This case report describes a unique presentation of sphingosine-1-phosphate lyase insufficiency syndrome (SPLIS) caused by a rare SGPL1 variant, highlighting the diagnostic and management challenges associated with this condition. A 2-year-old Iranian female presented with steroid-resistant nephrotic syndrome (NS), primary adrenal insufficiency (AI), growth delay, seizures, and hyperpigmentation. Laboratory evaluation revealed hypoalbuminemia, significant proteinuria, hyperkalemia, and elevated adrenocorticotropic hormone (ACTH) levels. The patient was diagnosed with SPLIS through genetic testing, revealing a c.1018 C > T variant in SGPL1. Despite supportive treatment, including corticosteroids and cyclosporine, the patient’s condition deteriorated, leading to end-stage renal disease and sepsis, ultimately resulting in death. This case underscores the clinical heterogeneity of SPLIS and the importance of early genetic evaluation in patients with combined NS and AI. Personalized management approaches and increased awareness among clinicians are essential to improve patient outcomes.

Background: Coronavirus disease 2019 (COVID-19) can cause pulmonary and systemic inflammation in both children and adults. Investigating the potential impact of micronutrient deficiencies on COVID-19 infection is of great importance. Objectives: The current study was designed to compare the serum levels of vitamins D and C and zinc between healthy children and children with mild or severe COVID-19 infection, as well as to investigate the impact of micronutrient deficiencies on the clinical symptoms of patients. Methods: This case-control study was conducted at a teaching hospital in Tehran, Iran. Control subjects were recruited from healthy children, and cases were included from children with mild and severe symptoms of COVID-19. Blood samples were obtained from participants to measure the levels of micronutrients and were analyzed using statistical software. Results: A total of 85 subjects were included (33 controls, 25 cases with mild symptoms, and 27 cases with severe symptoms). We found no differences in the means of serum vitamin D and vitamin C levels between the studied groups. However, the mean serum zinc level was significantly lower in severe patients compared to the controls (P < 0.01). Moreover, no significant difference was observed in the frequency of patients with micronutrient deficiencies based on their clinical conditions. Conclusions: Our findings revealed zinc deficiency in children with severe COVID-19 infection, while no significant differences were found in the mean serum levels of vitamins D and C between healthy children and patients. More studies are necessary to provide more robust evidence.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the recent pandemic. According to published reports, respiratory symptoms, such as pneumonia and inflammatory conditions, are common in this disease. Objectives: The current study aimed to investigate the level of antiphospholipid (aPL) antibodies in children with and without coronavirus disease 2019 (COVID-19). Methods: This descriptive-analytic cross-sectional study was conducted on patients under 16 years of age with and without COVID-19 admitted to Ali Asghar Hospital between December 2021 and February 2022. Patient information was collected by the researcher in a checklist. The checklist included demographic information, clinical findings, and information on laboratory and ultrasound results. Results: In this study, 99 patients were evaluated in three groups: control (without COVID-19), moderate, and severe. The means (standard deviation [SD]) of C-reactive protein (CRP) and D-dimer were significantly higher in the severe group. The Pearson correlation coefficient test was used to examine the relationship between aPL and anticardiolipin (aCL) antibodies with laboratory results. The only significant and direct relationship was observed between aCL antibody and D-dimer. Conclusions: Increased CRP and D-dimer in children with COVID-19 are associated with the severe form of this serious disease. However, there was no significant association between the severity of the disease and the levels of aCL and aPL antibodies and anti-beta 2-glycoprotein I antibodies (aβ2GPI) in children.

