Diagnostic accuracy of anti-DGP (IgG) for celiac disease.

Background: Celiac disease (CD) is an autoimmune enteropathy that is caused by the intake of gluten-containing grains in genetically susceptible humans. The gliadin and glutenin parts of wheat gluten are the essential factors that cause intestinal damage. Objectives: We analyzed the performance of a time-resolved immunofluorometric assay (TR-IFMA) in the diagnosis of CD in children. For this purpose, we compared the performance of IgA anti-tissue transglutaminase antibodies (IgA anti-TTG) and IgG antibodies against deamidated gliadin peptides (IgG anti-DGP) for the diagnosis of CD. Materials and Methods: In this cross-sectional study conducted in 2021 for a duration of about 6 months, 200 patients with suspected CD symptoms, children who needed screening due to Down syndrome or Turner syndrome, and the first-degree relatives of CD patients who underwent diagnostic evaluation were enrolled in a census study. Results: This study compares existing point-of-care anti-DGP Ab (IgG) and anti-TTG Ab (IgA) tests against each other using the gold standard of duodenal biopsy and pathology. Serology as a screening test was acceptable (93.6% for anti-DGP vs. 94.2% for anti-TTG) for both of them. This equivalent sensitivity of serum TTG and the DGP tests validates its potential as a basic tool for serological testing. Furthermore, endoscopy is carried out in patients positive for both. Conclusions: Our study showed that for the diagnosis of CD, anti-DGP antibodies had comparable characteristics with anti-TTG (IgA) in terms of diagnostic specificity and sensitivity. Specify of anti-DGP was higher than that of anti-TTG.

COVID-19 infection in an infant with cystic fibrosis: A case report and possible therapeutic effect of hypertonic saline.

Pulmonary infections represent the major causes of morbidity and mortality in cystic fibrosis (CF). Here, we report a 3-month-old infant with pancreatic insufficient CF was hospitalized with positive RT-PCR test for COVID-19. He was treated successfully. Hypertonic saline can be hypothesized as a treatment regimen against COVID-19 infection after further investigations.

The first report of Streptococcus pluranimalium infection from Iran: A case report and literature review.

The Streptococcus pluranimalium was isolated from both of animals and human infection. There is limited information about pathogenicity of S pluranimalium. As fastidious bacteria, S pluranimalium is not isolated in the routinely culture media and easily misidentified with other streptococci species with conventional microbiology test. According to review of the literatures, the cephalosporins, aminoglycosides, vancomycin, and linezolid are the first choice agents for treatment of infection caused by S pluranimalium.

Comparison of the efficacy of ranitidine and quince syrup on gastroesophageal reflux disease in children.

INTRODUCTION: Since the treatment of gastroesophageal reflux disease (GERD) symptoms in children is of the utmost importance, the current study is aimed to evaluating the efficacy of quince syrup and ranitidine in the management of pediatric patients with symptomatic GERD. METHODS AND MATERIALS: This double-blind, randomized clinical trial was performed on 96 children suspected of suffering from GERD. The patients referred to the gastrointestinal clinic of Ghaem Hospital, Iran, during 2017. The participants were randomly categorized into two groups (ranitidine and ranitidine plus quince syrup). The GERD symptoms, including the severity and frequency of vomiting, refusal of eating, difficulty in swallowing, choking at the time of eating, burping or belching, and abdominal or belly pain, were gathered before and after the intervention (4 weeks) using standardized Global Severity Questionnaire (GSQ-YC). RESULTS: The comparison of two groups in terms of vomiting, refusal of eating, burping or belching, and abdominal or belly pain showed a significant difference 4 and 6 weeks after the intervention (P< 0.05). However, the comparison of difficulty in swallowing and choking at the time of eating between the two groups showed that there was no significant difference after 2, 4, and 6 weeks of the intervention (P > 0.05). The comparison of the total scores between the two groups showed that there was a significant difference 2 (17.8 ±â€¯2.6 vs 23.4 ±â€¯4.0; P < 0.05), 4 (11.5 ±â€¯2.3 vs 18.8 ±â€¯3.6; P< 0.05), and 6 (12.2 ±â€¯2.3 vs 21.1 ±â€¯4.1; P<  0.05) weeks after the intervention. CONCLUSION: The results showed that the administration of ranitidine plus quince syrup was useful to improve pediatric GERD. However, it is recommended to conduct the future studies with a larger sample size and different dosage.

