Background: In December 2019, acute respiratory infection caused by coronavirus 2 (SARS-CoV-2) was diagnosed for the first time, leading to the COVID-19 pandemic. Pregnancy is known to be an independent risk factor for severe COVID-19 infection. Therefore, pregnant women have been among the priorities to receive the COVID-19 vaccines. The results following the injection of these vaccines are still unknown. Objectives: The present study evaluated the effects of Sinopharm vaccination on newborns. Methods: This study is a retrospective cohort study conducted among pregnant women aged 40 years or younger and their newborns, who were admitted to Baharloo Hospital, Tehran, in the year 2023. A total of 427 cases were reviewed, 144 of which were injected with the Sinopharm vaccine 3 months before pregnancy, 124 cases had been vaccinated during the first trimester, and 157 cases were unvaccinated. The data gathered from the files included: Name, date of admission, history of parity, the number of previous childbirths and the method (vaginal or caesarian section), drug history, date of injection according to the vaccination certificate, type of vaccine, and the number of doses up to the date of childbirth. The data gathered concerning the newborns included: Sex, 1st and 5th minute Apgar score, weight, indication for admission to neonatal intensive care unit and the duration, need for resuscitation, TTN, and newborn’s death. The information was gathered from the newborn files by midwives and doctors. The data was then analyzed by SPSS version 26 software. Results: According to the data analysis, unvaccinated individuals exhibited significant differences in delivery type (P = 0.012), history of COVID-19 (P < 0.001), presence of a positive past medical history (P < 0.001), and a positive drug history (P < 0.001) compared to vaccinated individuals. Furthermore, there was a significant difference in preterm birth and stillbirth rates between the two groups (odds of preterm: 0.84 (0.79 - 0.93), P = 0.04, odds of stillbirth: 0.83 (0.43 - 0.81), P < 0.001), which remained significant even after accounting for potential confounding factors (odds of preterm: 0.86 (0.67 - 0.89), P < 0.001, odds of stillbirth: 0.83 (0.43 - 0.79), P < 0.001). Conclusions: There was no relativity discovered between Sinopharm vaccination and a higher rate of stillbirth and newborn mortality. However, newborns of mothers vaccinated in the first trimester showed a significantly lower 5th minute Apgar.

Background: The COVID-19 pandemic significantly affected global healthcare, particularly affecting surgical practices. During the initial stages, there was a widespread suspension of elective surgeries, which posed challenges to surgical care centers. Protocols were developed to resume surgical activities, but the risk of perioperative infections persisted. Pediatric urology faced unique challenges due to the lack of consensus on preoperative screening for ambulatory surgical centers. Objectives: The present study aimed to assess the efficacy of a simple institutional preoperative screening method for adverse outcomes in pediatric ambulatory urology procedures during the pandemic. A retrospective review of medical records from an outpatient ambulatory surgery center was conducted for this purpose. Methods: This retrospective cross-sectional study analyzed the effectiveness of an institutional preoperative screening method in reducing the incidence of symptomatic viral infections and non-surgical complications during six distinct pandemic peaks in pediatric urology surgery in Iran (February 2020 to March 2023). Results: Of the 825 patients, most were male (758 males vs. 67 females), with an average age of 27.7 ± 30.0 months. Elective surgery cancellations were low (2.4%), primarily due to fever, cough, and elevated inflammatory markers. Polymerase chain reaction (PCR) tests were positive in 0.24% of symptomatic patients, none of whom developed postoperative COVID-19. There were significant correlations between symptomatic patients and cancellations during COVID-19 peaks (P = 0.035). Conclusions: A combination of clinical and laboratory examinations may suffice for preoperative screening of pediatric urology surgical procedures during the pandemic. Routine PCR testing is not recommended in this setting and should be confined to symptomatic patients. Moreover, the reported experience may be useful in addressing potential future viral outbreaks.

Background: Meningoencephalitis is a significant cause of mortality in children worldwide, and viral pathogens are the most common cause. This study conducted in northeastern Iran, where CSF samples were collected from children under 14 with meningitis and encephalitis symptoms. Objectives: The goal was to identify viral pathogens in the CSF, including enteroviruses, varicella-zoster virus (VZV), mumps virus, West Nile virus (WNV), herpes simplex virus (HSV), adenovirus, cytomegalovirus (CMV), and poliovirus. Methods: This cross-sectional study gathered 120 cerebrospinal fluid (CSF) samples from three tertiary university hospitals in northeastern Iran. The participants were children presenting with one or more symptoms related to meningitis and encephalitis, including headache, fever, seizures, nausea, vomiting, or neck stiffness. Nucleic acids were extracted from these samples, and two panels of multiplex PCR were employed to identify the most prevalent pathogens. Results: In a study of 120 CSF samples from children in northeastern Iran with symptoms of meningitis and encephalitis, 72 samples tested positive for viral infections. The most common viral pathogen was enterovirus, found in 48.6% of the positive samples. Other viruses detected were HSV and CMV, each at 13.9%, VZV at 9.7%, adenovirus and WNV, both at 5.5%, and poliovirus types 1 and 2, and poliovirus types 3 and 4 each at 1.4%. No samples tested positive for the mumps virus. The findings indicate that viral agents were present in over 50% of the cases studied and that enteroviruses are the most common cause of meningitis in this region. Despite their prevalence, viral pathogens are not routinely checked in clinical tests. Conclusions: Our findings show that viral agents were present in over 50% of the cases. Despite their prevalence, viral pathogens are not routinely checked in clinical tests.

