Does the rubella immunoglobulin G affect the severity of COVID- 19? : Rubella immunoglobulin G and COVID- 19.

OBJECTIVE & AIM: The coronavirus disease, so far (COVID-19) has brought about millions of infections and fatalities throughout the world. Our aim was to determine the correlation between rubella IGG titers with the severity COVID-19.  MATERIALS & METHODS: This study was conducted among COVID-19 confirmed patients over 18 years of age. The disease severity levels were categorized by WHO interim guidance. The rubella-specific IgG antibody-titer spectrum was measured (within first 48 h of hospitalization) by enzyme-linked immunosorbent assay (ELISA). RESULT: In a study of 46 inpatients with varying COVID-19 disease severity (mild, moderate, severe, and critical), we observed a negative correlation between rubella IgG antibody titers and COVID-19 severity (P-Value = 0.017), There was an interaction between COVID-19 vaccination history and rubella IGG on severity COVID-19 (P-Value = 0.0015). There was an interaction between age group under 44 years (including national measles- rubella (MR) vaccination in Iran) and rubella IGG titers on severity COVID-19 too (p-value = 0.014). CONCLUSION: In conclusion, MR vaccination seems to have a positive effect in reducing the severity of the disease, emphasizing that, the important and separate effect of the IGG rubella (due to natural or extrinsic immunity) titers is determining.

Epidemiology of nosocomial Staphylococcus epidermidis and Acinetobacter baumannii infections in a neonatal intensive care unit.

Background and Objectives: This study aimed to investigate epidemiology of Staphylococcus epidermidis (S. epidermidis) and Acinetobacter baumannii (A. baumannii) infections in neonatal intensive care unit (NICU) in a period of 8 years. Materials and Methods: This retrospective cohort study was conducted on 46 cases of nosocomial infection by S. epidermidis, and 44 neonates with A. baumannii in NICU of Valiasr hospital, Iran. Results: The trend of A. baumannii and S. epidermidis infection were as follows: 1 and 7 in 2014, 11 and 7 in 2015, 20 and 11 in 2016, 1 and 4 in 2017, 4 and 6 in 2018, 4 and 4 in 2019, 0 and 1 in 2020, and 3 and 6 in 2021-March 2022 respectively. Mortality proportion (%) in neonates with S. epidermidis and A. baumannii infection was at 8.3 and 32.1, respectively. There was a strong positive correlation between number of infected neonates in month and average of prescribed antibiotics before incidence of infection in every baby in that month. Fluconazole prescription before incidence of infection were associated with the A. baumannii infection in month too. Amikacin prescription had adjusted correlation on increasing of A. baumannii and S. epidermidis infection in month. Conclusion: It seems reducing of hospitalization duration and medication prescriptions management plays an important role in reducing of nosocomial infections.

Do Postpartum Maternal Iodine Status or Supplementation Affect Thyroid Function After Delivery? A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was, for the first time, to explore whether postpartum maternal iodine status or supplementation is associated with thyroid function after delivery. The MEDLINE/PubMed, Web of Science, Embase, and Scopus were searched up to December 2021 to identify relevant studies. The pooled mean thyroid stimulating hormone (TSH), free thyroxine (fT4), and thyroxine (T4) concentrations and 95% confidence intervals (CIs) were estimated based on maternal urinary iodine concentration (UIC) (< 50, 50-100, 100-200, and > 200 µg/L) or breast milk iodine concentration (BMIC) (< 100 µg/L vs. ≥ 100 µg/L) during postpartum. A fixed/random effects model was used based on the absence/presence of heterogeneity, respectively. The study is registered with PROSPERO, number CRD42022336145. A total of 2175 studies were identified, of which 18 were eligible for the meta-analysis. The pooled values for TSH, fT4, and T4 concentrations in all subgroups were within the normal range; however, except for TSH, comparing the 95% CI showed no statistically significant difference among different subgroups. The pooled mean for TSH concentration in women with UIC > 200 µg/L was 2.23 mIU/L, whereas the corresponding values in women with UIC < 50, 50-100 and 100-200 µg/L were 0.56, 0.56 and 0.95 mIU/L, respectively. Thyroid hormones in women with BMIC < 100 µg/L and ≥ 100 µg/L were within the normal range. Iodine supplementation during postpartum was not associated with any differences in thyroid parameters, compared to non-supplemented women. In conclusion, iodine status or supplementation had no effect on thyroid hormones in postpartum women.

