Bacillus sp. strain QW90, a bacterial strain with a high potential application in bioremediation of selenite

Introduction: Selenium oxyanions are toxic to living organisms at excessive levels. Selenite can interfere with cellular respiration, damage cellular antioxidant defenses, inactivate proteins by replacing sulfur, and block DNA repair. Microorganisms that are exposed to pollutants in the environment have a remarkable ability to fight the metal stress by various mechanisms. These metal-microbe interactions have already found an important role in bioremediation. The objective of this study was to isolate and characterize a bacterial strain with a high potential in selenite bioremediation.Methods: In this study, 263 strains were isolated from wastewater samples collected from selenium-contaminated sites in Qom, Iran using the enrichment culture technique and direct plating on agar. One bacterial strain designated QW90, identified as Bacillus sp. by morphological, biochemical and 16S rRNA gene sequencing, was studied for its ability to tolerate high levels of toxic selenite ions by challenging the microbe with different concentrations of sodium selenite (100-600 mM).Results: Strain QW90 showed maximum Minimum Inhibitory Concentration (MIC) to selenite (550 mM) and the maximum selenite removal was exhibited at 30 degrees C, while the activity was reduced by 20% and 33.8% at 25 and 40 degrees C, respectively. The optimum pH and shaking incubator for the removal activity were shown to be 7.0 and 150 rpm at 50.7% and 50.8%, respectively. Also, the concentration of toxic sodium selenite (800 μg/ml) in the supernatant of the bacterial culture medium decreased by 100% after 2 days, and the color of the medium changed to red due to the formation of less toxic elemental selenium.Conclusion: This study showed that the utilization of enrichment culture technique in comparison to the direct plating on agar leads to better isolation of selenite resistant bacteria. Bacterial strain was resistant to high concentrations of selenite and also it reduced selenite to red elemental selenium. Therefore, this microorganism could be further used for bioremediation of contaminated sites

Dilated Cardiomyopathy Several Months after Hemolytic Uremic Syndrome

This is a report of a 44-month-old baby girl diagnosed as a case of atypical hemolytic uremic syndrome (aHUS) presenting with hematuria, periorbital edema, anemia, thrombocytopenia, and hypertension lacking any history of previous bloody diarrhea. She was treated with plasma infusion followed by plasmapheresis and peritoneal dialysis. After two months, she was discharged in remission undergoing periodic plasmapheresis. Four months later, she was visited for fatigue, tachypnea, and palpitation. Cardiac evaluation revealed dilated cardiomyopathy with an ejection fraction of 15-20%.  She was hospitalized and treated with inotropes and diuretics; one week later, she was discharged in a favorable condition. After six months follow-up, she showed an acceptable renal and cardiac state. It seems that cardiomyopathy can occur as a late and rare complication of HUS. We recommend cardiac evaluation for all patients with HUS at its presentation and in later follow-ups.  Keywords: Cardiomyopathy; Hemolytic Uremic Syndrome; Child

Efficacy of Conventional Laser Irradiation Versus a New Method for Gingival Depigmentation (Sieve Method): A Clinical Trial

Introduction: Diode laser irradiation has recently shown promising results for treatment of gingival pigmentation. This study sought to compare the efficacy of 2 diode laser irradiation protocols for treatment of gingival pigmentations, namely the conventional method and the sieve method.Methods: In this split-mouth clinical trial, 15 patients with gingival pigmentation were selected and their pigmentation intensity was determined using Dummett’s oral pigmentation index (DOPI) in different dental regions. Diode laser (980 nm wavelength and 2 W power) was irradiated through a stipple pattern (sieve method) and conventionally in the other side of the mouth. Level of pain and satisfaction with the outcome (both patient and periodontist) were measured using a 0-10 visual analog scale (VAS) for both methods. Patients were followed up at 2 weeks, one month and 3 months. Pigmentation levels were compared using repeated measures of analysis of variance (ANOVA). The difference in level of pain and satisfaction between the 2 groups was analyzed by sample t test and general estimate equation model.Results: No significant differences were found regarding the reduction of pigmentation scores and pain and scores between the 2 groups. The difference in satisfaction with the results at the three time points was significant in both conventional and sieve methods in patients (P = 0.001) and periodontists (P = 0.015).Conclusion: Diode laser irradiation in both methods successfully eliminated gingival pigmentations. The sieve method was comparable to conventional technique, offering no additional advantage

Evaluating the overt extracardiac malformations in children with congenital heart disease in Khuzestan Province

