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Introduction: Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) during pregnancy is a rare but serious condition associated with high maternal and fetal complications. This condition is more common in multiparous women and typically occurs in the third trimester or early postpartum period, especially in the presence of risk factors such as pre-existing HTG and diabetes. Case Presentation: A 29-year-old primigravid woman presented at 21 weeks gestation to the obstetrics emergency department with acute, severe, persistent epigastric and left upper abdominal pain lasting for one day. Physical examination revealed tachycardia, slightly elevated blood pressure, and tenderness in the epigastrium and left upper quadrant. She had a history of primary infertility lasting three years but no other significant medical or surgical history. Her family history was negative for any specific diseases. Laboratory examinations showed elevated serum amylase levels (1170 IU/L) and a markedly high serum triglyceride level (8100 mg/dL). A diagnosis of acute HTG-induced pancreatitis was made, and the patient was successfully treated with a combination of plasma exchange, low molecular weight heparin, and an insulin/potassium/dextrose infusion. Pregnancy was completed with an elective cesarean delivery at 38 weeks gestation, with no episodes of recurrence or related complications observed during the follow-up period. Conclusions: Acute pancreatitis should be considered as a differential diagnosis in pregnant women presenting with epigastric pain across all trimesters, even in patients with no family or personal history of HTG, as early diagnosis can significantly improve maternal outcomes. [ABSTRACT FROM AUTHOR]

Objectives Shigellosis is one of the common causes of bacterial diarrhea in children. Seizures are common in shigellosis. It is essential to identify the risk factors of seizure in this disease. Materials & Methods This study was conducted on 224 children with shigellosis. The patients were divided into: With (case groups = 63 cases) and without seizures (control group = 161 cases). Groups were compared regarding different variables such as age, gender, clinical symptoms, and laboratory findings. Data analysis was done using statistical tests and SPSS software. Logistic regression analysis was used to determine the risk factors of seizures. Results Out of 224 cases of children with shigellosis, 107 (47.8%) were male and 117 (52.2%) female. Significant differences were observed between the two groups in terms of age, history of febrile convulsions, frequency of bloody diarrhea, frequency of fever, duration of diarrhea before hospitalization, abdominal pain, increase in BUN, hyponatremia, hypocalcemia, and red blood cell count in stool (P<0.05). Logistic regression analysis showed that a history of febrile seizure, fever, and hyponatremia are the risk factors for seizures in shigellosis. Conclusion This study concluded that a history of febrile seizure, fever, and hyponatremia are risk factors for seizure in childhood shigellosis, thus rapid diagnosis and treatment of childhood shigellosis with risk factors is very important. [ABSTRACT FROM AUTHOR]

Introduction: Limited resources and the large number of children in need of services in the pediatric intensive care unit (PICU) emphasize the need for effective allocation of resources for improving the outcome of at-risk patients. This study aimed to evaluate and compare the accuracy of PRISM4 and PIM3 systems in prediction of in-hospital mortality of patients admitted to PICU., Methods: The present retrospective cross-sectional study was a diagnostic accuracy study performed on patients admitted to PICU of Qods Hospital, Qazvin, Iran, during one year. Scores of PRISM4 and PIM3 scales were calculated for each patient using the available calculators, and the outcome of patients regarding in-hospital mortality was recorded. Finally, screening performance characteristics of the mentioned scales in prediction of patients' mortality were calculated and reported., Results: 218 patients with the mean age of 40.68 ± 37.92 (2-160) months were studied (57.8% female). There was a significant direct correlation between PIM3 score and duration of stay in PICU (p < 0.0001; r = 0.259), need for inotropic drug administration (p = 0.001), and mortality rate (p = 0.001). In addition, area under the receiver operating characteristic (ROC) curve of PIM3 and PRISM4 in prediction of mortality among patients admitted to the PICU was 0.939 (95%CI: 0.880 - 0.998) and 0.660 (95%CI: 0.371 - 0.950), respectively (p = 0.001). Based on the findings, the best cut-off point for PIM3 scale in prediction of mortality was the score of 4 and it was estimated to be the core of 8 for PRISM4 scale. Sensitivity and specificity of PIM3 scale in prediction of mortality in the cut-off of 4 points were 100.00 (95% CI: 56.09- 100.00) and 81.51 (95% CI: 75.47- 86.38), respectively. These measures were 42.85 (95%CI: 11.80- 79.76) and 98.10 (95%CI: 94.89- 99.39) for PRISM4 model, which indicates the higher sensitivity of PIM3 system in this regard., Conclusion: based on the results of the present study, the accuracy of PIM3 is significantly higher than PRISM4 in prediction of in-hospital mortality among patients admitted to the PICU. It seems that considering the 100% sensitivity of PIM3 in prediction of outcome, this model is a better tool for screening patients who are at risk for in-hospital mortality in order to pay more attention and allocate more resources to improve their outcome., Competing Interests: The authors declare no conflicts of interest in this study.