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BackgroundKawasaki disease (KD) as an acute, systemic vasculitis is the leading cause of acquired heart disease in children under the age of 5 years.MethodsA 10-year cross-sectional retrospective study was designed to assess 190 Iranian children with KD during 2008–2018. Demographic data, clinical and laboratory manifestations from the onset of symptoms to diagnosis, clinical signs and symptoms, and subsequent treatments were evaluated to predict hospitalization stay, complications, and response to treatment.ResultsChildren with KD had a male-to-female ratio of 1.18:1 and an average age of 36 months. There was an insignificantly more incidence of KD in cold seasons. The most frequent symptoms were fever (92.6%), oral mucus membrane changes (75.8%), bilateral bulbar conjunctival injection (73.7%), polymorphous skin rash (73.2%), peripheral extremity changes (63.7%), and cervical lymphadenopathy (60.0%). The rate of gastrointestinal, cardiac, joint, and hepatic complications was determined to be 38.4, 27.9, 6.8, and 4.2%, respectively. 89.5% of patients received intravenous immunoglobulin (IVIG) plus aspirin as the first line of treatment, while, 16.3% of them needed an extra second line of treatment. Significantly low serum sodium levels and high platelet counts were detected in KD patients with cardiac complications. Cardiac complications often were more encountered in patients who did not respond to the first line of treatment. Higher platelet count, lower serum sodium amount, and C-reactive protein (CRP) level were significantly associated with a need for an additive second line of treatment. A significant relationship between hospitalization stay and hemoglobin level was found.ConclusionAs most of the clinical manifestations and complications were following other reports released over the past few years, such data can be confidently used to diagnose KD in Iran. Seasonal incidence and a positive history of recent infection in a notable number of patients may provide clues to understand possible etiologies of KD. Laboratory markers can successfully contribute to health practitioners with the clinical judgment of the need for additional treatments, possible complications, and hospitalization duration.

Background Upper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy. Objective A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics. Methods A cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012–2018 was conducted. The ultrasound examination of kidneys and urinary tract during hospitalization, the incidence of clinical symptoms, and laboratory markers in blood and urine were monitored to identify the best predictive factors of early diagnosis of this bacterial infection. Results Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, and vomiting, while others were asymptomatic. A much frequency of pyuria (88.46%), Escherichia coli in urine (92.31%), leukocytosis (81.73%), and high ESR (> 10 mm/h, 92.30%) and CRP (> 10 mg/L, 82.82%) was observed. The kidney and urinary tract ultrasonography only in 32.7% of children revealed findings in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis). Conclusion There was a high frequency of clinical signs and laboratory markers associated with pyelonephritis. Ultrasound alone was not an efficient tool to track febrile UTI as most patients presented normal sonography.

Aim: We investigated the genetic characterization of the respiratory syncytial virus (RSV) ON-1 genotypes and their different lineages based on the G gene among children

Background Childhood hypertension (CH) is related to the dietary intake and diversity of children. The study aimed to assess the critical role of dietary diversity, and seafood long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) in reducing CH among the Iranian community. Methods A cross-sectional two-phase study with 7–12-year-old Iranian students was designed. In the initial phase, the socio-demographic characteristics, and blood pressure status (normal, pre-hypertension, and hypertension) based on systolic (SBP) and diastolic (DBP) blood pressure data were assessed. The 24-h dietary recall questionnaire was used to generate the dietary diversity score (DDS, count of consumed food groups) and dietary variety score (DVS, the cumulative number of daily consumed food items). In the second phase, the association between CH reduction and changes in serum 25-hydroxyvitamin D (25OHD), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG) levels of schoolchildren intervened by a seafood diet rich in omega-3 fatty acids were assessed using the regression analyses. Results The pre-hypertension and hypertension prevalence rates were 7.8 and 9.15%, respectively. CH was significantly associated with age, gender, and DDS. A significant inverse association was found between the high intake of seafood and CH (P = 0.032). The gas-chromatography analysis showed the high presence of α-linolenic (ALA, 6.72%), eicosapentaenoic (EPA, 7.62%), docosapentaenoic (DPA, 5.88%), and docosahexaenoic (DHA, 18.52%) acids in the seafood-based diet (p p Conclusions The age and DDS were efficient predictors for the different CH status. A regular seafood-rich dietary pattern due to the high LC n-3 PUFAs contents could significantly reduce the obesity-related cardiovascular risk factors.