Background: Hospital-acquired infections (HAIs), specifically those caused by gram-negative bacteria, are a significant public health concern with high mortality rates among patients worldwide, especially in developing countries. Objectives: This survey aimed to determine the prevalence and antibiotic resistance patterns of gram-negative nosocomial infections among patients admitted to different wards of a tertiary hospital in Iran. Methods: This cross-sectional study was conducted using samples collected from patients admitted to coronary care unit (CCU), intensive care unit (ICU), neonatal intensive care unit (NICU), general, and surgery wards of Yas Hospital, Tehran, Iran, from October 1st, 2022, to February 28th, 2023. After the detection of bacteria, antibiotic susceptibility tests were performed using the Kirby-Bauer disk diffusion method by the guidelines of the clinical and laboratory standards institute (CLSI) for gentamycin (GM), ciprofloxacin (CIP), cefepime (FEP), ceftazidime (CAZ), cefotaxime (CTX), imipenem (IPM), meropenem (MR), and piperacillin-tazobactam (TZP), and the results were analyzed using SPSS v22 software. Results: Two hundred and sixty isolates were collected from clinical specimens, most of which were isolated from the ICU ward (53.8%). Among the collected specimens, 98 (37.7%) were isolated from urine, 92 (35.4%) from sputum, 45 (17.3%) from blood, 17 (6.5%) from surgical wounds, and 8 (3.1%) belonged to other specimen types. Among detected bacteria, Klebsiella pneumoniae and Escherichia coli were found to be responsible for 78% of total infections. Based on the Kirby-Bauer disk diffusion results, Acinetobacter baumannii demonstrated the highest resistance to the antibiotics tested, with a resistance rate ranging from 92% to 97%. This was followed by K. pneumoniae, which demonstrated resistance rates between 70% and 85% across all classes of tested antibiotics. Conclusions: The study highlights a high prevalence of nosocomial infections in the ICU, with significant antibiotic resistance, particularly from A. baumannii. It emphasizes strict hospital monitoring, infection control, and responsible antibiotic use.

Background: Preterm premature rupture of membranes (PPROM) significantly contributes to fetal and maternal complications. Objectives: This study aimed to evaluate the risk factors, comorbidities, and outcomes associated with PPROM based on a well-characterized retrospective study. Methods: A cross-sectional study was conducted in Tehran, Iran, from 2020 to 2023. Patient files were assessed, and relevant data were extracted, including patients' age, underlying diseases, gestational age at admission, events preceding or following PROM, cause of death, cervical length, and duration of hospital admission. All data were statistically analyzed to identify correlations between PPROM and various variables. Results: A total of 396 patients with PPROM were included, and 153 separate neonatal files were reviewed. The mean gestational age at admission was 31.1 weeks. The main comorbidities associated with PPROM were vaginal bleeding (39.2%), labor pain (20.2%), and chorioamnionitis (10.7%). The mean duration of maternal hospitalization was 4 days. Low gestational age was a significant risk factor for neonatal mortality (P = 0.002), respiratory distress syndrome (RDS) (P < 0.001), and surfactant requirement (P = 0.008). Neonates with lower birth weights were at higher risk for surfactant requirement (P = 0.025). Normal vaginal delivery (NVD) was a significant factor influencing neonatal mortality among PPROM patients (P = 0.0001). The need for surfactant administration was more frequently observed in neonates born by cesarean delivery (P = 0.047). Conclusions: The findings of this study indicate that vaginal bleeding is a major complication following PPROM. Preterm premature rupture of membranes also leads to increased perinatal mortality and morbidity. These findings underscore the importance of early diagnosis and interventions to prevent adverse outcomes.

Introduction: This case report presents a rare manifestation of Shigella infection: Acute perforated appendicitis. It emphasizes the importance of differential diagnosis in patients presenting with diarrhea, especially when symptoms overlap with surgical emergencies like appendicitis. Case Presentation: Our case involved a 10-year-old girl who was referred to our hospital with complaints of abdominal pain and non-bloody watery diarrhea. Clinical examinations confirmed acute appendicitis, and an appendectomy was performed. A few days post-surgery, the patient developed dysentery. Stool culture identified Shigella flexneri, and the patient was treated with Piperacillin/tazobactam and ciprofloxacin based on the antibiogram and consultation with the infectious disease team. The patient responded well to treatment and was discharged in good general condition after completing the full course of therapy. Conclusions: Although shigellosis is a common gastrointestinal infection, it is rarely linked to appendicitis. This case highlights the need for thorough evaluation in patients with diarrhea, as infectious conditions like shigellosis can mimic or coexist with acute appendicitis, leading to potential diagnostic and management challenges.

