Although presentation of COVID‐19 in patients with immunodeficiency could be mild, it should not be missed, while early diagnosis and appropriate treatment can survive infected patients. Because even severe infections in PID patients may be presented with few symptoms and signs, this diagnosis should be considered in those immunocompromised patients who have exacerbating preexisting symptoms.

Purpose The study was aimed to assess the prognostic power The Pediatric Risk of Mortality-3 (PRISM-3) and the Pediatric Index of Mortality-3 (PIM-3) to predict in-hospital mortality in a sample of patients admitted to the PICUs. Design and methods The study was performed to include all children younger than 18 years of age admitted to receive critical care in two hospitals, Mashhad, northeast of Iran from December 2017 to November 2018. The predictive performance was quantified in terms of the overall performance by measuring the Brier Score (BS) and standardized mortality ratio (SMR), discrimination by assessing the AUC, and calibration by applying the Hosmer-Lemeshow test. Results A total of 2446 patients with the median age of 4.2 months (56% male) were included in the study. The PICU and in-hospital mortality were 12.4 and 16.14%, respectively. The BS of the PRISM-3 and PIM-3 was 0.088 and 0.093 for PICU mortality and 0.108 and 0.113 for in-hospital mortality. For the entire sample, the SMR of the PRISM-3 and PIM-3 were 1.34 and 1.37 for PICU mortality and 1.73 and 1.78 for in-hospital mortality, respectively. The PRISM-3 demonstrated significantly higher discrimination power in comparison with the PIM-3 (AUC = 0.829 vs 0.745) for in-hospital mortality. (AUC = 0.779 vs 0.739) for in-hospital mortality. The HL test revealed poor calibration for both models in both outcomes. Conclusions The performance measures of PRISM-3 were better than PIM-3 in both PICU and in-hospital mortality. However, further recalibration and modification studies are required to improve the predictive power to a clinically acceptable level before daily clinical use. Practice implications The calibration of the PRISM-3 model is more satisfactory than PIM-3, however both models have fair discrimination power.

Background:Bowel function has been reported to be adversely affected following surgery in cases of Hirschsprung. We retrospectively studied both the clinical outcome and bowel function status following surgery in patients diagnosed with Hirschprung's disease (HD). 161 cases, who underwent pull-through operations for HD in Sheikh Pediatric Tertiary Centre, Mashhad, Iran. The specified time bracket spanned between 2006 and 2011.Materials and Methods:Data was extracted from Health Information System with the aim of investigating patients for both short and long-term gastrointestinal (GI) complications after surgery bases in addition to the concurrence of any associated anomalies. Three main procedures were analysed in this respect (Swenson, Duhamel and Soave).Results:In a study of 96 (59%) boys and 65 (40.3%) girls, mortality rate was reported to be 15.5% (15 males and 10 females). A considerable majority of almost three fourths were detected with both early and late GI complications after surgery. The latter mainly included constipation (30.8%), incontinence (19.8%), enterocolitis (8%), diarrhea (11%) in a declining order of incidence. Down syndrome and others HD-associated anomalies were detected in 3.7% and 24.3% of cases respectively.Conclusions:Constipation and foecal incontinence were the most prevalent postoperative complications, which were reported almost as frequent in other studies. Yet, Enterocolitis, was reported slightly less in prevalence. Also mortality rates were considerably higher, compared to developed nations.

The prevalence of HTLV1 virus antibodies was determined in pregnant women and their neonates in Mashhad, northeast of Iran, as shown in this prospective cross-sectional study. 407 women who were hospitalized for delivery participated in this study. Venous blood sampling of pregnant women and umbilical cord of their neonates was done. The first samples of all women were tested for HTLV1 seropositivity by ELISA test and confirmed by PCR method. Then, the presence of HTLV1 in samples of umbilical cords blood in neonates who were delivered to an HTLV1-positive mother was determined by PCR method. All HTLV1-positive infants were called again at the age of 9–12 months, and PCR test was done using HTLV1-specific primers for them. Of all the participating women, 6 persons were HTLV1 seropositive by ELIZA test which was confirmed by PCR test. HTLV1 antibodies were found in cord blood samples by PCR test in 6 newborns who were born to HTLV1-seropositive women. All the six infants at the age of 9–12 months showed positive PCR results by HTLV1 LTR-specific primers; however, only one of them was PCR positive using HTLV1 TAX-specific primers. The prevalence of HTLV1 antibodies in pregnant women was 1.5%, and the vertical transmission rate to their neonates was 16.6%.

Oxidative stress has an important role in the pathophysiology of many occupational diseases. In this controlled exposure study, the intensity of oxidative stress biomarkers was assessed in the workers of natural sweet and sour gas refineries (SwGR and SoGR, respectively) and compared with controls. In addition, the role of gluthatione S-transferase M1 (GSTM1)-null and GSTT1-null polymorphisms on the intensity of oxidative stress and liver function tests (LFTs) was investigated. Blood samples were taken and measured for lipid peroxidation (LPO) level, total antioxidant capacity (TAC) and total thiol molecules (TTMs). GSTM1- and GSTT1-null genotypes were determined using polymerase chain reaction. LPO was significantly (p < 0.05) higher in the workers of SoGR. TAC was significantly lower in SwGR subjects (p < 0.001). TTMs were significantly lower in SoGR and SwGR subjects. Among LFTs, activities of aspartate aminotransferase and alanine aminotransferase but not alkaline phosphatase were elevated significantly (p < 0.001) in SoGR subjects. Multivariate linear regression revealed no association between studied polymorphisms, oxidative stress biomarkers, and LFTs. These results indicate that working in the SoGR and SwGR can lead to oxidative stress and abnormal LFTs. Continuous monitoring of natural gas workers for probable ongoing problems is therefore suggested.