Background The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis. Methods A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated. Results 92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI. Conclusions Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN.

Synbiotic yogurts (SYs) are potential natural cures with improved health outcomes and prevention and control of chronic diseases through the synergistic action of probiotic bacteria and prebiotic compounds. Recent clinical achievements in consuming SYs in healthy and patient pediatric and adult populations were critically reviewed. Some forthcoming challenges and interesting solutions to increase healthy nutritional effects of these dairy products have also been addressed. The use of SY-based nutrition pattern in children can considerably increase their body's immunity with an improvement in social and school functioning. SY consumption not only reduces childhood digestive problems but also remarkably decreases the illness duration and symptoms' severity. Increasing the number of bifidobacteria and lactobacilli in gastrointestinal (GI) tract of healthy adults consuming SYs can significantly reduce the pathogenic bacteria in feces. The regular intake of SYs with enhanced bioavailability of bioactive compounds in a short intestinal transit time reduces the risk of cardiovascular disease among hypercholesterolemic adults. Also, a meaningful improvement in the health status of adult patients with irritable bowel syndrome and nonalcoholic fatty liver disease has been assessed after eating this bio-functional supplement product. Administration of a healthy SY-based diet purposefully alters microbiota composition, provides a microbial balance in the gut, and promotes GI functions in pediatric and geriatric age groups. Full recovery without any further complications during the follow-up period in elderly patients can also be obtained by implementing the SY-based dietary guideline.

Background: Upper urinary tract infection (UTI) or pyelonephritismay increase the pathogenesis rate and risk of severe complications in children due to the atrophy of the kidneys.Objective: A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to reach early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics.Methods: A cross-sectional study was conducted on 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012-2018. The ultrasound examination of kidneys and urinary tract during the hospitalization period, the incidence of clinical symptoms, and the monitoring of laboratory markersin blood and urine were studied to identify the best predictive factors of early diagnosis of this bacterial infection.Results: Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, andvomiting, whileotherswere asymptomatic. A considerable frequency of pyuria(88.4%), Escherichia coli in urine (92%), leukocytosis (81.7%), and high ESR (> mm/h, 80%) and CRP (> 10mg/L, 82.8%) was observed. The kidney and urinary tract ultrasonography onlyin 32.7% of children showed in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis).Conclusion: In the majority of patients, there was a high prevalence of clinical signs and laboratory markers associated with pyelonephritis. Since most patients have normal sonography, ultrasound alonecould notbe an efficient tool fortracingfebrile UTI.

Background The Secretor (FUT2) and lewis gene (FUT3) are in charge of the construction of histo-blood group antigens, which act as a receptor for some Pathogenes. This study aimed to estimate the prevalence of five significant single nucleotide polymorphisms (SNPs) in Iranian children. Methods In this cross-sectional study, 102 blood samples collected from hospitalized children. The FUT2 gene region was amplified and sequenced to explore rs1047781 and rs601338, and the FUT3 gene region was amplified to explore rs28362459, rs812936, rs778986 SNPs. Results In FUT2 gene, Se358,428 that produces Se phenotype with 63% (0.53 - 0.72) prevalence, was the most common genotype. For FUT3 gene Le59,202,314 with 80% prevalence was most common genotype (0.71 - 0.87). Conclusion This study genotyped Secretor and Lewis genes and designated SNPs’ distinct distribution in Iran, and clarified at-risk groups for certain diseases.

