Search

Introduction: Varicella usually resolves without complications. However, there is a risk of necrotizing soft tissue infections such as necrotizing fasciitis (NF) that can complicate the management. Case series: Case 1 was a 5-year-old male who developed widespread vesicular lesions and fever, diagnosed as varicella. His condition worsened as he presented with abdominal distension and pain, leading to hospitalization for suspected toxic shock syndrome. Computed tomography (CT) of the chest and abdomen revealed features consistent with NF, prompting extensive debridement and subsequent vacuum-assisted closure (VAC) therapy. After several surgical revisions he underwent skin grafting and was eventually discharged home. Case 2 was a 4.5-year-old male with no significant medical history, who presented with generalized fever, neck pain, and rapidly spreading skin rashes. He subsequently developed severe acute idiopathic scrotal edema and extensive ecchymosis, requiring immediate hospitalization. Broad-spectrum antibiotics were started. He underwent emergent wide debridement of the ecchymotic areas. The pathology analysis confirmed necrotic tissue, and cultures were positive for bacteria and fungi. He underwent repeated debridement. The last debridement was followed by uncontrollable hemorrhage, and he passed away. Conclusion: While varicella is generally a mild disease, life-threatening complications such as necrotizing fasciitis can occur.

Mediastinal malignant rhabdoid tumor (MRT) is an exceedingly rare and aggressive neoplasm, particularly uncommon in infants. We present the case of a previously healthy 7-month-old male infant with mediastinal MRT. The patient initially presented with left eyelid ptosis and was otherwise asymptomatic. Initial investigations, including brain MRI, yielded unremarkable results, and the infant was discharged with vitamin B supplements. However, he was readmitted a week later with prolonged fever, poor feeding, diarrhea, and respiratory distress. Despite an initial diagnosis of bronchiolitis/viral respiratory tract infection, the patient's condition rapidly deteriorated. Subsequent evaluation revealed mediastinal MRT as the underlying cause. This case underscores the diagnostic challenges associated with mediastinal MRT in infants and highlights the importance of considering rare neoplastic etiologies in atypical clinical presentations.

Background: Children generally are less contaminated by COVID-19 than other age groups, but multisystem inflammatory syndrome-children (MIS-C) can cause severe outcomes in some children. The information about MIS-C patient mortality is limited, and the cause of mortality may vary by geographical region. Therefore, we performed this case series study to report the clinical features and treatment of MIS-C patients associated with COVID-19 who died in selected referral hospitals in Iran. Case Presentation: We presented 9 cases of deceased MIS-C patients hospitalized from March 2020 to September 2021. The median age of deceased patients was 89 months (interquartile range: 8-162 mo). Five patients (55%) were male. The COVID-19 reverse transcription polymerase chain reaction (PCR) or serology test was positive in 7 children (77%). About 80% of the patients had comorbidities, most commonly obesity. All the patients were febrile at admission, and 77.78% had a fever for over 5 days. Respiratory, cardiac, and gastrointestinal signs were the most common. On admission, 6 patients were transferred to the pediatric intensive care unit. All patients received intravenous immunoglobulin and steroids. Conclusions: The most common organ failure was lung, heart, liver, and kidney, but the main cause of death was cardiopulmonary failure. Early diagnosis and management of MIS-C are necessary to prevent severe complications and death.

[This corrects the article DOI: 10.1371/journal.pone.0274104.].

Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients

Abstract Background and Aims The prospect of using artificial intelligence (AI) in healthcare is bright and promising, and its use can have a significant impact on cost reduction and decrease the possibility of error and negligence among healthcare workers. This study aims to investigate the level of knowledge, attitude, and acceptance among Iranian physicians and nurses. Methods This cross‐sectional descriptive‐analytical study was conducted in eight public university hospitals located in Tehran on 400 physicians and nurses. To conduct the study, convenient sampling was used with the help of researcher‐made questionnaires. Statistical analysis was done by SPSS 21 The mean and standard deviation and Chi‐square and Fisher's exact tests were used. Results In this study, the level of knowledge among the research subjects was average (14.66 ± 4.53), the level of their attitude toward AI was relatively favorable (47.81 ± 6.74), and their level of acceptance of AI was average (103.19 ± 13.70). Moreover, from the participant's perspective, AI in medicine is most widely used in increasing the accuracy of diagnostic tests (86.5%), identifying drug interactions (82.75%), and helping to analyze medical tests and imaging (80%). There was a statistically significant relationship between the variable of acceptance of AI and the participant's level of education (p = 0.028), participation in an AI training course (p = 0.022), and the hospital department where they worked (p

Introduction: Given that children in Pediatric Intensive Care Unit (PICUs) are more vulnerable to safety risks, health care officials are required to identify the weaknesses and strengths of care and ensure the safety of these children. In this study, the safety status in PICUs of selected educational children’s hospitals in Tehran, Iran, was examined and compared with standards proposed by the World Health Organization (WHO). Methods: In this descriptive study, the performance of nurses with a bachelor’s degree or higher and minimum work experience of six months in the PICU was examined. The study environment included four selected educational hospitals located in Tehran, Iran. Data collection tools were eight safety observation checklists based on the safety standards of WHO. Data collection took five months and the nurses’ performance was categorized into three groups of undesirable, relatively desirable, and desirable. The data were analyzed using SPSS software version 13, descriptive statistics, and regression analysis. Results: Consistency of nursing care for the safety of hospitalized children was found undesirable in hand hygiene in accordance with the WHO standards. Nurses’ performance was relatively desirable in the fields of being more cautious about drugs with similar names or spelling to avoid medication errors, communication during patient hand-over, and performance of correct procedure at correct body site. Regarding other fields, the consistency was at a desirable level. Conclusion: Children’s safety in the PICUs is not desirable in terms of observing health codes and there is a long way to go to meet the international standards.

Objective To identify risk factors for severe disease in children hospitalised for SARS-CoV-2 infection.Design Multicentre retrospective cohort study.Setting 18 hospitals in Canada, Iran and Costa Rica from 1 February 2020 to 31 May 2021.Patients Children

Background: The increase in the spread of the novel coronavirus (SARS-CoV-2) has put many children at risk around the world. Some of these patients are in critical condition and present with shock symptoms and cardiac system problems. The ultrasonic cardiac output monitor (USCOM) is a non-invasive device that determines a person's cardiac output using continuous wave Doppler ultrasound. Objectives: The current study aims to present the clinical and laboratory manifestations of children with coronavirus disease (COVID-19) and to use a USCOM device for hemodynamic assessment to record and review their clinical information. Patients and Methods: We introduce 22 cases of children infected with coronavirus admitted to a public hospital in Iran. We examined the hemodynamics of these patients using USCOM and reported our experience with pediatric patients presenting with shock. This was a retrospective study, and data were collected using medical records. Results: In this study, 22 pediatric cases (10 girls and 12 boys) infected with coronavirus were reported. The youngest was 3 months old and the oldest was 14 years old. The most commonly observed symptoms were low back pain (N = 15), fever (N = 12), and seizures (N = 10). We found that the hemodynamics of the patients, including systemic vascular resistance (SVR), were abnormal and were associated with hypotension and unstable hemodynamics. The children responded well to the administration of an intravenous norepinephrine drip. Conclusion: This study presents detailed clinical and laboratory results of 22 children with COVID-19. Additionally, their hemodynamic status was measured and presented using the USCOM device. This information can provide physicians with a comprehensive understanding of the clinical history of patients referred with COVID-19, thereby improving their knowledge and care delivery. [ABSTRACT FROM AUTHOR]