Intestinal Colonization Rate of Candida albicans among Low Birth Weight Neonates after Using Oral Synbiotic Supplementation: A Randomized Placebo-controlled Trial

Background: The present study aimed to evaluate the effect of synbiotics on the intestinal colonization rate of Candida albicans in low birth weight neonates (i.e., under 2,500 g), which is one of the most important events for necrotizing enterocolitis (NEC).Methods: During one year, 106 preterm neonates with a birth weight of less than 2,500 g, admitted to the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran, were randomly selected and investigated in two groups of case and control. In the case group, 5 drops of synbiotics (under the trade name of Pedilact in which 5 drops are equivalent to 2.5×108 CFU), containing three probiotics of Bifidobacterium infantis, Lactobacillus rhamnosus, and Lactobacillus reuteri, as well as the prebiotic of fructooligosaccharide, were administered. On the other hand, 5 drops of distilled water were used for the control group. In the present single-blind study, the subjects were divided into two groups using a random number table. The stool cultures were obtained on the 1st and 10th days of admission. Then, the two groups were compared in terms of the amount of positive stool culture for Candida albicans, time of feeding initiation and full nutrition, duration of hospitalization, and time of discharge.Results: The incidence rate of positive stool culture for Candida albicans was 6.6%. A significant relationship was observed between gestational age and positive culture (P=0.009). However, there was no significant difference between the two groups in terms of the duration of hospitalization, time of feeding initiation and full feeding, good physical examination results, and wellbeing. In addition, the relationship between positive culture and birth weight was statistically significant (P=0.045) since the rates of positive culture were 57.1% and 42.9% in cases with the birth weight of ≤ 1,500 and > 1,500 g, respectively.Conclusion: Based on the results, synbiotic use showed no significant relationship with enteral positive cultures for Candida albicans, time of enteral feeding initiation and full feeding, and hospitalization duration

Clinical and laboratory characteristics of children with severe and nonsevere COVID‐19 in Kermanshah, west of Iran: A retrospective study

Abstract Background and Aims The study aimed to collect and compare clinical and laboratory findings of children with severe and nonsevere COVID‐19 in Kermanshah City, located in the west of Iran. Methods The study was conducted on 500 children with COVID‐19 hospitalized in Mohammad‐Kermanshahi Hospital in Kermanshah City. Pediatric COVID‐19 was confirmed by reverse transcription‐polymerase chain reaction (RT‐PCR) test using respiratory secretion samples. Medical records were reviewed and information related to demographic characteristics, underlying diseases, clinical manifestations, laboratory findings, and chest computed tomography (CT) scans were all extracted from electronic and paper records. Patients were divided into three groups according to the severity of the disease: mild, moderate, and severe. Clinical and laboratory findings were compared between the groups and the collected data were analyzed by statistical methods. Results Out of 500 patients, 286 were boys and 214 were girls. Of the patients, 321 cases were only COVID‐19, while 179 patients were diagnosed as Multisystem Inflammatory Syndrome in Children (MIS‐C) positive. The average age of COVID‐19 patients was 3.85 ± 4.48 and of MIS‐C patients was 3.1 ± 3.5. In order, fever, cough, and heart disorders were the most common symptoms in patients with COVID‐19 and MIS‐C, respectively. In terms of disease severity, 246 patients had mild disease, 19 patients had moderate disease, and 56 patients had severe disease. In severe patients, the average number of white blood cells (WBC) was higher, while the average number of lymphocytes was lower. Also, in these patients, the average age was lower, and most of them had respiratory distress. In mild patients, often cough, diarrhea, and vomiting were observed. Conclusion The results of our study showed that laboratory factors such as WBC count, lymphocyte count, CT findings, Respiratory distress, cough, diarrhea, and vomiting can be used to evaluate the severity of COVID‐19 in children