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Search Results: 1 - 10 of 401387 matches for " Rafeey M "
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Neonatal Cholestasis
M Rafeey,M Mahalehei
Iranian Journal of Pediatrics , 2005,
Abstract: Background: Neonatal cholestasis syndrome includes a wide spectrum of clinical conditions ranging from congenital malformations of the hepatobiliary tree, infections, and inborn errors of metabolism to some clinical conditions with or without genetic predilection. The aim of this study is the survey of epidemiological and clinical findings of cholestasis in our center for a better approach and management of cholestatic newborns. Methods: We undertook a retrospective analysis of the medical notes of all infants treated for cholestosis at our center between 1999-2004. Results: Male to female ratio of 61 analyzed cases of neonatal cholestasis syndrome was 2/1. Intrahepatic causes were responsible for 73.3 % of cholestasis cases consisting of neonatal hepatitis 2, inspissated bile syndrome 1, and histiocytosis 1 cases. Extrahepatic cholestasis was diagnosed in 20/3 % of cases as choledocal cyst in 2, and billiary atresia in 14 cases. Conclusion: Intrahepatic cholestasis is commonest form of neonatal cholestasis in our center. Early diagnosis and management of neonatal cholestasis is of great importance for good results of treatment. This can be achieved by instructing the parents and health personnel to refer the suspected newborns to neonatology center as soon as possible.
Clinical Characteristics and Complications in Oral Caustic Ingestion in Children
M. Rafeey,M. Shoaran
Pakistan Journal of Biological Sciences , 2008,
Abstract: The aim of this study is to evaluate the prevalence of gastrointestinal symptoms in caustic ingestion, the severity of lesions and the role of early conducted endoscopy in prediction of outcome. In a cross-sectional study all children hospitalized for caustic ingestion during two years, aged 12 years and younger were evaluated for clinical history, endoscopic findings, method of treatment and observed complications. Out of 51 children, 8 consumed acidic and 43 alkaline materials. The mean age of the children was 35.9±18 months. Thirty four (66.7%) patients were male and 17 (33.3%) were female. In endoscopic survey, 38% had grade 1 and 62% had a burning intensity of grade 2 or higher. During the follow-up, esophageal structure developed in 5 cases and Gastric Outlet Obstruction (GOO) in 1 case. Two of 5 patients with stricture were treated by endoscopic dilatation and 3 of them underwent colon transposition surgery. Gastrectomy was done for the patient with GOO. Esophageal structure as a complication had a more incidence in acid ingestion. Gastric Otlet Obstruction (GOO) occurred in a case of acid ingestion. One of the patients died. Positive statistical relation between early endoscopic findings and complications found in control endoscopy suggest that early endoscopy probably is safe and provides important prognostic information. The role of prevention as a comprehensive strategy promoted by medical councils and the mass media is imperative.
"Incidence And Epidemiology Of Esophagitis In Children Admitted To Endoscopy Unit Medical Center Of Children In Tehran "
Rafeey M,Khatami GH
Tehran University Medical Journal , 2004,
Abstract: Background: There has been a little attention to pediatrics esophagus problems until recent years. The term esoghagitis can be used to described chemical, infectious, inflammatory, ischemic, immunologic and degenerative abnormalities. Prevalence of reflux esophagitis varies between 2 to 5 percent of general population but little data about its incidence in pediatric age groups. The aim of this study was to evaluate the epidemiology and prevalence of esophagitis and study of symptom, diagnostic measures, therapeutic intervention and prevention of its complication. Materials and Methods: In this prospective and cross sectional study 500 patient under16 years with upper digestive complaints or alteration of their state of health under went upper endoscopy, with special attention paid to esophagus. Results: Among 500 children (205 male, 207 female), pathology reported esophagi is in 325 cases. Majority of the patient were 8 to12 years. Most common complaints was abdominal pain (45/7%) and the second complaints was vomiting (13%), but most common complaints in severe esophagitis was melena (66%) and hematemes(18/8%). Most of patient (63% ) had a mild grade of esophagitis. When difference between endoscopy and pathology compared: Mild esophagitis in endoscopy (67%) ,but in pathology was (63%), moderate esophagitis (14/7%) in endoscopy was (17%) in pathology and severe form 2/8% in endoscopy but (4/9%)in pathology. Conclusion: According to results of our study in children age group with chronic abdominal pain ,vomiting ,excessive regurgitation, failure to thrive, we noticed that esophagitis is common etiologic factor. Histological esophagitis frequently occur in the absence of gross endoscopic findings and we need biopsy and histological examination to confirm diagnosis.