Assessment of the Complications of Peripherally Inserted Central Catheter in Neonates Admitted to the Intensive Care Unit: A Center's Experience in Iran.

Background: Peripherally Inserted Central Catheter (PICC), which is inserted through peripheral veins into the superior or inferior vena cava, is used to inject medications or parenteral nutrition in neonates with long-term hospitalization in the intensive care unit. In this study, we assessed the complications of PICC in neonates admitted to the intensive care unit in hospital. Materials and Methods: In the present retrospective cohort, neonates admitted to the Neonatal Intensive Care Unit (NICU) of Valiasr Hospital during 2015-2018 had been divided into two groups with PICC and without it. Data included the occurrence of septicemia, tachycardia, perforation of large veins, pulmonary hypertension, cardiac tamponade, pericardial effusion, catheter site necrosis, hemorrhage, anemia, pleural effusion, ascites, phlebitis of catheter track and neonatal death, which were collected, using the comprehensive neonatal registry of Valiasr Hospital. Data analysis was performed with regression, mantel-haenszel and independent t-test. Results: Data from 174 neonates with PICC were compared to 207 infants with classic IV-Line. In the exposure group, the gestational age and birth weight were lower. Based on the results of the double logistic regression test, septicemia and hemorrhage in the injection site, independent of other variables, were related to the use of PICC and the risk of septicemia or hemorrhage in the injection site was significantly reduced if PCIC was used (p < 0.01). Conclusions: Using the PICC as a therapeutic procedure in hospitalized neonates in the NICU is a safe method. By improving its replacement skills among physicians and nurses, its side effects are minor and negligible.

Review of the Iranian Newborns' Health, Survival, and Care and Future Challenges.

INTRODUCTION: Providing, maintaining, and improving the health of newborns is one of the most important goals of the health care system in the Islamic Republic of Iran. On the eve of the 40th anniversary of the Islamic Revolution of Iran, we will review factors affecting the health of Iranian neonates over the past 40 years. METHODS: We investigated the evolution of neonatal health and contributing factors in all reports, documents, and articles published by the Iranian Ministry of Health and Medical Education and the former Iranian Ministry of Health as well as WHO, and UNICEF databases from 1970 to 2018. The main topics of the present study include recent developments in reduction of maternal and neonatal mortality, major measures taken to decrease risk of neonatal death, and future challenges. RESULTS: We have reviewed more than 3500 pages of documents and articles published by authoritative sources before and after the Islamic Revolution. A neonatal mortality rate (NMR) of 9.6 per 1000 in 2017 was recordred in Iran, demonstrating a reduction of over three-quarters compared with the pre-Revolution period. Improved prenatal care and nutrition, tetanus vaccination of pregnant mothers, performance of 96.4% of deliveries by trained individuals, circulation of clinical protocols for the integration of midwifery and maternity services, provision of neonatal resuscitation equipment in delivery rooms, promotion of breastfeeding from the first hour after birth onward, establishing and equipping NICUs, increased training of specialists and sub-specialists, prevention and treatment of infections, increasing awareness in families and family-centered neonatal care focused on neonatal brain development, the Newborn Indivisualized Developmental Care and Assessment Program (NIDCAP) and Kangaroo-Mother Care (KMC) are examples of progress made in neonate healthcare after the Islamic Revolution. CONCLUSION: Despite 8 years of war and a variety of sanctions being imposed against I.R. of Iran, very substantial improvements have been achieved in neonatal health and relevant underlying factors. However, we are still faced with challenges that require the engagement of experts and researchers in neonatal medicine.

