A Review on New Coronavirus Mechanism of Action

The new coronavirus outbreak caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV2) has resulted in more than 126750 deaths worldwide so far and billions of expenses for the governments. SARS-CoV2, similar to SARS, was transmitted from bats and spread via human to human closed contacts. The virus uses its spike protein to bind to angiotensin-converting enzyme 2 receptors on target cells to replicate. Consequently, it spreads from infected cells to contaminate other cells. The body’s first response toward the virus is to activate the innate immune system, leading to the synthesis of inflammatory mediators. In the next step, the adaptive immune system appears where B lymphocytes produce antibodies specific for the virus, and CD8+ cells kill the infected cells directly. In this article, we try to explain the virus mechanism of action and immune response in detail. Although many questions remain unanswered, we expect this review could help in vaccine and treatment progression, Keywords: COVID-19; SARS-CoV2; Mechanism; Review

Comparative Study of Prophylactic Antibiotic Twice a Week Versus Every Night in Recurrent Urinary Tract Infections in Children

Background and Aim: Urinary tract infection is one of the most common childhood diseases. The results of studies investigating discontinuation or continuation of antibiotics in children with recurrent urinary tract infections and urinary reflux are controversial. Therefore, this study was conducted to compare prophylactic antibiotic treatment twice a week versus every night in the recurrence of urinary tract infections in children. Methods: This clinical trial was conducted using non-random simple sampling. Group A was given a single daily dose of cephalexin 10 mg/kg and group B was given cotrimoxazole at a dose of 5 mg/kg. Both groups were followed for ten months. Recurrences of urinary tract infections were compared between the two groups. Results: The mean age of the participants was 3.53±2.04 years. Most of the subjects were female (n=37, 61.7%). Urinary reflux was unilateral in 65% of the cases (n=39) and bilateral in the rest. There was no significant difference in age distribution, sex, and type of reflux between groups A and B. The frequency of recurrent urinary tract infection was 8.3% in group A and 6.7% in group B indicating no significant difference (p = 0.500). Conclusion: The results of this study showed that the frequency of recurrence of urinary tract infections in children who received prophylactic antibiotic treatment twice a week was not significantly different compared to the group of children who received continuous antibiotic prophylaxis

Safety and Efficacy of Rituximab in Children with Steroid-Dependent or Resistant Nephrotic Syndrome

Backgroundand Aim:Rituximab is a novel therapy that can help patients with steroid-dependent or resistant nephrotic syndrome.The aim of this study was to evaluate the efficacy of rituximab in children with corticosteroid-dependent and resistant nephrotic syndrome and to determine the factors associated with its efficacy. Methods:In this study, 40 children with corticosteroid-dependent or resistant nephrotic syndrome who were treated with rituximab in Dr. Sheikh Hospital,Mashhad,between 2014 and 2018 were enrolled. Patients with a history of hematuria, severe urinary tract infection, or secondary nephrotic syndrome were excluded. Results:The mean age of patients was 11.9 ± 5.04 years, and 55% were female. The most common underlying pathology of nephrotic syndrome was focal segmental glomerulonephritis (FSGS) (42.5%) followed by membranoproliferative glomerulonephritis (MPGN) and minimal change disease (MCD). Most of the participants (62.5%) were steroid-dependent and the rest (27.5%) were steroid resistant. Only 10% of the patients showed complications following rituximab administration and 57.5% went into complete remission. A negative family history and steroid-dependent nephrotic syndrome were significantly associated with a better treatment response. Moreover, patients with steroid-resistant nephrotic syndrome were more likely to have a positive family history, while factors associated with steroid response included underlying pathology, gender, and family history. Conclusion: Rituximab can cause remission in more than half of the patients with steroid-resistant or dependent nephrotic syndrome. Moreover, the only factors that reduce response to rituximab are a history of corticosteroid resistance and a positive family history of nephrotic syndrome

Rapid Intravenous Rehydration to Correct Dehydration and Resolve Vomiting in Children with Acute Gastroenteritis

SUMMARYObjectivesThe objective of this study is to evaluate the effect of rapid intravenous rehydration to resolve vomiting in children with acute gastroenteritis.MethodsThis randomized control trial was conducted in the pediatric emergency department in a tertiary care center in Tabriz, North-West of Iran. The study participants' were 150 children with acute gastroenteritis and vomiting who were moderately dehydrated, had not responded to oral rehydration therapy and without any electrolyte abnormalities. 20–30 cc/kg of a crystalloid solution was given intravenously over 2 hours and the control group was admitted in the emergency department (ED) for a standard 24 hour hydration. Effectiveness of rapid intravenous rehydration in the resolution of vomiting in children with acute gastroenteritis was evaluated.ResultsIn 63 children of the intervention group (out of 75) vomiting was resolved after rapid IV rehydration and they were discharged. Among them, 12 that did not tolerate oral fluids were admitted. In the control group, 62 patients' vomiting was resolved in the first 4 hours after admission, and there was no significant difference between the two groups regarding resolution of vomiting.ConclusionsRapid intravenous rehydration in children with moderate dehydration and vomiting due to gastroenteritis is effective in reducing admission rates in the ED

Skin inflammatory reactions to capsaicin in rheumatoid arthritis patients compared to healthy controls