Objective: To evaluate the role of ID in the pathogenesis of FS. Methods: In this case-control study (2014-2016), 70 children were studied, 35 children with FS and 35 (controls)children with febrile diseases without convulsion (The mean age of cases was 2.191 ± 0946 vs. 1.93 ± 1.433 years in controls). Serum ferritin was estimated by the EIAS test. Data were compared between 2 groups, The ROC (receiver-operating-characteristic) curve was illustrated. The sensitivity, specificity, PPV, and NPV of the test, were calculated. Results: Serum ferritin levels had no significant difference between the 2 groups. The ferritin level (36ng/ml) had 74.3% sensitivity, 20% specificity, 56% PPV, and 52% NPV, with a Positive likelihood Ratio being 1.3 and a Negative likelihood Ratio: 0.93 to discriminate the 2 groups. Conclusion: Here the ferritin level (cut-off=36ng/ml) has an acceptable sensitivity (74.3%) but poor specificity (20%) and just 56% PPV and 52% NPV to differentiate the FS cases from non-convulsive febrile children. Although a different cut-off value 21.50 ng/ml provides 91% sensitivity and very low specificity . This lower threshold cut-off might have clinically relevant outcomes in FS children if considering the other comorbidities. In our opinion, ID could not lead to FS in all children, but in some cases, with a genetic basis; ID raises the threshold for seizures. The ferritin levels as an acute phase reactant are acceptable in every febrile case. The ferritin base level in each child (case /control) before infection was unknown, but in the present study, both groups were febrile in contrast to previous studies in which ferritin levels were compared with afebrile children. Due to the high prevalence of ID (26%), especially in the young Iranian population, adding iron to the diet might help decrease FS in susceptible cases. We recommend in the future study the FS cases selected with known iron levels before convulsion.

Introduction:Influenza-related viral myositis is observed mostly in children with influenza, and the disease is more common in influenza type B. The aim of the present study was to evaluate the prevalence, and clinical and laboratory features of acute viral myositis in children with influenza in 2019 and 2020. Methods:This retrospective cross-sectional study was performed in Ali Asghar Hospital, from December 2019 to February 2020. Children aged 2-14 years with symptoms of acute onset of fever, along with the symptoms of influenza with or without muscle pain who referred to the emergency department of Hazrat Ali Asghar Children's Hospital, were included in the study. The data were collected and analyzed by Statistical Package for the Social Sciences (SPSS) version 22. Results:Out of the 105 participants in this study, 62 (59%) were male and the rest were female. The average age of the patients was 5.34 years (SD = 2.63). Clinical signs of lower limb pain, myalgia, lameness, weakness, and lethargy were significantly more common in patients with myositis (P-value < 0.05). In-vitro examination demonstrated that creatine phosphokinase (CPK), aspartate aminotransferase (AST), and aAlanine aminotransferease (ALT) levels were significantly higher in patients with myositis. Conclusion:Based on the present results, the clinical symptoms in patients are quite clear, and based on the symptoms, it is possible to diagnose and treat myositis without relying on laboratory findings; due to the self-limitation of this complication and lack of the need for complex treatments in case of early diagnosis, physicians can diagnose and treat many cases, depending on the clinical symptoms and the accuracy of the examination.

Background: Neonatal jaundice is a common major problem; on the other hand, it is suggested that there is a correlation between plasma magnesium concentrations and hyperbilirubinemia during the neonatal period. Objectives: The study aims to validate a previously reported risk index for predicting the magnesium level of plasma for moderate to severe hyperbilirubinemia in infant neonates. Methods: A cross-sectional correlation study was performed on 93 term newborns with indirect hyperbilirubinemia admitted in neonatology unit of a children hospital and plasma magnesium level of moderate to severe Neonatal hyperbilirubinemia were determined, and statistical analysis was performed. Results: Authors did not find any statistically meaningful positive or negative correlation between plasma Mg level and bilirubin in patients studied; however, comparison of Mg level in two groups of severe and moderate hyperbilirubinemia showed decreased dispersion of medium Mg level in the severe group. Conclusions: Serum magnesium concentration is not useful in anticipation of which newborn infant will develop hyperbilirubinemia.

