Nonpharmacologic Treatments Alone are Enough to Prevent the Neurally Mediated Syncope: A 3 Years Follow-up Study

Background: Recurrences are common in neurally mediated syncope. The aim of this study is the evaluation of the effectiveness of nonpharmacologic treatments alone in preventing of syncope relapse. Methods: 70 patients (age 5-20 years) with neurally mediated syncope were enrolled. Thirty patients received pharmacologic therapies along with nonpharmacological methods, and 40 patients received just nonpharmacological treatments then followed them for 36 months. The incidences of different outcomes were analyzed with descriptive statistics using percentages. Results: The recurrence rate of syncope was significantly higher in pharmacological group than in nonpharmacological group in each period of the follow-up (P < 0.001). Conclusions: Nonpharmacologic treatment is very effective in the prevention of syncope relapses and can be a substitute for pharmacologic drugs in the initiation of treatment and if done correctly

A case series of pulmonary hypertension in small infants with atrial septal defect

BACKGROUND: Atrial septal defect (ASD) is one of the most common congenital heart defects (CHDs) with prevalence of 8 to to in children with CHD and incidence of 56 per 100000 live births. It is categorized according to the defect site in which the most common form is secundum ASD (ASD(2)) with the defect in the central part of the atrial septum. CASE REPORT: In our case series, we evaluated five children aged under one year old with ASD(2) and pulmonary hypertension (PH). All the patients were referred for surgical ASD closure. Their PH was improved and the size of right atrium (RA) and right ventricle (RV) became normal during the follow-up and one year after the surgery all of them had normal pulmonary artery pressure (PAP) with normal RA and RV size. CONCLUSION: According to our study and those done by others, the prevalence of PH in infants with ASD is low, but when this combination is found without any other CHD, ASD closure should be considered

Efficacy and safety of using amplatzer for transcatheter closure of atrial septal defect in small children with less than 10 kg

BACKGROUND: Atrial septal defect (ASD) accounts for about 10 of congenital heart diseases (CHDs). Self-closure of these defects in patients with defects less than 8 mm has been reported in several studies. In children, transcatheter closure of the ASD is suggested for asymptomatic patients older than two years and with weight > 15 kg. The purpose of this study was to show that transcatheter closure of ASD in small children with body weight less than 10 kg is an effective and safe method. METHODS: Between July 2016 and September 2018, 35 children with body weight less than 10 kg underwent percutaneous closure of ASD using amplatzer. All patients had minimum defect size of 6 mm, pulmonary blood flow (Qp) to systemic blood flow (Qs) ratio above 1.5, right atrial and ventricular dilation, symptoms of delayed growth, and recurrent respiratory infections in their evaluation and had acceptable rims for intervention. Follow-up evaluations were done 1 day, 1 week, 1 month, 6 months, and yearly after discharge with transthoracic echocardiography (TTE) and electrocardiography (ECG). RESULTS: The mean age of patients at procedure was 12.06 +/- 4.47 months (range: 6 to 14 months), mean weight was 8.32 +/- 0.72 kg (range: 7.5 to 9.8 kg). The mean defect size was 10.00 +/- 2.32 mm (range: 6-13 mm). The mean device size used was 10.57 +/- 2.57 mm (range: 7.5 to 15 mm). Mean duration of follow-up was 16.66 +/- 6.93 months (range: 1-29 months). Respiratory rate, heart rate, pulmonary stenosis (PS), and Qp to Qs ratio had significant difference before and after procedure during the follow up (P < 0.001). CONCLUSION: Transcatheter closure of ASD with amplatzer in symptomatic small children and infants is a safe and effective treatment associated with excellent success, but long-term followup in a large number of patients would be warranted

Early Results of the Persian Registry of Cardiovascular Disease/Congenital Heart Disease (PROVE/CHD) in Isfahan

Background: In 2016, a prospective registry for pediatric patients with congenital heart disease (CHD) was established in Isfahan, Iran. Data on pediatric CHD in Iran are scant; accordingly, we aimed to report the early results of the Persian Registry Of cardioVascular diseasE (PROVE/CHD) Registry in Isfahan. Methods: All patients with CHD and associated defects diagnosed by pediatric cardiologists were assessed via echocardiography for inclusion in the present study between late 2016 and August 2019. The participants' sociodemographic characteristics, maternal history, birth history, medical history, current clinical presentations in the clinic or hospital, paraclinical data, cardiac diagnoses based on the International Classification of Diseases, 10th Revision (ICD-10), disease management plans, and medications were entered into a questionnaire by the subjects' parents/legal custodians and physicians and then transferred to the PROVE/CHD Registry. Results: The PROVE/CHD registry encompasses 1252 patients with CHD (49.9 male) at a mean age of 6.50±6.36 years. The most frequent cardiac diagnoses were ventricular septal defect (39.3), atrial septal defect (29.7), patent ductus arteriosus (25.4), pulmonary stenosis (11.0), tetralogy of Fallot (6.1), coarctation of the aorta (5.4), and aortic stenosis (5.1), respectively. The most frequent interventions were patent ductus arteriosus closure (4.3), atrial septal defect closure (3.6), pulmonary valvuloplasty (2.2), coarctation of the aorta angioplasty (1.9), and ventricular septal defect closure (1.1), correspondingly. The approximate corresponding rates of corrective and palliative surgeries were 32.0 and 13.1. The corrective surgeries were mainly comprised of ventricular septal defect closure (7.8), patent ductus arteriosus closure (7.3), atrial septal defect closure (5.1), and tetralogy of Fallot repair (3.8), respectively. The palliative surgeries mainly consisted of the Glenn shunt (9.0) and pulmonary artery banding (3.6). Conclusion: The PROVE/CHD Registry collects data on pediatric patients with CHD. The results of this registry can provide epidemiological data and a set of homogeneously defined cases for further studies

