Introduction: Metabolic Syndrome (MS) in children and adolescents is becoming a global public health concern. MS tracks into adulthood increasing the risk for type 2 diabetes mellitus and cardiovascular diseases. This study was designed to verify the rate of MS in elementary school students of Birjand, as a representative sample of Iranian children to verify the best preventive measures in this age group. Methods: This descriptive-analytical, cross-sectional study was performed on 1425 elementary school children through multiple-cluster sampling in 2013. Height, weight, waist circumference and blood pressure of children were measured by standard methods. Blood glucose, triglycerides, cholesterol, High-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) levels were also measured after 12 hours fasting. MS was defined according to the Adult Treatment Panel III (ATP-III) based on the National Cholesterol Education Program. Data were analyzed by SPSS using t test and chi-square test. Significance level was set at P < 0.05. Results: The prevalence of MS was 5.3% which increased with age. 43.5% of the studied cases had one or more components of the MS. The most common components were hypertension, abdominal obesity, hypertriglyceridemia, low HDL-cholesterol and impaired fasting glucose, respectively. MS prevalence was 0.9% in normal weight, 11.3% in overweight and 36.2% in obese children. Conclusion: Regarding the high prevalence of MS in elementary school children in our region, screening for obesity is recommended to prevent adulthood complications. Therapeutic lifestyle changes and maintenance of regular physical activity are the most important strategies for preventing childhood obesity.

Background: Phenylketonuria is a metabolic disorder resulting from a defect in phenylalanine metabolism with a global prevalence of 1 in 10000. Delayed initiation of dietary modification leads to brain injury and cognitive and behavioral problems. The main objective of this study was to assess the demographic and social factors affecting the metabolic control of patients having phenylketonuria in Southern Khorasan Province, Iran. Methods: In this cross-sectional descriptive-analytic study which was performed during the summer of 2019, a total of 32 out of 37 known children and adolescents having phenylketonuria in Southern Khorasan Province were assessed. The age and gender of patients, parents’ marital status, parents’ occupational status, parents’ educational level, the distance between home and phenylketonuria clinic, and the number of affected siblings having phenylketonuria were documented. We were not able to contact five patients having phenylketonuria in Southern Khorasan Province. Data were analyzed by SPSS 16 software using the Mann-Whitney U test and the Kruskal-Wallis test. The significance level was considered P<0.05. Results: Totally, 32 patients with a Mean±SD age of 6.6±4.7 years enrolled in this study among whom 23 were male (71.9%) and 9 patients were female (28.1%). The Mean±SD phenylalanine level in this study group was 8.1±5.2 mg/dL. The disease was optimally controlled in 14 patients (43.3%) and poorly controlled in 18 patients (56.3%). There was not any statistically significant relation between the metabolic control of the disease and any of the assessed social and demographic factors. Conclusions: The disease was properly controlled in 43.3% of the assessed population, and 56.3% had poor metabolic control. There was not any statistically significant relation between the metabolic control of patients having phenylketonuria in Southern Khorasan Province and the assessed demographic and social variables. As the number of known cases in South Khorasan province is limited, the small sample size could be one of the main limitations of our study.

Objectives: Opioid poisoning in children is a common pediatric emergency in Iran. The emergence and spread of new synthetic opioids have come up with new consequences in case of toxicity. In this study, we aimed to evaluate electrocardiographic changes in children with acute opiate poisoning.Methods: This cross-sectional study was performed on all children with opioid poisoning admitted to the emergency ward of Vali-e-Asr Hospital, Birjand, Iran, from December 2015 to February 2017. Data (demographics, manifestations, clinical course, and outcome) were collected using a predesigned checklist. An electrocardiogram (ECG) was obtained and evaluated for arrhythmias, corrected QT interval (QTc), and other ECG indices. Data were analyzed using SPSS version 21. Avalue of P less than 0.05 was considered statistically significant.Results: A total of 85 children were enrolled in this study. Most of them were male (51.8%). The mean age of the patients was 3.46 ± 3.36 years. Among these children, 38.8% were poisoned with synthetic opioids (methadone). Mean QTc length was 399 ± 24 milliseconds in nonsynthetic opioid poisoning and 407 ± 66 milliseconds in methadone poisoning, and it was prolonged (>450 milliseconds) in 3.5% of cases. Other ECG changes were limited to 1 U wave formation (1.2%) that was detected in a patient with methadone poisoning. Conclusions:Electrocardiogram changes due to acute opioid toxicity in children are not common, although in the case of methadone poisoning, long QT interval and associated arrhythmias should be anticipated. Moreover, because of life-threatening effects of opioids such as respiratory insufficiency and decreased consciousness, it is necessary to be prepared for these conditions.

Background: Phenylketonuria is a metabolic disorder resulting from a defect in phenylalanine metabolism with a global prevalence of 1 in 10000. Delayed initiation of dietary modification leads to brain injury and cognitive and behavioral problems. The main objective of this study was to assess the demographic and social factors affecting metabolic control of patients having phenylketonuria in Southern Khorasan Province.Methods: In this cross-sectional descriptive analytic study which was performed during summer 2019, 32 out of 37 known children and adolescents having phenylketonuria in Southern Khorasan Province were assessed. The age of patients, the gender of patients, parents` marital status, parents` occupational status, parents` educational level, the distance between home and phenylketonuria clinic, and the number of affected siblings having phenylketonuria were documented. We were not able to contact five patients having phenylketonuria in Southern Khorasan Province. Data were analyzed by SPSS 16 software using Mann-Whitney U test and Kruskal-Wallis test. The significance level was considered as p <0.05.Results: 32 patients with a mean age of 6.6±4.7 years were enrolled in this study. 23 of them were male (71.9%) and 9 patients were females (28.1%). The mean phenylalanine level in this study group was 8.1±5.2 mg/dl. The disease was optimally controlled in 14 patients (43.3%) and poorly controlled in 18 of them (56.3%). There was not any statistically significant relation between the metabolic control of the disease and any of the assessed social and demographic factors.Conclusion: The disease was properly controlled in 43.3% of the assessed population, and 56.3% had poor metabolic control. There was not any statistically significant relation between the metabolic control of patients having phenylketonuria in Southern Khorasan Province and assessed demographic and social. As the number of known cases in South Khorasan province is limited, small sample size could be one of the main limitations of our study.