Background Most premature and very low birthweight infants cannot tolerate breast milk feeding in the first few days of life and are deprived of its benefits. This study evaluates the clinical outcomes of administering breast milk cell fractions to neonates with a birthweight of ≤1800 g. Methods We conducted a randomized controlled trial on 156 infants in the neonatal intensive care unit of Mahdieh Maternity Hospital in Tehran, Iran, from May 2019 to April 2020. All neonates with a birthweight ≤1800 g were enrolled and divided into intervention and control groups using stratified block randomization. Neonates in the intervention group received the extracted breast milk cell fractions (BMCFs) of their own mother’s milk after being centrifuged in the first 6 to 12 h after birth. The control group received routine care, and breastfeeding was started as soon as tolerated in both groups. Study outcomes were necrotizing enterocolitis (NEC), death, and in-hospital complications. Results We divided participants into two groups: 75 neonates in the intervention group and 81 neonates in the control group. The mean birthweight of neonates was 1390.1 ± 314.4 g, and 19 (12.2%) neonates deceased during their in-hospital stay. The incidence of NEC was similar in both groups. After adjustment for possible confounders in the multivariable model, receiving BMCFs were independently associated with lower in-hospital mortality (5 [26.3%] vs. 70 (51.1%]; odds ratio (OR): 0.24; 95% confidence interval [CI] 0.07, 0.86). Also, in a subgroup analysis of neonates with birthweight less than 1500 g, in-hospital mortality was significantly lower in the intervention group (4 [9.5%] vs. 13 [30.2%]; OR: 0.24; 95% CI 0.07, 0.82). There were no differences in major complications such as bronchopulmonary dysplasia and retinopathy of prematurity between the two groups. No adverse effects occurred. Conclusions Our research demonstrated a significantly lower mortality rate in neonates (with a birthweight of ≤1800 g) who received breast milk cell fractions on the first day of life. Since this is a novel method with minimal intervention, we are looking forward to developing and evaluating this method in larger studies. Trial registration IIranian Registry of Clinical Trials. Registered 25 May 2019, IRCT20190228042868N1.

In this multicenter study, we compared the status of antibody production in health care personnel before and after the vaccination using different brands of COVID-19 vaccines between March 2021 and September 2021. Out of a total of 962 HCP enrolled in our study, the antibody against the S1 domain of SARS-CoV-2 was detected in 48.3%, 95.5%, and 96.2% of them before, after the first, and the second doses of the vaccines, respectively. Our results showed post-vaccination infection in 3.7% and 5.9% of the individuals after the first and second doses of vaccines, respectively. The infection was significantly lower in HCP who presented higher antibody titers before the vaccination. Although types of vaccines didn't show a significant difference in the infection rate, a lower infection rate was recorded for AstraZeneca after the second vaccination course. This rate was equal among individuals receiving a second dose of Sinopharm and Sputnik. Vaccine-related side effects were more frequent among AstraZeneca recipients after the first dose and among Sputnik recipients after the second dose. In conclusion, our results showed diversity among different brands of Covid-19 vaccines; however, it seems that two doses of the vaccines could induce an antibody response in most of HCP. The induced immunity could persist for 3-5 months after the second vaccination course.

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Background: Various strategies have been suggested for the treatment of neonatal respiratory distress syndrome (NRDS). Objectives: Nowadays, most of the high-risk pregnancies are successfully ended although they normally result in the delivery of premature and preterm neonates. The rate of NRDS increases in these neonates, which consequently demands for more interventions to save them. Methods: This was a case-control study in which, 52 neonates of 27-32 weeks' gestation and birth weight 1000-3000 g were treated with Curosurf (a natural surfactant) and NCPAP (Nasal continuous positive airway pressure) as the case group. The control group consisted of 52 matched neonates untreated with surfactant and NCPAP. Results: Studying 6 common NRDS-induced complications (pneumothorax, pulmonary hemorrhage, chronic lung disease, intraventricular hemorrhage, sepsis and patent ductus arteriosus) showed that there were no significant differences between the case and control groups (P > 0.05). Also, there were no significant differences in mortality and ventilator usage rates and duration of hospitalization (P > 0.05). In total, 9 neonates in the case group (17%) and 16 in the control group (30%) died consequently. Conclusions: The results showed that surfactant therapy had no significant effect on mortality and ventilator usage rates, duration of hospitalization, and NRDS-induced complications.

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