No abstract

Background and objectives: Metachromatic leukodystrophy (MLD) is an autosomal recessive neurodegenerative disease, with an estimated prevalence rate of 1 per 40,000 to 160,000 worldwide. Progressive alteration in motor and cognitive functions is the most common clinical presentation. Late infantile MLD is the most common form of the disease that presents with a progressive decrease in visual acuity, impaired swallowing, muscle rigidity, seizures, and developmental delays. We herein present a rare case of late infantile MLD in a four-and-halfyear-old male patient presenting with gradually-onset paraplegia. Case description: The patient had normal growth and neurodevelopmental pattern until 15 months of age. Afterward, he had a gradually increasing abnormality in gate and finally became paralyzed since the age of three years. The patient was also suffering from dysphagia, bilateral ptosis, and bad temperament. Normal metabolic test, myopathies, and brain MRI findings led to the diagnosis of MLD with gradually-onset paraplegia. Conclusion: Generally, early diagnosis of MLD may increase the chance of recovery from the disease. We suggest considering MLD in patients suffering from behavioral, visual, and motor regressions, especially those with normal metabolic tests.

Background and objectives: Diagnosis and treatment of urinary tract infection (UTI) in children before kidney damage is necessary. The purpose of this study was to compare efficacy of co-trimoxazole and cephalexin in the prevention of recurrent UTI in children. Methods: The study was performed on 100 children aged three months to 14 years who were referred to the Taleghani Pediatric Hospital in Gorgan (Iran) during 2016. The subjects had a history of UTI and required antibiotic prophylaxis to prevent UTI. They were divided into two groups of co-trimoxazole and cephalexin. Data were analyzed using SPSS (version 18) and at significance level of 0.05. Results: Recurrent UTI was observed in eight children (16.0%) taking cephalexin and in six children (12.0%) receiving co-trimoxazole (p=0.56). Urine culture examination revealed Escherichia coli as the causative agent of UTI in six cases (75 %) receiving cephalexin and in five cases (83.3%) receiving co-trimoxazole (p=0.70). It should be noted that unilateral moderate hydronephrosis was the most frequent anomaly (n=26) in the study groups. Conclusion: According to the results of the present study, both cephalexin and co-trimoxazole have similar efficacy in the prevention of UTI among children.