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Introduction : Acute gastroenteritis is a typical disorder that accounts for 8-12% of pediatric outpatient visits. Campylobacter and Salmonella infections account for about 8.4% and 11% of global diarrhea cases. Due to the importance of these bacteria in pediatric diseases, the aim of this study was to determine the infectious rate of Salmonella and Campylobacter species and also the frequency of the gene encoding Cytholethal distending toxin in children with community-acquired diarrhea. Materials and Methods: Stool samples of children under 5 years of age with diarrhea were collected. The samples were related to children referred to hospitals in Hamadan, Ardabil, Bandar Abbas and two hospitals in Tehran. DNA was extracted from the samples using a DNA extraction kit from stool. The presence of Campylobacter in the studied samples was detected by polymerase chain reaction using specific primers. A control stool sample was spiked with 10-fold dilution of C. jejuni suspension for LOD (detection limit determination) measurement. Results: In this study, PCR results showed a LOD of 100 CFU per gram in the spiked feces sample. Accordingly, out of 144 fecal samples of children with acute diarrhea, one case was positive for Campylobacter jejuni;this sample was also positive for the presence of cdtB gene. Presence of Salmonella was confirmed in two samples of the patients (1.4%). Conclusion: Low prevalence of Campylobacter and Salmonella was detected in symptomatic children under 5 years of age during the Covid-19 pandemic. Examination of these samples for viruses and other microbial agents can clarify the etiology of diarrhea in children referred to the hospitals.
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Background: In December 2019, a novel coronavirus (a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) emerged in Wuhan, China. Objectives: The current research aimed to evaluate the clinical features of COVID-19 infection in pediatric patients and compare them with those of adult patients in Sanandaj, Iran. Methods: Retrospectively, 56 hospitalized cases, including 32 adult and 24 pediatric patients with COVID-19 from March 7th, 2020, to June 5th, 2020, were enrolled in this study. The clinical and laboratory findings of the pediatric patients with COVID-19 infection were analyzed and compared with those of the adult patients. Results: The average number of fever days in adults was higher than that of pediatric patients (P = 0.04). Cough was more severe in adults than in pediatric patients (P = 0.03). Diarrhea was not statistically different between the two groups. Dizziness was far more common in adults than pediatric patients (P = 0.01). The percentage of blood oxygen saturation decreased in both groups, but there was no statistically significant difference between the two groups. C-reactive protein (CRP) was positive in many patients in both groups;however, there was no difference between the pediatric and adult patients. Lymphopenia was significantly higher in adults than in pediatric patients (P = 0.02). As in pediatric patients, an increase in liver enzymes was seen in adults. However, there was no statistically significant difference between the two groups. Conclusions: The present study showed that pediatric patients with COVID-19 infection have milder clinical symptoms than adults. However, according to the laboratory findings, pediatric patients need to be followed up as well as adult patients.
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Background: Technologies can predict various aspects of COVID-19, such as early prediction of cases and those at higher risks of severe disease. Predictions will yield numerous benefits and can result in a lower number of cases and deaths. Herein, we aimed to review the published models and techniques that predict various COVID-19 outcomes and identify their role in the management of the COVID-19. Methods: This study was a review identifying the prediction models and techniques for management of the COVID-19. Web of Science, Scopus, and PubMed were searched from December 2019 until September 4th, 2021. In addition, Google Scholar was also searched. Results: We have reviewed 59 studies. The authors reviewed prediction techniques in COVID-19 disease management. Studies in these articles have shown that in the section medical setting, most of the subjects were inpatients. In the purpose of the prediction section, mortality was also the most item. In the type of data/predict section, basic patient information, demographic, and laboratory values were the most cases. Also, in the type of technique section, logistic regression was the most item used. Training, internal and external validation, and cross-validation were among the issues raised in the type of validation section. Conclusion: Artificial intelligence and machine learning methods were found to be useful in disease control and prevention. They accelerate the process of diagnosis and move toward great progress in emergency circumstances like the COVID-19 pandemic. Copyright © 2023, Journal of Iranian Medical Council. All rights reserved. