فهرست مطالب mohammad golshan-tafti

Pyruvate carboxylase catalyzes the carboxylation of pyruvate to oxaloacetate, a crucial intermediate of the tricarboxylic acid (TCA) cycle and the initial step in converting pyruvate to glucose (gluconeogenesis). Pyruvate carboxylase deficiency is a rare metabolic disorder characterized by lactic acidosis, failure to thrive, development delay, and recurrent seizures at an early age in severely affected patients. The onset and severity of pyruvate carboxylase deficiency have been classified as severe neonatal (type B), usually fatal, less severe infantile (type A), compatible with survival but with impaired neurologic development, and milder, later onset (type C) with some residual impairment. Clinical manifestations include hypotonia, mixed hypertonia, ataxia, choreoathetosis, microcephaly, and other signs of impaired white matter development.

Case Report: 

A 7-day-old baby with a birth weight of 3kg, born to related parents, presented with clinical symptoms such as lethargy, poor feeding, and grunting since birth. Additionally, he experienced a drop in O2 saturation and cyanosis during his hospitalization. Test results revealed lactic acidosis and hyperammonemia. Furthermore, serum amino acids chromatography- HPLC indicated an increase in lysine and citrulline. The patient succumbed after 16 days due to multi-organ damage. Genetic analysis identified pyruvate carboxylase enzyme deficiency.

Pyruvate carboxylase deficiency is a rare inborn error of metabolism that can lead to developmental delay and failure to thrive, typically beginning in the neonatal or early infantile period. The possibility of pyruvate carboxylase deficiency should be considered in any child presenting with lactic acidosis and neurological abnormalities, particularly if associated with hypoglycemia, hyperammonemia, or ketosis.

Hypoxic-ischemic encephalopathy (HIE), caused due to reduced oxygenation and brain blood flow, occurs in 1-8 per 1000 live full-term births in developed countries and up to 26 per 1000 live in the developing world. The growth status of survivors of birth HIE has not been evaluated sufficiently.

This study evaluated, the growth parameters (weight, height, and head circumference) of neonates with Sarnat stage.2 of HIE at 6, 10, and 12 months and its relationship with findings of neonatal brain diffusion-weighted imaging (DWI) sequence.

Medical records and growth parameters of 35 neonates with gestational age > 34 wk who were admitted with stage.2 of HIE in Neonatal Intensive Care Unit of Shahid Sadoughi hospital, Yazd, Iran from March 2021-March 2022, and its relationship with neonatal brain DWI sequence finding was evaluated.

15 girls and 20 boys with a mean birth weight of 2880.3 ± 221.8 gr were evaluated. Conventional magnetic resonance imaging and DWI were found to be abnormal in 6 (17.1%) and 18 neonates (51.4%). The most abnormal finding of DWI was high signal in basal ganglia/thalamus in 9 neonates (25.7%). Abnormal DWI is more frequent in neonates with seizures and low birth weight. Hospital stay days were more prolonged in neonates with abnormal DWI. Microcephaly at 12 months was more frequent in children with abnormal DWI.

In survivors of moderate neonatal HIE, abnormal brain DWI sequence might predict inappropriate head growth, and need close medical and nutritional interventions for growth improvement.

During the COVID-19 epidemic, many neonates were involved, but they had fewer complications and deaths than adults. Therefore, in this review study, we investigated the immune mechanisms of neonates in response to COVID-19.

We reviewed articles that evaluated the immune system, COVID-19, or SARS-COV2 in neonates. We searched the databases of Google Scholar, PubMed, Scopus, Web of Sciences, SciELO, and CNKI databases published up to December 2022.

There are different immune mechanisms in response to COVID-19 in infants, which lead to a different response to COVID-19 compared to adults. The important mechanisms include lower expression of ACE2 receptor, abundant of naive T cells, absence of cytokine storm, abundant of immunosuppressive cells, less inflammatory reactions, breastmilk secretory IgA, transfer of IgG through the placenta, and absence of chronic comorbidities. Also, in comparison with pediatrics multisystem inflammatory syndrome in children (MIS‐C) doesn’t observe in neonates.

The exact immune mechanisms in response to COVID-19 in infants have not yet been discovered, but knowing the exact mechanisms can be effective in future treatments, the production of effective vaccines, and other viral treatments, so there is a need for more investigations in this field.

