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Overview of aseptic meningitis after MMR vaccination in a group of Iranian infants in Children’s Medical Center
Parisa Rahmani, Mohammad Roshanghalb, Hosein Alimadadi, Behnaz Bazargani, Nasir Fakhar, Reihaneh Mohsenipour,
Volume 78, Issue 8 (11-2020)
Abstract
Background: CNS infection can be focal or generalized. Meningitis, besides other etiologies, can occur after a viral infection or viral vaccine. Although meningitis can occur in at any age but it is more common in children less than five years old. Aseptic meningitis and meningoencephalitis are two of the most common complications of mumps (wild type or vaccine). As a result of their serious complication, we decided to obtain more information about clinical manifestations and laboratory findings after the injection of the Hoshino MMR vaccine in a group of children in an Iranian referral hospital.
Methods: In this cross-sectional study, performed from March 2013 to February 2015 on 73 children with meningochemical symptoms of meningitis, children who have been diagnosed with aseptic meningitis followed by an MMR vaccine in an infectious ward or emergency department of the Children’s Medical Center were enrolled in the study and their information was recorded from their files. A questionnaire was provided for children with diagnostic criteria of aseptic meningitis and their data were collected.
Results: The gender ratio of patients was 46 males to 27 females. After collecting the symptoms of meningitis, the frequency of symptoms in these patients was as below: fever 66%, headache 49.3%, nausea and vomiting 74%, parotid swelling 0%, seizure 21.9% and meningeal symptoms 37%. Their laboratory data showed that 8.2% of patients had normal WBC and 76.7% had Abnormal results in their CSF (Cerebrospinal fluid) analysis. Mumps PCR (Polymerase chain reaction) was positive in 85% of samples.
Conclusion: our study revealed that nausea and vomiting were the most frequent symptom after MMR vaccination in children and fever was in second grade in aseptic meningitis. There was no relation between clinical symptoms together, therefore we should take care of children after MMR vaccination to avoid complications when they become symptomatic.

Comparing outcomes of slow versus rapid feeding in premature neonates hospitalized in Al-Zahra hospital, Rasht
Seyedeh Zohreh Jalali, Sadroddin Mahdipour, Reza Sharafi, Fariborz Torkipour, Afagh Hassanzadeh Rad , Babak Moqtader, Marjaneh Zarkesh ,
Volume 79, Issue 10 (1-2022)
Abstract
Background: one of the leading clinical problems for premature neonates especially with very low birth weight is the type and amount of feeding. The authors aimed to compare outcomes of slow versus rapid feeding in premature neonates hospitalized in Al-Zahra hospital, Rasht.
Methods: This is a clinical trial that was conducted on 62 premature neonates aged less than 35 weeks of gestation who were referred to Al-Zahra Hospital from April 2015 to April 2016. They weighed 1000-2000 gr at birth. Samples were randomly assigned to intervention or control groups. The intervention included neonatal feeding with breast milk or formula with feeding advancement of 30 cc/kg/day which was compared with the routine method of slow feeding (20 cc/kg/day). Neonates were assessed until discharge or the occurrence of Necrotizing enterocolitis. Data were reported by descriptive statistics including mean, standard deviation, frequency, and percent, and analyzed by independent samples t-test and chi-square test in SPSS software, version 22 (IBM SPSS, Armonk, NY, USA).
Results: All 62 patients finished the study including 31 neonates weighing 1000-2000 gr at birth in the intervention group and 31 neonates weighing 1000-2000 gr at birth in the control group. Neonates in the intervention group reached to full milk feeding of 150 cc/kg/day sooner (6.06±1.34 versus 9.45±2.39), return to birth weight faster (9.89±3.57 versus 12.9±6.46), had a lower duration of needing parenteral fluids (5.10±1.61 versus 8.86±3.81), and had a lower duration of hospitalization (9.97±4.03 versus 16.87±9.13) compared to controls. Results showed that there was no necrotizing enterocolitis in the intervention and control groups.
Conclusion: The results of this study showed that initiating feeding by 30 cc/kg/day method shortened the duration of access to intravenous line and hospitalization and caused sooner discharge. Also, no adverse complication was noted. Therefore, it seems that further investigations assessing these methods can be help manage preterm neonates.