AIM: The objective of this study was to evaluate the frequency of risk factors for bacteremia in children less than 15 years of age was determined in Bahrami Hospital during 2013-2016. METHODS: This study conducted on 84 children aged 3 months’ to15 years old, who hospitalised in the pediatrics ward and the PICU in Bahrami Hospital from 2012 to 2016. Our study consisted of 46 boys (54.2%) and 38 girls. Moreover, 24.1% of subjects (20 patients) were entered in the study as young as three months old, followed by three months to three years (49.4 %; 41 subjects), and 3 to 15 years of age (26.5%; 22 individuals). RESULTS: The average hospitalization duration was determined to be 15.30 ± 8.75 days. Moreover, our results revealed that a history of blood transfusion in 11.2% of patients. On the other hand, 35.7% of cases were determined to be positive for blood cultures. The microorganisms reported from positive blood cultures include Enterobacter (81.48%), Escherichia coli (11.11%) and Klebsiella (3.70%). Also, 50% of patients were hospitalised in the internal ward, 12% received immunosuppressive drugs, and 96.4% of the patients had a history of vaccination. CONCLUSION: Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to those reported in critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted.

One of the causes of infants' hospitalizations is bronchiolitis, while different viral agents could be causative agents. As there is little information regarding the common agents of bronchiolitis in Iranian infants, we designed this study to determine which agents were responsible for hospitalization due to bronchiolitis among infants in an Iranian tertiary center. Two hundred and three infants with bronchiolitis who were hospitalized in Bahrami hospital were enrolled. Data regarding age, sex, duration of hospitalization, exposure to smoking, previous antibiotic usage and fever were collected for all enrolled cases. Throat sample by means of soap was collected and rapid test with immunochromatography (IC) test was performed. Rapid test was positive in 59 (29%) cases and three cases had concomitant infection with two viruses. The most common viral agent was RSV (Respiratory Syncytial Virus). Mean age was significantly lower in cases with RSV or RSV+ adenovirus infectious in comparison with other two groups (adenovirus or influenza only), while mean duration of hospitalization was significantly longer in RSV/RSV+ adenovirus group. RSV is the most common viral etiology of bronchiolitis in Iranian infants less than one year old, which is related with younger age and longer duration of hospitalization.

The RSV-associated disease accounts for a significant health burden particularly in infants and young children who need to be hospitalized. Since continuous surveillance of circulating RSV genotypes is critical worldwide, this study aimed to investigate the genetic diversity of RSV circulating strains causing upper or lower acute respiratory infection. Our attention was geared towards studying the cases in hospitalized or outpatient children younger than 2 years of age in Iran during 2018/2019. In this study, nasopharyngeal aspirates collected from 206 children who presented with respiratory infection symptoms, were admitted to the referral pediatric ward of Bahrami children’s hospital in Tehran, Iran. RSV-positive samples were detected via Nested RT-PCR. The glycoprotein gene was sequenced, and virus genotypes were confirmed through phylogenetic analysis by the MEGA X program. A total of 74(35.92%) samples tested positive for RSV. Among them, sequencing was done in 10 specimens from 2018 (RSV-A: RSV-B =4:6) and 19 specimens from 2019 (RSV-A: RSV-B =16:3). According to Phylogenetic analysis, all RSV-A strains were assigned as ON1 genotype and RSV-B strains were assigned as BA9 genotype. A new N-glycosylation site in Iranian BA9 and positive selection in ON1 genotype was observed. Phylogenetic characterization of strains in the current study revealed co-circulation of ON1 and BA9 as the only prevalent genotypes of both RSV-A and –B groups.

An accumulating body of evidence suggests that the endocannabinoid system plays a significant role in pathophysiological processes and impacts disease severity. Here we investigate the possible role of a cannabinoid receptor type 2 (CB2) functional variant in determining disease severity and the potential pharmacological therapeutic effects of CB2 activation in viral respiratory infection. The common missense variant (CAA/CGG; Q63R) of the gene-encoding CB2 receptor (CNR2) was evaluated in 90 inpatient and 90 outpatient children with acute respiratory tract infection (ARTI). The frequency distribution of respiratory syncytial virus (RSV)-the main cause of severe cases of bronchiolitis and pneumonia in children-was studied in all collected samples. The mechanism through which CB2 affects clinical outcomes in case of RSV infection was studied in Balb/c mice model using AM630 as a CB2 antagonist. The potential therapeutic effect of CB2 activation during RSV infection was studied using a selective agonist, JWH133. The CB2 Q63R variation was associated with increased risk of hospitalization in children with ARTI. Children carrying the QQ genotype were more prone to developing severe ARTI (OR = 3.275, 95% CI: 1.221–8.705; p = 0.019). Of all the children enrolled in the study, 83 patients (46.1%) were found positive for RSV infection. The associated risk of developing severe ARTI following RSV infection increased more than two-fold in children carrying the Q allele (OR = 2.148, 95% CI: 1.092–4.224; p = 0.026). In mice, the blockade of CB2 by AM630 during RSV infection enhanced the influx of BAL cells and production of cytokines/chemokines while exaggerating lung pathology. CB2 activation by JWH133 reduces the influx of BAL cells and production of cytokines/chemokines while alleviating lung pathology. Collectively, CB2 is associated with RSV severity during infancy and may serve as a therapeutic target in RSV infection through the alleviation of virus-associated immunopathology.