Superior mesenteric artery syndrome in a child with acute gastric dilatation with refractory Guillain-Barré syndrome.

Superior Mesenteric Artery Syndrome (SMAS) resulting from proximal partial small bowel obstruction is one of possible causes of acute gastric dilatation (AGD). A child with refractory demyelinating Guillain-Barré syndrome which received 5 times IVIG and consequently 5 times plasmapheresis intubated until 59th day of admission. Because of complicated treatment and cardiopulmonary resuscitation (CPR) nutrition was completely neglected which lead to severe SMAS because of weight loss. Gradual advancements of continuous enteral and parenteral nutrition improved patient's symptoms significantly. Hypophosphatemia complicated the weaning from ventilator which after nutrition therapy resolved and patient extubated. Present case is the first report of pediatric demyelinating GBS suspected to SMAS.

Relationship between platelet count and platelet width distribution and serum uric acid concentrations in patients with untreated essential hypertension.

Hematological parameters have emerged as independent determinants of high serum concentrations of uric acid (UA) and predictive factors in the evaluation of the total cardiovascular risk in patients with essential hypertensive. Here, we have investigated the possible relationships between hematological factors and serum uric acid levels in hypertensive patients recruited as part of Mashhad Stroke and Heart Atherosclerotic Disorders cohort study. Two-thousand three-hundred and thirty-four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum UA concentrations. Demographic, biochemical, and hematological characteristics of population were evaluated in all the subjects. Logistic-regression analysis was performed to determine the association of hematological parameters with hypertension (HTN). Of the 2334 hypertensive subjects, 290 cases had low UA, and 2044 had high serum UA concentrations. Compared with the low UA group, the patients with high serum UA, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum high sensitivity-c reactive protein (hs-CRP) were correlated with serum UA level. Stepwise multiple logistic regression model confirmed that platelet distribution width (PDW) and gender were independent determinant of a high serum UA. PDW and PLT appear to be independently associated with serum UA level in patients with HTN. © 2018 BioFactors, 44(6):532-538, 2018.

The effect of music on pain and vital signs of children before and after endoscopy.

BACKGROUND AND AIM: Gentle music has relaxing and pain reducing effects. In this study, the effect of music on patients' vital signs and pain was investigated before and after endoscopy. METHODS: This clinical trial study was conducted on 100 children from seven to fourteen years of age in Gha'em Hospital, Mashhad in 2015. Children were divided into two equal groups (case group=50 and control group=50). The control group received endoscopy according to the standards, without any other procedure. For the case group, a classic musical piece by Clayderman was played during endoscopy (from the time of entering the endoscopy room to the end of the process). After conducting endoscopy, FALCC scale and Baker-Wong pain scale were filled for both groups. In addition, children's vital signs including: heart rate (pulse), diastolic and systolic blood pressure were measured before and after endoscopy for both groups. Data analysis was conducted using SPSS16 with the help of Mann-Whitney and Chi-square tests. RESULTS: No significant difference was found in age, gender distribution of case or control groups (p>0.05). Heart rate and diastolic blood pressure was significantly lower in the music (case) group compared to the control group before endoscopy (p=0.012). In addition, pain score in patients of the music group was lower than the control group (p<0.05). CONCLUSION: Playing music for children during endoscopy can reduce pain and anxiety in patients before and after endoscopy.

Clinical and endoscopic findings of children hospitalized in Qa'em Hospital of Mashhad due to caustic ingestion (2011-2013).

