The results suggest that adjuvant treatment with zinc accelerates recovery from severe pneumonia in young children and significantly reduces the duration of hospital stay. Further studies are required to develop appropriate recommendations for the use of zinc in the treatment of severe pneumonia in other populations.

Background: The decreasing of mortality rate is one of the most important goals in every intensive care unit (ICU). This study was performed to determine the main causes of admission and mortality rate in our referral pediatric ICU (PICU). Methods: In this retrospective study, all patients (age-group, 1 month-16 years) admitted to the PICU in one year were included and patients with less than a 3h duration of admission, multiple traumas, and post-surgery patients were excluded. Results: Among the 688 patients enrolled in the study, 55.6% were male and the mean patient age was 2.7 years. The most common causes of admission were pneumonia (22.9%), bronchiolitis (8.6%), and septicemia (7.9%). The mean duration of hospitalization was 3.3 days and the mortality rate was 16.5%, with a mean age of 2.2 years and 51.8% male. The most common causes of overall mortality were pneumonia (21.6%) and septicemia (16.2%), however, mortality was more common in patients admitted with septicemia (36.6%), liver failure (31.6%), chronic renal failure (28.6%), and meningitis (27.3%). Patients who had undergone intubation before admission, decreased level of consciousness, and prolonged duration of hospitalization were significantly correlated with the mortality (P < 0.05). Conclusions: Our results indicate that the respiratory failure and severe infections are the most common causes of admission and mortality in the PICU and very young children are at risk of high incidence of mortality.

Scorpion envenomations are a public health problem in many countries. Scorpions are second only to snakes in causing human fatalities from envenomation. Species of scorpions capable of inflicting fatal stings are living in North and South Africa, the Middle East, India, America, Trinidad, and Tobago. Hemiscorpius lepturus (from the Hemiscorpiidae family) is the most medically important scorpion in Iran which accounts for 92% of all hospitalized scorpion sting cases. The venom from H. lepturus is primarily a cytotoxic agent and has hemolytic, nephrotoxic, and to some extent, hepatotoxic activities. We found a combination of microangiopatic hemolytic anemia, thrombocytopenia, and acute renal failure in a seven year-old female child who was referred to us with a 12 h history of bloody urine following a H. lepturus sting. Her blood smear showed fragmented erythrocytes and burr cells, leading us to a diagnosis of hemolytic uremic syndrome (HUS). This report highlights the importance of acceptable prophylaxis and therapeutic protocols for HUS in these patients.

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Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of malignancies. However, its clinical use is limited by renal tubular dysfunction that occurs in a significant percent of patients. The aim of the present study was to evaluate the possible protective effect of theophyline in the prevention of cisplatin-induced nephrotoxicity. The trial design was prospective, randomized, double-blinded and placebo controlled. Chemotherapeutic patients who received cisplatin at a dosage of at least 50 mg/m 2 alone or in combination with other chemotherapy agent(s) were included in the study. There were a total of 76 patients who were randomly divided into two groups. In group 1 (n = 38), placebo was advised; in group 2 (n = 38), patients received 4 mg/kg aminophyline as an intravenous loading dose, followed by theophyline in a dose of 200 mg three times daily orally for four consecutive days. The placebo group had 22 males and 16 females and the theophyline group had 26 males and 12 females. The mean age was 51 ± 17.6 years and the mean dose of cisplatin was 86.71 ± 43.18 mg. The prevalence of cisplatin nephrotoxicity in groups 1 and 2 was 7.9 and 5.3%, respectively, and the difference was not significant (P = 1). In addition, there was no significant association of cisplatin nephrotoxicity with age (P = 0.1), gender (P = 0.64) and mean dose of cisplatin (P = 0.8). These results indicate that prophy-lactic application of aminophyline and theophyline does not have a protective effect against cisplatin nephrotoxicity.