Objective: Febrile convulsion (FC) is the most common form of seizures disorder (3-4%) in childhood with good prognosis. Some evidences indicate that iron deficiency (ID) might play a role in initiation of FC. The aim of this case‐control study was to evaluate, the role for ID in pathogenesis of FC (febrile convulsion). We studied 35 FC children and 35 controls (febrile diseases without convulsion) Results The mean age of cases were 2.191 ± 0946 vs 1.93 ± 1.433 years in controls .Mean Hemoglobin level (11.6 ± 079 vs 11.86± 071; p value= 0.2); MCV (75.8 ± 4.3 vs 77.62± 4.1,p value= 0.08) ;serum ferritin levels (54.57 ± 24 vs 58.31± 23, p value= 0.64) had not significant difference between 2 groups. The ferritin level 36ng/ml; had 74.3% sensitivity, 20% specifity, 56% PPV, 52% NPV, Positive likelihood Ratio: 1.3; Negative likelihood Ratio: 0.93 to discriminate 2 groups. In our opinion, ID could not lead to FC in all children, but in some cases with genetic basis; ID raises the threshold for seizures. Due to high prevalence of ID (26%) especially in your Iranian population, adding the Iron to diet might be helpful in decreasing FC in susceptible cases.

Background: Intrauterine infections (TORCH) lead to the involvement of various organs of the body of the fetus, including the eye. The aim of this study was to determine the frequency and clinical response of eye lesions to specific drugs, in infants with confirmed TORCH induced ocular lesions. Methods: This historical cohort study from 2011 to 2017, had done in Pediatrics and Ophthalmology Department of Rasoul Akram Hospital, Tehran, Iran. Cases included; 78 infants with confirmed intrauterine infection (TORCH) with ophthalmologic disorders (glaucoma, cataract, and retinitis), 3 cases died (without any treatment). The cases with incomplete diagnosis, no treatment or without follow-up excluded from study. Out of 74 children with confirmed TORCH induced ophthalmologic disorders, finally 37 children (25 cytomegalovirus, 12 toxoplasma) were treated with specific drugs, and clinical response to treatment was followed-up to 1 year by ophthalmologic examination. Results: From 12 cases with ophthalmologic disorders due to congenital toxoplasmosis, 5 cases had full treatment, 4 cases had complete response. One case had not any improvement. From 25 cases with congenital cytomegalovirus (CMV), 18 patients continued treatment, 9 cases with complete clinical response, 9 cases had not response to antiviral treatment, indeed most non responder cases had central nervous system involvement from birth. The best response observed in CMV infected cases accompanied with sensory hearing loss (without CNS involvement). Conclusion: Good clinical response of ophthalmic diseases in 80% of congenital toxoplasma; and 50% of congenital cytomegalovirus infected cases. Probably with initial diagnosis and rapid treatment of cases with TORCH induced ophthalmic disorders (especially cases without CNS involvement) it would lead to stopping ocular lesions. Abstract

Background: High resistance to common antibiotics has become a huge global dilemma in eradicating Helicobacter Pylori infection in both children and adults. The great concern is about the resistance to different classes of antibiotics especially Clarithromycin because of its widespread use. Objective: The present survey aimed to assess the resistance rate to Clarithromycin in Helicobacter Pylori isolated in patients aged less than 15 years as compared to patients older than 15 years of age. Methods: In this cross-sectional study, total 72 patients with upper gastrointestinal symptoms requiring diagnostic endoscopy referred to Rasoul-e-Akram Hospital in Tehran during one year (August 2015 to August 2016). Helicobacter Pylori infection was diagnosed in patients using the Rapid Urease Test. The antibiotics resistance was detected in genomes using the real-time polymerase chain reaction (PCR) on 23S rRNA gene. Results: In total 72 patients, 36 cases aged less than or equal to 15 years and 36 patients were older than 15 years. Of all patients in this study, 17 cases were detected with gene mutations or polymorphisms related to resistance to Clarithromycin. Overall prevalence rate of resistance was reported 23.61%. Three polymorphisms on 23S rRNA gene including A2142G, A2142C, and A2143G were revealed in 47.1%, 5.9%, and 47.1% of patients, respectively. The bacterial resistance to Clarithromycin was observed more prevalent in patients that aged older than 15 years compared to patients younger than 15 years of age. Also, frequent consumption of any type of antibiotics was significantly associated with the higher resistance of bacterium to Clarithromycin. Conclusion: The results of our study regarding the resistance of Helicobacter Pylori to Clarithromycin were similar to findings of other studies around the world. But, the Clarithromycin resistance rate was reported higher in patients older than 15 years of age and those patients who repeatedly received different types of antibiotics regardless of their age. Of all mutations in bacterial genome, the prominent mutations responsible for bacterial resistance to Clarithromycin included A2142C, A2142G, and A2143G nucleotide polymorphism on 23S rRNA gene.