Background:Children with urolithiasis have a wide range of metabolic disorders which should be carefully considered. The response to medical treatment could predict recurrence and need for surgical interventions. Objectives:The goal of this retrospective study is to determine the prevalence of metabolic disorders in Iranian children and assess patients’ response to treatment based on the etiology of their urolithiasis. Materials and methods:Medical record of 100 children with urolithiasis who were referred to Bahrami hospital (affiliated hospital of Tehran University of Medical Sciences) between 2007 and 2017. Data regarding age, sex, family history, symptoms, size of the stones, type of treatments, response to treatment, and recurrence were recorded for all cases Results:Subjects had a mean age of 36 ±36 months and 62 (62%) of them were females. Twenty-two percent had a family history of urolithiasis. The mean age was 37.2±35 months in the complete response group, 38±44.4 months in the partial group, and 30±33.1 months in the no response group (p=0.7). There was no significant difference regarding sex and age with treatment response (p=0.8). In the complete response group, nearly 72% of cases had stones with sizes less than 3 mm. Three cases had surgical interventions and 18 had recurrence. Conclusions:Hypercalciuria followed by hyperoxaluria were the most common metabolic disorders in Iranian children with urolithiasis. Stone size plays an important role in the response to treatment.

Dietary diversity scoring is a good method to assess quality of individual's diet. The study aimed to investigate the association between dietary diversity and body mass index among elementary school students in the south of Tehran, Iran. This cross-sectional study was conducted on elementary school students, age range of 7-12 years old, in 2015. Data were collected using a personal information questionnaire and three 24-h recall questionnaires. Dietary diversity score was calculated from the number of food groups in these questionnaires. A total of 536 students, 258 (48.1%) female and 278 (51.9%) male, were recruited in the study. The mean age of the students was 9.43 ± 1.73 years. Seafood consumption was more frequent and beans was lower frequent in students at higher BMI (≥95th percentile) than the other children (34% vs 25% and 71% vs 83%, respectively, p

Legionella pneumophila is the causative agent of more than 95% cases of severe Legionella pneumonia. Nosocomial pneumonias in different hospital wards is an important medical and pharmaceutical concern. This study aimed to detect Legionella with two methods: polymerase chain reaction [PCR] and detection of urine antigenic test [UAT] in patients suffering from nosocomial pneumonia admitted to pediatric intensive care unit [PICU] of children hospitals. This study was conducted in PICU wards of Rasool Akram and Bahrami children hospitals, Tehran, Iran during 2013 - 2014. In patients diagnosed with hospital-acquired pneumonia, intratracheal secretion samples for PCR and urine sample for urinary antigen test [UTA] were taken. Simultaneously, PCR and urinary antigen test were conducted using commercial kits. The results of urinary antigen test and PCR were analyzed by SPSS v.19 for statistical comparison. In this study, 96 patients aging 2.77 years on average with two age peaks of less than 1 year and 7-8 year were enrolled. More than half of the patients were under 1 year old. The most common underlying diseases were seizure, Acute Lymphoblastic Lymphoma, Down syndrome and metabolic syndromes. The positivity rate of Legionella urinary antigen test was 16.7% and positivity rate of PCR test was 19.8%. There were no significant associations between the results obtained by both assays with age, gender or underlying diseases. In conclusion, PCR is a better detection method for Legionella infection than urinary antigen test, but the difference between the two methods was not significant.

