The purpose of this study was to determine underlying causes of prolonged neonatal icterus. Icterus or jaundice is an important common problem in neonatology. When this condition persists beyond 14 days, it is called prolonged or protracted neonatal icterus. Determining underlying causes of this problem is a pivotal step for management, because a delay in treatment may lead to serious complications or even death. In a prospective study, newborns with diagnosis of prolonged icterus were evaluated during a six-month period in Tabriz Children Teaching Hospital. Data regarding the past medical history, physical examination and appropriate laboratory and paraclinical investigations were gathered and accordingly, the underlying cause of jaundice was documented. One hundred newborns, 67 males and 33 females with a mean age of 21.5 +/- 4.5 days were enrolled. Breastfeeding, urinary tract infection, glucose 6-phosphate dehydrogenase deficiency and hypothyroidism were found as the main underlying causes in 75, 7, 7 and 4% of the cases. The exact etiology was unknown in 4% of newborns. ABO incompatibility, sepsis and Down syndrome were underlying etiologies in remaining three patients. Present study showed that the underlying causes of prolonged neonatal jaundice could be determined in majority of cases and breastfeeding is the most common one in this regard.

The outcome of pediatric renal transplantation was previously reported by a single-center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi-center nationwide study. In this nationwide report, medical records of 907 children (≤18yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow-up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10yr (n=91) and the ones with graft survival time of equal or less than 10yr (n=831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d.=3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p<0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.

Desmopressin and oxybutynin combination therapy is more effective than desmopressin monotherapy for treating children with enuresis.Please cite this paper as: Ravanshad Y, Azarfar A, Ghalegolab-Behbahan A, Mortazavi F, Ahmadzadeh S, Ghorat F, et al.Comparing the efficacy of desmopressin and oxybutynin combination therapy and desmopressin monotherapy in children with primary nocturnal enuresis; a randomized clinical trial.

Outcome of end-stage renal disease (ESRD) in children has considerably improved since the development of dialysis and kidney transplantation. This study was conducted to evaluate the management and outcome of ESRD children in a referral pediatric center in northwest Iran. A cross-sectional study of medical records of ESRD children (glomerular filtration rate less than 15 ml/min/1.73 m2) younger than 16 years who were admitted in Children's Hospital of Tabriz between October 1999 and October 2009 was performed. Ninety-four children with ESRD including 51 boys (54.3%) and 43 girls (45.7%) with a mean age of 7.9 ± 3.49 years were studied. Parents of nine patients (7.8%) refused treatment. Eighty patients underwent renal replacement therapy (RRT) and were followed for a mean period of 4.86 ± 2.77 years. Initial modality of RRT was hemodialysis in 81.25%, continuous ambulatory peritoneal dialysis in 16.25%, and preemptive kidney transplantation in 2.5%. Thirty-two patients (34%) underwent renal transplantation. The mean duration of staying on dialysis before transplantation was 12.4 ± 11 months. Twenty-nine of kidney donors (90.6%) were living unrelated donors. The 1-and 3-year graft survival rates were 81.2% and 68.8% and the 1- and 3-year patient survival rates were 96.9% and 93.8%, respectively. Thirty-one patients died (33%). The mortality of girls was significantly higher than boys (P=0.04). There was a significant negative correlation between age and mortality (P=0.01). Heart failure and infections were the most common cause of death. This study showed that ESRD children in our area have a poor outcome in comparison with developed countries.

The aim of this study was to evaluate the etiology of pediatric Chronic Kidney Disease (CKD) in a tertiary care hospital in north-west of Iran. Medical records of admitted children with CKD in Children's Hospital of Tabriz from 1999 to 2009 were studied retrospectively. CKD was defined as GFR less than 60 mL min(-1) 1.73 m2 for more than 3 month. The etiology of CKD was determined by clinical, biological, radiological and histopathological examination. During 10 years 115 children including 61 boys (53%) and 54 girls (47%) were studied. The mean age of patients was 8.1 +/- 3.53 years (range: 4 months to 14 years). Urological abnormalities were the most common cause of CKD (36.5%) followed by acquired glomerular diseases (23.5%), hereditary nephropathies (21.7%), unknown etiology (9.5%) and systemic diseases (6%). The most common urologic anomaly was vesicoureteral reflux (VUR) that accounted for 24.3% of total etiologies followed by obstructive uropathies. Focal segmental glomerulosclerosis was the most frequent glomerular disease and was responsible for 13.9% of patients. Nephronophtisis, cystinosis, infantile polycystic disease and congenital nephrotic syndrome were the most frequent hereditary nephropathies in a descending order. Frequency of parental consanguinity in patients with hereditary nephropathy was significantly higher than other patients (p = 0.001). High frequency of VUR in present study compared with developed countries necessitates more efforts for improving the management and follow up of urinary tract infections.

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Discussion The progressive increase in patients supported with this therapy mirrors its remarkable growth internationally. CVVH is the most dominant form of artificial renal support in Australian and European critical care, and its role as adjuvant therapy in sepsis is attracting increased focus. 3Conclusion CVVH activity is increasing at our institution, facilitated by a competent and flexible team of CVVH specialists. Future adequately powered multivariate logistic regression analysis should address outcomes of patients supported on CVVH. Background Hypercalciuria has been considered as a predisposing factor for recurrent urinary tract infection (UTI) in recent studies. The mechanism may be related to uroepithelial injury by calcium microcrystals. The aim of this study was to evaluate the association of idiopathic Hypercalciuria with recurrent UTI in children. Methods In this analytic study urine calcium:creatinine ratio of 40 children at the age of 2-16 years with recurrent urinary tract infection (without urinary tract anomalies and voiding dysfunction) was compared with 40 age and sex matched healthy children. Calcium:creatinine ratio more than 0.2 in a spot urine test was considered as hypercalciuria. Cases with hypercalcemia were excluded from the study. Recurrent UTI was defined as at least 3 episodes of UTI during 1 year or 2 episodes in 6 months. Results Mean age of patients was 5 ± 2.22 years and mean age of control group was 5.13 ± 1.98 years. The mean calcium:creatinine ratio in case group (0.21 ± 0.17) was significantly higher than control group (0.08 ± 0.08) (p < 0.05). Hypercalcuria was detected in nineteen out of forty patients in case group (47.5%) and in 7.5% of control group (p < 0.001). History of familial urolithiasis was positive in 21% of hypercalciuric patients. There was not any significant difference in frequency of urinary symptoms between hypercalciuric and normocalciuric patients with recurrent UTI. Conclusion Children who suffer from recurrent UTI in spite of absence of urinary tract anomalies should be checked for hypercalciuria. Control of hypercalciuria with low salt regimen and high fluid intake and treatment with hydrochlorothiazide may decrease UTI episodes. PO-0789

At present, e-banking is being considered not only as a competitive advantage, but rather as a competitive necessity for banks. The question that arises for the majority of users of ebanking is whether the e-banking technology in Iran is the same as other countries? Millions of Iranians already take advantage of e-banking technology and the number of e-banking user is increasing every day. In this paper we examines the factors that affect the adoption of e-banking and users tendency to use it and also the willingness of customers in using electronic banking or traditional banking. Research has shown that the factors of comparative advantage, the ability to view the results of using ebanking, the complexity or simplicity of the process, security, existing appropriate legal infrastructure, ease of use, and users' information literacy have an impact on the acceptance of e-banking by users. The results of this paper can help the managers of developing banks to achieve better distribution solutions for serving the customers.