Introduction:The sacral bone anomalies have an important effect on urinary and gastrointestinal tract and sacral ratio was defined as an indicator for estimating the anorectal abnormalities in children. This study was carried out for determining the association between sacral ratio and Urinary Tract Infections (UTI) among children.Material and Methods:In a cross sectional study, 100 children under 15 years with proven febrile UTI were referred to a referral children center considering the presence and grading of VUR according to VCUG enrolled in this study.Sacral ratio was measured for all cases and the data were compared by student T test, Chi 2 and Mann Whitney tests. SPSS 16.0 software was used for data analysis. P values less than 0.05 were considered significant.Results:41 boys and 59 girls with mean age 4.8 years were enrolled in this study. The average range of sacral ratio was 0.82. There was no staistical difference between two different genders and ages (p> 0.05).The values of SR in patients with VUR were lower than patients without VUR(P˂0.05) but there was no statistically significant difference between both bilateral and unilateral VUR and SR (p> 0.05).Conclusion:The risk of sacral bone abnormality in patients with VUR is more than patients without VUR. Therefore, in patients with UTI and low SR simultaneously, tighter evaluation for VUR and treatment should be considered.

BACKGROUND Pyelonephritis is the most common and important infection among Iranian pediatric population. Differentiation between upper and lower Urinary Tract Infection (UTI) is often difficult based on clinical data. Therefore, definite diagnosis is helpful for choosing appropriate antibiotic and decision for hospital admission. The main purpose of this study was todetermine the diagnostic value of serum STREM-1 level in children suspicious to UTI and differentiation of upper UTI and lower UTI. MATERIAL & METHODS This prospective cross sectional study (2010-2011) was performed to evaluate and compare the serum level of STREM- 1 (pg. /ml) in 36 diagnosed UTI patients (24 upper and 12 lower UTI) with 25 normal children (without UTI) in Rasoul Akram hospital, Tehran, Iran. The mean age of studied children was 3.64 years; 24 male and 37 female. Urinary analysis and urine culture were performed for all UTI cases and only the positive cultured cases with the same microorganism were enrolled in the study. Distinguishing the upper from lower UTI was done on the basis of clinical manifestation and laboratory tests and confirmed by Imaging studies (ultra sonography /or DMSA scan). Blood sampling was taken from all children and centrifuged .The level of STREM-1 (pg /ml) in all sera was determined by Enzyme immunoassay technique (Human TREM-1 immunoassay Sandwich test, Quantikine, R&D systems, Minneapolis; USA). Cut-off levels for STREM-1 were illustrated by ROC curve. The p<0.05 was considered as significant for differences between groups. FINDINGS The mean of STREM -1level had significant difference between overall cases of UTI (427.72pg/ml) and controls (124.24 pg. /ml; P =0.000) ; with cutoff point 111.5 pg./ml ; it had 83.3% sensitivity; and 60 % specificity to distinguish UTI from control. Serum STREM -1 level had no significantly difference between the upper and lower UTI (500pg/ml vs. 283 pg. /ml, P value=0.1) with cutoff point 132 pg./ml it had 83.3% sensitivity ; and 60 % specificity to distinguish upper UTI from lower UTI. CONCLUSION Our study demonstrates that even low amount of serum STREM-1 (111.5 pg./ml) has 83.3% sensitivity ; and 60 % specificity to distinguish the UTI from normal cases (P value =0.000) but higher level (132 pg./ml) was needed for definite diagnosis (83.3% sensitivity; 60 % specificity) of upper and lower UTI. It is concluded that serum STREM-1 level test is a valuable tool for early diagnosis of the normal cases with false positive urine culture, or in highly suspicious upper UTI cases with false negative urine culture. Indeed higher titer of this biomarker could be helpful for discriminating the upper from lower UTI. Therefore adding this new biologic marker (STREM-1) to previous ones (CRP, PCT) is suggested to prevent the unnecessary hospital admission and empiric antibiotic therapy.