Objective: Previous studies have examined the role of sensory nerves and neural mediators in symmetrical joint inflammation and autoimmunity in rheumatoid arthritis (RA). In this study, we sought to examine the association between capsaicin skin test and disease activity in RA patients. Materials and Methods: Eighty RA patients (case group) and 20 healthy volunteers were enrolled in this experiment. The subjects in case group were calcified to newly diagnosed patients and those previously diagnosed with RA. A topical solution of capsaicin (0.075%) was applied on the volar forearm during the skin test, and evaluations were done after 5, 10, and 20 min. The parameters recorded in capsaicin skin test were time to tingling, area of induration (cm2), and area of redness (cm2). Results: A faster capsaicin skin reaction was observed in healthy controls compared to the case group (p=0.02). Newly diagnosed and previously diagnosed RA patients were not significantly different in terms of reaction latency (p=0.06). The redness area after 15 (p=0.04) and 20 (p=0.001) min was significantly larger in previously diagnosed RA patients than in newly diagnosed ones. The ​​area of redness and time to tingling did not show any difference between active and inactive RA patients, but after 15 and 20 min, the area of redness was significantly greater in inactive RA patients compared to active RA patients (p=0.01 and p=0.03, respectively). Conclusion: This study suggested that capsaicin skin test is not an efficient tool for the examination of synovial inflammation and disease activity in RA

Evaluation of Knowledge, Attitude, and Practice of Mothers Presenting to Pediatric Clinic Regarding Urinary Tract Infection Prevention in Children

Introduction: Urinary tract infection is one of the most common bacterial infections in children. It is preventable in many cases and appropriate health behaviors can protect a child from the disease or minimize its risk. Considering the relatively high prevalence of urinary tract infections in children and with regard to the important role of healthy behaviors in preventing this infection, we decided to evaluate the knowledge, attitude and practice of mothers regarding the prevention of urinary tract infections.Materials and Methods: This cross-sectional descriptive-analytic study was performed in the Pediatric Clinic of Imam Khomeini Hospital to determine the knowledge, attitude, and practice of mothers about UTI in children and to evaluate its relationships with some demographic features. The data collection tool was a researcher-made questionnaire based on the literature review. The collected data were analyzed using SPSS 22 software and P-values less than 5% were considered significant.Results: One hundred and fifteen mothers who presented to the Pediatric Clinic of Imam Khomeini Hospital participated in this study. The average knowledge, attitude, and practice score in the first part and the practice score in the second part was 6.21, 47.85, 13.86, and 10.66, respectively.A statistically significant relationship was found between the score of knowledge and attitude. The knowledge score had a significant relationship between maternal employment status, household income, and household location. There was also a significant relationship between access to information and both the knowledge and attitude scores.Conclusions: The significant relationship between access to information resources and the maternal knowledge and attitude scores confirms the importance of awareness in improving the knowledge of mothers in preventing urinary tract infection.Keywords: Knowledge; Attitudes; Practice; Urinary Tract Infections; Pediatrics

Lead Poisoning in an Infant: A Case Report

There is inadequate knowledge about acute poisoning as a common problem in children. Acute poisoning in children, , is one of the health problems, requiring immediate treatment. Case report: A two-month-old male infant with discoloration of the nails was admitted to the Emergency Pediatric Unit of Imam Reza Hospital, Mashhad, Iran in 2014. Following clinical evaluations, the blood lead level was determined to be high. The cause of neonatal condition was a traditional medicine, applied by the mother for the treatment of dermatitis in the infant. The lead concentration was high in this medicine, thus resulting in neonatal lead poisoning. Conclusion: It is obvious that medicinal drugs should be used cautiously for children, especially infants. Also, drug characteristics and the process of production should be precisely specified. In fact, without taking precautions, any medicinal drug or substance could have various adverse effects on pediatric populations

LXRs: The Key Regulators of Intermediary Metabolism in Metabolic Syndrome

Metabolic syndrome and its various manifestations are considered to be a significant health epidemic in the developed and developing countries across the world. Metabolic syndrome is characterized by a series of metabolic abnormalities, such as central adiposity, insulin resistance, hypertension, glucose intolerance, and dyslipidemia. Patients with metabolic syndrome are at a higher risk of major complications, including fatty liver, type II diabetes mellitus, and cardiovascular diseases. Nuclear receptors are the key regulators of gene transcription, as well as several metabolic pathways. Among these receptors, LXRα and β play a major role in the regulation of lipogenesis, cholesterol/glucose homoeostasis, and inflammatory pathways through the induction or repression of target genes. In addition to metabolic homeostasis and diseases, lipogenesis and hypertriglyceridemia are regarded as the most significant adverse effects of liver X receptor (LXR) activation. Given the importance of lipid and carbohydrate metabolism and inflammation in the development of metabolic disorders, the present study aimed to review the impact of LXR signaling on the risk of metabolic syndrome and its phenotypes, with an emphasis on their potential therapeutic applications in the treatment of metabolic syndrome. In general, growing evidence supports the notion that LXRs may represent the potential drug targets for the treatment of metabolic syndrome

Misdiagnosis of spider bite in a 3-year-old child

Abdominal pain is a common complaint among children with a vast differential diagnosis. Hip pain is also a nonspecific sign. Here, we present a case of a 3-year-old boy with a complaint of abdominal pain and pain in both hips, much on the right one. After evaluations, the diagnosis was a spider bite