INTRODUCTION: One of the leading causes of damage to the gastrointestinal tract in children is caustic ingestion which is sometimes life-threatening. The most reliable way to study the severity and extent of damage is endoscopy, which can be harmless in terms of time and technique. The aim of this study was to investigate, evaluate and compare clinical findings and endoscopic results of caustic ingestion. METHODS: This retrospective cross-sectional study was conducted on the records of children diagnosed with caustic ingestion, and hospitalized in Qa'em Hospital of Mashhad from March 2011 to December 2013. Intended data were extracted from patients' records and in case of any ambiguity, it was removed by phone call. Obtained data were analyzed using SPSS 11.5 and chi-square test. RESULTS: Of 54 patients, there were 36 cases of burn with acidic substance and 16 cases of burn with alkaline. The highest value was related to caustics related to acid batteries (31.5%) and in 77.5% of cases the container of caustic agent was not standard. In endoscopic results, 50 patients out of 54, had esophagus burn such that in 6 cases it was grade I burn, in 15 cases grade IIa, 27 cases with grade IIb and 2 cases with Grade IIIa burn. In addition, mild erythema of stomach in 6 cases, average erythema in 5 cases, mild ulcer in 15 cases, average ulcer in 5 cases and 3 cases with severe ulcer were reported. There was no significant relation between clinical findings and endoscopic results (p=0.68). CONCLUSION: Since caustic ingestion can be regarded as a life-threatening factor for children, the importance of observing precautions in the storage of caustics and the role of training and adequate attention of parents to this issue to prevent such accidents is clear.

Evaluation of Patients' Rights Observance According to Patients' Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs' Views.

INTRODUCTION: To supply quality services and healthcare, it is evident that medical ethics and patients' rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients' Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences. METHODS: This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients' rights, including demographic data and inventory of patients' rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation. RESULTS: Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients' rights was related to the area of respecting patients' privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients' rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients' rights (p>0.05). CONCLUSION: Although in this study, the observance of patients' rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients' Rights Charter along with training courses, to strengthen medical staff's awareness in this regard.

A multi-strain Synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Asthma is a growing problem worldwide. Acute exacerbations impose considerable morbidity, mortality, and increased cost. Viral respiratory infections are the most common cause (80-85%) of pediatric asthma exacerbations and admissions to the hospital. The aim of this study was to determine the effect of a new synbiotic Lactocare® on viral respiratory infections and asthma exacerbations in asthmatic children. METHODS: In this double blind, placebo-controlled, randomized clinical trial, 72 children with mild persistent asthma, aged between 6 and 12 years, were randomized to receive either Lactocare®, a Synbiotic containing 1 billion CFU/Capsule of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo daily for 60 days. The primary outcome was the number of viral respiratory infections, and secondary outcomes were school absence, salbutamol and prednisolone usage, outpatient visits, and hospital admission for asthma. The outcomes were compared among study groups using the SPSS 11.5 program and the Mann Whitney and Fisher exact tests. RESULTS: Of the 72 children who were enrolled with mild persistent asthma, 36 were assigned randomly to be treated with synbiotic and 36 with placebo. The number of viral respiratory infections was significantly higher in placebo group than the synbiotic group during the first month of intervention (0.74 ± 0.12 vs. 0.44 ± 0.1, p < 0.007) but not during the second month (0.5 ± 0.8 vs. 0.5 ± 0.8, p < 0.641). Considering the total duration of the study (two months), infection episodes also were significantly lower in the synbiotic group (0.92 ± 0.15 vs. 0.69 ± 0.11, p < 0.046). Salbutamol consumption was significantly lower in the synbiotic group, but there were no significant differences in school absenteeism, oral prednisolone use, outpatient visits, or hospital admissions. CONCLUSION: This new synbiotic (a mixture of seven probiotic strains plus fructooligosacharide may reduce episodes of viral infection in asthmatic children. TRIAL REGISTRATION: This study is registered in Iranian Registry of Clinical Trials with registration number of IRCT201509234976N3. FUNDING: This research was supported financially by the Research Council of Mashhad University of Medical Sciences (Grant Number: 911048).

Can Dermatoglyphics Be Used as a Marker for Predicting Future Malocclusions?

