Objectives: Nephrotic syndrome is a glomerular disease characterised by a loss of albumin and high-molecular-weight proteins such as thyroxine-binding globulin and thyroid hormones, potentially resulting in subclinical or even overt hypothyroidism. This study aimed to compare thyroid hormone levels between nephrotic children and healthy controls as well as between nephrotic children in the active phase of the disease and those in remission. Methods: This case-control study was conducted between March 2016 and 2018 at a paediatric hospital in Qazvin, Iran. A total of 73 nephrotic children comprised the case group—including 49 with active disease and 24 in remission—while the control group included 74 healthy children. Thyroid function was assessed according to levels of thyroid-stimulating hormone (TSH), free triiodothyronine (T3), free thyroxine (T4), total T4, total T3 and anti-thyroid peroxidase. Results: All of the controls had normal total T4 levels. Elevated TSH levels were more frequent in nephrotic children compared to controls (34.2% versus 10.8%; P = 0.001). A significantly lower number of patients with active disease were euthyroid compared to those in remission (51% versus 95.8%; P = 0.001). Moreover, 7 (9.5%) of patients in the active and no patient in remission phase had abnormal total T4 levels (P <0.001), while 14.3% and 0% had highly elevated TSH levels (P = 0.002). Conclusion: Due to the prevalence of subclinical and even overt hypothyroidism, thyroid screening tests may be required for nephrotic children. However, further research is needed to confirm these findings. Keywords: Nephrotic Syndrome; Children; Albuminuria; Proteinuria; Hypothyroidism; Iran.
Background: Nonalcoholic fatty liver disease (NAFLD) is the most frequent form of liver disease in children, defined as the infiltration of fat into more than 5% of liver cells with metabolic syndrome consisting of dyslipidemia, insulin resistance, and obesity. Objectives: This study aimed to assay the effect of metformin or vitamin E on ultrasonographic grade and biochemical findings of children and adolescents with NAFLD. Methods: This clinical trial was performed on 150 non-diabetic obese children with NAFLD in the age range of 10 to 14 in Qazvin, Iran, during 2018 - 2019. The participants were randomly assigned to three groups: group 1 was treated with metformin at a dose of 500 mg twice daily for three months; group 2 received vitamin E at a dose of 400 units twice daily; and group 3 received a placebo. In addition, all the three groups were given the same proper diet and advised to increase their physical activity. SPSS software version 23 was used to analyze the data. Results: After the intervention, in groups receiving metformin and vitamin E, the grades of fatty liver decreased significantly (P < 0.05), and the decrease was more significant in the group receiving metformin. Conclusions: Insulin resistance is one of the critical factors in the development of nonalcoholic fatty liver disease. By reducing insulin resistance with drug treatment, desirable results can be achieved.
Background: Overactive bladder (OAB) is a common cause of voiding dysfunction in children and is classified as lower urinary tract dysfunction (LUTD). In recent studies, obesity and overweight are assumed as risk factors for voiding dysfunction and urinary incontinence in children. Objectives: This study was conducted to evaluate the correlation between overweight and obesity with OAB in children. Methods: This cross-sectional study measured BMI in 56 children aged between 3 and 16 years with OAB (case group) and 56 healthy matched children (control group). Overweight and obesity were compared between the two groups. The study also accessed lower urinary tract symptoms and their association with BMI in the OAB children. The data were analyzed using the SPSS software version 18.0 for windows (SPSS Inc., Chicago, IL). Results: The mean age of the OAB patients was 7.71 ± 2.65 years, and 38 (67.8%) of them were female. Frequency and holding maneuvers were the most prevalent complaints. A history of urinary tract infection was detected in 46 (82.1%) of the OAB patients. There were no significant differences in overweight and obesity between the two groups (P = 0.23). Conclusions: No correlation was observed between overweight and obesity with OAB. The reason may be different socioeconomic conditions or malnutrition in these children. Thus, it is recommended to perform a study with a larger sample size in our community to assess malnutrition in the general children population.
Objectives: This study aimed to evaluate the effect of yeast probiotic Saccharomyces boulardii on the frequency and duration of acute diarrhea in children. Methods: Sixty children were randomized to receive yeast probiotic S. boulardii in a daily dose of 250 mg (trial group-30 patients) or placebo (control group-30 patients) for five days. The clinical and demographic characteristics of two groups were recorded before the intervention. After intervention, the two groups were compared in terms of frequency of diarrhea, duration of diarrhea, and hospital stay. Results: The median (interquartile range) of frequency of diarrhea in the trial group was significantly lower than placebo group (4 [2] vs. 5 [2.5]) (P = 0.04). Also, the median (interquartile range) of duration of diarrhea in the trial group was significantly lower than placebo group (3 [2] vs. 4 [2.5]) (P = 0.03). There was no significant difference between groups for hospital stay (P = 0.8). Conclusions: The present study reveals that the use of yeast probiotic S. boulardii can reduce the frequency and duration of acute diarrhea. Therefore, we recommended S. boulardii administration to acute diarrhea in children.
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