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Background In most term neonates, the ductus arteriosus closes functionally on the first day of life, and a permanently open ductus arteriosus is abnormal. Objectives To evaluate the effect of oral acetaminophen on patent arterial duct (PDA) closure in premature infants less than 32 weeks. Methods This randomized clinical trial was performed on 140 preterm neonates with gestational age less than 32 weeks and birth weight less than 1,500 g, admitted to the neonatal intensive care unit of Ali Enbe Abitalib Hospital in Zahedan between 2019 and 2021. The neonates were randomly divided into two groups, with and without acetaminophen administration. In the intervention group, acetaminophen drops were started during the first 24 hours after birth and were administered for five days. In both groups, echocardiography was performed five days after birth. Finally, the data were analyzed in SPSS software. Results About 140 neonates with gestational age of ≤32 weeks and weight at birth ≤1,500 g were admitted for the study. The neonates were equally divided into two groups and acetaminophen medication assigned for one of the groups. Of the 70 neonates who did not receive acetaminophen administration, 75.7% had PDA closure spontaneously; this pattern was 94.3% in patients who had treatment with acetaminophen. This effect of treatment was significant (X2=9.468, p=0.002). Conclusion The study showed significant improvement in PDA in neonates receiving paracetamol. This can have a significant impact on the treatment approach to preterm neonates.

Objectives: Infant screening for congenital heart disease (CHD) includes a straightforward bedside test called pulse oximetry. Low degrees of oxygen in the blood can be an indication of a critical CHD. The aim of the present study was to evaluate the role of pulse oximetry in the early detection of asymptomatic CHD in new borns before discharge from Hospital. Methodology: This cross-sectional study conducted on 3151 term neonates first stage of SPO2 was performed 2-12 hours after birth. If SPO2 was < 95%, premeasured within the first 12 to 24 hours of life. If the neonates maintained their SPO2

Background: Celiac disease is a hereditary digestive disease in children associated with an autoimmune disorder of the small intestine. This study aimed to study aortic stiffness in children with celiac disease compared with controls and assess the effects of a gluten-free diet on aortic stiffness parameters. Methods: This case-control study was conducted on 114 children with celiac disease and 57 healthy volunteers. Children with celiac disease comprised three groups: Gluten-free diet (GFD)-responsive, GFD-nonresponsive, and newly diagnosed. Systolic and diastolic diameters of the ascending aorta were recorded by M-mode echocardiography. Data were analyzed using SPSS 20. Study data had free distribution and nonparametric tests were applied for the analysis. The tests were Mann-Whitney U and Kruskal-Wallis with P value < 0.05as the significance level. Results: Aortic strain (11.15 ± 7.47 vs. 13.78 ± 6.95, P = 0.002) and aortic distensibility (6.98 ± 5.03 vs. 8.33 ± 5.13, P = 0.037) were lower in celiac disease (CD) while pressure strain elastic modulus (410.60 ± 247.45 vs. 330.71 ± 216.94, P = 0.012) and aortic strain β index (1.79 ± 0.62 vs. 1.44 ± 0.51, P < 0.001) were higher. The aortic strain significantly differed between control and response to GFD (P = 0.026), control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.003), and no response to GFD and new diagnosis (P < 0.001) groups. The aortic strain β index differed significantly between control and response to GFD (P ≤ 0.001), control and new diagnosis (P < 0.001), response to GFD and no response to GFD (P = 0.035), response to GFD and new diagnosis (P = 0.002), and no response to GFD and new diagnosis (P < 0.001) groups. Aortic distensibility significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Pressure strain elastic modulus significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Conclusions: The present study concluded that the elasticity parameters will change due to celiac disease. Gluten-free diet had no significant effect on aortic stiffing measures except the ASβ index.