Background: COVID-19 is a highly contagious respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While nasopharyngeal swab testing remains the primary method for identifying SARS-CoV-2 carriers, the virus’s genetic material can be detected in various bodily samples, suggesting potential transmission through non-respiratory routes. Objectives: This study aimed to investigate the presence and quantity of SARS-CoV-2 RNA in stool, endotracheal tube (ETT) samples, cerebrospinal fluid (CSF), bronchoalveolar lavage (BAL), and sputum. The research sought to correlate these findings with clinical characteristics and the severity of illness. Methods: We retrospectively collected 1,567 samples, including 550 BAL samples, 464 ETT samples, 45 fecal samples, 21 CSF samples, and 487 sputum samples from patients admitted to Namazi Hospital between April 1, 2020, and the end of September 2022. Clinical characteristics, patient demographics, radiographic, and laboratory results were among the medical data gathered and assessed. We used reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to detect and measure SARS-CoV-2 RNA shedding in different samples of individuals infected with COVID-19. Results: Among the 550 BAL samples collected from patients, 20.7% tested positive for SARS-CoV-2. Additionally, the virus’s genome was detected in 17.8% of 45 CSF samples, 11% of 464 ETT samples, 4.76% of 21 fecal samples, and 2.9% of 487 sputum samples. Notably, patients with SARS-CoV-2-positive BAL samples exhibited a significantly higher frequency of cough and dyspnea than those who tested negative. Conclusions: These findings revealed that SARS-CoV-2 has been detected in diverse specimens collected from the upper and lower respiratory systems (sputum, ETT, and BAL samples), the central nervous system (CSF), and the digestive tract (fecal samples) during the infection’s progression. This widespread presence significantly impacts our understanding of the disease’s pathogenesis and enhances diagnostic capabilities, proving a valuable asset in managing the infection.

Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a rare complication of COVID-19, and bone marrow suppression is an exceedingly rare manifestation of MIS-C. This report presents a 10-year-old boy with periorbital ecchymosis, lethargy, and a history of fever and cough, who was diagnosed with MIS-C accompanied by severe bone marrow suppression. Case Presentation: A 10-year-old boy was referred to our hospital with complaints of ecchymosis around the eyelids, especially the upper eyelids, and lethargy. He also reported a history of cough, fever, and bone pain over the past 10 days. Although fever and cough had subsided, the patient remained lethargic. Laboratory studies were performed, and a complete blood count (CBC) revealed severe bone marrow suppression. Additional tests showed markedly elevated urea and creatinine levels, severe hyperphosphatemia, and severe hyperuricemia, indicating renal failure. Given the laboratory findings and his lethargic condition, the patient was hospitalized and underwent hemodialysis. Blood products, including packed red cells and platelet units, were transfused following hematology consultation. Further laboratory tests ruled out rheumatological conditions, with all rheumatological tests reported as normal. However, Interleukin-6 (IL-6) and fibrinogen levels were significantly elevated, and the COVID-19 PCR test was positive. Based on these findings, the diagnosis of MIS-C was established. Treatment with remdesivir and methylprednisolone pulse therapy was initiated. Other potential infectious causes of bone marrow suppression, such as leishmaniasis, were excluded due to normal test results and a normal CBC performed one week prior to the onset of clinical symptoms. Following the completion of treatment, the hematological and nephrological complications resolved, and the patient was discharged in good condition. He remains under regular follow-up. Conclusions: Multisystem inflammatory syndrome in children can lead to bone marrow suppression, and a combination of remdesivir and methylprednisolone appears to be an effective treatment for managing this condition.

Background: The impact of COVID-19 on pediatric cancer patients remains a critical area of investigation. Objectives: This study aimed to compare the clinical characteristics and outcomes of COVID-19 in children with and without malignancies. Methods: 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. Results: 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. Conclusions: 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.

Background: Pregnant women and their fetuses are considered high-risk populations during pandemics, including coronavirus disease 2019 (COVID-19). Objectives: This study aims to evaluate maternal and neonatal outcomes among pregnant women infected with COVID-19. Methods: This descriptive, analytical, retrospective case-control study included COVID-19-infected pregnant women referred to hospitals affiliated with Shiraz University of Medical Sciences in southern Iran from March 2021 to March 2022. Data were collected using a pre-designed checklist covering demographic information and maternal and neonatal outcomes. Analyses were performed using SPSS version 25, with the significance level set at P < 0.05. Results: Significant differences were observed in maternal and neonatal outcomes for variables such as vaginal bleeding, fetal distress, premature birth, intrauterine death, ICU admission, low birth weight, and NICU admission (P < 0.05). Although neonatal transient tachypnea and pneumonia were more than twice as common in infants of COVID-19-infected mothers compared to controls, these findings were not statistically significant (P > 0.05). Similarly, abnormal lung X-rays, thrombocytopenia, and positive CRP were slightly more frequent in infants born to COVID-19-infected mothers, but these differences did not reach statistical significance (P > 0.05). Conclusions: The study highlights the increased risks of adverse short-term and long-term maternal and neonatal outcomes associated with COVID-19 during pregnancy. Prioritizing pregnancy-specific interventions is crucial in pandemic management to mitigate these risks and improve outcomes for both mothers and their infants.