PURPOSE:The aim was to describe the clinical manifestations, complications and long-term outcome of a cohort of Iranian patients with primary immune deficiency (PID). METHOD:We retrospectively studied the demographic, clinical and immunological characteristics of the PID patients in a single tertiary centre, from January 1989 to July 2014. The patients were classified according to the International Union of Immunological Societies Expert Committee on PID. RESULTS:98 patients were diagnosed with and followed-up for 15 disorders. The mean age at onset and diagnosis and the diagnostic delay were 8±10, 14.2±13.1 and 6.1±7 years, respectively. Parental consanguinity rate was 57%. Predominantly Antibody Deficiency was the most common diagnosis (n=63), followed by congenital defects of phagocytes (n=16), combined immunodeficiencies (n=12), well defined syndromes (n=4) and defects in innate immunity (n=3). Recurrent sinopulmonary infection was the most common presentation. Active infections were treated appropriately, in addition to prophylactic therapy with IVIG and antimicrobials. Not all the patients were compliant with prophylactic regimens due to cost and unavailability. One SCID patient underwent successful bone marrow transplantation. The total mortality rate was 19% during the follow-up period (7.8±7.6 years). The mean age of living patients at the time of study was 23±11.7 years. CONCLUSIONS:Physicians awareness of PID has been rising dramatically in Iran, ensuring an increasing number of patients being diagnosed and treated. More effective treatment services, including health insurance coverage and drug availability are needed to improve the outcome of PID patients.

Background: Group A beta-hemolytic Streptococcal (GAS) pharyngitis is a common illness in children. Diagnosis and proper treatment of group A streptococcal sore throat is important particularly to prevent non-superlative sequel. Clinical findings continue to be used in differentiating streptococcal infection from viral sore throat.Objectives: The aim of this study was to evaluate the accuracy of clinical findings and rapid test in comparison with culture in the diagnosis of group A Streptococcal (GAS) pharyngitis.Patients andMethods: Ninety-four children between 3 to 16 years, who were referred to the pediatric clinic of Rasoul-e-Akram hospital with clinical findings of fever or sore throat were evaluated from October 2006 to May 2007. Clinical findings were recorded and swabs were taken for group A streptococcal cultures and streptococcal rapid antigen detection test. Analysis of statistical significance was performed using the chi-square method. The accuracy of clinical findings and rapid test was compared with the culture method as the gold standard, and sensitivity, specificity, positive predictive values, negative predictive value, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated.Results: The culture was positive in 38 (40.4%) of the 94 evaluated children. The mean age of children was 8 +/- 3.7 years. The presence of petechiae, exudate and Lymphadenopathy (LAP) was more likely in children with positive streptococcus culture and rapid test (P value < 0.05). Lymphadenopathy was known to feature the most sensitivity (100%), specificity (76.8%), and positive predictive value (74.5%), negative predictive value (100%) and positive likelihood ratio (LR) (4.3) among clinical findings. The results of rapid test showed sensitivity of 89.4%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.3% in comparison with culture as the gold standard. In general, the accuracy of rapid test was found higher than subjective clinical findings (P = 0.001).Conclusions: Although LAP had good performance in early diagnosis of GAS, a combination of clinical findings, including tonsillar exudates, petechiae with results of rapid antigen test or culture is necessary for clinician judgment. Throat culture is the gold standard test for detecting group A Streptococcal infection, but rapid test is a good replacement for culture.

BACKGROUND:Delay in diagnosis and treatment of acute appendicitis (AA) results in an increased rate of perforation, postoperative morbidity, mortality and hospital length of stay. Several biochemical parameters including white blood cell (WBC) count, C-reactive protein (CRP), interleukin-6 (IL6) and Procalcitonin (PCT) have been used to further improve the clinical diagnosis of AA. The aim of this study was to assess the value of procalcitonin as a predictor of diagnosis and severity of appendicitis in order to improve the clinical decision making, since other studies have been unable to demonstrate a diagnostic value for PCT elevation in acute appendicitis.METHODS:One-hundred patients who underwent open appendectomy, including 75 men and 25 women with a mean age of 28 years were included in this study. Procalcitonin values were measured by an immunofluorescent method). Serum PCT>0.5 ng/ml was considered positive. The PCT serum values were measured in four different categories, including ˂0.5ng/ml, 0.5-2 ng/ml, 2-10ng/ml and more than 10ng/ml.RESULTS:The sensitivity and specificity of PCT level measurement for acute appendicitis diagnosis were 44% and 100% respectively. The value of PCT increased with the severity of appendicitis and also with the presence of peritonitis and infection, at the site of surgery.CONCLUSIONS:Procalcitonin measurement cannot be used as a diagnostic test for adult patients with acute appendicitis and its routine use in such patients is not cost effective and conclusive. Procalcitonin values can be used as a prognostic marker and predictor of infectious complications following surgery and it can help to carry out timely surgical intervention which is highly recommended in patients with PCT values more than 0.5ng/ml.

Background: The incidence and clinical presentation of congenital toxoplasmosis in our newborns was not studied until yet. Goal of study is to evaluates the newborns for congenital Toxoplasma.Gondii infection and describe the clinical presentation from birth and follow up them. Methods: We conducted a prospective study upon 270 newborns were born in two university hospitals in Tehran (Rasoul akram & Akbar Abadi) during 2011-2012. Cord blood sample obtained from the newborns during labour. The samples centrifuged, transported and restored in -80 centigrade freezer in our Research Laboratory. Specific T.Gondii- antibodies (IGG, IGM) evaluated by ELISA methods. Neonates with positive T.Gondii- IGM diagnosed and studied as infected cases. The infected cases treated and followed for progression of disease. Results: Gestational age of newborns was between 28-41 weeks. Positive T.Gondii -IGM and T.Gondii -IGG determined in 1.5%, 44.1% of cases respectively. The most common clinical presentation in seropositive cases was eye involvement (50%), and brain disorders (50%). Positive PCR had not found in cerebrospinal fluids of seropositive (IgM) cases.Conclusion: One and a half percent of newborns were seropositive for T.Gondii. Wide variation of clinical presentation and early diagnosis of infected newborns in our country is so important. Adding the serologic tests (IGM) to neonatal screening test is recommended strongly.

OBJECTIVE: The aim of this study was to determine the association between previously documented risk factors such as recurrent pyelonephritis with the incidence of renal scarring after acute pyelonephritis in children. MATERIAL AND METHODS: Children with acute pyelonephritis who were admitted to the Department of Pediatrics of a teaching hospital during 2007-2009 were enrolled in this study. DMSA scans were obtained 4-6 months after the last episode of pyelonephritis in all patients. RESULTS: A total of 80 children with acute pyelonephritis were enrolled in this study. Most of them were girls (77.5%), with a median age of 12 months. Nearly half of the children (n = 44; 55%) had one or more renal scars. The distribution of gender, CRP level and leukocytosis did not differ significantly regardingthe absence or presence of renal scars (p > 0.05). Most of the scars occurred in children who had presented with bilateral pyelonephritis (69.4% vs. 18.2%, p = 0.001). Most of the patients with renal scars had a positive history of vesicoureteral reflux (VUR) (75% vs.13.6%, p = 0.001). The significant roles of recurrent pyelonephritis and presence of VUR were further confirmed by multivariate analysis. CONCLUSIONS: According to our findings, presence of VUR and recurrent pyelonephritis are independently associated with a higher incidence of renal scarring.

