Our data demonstrate that a partial upper sternotomy is a safe and effective technique for AVR. Postoperative morbidity is not significantly reduced in patients undergoing AVR by this approach. Further studies in a larger patient population are necessary to assess whether postoperative morbidity is significantly reduced.

Background: Acute gastroenteritis is one of the major causes of pediatric hospitalization and mortality worldwide. Vitamin D can improve the immune system, and its deficiency may exacerbate the severe symptoms of any infectious disease. Thus, the aim of this study was to investigate the effect of vitamin D on children admitted to a hospital due to acute gastroenteritis. Methods: In this double-blind randomized placebo-controlled trial, 100 children aged 3 months to 14 years old hospitalized due to acute gastroenteritis in Bandar Abbas pediatric hospital, Iran, were enrolled. The participants were divided into two groups of case and placebo (n = 50 per group). Patients were excluded from the study if they met the exclusion criteria. After obtaining parental (or guardian) consent, in addition to the conventional treatment of gastroenteritis, the placebo group received 2 cc of olive oil (as placebo) and the cases received 100000 IU of vitamin D (ZAHRAVI Vit D3). Discharge criteria included reduction of fever and defecation and improvement of the patient's general condition. The required data including age, sex, baseline serum vitamin D level, level of dehydration, axillary temperature, and length of hospital stay were recorded in a checklist by a physician. Descriptive statistics, chi-square test, and Student's t-test were used to compare the recorded data in SPSS, version 24. Results: The mean lengths of hospital stay were 3.46 and 2.54 days in the placebo and case groups, respectively, indicating a significant difference between the two groups in this regard (P < 0.001). However, there were no significant age and sex differences between the two groups regarding hospital stay (P = 0.09 and P = 0.14). Furthermore, there was no significant relationship between length of hospital stay and the level of dehydration in either group (P = 0.15). We found that axillary temperature at discharge was significantly lower in the vitamin D group than the placebo group (P = 0.017). In general, length of hospital stay was shorter in the vitamin D group, and there was no difference between patients with baseline vitamin D level of < 30 ng/mL and those with vitamin D level of ≥ 30 ng/mL in the vitamin D group regarding length of hospital stay (P = 0.057). On the contrary, in placebo group, hospital stay was significantly longer in those with vitamin D level of < 30 ng/mL (P = 0.039). Conclusions: This prospective study demonstrated that vitamin D supplementation is significantly related to the reduction of hospital stay in pediatric acute gastroenteritis patients aged 3 months to 14 years old. This finding was achieved after unification of the confounding variables such as socioeconomic status. We also noted that the effect of vitamin D on hospital stay was not associated with age, sex, and level of dehydration.

Background: Many children are affected by pneumonia and its complications annually, despite the fact that there are several known risk factors; vitamin D deficiency may play a role in this disease.

Objectives This study aimed to assess the clinical characteristics, treatment and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 in five different geographical regions of Iran. Methods In this multicenter observational study, patients <21 years were included between March 2020 and October 2021. By Disease Control and Prevention (CDC) checklist, demographic characteristics, comorbidities, clinical signs and symptoms, laboratory and radiology findings, and treatment were collected. Statistical analysis was using Chi-square and t-test in STATA14. Results In total 225 patients with median age of 55 (26–96) months were included that 59.56% boys. 57.33% were admitted to the PICU with a median of 7 days (4–10). 95.56% of patients were discharged with recovery and the rest died. All of the patients in our study were included based on the MIS-C criteria. However, some patients had Kawasaki symptoms, so we compared the clinical and epidemiological characteristics of the two groups. Conjunctival injection, cervical lymphadenopathy>1.5 cm diameter, and strawberry tongue in Kawasaki-like MIS-C patients were higher than of MIS-C patients, and this difference was significant(p<0.001). The most common comorbidity was obesity (24.86%). Most patients tested for COVID-19 and about 60% of the patients had a positive test by serology or reverse transcription-polymerase chain reaction (RT-PCR). Gastrointestinal (88.89%) and hematologic signs (84.44%) were most common. Most drugs used in patients were IVIG and steroids. 88.07% and 61.29% of the patients had at least one problem in echocardiography and lung CT, respectively. Conclusions The best outcome was seen in patients who were treated with both IVIG and steroids on the first days of admission. Myocarditis was common in two groups of patients. According to most patients had echocardiography abnormal, screening of heart function is recommended for patients.