INTRODUCTION: Dermal ridges and craniofacial structures form from the same embryonic tissues during the same embryonic period. Thus, this might indicate a possible association between dermatoglyphics and facial skeletal disorders, such as malocclusions. Early diagnosis of skeletal malocclusions sometimes can prevent future surgical procedures. The aim of this study was to compare the dermatoglyphic characteristics of different malocclusions. METHODS: In this cross-sectional study, 323 patients who were referred to Orthodontic Department of Mashhad Dental School were recruited. The participants were classified into three groups according to Angle's classification, i.e., Skeletal Class 1 (n = 163), Skeletal Class 2 (n = 111), and Skeletal Class 3 (n = 49). For all participants, we recorded the total ridge counts of each finger (TRC), atd angles, a-b ridge counts, and types of fingerprint patterns. Right- and left-hand asymmetry scores were calculated. The chi-squared test was used to compare the dissimilarity of the types of patterns for each finger. Asymmetry of other parameters was analyzed statistically using the ANOVA or Kruskal-Wallis tests. P-values greater than 0.05 were considered to be significant. RESULTS: A significant difference was determined between Class I and Class III patients in terms of left a-b ridge count (p=0.049). Loop was the most frequent pattern in the three groups, whereas the arch pattern occurred with the lowest frequency. No significant difference was found in the other parameters that were studied. CONCLUSION: Although there were some slight differences in dermatoglyphic peculiarities of different skeletal malocclusions, most of the palm and fingerprint characteristics failed to indicate any significant differences.

Epidemiological survey of pediatric food allergy in Mashhad in Northeast Iran.

INTRODUCTION: Food allergy is an increasing problem worldwide, but the foods responsible for food allergy are not the same in different countries, probably because of the role of genetic, cultural, and nutritional factors. The aim of this study was to determine the common food allergens in pediatric patients with different presentation of food allergy. METHODS: In this cross-sectional study, all of the patients were referred to pediatric allergy clinics affiliated with Mashhad University of Medical Sciences from September 2012 to August 2014. For patients with IgE-mediated food allergy that was diagnosed with clinical manifestations, the skin prick test was done. The results were analyzed by SPSS version 17 and statistical analysis was done with the chi-squared test and the t-test. P values < 0.05 were considered statistically significant. RESULTS: Three hundred seventy-one patients (53.9% male, 46.1% female) with ages in the range of three months to 18 years were studied. The most frequent food allergen in all patients with decreasing prevalence were egg white (17.8%), pepper (15.8%), curry (14.3%), egg yolk (14%), cow's milk (10%), and tomato (7.8%). The most common presenting symptoms were respiratory (allergic rhinitis 45%, asthma 32%), dermatologic (atopic dermatitis 30%, urticaria 8.3%), colitis (17.5%), and gasteroesophagial reflux disease (GERD) (2%). According to the prevalence of food allergens in different age groups, we realized that, after the age of three years, the frequency of sensitization to egg white, egg yolk, cow's milk, wheat and cereals was decreased and allergy to pepper and curry was increased. CONCLUSION: The prevalence of culprit foods that produce food allergies depends on several factors, including age, presenting manifestation, and where the patient lives. As many food allergies are outgrown, patients should be reevaluated regularly to determine whether they have lost their reactivity or not.

Probiotic for irritable bowel syndrome in pediatric patients: a randomized controlled clinical trial.