Glycogen Storage Disease with Inflammatory Bowel Disease and Hepatic Adenoma
M Rafeey,A Safaralizadeh
Iranian Journal of Pediatrics , 2006,
Abstract: Objective: Inherited metabolic diseases, including glycogen storage disease (GSD), are frequently seen in Iranians due to the high consanguinity rate, but the distribution of various types of GSD is unknown. Hypoglycemia, hepatomegaly, growth retardation, hyperlipidemia, hyperlactacidemia, and hyperuricemia are the common features of GSD type 1, inflammatory bowel disease (IBD)-like colitis is a known entity in GSD. Case presentation: We report a female patient with type Ia GSD (GSD Ia) who was followed-up for more than 17 years. GSD Ia was diagnosed based on biochemical tests and the pathology from a liver biopsy as she was 3 years old. Conclusion: With ageing, more and more complications will develop, of which those related to liver adenomas are likely to be major causes of morbidity and mortality.
Survey Of Lower Gastrointestinal Bleeding In Children
M Rafeey,AJ Khosroshahy
Iranian Journal of Pediatrics , 2005,
Abstract: Background: The presence of visible blood in stool or emesis is frightening to the child family, and at times, even to the physician. While usually patients with obvious gastrointestinal (GI) bleeding will quickly seek medical attention, those with occult intestinal blood loss are problematic. Iron deficiency anemia or guaiac positive stools may be the only evidence of intestinal bleeding. Therefore, a diagnostic and therapeutic approach to the child with suspected intestinal blood loss is critical to avoid a delay in diagnosis for the seriously ill child. Methods: In a period of 2 years (march 2001- march 2003), we studied children with lower GI bleeding hospitalized in the Children’s Hospital, Tabriz or seen in the outpatient clinic. Data on age, sex, chief complaint, endoscopic and colonoscopic results were recorded and statistically analyzed. Findings: There were 59 patients consisting of 20 (33.9%) females and 39 (66.1%) males. Children in preschool age formed with 31 (52.5%) cases the prevalent group. Fourty-nine (83.1%) cases presented with a complained of hematochesia and 10 cases (16.9%) had melena. Endoscopy was done in 46 patients (78%) and biopsy was obtained in 45 cases(97.8%). Polyp was the most common etiology(32.2%). Conclusion: According to this study the majority of patients with lower GI bleeding had hematochesia as chief complaint. Colonoscopy is the best diagnostic method for determining the source of bleeding and provision of appropriate patient care is crucial in these patients.. The incidence of lesions varies depending on the age of the patient.
Comparison of Accuracy of Ultrasonography and Isotope scan in Diagnosis of Extrahepatic Biliary Atresia
M. Nemati,M. Rafeey,A. Shakeri Bavil
Iranian Journal of Radiology , 2008,
Abstract: Background/Objective: Infantile cholestasis continues to represent a diagnostic chalange. Prolonges conjugated hyperbilirubinemia can be caused by extrahepatic biliary atresia (EHBA) or by nonobstructive metabolic and inflammatory causes. "nNowadays, isotopscanning including HIDA is the most popular method to rule out of EHBA and finally liver biopsy is the last step in preoperative confirmation of EHBA. Currently the role of ultrasound in these patients is a dilemma and contraversial. "nPatients and Methods: In this prospective study, 49 infants with prolonged jaundice were studied between January 2004 and April 2006 in Tabriz children's Hospital. All of these infants were evaluated with ultrasonography and isotopscan and finally all of them were biopsied under guide of sonography. "nIn their Sonogrphic evaluation, absence or pres-ence of gall bladder, its size and wall thickness and also its depletion after nutrition was controlled and beside this, triangular cord sign (TACS) was checked in all of them."nResults: In diagnosis of EHBA, the PPV, NPV and accuracy of nonvisulaization of gall bladder is 75%, 81.4%, 79% respectively. The accuracy of postnutrition depletion of gall blodder in diagnosis of EHBA is 90%. "nThe PPV of TACS in diagnosis of EHBA is 100% and its NVP and accuracy are 78.5%, 80%."nOverall accuracy, PPV, NPV, specificity and sensitivity of sonographic technics (in combination with each other) is 93%, 92%, 94%, 97%, 86% respectively."nOn the other hand, though the NPV and sensitivity of isotopscan is 100% but due to high false positive findings, its PPV, specificity and accuracy are low (46.6%, 51.3%, 66%) respectively."nConclusion: Ultrasonographic findings are more accurate, more specific and its positive results are more reliable than isotopscanning in diagnosis of EHBA.