A rare complication of covid-19 infection in a 14-month-old infant: a case report
Asra Moradkhani, Mobin Azami, Massomeh Abedini ,
Volume 80, Issue 12 (3-2023)
Abstract
Background: Sever Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in some patients leads to cytokine storm and causes hemophagocytic lymphohistiocytosis (HLH) secondary to this viral agent. HLH is a rare and aggressive disease that increases in children, and is caused by changes in the immune system that associated with high mortality. Consideing the current pandemic, early diagnosis and treatment is important. Herein, we report a case of a 14-month-old infant presented with COVID-19 and prolonged fever who was eventually treated with the diagnosis of HLH. The study has been done in Sanandaj in January 2020.
Case Presentation: A 14-month-old female infant with Covid-19, in November 2019 with prolonged fever lasting for 12 days, weakness and lethargy was admitted to Sanandaj Social Security Hospital, in November 2019. The infant did not have any history of illness, drug or allergy and had received vaccination according to the country's protocol. Later she was transferred to Besat Hospital in Sanandaj due to persistent fever and elevated liver enzymes. The patient had severe leukocytosis and hepatosplenomegaly in the second center. During the diagnostic measures for the patient and the rule out of other possible causes through imaging and laboratory investigations and also the evaluation of relevant criteria, HLH was suggested and treated with antibiotics (ceftriaxone, meropenem), IVIg, dexamethasone and pantoprazole. After that the fever decreased, then oral prednisolone was prescribed and a follow-up was recommended. She was discharged in good general condition.
Conclusion: The current Covid-19 pandemic causes infection of children and may lead to occurrence of secondary HLH disease. therefore, assessment of children with liver manifestations and resistant fever should be considered by performing a PCR test to avoid complications and consequences as much as possible by timely treatment. more studies should be done in the field of its various dimensions.

Investigating the relationship between the type of delivery and neonatal and maternal outcomes in public and private hospitals in Yazd
Morad Ali Zareipour, Shahla Mohammad Khani , Behjat Khorsandi , Faezeh Afkhami Aghda , Fateme Moshirenia, Mahdieh Hardani Naeemzadeh ,
Volume 82, Issue 1 (3-2024)
Abstract

Background: The type of delivery significantly affects a woman's life and her newborn's health. Various factors, including medical conditions, personal preferences, and cultural influences, shape this decision. Increasing cesarean delivery rates have raised concerns about associated risks. This study examines the health impacts of different delivery types on mothers and newborns in Yazd hospitals, with a focus on maternal and neonatal outcomes.
Methods: This cross-sectional analytical study involved a substantial cohort of 69,321 mothers who delivered in Yazd between March 21, 2018 to March 20, 2022. Comprehensive data were collected from Iman Hospital and relevant online patient records. To analyze the relationship between delivery type and health outcomes, independent samples t test and chi-square test were utilized. Additionally, odds ratios were calculated to assess relative risks concerning various maternal and neonatal outcomes. SPSS 26 software was employed for all analyses, with a significance level set at 5% to ensure robustness in the findings.

Results: The average age of participants in the study was 34.45±6.44 years, highlighting a mature population of mothers. Neonatal outcomes indicated that babies delivered naturally were more likely to have unfavorable Apgar scores (ranging from four to six) when compared to infants delivered via cesarean section (CI=0.99-1.55, P=0.05, OR=1.24). Furthermore, naturally delivered infants showed a significantly higher likelihood of having Apgar scores below six (CI=0.90-1.03, P=0.001). Alarmingly, the odds of neonatal death were found to be 1.22 times higher for cesarean births (CI=1.19-1.25, P<0.001). Additionally, mothers who underwent cesarean deliveries exhibited nearly a 4.9 times higher likelihood of requiring intensive care after delivery (CI=4.71-5.12, P<0.001, OR=4.9) and were 14.3 times more likely to be hospitalized postoperatively compared to those who had natural deliveries (CI=3.53-1.31, P<0.001, OR=14.33).
Conclusion: This study indicates that cesarean delivery is associated with higher complications for both mothers and newborns, highlighting the need to promote natural childbirth for better health outcomes.

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