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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]

Background: Type 1 Diabetes (T1D) is an autoimmune condition, in which the pancreas produces little or no insulin. Nephropathy is a serious T1D microvascular complication that is associated with high mortality and morbidity. Objective: This study aimed to investigate the prevalence of diabetic nephropathy and comorbidities in children with T1D. Methods: This cross-sectional study was conducted on 208 children (aged 1--18 years old) with T1D who were referred to the Qazvin endocrinology clinic from 2017 to 2019. Anthropometric, demographic, laboratory, and comorbidities data were collected. Results: The Mean±SD age at diagnosis of diabetes was 7.59 years, and the Mean±SD HbA1c level of the study subjects was 8.68±1.42 mmol/mol. Out of 208 diabetic patients, 64 cases (30.7%) had diabetic nephropathy, of whom 53 cases (25.5%) had microalbuminuria and 11 cases (5.3%) had macroalbuminuria. Among the studied diabetic patients, 30 cases (14.45%) had hypothyroidism, 12 patients (5.8%) had celiac disease, and 14 patients (6.7%) had anemia. Retinopathy was not found in any of the patients. Moreover, variables, such as the duration of diabetes, puberty status, mean HbA1c levels, and age were significantly associated with diabetic nephropathy (P<0.05). Conclusion: Mean HbA1c levels were significantly higher in patients with macroalbuminuria, which may corroborate the role of metabolic control of diabetes in the development of albuminuria. [ABSTRACT FROM AUTHOR]

Background: Subglottic stenosis is among the most common airway problems in children, i.e., acquired or congenital. More than 90% of acquired cases are secondary to endotracheal intubation and occur iatrogenically. Subglottic stenosis is an unexpected problem that requires timely diagnosis and intervention. Most cases of subglottic stenosis in children are mild to moderate. Case Presentation: The presented patient was a 10-year-old child who, after long intubation due to head trauma following early discharge from the surgical center, was referred to the Children's Hospital on the same day with a complaint of high fever and shortness of breath. With the development of respiratory distress and cyanosis, the patient was transferred to the intensive care unit. Due to the impossibility of passing the tracheal tube with the appropriate age for the patient, the initial diagnosis of subglottic stenosis was established and a tracheostomy was performed. Diagnostic bronchoscopy confirmed severe subglottic stenosis, and the child was referred to a specialized Ear, Nose, Throat (ENT) center for the repair of the tracheal stenosis. Conclusion: One of the most common causes of stridor in children is subglottic stenosis following prolonged intubation. Recognizing the predisposing factors, prevention, strong clinical suspicion, timely diagnosis, and treatment can prevent further adverse complications or consequences in children. [ABSTRACT FROM AUTHOR]

Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare and the most severe form of functional intestinal obstruction in the newborn. The characteristic features of this congenital and fatal disease are abdominal distension, absent or decreased bowel peristalsis. Abdominal distension is a consequence of the distended, unobstructed urinary bladder with or without hydronephrosis. We present a case of female newborn with antenatal ultrasound revealing a large cystic mass in pelvic with urinary tract origin, abdominal distension, aperistalsis of the intestine and micro colon. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Re: Serum Zinc Concentrations in Children with Acute Bloody and Watery Diarrhoea" in the November 2015 issue is presented.

Background: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication, which can cause high morbidity and mortality. Use of gonadotropin releasing hormone (GnRH) agonist instead of human chorionic gonadotropin (hCG) in GnRH antagonist cycles causes luteinizing hormone surge by GnRH stimulation which reduces the risk of OHSS by reducing the total amount of gonadotropin; however, there is no possibility of transferring fresh embryos. Objective: The current study aimed to evaluate the effect of hCG along with GnRH agonist administration in the occurrence of OHSS and pregnancy rate in females undergoing in vitro fertilization. Materials and Methods: The current randomized clinical trial was conducted on 80 cases in 2 groups. Gonal-F was used to stimulate the oocyte from the second day of menstruation. When follicle size was 12-14 mm, GnRH antagonist was added to the protocol till the detection of more than two follicles greater than 18 mm. Then, GnRH agonist was added to the protocol as a trigger. In group A, 35 hr after the administration of GnRH agonist, the low-dose human hCG, 1500 IU, was used. In group B, low-dose hCG, 1500 IU, was used at the same time by GnRH agonist administration. The rate of pregnancy, OHSS, and its severity were compared between 2 groups within 2 wk. Results: There was no significant difference regarding chemical and clinical pregnancies between the 2 groups. Severe OHSS was significantly higher in group B (p= 0.03). Conclusion: Administration of hCG 35 hr after GnRH agonist administration results in lower rate of severe OHSS. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the serum concentration of zinc in children with acute pyelonephritis. Serum zinc levels of 60 children with acute pyelonephritis and 60 healthy children were compared. Acute pyelonephritis was diagnosed using Tc-99m dimercaptosuccinic acid (DMSA) renal scan. Serum zinc levels were measured by the atomic absorption flame spectrophotometry. The levels in question in the case and control groups were 70.73 ± 14.15 and 87.61 ± 12.68 mcg/dL, respectively (P=0.001). There was no correlation between serum zinc level with inflammatory markers, severity of acute pyelonephritis and duration of the disease. This study showed that there is a correlation between serum zinc level and acute pyelonephritis. Zinc would therefore appear to play a certain role in the pathogenesis of acute pyelonephritis.