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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With the development of modern technologies in the field of healthcare, the use of Artificial Intelligence (AI) in disease management is increasing. AI methods may assist healthcare providers in the COVID-19 era. The current study aimed to observe the efficacy and importance of AI for managing the COVID-19 pandemic. An organized search was conducted, utilizing PubMed, Web of Science, Scopus, Embase, and Cochrane up to September 2022. Studies were considered qualified for inclusion if they met the inclusion criterion. We conducted review according to the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA) guidelines. There were 52 documents that met the eligibility criteria to be included in the review. The most common item using AI during the COVID-19 era was predictive models to foretell pneumonia and mortality risks in people with COVID-19 based on medical and experimental parameters. COVID-19 mortality was related to being male and elderly based on the Artificial Neural Network (ANN) and Convolutional Neural Network (CNN) logistic regression analysis of demographics, clinical data, and laboratory tests of hospitalized COVID-19 patients. AI can predict, diagnose and model COVID-19 by using techniques such as support vector machines, decision trees, and neural networks. It is suggested that future research should deal with the design and development of AI-based tools for the management of chronic diseases such as COVID-19. © 2023 Samaneh Mohammadi, SeyedAhmad SeyedAlinaghi, Mohammad Heydari, Zahra Pashaei, Pegah Mirzapour, Amirali Karimi, Amir Masoud Afsahi, Peyman Mirghaderi, Parsa Mohammadi, Ghazal Arjmand, Yasna Soleimani, Ayein Azarnoush, Hengameh Mojdeganlou, Mohsen Dashti, Hadiseh Azadi Cheshmekabodi, Sanaz Varshochi, Mohammad Mehrtak, Ahmadreza Shamsabadi, Esmaeil Mehraeen, and Daniel Hackett. This open-access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
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Background: Due to the lack of definitive treatments for corona disease and the use of various medications in protocols around the world, it is necessary to conduct more epidemiological studies exploring the effect of different available therapeutic regimes;therefore, the present study aimed to explore the current effective drugs for the treatment of hospitalized COVID-19 patients. Methods: The present study is a descriptive-analytical study that was conducted between August and September of 2021 at Khalkhal University of Medical Sciences. A convenient sampling method was employed to retrieve the data from the available hospital records, including 252 documents from COVID-19 hospitalized patients. A researcher-made checklist was used to record the data. Data were analyzed using SPSS 26 software. Results: The findings showed that Hypertension and Hypotension (n=47,18.7%) are the most common underlying diseases in the study sample. The most therapeutic regimen was the combination of Remdesivir and Dexametason (n=137,54.4%) in hospitalized COVID-19 patients. There are a variety of organ involvements and presentations to the COVID-19;however, most patients experience a mild-to-moderate, self-limited disease;even though, the disease could progress to more fatal cases and lead to death. Conclusion: The main pathology exists in the lungs which are caused by an inappropriate immune response that leads to a severe inflammatory response. Therefore, antiviral and anti-inflammatory drugs are currently the first-line therapy for hospitalized patients. Copyright 2023, Journal of Iranian Medical Council.
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Introduction: SARS-CoV-2 is the cause of the recent pandemic. Although children are less affected by the virus, they can present with various presentations ranging from asymptomatic or fatigue and fever to multisystem inflammatory syndrome in children (MIS-C). Case Presentation: In this case report, we presented a case of a 9-year-old boy who presented with bilateral deep vein thromboses (DVTs) of the femoral and iliac veins as his main presentation of MIS-C, which occurred following a COVID-19 infection. A complete history was taken from the patient, and then a series of tests, including complete blood counts (CBCs), liver function tests (LFTs), and D-dimer, were performed. Bilateral doppler sonography to confirm the event and its location, as well as a decent follow-up method, were performed. Levels of anti-Xa assays followed the toxic levels of enoxaparin. The child was treated with a regimen of enoxaparin and corticosteroids, with a dosage of 1 mg/kg/12 h for both. The child was in the hospital for two weeks, after which he got better and was managed as an out-patient with a regularly scheduled appointment. Finally, once the radiologic evidence of DVTs was cleared, the patient tapered off his enoxaparin over the course of three weeks. Conclusion(s): Thrombotic events following COVID-19-associated MIS-C are an unlikely yet deadly event, especially in children. Prompt treatment with anticoagulants and corticosteroids alongside monitoring the patients are strongly advised.Copyright © 2022, Author(s).
