Background: Delirium is often not diagnosed or treated in pediatric intensive care unit (PICU). Delirium leads to a longer hospital stay period, which in turn can result in an increase in hospital treatment costs and an increase in the risk of nosocomial infections. Objectives: The present study aimed to determine the prevalence of delirium and its risk factors in PICU pediatric. Methods: This cross-sectional study was conducted in 2021 - 2022 in hospitals affiliated to Kermanshah University of Medical Sciences. The data collection instruments included the Richmond Agitation-Sedation Scale (RASS) and the Cornell Assessment of Pediatric Delirium (CAPD) questionnaire. Delirium was assessed by the researcher twice a day, in the morning and the evening. The assessment was carried out by a trained person, and the examination results were confirmed by an anesthesiologist who was a member of the research team. Data analysis was carried out using SPSS ver. 16. Results: According to our study results, the majority of the 89 examined patients were male (n = 52 cases, 59.8%), aged 13 - 16 years (n = 37 cases, 42.5%), and were admitted due to pneumonia (n = 24 cases, 27.6%). The prevalence of delirium was higher in patients with pain and those requiring oxygen therapy (P < 0.05). Furthermore, the overall prevalence of delirium in PICU patients was 25.3% (n = 22 cases). Conclusions: Investigating the prevalence of delirium in all age groups – pediatric and adolescents, in particular – was found to be extremely important. It was also found that the prevalence of delirium in PICU patients was significant; therefore, it was recommended that necessary preventive and medical interventions should be made to deal with these patients.

Context: In recent decades, the growing number of factories and vehicles has accelerated the release of environmental contaminants such as heavy metals. These inhalable pollutants often cause respiratory diseases and can endanger human health. Some heavy metals (e.g., zinc), on the other hand, are beneficial micronutrients, playing critical roles in the body. Objectives: This systemic review and meta-analysis study aimed to examine the role of lead (Pb) and zinc (Zn) in asthma. Methods: MeSH keywords, including lead, asthma, and zinc, along with their Persian equivalents were searched in the PubMed, Google, Web of Sciences, Google Scholar, and SID databases. The articles published between 2000 and 2018 were included. For assessing heterogeneity, the Q and I2 statistics were applied. STATA version 14 was used for data analysis. The review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Results: The frequency of asthma was 12% (95% CI: 11 - 13%, P < 0.001). The frequencies of high blood lead levels (BLL) in controls and patients with asthma were 2% (95% CI: 0 - 2.03, P < 0.001) and 3% (95% CI: 0 - 3.04, P < 0.001), respectively. The ratios of BLL of < 5, 5 - 10, and > 10 µg/dL were found to be 8% (95% CI: 0 - 9.7, P < 0.001), 10% (95% CI: 0.8 - 11, P < 0.001), and 9% (95% CI: 0.08 - 11, P < 0.001), respectively. The forced expiratory volume (FEV) was significantly correlated with zinc level. The results from meta-regression analysis suggested an increasing trend in asthma occurrence from 2000 to 2018. Conclusions: While zinc may have been protective against asthma, lead was a risk factor for respiratory diseases and asthma. Educating children and their parents about lead poisoning may have prevented or reduced lead intoxication and asthma in children.

Allergic rhinitis, asthma, and sinusitis represent a major global health problem; to date, there have not been any multiple large sample-sized studies investigating respiratory disease in various provinces of Iran. →What this article adds:Rhinosinusitis is a common condition among Iranian patients. Factors such as environmental location and smoking proved to be important in determining the prevalence of AR, asthma, and sinusitis.