دکتر شهناز آرمین

The dedication of healthcare teams to adhering to protocols for the use of personal protective equipment (PPE), maintaining vaccination coverage among healthcare workers (HCWs), and ensuring environmental health are crucial elements in managing hospital-acquired infections.

This study aimed to evaluate adherence to PPE use, vaccination history, hand hygiene protocols, and environmental health practices in a tertiary children's hospital in Iran.

This cross-sectional study evaluated compliance with PPE use, vaccination history among doctors, nurses, and hospital staff, adherence to strict hygiene practices, patient isolation protocols, and environmental health measures based on an Iranian Health Ministry query. Data collection was conducted over three months, from May to August 2023.

During the study, 285 staff members were assessed for compliance with hand hygiene protocols. Nurses demonstrated the highest level of compliance, reaching 51%. The highest compliance with hand hygiene protocols at the five designated moments was approximately 79%, with the transplantation and hemodialysis wards achieving the highest rates. Nurses also showed the most positive vaccination records. Personal protective equipment was used correctly in various wards, with an overall compliance rate of 79%.

This study revealed that compliance with health protocols in different parts of the hospital was suboptimal and required significant improvement.

The impact of COVID-19 on pediatric cancer patients remains a critical area of investigation.

This study aimed to compare the clinical characteristics and outcomes of COVID-19 in children with and without malignancies.

A retrospective cohort study was conducted at Mofid Children's Hospital in Tehran, Iran, from July 2020 to December 2022. The study included 210 children with confirmed SARS-CoV-2 infection: 105 with malignancies (case group) and 105 without malignancies (control group). Clinical presentations, laboratory parameters, imaging findings, and outcomes were analyzed.

Children with malignancies exhibited lower rates of fever (P = 0.044), respiratory distress (P = 0.035), and nausea/vomiting (P = 0.002). Significant differences in laboratory findings were observed between the case and control groups, including WBC count (P = 0.007), hemoglobin levels (P < 0.001), platelet count (P = 0.002), and ESR (P = 0.001). Ground-glass opacity on chest imaging was significantly associated with malignancy (P = 0.003). Although not statistically significant, the malignancy group showed a trend toward higher mortality (OR = 2.686, P = 0.105). Thrombotic events were rare in both groups.

Pediatric cancer patients with COVID-19 exhibited more severe symptoms and distinct laboratory and imaging findings compared to non-cancer patients. While mortality rates were similar, the trend toward higher risk in the malignancy group highlights the need for specialized management strategies for this vulnerable population.

Recognizing risk factors for poor prognosis among COVID-19 patients is crucial, especially given the absence of standardized treatments and medications.

In the present study, our aim was to survey changes in clinical parameters in children diagnosed with COVID-19 infection from admission to discharge.

The present retrospective cross-sectional study focused on children with COVID-19 infection. All demographic data and clinical information of patients were extracted upon admission and at discharge from the hospital. Data analysis utilized the Mann-Whitney U test and Fisher exact test. Multivariable regression modeling was employed to identify factors predicting the probability and duration of hospitalization in ICUs for children with COVID-19.

Elevated levels of ESR, CRP, creatinine, and ferritin were found in 51.7%, 67.4%, 69.3%, and 53.6% of patients upon admission. Moreover, 98.2% and 38.3% of patients had high levels of ALP and AST. Platelet (PLT) and neutrophil levels were higher at discharge compared to admission (P < 0.001), while creatinine levels were lower at admission than at discharge (P < 0.001). Patients admitted to ICUs exhibited significantly higher levels of pulse rate (P < 0.001), respiratory rate (P < 0.001), mean corpuscular volume (MCV) (P = 0.01), red cell distribution width (RDW) (P = 0.002), prothrombin time (PT) (P = 0.006), and ESR (P = 0.04).

Pulse rate, respiratory rate, MCV, RDW, PT, ESR, and oxygen saturation (SPO 2 ) percentage can be used to predict the severity of COVID-19 disease. However, further studies are needed to determine the prognosis and severity of COVID-19 infection in children.

The COVID-19 pandemic has disrupted healthcare systems globally, leading to the suspension of many elective surgeries. The impact of the pandemic on pediatric surgical care in tertiary centers is not well understood. This retrospective study aims to examine the effect of COVID-19 on the management of surgical diseases in children.
A retrospective single-center cross-sectional study was performed to collect information on the children who were operated either emergently or in an elective setting. The demographics, field of surgery, outcomes, and the rates of mortality and morbidity were measured. Moreover, this study evaluated the associations between coronavirus disease 2019 (COVID-19) infection and surgical outcomes and length of hospital stay.
A total of 1028 children were included in the study with an average age of 60.51 ± 50.3 months. Only 33 children (3.2%) were positive for COVID-19 during the admission days. Moreover, 87 (8.5%) patients developed pulmonary, gastrointestinal, or infectious complications, and 22 patients (2.5%) expired. Morbidity was significantly associated with the presence of COVID-19 infection (p < 0.001). Furthermore, the rate of complications was much higher in patients who underwent emergency operations (p < 0.001). In addition, mortality in positive cases was remarkably higher than that in negative cases (22.2% vs. 1.9%, p < 0.001).
The overall rates of complications, morbidity, and mortality were much higher in emergency operations compared to elective surgeries. Also, the presence of COVID-19 infection in this population led to more cases of morbidity.

