Mojtaba Yousefi Zoshk; Melika Zamanian; Melika Farshidianfar; Alireza Masoumi; Mohammad Mobin Mirimoghaddam; Elahe Bakhshi; Anoush Azarfar
Abstract
The coronavirus disease 2019 (COVID-19) has afflicted individuals of all ages, which has a high rate of morbidity and fatality. Although most children with COVID-19 infection experience minor symptoms, a growing proportion of COVID-19 infections in children are linked to a novel multisystem inflammatory ...
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The coronavirus disease 2019 (COVID-19) has afflicted individuals of all ages, which has a high rate of morbidity and fatality. Although most children with COVID-19 infection experience minor symptoms, a growing proportion of COVID-19 infections in children are linked to a novel multisystem inflammatory syndrome with Kawasaki disease-like clinical features. Multisystem inflammatory syndrome in children (MIS-C) is a novel hyperinflammatory syndrome that can impact about any organ system. The most frequent symptoms are fever and gastrointestinal disorders, although neurologic and dermatologic manifestations are also well-documented. The clinical symptoms of MIS-C coincide with those of Kawasaki disease, toxic shock syndrome, and shock syndrome, making diagnosis challenging. Elevated inflammatory markers are common in MIS-C patients, and an abnormal echocardiogram or electrocardiogram may be present. Intravenous immunoglobulin, anticoagulation, and corticosteroids should all be considered in the treatment of MIS-C patients. Even those with significant cardiovascular involvement, the majority of patients recover without complications. Echocardiographic follow-up is required as coronary aneurysms have been documented. This narrative review is to review the epidemiology, pathophysiology, clinical presentations, laboratory findings, diagnostic criteria, and treatment options for MIS-C patients in order to increase pediatricians’ knowledge of this novel syndrome.
Nasrin Moazzen; Fatemeh Shahrahmani; Yalda Ravanshad; anoush azarfar
Abstract
Background: Concern over male infertility has grown, with over half of infertility cases linked to male causes. The effect of radiofrequency electromagnetic radiation (RF-EMR) from mobile phones on sperm DNA fragmentation has been investigated. This mini-review evaluates literature on the correlation ...
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Background: Concern over male infertility has grown, with over half of infertility cases linked to male causes. The effect of radiofrequency electromagnetic radiation (RF-EMR) from mobile phones on sperm DNA fragmentation has been investigated. This mini-review evaluates literature on the correlation between RF-EMR and sperm DNA fragmentation.Methods: A systematic review was conducted using Google Scholar and PubMed databases up to July 2020. MeSH terms related to DNA fragmentation, sperm, mobile phones, radiofrequency, and related synonyms identified relevant studies. Nine studies were selected, and their methodologies examined.Results: The studies reviewed presented diverse findings on the correlation between RF-EMR from mobile phones and sperm DNA fragmentation. Of the nine investigations—five in vitro and four in vivo—all in vivo studies found significant DNA fragmentation in men who used their phones extensively, especially when carried in pants pockets. Three of the five in vitro tests showed a substantial effect, while the other two found no significant change between exposed and unexposed samples.Conclusion: Although more studies reported decreased sperm quality with prolonged and intense RF-EMR exposure, the evidence regarding DNA fragmentation remains inconclusive. With the widespread use of mobile phones, it is critical to further investigate their potential impact on male fertility and reproductive health. Existing evidence underscores the need for continued research in this area.
Behnaz Hatami; Omid Shoraka; Asef Younesi; Gelayol Bavafa; Melika Zamanian; Niloofar Nikpasand; Amirhossein Mohammadzade; Sara Naghizadeh Kashani; Anoush Azarfar; Mojtaba Yousefi Zoshk
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, ...
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Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, with substantial cardiac complications. Cardiac involvement is frequently reported in MIS-C patients and includes arrhythmia, coronary artery aneurysm and dilation, conduction abnormalities, and ventricular dysfunction. Cardiogenic or vasodilatory shock may develop in patients with severe MIS-C, necessitating inotropic support, fluid resuscitation, mechanical ventilation, and extracorporeal membrane oxygenation. Empirical therapies have attempted to reverse the inflammatory response, and steroids or intravenous immunoglobulin have all been commonly used. Most children will survive with prompt diagnosis and appropriate treatment, but since the disease's outcomes are unclear, long-term follow-ups are necessary. This narrative review summarizes the available studies regarding cardiac involvement in MIS-C cases as well as clinical considerations for cardiac examination and follow-up.
