A Review on Fungal Infections and Their Treatments in Children with Renal Disorders

Fungal infections especially invasive ones (IFI), now are among well known and hard to manage problems in various kidney diseases in children. Various databases including pubmed, scopus, ovid and Web of Science Core Collection were looked for keywords including antifungals, fungal infections, kidney diseases Since 1990 to 2017. Renal side effects were looked using the site WWW.DRUG.COM as well. For common cases with Identified Pathogens Infectious diseases society of America (IDSA) recommendations for antifungal therapy as the most acceptable plan has been summarized at the end of article; specific therapeutic issues have been also discussed in their sections.Keywords: Fungal Infections; Renal Diseases; Acute Kidney Injury; Hemodialysis; CAPD, Kidney Transplantation

Case report partial seizure due to COVID19 infection in an infant

We live at the time of the coronavirus pandemic in the world (1, 2). The symptoms of COVID19 are similar in children and adults. However, children with confirmed COVID19 have generally shown mild symptoms (3). The symptoms in children include cold-like symptoms, such as fever, runny nose, and cough, vomiting, and diarrhea. In this study, we describe an eight-month-old boy with recurrent partial seizure and mild diarrhea. It was later revealed that he was COVID19 positiv

The validity of a scoring system in predicting intravenous immunoglobulin treatment failure in children with kawasaki disease

Background: Between 10 and 20 of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment, and are prone to coronary abnormalities. A variety of predicting scoring systems, including the Kobayashi system, have been proposed, but have not yet been evaluated using Iranian patients. Objectives: To evaluate the Kobayashi scoring system with regard to predicting response to IVIG treatment in Iranian children. Patients and Methods: All patients who received a final diagnosis of KD at Aliasghar children�s hospital between 1982 and 2013, and who met the inclusion criteria, were enrolled in this retrospective cohort study. We excluded patients with missing data, abnormal echocardiographic finding on admission, late admission, atypical or afebrile cases, and those who had received an insufficient amount of IVIG. We compared demographic and echocardiographic data before IVIG, and within 7 days of treatment, as well as C reactive protein (CRP), sodium, aspartate aminotransferase, platelet levels, neutrophil percentage, age of patients, and duration of fever before IVIG administration, in treatment responders and non-responders. Results: Of the 141 cases, 97 patients met the criteria and were enrolled. Of these, 19 (19.6) did not respond to IVIG. A total of 61.8 of patients were male, and the mean patient age was 36.9 months (SD = 32.1 months). Echocardiographic evaluation revealed early coronary involvement in 15.3 of patients, and coronary abnormalities were diagnosed in 10 of patients within the first 10 days of presentation and concurrent with their IVIG treatment. A between-groups comparison of quantitative CRP, absolute neutrophil count, and platelet count showed that platelet count alone was significantly higher in nonresponders (P = 0.04). With regard to items of Kobayashi scoring system, data were present for just 41 cases, but a significant difference between the two groups was shown, with the treatment-refractory group having a significantly higher score (P = 0.002). Receiver-operating characteristic curve analysis revealed that the optimum cut-off point for our population would be 2, which makes the sensitivity of the test equal to 75, with a specificity of 60. Conclusions: This preliminary study showed that patients with KD and a high Kobayashi score are at greater risk of being unresponsive to IVIG treatment. Further studies, preferably multicenter evaluations, are required in order to understand the exact application of various scoring systems in the management of people with KD in Iran. © 2016, Pediartric Infections Research Center

Customized Oral Corrective Feedback: Learners’ Preferences and Personality Traits

This study aims at investigating second language learners’ preferences for receiving oral corrective feedback on lexical and grammatical errors in relation to their personality traits. Given the established benefits of providing corrective feedback, the question remains how to customize corrective feedback in order to be effective and appropriate to the individual’s personality. For this purpose, 324 language learners in a language institution were asked to complete Revised NEO Personality Inventory (NEO PI-R) and feedback preference questionnaires. T-test showed that more extroverted learners prefer explicit and immediate feedback while more introverted ones prefer implicit and non-immediate feedback. Moreover, introverts preferred recasts for lexical and grammatical errors while extroverts preferred explicit correction and metalinguistic feedback the most. A follow-up content analysis of interview data revealed learners’ reasons regarding their preferences for receiving corrective feedback. Interviewed extroverts mentioned that explicit correction eliminated ambiguities of peer correction and metalinguistic feedback helped to feel independent. However, recasts were disliked by extroverts because they could not notice the correction, whereas welcomed by introverts due to their least obtrusive nature

The Association of Acute Motor Axonal Neuropathy (Guillain-Barre’ Syndrome Variant) with Coronavirus (SARS-Cov-2) in a Child: A Case Report

  Various reports of neurological manifestations of SARS-COV-2 infection after the virus outbreak are available, including anosmia, seizures, acute flaccid myelitis, Guillain-Barré syndrome (GBS), and encephalitis. Most of the literature has focused on the respiratory manifestation of SARS-CoV-2 infection in adults, but recent evidence showed that it is not confined to the respiratory tract. This report is about a rare variant of GBS acute motor axonal neuropathy (AMAN) in a child due to COVID-19 infection An 11 years old boy was referred to the hospital with a history of three-day lasting mild fever, and gastroenteritis, two weeks before starting symptoms. He was presented with progressive ascending weakness, paresthesia, and areflexia in four limbs four days ago. Nasopharyngeal swab polymerase chain reaction (PCR) was positive for SARS-CoV-2. The electrodiagnostic finding was compatible with acute generalized axonal motor neuropathy, and imaging revealed thoracolumbar syrinx and nerve root enhancement in lumbosacral MRI. Other lab tests were normal. GBS and its variant are one of the manifestations of SARS-CoV-2 in children. Children with an unexplained neurological process should be tested for SARS-CoV-2

