COVID-19 pneumonia in a child with hepatic encephalopathy: A case study

Coronavirus disease 2019 (COVID-19) is caused by the seventh coronavirus, known as the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Children often have milder diseases than adults with very rare mortality. Gastrointestinal manifestations and a mild increase in liver enzymes have been reported in 8.8% to 53% of COVID-19 cases. However, liver failure is extremely rare and has not been reported so far in the literature. The prevalence of comorbidities is not clear in children with COVID-19. Here, we reported a fatal case of simultaneous pneumonia secondary to SARS-CoV-2and acute liver failure in a 14-year-old boy with liver cirrhosis. &nbsp

Autoimmune pancreatitis as a very rare cause of recurrent pancreatitis in children; a case report and review of literature

Autoimmune pancreatitis as chronic inflammation of the pancreas due to an autoimmune mechanism is a rare type of pancreatitis. A 14 years old girl presented with multiple episodes of abdominal pain, nausea with elevation of amylase and lipase suspicions of acute recurrent pancreatitis since 3 years of age. After through evaluation about secondary causes of recurrent and familial pancreatitis finally she responded to corticosteroid treatment. Although very rare but autoimmune processes should be considered in teenagers with recurrent pancreatitis

It's time to revise the role of positive D- penicillamine challenge test in diagnosis of Wilson disease

Hepatic involvement in Wilson disease consists of isolated elevated liver enzyme, asymptomatic hepatomegaly, cirrhosis and acute liver failure. Here, we report three patients with unexplained elevated liver enzymes. By considering the level of urinary excretion of copper after penicillamine challenge test, we had some problems in the process of diagnosis. Therefore, we thought of cautiously applying the diagnostic cut-off in the mentioned challenge tes

Assessment of Serum Amino Acid Chromatography in Children with Inflammatory Bowel Diseases

Background: Given the important role of amino acids in regulating many metabolic pathways of the body and considering the scarcity of markers for the diagnosis of inflammatory bowel disease (IBD) and its differentiation, we aimed to investigate the status of serum amino acids chromatography in children with IBD. Materials and Methods This case-control study was conducted among children with primary diagnosis of IBD who referred to Mofid Children's hospital in Tehran, Iran. Children with a definite diagnosis of chronic IBD on the basis of endoscopy and biopsy were enrolled. In addition, 100 children without any history of predisposing, chronic, or inflammatory disease who referred to the same hospital during the period of the study were also selected. All samples underwent serum amino acids chromatography via HPLC method. Results Of all the patients in the IBD group, 18 patients (18%) suffered from Crohn's disease and 82 patients (82%) had ulcerative colitis; the disease was active in 54 patients (54%). The results of serum amino acids chromatography showed that several amino acids were significantly higher in patients with IBD. Considering the normal serum levels of amino acids, only the levels of two amino acids of histidine and tryptophan were significantly different in the IBD group compared the control group. In total, of all the subjects, 30 children (15%) had abnormal amino acid serum chromatography; hence, its prevalence was significantly higher in the IBD group (P=0.048). Conclusion The current study showed that serum amino acid chromatography in children with IBD were different from that in healthy children. More specifically, the decrease in tryptophan level was more observed in patients with active disease

Prevalence of Malnutrition among Iranian Pediatric Patients before and After Hospitalization (2015 To 2017): A Multicenter Study

Background: Malnutrition undermines the beneficial outcomes of clinical interventions and also increases hospital costs. Therefore, this study aimed to estimate the prevalence of malnutrition through a multicenter observational study at the time of admission and discharge in Iranian hospitalized children and adolescents. Methods: The present cross-sectional study was performed on children and adolescents aged one month to 18 years from three Iranian public tertiary pediatric hospitals located in different cities of Iran. To determine the participants’ nutritional status, Z-score of the weight for height (for those with 1month to 5years of age) and Z-score of BMI (for ≥5 to 18-year-old patients) were calculated using the WHO growth standards. Data were analyzed using SPSS version 23. Results: Information about 1499 patients was collected. At the time of admission, 64% of the participants had a good nutritional status, 15.5% were at high risk of wasting, 8.4% were wasted, and 12.1% were severely wasted. Among 295 malnourished patients, the nutritional status of 182 patients (63%) had been improved at the time of discharge. Also, 23% of all subjects with normal nutritional status at the admission time (85 participants), were at risk of malnutrition at discharge. The prevalence of moderate and severe malnutrition at the discharge time was about 20%. Conclusion: More than one-third of the hospitalized children had moderate or severe malnutrition or were at high risk. Although the prevalence of malnutrition decreased somewhat during hospitalization, some children were not malnourished at the time of admission and were malnourished at discharge

Evaluation of Clarithromycin and Metronidazole Resistance of Helicobacter Pylori Infection in Symptomatic Iranian Children

