The recent surge in COVID-19 cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. Here, we investigated the anxiety level in this population. This multi-center, cross-sectional study was performed on 1038 HCWs in 14 hospitals during the COVID-19 pandemic. Beck anxiety inventory (BAI) was used to measure the level of anxiety in this population. In all, 1038 hospital staffs with a mean age of 36.30+/-8.23 years old participated in this study. Most participants were 31 to 40 years old (43.2), female (87.6%), and nurses (49.5%). The BAI scores for the participants were in a positive skew distribution, with a score range of 0-63, a median of 12 and a mean value of 15.30+/-11.43. Of the 1038 hospital staff, 411 (39.6%) had moderate to severe anxiety. The anxiety level was significantly higher in health care workers ≤40 years old, women, and nurses. Gender, age, and working positions had the most relation with anxiety, respectively. It seems that HCWs experienced a high level of anxiety in the COVID-19 outbreak. One of the important measures in each epidemic is doing supportive care to maintain the mental well-being of HCWs, especially in higher risk groups, including younger HCWs, women, and nurses.

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Background: Nosocomial Infection (NI) is one of the leading causes of short- and long-term morbidity and mortality among neonates, especially in Neonatal Intensive Care Units (NICUs). Objectives: We aimed to evaluate the epidemiology of NIs and associated factors. Methods: From March 2017 to September 2018, all the neonates who were admitted to the NICUs of Bahrami Children’s Hospital were enrolled. Nosocomial infections were identified based on the definition of CDC-NNIS. Demographic, clinical, and laboratory data of the patients were extracted from the medical records. Results: A total of 979 neonates were admitted to the NICU, of whom 60 were diagnosed with NI. The incidence of NI was 6.1 per 100 hospitalized patients. The most prevalent NI was bloodstream infection (30%), followed by pneumonia (21.7%). The most frequent presentations were respiratory distress (31.7%) and poor feeding (26.7%). Major pathogens were Gram-positive bacteria such as Staphylococcus aureus (25.7%) and Coagulase-negative staphylococci (25.7%). The mean hospital stay was 25.2 ± 20.89 days. The mortality rate of patients with NI was 16.7%. The factors associated with an increased risk of mortality among patients with NI were a lack of ventilation support, low birth weight, and WBCs with an abnormal range. Conclusions: The results of the present study showed that the incidence of NI was high, and the cultures collected from body fluids had a particular role in the diagnosis and treatment of NI. Standard infection control practices should be applied to reduce the incidence of NI and subsequent morbidity and mortality.

Background Previous studies have indicated that the majority of cases with “failed” results related to transient evoked otoacoustic emissions (OAE) test have the normal hearing. The present study aimed to assess the possible relationships between perinatal factors and the false-positive OAE results. Methods A case-control study was carried out in an Iranian Hospital in 2020. Based on the OAE results on the first day of life, newborns were divided into 2 groups; Control group included subjects with “Pass” OAE results. Every neonate with “Fail” OAE result was referred for auditory brainstem response (ABR). Neonates with bilateral fail OAE but normal ABR results (false-positive OAE) were considered as the case group. All recorded data were analyzed to assess the possible correlations between maternal/neonatal factors and the false-positive OAE results. Results One hundred and eighty-one neonates entered the study. Of all included neonates, 87 (48.1%) cases showed bilateral fail OAE and 94 (51.9%) subjects passed the OAE test. Normal ABR results (false-positive OAE) were observed in all cases with bilateral fail OAE. Comparisons of variables affecting the OAE results showed that of all perinatal factors, neonate’s sex (p = 0.046) and cesarean section (p = 0.003) were the only influencing factors that increased the risk of false-positive OAE results. Conclusion Based on the results, the cesarean section delivery and neonate’s male sex increased the risk of false-positive results related to OAE test. Implementing other screening tests such as ABR or Automated ABR as the initial screening test could be suggested for such cases.

Bilious vomiting is highly suggestive of an acute and emergent condition among neonates. The aim of this study was to investigate the non-surgical causes of bilious vomiting in neonates admitted to a tertiary center and to compare them with the surgical causes. This cross-sectional study was performed on 80 infants with bilious vomiting who were admitted at the neonatal intensive care unit of a pediatric tertiary center over two years. The demographic characteristics, clinical symptoms and signs, diagnostic assessments, and therapeutic approaches were recorded. The mean age of neonates was 9.07±8.84 days, and 55% of them were males. The most common final diagnosis was: Necrotizing Enterocolitis (NEC), duodenal atresia, Hirschsprung’s disease, gastroesophageal reflux disease (GERD), volvulus, sepsis, meconium plug, isolated mal-rotation, metabolic abnormalities, imperforate anus, and Ladd’s bands, respectively. Abnormal findings in ultrasound and X-rays were detected in 35% and 46.3%, respectively. About half of the affected neonates were treated non-surgically. Overall, 17.5% of the patients died. Most deaths were seen in infants with NEC. Using multivariable logistic regression analysis, the presence of NEC as an underlying etiology was the only predictor of neonatal death in neonates with bilious vomiting (OR=12.455, 95%CI: 1.365-113.618, P=0.025). The most common cause of bilious vomiting was NEC, followed by duodenal atresia. Half of the neonates with bilious vomiting were treated medically without operation.

Background: Recurrent implantation failure (RIF) is the absence of implantation after three consecutive In Vitro Fertilization (IVF) cycles with transferring at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under 40 years. The definition and management of RIF is under constant scrutiny. Objective: To investigate the effects of Granulocyte colony stimulating factor (G-CSF) on RIF, pregnancy rate, abortion rate and implantation rates. Materials and Methods: A double blind placebo controlled randomized trial was conducted at two tertiary university based hospitals. One hundred patients with the history of RIF from December 2011 until January 2014 were recruited in the study. G-CSF 300µg/1ml was administered at the day of oocyte puncture or day of progesterone administration of FET cycle. Forty patients were recruited at G-CSF group, 40 in saline and 20 in placebo group. Results: The mean age for whole study group was 35.3±4.2 yrs (G-CSF 35.5±4.32, saline 35.3±3.98, placebo 35.4±4.01, respectively). Seventeen patients had a positive pregnancy test after embryo transfer [10 (25%) in G-CSF; 5 (12.5%) in saline; and 2 (10%) in placebo group]. The mean of abortion rates was 17.6% (3), two of them in G-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% in saline and 4.7% in placebo group. Conclusion: G-CSF may increase chemical pregnancy and implantation rate in patients with recurrent implantation failure but clinical pregnancy rate and abortion rate was unaffected.