Background Antimicrobial stewardship program (ASP) is a distinguished method to improve the prescription and efficacy of antibiotics. Aim The efficacy of ASP and conventional methods was compared to measure the effectiveness of meropenem (MPM) and vancomycin (VMN) antibiotics in pediatric patients. Design In an interventional quasi-experimental study, 135 children admitted in Children’s Hospital affiliated to University of Medical Sciences in time periods of 2014–2015 and 2015–2016 were assessed. Methods The conventional and ASP methods in 2014–2015 and 2015–2016 were respectively utilized to provide the best antimicrobial therapy of MPM and VMN antibiotics in patient children. The data of mortality rate (MR), antibiotic prescription (AP), antibiotic dose (ADe), antibiotic duration (ADn), length of hospital stay (LOHS), and blood cultures (BCs) were compared across the years using the Chi square, independent t test, and Fisher’s exact test. Results The levels of MR, AP, ADe, ADn, LOHS, and positive BCs using the ASP method in 2015–2016 were significantly lower those of in 2014–2015 using the conventional one (p

Background: Major attention has been drawn to the prognostic value of plasma/serum neutrophil gelatinase-associated lipocalin (NGAL) in detection of acute kidney injury (AKI) in children, but still no consensus has been reached. Accordingly, the present study aimed to assess the diagnostic value of this biomarker in detection of acute kidney injury in children through a systematic review and meta-analysis. Materials and Methods: Two independent reviewers carried out a comprehensive search in electronic databases up to the end of August, 2016. After summarization of studies, screening performance characteristics of plasma/serum NGAL were evaluated in detection of AKI. The area under the curve of receiver operating characteristics curve, sensitivity, specificity, positive and negative likelihood ratios and diagnostic odds ratio of NGAL were calculated using a mixed-effects binary regression model. A p-value less than 0.05 was considered as significance threshold in all analyses. Results : Data from 22 studies (2,213 non-AKI children and 1,109 AKI patients) were pooled and analyzed. Analyses revealed that the performance of plasma/seum NGAL is maximal when the level of this biomarker is measured in the first 12 hours after admission or surgery, considering a cut-off level of 100 mg/dL. In this setting the area under the curve, sensitivity, specificity and diagnostic odds ratio of plasma/serum NGAL were 0.94 (95% CI: 0.91-0.95), 0.87 (95% CI: 0.67-0.96), 0.88 (95% CI: 0.65-0.96) and 48.05 (95% CI: 9.20-251.04), respectively. Conclusion: The high diagnostic value in the first few hours is one of the advantages of plasma/serum NGAL, emphasizing its usefulness in clinical evaluations.

Background and Objective: Diarrhea (as one of the main manifestations of parasitic or microbial infections in gastrointestinal tract) is still a leading cause of mortality and morbidity in children younger than 5 years old in developing countries such as Iran. Objective: Identify and compare the relationship between serum levels of zinc, vitamin A and D in children with acute gastroenteritis (AGE) and the control group to demonstrate that those who need hospitalization due to infection have lower levels of said elements. Materials and Methods: This was a cross sectional study on 25 patients with AGE in pediatric ward of Rasul Akram hospital and Bahrami Hospital during a year (2011-2012), were compared to 40 other patients who were admitted to surgical wards for elective surgery. 72% of all the patients were male and 28% were female. All patients were older than 6 months years; mean age of cases was 2.17 years. Serum levels of vitamins A and D and zinc were measured using HPLC; Radioimmunoassay; atomic methods in 2 groups. Findings: Despite the lower levels of vitamins A in cases than controls, serum levels were not significantly different (p=0.5). Serum levels of zinc were considerably but not significantly lower in cases than the controls (p=0.06). However, serum levels of vitamin D were significantly lower in AGE cases (p=0.003). Conclusion: We found lower serum levels of vitamin D in AGE cases but no difference had found in serum levels of vitamin A and zinc between the two groups probably is the end result of various effects of vitamin A and zinc on diarrhea in different age groups and AGE. This trial emphasizes therapeutic effects of vitamin D supplementation on AGE in children especially in those with malnutrition and in developing countries. Therefore, other trials on a larger scale designed to investigate discriminating different etiologies for AGE and in different age groups is performed.