Background: Extracardiac malformations can be seen in 20-45% of infants with congenital heart disease (CHD). Chromosomal abnormalities exist in 5-10% of patients with CHD. The aim of this study was to assess the frequency of overt extra cardiac malformations in children with CHD. Methods: This descriptive epidemiologic study was conducted on 720 patients with CHD referred to the pediatric cardiac clinic of the most important south west referral center of Iran in 2014. Data were collected by studying patients' files during this time. Results: Totally, 401(55.7%) and 319 (44.3%) of patients were male and female, respectively. Extracardiac malformations were diagnosed in 53 cases (7.36%) and multiple extracardiac malformations involving more than one anomaly were present in 10 cases (1.38%). The most frequent extracardiac malformations in the current study included skeletal and visceral abnormalities and then genitourinary was seen. Of all patients, 33 (4.58%) cases were affected by syndromic features of which Down syndrome was the most common. Conclusions: Investigation for extra cardiac abnormalities in patients with CHD is very important, since proper diagnosis and early treatment of these abnormalities can improve the patients' outcomes. On the other hand all the patients with overt and syndromic abnormalities require investigation for a possible CHD

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Relationship between echocardiographic findings and laboratory serum biomarkers in patients with and without low cardiac output

Abstract BACKGROUND: Cardiac dysfunction is seen in many patients and could be evaluated with echocardiography and serum biomarkers. The aim of this study was evaluation of the relationship between echocardiographic findings and laboratory serum biomarkers in children with and without low cardiac output

Vestibular neuritis in pediatrics: a mini review

Background and aims: Vestibular neuritis (VN) is a clinical feature, portrayed by acute and prolonged vertigo from peripheral source without associated auditory symptoms. the appearance of vestibular disease may also lead to cognitive deficits, including attention deficits. Therefore, the purpose of this mini-review is to describe the clinical characteristics, etiology, prevalence and treatment of vestibular neuritis in children. Materials and methods: The present study was conducted in January 2021. The study was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. The comprehensive search was conducted in the literature of the international databases (PubMed, Scopus, and Google Scholar) and national databases including scientific information database (SID), Magiran and iranDoc until January 13, 2021. Search keywords included "vestibular neuritis", "vestibular disorder", "balance disorder", and "pediatrics" or "children" or "adolescent" or "infants". The time limit for publishing articles was from 2010 onwards. Results: In the initial search, 17 articles were extracted. After reviewing the title and abstract, 6 studies were excluded. In the evaluation and full-text review, 2 articles were excluded due to low quality and lack of access to the full text of another article. Finally, 9 studies were included in the present study. Conclusion: We conclude that vestibular neuritis should always be considered in pediatric patients presenting with vertigo, and especially with nasopharyngeal viral infection, in addition to other differential diagnoses. Vestibular neuritis is one of the most common diseases in vestibular disorders in children, and different prevalence rates have been reported in studies so it needs further investigation. Once the diagnosis of vestibular neuritis is confirmed, symptomatic treatment should be started for the child

Effect of Ventolin on QTc in children with respiratory distress

Introduction: β2–agonists are first election drugs for the treatment of respiratory disease that may alter cardiac autonomic modulation. The aim of this study was to evaluate the effects of nebulized Ventolin on electrocardiogram, particularly QTc interval to assess the potential arrhythmogenic risks. Methods: A total of 192 patients between 2 months and 15 years which received nebulized Ventolin were enrolled in this study. Patients were divided into two groups. Electrocardiograms of patients before and after nebulized Ventolin were taken. Differences between two groups were assessed using a paired student’s t test. Results: There was statistically significant differences in QTc before and after Ventolin in each groups (P < 0.005).Ventolin effect on QTc interval in both groups did not differ. In first group, there was statistically significant differences between heart rate before and after Ventolin taken (P = 0.009) but in second group there was not statistically significant differences between heart rate (P = 0.345). Conclusion: Although Ventolin can cause changes in QTc, Ventolin with 0.15 mg/kg/dose in comparison with 0.1 mg/kg/dose does not cause significant changes in QTc

Aortic Pseudoaneurysm following Ventricular Septal Defect Closure in a Pediatric Patient: A Case Report and Literature Review

Aortic pseudoaneurysm, a rare condition characterized by localized transmural disruption and dilatation of the aorta, is very rare in the pediatric population. It is primarily caused by previous cardiovascular procedures such as aortic coarctation repair, aortic valve replacement, and subaortic membrane resection. We present a unique case of aortic pseudoaneurysm following surgery to repair a perimembranous ventricular septal defect in a 19-month-old boy who presented with fever as the sole symptom. The fever started on the 30th day after the surgery, and the patient exhibited abnormal laboratory results, including a white blood cell (WBC) count of 28.3×109/L, neutrophil percentage of 68%, platelet count of 880×109/L, erythrocyte sedimentation rate (ESR) of 200 mm/hour, and 3+ positive C-reactive protein. Echocardiogram revealed a large cystic mass (5×4.8 cm) in the ascending aorta, compressing the superior vena cava. Based on this finding, a diagnosis of aortic pseudoaneurysm was suspected. The diagnosis was confirmed through cardiac computed tomographic angiography, and the patient underwent emergent surgery for the repair of the aortic pseudoaneurysm under deep hypothermia and circulatory arrest. Unfortunately, our patient died shortly after the surgery