Background: Takayasu arteritis (TA) or giant cell vasculitis is the third common vasculitis after Henoch-Schoenline purpura and Kawasaki DISEASE in children. This vasculitis usually affects large vessels and is more common in females during the childhood. Aim of this report is to present three Iranian children (two boys, one girl) with TA.Case Presentation: Mean age of our cases on admission was 10 years. Patients most commonly presented with episodes of systemic symptoms including, fever, headache, increased arterial blood pressure in one limb and convulsion. Other related symptoms were myalgia, limb pain, chest pain, and abdominal pain. Supra sternal, and abdominal bruit was noted in all patients. Angiography was performed in all cases. This revealed stenosis of the left subclavian artery and common carotid artery in one patient, generalized aortitis in one case and stenotic right renal artery in one patient. One boy was diagnosed as having systemic onset of juvenile idiopathic arthritis. One case was referred with hand pain and headache, and one case for control of hypertension. Follow-up ranged from 2 to 7 years since diagnosis. All patients were I treated with prednisone, azathioprine, aspirin, and antihypertensive drugs. Each patient received either methotrexate, or hydroxychloroquine or mycofenolate mofetil.Conclusion: Although TA is uncommon before 10th year of life, it should be considered in patients presenting with hypertension and systemic symptoms such as fever, limb pain and PULSELESS limb.

Background: Takayasu is a form of large vessel vasculitis that mainly affects the aorta and its branches. It is a chronic DISEASE, and the long-term prognosis depends on arterial complications and its progressive stage. Objectives: This project is a single-center descriptive study of Takayasu’, s arteritis patients in Arak city aimed to determine these demographic patterns, which can help physicians in early diagnosis. Methods: All Takayasu’, s arteritis patients referred to the rheumatology center of Amir Al-Momenin subspecialty clinic were studied from 2009 to 2019. Imaging methods were used for diagnosis, and SPSS version 23 was used for statistical analysis. Results: Out of 17 registered patients, information of nine patients was available from the beginning of diagnosis. Constitutional signs and symptoms indicated an inflammatory process in 77. 78% of the patients. All patients in this study received a steroid-sparing drug as a part of the treatment, and the most commonly used drug was methotrexate, which was used in all patients at the onset. Conclusions: This study reports the details and the characteristics of patients with Takayasu’, s Arteritis in Arak, Iran. Although the number of patients was small, these results can inform the physicians about the signs, symptoms, and complications of delayed diagnosis of this DISEASE. One of the most important points in the diagnosis of Takayasu is the delay between the onset of symptoms and the diagnosis of the DISEASE. This delay may lead to irreversible complications and increased morbidity.

While substantial efforts on an understanding of ventricular fibrillation (VF) pathophysiology have reduced deaths from ventricular fibrillation and ventricular tachycardia (1), PULSELESS electrical activity (PEA) during years have been associated with poor outcome. The focus of treatment in ventricular fibrillation is delivering shock; treatment of underlying etiology comes in the next stage, whereas in PEA, primary and timely diagnosis of the underlying cause is acknowledged...

Treatment of cancer in children often requires a combination of chemotherapy, surgery, and/or radiotherapy. Radiotherapy and chemotherapy are not painful processes, but children undergoing these procedures must be made motionless through anesthesia or sedation. There are a few reports of complications during these procedures in relation to the procedures themselves or to the anesthesia given. This report describes an unexpected PULSELESS radial artery which was preliminarily and unduly attributed to anesthesia. A 2.5 year-old male pediatric patient with an acute lymphoblastic leukaemia was scheduled for radiotherapy. Anesthesia with intramuscular ketamine was induced before starting radiotherapy. About 5 minutes after injection of ketamine we found the right radial pulse undetectable. There was no other manifestation of hypoxia or hypo-perfusion. Carotid pulsation was normal. Examination of the left radial pulse and other peripheral pulses showed normal pulsation. The procedure was continued uneventfully. The next follow-up after radiotherapy, showed a scar and swelling on the right antecubital area, caused by extravasation of chemotherapeutic agent in the prior period of chemotherapy. Doppler ultrasonography of the antecubital vein confirmed the diagnosis. This case study therefore demonstrates that proper intravenous cannula establishment before chemotherapy is of great importance. Furthermore, accurate history and physical examination before induction of anesthesia or sedation may be useful in preventing mismanagement in pediatric cancer procedures.

Introduction. This fascinating disorder is also known as Sinus Histiocytosis. It is very rare, probably less than 1000 cases reported in the literature. R.D.D affects lymph nodes, although extranodal involvement has been reported such as: Centaral nervous system (CN.S). All of the cases of R.D.D with CN.S involvement without other sites involvement are 11 cases. Methods. The case is a male patient, 26y/o, with a history of head trauma 2 years ago that has been resulted to unconsciousness. He has been referred to a hospital and brain CT scan and brain M.R.I has been done for him. In M.R.I a brain tumor with left orbit and sphenoidal sinus involvement and compression effect on frontal lobe has been seen. A neurosurgeon operated him and the pathological report was Rosai-Dorfman DISEASE. Then he was referred to radiation therapy department.Results. Treatment approach in CN.S involvement cases consists of surgery, radiotherapy and chemotherapy. Discussion. Over all, response has been inferior to those expected with malignant hematopoietic neoplasms.

In 2019 a newly emerged coronavirus was detected by the Center for DISEASE control (CDC) in China. Nucleic acid sequencing from nose and throat swab samples of patients revealed that it was like severe acute respiratory syndrome coronavirus (SARS-CoV). World Health Organization (WHO) named it coronavirus DISEASE 2019 (COVID-19) and reported more than 100000 positive tests until March 2020 for COVID-19. During the past 20 years, the world has been affected by three coronavirus epidemics, SARS-COV, Middle East respiratory syndrome coronavirus (MERS-CoV), and COVID-19 that make world attention. The mortality rate of COVID-19 was more than other coronaviruses, but because of more people affected by it, it seems that it has a less fatality rate compared with MERS-CoV. Initial data showed that more than 80% of patients did not have any symptoms or may had light symptoms. 15% showed severe pneumonia, 5% became critically ill, and developed multiorgan dysfunction and septic shock. Due to the epidemic of emerging viruses and the lack of information about it, this study aimed to provide a quick overview of the most recent studies in the world. To perform this review, keywords such as COVID-19, severe acute respiratory syndrome coronavirus 2, and Angiotensin-converting enzyme 2 were retrieved using the medical subject headings (MeSH) system and then searched in English in PubMed, Scopus, Google Scholar, and Web of Science databases. COVID-19 virus enters its genome into the cells by binding to Angiotensin-converting enzyme 2 in some organs such as the lungs. Although the transmission route is unclear, it enters the body through respiratory droplets. The clinical symptoms includ fever, cough, dyspnea, myalgia, confusion, headache, sore throat, rhinorrhea, chest pain, diarrhea, nausea, vomiting, malaise, and convulsion. The standard diagnostic method is Real-time polymerase chain reaction (RT-PCR), but due to the time-consuming and sensitivity and the existing errors in this technique, chest CT and hematologic data are preferred. No definitive cure for the virus has been suggested so far, but antiviral drugs such as Oseltamivir, Ganciclovir, Lopinavir, Ritonavir and Remdesivir, and the anti-malarial drug Chloroquine phosphate and Interferon are in use until the discovery of the vaccine.