The adverse outcomes correlated with GDM for both the mother and the offspring are diverse. The link between polymorphisms at fat mass and obesity‐correlated protein (FTO), leptin (LEP), and leptin receptor (LEPR) genes and GDM is ambiguous. In this meta-analysis, we sought to investigate the correlation of FTO, LEP, and LEPR polymorphisms with GDM risk. We performed an online search on PubMed, Web of Science, and Google Scholar databases to identify all relevant research. A total of 18 case-control studies including seven research with 893 cases and 2875 controls on FTO rs9939609, four research with 1345 cases and 1116 controls on FTO rs8050136, two research with 207 cases and 205 controls on FTO rs1421085, three studies with 529 cases and 581 controls on LEP rs7799039, and two research with 480 cases and 477 controls on LPER rs1137101 met our criteria. Combined data illustrated that the FTO rs9939609 and rs8050136 were correlated with substantial risk of GDM in the overall population, but not FTO rs1421085. Furthermore, LEP rs2167270 and rs7799039 polymorphisms were not correlated with GDM risk. Sorted analyses illustrated that the FTO rs9939609 polymorphism was correlated with GDM in Caucasian women. This meta-analysis results illustrated that the FTO rs9939609 and rs8050136 were correlated with substantial risk of GDM, but not FTO rs1421085, LEP rs7799039, and LPER rs1137101. Larger and more rigorous studies among different ethnicities are needed to further evaluate the correlations with GDM.

The present study aimed to evaluate the frequency and risk factors of peritonitis end-stage renal disease (ESRD) pediatrics on peritoneal dialysis (PD) in Yazd City, Iran.

This cross-sectional study was conducted on ESRD pediatrics on PD in Shahid Sadoughi hospital, Yazd City, Iran from 2016 to 2020. Demographic characteristics, such as age, sex, body mass index (BMI) at the commencement of PD, underlying medical conditions, the microbiology of peritonitis, and the recovery rate were investigated. Results were evaluated using SPSS software, version 26 (SPSS Institute, Inc., Chicago, IL, USA).

A total of 23 children (56.5% females) were included in this study. The Mean±SD age was 13.30±4.38 years, and the mean BMI was 15.71±5.53. PD-associated peritonitis was diagnosed in 18 cases (78.3%). A total of 21.7% had at least one underlying disease. No significant relationship was observed between sex (P=0.9), mean age (P=0.41), mean BMI (P=0.24), and underlying condition (P=0.29) according to pediatrics with and without PDassociated peritonitis. Bacterial and fungal infections were responsible for peritonitis in 15 (62.5%) and 3 (13%) pediatrics on PD, respectively.

The frequency of PD-associated peritonitis in the ESRD children of our study was 78.3%.

There is little data on the mortality rate and severity of COVID-19 infection among pediatrics. This knowledge is particularly significant because pneumonia is the main underlying cause of death in children worldwide. This systematic review and meta-analysis aims to evaluate the mortality rate of COVID-19 in the pediatric population in Iran.

A systematic review and meta-analysis of the publications was conducted based on the PRISMA guidelines to search for COVID-19 child mortality. PubMed, Google Scholar, Embase, Medline databases, and Persian database were searched for publications on pediatric COVID-19 infections published in Iran with a focus on mortality in children with COVID -19 infection in Iran between January 1st to April 30th, 2021. Articles representing at least one Pediatric with and without comorbidities, COVID-19 infection, and informed outcomes were examined.

Eight studies including three case series, and five retrospective cross-sectional studies altogether representing a total of 238 pediatric patients with COVID-19 were included in this meta-analysis. Of this population, 14 patients had died. In this study, the mean age of the study sample was 6.7 years. The mortality rate among children hospitalized with COVID-19 was 9% (95% CI 0.055-0.146). Also, children with comorbidities had a higher risk of COVID-19 related mortality.

Unlike adults, most infected children are asymptomatic and are not usually hospitalized. Children with underlying conditions are at increased risk of severe COVID-19 related mortality than children without underlying illness. More attention should be paid to children with comorbidities and children of young age.

Most pregnant women with COVID-19 develop less severe form of the disease, with few cases of severe maternal morbidity and mortality, or perinatal deaths. This meta-analysis was conducted to evaluate the frequency of miscarriage in pregnant women affected by the SARS-COV-2 infection.

A comprehensive search was performed in online databases to identify all relevant studies published up to 5th March 2021. Case-control studies and case series reported the frequency of miscarriage in pregnant women with COVID-19 was selected.

A total of 22 studies with 8591 infected pregnant women and 141 abortions were selected. The frequency of miscarriage was 3.9% (95% CI 0.023-0.063) in infected pregnant women with COVID-19. It had the highest frequency in Asian (6.3%) followed by European (2.9%), West-Asian (2.5%) and Caucasian (2.3%) infected pregnant women. Moreover, stratified analysis by country showed that the frequency of miscarriage is the highest in Chinese (11.3%) followed by Italy (11.2%), India (2.7%), Turkey (2.2%), USA (1.2%) and France (0.9%) infected pregnant women.

