A 9-year-old girl with signs and symptoms of acute toxic myocarditis and cardiogenic shock with elevated cardiac enzymes was admitted to the Critical Care Unit (CCU) of our hospital with an ejection fraction of 25%. The patient was managed with supportive care and the administration of polyvalent antivenom and inotropes, and after 8 days, she was discharged without any complication with normal ejection fraction. Toxic myocarditis can be a result of scorpion envenomation. After two months of follow-up, the patient recovered completely and medications were discontinued.

Objective: Recently, sildenafil as a drug effective in relaxing smooth muscles can be used as an adjunct to delay the onset of uterine contractions and therefore the occurrence of preterm labor. The aim of this study was to evaluate the effect of nifedipine combination with sildenafil on preterm delivery compared with nifedipine alone. Materials and methods: This randomized double-blinded clinical trial was performed on pregnant women with a gestational age of 26-34 weeks with singleton pregnancy and symptoms of preterm delivery. The mothers were randomly assigned into two groups receiving nifedipine plus sildenafil or those receiving nifedipine alone. The time of delivery, maternal and neonatal complications were compared between the two groups. Results: Mothers who received the combination therapy experienced significantly lower preterm delivery within 72 hours of intervention compared to nifedipine alone (4.5% versus 27.3%, p = 0.002). The rate of delivery during the first 7 days after discharge was 7.6% and 31.8% in nifedipine plus sildenafil and nifedipine alone, respectively (P = 0.001). The prevalence of neonatal respiratory distress syndrome (RDS) as well as mean birth weight was higher in the nifedipine group alone. Treatment protocol with nifedipine and sildenafil compared with nifedipine alone was associated with a significant increase in preterm delivery delay (beta =-5.819, p = 0.001). Conclusion: The use of sildenafil in addition to nifedipine causes more delay in delivery in cases of preterm labor, followed by lower risk for RDS, reduces neonatal intensive care unit (NICU) admission, and preserves neonatal birth weight.

For the first time, Mirvis noticed a significant irregularity of the QT intervals in patients with acute myocarditis compared to the healthy population (Mirvis, 1985). Later, in 1990, Day et al. proposed a potential application of this inter-lead difference using standard 12-lead electrocardiograms (ECGs) (Day et al., 1990). Since then, numerous studies have investigated the differences between QT max and min in different ECG leads, entitled QT dispersion (QTd) (Day et al., 1990).Several studies have shown an association between death from a cardiac cause and QTd (Barr et al., 1994;Bazoukis et al., 2020;Naas et al., 1998). It should be noted that some findings have challenged this association. For example, QTd may decrease as a result of drug

Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Cardiac involvement is rare especially without liver and lungs tissue involvement. We describe a 12-year-old male patient referred to Mofid Children's Hospital, Tehran, Iran in Jul 2020 due to chronic pericardial effusion and suspected tuberculosis infection from Afghanistan. Echocardiography revealed a cystic lesion in the interventricular septum. Thoracic and abdominal computed tomography showed no similar cystic lesion in the lungs and liver. The patient underwent open-heart surgery for cystectomy and medical treatment with albendazole. Histological examination confirmed hydatid cyst diagnosis. The patient was discharged in good condition and oral albendazole was continued.