Background. Acute gastroenteritis is one of the major sources of morbidity and mortality among young children in developed and developing countries. The aim of this study was to determine the prevalence of human adenovirus- (HAdV-) 40 and HAdV-41 in children hospitalized with gastroenteritis in five different health centers of Iran. Methods. In a cross-sectional epidemiological study, we studied 2682 fecal specimens that were collected from children under the age of 5 years in five educational and therapeutic pediatric centers in Iran from February 2012 to February 2013. Samples were tested for HAdV-40 and HAdV-41, using a specific pair of primers in polymerase chain reaction (PCR) method. Results. HAdV-40 and HAdV-41 were detected in 132 (5.18%) of the patients with diarrhea. A significantly higher prevalence of HAdV-40 and HAdV-41 (58.3%) was observed in children under 12 months of age, compared to other age groups. The male to female ratio was 1.7. Conclusion. The results of this study demonstrated that HAdV-40 and HAdV-41 could be considered etiological agents for acute gastroenteritis among children in Iran. The PCR as a rapid test may increase the chance for a relatively mild course of the disease followed by a complete recovery and avoiding administration of unnecessary antibiotics.

Background & Objective: Vitamin D deficiency has been implicated in a wide range of conditions such as infectious and autoimmune diseases, cardiovascular and cerebrovascular events, and various malignancies to unfavorable birth outcomes. We studied vitamin D status in a group of neonates with congenital heart disease (CHD) and its relationship with the outcome of heart surgery.Materials & Methods: Total vitamin D levels in plasma were measured before and 24 hours after the operation in 45 neonates with CHD undergoing heart surgery and in 77 hospitalized neonates without a history of CHD as controls, at Children's Medical Center between March and September 2018.Results: Preoperative vitamin D levels in patients with CHD were not significantly different from the control group (42.4 +/-18.0 versus 46.9 +/-27.7 nmol/L, P=0.640). Patients' vitamin D levels decreased postoperatively (42.4 +/-18.0 versus 36.2 +/-14.5 nmol/L, P=0.013). This decline was significant in the cyanotic and open-heart surgery groups, but not in non-cyanotic or closed-heart surgery groups. In 41 (91.1%) patients, the outcome was successful discharge from the hospital, in 3 (6.7%), the outcome was demise, and in one, it was not determined due to early discharge. Preoperative and postoperative vitamin D levels did not show any relationship with the outcome. However, logistic regression analysis revealed a significant relationship between the amount of postoperative decline in vitamin D levels and the outcome of death (OR=1.261, 95% CI=1.026-1.551, P=0.028). Conclusion:Results corroborates previous findings and suggests the amount of postoperative decline in vitamin D levels as a predictor of the outcome of heart surgery in CHD.

Neonates in critical care constitute a vulnerable group, and vitamin D status in this group is the subject of extensive research. Studies suggest that critically ill neonates and children have lower mean vitamin D levels than healthy ones, and there is evidence linking vitamin D deficiency to an increased risk of mortality, illness severity, and complications in these patients. Vitamin D deficiency in neonates and children with congenital heart disease (CHD) undergoing corrective surgical treatment has attracted particular attention. Overall, studies show high prevalence rates of vitamin D deficiency in this group. Moreover, several studies report significant associations between low vitamin D levels and unfavorable findings, such as increased requirements for vasoactive support and mechanical ventilation and prolonged ICU stays. Available data suggest vitamin D deficiency as a risk factor in neonatal and pediatric critical illness, specifically in CHD patients undergoing surgical treatment. Clinical trials have been proposed to examine the beneficial effect of preoperational vitamin D supplementation on the outcome in this group. However, for now, vitamin D supplementation should be considered in critically ill neonates, particularly those undergoing surgery for CHD, aiming to maintain vitamin D at safe levels over the threshold of vitamin D deficiency.