Leptospirosis mimicking collagen vascular disease in a thirteen-year-old Iranian girl

A thirteen-year-old girl from Dezfoul, Iran was referred to our hospital with a history of eight days of high fever, headache, odynophagia, diffuse abdominal and body pain especially limb pain. She then developed conjunctival erythema, transient maculopapular rash on the trunk and also diplopia. No obvious or specific point was shown in the history. In the lab studies, she had very high sedimentation rate (ESR), bandemia and leukocytosis and thrombocytosis with negative results for an array of infectious diseases. Before making a vasculitis diagnosis a microscopic agglutination test for leptospira and then PCR test in blood and stool were requested and revealed to be positive for leptospira. She responded to doxycycline and remained well after one year of follow-up. Leptospirosis should be considered in differential diagnosis of vasculitic syndromes in Iran even for patients from seemingly non-enzootic areas. © 2012, Shahid Beheshti University of Medical Sciencces

A decade trends of the distribution and antimicrobial susceptibility of prevalent uropathogens among pediatric patients from Tehran, Iran during 2005�2016

Objectives: To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016. Methods: A cross-sectional analysis of uropathogens and their antimicrobial resistance within inpatient children was performed over the 11-year period, 2005 to 2016, in Ali Asghar children's hospital. The rate of antibiotic resistance among patients was evaluated according to demographic data including age, sex, urinary tract abnormities and history of antibiotic consumption. Results: In total, 958 female and 349 male positive cultures were analyzed. Escherichia coli (77.6) was the most common causative agent of urinary tract infection (UTI) in children and Klebsiella pneumoniae (10.4), Pseudomonas aeruginosa (2.4), and Enterococcus spp (2.4) were less frequent isolated bacteria. The resistance rates of E. coli isolates were increased against amikacin, ceftriaxone, ceftazidime, ciprofloxacin, cotrimoxazole and imipenem from 2005 to 2010. However, we observed a decreasing trend for some of antibiotics including amikacin, gentamicin, imipenem, ceftazidime and cotrimoxazole during 2014�2016. The rate of antibiotic resistance was greater in boys than in girls against many antibiotics. The rate of resistance to amikacin, gentamicin, nitrofurantoin and cotrimoxazole in patients aged <1 year was higher than other age groups (p < 0.001). A higher antibiotic resistance rate was observed in patients with anatomical abnormality and those who have had a history of antibiotic consumption. Conclusion: The study indicated the significant decrease in E. coli antibiotic resistance in the last 3 years. An effective empirical treatment regime should be based on local epidemiology and antimicrobial susceptibility testing. © 2020 Editorial Office of Asian Journal of Urolog

Effects of temperature and storage time on the motility, viability, DNA integrity and apoptosis of processed human spermatozoa

The aim of this study was to evaluate motility, viability, DNA integrity and apoptosis of spermatozoa when washed semen samples were kept for up to 12 days at 4–6°C and 25°C. In this experimental study, 26 normozoospermic semen samples were washed twice in Modified Ham's F10 and resuspended in IVF fertilisation medium. Half of the specimens were stored at 4–6°C, and the other half was kept at 25°C for 12 days. The proportions of viable, motile, spermatozoa with double-stranded DNA and apoptotic spermatozoa were examined during storage time. Apoptosis was measured using annexin V-PI staining followed by flow cytometry. Results showed that sperm motility and viability decreased during 12 days of sample storage (p < .001). There was no significant difference between the two temperatures in terms of motility and viability for up to 2 days (p < .05)

Detection of human metapneumovirus and respiratory syncytial virus by real-time polymerase chain reaction among hospitalized young children in Iran

Background: Acute respiratory infection plays an important role in hospitalization of children in developing countries; detection of viral causes in such infections is very important. The respiratory syncytial virus (RSV) is the most common etiological agent of viral lower respiratory tract infection in children, and human metapneumovirus (hMPV) is associated with both upper and lower respiratory tract infections among infants and children. Objectives: This study evaluated the frequency and seasonal prevalence of hMPV and RSV in hospitalized children under the age of five, who were admitted to Aliasghar children�s hospital of Iran University of Medical Sciences from March 2010 until March 2013. Patients and Methods: Nasopharyngeal or throat swabs from 158 hospitalized children with fever and respiratory distress were evaluated for RSV and hMPV RNA by the real-time polymerase chain reaction (PCR) method. Results: Among the 158 children evaluated in this study, 49 individuals (31.1) had RSV infection while nine individuals (5.7) had hMPV infection. Five (55.5) of the hMPV-infected children were male while four (44.5) were female and 27 (55.2) of the RSV-infected patients were females and 22 (44.8) were males. The RSV infections were detected in mainly one year old children. Both RSV and hMPV infections had occurred mainly during winter and spring seasons. Conclusions: Respiratory syncytial virus was the major cause of acute respiratory infection in children under one-year of age while human metapneumovirus had a low prevalence in this group. The seasonal occurrence of both viruses was the same. © 2016, Ahvaz Jundishapur University of Medical Sciences