Yalda Ravanshad; Mohadese Golsorkhi; Sahar Ravanshad; Zahra sadat Mohajeri; Anoush Azarfar
Abstract
Introduction: Nowadays, fake doctors, known as “Bandis” in our country Iran, represent themselves as traditional healers and use superstitious ideas for the healing of the ill, especially children. Their activities do not comply with any scientific methods. No research has been focused on ...
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Introduction: Nowadays, fake doctors, known as “Bandis” in our country Iran, represent themselves as traditional healers and use superstitious ideas for the healing of the ill, especially children. Their activities do not comply with any scientific methods. No research has been focused on this issue. The present study aimed to evaluate the education and social levels of the patients and their reasons for referring to these quackeries.Methods: This cross-sectional study was conducted on 1,300 children who were managed in the pediatric clinics of Dr. Sheikh Hospital for children, which is a tertiary care center in Mashhad, Iran. Informed consent was obtained from the guardians and patients. Upon examination, the parents of the children were asked to complete a checklist for data collection. Data analysis was performed in SPSS version 16, and the P-value of less than 0.05 was considered statistically significant.Results: In total, 1,300 children (621 females and 679 male) aged 2.5-12 years (mean age: 5.3±2.9 years) were enrolled in the study. Among the guardians, 62.5% were familiar with traditional healers, and 457 (37.2%) of the respondents had visited these individuals at least once. In addition, 106 of these cases had visited traditional healers more than three times. The parents were enquired about the reasons for visiting traditional healers instead of physicians, and 46.7% believed the applied methods by these individuals to be more effective. Moreover, 3.1% mentioned the lower treatment costs compared to physician visits, 2.9% reported the acute diseases of their children that did not respond to medical treatments, and 47.3% acknowledged those methods as real traditional practices.Conclusion: According to the results traditional healers, are a major public health concern. For unjustified reasons, many people prefer their methods to conventional medicine. Therefore, healthcare authorities must raise public awareness in this regarding through systematic plans in order to prevent future complications.
Yalda Ravanshad; Abbasali Zeraati; Mohadese Golsorkhi; Sahar Ravanshad; Anoush Azarfar; Hanieh Jafari
Abstract
Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome ...
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Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome remains a matter of debate, and the evidence on its efficacy and safety is inconclusive.The present study aimed to compare the benefits and limitations of tacrolimus and cyclosporine in the treatment of steroid-resistant nephrotic syndrome. Methods: This systematic review and meta-analysis was conducted via searching for the relevant trials performed until January 2018 in electronic databases such as PubMed, Scopus, ScienceDirect, Cochrane Library, and Web of Science. In total, 285 potentially relevant articles were identified, and four articles were selected for the review. A random effects model was used to analyze data, and the heterogeneity of the articles was assessed using Chi-square-based Cochran’s Q and I2 statistics, and heterogeneity was considered statistically significant with I2>50%. The outcomes were presented as relative risk with 95% confidence interval, and P-value of less than 0.05 was considered statistically significant. In addition, meta-analysis was used for further data analysis. Result: Four eligible randomized controlled trials were evaluated in this systematic review. In terms of partial and complete remission, no significant differences were observed between tacrolimus and cyclosporine. However, lack of response to therapy was significantly lower with tacrolimus (RR=0.289; P=0.02) compared to cyclosporine. No significant differences were observed between the drugs in terms of the infection rate, hypertension, ALT/AST elevation, and gastrointestinal symptoms, while nephrotoxicity (RR=0.395; P=0.004) and hypertrichosis (RR=0.018; P<0.001) were significantly lower with tacrolimus. Conclusions: In conclusion, Tacrolimus is superior to Cyclosporine in treating in patients with steroid resistance nephrotic syndrome in terms of no response to therapy, nephrotoxicity and hypertrichosis