Objective. In this study, by using clinical and paraclinical characteristics, we have aimed to predict the severity of the disease in hospitalized COVID-19 children. Method. This cross-sectional study was conducted on medical records about epidemiologic data, underlying diseases, symptoms, and laboratory tests from March to October, 2020, on 238 hospitalized confirmed COVID-19 paediatric cases in several children’s hospitals of Tehran, Ahwaz, Isfahan, and Bandar Abbas. Results. From 238 patients, 140 (59%) were male and most of them were in the age group of 1 to 5 years (34.6%). Among all hospitalized patients, 38% had an underlying disease and in total, 5% of cases were expired. Conclusion. Determining patient severity is essential for appropriate clinical decision making; our results showed that in hospitalized pediatric patients, by using several variables such as SGOT, CRP, ALC, LDH, WBC, O2sat, and ferritin, we can use clinical and paraclinical characteristics for predicting the severity of COVID-19.

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The relationship between ABO blood group distribution and Peptic Ulcer Disease (PUD) has been widely evaluated in the past. But data concerning the same evaluation are very limited in Iran. This study sought to determine the distribution of ABO blood group in patients with PUD in Iranian subjects. Eighty-one patients with PUD (51 male and 30 female; mean age: 49 +/- 18 years) who attended our endoscopy section were enrolled. Blood samples were used for ABO/Rhesus (Rh) blood group antigen typing. The ABO blood group phenotype distribution in subjects was as follows: 37.1% (30/81) for group A, 23.4% (19/81) for group B, 35.6% (28/81) for group O and 4.9% (4/81) for group AB. Rh positivity was found in 63% (51/81) of patients. In local healthy population, ABO/Rh blood group distribution was 33.8, 20.7, 34.7, 8.4 and 89.6% for A, B, O, AB and Rh, respectively. AB blood group distribution in healthy population was higher than PUD (8.4 vs 4.9%). In contrast, Rh positivity of PUD in Iran is lower than healthy subjects (63 vs 89.6%). Variation in the results of studies is related to different study communities. According to these results, probably ABO/Rh blood group has an important role in patients with peptic ulceration. The functional significance of ABO blood group distribution might be associated with biological behavior of PUD. The impact of blood group on PUD may be a focus for further studies.

BackgroundZinc deficiency is an important problem in children, especially in developing countries. Zinc supplements have beneficial effects on multiple factors, including treatment of growth retardation and hypogonadism, and they can be used as therapeutic and prophylactic agents against infection in children.ObjectiveTo determine the prevalence of zinc deficiency in 6-month to 12-year-old children in Bandar Abbas.MethodsThis study was done in Bandar Abbas in 2013. In this cross-sectional study, 583 children were evaluated after obtaining a written informed consent from their parents. Zinc levels < 6 μg/dl were defined as zinc deficiency, zinc levels of 80–66 μg/dl were defined as insufficient, and zinc levels of 80–115 μg/dl were defined as sufficient levels. SPSS software, version 20, descriptive statistics, the chi-squared test, and the t-test were used to analyze the data.ResultsFive hundred and eighty-three children with a mean age of 42.82±30.68 months participated in this study. Among the participants, 263 (45.1%) were females, and 320 (54.9%) were males. The prevalence of zinc deficiency was 17.5% in this study. Zinc deficiencies were reported in 67 males (20.94%) males and in 35 females (13.30%). Zinc deficiencies were more common in boys, and this difference was statistically significant (p=0.01).ConclusionThe results of this study indicated that the prevalence of zinc deficiencies is high in Bandar Abbas and that it is more prevalent in males than in females. The children in this area should be screened for zinc deficiency. Future studies should focus on then treatment of zinc deficiency and its role in different aspects of children’s health.