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in children. Recently, probiotics have been suggested as a treatment option for gastrointestinal disorders. The most effective species and the most appropriate doses are still unknown. OBJECTIVE: The aim of this study was to assess the effects of Lactobacillus GG (LGG) for treating IBS in pediatric patients. METHODS: In a controlled, double blind, randomized trial, patients with IBS diagnosed by Rome III criteria from August 2012 to September 2012 at Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Iran, were assigned to one of two groups, i.e., intervention and control groups. For four weeks, the intervention group received a probiotic in capsule form that contained LGG at a concentration of 1×10(10) cfu/ml bacteria. For the same period, the control group received a placebo capsule that had the same shape and color but only contained inulin, which also was present in the LGG capsules. The primary outcome was any change in the severity of the patients' pain, and we used a five-point Likert scale to evaluate the severity of their pain. Secondary outcomes were ghanges of the functional scale, stool patterns, and associated problems. RESULTS: Fifty-two patients participated in the study, and 26 patients were assigned randomly to each of the two groups. The severity of the patients' pain decreased significantly in the intervention group after one, two, three, and four weeks of treatment, as indicated by P-values of 0.01, 0.00, 0.00, and 0.00, respectively. Also, there was significant improvement in the functional scale after two weeks of treatment (P-value ≤ 0.00). CONCLUSION: Lactobacillus GG at a concentration of 1×10(10) cfu/ml for a period of four weeks can lessen the severity of the patients' pain and improve the functional scale in patients with irritable bowel syndrome. Probiotics can have therapeutic effects for IBS patients.

Selecting the patients for morning report sessions: case-based vs. conventional method.

BACKGROUND: One of the most important issues in morning report sessions is the number of patients. The aim of this study was to investigate and compare the number of cases reported in the morning report sessions in terms of case-based and conventional methods from the perspective of pediatric residents of Mashhad University of Medical Sciences. METHODS: The present study was conducted on 24 pediatric residents of Mashhad University of Medical Sciences in the academic year 2014-2015. In this survey, the residents replied to a 20-question researcher-made questionnaire that had been designed to measure the views of residents regarding the number of patients in the morning report sessions using case-based and conventional methods. The validity of the questionnaire was confirmed by experts' views and its reliability by calculating Cronbach's alpha coefficients. Data were analyzed by t-test analysis. RESULTS: The mean age of the residents was 30.852 ± 2.506, and 66.6% of them were female. The results showed that there was no significant relationship among the variables of academic year, gender, and residents' perspective to choosing the number of patients in the morning report sessions (P > 0.05). T-test analysis showed a significant relationship among the average scores of residents in the selection of the case-based method in comparison to the conventional method (P < 0.001). CONCLUSION: From the perspective of residents, the case-based morning report was preferred compared to the conventional method. This method makes residents pay more attention to the details of patients' issues and therefore helps them to better plan how to address patient problems and improve their differential diagnosis skills.

Health-related quality of life (HRQOL) in children with chronic liver disease in North East Iran using PedsQL™ 4.0.

BACKGROUND: Health-related quality of life (HRQOL) is a concept that relates to an individual's perception of health status in relation to the culture and value systems in which they live, in addition to their expectations, goals, concerns, and living standards. Considering the size of the population affected by Chronic Liver Diseases (CLDs) and the severity and chronic nature of the symptoms, there is an emerging need to evaluate the quality of life of patients using a standard protocol. The aim of this study is to assess the HRQOL in children with CLD based on child self-report and parent proxy-report forms. METHODS: A total of 164 children, 55 CLD and 109 healthy children (aged 6-17 years), upon referral from the Pediatric Department at Ghaem Hospital in Mashhad from 2010 to 2014 were enrolled in this case-control study. We used the PedsQL(TM) 4.0 generic score scale to assess the HRQOL in children with CLD compared to the control group based on child self- and parent proxy reports. RESULTS: According to the child self-reports, the total HRQOL in the case group (89.93±9.63) was significantly lower than control group (93.05±9.28) (p=0.006). We found significant differences in emotional functioning based on the CLD child self-reports (p=0.001) and their parent proxy-reports (p=0.002). Furthermore, there was a statistically significant correlation between the severity and physical functioning as reported by the Child-Pugh score (p=0.03, r= -0.31) and the MELD/PELD scores (p=0.01, r= -0.35), based on child self-reports. Gender, age of onset, CLD types, duration of the disease, and treatment showed no significant differences with total HRQOL. CONCLUSION: HRQOL is significantly lower in children with CLD in comparison to the normal population. We strongly recommend considering different aspects of quality of life, especially emotional functioning concomitant to the therapy programs.

Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran.