Helicobacter Pylori (H. pylori) as a gram-negative bacterium is the most common infection of the gastrointestinal tract, and worldwide it affects the children over three years of age. H. pylori could cause gastrointestinal and extra-intestinal manifestations. Antibiotic resistance can happen primarily and occurs during treatment. We aimed to evaluate the resistance gene of H. pylori obtained from gastric biopsy by polymerase chain reaction (PCR) method in Iranian children over 3 years old. Materials and Methods This study was a cross-sectional to evaluate the resistance gene of H. pylori obtained from gastric biopsy by polymerase chain reaction method for metronidazole and clarithromycin in children over three years old referring to the Mofid Children's Medical Center in Tehran, Iran. Results: Finally, data from seventy-nine samples included (mean age=10.7 years and male gender = 60.8%). Beta Globulin (BG) gene were detectable in 75 (94.93%) specimens of 79 (100%). Seventeen out of 75 specimens showed positive results for molecular detection of H. pylori. The results of RFLP-PCR technique showed that mutation of RdxA gene in seven of 17 (41.1%) for Metronidazole resistance and one case of 17 (5.8%) mutation of 23Y RNA gene that leads to clarithromycin resistance. Conclusion: Regarding the results of our study, it is better to check microbial resistance by culture and antibiogram for the antibiotic regimen of the first and second line of H. pylori treatment in children

Levels of Blood Biomarkers among Patients with Myocardial Infarction in Comparison to Control Group

BACKGROUND: Myocardial infarction (MI) as a term for a heart attack happens due to reduced blood flow to heart myocardium and lack of oxygen supply caused by plaques inthe interior walls of coronary arteries. With respect to the importance of MI etiology, we aimed to study the relationship of MI and blood examination variables.METHODS: This study was conducted in Mazandaran Heart Center as a hospital-based case-control Comprising 894 participants including 465 cases and 429 controls, individually matched by sex and age. Considered blood markers were analyzed using routine laboratory methods and equipment.RESULTS: Of all participants, 64.3% of the cases and 51.0% of the controls were males with a mean age of 61.2 (±13.8) in cases and 62.4 (±14.) in controls. We could not find any differences between cases and controls for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and alkaline-phosphatase (ALP) (P>0.05). However, levels of creatine-kinase-muscle/brain (CK-MB) (P<0.0001), fasting-blood-sugar (FBS) (P<0.0001), aspartateaminotransferase (AST) (P<0.0001), alanine-transferase (ALT) (P<0.0001) and erythrocyte sedimentation rate (ESR) (P=0.001) were significantly higher in cases compared to the controls (P<0.05). Multivariable analyses revealed that the risk of MI was associated with high levels of AST (adjusted OR=24.3, 95%CI=3.5±165.6, P=0.001) and LDL (adjusted OR=7.4, 95%CI=1.0±51.8, P=0.001).CONCLUSION: Our investigation indicated that the levels of CK-MB, FBS, AST, ALT and ESR were significantly higher in patients with MI. Besides, our findings showed that the risk of MI in cases with high levels of AST and LDL was about 24 and 7 times more than the control group respectively

Solitary polypoid lesion in gastric cardia; a case report and review of literature

AbstractIntroduction: Hyperplastic polyps of the esophago-gastric junction are seen during endoscopic evaluation of upper gastrointestinal tract. They are usually asymptomatic and discovered accidentally during endoscopic evaluation for other problems. These protrusions are mucosal regenerative response to surrounding mucosal injury. Case: Here we present a 9-year-old boy presenting with abdominal pain and vomiting since about one year ago. Recently, he was suffering from retrosternal chest pain. So after thorough clinical and paraclinical evaluations, upper endoscopy was done and, a small polypoid lesion in esophago-gastric junction was seen. Its surface seems normal and the polyp has no true stalk. Polypectomy was performed without any complication.Discussion: These lesions usually are regenerative response to surrounding mucosal injury. So, a thorough clinical evaluation and obtaining the sufficient biopsy specimen of the nonpolypoid mucosa are necessary for determining the clinicopathologic context in which the polyps have developed

Explaining and Presenting a Model of Organizational Empathy Improvement in the Country Education Assessment Organization Using the Data Theory Approach

. In the qualitative section based on the data theory approach of the foundation and in-depth semi-structured interviews from the sample of the study, 17 scientific and organizational experts were selected through theoretical sampling. Then coding was done and identifying dimensions, main categories and subcategories and concepts related to each code were obtained and finally fitting the research paradigm model using quantitative data collected through questionnaire. 200 patients were selected by simple random sampling. The qualitative results of the study revealed 11 main categories and 32 subcategories and 175 concepts that were in the framework of organizational empathy paradigm including: causal conditions (organizational factors: organizational climate, organizational structure, collaborative organizational culture, organizational goals, organizational justice, environmental factors : External organizational environment, Internal organizational environment, Individual factors: Demographic characteristics, Personality traits, Interventional factors (Burnout: Emotional exhaustion, Depersonalization of personality, Decreasing personal competence, Management factors: Ineffective management , Organizational apathy), contextual factors (motivational and supportive factors: managerial support, performance appraisal system, job factors: solely B. Person-Occupation, Job Characteristics), Strategies (Improving Organizational Processes: Trust in the Organization, Effective Teaming, Effective Organizational Leadership: Effective Management, Empathy Training, Career Development), and Outcomes (Organizational Productivity: Communication Effectiveness, Organizational Effectiveness, Conflict, Organizational Citizenship Behavior, Creativity and Innovation, Organizational Commitment, Individual Development: Job Development, Individual Well-being, Individual Performance, There was little indication that the data fit the model well and confirmed the hypotheses derived from the model