The commencement of congenital heart diseases registry in Isfahan, Iran: Methodology and design

BACKGROUND: Reported prevalence of congenital heart diseases (CHDs) varies widely among studies worldwide. The incidence of CHD, total number of pediatric and adult grown-up congenital heart disease (GUCH), is not determined in Iran. Therefore, we have designed a system to register the information of patients with CHD for the first time in our country. METHODS: CHD registry is a database in which the patients' data are collected by five pediatric cardiologists from three referral hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, and five outpatient clinics. We enrolled patients with CHD either as new cases who were referred for evaluation of potential CHD or those who were being followed within the outpatient clinics and entered their whole information in a website specifically designed for it. All the information was collected from checklist by those pediatric cardiologists RESULTS: From April 2017 to April 2020, after developing the forms and website, the Quality Control Committee evaluated the first 558 files. 73 files (13) needed major revisions. Among them, 34 (46) files were omitted totally and the 39 remaining files were revised and completed. After that revision, we changed our checklist and gathered about 1600 patients accordingly. CONCLUSION: Registry of CHDs not only improves epidemiologic studies but also assists researchers to understand how much a disease management is useful and how to raise the quality of cares and outcomes. Moreover, this provides a better insight for policymakers to understand the extent of health-related problems as well as the issues related to the prevention and management of CHDs all around the world

Right Atrial Thrombus in a COVID-19 Child Treated Through Cardiac Surgery

We herein report a case of large intracardiac thrombus in a child with SARS-CoV-2 infection (COVID-19). The diagnosis of COVID-19 was confirmed through HRCT and RT-PCR. Transthoracic echocardiography revealed a large thrombus in the right atrium treated successfully via cardiac surgery. The underlying mechanisms of this thrombus in the COVID-19 infection may be attributed to the hypercoagulation and inflammatory condition incurred by the COVID-19 virus

The Yin and Yang of Sodium Lauryl Sulfate Use for Oral and Periodontal Health: A Literature Review

Sodium lauryl sulfate (SLS) is an anionic surfactant, which has a wide range of usage in the health sector and in dental pharmaceutical products, especially in toothpastes. The objective of this review was to investigate the effects of SLS containing dentifrices on oral and periodontal health, possible side effects, and its benefits. A thorough literature search was done using databases of PubMed and Google Scholar and finally, 40 articles were included in the study. This narrative review revealed the sources of discrepancy and conflicting results regarding the impact of SLS on oral cavity as well as a lack of sufficient evidence in most topics. Hence, the evidence suggests improved drug bioavailability when used as a solubilizer, improved plaque control, and reduction in bad breath. On the other hand, SLS can serve as a risk indicator of prolonged oral wound healing time, recurrent aphthous stomatitis

Bi-allelic pathogenic variants in TRMT1 disrupt tRNA modification and induce a neurodevelopmental disorder

The post-transcriptional modification of tRNAs plays a crucial role in tRNA structure and function. Pathogenic variants in tRNA-modification enzymes have been implicated in a wide range of human neurodevelopmental and neurological disorders. However, the molecular basis for many of these disorders remains unknown. Here, we describe a comprehensive cohort of 43 individuals from 31 unrelated families with bi-allelic variants in tRNA methyltransferase 1 (TRMT1). These individuals present with a neurodevelopmental disorder universally characterized by developmental delay and intellectual disability, accompanied by variable behavioral abnormalities, epilepsy, and facial dysmorphism. The identified variants include ultra-rare TRMT1 variants, comprising missense and predicted loss-of-function variants, which segregate with the observed clinical pathology. Our findings reveal that several variants lead to mis-splicing and a consequent loss of TRMT1 protein accumulation. Moreover, cells derived from individuals harboring TRMT1 variants exhibit a deficiency in tRNA modifications catalyzed by TRMT1. Molecular analysis reveals distinct regions of TRMT1 required for tRNA-modification activity and binding. Notably, depletion of Trmt1 protein in zebrafish is sufficient to induce developmental and behavioral phenotypes along with gene-expression changes associated with disrupted cell cycle, immune response, and neurodegenerative disorders. Altogether, these findings demonstrate that loss of TRMT1-catalyzed tRNA modifications leads to intellectual disability and provides insight into the molecular underpinnings of tRNA-modification deficiency caused by pathogenic TRMT1 variants. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

Report of a Coarctation of Aorta Stenting in an Infant

Coarctation of aorta (CoA) is a congenital heart disease that can lead to heart failure during infancy and neonatal period. Several treatments have been proposed for this disease, including surgery and balloon angioplasty. The experiences of using stents in small infants or neonatal patients are very low. In this article, we report a 3 months old age infant who after balloon angioplasty, his CoA symptoms had return and stenting of CoA was performed for him