Iranian neonatal diabetes mellitus due to mutation in PDX1 gene: a case report.

BACKGROUND: Neonatal diabetes mellitus with hyperglycemia during the first 6 months of life is a rare disorder that can occur in all races and societies. CASE PRESENTATION: In this study, we introduced an Iranian (Persian) 65-day-old patient with neonatal diabetes mellitus with novel homozygous mutation in the pancreatic and duodenal homeobox 1, PDX1, gene, which is also known as IPF1 gene, located in exon 2. This case was a newborn boy born in Vali-Asr Hospital, Tehran; he was diagnosed as having hyperglycemia on 28th day. Genetic analysis detected a homozygous mutation on PDX1 gene on chromosome 13. It is a novel homozygous mutation in the PDX1 gene (NM_000209.3), p.Phe167Val. This mutation was confirmed by Sanger sequencing. There was no evidence of agenesis of the pancreas. CONCLUSIONS: We reported a case of neonatal diabetes mellitus due to novel homozygous mutation in the PDX1 gene without exocrine pancreas manifestations.

The Effects of a Peer-Counseling Program on Increase Rate and Continuity of Lactation in Tehran Nursing Mothers.

Objective: The practice of breastfeeding is considered a blessing since its effects on health are well recognized and applies to both mothers and infants. The objective of this study was to evaluate the effectiveness of peer support and training on breastfeeding initiation, duration and exclusivity. Materials and methods: This community-based clinical trial, (IRCT No: 201504049568N12), was conducted during 2015 in the Municipality of Tehran 19 District. First, a total of 150 mothers with their infants from 4 to 20 months of age were asked to complete a questionnaire, which included the demographic characteristics, educational level, and the type of lactation, the initial age of infant for breastfeeding, and the duration of exclusive breastfeeding. Afterwards, 25 volunteer women were selected for lactation counseling. After 6 months, another sample of 116 nursing mothers in the region who had received peer counseling was selected and questioned through the previously mentioned questionnaire. Finally, the results, which were collected from the behavior of the target population before and after the intervention, were compared. Results: The results of the present study indicated that the nursing mothers who received peer counseling proved to have longer durations of breastfeeding (P-value = 0.039), and higher frequency of first hour initiation of breastfeeding (P-value = 0.003) however, the volunteer counselors were mainly housewives who had lower levels of education (P-value = 0.009) and were younger (P-value = 0.009) than those of untrained control group. Conclusion: The study demonstrated the significant effect of peer counseling on breastfeeding initiation and continuation. It is suggested that lactation training could be initiated during the prenatal period along with the conventional methods of training.

Increase Concentration of Transforming Growth Factor Beta (TGF-ß) in Breast Milk of Mothers With Psychological Disorders.

Several studies have shown an imbalance between proinflammatory and anti-inflammatory cytokines in depression and anxiety disorders. However, less attention has been paid to the role of cytokines in psychological disorder in mothers who breastfeed. This study looks at whether concentration levels of TGF-ß2 are altered in anxious and depressive breastfeeding mothers. This study checked the concentration level of TGF-B2 in relation with psychological symptoms on 110 breastfeeding mothers; based on random sampling method with using of Beck Depression Inventory (BDI), General Health Questionnaire (GHQ) and Spielberger Stress Scale (STAI) in 2015 also TGF-ß2 was measured in breast milk using ELISA. We used of Pearson Correlation Method, independent t-test and one-way analysis of variance (ANOVA) to analyze the data. Psychological symptoms (Anxiety and depression) showed positive correlation with TGF-Beta level in which relationships were significant (P=0.01). Psychological problems may be uniquely associated with the level of TGF-ß in breast milk. More attention should be paid to the mental health of mothers during breastfeeding, and more research needs to be done in this subject to clarify the relationship between psychological variables with the level of TGF-ß in breast milk.