The world is currently challenging the serious effects of the pandemic of the Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Data on pediatric COVID are rare and scattered in the literature. In this article, we presented the updated knowledge on the pediatric COVID-19 from different aspects. We hope it will increase the awareness of the pediatricians and health care professionals on this pandemic.

Background: Although iron chelation therapies have been available for many years for thalassemia intermedia patients, iron accumulation remains the major cause of death. Therefore, the need for additional chelation options is in demand. This randomized controlled study aimed to understand the effects of green tea on iron balance in thalassemia intermedia patients. Methods: Using a random selection method, 141 thalassemia intermedia patients were initially screened for inclusion in this trial; only 68 patients included after applying exclusion criteria. Two equal groups were generated (n=34/group): green tea (three cups/day after meals) + usual treatment (deferasirox iron chelator and on demand blood transfusion); and control (only usual treatment). The study lasted for a period of 12 months. Patients failing to comply to the trial methodology were excluded, leaving a final total of 29 patients in the green tea group and 28 patients in the control group. Liver iron concentration, and serum ferritin were assessed at baseline and 12 months, while hemoglobin levels were assessed monthly. Results: At baseline, both groups were matched regarding general demographics. At 12 months, the net drop of liver iron concentration in the green tea group (7.3 mg Fe/g dry weight) was significantly higher than the control group (4.6 mg Fe/g dry weight) (p<0.05). This was also seen with serum ferritin; net reduction in green tea and control groups were 1289 ng/ml and 871 ng/ml, respectively (p<0.05). Hemoglobin levels were slightly higher in the green tea group compared with the control group, but this was not significant. Conclusions: Regular green tea consumption had a significant capability to improve iron deposition in thalassemia intermedia patients who already undergo deferesirox iron chelation therapy. Trial registration: UMIN-CTR Clinical Trials Registry, UMIN000040841 (retrospectively registered June 21, 2020).

BACKGROUND: Preeclampsia (PE) is a possible etiology of obstetrical and neonatal complications which are increased in resource-limited settings and developing countries. AIM: We aimed to find out the prevalence of PE in Iraqi ladies and specific outcomes, including gestational weight gain (GWG), cesarean section (CS), preterm delivery (PD), and low birth weight (LBW). METHODS: All singleton pregnant women visiting our tertiary center for delivery were involved over 3 years. PE women were compared with non-PE ladies. Complete history and examination were done during pregnancy and after delivery by the attending obstetrician and neonatologist with full documentation in medical records. RESULTS: PE prevalence was 4.79%, and the affected women had significant (p < 0.05) higher age, body mass index, and GWG, but lower gestational age at delivery. The mean significant difference of GWG in PE and non-PE patients was 1.82 kg. PD and LBW had significant higher frequencies in PE. After considering several confounding factors, crude and adjusted odds ratio (OR) of PE with 95% confidence interval (95% CI) were significant in CS (crude OR = 2.25 and 95% CI = 1.42-2.87 while adjusted OR = 2.89 and 95% CI = 1.43–3.06) and PD (crude OR = 2.41 and 95% CI = 1.73–2.46 while adjusted OR = 3.96 and 95% CI = 2.65–6.37). On the other hand, only the crude model touched significance in LBW (crude OR = 3.67 and 95% CI = 2.51–4.99). CONCLUSIONS: Prevalence of PE in Iraqi pregnant females was higher than other neighboring developing countries. In PE ladies, maternal parameters, including GWG and operative delivery, and neonatal complications, including PD and LBW, were significantly higher than pregnant women without PE.

Bleeding disorders in pediatrics is an important issue and can be life-threatening if not diagnosed and treated appropriately. We aimed to evaluate Iraqi pediatric practice (as an example of resource-limited settings) about the use of Recombinant Activated Factor VII (RFVIIa) in bleeding disorders, with emphasis on its effectiveness and safety, in comparison with adjuvant therapy. Budget restrictions may affect the availability of even lifesaving drugs such as (RFVIIa). Therefore, we tried to investigate the local experience of pediatric bleeding, with the evaluation of the potential ability of adjuvant therapy of blood products and vitamin K to substitute RFVIIa in case of non-availability. During a complete one year`s period, 35 patients were recruited prospectively and divided into two categories; study group (on RFVIIa, with or without adjuvant therapy) and control group (only on adjuvant therapy of blood products, and vitamin K), involving 19, and 16 patients, respectively. The mortality rate in the study group was significantly less than the control group; (36.84%) versus (56.25%). Larger drops in prothrombin time (PT) (42%), and partial thromboplastin time (PTT) (47%), with less multi-organ dysfunction (29%) were noticed with the use of RFVIIa. Septicemia-associated disseminated intravascular coagulation was the most frequent indication of both groups; (31.58%) versus (37.50%), with a significant positive outcome in the study group. Total serum bilirubin levels were found to be lower in all neonates with jaundice within the study group. One patient had venous thrombosis following the RFVIIa administration.In conclusion, RFVIIa has the potential to stop pediatric bleeding episodes significantly better than adjuvant therapy alone, with significantly less mortality. Safety was ensured in all survived cases except one who had thromboembolism. Neonatal jaundice was improved by the use of RFVIIa.

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