Comparison of Umbilical Cord Interlukin-8 in Low Birth Weight Infants with Premature Rupture of Membranes and Intact Membranes
N. Najati,M. Rafeey,Melekian Taghy
Pakistan Journal of Biological Sciences , 2009,
Abstract: Some studies showed increased levels of proinflammatory cytokines like IL-6, IL-8 and TNF-α in the blood samples of pregnant women with PROM (Premature rupture of membranes) and their neonates. The aim of this study was to find a relationship between increased level of IL-8 and PROM, a cost benefit method for early diagnosis and reduction of hospitalization period of neonatal sepsis. This case control study was conducted in Obstetrics and Gynecology Department of Al-Zahra Hospital at Tabriz University of Medical Sciences, Iran from 10th April 2001 to 20th June 2003. We studied 50 LBW (Low birth weight) neonates born from mothers with PROM as the case group and fifty LBW neonates born from mothers without PROM as our control group Neonates born from pregnant women with PROM underwent sepsis workup and blood samples from their umbilical cord were sent for blood culture and IL-8 level measurement. Mean levels of IL-8 in study and control groups were 128.12 and 39.2 pg mL-1, respectively. We had no positive blood culture and no bacteria could be isolated. Significantly elevated values (p<0.0003) were showed in cases with PROM compared to cases without PROM (medians 67.5 pg mL-1 vs. 29.5 pg mL-1, respectively). This study showed a strong relationship between IL-8 elevation and PROM. Increased levels of IL-8 can be used as indicator for early diagnosis of neonatal sepsis.
Ultrasound Findings in Biliary Atresia: The Role of Triangular Cord Sign
M. Nemati,M. Rafeey,A.B. Shakeri
Pakistan Journal of Biological Sciences , 2009,
Abstract: In this prospective study, 49 infants with prolonged jaundice, were studied between January 2005 to April 2007 in Tabriz Children`s Hospital. All of these infants were evaluated with ultrasonography and isotopscan and finally biopsy was done in all of them under guide of sonography. In their sonographic evaluation, absence or presence of gall bladder, its size and also its evacuation after feeding was checked and beside this triangular cord sign was controlled. The PPV and specificity of triangular cord sign in diagnosis of extrahepatic biliary atresia (EHBA) was 100% but its NPV was only 78.5%. The overall accuracy, PPV, NPV, specificity and sensitivity of ultrasonographic findings in diagnosis of EHBA was about 94, 92, 94, 97 and 86%. Ultrasonography is a reliable screening method in early diagnosis of EHBA and triangular cord sign increases its accuracy especially its specificity.
Early age onset familial Mediterranean fever associated with compound heterozygote M680I /M694V mutation
S Farajnia, A Nakhlband, M Rafeey, K Sakha
African Journal of Biotechnology , 2006,
Abstract: Familial Mediterranean fever (FMF) is an autosomal recessive genetic disorder characterized by acute episodes of fever accompanied by severe abdominal pain, pleurisy, arthritis, and skin rash. The clinical variability of the disease has been mainly attributed to MEFV gene allelic heterogeneity and partly to the influence of additional genetic and/or environmental factors. We present a 6-month-old boy who suffered from recurrent fever accompanied by abdominal pain and skin rashes. Molecular screening by polymerase chain reaction (PCR) and sequencing for common mutations causing FMF revealed presence of a 694V/680I compound heterozygote mutation in exon 10 of the related gene. This is the first report of early onset and severe phenotype FMF case associated with a 694V/680I compound heterozygote mutation.
Lactobacillus acidophilus Yogurt and Supplement in Children with Acute Diarrhea: A Clinical Trial
M. Rafeey,A. Ostadrahimi,M. Boniadi,Z. Ghorashi,M.M. Alizadeh,V. Hadafey
Research Journal of Medical Sciences , 2012,
Abstract: Acute gastroenteritis is a major cause of children morbidity and mortality worldwide. Probiotics like Lactobacillus Acidophilus (L.acidophilus) may be beneficial in treatment of acute diarrhea. This study aimed at comparing the effects of yogurt fermented by L.acidophilus (L.acidophilus yogurt), L.acidophilus supplement, conventional yogurt and placebo added to routine fluid therapy in children with acute non-bloody diarrhea. In a randomized clinical trial, 160 children with acute diarrhea admitted in Tabriz Children Hospital were assessed in a clinical trial. They were randomized in 4 groups: Group A received 300 g day 1 of yogurt fermented by lactobacillus acidophilus, group B received 2 capsules/day of lactobacillus acidophilus supplement, group C received 300 g day 1 of conventional yogurt and group D received placebo material (control group). The standard fluid therapy was administered in all patients. Age, sex, duration of diarrhea before admission, weigh on admission and discharge and its change, frequency of stool passing on days 1, 2 and 3 post-admission and their changes, type of diarrhea, signs and symptoms on admission and day 3 and duration of hospital stay were determined in each patient. One hundred (62.5%) males and 60 (37.5%) females, with the mean age of 18.36 6.47 (12-48) months enrolled in the study. Four groups were matched considering the baseline characteristics. The mean frequency of stool passing on day 3 post-admission and the mean amount of decrement in stool passing frequency 72 h after hospitalization were significantly higher and lower in group A, respectively (p = 0.015 and 0.029, respectively). Dehydration rate on day 3 was significantly lower in groups A and B (p< 0.001). The mean duration of hospital stay was significantly shorter in group B (p=0.037). L.acidophilus yogurt and L.acidophilus supplement would diminish the severity of acute non-bloody diarrhea in children.
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