Our pooled data revealed that the frequencies of miscarriage in pregnant women with SARS-COV-2 infection were 3.9%.

Gestational diabetes mellitus (GDM) is a complex metabolic disorder of pregnancy with a strong genetic predisposition. GDM is associated with complications during pregnancy and increased risk of type 2 diabetes later in mothers and develops a vicious cycle of metabolic diseases for future generations. Evidence is accumulating that women with genetic variants at transcription factor 7-like 2 (TCF7L2) gene are more susceptible to GDM. The aim of the current meta-analysis was to assess the association of the TCF7L2 polymorphisms with GDM risk.

PubMed, Web of Science, Embase, SID and CNKI databases were searched to identify relevant studies up to November 01, 2020. Using the fixed-effect or random-effect model, the pooled odds ratio and its corresponding 95% confidence interval were computed.

A total of 38 case-control studies including 24 studies with 6021 cases and 13289 controls on rs7903146, eight studies with 2404 cases and 2615 controls on rs12255372 and six studies with 1357 cases and 2858 controls on rs7901695 polymorphism were selected. Pooled data showed that there was a significant association between the TCF7L2 rs7903146, rs12255372 and rs7901695 polymorphisms and an increased risk of GDM in whole population. Stratified analysis showed that the TCF7L2 rs7903146 polymorphism was associated with GDM in Caucasian, mixed and Chinese women, but not in Asians. Moreover, the TCF7L2 rs12255372 polymorphism was associated with GDM in Asians and Caucasians women with GDM.

The combined data indicated that the TCF7L2 rs7903146, rs12255372 and rs7901695 polymorphisms were associated with a significant risk of GDM in whole population, especially in Caucasian women.

Kidney stones are one of several serious health problems in childhood that cause nutritional and growth disorders, and may finally lead to chronic kidney failure in this group.

In this analytical study conducted through a case-control design, 30 children under the age of two with kidney stones, and 125 children of the same age and sex without stones were studied. Patient information including personal profile and the results of some necessary tests were extracted from patient records and listed in a checklist. The data was analyzed using SPSS (Version 17.0). Statistical significance was considered when p-value was <0.05.

In terms of duration of breastfeeding, a significant difference was observed between the patients with stones and patients without stones; the duration of breastfeeding was longer in the control group (p=0.003). In addition, the duration of feeding with formula milk and cow milk was longer in the case group (p=0.038 and p=0.012, respectively).

Breastfeeding can serve as a nutritional factor that plays a preventive and protective role against the formation of kidney stones in infants.

Many elderly populations feel lonely and it has a significant negative relationship to their health status. Doll therapy may seem childish and ridiculous for adults, but it can have an undeniable effect on the elderly's health. The positive impact of doll therapy has already been proven in depression and dementia. The aim of this study was to evaluate the influence of doll therapy in agitation, aggression, and interactions of elderly people..

Methods and Materials:

 Sixty elderly people were selected at the Kahrizak charity foundation in Tehran. Ten different dolls (5 popular characters and 5 newborn dolls in neutral and specific genders) were presented to them. Their reaction to all dolls recorded (no reaction: 0, watch closely: 1, caring the doll: 2, communicating with the doll: 3) and each elderly chose one doll to keep it for 6 weeks. The aggression, agitation, and interactions with other elderly people and also with the nursing home staff were asked before and after a 6-week period of doll therapy from their caregivers by the Likert scale.

Twelve of 60 samples exited from the study because they were unwilling. Twenty elderly did not meet the inclusion criteria. After 6 weeks, 8 subjects donated their dolls to someone else. Eventually 26, people stayed in the study, and their dada were analyzed. The highest doll selection rate was for neutral gender dolls and popular dolls were almost ignored by the elderly. Paired sample T-test showed significant differences for aggression and agitation (P<0.001) and also interactions (P<0.05)

Although the sample size after all exclusion seems to be small, we can conclude that doll therapy is not a consistent method for all elderly, but it is beneficial and can improve their relationships and reduce their aggression and agitation. More researches with larger samples are suggested.

