mohsen vigeh

 After launching coronavirus disease 2019 (COVID-19) vaccination programs, healthcare workers and the general population were worried about the efficacy and safety of vaccines in mothers and fetuses due to insufficient data. During the phases of clinical trial and mass vaccinations, many unplanned pregnancies occurred in vaccinated women, which helped to investigate protection rates of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their side effects.

 This review study had two main objectives, including finding original articles about vaccinated pregnant women and collecting suggestions/recommendations in published documents, including the effectiveness, benefits, side effects, and instructions for vaccination of pregnant women.

 The web-based literature was extensively searched to retrieve the related documents. Due to the emerging nature of evidence, rapid onset of the SARS-CoV-2 outbreak, and recent vaccination programs, no limitation was applied regarding inclusion criteria and the study type.

 Sixteen documents were selected for full text reading. Due to the significant benefits of vaccines (mostly mRNA types), such as the reduced risk of disease severity, premature labor, and virus transmission, vaccination of pregnant women has been recommended by the Joint Committee on Vaccination and Immunization as well as several other organizations.

 the consequences of SARS-CoV-2 disease during pregnancy seem to outweigh the known side effects of the vaccination.

Due to the chronic nature of diabetes, children with type 1 diabetes are prone to a number of long-term complications. One of the most important complications of this disease is cardiovascular involvement due to atherosclerosis, which is directly related to the control of blood lipids. The use of probiotics may be effective in the process of complications in these patients by affecting fat metabolism. The aim of this study was to evaluate the effect of oral probiotics on lipid profiles in children with type 1 diabetes.

This study was conducted at Bahrami Children's Hospital from May 2018 to May 2019. In this single-blind randomized controlled clinical trial, 52 children with type 1 diabetes (aged 2 to 16 years) were studied. We created two groups of 26 individuals. The inclusion criteria were determined as follows: Proof of T1DM by history and information of children’s medical record. Also, the Exclusion criteria were determined in this way: Patients consuming probiotics in the last 4 weeks, gastrointestinal infections in the last 2 weeks, and presence of chronic underlying intestinal diseases. The probiotic group received, in addition to insulin therapy, a daily probiotic capsule for 90 days. The control group received only routine insulin therapy. Blood samples were taken to measure lipid profiles at the beginning and end of the trial.

A total of 52 patients were included. The mean age of children was 9.3±2.9 (4 to 14 years). The mean age in the probiotic and control groups was 9.6±3.5 and 9.4±3.0 respectively. The results of this study showed that HDL-C was increased in the probiotic group compared to the control group, although it was not statistically significant (P>0.05). Also, changes in total cholesterol, LDL-C, and triglyceride were not statistically significant

In this study, the use of oral probiotics for 90 days in children with type 1 diabetes did not have a significant effect on blood lipid profiles compared to the control group.

Fetal demise can complicate aneuploidy screening in a multi fetal pregnancy. The cell-free DNA (CF-DNA) from a non-viable conception may be discordant with the viable fetuses. The Aim of study was to review the waiting period, follow-on single fetal demise in a twin gestation before performing NIPT (Non-Invasive Prenatal Testing). In this review article we searched through online databases of CINAHL, Cochrane, Database of Abstracts of Reviews of Effects (DARE), PubMed, Medical Library, and Google Scholar for English literature between 2011 to 2020, with the following keywords: “NIPT”, “non-invasive prenatal screening testing”, “cell-free DNA”, “vanishing twin” and “co-twin demise”. We included the studies regarding the duration between the twin vanishing or reduction and NIPT false results. 201 studies across the eight scientific websites were detected; 178 of which were excluded for duplication or being irrelevant. And 29 studies were fully read. 4 case series, finally, met the criteria for systematic review. The findings suggested that the NIPT screening test can be falsely-positive several weeks after vanishing twins although the live fetus is normal. Therefore, the time duration in which the placenta can release CF-DNA of the vanished twin is unknown. In addition, several weeks after reduction, the fetal CF-DNA increases and then decreases, thus CF-DNA analyzing in multifetal pregnancies with reduction can be challenging as well. In pregnancies with vanishing twin or reduction, evaluating NIPT results is more complex than single fetal pregnancy. According to the reviewed studies, after a fetal demise, the cytotrophoblast continues to release to the CF-DNA in the maternal circulation for a variable time, which may cause a false-positive result if the demised twin is aneuploidy.

Recent studies show that exposure to heavy metals can affect thyroid function. This study aimed to assess heavy metals in breast milk during the first few days postpartum and their relationships with hyperthyrotropinemia in neonates.

In this case-control study, 82 mother-infant pairs, consisting of 21 pairs (neonates with hyperthyrotropinemia) in the case group and 61 pairs (healthy neonates) in the control group, were assessed at 3-5 days postpartum. Thyrotropin concentrations >5 mIU/L in the heel blood sample were considered as hyperthyrotropinemia. In the case group, thyrotropin concentration was also measured in the venous blood sample for confirmation. At the same time, to assess mercury (Hg), lead (Pb), and cadmium (Cd) concentrations, a breast milk sample was collected from each mother.