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Background: The coronavirus disease 2019 (COVID-19) pandemic was a unique global challenge with a wide range of severity extending from an asymptomatic form to a serious intense respiratory syndrome. This study aimed to detect SARS-CoV-2 in the follicular and endocervical fluid of in vitro fertilization (IVF) candidate patients with a positive polymerase chain reaction (PCR) test for SARS-CoV-2. Method(s): All participants and their partners, who were a candidate to start assisted reproductive technology (ART) from April 2020 to October 2020, completed a triage questionnaire two weeks before starting the ART cycle. According to Avicenna center protocol, a diagnostic test for COVID-19 using real-time PCR of nasopharyngeal swabs was performed on all ART candidates, 48 hours before the day of the oocyte trigger. In the operating room, sterile swabs were used to provide cervicovaginal specimens to determine SARS-CoV-2 in cervicovaginal fluid. Moreover, the first aspirated follicular fluid was referred to the lab to assess the presence of SARS-CoV-2. Result(s): A positive PCR test for SARS-CoV-2 was verified in 32 participants. In this study, virus particles were not detected in the follicular and endocervical fluid of the women with positive PCR tests. Conclusion(s): We are still at the beginning of the road and need reliable data on the safety of ART at the time of the pandemic. The risk of infection during all processes of ART including oocyte retrieval needs attention. The fluid from mature follicles is a potential site to be infected and the human cumulus cells could not be a deterrent factor to the entrance of the virus in the oocyte. This process may lead to gametes infection. We did not detect virus RNA in the follicular and endocervical fluid of the patients with a positive PCR test. Although, more studies with a larger sample size are mandatory in this field.
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Background: The large proportion of coronavirus disease 2019 (COVID-19) patients has been associated with a large number of neu-ropsychiatric manifestations. Despite the high prevalence of COVID-19, few studies have examined such manifestations, especially in children and adolescents. Objective(s): This study investigated neuropsychiatric manifestations in hospitalized children and adolescents admitted for COVID-19 infection in Iran. Method(s): This prospective observational study included admitted children and adolescents (4-18 years old) diagnosed with COVID-19 infection, pediatric neurologists, child and adolescent psychiatrists, and infectious disease specialists, and assessed 375 infected patients during August and December 2021. Result(s): Of the 375 patients, 176 (47%) were female, with a mean age of 9.0 +/- 3.39 years. Psychiatric and neurological manifestations were reported in 58 (15.5%) and 58 (15.5%) patients, respectively. The most prevalent psychiatric disorders were separation anxiety disorder (SAD) (5.1%), major depressive disorder (MDD) (3.5%), generalized anxiety disorder (GAD) (2.7%), insomnia (2.4%), and op-positional defiant disorder (ODD) (2.4%). Regarding neurological complications, seizures were the most prevalent (13.1%), followed by encephalitis (1.9%), transverse myelitis (0.3%), acute ischemic stroke (0.3%), and Guillain-Barre syndrome (0.3%). There was no significant relationship between the duration of COVID-19 infection (P = 0.54) and ICU admission (P = 0.44) with the emergence of psychiatric symptoms. Conclusion(s): The most prevalent neurologic and psychiatric complications among children and adolescents with COVID-19 infection were seizures and the symptoms of anxiety/mood disorders, respectively.Copyright © 2023, Author(s).
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Background: During the Coronavirus 2019 (COVID-19) outbreak, Iranian medical sciences students were at higher risk of contracting this virus because they were in infected environments. So, they are predisposed to high levels of anxiety that could worsen their lives. The determent of factors and levels of anxiety could be helpful to reduce anxiety and control its worse effects. Hence, this study aimed to measure the anxiety index and its factors among medical sciences students during the COVID-19 pandemic in Iran. Materials and Methods: In this cross-sectional study, an online survey was sent to students from 27 medical sciences universities in Iran from 20th December 2020 to 10th March 2021. The online survey consists of the Health Anxiety Inventory (HAI) for measured general health anxiety as well as the baseline characteristics of students. Results: 723 students responded, including 483 (66.8%) females and mean HAI score was 16.76 +/- 8.35. Based on our findings, gender, past medical, and drug history were significantly related to the high level of anxiety. However, there was no coloration between HAI scores with age, the field of study, study duration, university location, and attendance in the hospital and/ or COVID-19 ward (P>0.05). Conclusions: Students with notable past medical history and/or drug history and female students more than others were predisposed to anxiety in a pandemic such as COVID-19. Hence, in a pandemic situation, psychological care should concern them. [GMJ.2022;11:e2537] DOI:10.31661/gmj.v11i.2537
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Background: Hospital-acquired infection with carbapenem-resistant Enterobacteriaceae (CRE) is a global concern. The administration of antibiotics among the infected and non-infected immunocompromised children with SARS-CoV-2 is associated with an increased risk of intestinal CRE colonization and bacteremia during hospitalization. Objective(s): The present study aimed to detect the correlation between the intestinal colonization of carbapenemase encoding Enterobacteriaceae with SARS-CoV-2 infection and antibiotic prescription among immunocompromised children admitted to the oncology and Bone Marrow Transplantation (BMT) wards. Method(s): Stool samples were collected from the immunocompromised children, and the members of Enterobacteriaceae were isolated using standard microbiological laboratory methods. Carbapenem resistance isolates were initially characterized by the disc diffusion method according to CLSI 2021 and further confirmed by the PCR assay. SARS-CoV-2 infection was also recorded according to documented real-time PCR results. Result(s): In this study, 102 Enterobacteriaceae isolates were collected from the stool samples. The isolates were from Escherichia spp. (59/102, 57.8%), Klebsiella spp. (34/102, 33.3%), Enterobacter spp. (5/102, 4.9%), Citrobacter spp. (2/102, 1.9%), and Serratia spp. (2/102, 1.9%). The carbapenem resistance phenotype was detected among 42.37%, 73.52%, 40%, 50%, and 100% of Escherichia spp., Klebsiella spp., Enterobacter spp., Citrobacter spp., and Serratia spp., respectively. Moreover, blaOXA-48 (49.1%) and blaNDM-1 (29.4%), as well as blaVIM (19.6%) and blaKPC (17.6%) were common in the CRE isolates. SARS-CoV-2 infection was detected in 50% of the participants;however, it was confirmed in 65.45% (36/55) of the intestinal CRE carriers. The administration of antibiotics, mainly broad-spectrum antibiotics, had a significant correlation with the CRE colonization in both the infected and non-infected children with SARS-CoV-2 infection. Conclusion(s): Regardless of the COVID-19 status, prolonged hospitalization and antibiotic prescription are major risk factors associated with the CRE intestinal colonization in immunocompromised children. Copyright © 2023, Author(s).
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Introduction: Acute gastroenteritis is a typical disorder that accounts for 8-12% of pediatric outpatient visits. Campylobacter and Salmonella infections account for about 8.4% and 11% of global diarrhea cases. Due to the importance of these bacteria in pediatric diseases, the aim of this study was to determine the infectious rate of Salmonella and Campylobacter species and also the frequency of the gene encoding Cytholethal distending toxin in children with community-acquired diarrhea. Material(s) and Method(s): Stool samples of children under 5 years of age with diarrhea were collected. The samples were related to children referred to hospitals in Hamadan, Ardabil, Bandar Abbas and two hospitals in Tehran. DNA was extracted from the samples using a DNA extraction kit from stool. The presence of Campylobacter in the studied samples was detected by polymerase chain reaction using specific primers. A control stool sample was spiked with 10-fold dilution of C. jejuni suspension for LOD (detection limit determination) measurement. Result(s): In this study, PCR results showed a LOD of 100 CFU per gram in the spiked feces sample. Accordingly, out of 144 fecal samples of children with acute diarrhea, one case was positive for Campylobacter jejuni;this sample was also positive for the presence of cdtB gene. Presence of Salmonella was confirmed in two samples of the patients (1.4%). Conclusion(s): Low prevalence of Campylobacter and Salmonella was detected in symptomatic children under 5 years of age during the Covid-19 pandemic. Examination of these samples for viruses and other microbial agents can clarify the etiology of diarrhea in children referred to the hospitals. Copyright © 2022, Semnan University of Medical Sciences. All rights reserved.
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Many universities stopped face-to-face instruction in March 2020 due to the COVID-19 pandemic and forced courses to be online through the summer 2021. In the fall 2021, many students returned to face-to-face instruction. After the two face-to-face exams, nearly 60% of the class was failing a heat transfer class that is significantly higher than pre-pandemic semesters. The instructor offered to meet one-on-one with each student and two-thirds of the class did meet with the instructor. The instructor learned that many students (1) devoting less than 2 hours per week to the course outside class room, (2) do not read the textbook and (3) primarily study by reviewing instructor-provided notes the evening before the exam. The individual meeting helped build instructor-student connectedness and helped students develop a personal strategy to improve class performance. Many students responded positively and grades improved from 40% mid-term pass rate to 73% final course pass rate, yet this is about 20% lower than pre-pandemic pass rates. The improvement is largely attributed to improved student-instructor rapport and students being open to practical suggestions to help increase study productivity and improve student learning. © American Society for Engineering Education, 2022.
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The coronavirus disease 2019 (COVID-19) outbreak started in December 2019. The disease can manifest in various respiratory and non-respiratory symptoms and clinical findings. The signs and symptoms of this disease in children are not entirely known yet. Ground-glass opacity and pleural effusion in the chest computed tomography scan have been reported in infected patients. The pleural effusion has been reported in a few cases. The present case report describes a pediatric patient with the chief complaints of fever, diarrhea, and vomiting who presented to an emergency department with a differential diagnosis of a gastrointestinal infection. However, he was diagnosed with COVID-19, which was complicated by respiratory distress and pleural effusion.
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Background and Aim: The objective of this study was to determine the seroepidemiological history of SARS-CoV-2 infection among asymptomatic children in Tehran. Materials and Methods: Blood samples of children younger than 14 years old were collected during the period autumn-winter 2020 and spring 2021 and tested for SARS-CoV-2 IgG antibody using the EUROIMMUN ELISA kit. In addition, questionnaires were used to collect demographic and infection status information in the participants. Data were analyzed using the SPSS software.
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Due to our mistake in entering the affiliation and name of Mojgan Sarmadi in our article (Article ID: 110201, DOI: 10.5812/pedinfect.110201), we would like to apologize for any inconvenience made to our author and her affiliated organization, which is "National Institute of Dental and Craniofacial Research, Oral Immunity and Infection Unit, Oral and Pharyngeal Cancer Branch, National Institute of Health, Bethesda, MD 20892, US". We declare the correct affiliation of Mojgan Sarmadi is a private practice. © 2022, Author(s).
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Context: COVID-19 and influenza coinfection may increase mortality and morbidity during the COVID-19 pandemic. Recognizing the differences and similarities between COVID-19 and influenza helps us diagnose and treat these 2 diseases. Accordingly, we aimed to compare virologic, clinical, paraclinical, and radiological features and prophylactic and therapeutic management of SARS-CoV-2 and influenza infections. We also provided an algorithmic approach to the diagnosis and treatment of SARS-CoV-2 and influenza coinfection in children. Evidence Acquisition: Electronic databases, including Cochrane Collaboration, PubMed, Google Scholar, and EMBASE, were searched for the articles published in English language using the following keywords: “influenza virus,” “SARS-CoV-2 virus,” “COVID-19,” “comparison,” “coinfection,” “management,” “treatment,” “antiviral therapy,” “vaccines,” “children,” and “adults.” Boolean op-erations (AND and OR) were used to refine the search. No date limitation was applied. Results: SARS-CoV-2 and influenza are both RNA viruses with different receptors. The reproductive rate of SARS-CoV-2 is higher than influenza. Patients with SARS-CoV-2 infection, particularly adults, have higher rates of anosmia/ageusia. Organ involvement occurs more frequently in COVID-19 cases, and multisystem inflammatory syndrome in children (MIS-C) occurs especially in children. Disease severity, excessive immune response, and mortality are higher in SARS-CoV-2. Radiological peripheral lesions and ground-glass appearance are characteristic of COVID-19 infection. It is important to rule out influenza and SARS-CoV-2 infection in patients with respiratory problems during the pandemic. Timely prescription of currently available antiviral drugs is essential. Conclusions: Treatment of patients suspected of having a coinfection is determined by the patient’s condition and polymerase chain reaction (PCR) evaluation.
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Guillain-Barre syndrome (GBS) characterizes a monophasic ascending, symmetrical paralysis, with areflexia, progressing over days to weeks. Normally, as a post-infectious autoimmune procedure, it leads to destroying myelin. Scattered reports exist regarding the concurrent evidence of COVID-19 infection and adults with possible GBS. However, few former cases were reported in children. Here in, we report an 11 years-old boy with GBS concurrent with COVID-19 infection. © 2021, Author(s).
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Serious, and sometimes, deadly complications of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are devastating. Whereas most manifestations of COVID-19 are respiratory (fever, dry cough, fatigue, pneumonia), it is getting to be progressively recognized that numerous organ functions can be affected by this disease, and the nervous system is one of them as neurological complications can affect up to 36% of adult patients. However, the prevalence and pathophysiology of these complications have yet to be fully elucidated in children. Here, we discuss an infant with neurological symptoms manifested as chronic isolated aseptic meningitis associated with COVID-19, which was unresponsive to ordinary treatments and dramatically responsive to dexamethasone. Immune-mediated reactions may have had a major pathophysiologic role in this case. © 2021, Author(s).