Asthma is the most common chronic airway disease in children, which is caused by genetic and environmental factors such as obesity. The aim of this study was to evaluate the relationship between obesity and asthma severity in children. This cross-sectional descriptive study included 200 asthmatic children aged 6 to 12 years in Yazd Shohadaye Kargar hospital in 2015 - 2016. The participants' demographic data were recorded. According to the Australian National Asthma Campaign, they were categorized into mild, moderate, and severe groups considering their severity of asthma. In order to compare the studied variables t, chi-square, and Mann-Whitney tests were used by SPSS 18. The results showed that 11 (27.5%) obese children had severe asthma, but only 7 children (4.4%) with normal BMI had severe asthma (P <0.001). It was also found that the mean BMI in children with severe asthma was 21.68, in children with moderate asthma was 19.73, and in children with mild asthma was 18.27 (P <0.001). Other variables including age, birth weight, maternal age, socioeconomic status, and educational level did not have any significant effect on the severity of asthma (P> 0.05). Our study showed that the prevalence of severe asthma was high in obese children and this relationship was stronger in boys. Therefore, obese children have a higher risk for severe asthma. To reduce obesity in children,  treatments such as regimen are required.

At the beginning of the birth, due to an increase in enterohepatic cycle, the baby is at high risk for jaundice, leading to a physiologic jaundice. Although phototherapy is a safe treatment, it can lead to complications such as hyperthermia, erythematous rashes, inflammatory fluids, and diarrhea. Thus, a new therapeutic approach to lowering the level of bilirubin and also reducing the need for phototherapy can be According to the studies, probiotics (pedilact) regulate intestinal function of the enterohepatic vasculature and therefore may be effective in the treatment of neonatal hyperbilirubinemia. The aim of this study was to investigate the effect of probiotics on indirect indirect bilirubin levels in the blood.
Material and This analytical study was carried out using clinical parallels and parallelism with B & A design the study population consisted of 80 neonates with Hyperbilirubinemia who were randomly divided into two groups of exposed and non-invasive subjects. Non-existent group members were treated with phototherapy only and the newborns in the exposure group received 5 drops of probiotics daily for discharge until they were received. Data were analyzed using SPSS 17 software and independent t-test, paired t-test and ANOVA The mean of indirect bilirubin reduction on the first day was 3.4 mg / dl in the phototherapy group and 3.5 mg / dl in the phototherapy + probiotic group and was not significant with p-value of 949.0. The mean of indirect bilirubin reduction per day The second one was 6.3 mg / dl in the phototherapy group and 7.mg / dl in the phototherapy + probiotic group, which was more than the phototherapy group and had no significance with p-value = 0.177. Indirect bilirubin reduction on day 3 of the phototherapy group / 6mg / dl in the phototherapy + probiotic group was 7.1 mg / dl, which is more than phototherapy group and does not have significant significance with p-value=0.618. The mean of bilirubin reduction in the phototherapy + probiotic group is slightly higher than that in the phototherapy group but is not statistically significant.

Neonatal jaundice is one of the most common findings in examination of neonates. Phototherapy is a health and safe procedure as well as one of the most common methods for treating of indirect hyperbilirubinemia. The aim of this study was to compare characteristics of home phototherapy with hospital phototherapy in jaundiced neonates.
Material and This research was a cohort study. This study was carried out on 120 term(and older than 24 hours) neonates who was admitted to the pediatric ward of Shohadaye Kargar Hospital, Yazd, Iran and also the refereed neonates to Yazd Isatis Emdad for phototherapy. The neonates was divided into 2 groups (home phototherapy and hospital phototherapy), randomly. Phototherapy was performed in both groups. Serum bilirubin was measured and recorded in neonates in the beginning of phototherapy and after 24 hour. Data was collected and analyzed by appropriate statistical tests using SPSS software version 17. According to the present study, the average serum bilirubin level in home phototherapy and hospital phototherapy was 10.52 and 10.97 respectively. (SD 2.09 vs. 1.72). Bilirubin decreased 3.84 mg/dl in home phototherapy and 3.73 mg/dl in hospital phototherapy. The average duration of phototherapy at home was lower than hospital phototherapy. In addition, average cost of phototherapy at home was lower than hospital phototherapy. Dehydration was not obvious in the study duration. Diarrhea was found in 2 neonates at home and 6 neonates in hospital during phototherapy. During phototherapy, 31 neonates at home and 38 neonates in hospital suffered skin rash. Satisfaction rate was 92.3% in hope phototherapy and 70% in hospital phototherapy. According to this study, age, gender, weight at birth and phototherapy complications were equal in home phototherapy and hospital phototherapy. Decreased level of bilirubin in home phototherapy was same to hospital phototherapy. Moreover, Duration of phototherapy and costs in home group were lower than hospital group, significantly.

The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks.
The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life.
In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group.
The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8).
The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought.