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Background: Black disease, also known as visceral leishmaniasis (VL), is a parasitic illness caused by various Leishmania species. The risk of morbidity and mortality increases with delayed diagnosis and treatment. Early VL diagnosis and fast appropriate treatment are critical issues in endemic areas. Methods: This study was a retrospective cross-sectional study to investigate the diagnostic and therapeutic course of patients admitted with the diagnosis of VL in the Children's Medical Center (CMC) Hospital, Tehran, Iran. All cases of VL in patients under the age of 18 hospitalized between the years 2012 to 2022 were enrolled. Results: Twenty-seven patients were enrolled with an average age of 28.13 months with the majority of females (51.8%). Common clinical signs were fever (96.2%) and splenomegaly (92.59%). However, lymphadenopathy was rare. The largest number of patients was from Tehran Province, followed by Ardabil, Khuzestan, Gilan, and Alborz provinces. The most common hematological abnormalities were anemia (85.1%) and thrombocytopenia (44.4%). In accordance with the treatment strategy, liposomal amphotericin B and amphotericin B deoxycholate were given to 11 and 5 patients, respectively. Eleven of them received glucantime. The average length of hospitalization for liposomal amphotericin B was 15.36 ± 12.49 days. In comparison with glucantime (18.38 ±10.26 days) and amphotericin B deoxycholate (20.20± 6.18 days), liposomal amphotericin B group hospitalization was shorter than others were. Conclusion: VL should be included in the differential diagnosis of any child who presents with fever, splenomegaly, and anemia. Concerning the treatment strategy in this study, liposomal amphotericin B had more efficiency and shorter hospitalization duration. [ABSTRACT FROM AUTHOR]

Although coronavirus disease 2019 (COVID-19) prognosis is mostly good in pediatric patients with no underlying diseases, there are a few reports on children with oncological underlying malignancies. This study aimed to describe the clinical and laboratory features of 20 children with COVID-19 who had underlying malignancies in an Iranian referral pediatrics hospital. All children under 15-year-old of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and presence of an underlying malignancy were included in the study. In this study, among 20 patients, 11 were male (55%). The mean age of the patients was 6.0 ± 4.1 years. Twelve patients (60%) had acute lymphocytic leukemia, two had acute myeloid leukemia (10%), and six had solid organ tumors (30%). The most common symptoms were fever (65%) and cough (65%). We reported severe pneumonia in seven hospitalized patients (35%) and three patients (20%) required intensive care unit admission and mechanical ventilation. Procalcitonin was normal in 73% of the cases (11 out of 15), but it was highly elevated in four cases (27%). Five patients (25%) had positive blood cultures and a mortality of 20% was reported. This is the largest study on SARS-CoV-2 infected pediatric patients with underlying malignancies in Iran. Since the risk of exposure to SARS-CoV-2 and even death in children with malignancy, either in the hospital or community setting during the pandemic is high, special precautions to reduce the risk of transmission are highly suggested. [ABSTRACT FROM AUTHOR]

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COVID-19 as a viral infection is usually asymptomatic in children, but complication of this disease in children is not rare and may be fatal. Hyper inflammation of COVID-19 is a potential fatal in undiagnosed children. It is very similar to Kawasaki disease but with higher mortality and morbidity. Multisystem inflammatory syndrome in children (MIS-C) and multi-organ involvement was reported in hyper inflammation syndrome following COVID19. Herein we report our algorithmic approach to Kawasaki-like syndromes due to COVID-19 in our center. Based-on this approach we had no mortality during the last 5 months. [ABSTRACT FROM AUTHOR]

Background: Infections resulted from multi-resistant Staphylococcus aureus are increasing worldwide. In the present study, a Multiplex-PCR assay for the detection of antibiotic resistance genes among S. aureus clinical isolates and for the concomitant identification of these isolates was described. Methods: A total of 127 S. aureus isolates were collected from clinical specimens at three teaching hospitals in Tehran, Iran. Screening for methicillin and mupirocin resistance in staphylococcal isolates was performed by disk diffusion method, according to Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of femB, mecA, and iles-2 genes was investigated by multiplex-PCR. Results: The 62.2% and 7.8% of Staphylococcus isolates were positive for mecA and ileS-2 genes, respectively. The femB fragment was amplified in all S. aureus strains tested. There is a 100% concordance between susceptibility and PCR results for isolates which harbored ileS-2. However, 55.1% of staphylococci were found as MRSA in the phenotypic assay. Conclusions: The PCR assay described in this study was able detect three genes for identification of S. aureus and its methicillin and mupirocin resistant genotypes concomitantly in a single reaction. Hence, this method can be used on regular basis as a valuable diagnostic and surveillance tool in clinical laboratories. [ABSTRACT FROM AUTHOR]

Introduction: Echinococcosis, as an important zoonotic infection, has a major worldwide distribution. Pediatric echinococcosis has still become health concerning issue in developing countries, particularly, in the Middle East and Iran. The aim of this study was to investigate the human echinococcosis in children in northern Iran., Methods: Patients admitted to the pediatric subspecialty hospital of Amir Kala, Babol, Iran, from 2011 to 2016 with a confirmed diagnosis of echinococcosis, were reviewed. Records of the patients, including demographic data, clinical manifestations of the disease, type of cysts, and other related factors, were collected., Results: Sixteen pediatric patients, twelve (75%) male, and four (25%) female were evaluated. All cases had cystic echinococcosis. The results showed that fever (75%) following vomiting, nausea, and coughing (44%) were the most common clinical manifestations. The most common localizations of cases were determined as liver (n=10, 62.5%) and lung (n=9, 56%). The frequency of the involvement of more than one organ was 31% (5 cases). The co-occurrence of liver and lung was seen in 2 (12.5%) cases, and in one case, the co-occurrence of the liver and spleen was reported. In one case, lung, liver and, the pelvis was involved, while in another case, liver, sub diaphragm and kidney involvement were observed., Conclusion: Cystic echinococcosis should be kept in mind when a cystic lesion is encountered anywhere in the body, particularly, in patients lining in the endemic regions. Since cystic echinococcosis has a considerable economic impact in Iran, the implementation of a control program and the surveillance system are highly recommended to reduce the economic burden of this disease., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aims and Objectives: The present work aimed to evaluate the frequency of aminoglycoside- modifying enzymes encoding genes in the E. faecalis and E. faecium and their antibiotic resistance profile., Methods: A total of 305 different clinical samples were subjected for identification and antibiotic susceptibility test. The high-level aminoglycoside resistance was identified by MIC and Kirby Bauer disc diffusion method. The prevalence of aac (6')-Ie-aph (2'')-Ia, aph (3')-IIIa and ant (4')- Ia genes was determined by multiplex- PCR. In total, 100 enterococci strains were isolated. The prevalence of E. faecalis and E. faecium isolates was 78% and 22%, respectively., Results: All isolates were susceptible to linezolid. So, all E. faecalis were susceptible to vancomycin but, 36.4% of E. faecium were resistant to it. The prevalence of multiple drug resistance strains was 100% and 67.9% of E. faecium and E. faecalis, respectively. High-level-gentamicin and streptomycin resistant rates were as follows; 26.9% and 73.1% of E. faecalis and 77.3% and 90.1% of E. faecium. Conclucion: The results of the current study showed a high frequency of aac (6')-Ie-aph (2'')-Ia genes among enterococcal isolates. A high rate of resistance to antimicrobials in Enterococcus is obviously problematic, and a novel policy is needed to decrease resistance in these microorganisms., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Non-traumatic subluxation of atlanto-axial joint known as Grisel's syndrome is a rare condition. The pathogenesis of Grisel syndrome in not clear but it seems laxity of cervical ligaments in children and an inflammatory process in neck might cause the syndrome. Here we present a case of Grisel's syndrome, a 9 -year- old boy presented with torticollis and discuss about clinical radiological and treatment aspects of the syndrome.

Introduction: Acinetobacter baumannii has emerged as an important nosocomial pathogen in the past decades. Due to the prevalence of A. baumannii across the world, suitable typing methods to investigate the epidemiological distribution of the organism have been developed. The aim of this study was to investigate the epidemiological and molecular diversity of A. baumannii strains isolated from nosocomial infections of hospitalized children in Children Medical Center Hospital (CMC), an Iranian referral hospital, in Tehran, Iran., Material and Methods: A total of 27 non-duplicate clinical A. baumannii isolates were collected during October 2013 to March 2014 and tested for antimicrobial resistance to several antibiotic agents. The genetic similarity of the strains was investigated by amplification of Random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) method., Results: One predominant RAPD profile (type B) was identified in 15 strains (56% of all typed isolates). Other clusters depicted in the dendrogram, namely A, C, and D comprised 6 (22%), 5 (19%) and 1 (3%) isolates, respectively. All A. baumannii strains were resistant to all antibiotics except colistin., Conclusion: This study highlights the clonal spread of multidrug-resistant A. baumannii in our hospital. Therefore, the factors responsible for dissemination of such isolates need to be identified, controlled, and prevented to avoid major outbreaks., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function., Methods: The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers., Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care., Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.