The main purpose of microbial typing is to evaluate the relationships between microbial isolates. Microbial typing can use for identifying the source of infection by detecting a clonal link between the strains. Moreover, it can analyze outbreaks, antimicrobial-resistant strains, and evaluate the effectiveness of control measures so, the efficiency of monitoring systems would increase. HAIs can affect hospitalized patients in all age ranges with any clinical situation, and lead to death. Molecular epidemiology is useful to determine genetic relatedness between isolated pathogens from patients, and design proper prevention plans to prevent infection through the hospital and community. Nowadays, typing methods for a wide range of bacterial strains are known as essential epidemiological tools to prevent and control infections in hospitals and communities. Although basic typing methods were more focused on phenotypic techniques like antibiogram and serotyping, new methods are based on molecular techniques including PCR-based methods and sequencing-based methods. Due to the high frequency of methods, choosing the right one for research applications seems difficult and requires basic knowledge about all of them. In this review, we aim to introduce the most useful and practical molecular typing techniques. Also, their utilization, advantages, and disadvantages were compared.

Several surveys have been conducted on the seroprevalence of viral infections caused by Chikungunya and West Nile viruses in humans. However, there is a paucity of studies on the seroprevalence and spread of these viruses in children.

We aimed to investigate the seropositivity of IgG antibodies against Chikungunya and West Nile viruses in a group of Iranian children aged one month to 14 years.

A cross-sectional study was performed on blood samples collected from children aged one month to 14 years in Tehran who attended the outpatient clinics of a children’s hospital from March to December 2018. The serum IgG levels against Chikungunya and West Nile viruses were assessed using the ELISA technique.

Of 180 serum samples assessed for positivity, four (three from boys and one from girls) had positive IgG for Chikungunya and 11 (seven from boys and four from girls) had positive IgG for West Nile, causing overall seropositivity of 2.2% and 6.1% for Chikungunya and West Nile infections, respectively. Moreover, Chikungunya and West Nile viruses showed no significant association between seropositivity and sex. High seropositivity was observed predominantly in the age groups of below two years and over 10 years in Chikungunya and West Nile infections, respectively. However, the difference was not significant (P-value > 0.05). In the age group of one month to two years, all cases with positive IgG were less than six-month-old.

The results of the seroprevalence of Chikungunya and West Nile viruses among children in Tehran showed the prevalence of these viral infections in this region. Therefore, these infections should be considered in the differential diagnosis for children with clinical symptoms of viral diseases.

For the therapeutic application and drug delivery of AgNPs in medicine, pharmacy and cosmeticproducts, it is essential to know the distribution and local or systemic toxicity associated with them.For this purpose, this study was carried out to assess the potential consequences of skin injection ofnanochelating based synthesized AgNPs on the mice models. Nanochelating technology used to designand synthesize the AgNPs. The histopathological findings in skin and tissue of micemodels have assessedvia histopathological analysis.All samples were visualized by an independent pathologist. The results ofeach sample have reported as follows, micrograph of the skin cells have shown the normal architectureand cells in all samples. Moreover, histopathological evaluation of samples have shown normal withoutany significant pathological changes compared to control groups in volume of derm and epiderm, andthe number of fibroblast, neutrophil, and macrophage.In summary, this study has observed no obviousdecline of immunological performance and morphological signs of skin damage in the mice caused bynanochelating based AgNPs exposure. These findings could provide a fundamental understanding of theintrinsic toxicity associated with nanochelating based AgNPs on biological models. Moreover, this studywould arisetypical attentions on the future applications of nanochelating based AgNPs on human, whichis valuable for short-term and low dose treatment in nanomedicines.

Febrile seizures (FS) are common in young children. Viral infections that result in high fever are frequent etiologic agents that lead to febrile seizures. Human Herpesvirus 6 (HHV6), Influenza virus, adenovirus, and enterovirus have been named as the most common viruses causing high fevers in young children. Although bacterial infections have rarely been found as causative agents, many children with febrile seizures are treated with empiric antibiotics.

To determine the epidemiology of the viral (HHV6, Adenovirus, HSV1, Enterovirus) and bacterial infection in children presenting with febrile seizures.

In a descriptive study, data was collected from 93 children, 3 months to 5 years of age, hospitalized with febrile seizures between September 2016 and April 2017. Relevant information was documented on a previously designed questionnaire. Blood samples were collected for culture, Serum 16S rRNA for bacteria, and PCR assay for 4 viruses (HHV6, adenovirus, enterovirus and HSV), in addition to routine investigations.

Of the 93 patients, serum PCR results were negative for 73 patients (78.49%) and 15 (16.13%) were positive for viruses (11 for HHV6 and 4 for Adenovirus). Serum 16S rRNA for bacteria was detected in 5 cases and blood culture was positive in 4 cases.

Findings of this study indicate a significant prevalence of viruses and a very low rate of bacterial infection in children with febrile seizures, thus, negating the use of empirical antibiotic therapy