48%] patients had hemoglobin values<8 g/dL [severe anemia]. The mean age for these patients was 15.5 +/- 3.7 years and the mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was a inverse relation between severity of anemia and duration of hemodialysis [p=0.019, r=-0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P=0.09, r=0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [p=0.023]. There was a correlation between serum albumin and hemoglobin level [r=0.511, P=0.01]. Parathyroid hormone [PTH] levels was>200 pg/ml in 16 patients [66%] and>400 pg/ml in 9 patients [37.5%]. There was a reverse correlation between PTH level>200 pg/ml and hemoglobin level [r=-0.505, P=0.046]. The prevalence of anemia in children on hemodialysis in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months], low albumin and severe hyperparathyroidism

Prevalence and severity of anemia in pediatric hemodialysis patients, a single center study

This study was conducted to determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis, and to identify independent predictors of anemia in children on hemodialysis. This cross-sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7+20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan. A total of 22 [88%] patients had hemoglobin levels of <11 g/dL [anemic] and 12 patients [48%] had hemoglobin levels of <8 g/dL [severe anemia]. The mean age of these patients was 15.5 +/- 3.7 years. Mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was an inverse relationship between the severity of anemia and duration of hemodialysis [P = 0.019, r = - 0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P = 0.09, r = 0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [P = 0.023]. There was a correlation between serum albumin and hemoglobin level [r = 0.511, P = 0.01]. Intact PTH levels were >200 pg/ml in 16 patients [66%] and >400 pg/ml in 9 patients [37. 5%]. There was a reverse correlation between intact PTH level >200 pg/ml and hemoglobin level [r = -0.505, P = 0.046]. The prevalence of anemia in hemodialysis children in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months] and in those with low albumin and severe hyperparathyroidism

epidemiological study of enuresis among primary school children in Isfahan, Iran

To estimate the prevalence of enuresis in primary school children in Iran and to determine the factors associated with this disorder. A cross-sectional time-ordered study was performed at the Faculty of Medicine, Isfahan Medical University, Isfahan, Iran from September 2005 to January 2006. A total of 4500 self-administered questionnaires were distributed to parents of children aged 6-12 years attending 30 primary schools. From an overall response rate of 69.9%, enuresis was reported in 216 children [7%], comprising 6.2% for nocturnal enuresis according to ICD10 and 3.3% according to DSM IV, 0.5% for diurnal enuresis and 0.8% for combined day and night wetting. Primary nocturnal enuresis was reported in 166 children [5.3%]. Seventy-one [50.7%] of the 140 children with nocturnal enuresis had ?3 wet nights per week. A positive family history in father and mother was seen in 51% and 39% of children with primary nocturnal enuresis respectively. Using logistic regression analysis, younger age [p<0.002], gender [p<0.0001] and low level of education of mother [p<0.028] were significant predictors of enuresis. Positive history of enuresis in father was a significant predictor of primary nocturnal enuresis [p<0.012]. The prevalence of nocturnal enuresis in Iran is lower than those reported in western countries, however, higher percentage demonstrated severe enuresis. The prevalence of diurnal enuresis is lower than previous studies. Age, gender and the educational level of the mother are the main risk determinants of enuresis and the prevalence of primary nocturnal enuresis appears to be significantly related to positive history of enuresis in father