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1.  Ingested Foreign Bodies Removed by Lexible Endoscopy in Pediatric Patients: A 10-year Retrospective Study 
Introduction:
Determination of type and location of trapped objects and endoscopic observations among children with foreign-body ingestion.
Materials and Methods:
We evaluated 105 endoscopic records of patients presenting with foreign-body ingestion from 2001–2011.
Results:
Button batteries were the most common objects removed (41%). The lower segment of the esophagus was the most common trapping site. There was significant correlation between type of foreign body and its location of trapping. Abnormal endoscopic observations were reported in 33% patients. There was significant correlation between the type of foreign body and endoscopic observations. There was also a significant correlation between the location of the foreign body and endoscopic observation.
Conclusion:
The pattern of foreign-body ingestion is somewhat different in our center compared with other studies. Awareness among parents about the prevention of this accident is an important step in decreasing the incidence of foreign-body ingestion.
PMCID: PMC4087857
Endoscopy; Ingestion; Pediatric
2.  Effects of Probiotics on Quality of Life in Children with Cystic Fibrosis; A Randomized Controlled Trial 
Iranian Journal of Pediatrics  2013;23(6):669-674.
Objective
Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota and dysregulated immune mediators due to massive exposure to antibiotics. Probiotics as immunomodulatory and anti-inflammatory substances are considered to improve both clinical and biochemical intestinal and pulmonary function in CF patients. We decided to investigate the effects of probiotics on quality of life and pulmonary exacerbations in children with cystic fibrosis.
Methods
In a prospective, randomized, controlled clinical trial, 37 CF patients (2-12 years old) were randomly divided into two groups. 20 patients of probiotic group took probiotics (2×109CFU/d) for one month while 17 patients of control group took placebo capsules. Quality of life was determined using PedsQL™4.0 questionnaire at the beginning, then three and six months after completing the treatment period. Rate of pulmonary exacerbation in probiotic group patients was also evaluated during three months after intervention and compared to the same three months of the previous year. Results were analyzed using SPSS (11.5). P<0.05 was considered statistically significant.
Findings
Significant improvement was observed in the mean total score of parent reported quality of life among probiotic group patients in comparison with placebo group at 3rd month (P=0.01), but this was not significant at 6th month of probiotic treatment. Rate of pulmonary exacerbation was significantly reduced among probiotic group (P<0.01).
Conclusion
Probiotics are considered as useful nutritional supplements on reducing number of pulmonary exacerbations and improving quality of life in patients with cystic fibrosis. Effects of probiotics seem to be temporary and probably continuous ingestion might have more stable improving effects on quality of life.
PMCID: PMC4025125  PMID: 24910746
Cystic Fibrosis; Probiotics; Quality of Life; Pulmonary Exacerbation
3.  Respiratory viral infections in children with asthma: do they matter and can we prevent them? 
BMC Pediatrics  2012;12:147.
Background
Asthma is a major public health problem with a huge social and economic burden affecting 300 million people worldwide. Viral respiratory infections are the major cause of acute asthma exacerbations and may contribute to asthma inception in high risk young children with susceptible genetic background. Acute exacerbations are associated with decreased lung growth or accelerated loss of lung function and, as such, add substantially to both the cost and morbidity associated with asthma.
Discussion
While the importance of preventing viral infection is well established, preventive strategies have not been well explored. Good personal hygiene, hand-washing and avoidance of cigarette smoke are likely to reduce respiratory viral infections. Eating a healthy balanced diet, active probiotic supplements and bacterial-derived products, such as OM-85, may reduce recurrent infections in susceptible children. There are no practical anti-viral therapies currently available that are suitable for widespread use.
Summary
Hand hygiene is the best measure to prevent the common cold. A healthy balanced diet, active probiotic supplements and immunostimulant OM-85 may reduce recurrent infections in asthmatic children.
doi:10.1186/1471-2431-12-147
PMCID: PMC3471019  PMID: 22974166
Acute respiratory infections; Childhood asthma; Common cold; Acute exacerbations; Rhinovirus
4.  Effect of a New Synbiotic Mixture on Atopic Dermatitis in Children: a Randomized-Controlled Trial 
Iranian Journal of Pediatrics  2011;21(2):225-230.
Objective
Atopic dermatitis (AD) is the most common chronic relapsing skin disease seen in infancy and childhood. The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders. Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases. We studied the clinical and immunologic effects of a new symbiotic (a mixture of seven probiotic strains of bacteria and Fructooligosaccharide) in infants and children with AD.
Methods
In a randomized, double-blind, placebo-controlled study, 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks. The Severity Scoring of Atopic Dermatitis (SCORAD) index was recorded at baseline and also at 4 and 8 weeks of treatment.
Findings
There was no significant difference between the probiotic and placebo group in baseline characteristics including sex, age, family history, corticosteroid usage and prick testing. Mean age was 23 months. The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group (P=0.001). No specific effect was demonstrated of the probiotics employed on cytokine profile (P=0.4, P=0.6). Egg white was the most common (45%) allergen followed by peanut and cow's milk.
Conclusion
This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinically improve the severity of AD in young children. Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD.
PMCID: PMC3446166  PMID: 23056792
Atopic dermatitis; Synbiotic; Cytokine; Children; Randomized Controlled Trial

Results 1-4 (4)