The median (interquartile range, IQR) thyrotropin concentrations in the heel blood sample of healthy neonates and neonates with hyperthyrotropinemia were 0.90 (0.40-1.85) and 6.80 (5.70-8.80) mIU/L, respectively (P<0.001). This value was 5.50 (5.00-6.75) mIU/L in the venous sample of neonates with hyperthyrotropinemia. None of the heavy metals in breast milk showed a significant correlation with thyrotropin concentration in the heel blood sample. However, there was a significant correlation between the concentration of Pb in breast milk and thyrotropin level in the venous blood sample (r=0.478, P=0.029). No correlations were observed between breast milk Hg and Cd concentrations and venous thyrotropin level.

The present findings indicate that the concentration of Pb in breast milk correlates with neonates' thyroid function. However, further studies with larger sample sizes are needed to confirm our results.

Acute gastroenteritis is one of the most common diseases in children with a high rate of nausea and vomiting. Drugs such as ondansetron are used to treat vomiting.

The aim of the study was to compare the success rate of oral vs intramuscular ondansetron to reduce vomiting in children with acute gastroenteritis.

A single-blind randomized clinical trial study was conducted on 100 children with acute gastroenteritis. Two groups of patients were created; one group received an intramuscular injection of ondansetron and the other received oral ondansetron. The vomiting rate, hospitalization, and side effects were evaluated 30 minutes, 4, and 48 hours after drug administration.

Fifty-nine (59%) participants were boys. The mean age of the patients was 3.07 ± 2.20 years. There were no significant differences between the groups in terms of age, weight, and rate of vomiting before the treatment was launched. No significant difference between the drug administration route and the outcome of vomiting during the first half, 4, and 48 hours after receiving the drug was found either.

The study showed that the success rate of oral ondansetron did not vary significantly compared to intramuscular injection in terms of reducing the vomiting rate in children with acute gastroenteritis.

Exposure to toxic metals remains a public health problem with lifelong impacts on childhood growth and development. We aimed to investigate metals effects on preschool children’s anthropometric variables.

The study was conducted in Tehran, Iran, from Jul 2013 to Mar 2016. We measured scalp hair metal concentrations (lead, cadmium, arsenic, zinc, manganese, and cobalt), using inductively coupled plasma mass spectrometry, in 207 preschool children’s (36 to 72 months old).

A significant negative correlation between children's hair lead levels and children's weight was found (r= −0.178, P<0.05). Linear regression analysis confirmed the relationship when adjusted for the confounders, including children's age, sex, height, family income, and maternal education (β= −0.191; t= −3.426, P< 0.01). The ANOVA analysis showed a significant (P<0.01) difference between hair lead level and children's weight-for-age percentiles. Totally and separately, in almost all weight percentiles, hair lead levels were higher in girls than boys.

The present study on Iranian children showed the current levels of lead exposure might negatively influence on children growth, with higher risk for girls than boys.

Although the level of exposure to many toxic metals decreased recently, the adverse effects of these metals on children’s growth and development remain a serious public health issue.
The present study was conducted in three teaching hospitals affiliated with Tehran University of Medical Sciences (Tehran, Iran) from Sep 2012 to Mar 2013. To study the relationship between metals and childhood growth, concentrations of zinc and several potentially toxic metals (lead, cadmium, antimony, cobalt, and molybdenum) were measured in scalp hair for 174 children, aged 20 to 36 months.
The hair concentrations of cobalt were significantly (P Gender may play a significant role in absorption and/or accumulation of metals. It should be considered when we study metal toxicity in children.

An important part of male infertility of unknown etiology may be attributed to various environmental and occupational exposures to toxic substances, such as lead. The reproductive effects of lead are complex and appear to involve multiple pathways, not all of which are fully understood. It is still unclear, for example, if male reproductive issues in lead-exposed persons are mostly related to the disruption of reproductive hormones, whether the problems are due to the lead’s direct effects on the gonads, or both? This question has been difficult to answer, because lead, especially at high levels, may adversely affect many human organs. Although lead can potentially reduce male fertility by decreasing sperm count and motility, inducing abnormal morphology and affecting functional parameters; not all studies have been able to clearly demonstrate such findings. In addition, research has shown that the blood-testis barrier can protect testicular cells from direct exposure to high levels of blood lead. For these reasons and considering the wide spectrum of lead toxicity on reproductive hormones, the present review suggests that lead’s main influence on male reproduction probably occurs by altering the reproductive hormonal axis and the hormonal control on spermatogenesis, rather than by a direct toxic effect on the seminiferous tubules of the testes. As blood lead concentrations below the currently accepted worker protection standard may still adversely affect male fertility, future studies should aim to establish more concrete links between lead exposure (especially at low levels) and subsequent male infertility. Research should also pay more attention to lead’s effects on reducing male fertility rates based on not only hormonal axis alteration, but also on the changes in sperm characteristic among exposed subjects.