Ultrasonication is an emerging nonthermal process to extract pectins and pectic-polysaccharides from natural sources. This review aimed to highlight recent results of techno-functional (e.g., water and oil holding capacities, foaming capacity and stability, emulsifying activity, emulsion stability, rheological and pasting properties, and tin corrosion inhibitory activity) and biofunctional (e.g., antioxidant, antiradical, antiglycation, anticoagulant, antitumor, anti-inflammatory, immunostimulatory, and analgesic activities) properties of pectins extracted using both single and combined sonication modes. Integrating the ultrasound with other techniques (e.g., microwave heating and enzymatic digestion) can significantly increase the cell disruption, better penetration, and mass transfer of pectins at a shorter time. The ultrasound-microwave (UMAE) and ultrasound-enzyme (UEAE) assisted extraction systems compared to the ultrasound-assisted extraction (UAE) can more improve the techno-functional quality of pectins and their body's healing capacity to accomplish optimum health and functioning. The current opportunities and promising perspectives are also presented to enhance the pectin bioavailability in clinical studies.

HRSV is a principle cause of infant hospitalization, childhood wheezing and a common pathogen in the elderly. Limited information exists regarding HRSV genotypes in Iran. In order to better understand HRSV strain diversity, we performed an in-depth evaluation of the genetic variability of the HRSV F protein detected in children under two years of age that, presented with acute respiratory symptoms during 2015-2016 in Tehran. A total of 180 nasopharyngeal swabs were evaluated. The HRSV positive samples were genotyped for G and F gene sequences using RT-PCR and sequencing methods. Phylogenetic analysis was performed using the neighbor-joining and maximum likelihood methods. Genetic and antigenic characteristics of the F gene, nucleotide and amino acids in significant positions and immune system binding regions, as well as the p-distance, positive/negative selection site, linear epitopes and glycosylation sites were investigated in all selected sequences. Among the 83 HRSV positive samples, the Fifty-five cases were successfully sequenced. All of them were classified as subgroup A and belonged to the ON-1 genotype, which possessed 72-nt duplication in the G gene. This study is the first report on the emergence of ON-1 in Iran. ON-1 Iranian sequences clustered in three lineages according to virus fusion (F) gene variations. F gene sequence analysis showed that all genetic changes in the isolates from Iran were base substitutions and no deletion/insertions were identified. The low dN/dS ratio and lack of positively selected sites showed that the fusion genes found in the strains from Iran are not under host selective pressure. Continuing and long-term molecular epidemiological surveys for early detection of circulating and newly emerging genotypes are necessary to gain a better understanding of their epidemic potential.

BACKGROUND: Neonatal jaundice is one of the main causes of the patient's admission in the neonatal period and is potentially linked to morbidity.AIM: This study aimed to determine the possible risk factors for neonatal jaundice.METHODS: We investigated the case of infants who were admitted to the neonatal department of Ziyaeian hospital and Imam Khomeini Hospital for jaundice. Simple random sampling was used to evaluate variables related to maternal and neonatal predisposing factors based on the medical records and clinical profiles. All variables in this study were analysed using SPSS software.RESULTS: In this study, about 200 mothers and neonates were examined. Our findings depicted that mother's WBC, Hb, PLT, and gestational age were associated with jaundice (P < 0.05). Furthermore, there were significant relationships between different degrees of bilirubin with TSH, T4 levels and G6PD (P < 0.05). In fact, TSH, T4 levels and G6PD were found to be linked to neonatal hyperbilirubinemia. The risk factors for jaundice in our study population comprise some predisposing factors such as WBC, Hb, PLT, gestational age, TSH, and T4 levels, as well as G6PD. Neonates at risk of jaundice are linked to some maternal and neonatal factors that can provide necessary interventions to reduce the burden of the disease. Therefore, identification of associated factors can facilitate early diagnosis, and reduce subsequent complications.CONCLUSION: Neonatal jaundice should be considered as the main policy in all health care settings of the country. Therefore, identification of factors affecting the incidence of jaundice can be effective in preventing susceptible predisposing factors in newborns and high-risk mothers.