Background: Poisoning is a critical global health problem, especially among children. This study aimed to assess the epidemiological features, clinical signs, and risk factors of childhood poisoning in the southeastern region of Iran. Patients and Methods: This cross-sectional study was conducted on 636 children and adolescents admitted to the Emergency Department of Ali Ebne Abitaleb Teaching Hospital in Zahedan, Iran, within 2014 to 2020. The collected data were clinical symptoms at the time of admission, socioeconomic and demographic determinants, poisoning agents, admission to the pediatric intensive care unit (PICU), using antidote, hospital stay in days, discharge status from the hospital, self-poisoning, gender, and place of residency. The data were analyzed using SPSS software (version 18). Mean and standard deviation, Pearson and chi-square were used to assess the association between two specific categorical variables, and the level of significance was considered 0.05. Results: Opium was the most common poisoning agent with the age of 8 years and femalepriority. Among poisoned subjects by chemical agents, the highlighted symptoms were respiratory distress, decreased peripheral oxygen saturation (SPO2), nausea and vomiting, fever, and a decrease in heart rate in the given order. Among poisoned subjects by medicinal agents with a decrease in SPO2, a decrease in consciousness and blood pressure was common. More frequent symptoms in children poisoned by opium were a decrease in SPO2, myosis, a decrease in heart rate, a decrease in respiratory rate, seizures, and nausea and vomiting. The factors, including antidote, gender, place of residency, poisoning by accidental events, admission to PICU, and days stayed in the hospital, were the significant factors in poisoning. Conclusions: Poisoning by opium agents was more common than other agents in Iran in lower age groups. Poisoned children by opium agents had severe symptoms with higher frequency than other agents. Antidote, gender, place of residency, poisoning by accidental events, admission to PICU, and days stayed in the hospital were significant factors in agent poisoning.

Background: Pediatric poisoning is a serious issue worldwide and a common cause of children's morbidity and mortality. Objectives: This work aimed to study pediatric poisonings due to chemical substances and their related factors. Patents and Methods: A seven-year retrospective cross-sectional study was performed on the poisoning of children equal to or less than 18 years of age who presented to the emergency ward in 2014. Data were analyzed using mean and SD for descriptive statistics and Pearson's chi-squared test for inferential statistics. The collected data were analyzed using SPSS 20, considering 0.05 as a significant error when statistical tests were used. Results: Among poisoned children, boys were more in total, as well in all age groups except > 10 years. Age (χ2 = 22.494, P = 0.013), intentionally (χ2 = 32.176, P < 0.001) had a significant association with chemical substances. Among the demographic and socioeconomic features, none was associated with the type of chemical substances except age. Among the symptoms, all were associated with chemical poisoning substances except seizures. Of 114 with RDS, about 30.7% were poisoned by kerosene. Of 63 with low BP, 66.7%, 31.7%, and 1.6% were due to medicines, bites, and detergents, respectively, and from six children with high BP, all were due to toxins. Of 79 with low consciousness, 69.6% were due to medicines. Seventy children had fever, of which 55.7% were due to bites. Thirty-two had seizures that 46.9% and 18.8% were due to medicines and kerosene. Ninety-seven had vomiting and nausea, of which 32% and 30.9% were due to medicines and kerosene, respectively. Finally, 159 had low SPO2, of which 47.8%, 13.8%, and 20.1% were due to medicines, toxins, and kerosene, respectively. Conclusions: It was concluded that in poisoned children, boys were more but girls in self-poisoning, especially at older ages. Girls were poisoned more by medicinal and kerosene substances, but boys by bites, toxins, and detergents. All the poisoning symptoms were observed in medicinal substances and bites. Poisoning by kerosene more occurred in the cold months, and detergents and bite poisoning were more frequent in summer. There is a need for further, longer prospective studies to lead to preventing measures.

Janus nanoparticles (JNPs), as a new and special type of nanoparticles (NPs), have a great potential to use in enhanced oil recovery (EOR) processes. The surfaces of JNPs have two or more distinct physical properties which allow them to have different chemical behaviors at the same time. Nowadays, this type of nanoparticle has drawn much attention in EOR. In this study, the application of JNPs in EOR processes is reviewed and JNPs are compared with common NPs. Special features, synthesis methods, advantages, and disadvantages of the JNPs for use in oil recovery methods are discussed. Also, the influence of the JNPs on the viscosity alteration, interfacial tension (IFT) reduction, wettability alteration, and oil recovery factor are discussed by reviewing previous conducted experimental and numerical studies. Despite all the studies conducted in this field, many challenges are facing these materials for use at field-scale operations that are discussed in this study. Producing JNPs with different bases such as metal oxides bases, synthesize a new JNPs at an industrial scale, the effect of reservoir's pressure and temperature, and development of new strategies are still needed to investigate in future studies to find the mechanism of JNPs in oil reservoirs and utilize them in real EOR operations.