INTRODUCTION: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P) among live births in Mashhad, North-Eastern Iran. MATERIALS AND METHODS: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis. RESULTS: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP) was the most prevalent type of cleft (50%), followed by isolated cleft lip (35.2%) and isolated cleft palate (14.8%). A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3). The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002-2011 (P=0.027). There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively). Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05). CONCLUSION: This study indicates a frequency of CL/P close to the findings in East Asian countries and higher than some previous reports from Iran, European and American countries. Ethnicity-related genetic factors may have a role in the conflicting results obtained from different populations.

Ingested Foreign Bodies Removed by flexible Endoscopy in Pediatric Patients: A 10-year Retrospective Study [corrected].

INTRODUCTION: Determination of type and location of trapped objects and endoscopic observations among children with foreign-body ingestion. MATERIALS AND METHODS: We evaluated 105 endoscopic records of patients presenting with foreign-body ingestion from 2001-2011. RESULTS: Button batteries were the most common objects removed (41%). The lower segment of the esophagus was the most common trapping site. There was significant correlation between type of foreign body and its location of trapping. Abnormal endoscopic observations were reported in 33% patients. There was significant correlation between the type of foreign body and endoscopic observations. There was also a significant correlation between the location of the foreign body and endoscopic observation. CONCLUSION: The pattern of foreign-body ingestion is somewhat different in our center compared with other studies. Awareness among parents about the prevention of this accident is an important step in decreasing the incidence of foreign-body ingestion.

Synbiotic in the management of infantile colic: a randomised controlled trial.

AIM: Infant colic is a frequent problem affecting up to 10-30% of infants in first 3 months of life. Results from previous trials have shown that manipulation of gut microbiota can lead to symptomatic improvements. In a randomised clinical trial, we aimed to determine efficacy of synbiotic in reducing average infant crying time at day 7 and day 30 after starting intervention. METHODS: Fifty breastfed infants aged 15-120 days with infantile colic randomly assigned to receive either the synbiotic sachet containing 1 billion CFU of: Lactobacillus casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, B. infantis, L. bulgaricus and fructooligosacharide (Protexin Healthcare, Somerset, UK), or placebo daily for 30 days. Parents were asked to record details of crying times in a symptoms diary. The primary outcome measure was the treatment success (reduction in the daily crying time >50%) and the secondary outcome measure was symptom resolution (reduction in the daily crying time >90%). RESULTS: The treatment success was significantly higher in synbiotic group (82.6%) compared with placebo (35.7%) at day 7 (P < 0.005). At day30, treatment success was 87% and 46% in synbiotic and placebo group, respectively (P < 0.01). Symptom resolution was also higher in synbiotic group (39%) compared with placebo (7%) at day 7 (P < 0.03) but not at day 30 (56% vs.36%, P = 0.24). We encountered no complication related to synbiotic use. CONCLUSION: This synbiotic (a mixture of seven probiotic strains plus FOS) significantly improved colic symptoms in comparison with placebo.

Comparison Between Impact Factor, Eigenfactor Metrics, and SCimago Journal Rank Indicator of Pediatric Neurology Journals.

BACKGROUND: Impact Factor (IF) as a major journal quality indicator has a series of shortcomings including effect of self-citation, review articles, total number of articles, etc. In this study, we compared 4 journals quality indices ((IF), Eigenfactor Score (ES), Article Influence Score (AIS) and SCImago Journal Rank indicator (SJR)) in the specific Pediatric Neurology journals. METHODS: All ISI and Scopus indexed specific Pediatric Neurology journals were compared regarding their 2011 IF, ES, AIS and SJR. RESULTS: Fourteen pediatric Neurology journals were identified, 3 of which were only Scopus indexed and the others were both ISI and Scopus indexed. High correlation was found between IF and AIS (0.850). Correlations between IF and other indices were not that high. Self-citation, total article number and review articles were related to the IF and other indices as well as their ranks. English language and citation to non citable item didn't have any effect on pediatric neurology journals ranks. CONCLUSION: Although all the above mentioned indicators can be used interchangeably, using all considered indices is a more appropriate way than using only IF for quality assessment of pediatric neurology journals.

Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate.

The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.