Background and Objective: To evaluate extended spectrum betalactamase (ESBL) positive strains of Klebsiella pneumonia and Escherichia coli in positive bacterial cultures. Materials and Methods: In this analytical cross-sectional study, between March 2006 and March 2007, 170 bacterial isolates including 133 cases of E. coli and 37cases of K. pneumonia were examined. All cases underwent double disk diffusion for ESBL. Demographic data were assessed and all data analyzed accordingly. Results: Patients' mean age was 55 ±26.63 yr. Ninety six cases (56.5%) were female and 74 cases (43.5%) were male. Clinical presentation of infection were 118 cases UTI (96.4%), 15 cases septicemia (8.8%), 16cases wound infection (9.4%), 7 cases pneumonia (4.1%), 1 case meningitis (0.6%) and 13 cases other presentations (7.6%). Frequency of ESBL positive in E. coli isolates was 38 cases (28.6%) and in K. pneumonia isolates was 10 cases (27%). There was no significant correlation between ESBL positivity and age, gender, ward or clinical presentation of infection. Conclusion: Incidence of ESBL positive isolates of E. coli and K. pneumonia was high. These results should be considered in administration of broad-spectrum antibiotics by clinicians.

Objective: Febrile convulsion is the most common disorder in childhood with good prognosis. There are different hypotheses about neurotransmitters and trace element (such as zinc) changes in cerebrospinal fluid and serum, which can have a role in pathogenesis of febrile convulsion. The aim of the present prospective analytical case-control study was to determine whether there was any changes in serum zinc level in children with febrile convulsion during seizure.Methods: Ninety-two children aged 6 months to 5 years were divided into three groups: group A, 34 children with febrile convulsion, group B, 40 children having fever without convulsion, and group Q and 18 children with non-febrile convulsion, Serum zinc levels for the three groups were estimated by atomic absorption spectrophotometry (AAS). Data were analyzed to compare zinc level among the three groups using appropriate statistical tools employing SPSS 13.Findings: Serum zinc levels of groups A, B, and C had a mean value of 76.82 +/- 24.36mg/l, 90.12 +/- 14.63 mg/l, and 94.53 +/- 7.39 mg/l, respectively. Serum zinc level of group A was lower than those of the other two groups (P<0.006). It was also lower in group B than in group C (P<0.006).Conclusion: These findings revealed that serum zinc level decreases during infection; this decrease was more significant in patients with febrile convulsion.

Background and Aim: Pneumonia is now one of the most important causes of childhood mortality in developing countries like Iran. The increased susceptibility to pneumonia, particularly in malnourished children of developing countries, is postulated to be due to reduction in cellular immunity. One of the reasons for reduced immunological competence in malnourished children may be zinc deficiency. However, relatively well nourished children of developing countries also suffer from pneumonia and it is possible that they have impaired immunity due to zinc deficiency. This study was done to investigate the zinc status of well nourished Iranian children with pneumonia in comparision with control group. Patients and Methods: In this case control study, estimation of serum zinc was performed in 142 well nourished children, aged 3-60 months suffering from pneumonia and compared with 142 normal matched controls. Results: Serum zinc was low in children suffering from pneumonia as compared to control (437/1 ± 39/65 μ mol/l vs 511/23 ± 36/931 μ mol/l) Conclusion: We conclude that children suffering from pneumonia, have significantly decreased levels of serum zinc (P=0.0075).