Background/AimsGastroesophageal reflux disease (GERD) is common in children. Recurrent exposure to gastric acid in GERD may contribute to tooth erosion.MethodsIn this prospective study, 54 GERD patients qualified according to endoscopy, pH-metry, and the GERD questionnaire and 58 healthy controls qualified by the GERD questionnaire were assessed. Two groups underwent dental evaluations for the presence, severity, and patterns of erosion and for the stage of dentition using a Tooth Wear Index. The health care providers who performed the dental exams did not know which children had been diagnosed with GERD.ResultsA total of 112 children, 3 to 12 years old were enrolled in the study, and 53 of 54 (98.1%) GERD patients and 11 of 58 (19.0%) controls had dental erosions (p<0.0001). In GERD patients, the posterior occlusal surfaces of milk teeth were more affected (p<0.0001). There was no correlation between GERD and the affected surfaces in permanent teeth, nor in the patterns or erosion grades (localized or general). In both groups, milk teeth had more erosions than permanent teeth, but the difference was not statistically significant.ConclusionsAccording to this study, there is a positive correlation between GERD and dental erosion. Posterior occlusal surface erosions in milk teeth could indicate GERD.

In conclusion, mother-to-child transmission is the main route of intrafamilial transmission of H. pylori in Iranian families. Molecular typing of H. pylori can be useful in identifying a high-risk population.

Objective: To study the clinical presentation, histology and colonoscopic features of lower gastrointestinal polyps in Iranian children. Material and Methods: Medical reports of children with colorectal polyps were retrospectively reviewed from 1996 to 2005 at the Children’s Medical Center Hospital, Iran. A total of 563 cases were studied. Data related to age, sex, family history, signs and symptoms, the size, location, polyp types and associated lesions were collected and analyzed. Results: The mean age of children was 5.66 ± 2.88 years (range 2 months to 17 years), with a male-to-female ratio of 1.61:1.0. The highest incidence was between ages 2 and 10 years (85.1%). Rectal bleeding was the presenting symptom in 78.5% cases. The polyps were solitary in 94% of cases. A majority of polyps (86.3%) were juvenile and 86.7% located in the rectosigmoid area. Three percent of cases had a positive family history. One case of Turcot syndrome was also identified. Conclusion: Juvenile polyps remain the most common polyps in Iranian children. Although the presence of a solitary polyp in the rectosigmoid colon is more prevalent, in a significant number of cases they are multiple and located in proximal parts. Polyps must be removed even when asymptomatic because of their probable neoplastic potential.

Background: Diarrhea infection has been established as one of the major etiologies and risk factors of malnutrition in children. Objectives: The aim of this study was to assess the maternal knowledge, attitude and practices when treating diarrhea in their children less than 5 years old in the Zahedan, south-east province of Iran. Materials and Methods: This cross-sectional study was conducted in urban health centers in Zahedan. Three hundred mothers who had less than five years old children and had been referred to the health centers for six months duration had been included. The questions were about demographic characteristics, knowledge and practice regarding childhood diarrhea, and had been designed to obtain information through an interview. Results: The findings indicated that knowledge of the majority of mothers (64.3%) regarding diarrhea and diet was moderate and only 3.7% had good knowledge. The majority of mothers (56%) had a moderate practicing knowledge of diarrhea and diet and only 2.3% had a good practice. Conclusions: Based on the low level of knowledge and practice among the study population, the usual practice of focusing on a target group would be necessary. Our findings indicated a serious lack of competence in dealing with this problem.

Background: Diarrhea infection has been established as one of the major etiologies and risk factors of malnutrition in children. Objectives:The aim of this study was to assess the maternal knowledge, attitude and practices when treating diarrhea in their children less than 5 years old in the Zahedan, south-east province of Iran. Materials and Methods:This cross-sectional study was conducted in urban health centers in Zahedan. Three hundred mothers who had less than five years old children and had been referred to the health centers for six months duration had been included. The questions were about demographic characteristics, knowledge and practice regarding childhood diarrhea, and had been designed to obtain information through an interview. Results: The findings indicated that knowledge of the majority of mothers (64.3%) regarding diarrhea and diet was moderate and only 3.7% had good knowledge. The majority of mothers (56%) had a moderate practicing knowledge of diarrhea and diet and only 2.3% had a good practice. Conclusions: Based on the low level of knowledge and practice among the study population, the usual practice of focusing on a target group would be necessary. Our findings indicated a serious lack of competence in dealing with this problem.

Our data suggest that synergistic sedation with oral ketamine and IV midazolam for UGIE in children is a suitable and safe sedation. The higher rate of vomiting in group B in contrast to previous studies must be caused mainly by the oral route of ketamine administration.

Background/AimsGastroesophageal reflux disease (GERD) and cow's milk allergy (CMA) are two common conditions that occur in infancy. This study was performed to investigate the frequency of CMA in a group of patients with GERD.MethodsEighty-one children with signs and symptoms of GERD were enrolled in this study. All subjects received omeprazole for 4 weeks after the initial evaluation. Empirical elimination of cow's milk from the diet was started for the patients who did not respond to the omeprazole treatment.ResultsSeventy-two cases presented with gastrointestinal signs and symptoms, whereas the remaining nine cases presented with respiratory complaints. After the initial treatment with omeprazole, two thirds of the cases (54 patients, 66.7%) responded well, and all of their symptoms were resolved. Cow's milk was eliminated from the diets of the remaining 27 patients. All signs and symptoms of GERD were resolved in this group after a 4 week elimination of cow's milk from the diet.ConclusionsA diagnosis of CMA was considered in one third of the pediatric cases with signs and symptoms of GERD. This finding shows that CMA can mimic or aggravate all signs and symptoms of severe GERD during infancy.

Introduction: Extra-hepatic biliary atresia (EHBA) is an important cause of neonatal cholestasis. Several infectious agents have been proposed as etiologic factors such as Rotavirus and Reovirus. There is limited data on the role of Epstein Barr virus (EBV) infection in EHBA, so we decided to study the presence of EBV virus in a series of 16 proven EHBA cases by Chromogenic in situ hybridization (CISH) technique.