Summary Background A consensus has not been reached yet about the efficacy of probiotics in reducing the incidence of urinary tract infections (UTIs) in children. This systematic review and meta-analysis was designed to assess the efficacy of probiotics in prevention UTI in children. Methods The present study was designed based on guidelines for systematic reviews of clinical trials. Two independent reviewers performed an extensive search in the Medline, Embase, Web of Science and Scopus electronic databases up to the end of 2016. The summery of eligible studies was assessed independently by two reviewers and recorded in the data extraction form. Finally, a pooled relative risk (RR) was reported with a 95% confidence interval (95% CI). Results Data from 10 studies were entered in the present meta-analysis. Probiotic therapy did not have any beneficial effect on the incidence of UTI (RR = 0.94; 95% CI 0.85–1.03; p = 0.19) and its recurrence (RR = 0.93; 95% CI 0.85–1.02; p = 0.14). Subgroup analyses showed that probiotics as monotherapy do not have any beneficial effects on prevention of UTI (RR = 0.96; 95% CI 0.89–1.04; p = 0.31). However, the incidence of UTI is reduced if probiotics are used as adjuvant therapy to antibiotics (RR = 0.92; 95% CI 0.85–0.99; p = 0.02). Conclusion The present meta-analysis showed that probiotics did not have a beneficial effect in reducing the incidence or recurrence of UTI. Only a moderate efficacy was seen when a probiotic was used as adjuvant therapy to antibiotics.

This updated review summarizes the available literature on major bio-functionalities of Ca-M and its protein hydrolysates such as antimicrobial, antioxidant, antiradical, antidiabetic, angiotensin-converting enzyme inhibitory, anticancer, anti-inflammatory, hepatoprotective, antiallergic, and anti-autism activities. The most important bioactive compounds affecting health functions are some minerals (Zn and Mg), vitamins (C and E), protective proteins (lactoferrin, lysozyme, and immunoglobulins), and antioxidant enzymes (glutathione peroxidase and superoxide dismutase). Bioactive peptides derived from Ca-M proteins during fermentation processes and hydrolysis reactions by proteolytic enzymes play protective roles for body cells through the release of amino acids such as proline. In contrast with bovine milk, Ca-M has lower antiallergic effects due to the presence of immunoglobins and its protein (free of β-lactoglobulin) profile. The short- and long-term regular consumption of Ca-M because of the suppression of oxidative/inflammation stresses significantly improves diabetes and hypertension in adults and the behavioral of children with autism spectrum disorder.

Background: Lead elements have an adverse effect on human health. The most important complications of lead poisoning are disorders of nervous system particularly seizure .This study aimed to evaluate the blood lead levels and its association with convulsion in a group of hospitalized febrile children. Methods: In this analytic cross-sectional study, 60 hospitalized febrile children with 1- 60 month old participated in the study via non-probability convenience sampling method. All of the information included sex, age, weight, blood lead levels and history of convulsion gathered in the questionnaire. Finally all of data were statistically analyzed. Results: 66.7% of samples were male and 33.3% were female. The mean age was 32.57±38.27 months and the mean weight was 13.04±9.61kg. The Mean and Standard deviation of Blood lead level was 4.83±3.50μg/dL. 10% of samples had lead levels greater than 10μg/dL. 53.3% of patients have convulsion and other don’t have it. Blood lead levels was 4.91±3.65μg/dL in children with convulsion and 4.73± 3.38μg/dL in children without it; the difference was not significant (p= 0.8). Conclusion: Overall, no significant association was found between blood lead levels and convulsion.

Papillon Lefevre Syndrome ( PLS ) is a very rare genetic syndrome that only less than 500 cases have reported in the world. Patients have a typical cutaneous involvement with hyperkeratosis especially on the soles and palms and early shedding of primary teeth. Internal organs involvement such as liver abscess has been presented as case reports. This is for the first time that a genetically documented PLS with footsteps of mycobacterium tuberculosis in liver and kidney will report.