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Niloufar Shashaani,1 Reza Shiari,2 Abdullah Karimi,3 Shima Salehi,4 Roxana Ghanaei,3 Mehrnoush Hassas Yeganeh,2 Sara Shiari,1 Khosro Rahmani,2 Vadood Javadi Parvaneh2 1Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Department of Pediatric Rheumatology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Department of Infectious Diseases, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Faculty of Medicine, Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, IranCorrespondence: Reza Shiari Tel +98-21-22227033Email shiareza@yahoo.comIntroduction: Kawasaki disease (KD) is a systemic vasculitis that occurs mostly in children under five years old. Kawasaki affects the middle-size arteries, especially the coronary arteries. Therefore, without adequate treatment, it may cause coronary artery aneurysm in 25% of patients. The purpose of this study was to investigate the relationship between Kobayashi, Sano, and Egami criterions with coronary artery aneurysm in KD patients during the last ten years and to identify risk factors in patients with intravenous immunoglobulin (IVIG)-resistant and coronary artery aneurysms.Methodology: Medical records of 363 Kawasaki patients referred during 2008– 2017 were reviewed. Patients’ demographic data and Kobayashi, Sano, and Egami scores of each patient were calculated. Based on echocardiographic findings, cases of coronary artery aneurysm were determined. Sensitivity, specificity, positive and negative predictive value, and the accuracy of each criterion were determined to predicting IVIG resistance and detect coronary artery aneurysm.Results: There was a slight relationship between IVIG-resistance in Kawasaki children and its prediction based on the Kobayashi risk score, but no relationship was found between the Egami and Sano criteria. Sixty-three patients (17.4%) had coronary artery lesions (CALs) on time of diagnosis. There were no statistically significant differences between gender and mean age of children with and without CALs. Also, there was no significant relationship between coronary artery aneurysm in Kawasaki children and its prediction based on the above three risk factors. The area under the ROC-curve of all three risk measures of Kobayashi, Egami, and Sano indicated that all three criteria were not useful in predicting CALs.Conclusion: Despite the low accuracy of the three above criteria to predictive of patients with IVIG resistance, it seems that the variables of age, duration of fever, and C-reactive protein (CRP) are more useful than other variables and may be utilized to evaluate patients by establishing a more appropriate cut-off point.Keywords: Kawasaki disease, coronary artery aneurysm, IVIG-resistant, Kobayashi, Sano, Egami

Background and Aim: Screening of neonates for early detection and timely treatment of congenital hypothyroidism (CH) is one of the most important public health programs in the world. The purpose of this study was to review the structures, processes and achievements of the CH Screening program in Iran. Materials and Methods: Data were obtained from the surveillance program of the noncommunicable diseases office, review of records, documents, books, published articles and also interviews with process owners and experts of CH screening program in Iran in 2019. Results: TSH measurements on the 3 rd to 5 th days after birth, supplementary and confirmatory testsfor children with TSH ≥ 5 mu/L,timely treatment of hypothyroid children using levothyroxine tablets and assessment of the program by follow-up and continuous monitoring were the most important parts of the national neonatal screening program for congenital hypothyroidism in Iran. Conclusion: The present study provides an overview of the principles and implementation of the CH screening program in Iran, and can be used as an educational and research source for policymakers, researchers, and health providers who work in the field of neonatal metabolic disorders.

Vadood Javadi,1 Reza Shiari,1 Khosro Rahmani,1 Nazanin Farahbakhsh2 1Pediatric Rheumatology Department, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Pediatric Pulmonology Department, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Reza ShiariMofid Children’s Hospital, Shariati Ave, Tehran, IranTel/Fax +982122227033Email shiareza@yahoo.comAbstract: Kawasaki disease is a mysterious childhood vasculitis. It presents with multi-systemic involvement in which the prolonged high-grade fever and mucocutaneous and lymph node manifestations are the prominent features. Sometimes, the disease has an unusual, atypical or incomplete presentation. Herein, we present a child with hilar lymphadenopathy as a manifestation of Kawasaki disease.Keywords: Kawasaki disease, children, lymphadenopathy, pulmonary, mediastinum

Vadood Javadi Parvaneh, Mohsen Jari, Saeideh Qhasemi, Mohammad Mahdi Nasehi, Khosro Rahmani, Reza ShiariMofid Children’s Hospital, Shahid Beheshti Medical University of Sciences, Tehran, IranBackground: Systemic lupus erythematosus (SLE) is an autoimmune disease which involves multiple organs, including peripheral nervous system.Case presentation: We describe a 12-year-old boy with progressively worsening neurological symptoms as first manifestation. Legs pain, loss of balance, and lower extremity weakness were the reason for his admission in neurologic ward. The patient was started on intravenous immunoglobulin therapy due to the possibility of Guillain–Barre syndrome and acute inflammatory demyelinating polyneuropathy (AIDP). However, there was no appropriate response and he developed recurrent attacks of polyneuropathy again with diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Then, he received intravenous pulse of methylprednisolone for 5 consecutive days followed by oral prednisolone for 3 months. One month after withdrawal of corticosteroid he admitted again with the same manifestations. Rheumatologic workup revealed the presence of leukopenia, hemolytic anemia, hematuria, proteinuria, positive antinuclear antibodies, and ds-DNA antibodies. On the basis of the American College of Rheumatology and Systemic Lupus International Collaborating Clinics Classification Criteria for SLE, the patient had underlying diagnosis of SLE. Eventually, he was treated by the pulse of methylprednisolone and cyclophosphamide, and oral hydroxychloroquine and prednisolone. His neurological and physical symptoms improved and complete neurological recovery occurred several months later.Conclusion: SLE and AIDP/CIDP are different entities, but ADP/CIDP can be part of the neurologic manifestations of the SLE. Although the association between AIDP/CIDP and SLE is very rare especially as a first manifestation of SLE, it should be early recognized for rapid appropriate treatment.Keywords: Guillain–Barre syndrome, chronic inflammatory demyelinating polyneuropathy, systemic lupus erythematosus, nerve disorders

Vadood Javadi Parvaneh, Mohsen Jari, Sheri Motahari, Khosro Rahmani, Reza ShiariDepartment of Pediatric Rheumatology, Shahid Beheshti University of Medical Sciences, Tehran, IranIntroduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide, various, and sometimes deceptive clinical and serological manifestations. Environmental factors such as ultraviolet radiation, viral infections, drugs, hormones, and chemicals could trigger SLE flares in genetically predisposed patients.Case report: We presented a 13-year-old girl with the first presentation of systemic lupus erythematosus triggered by a mosquito bite. She presented with a malar rash started after a mosquito bite on her left cheek. She had oral ulcers, photosensitivity, lymphopenia, proteinuria, and positive serologic tests for SLE. Renal biopsy revealed class II lupus nephritis.Conclusion: Environmental factors can trigger the onset of SLE in genetically susceptible cases. Besides microbial agents, UV radiation, hormones, drugs, emotional stresses, immunization, and chemicals are some of the published examples. We presented a case with a mosquito bite as the possible environmental trigger.Keywords: mosquito bite, systemic lupus erythematosus, children, pediatrics, etiology, case report

In developing countries, broiler farmers often use imbalanced energy diets, hence our study aims to evaluate the combined effect of addition of commercial exogenous enzymes (CEE), in low energy level corn/soybean meal based-diet on performance, serum biochemical parameters, meat characteristics in male and female of broiler chickens. A total of 120 one day old Hubbard F15 broiler chickens were divided on 2 groups (60 animals/group) with 5 replicates/group. The control group received a standard diet, while CEE group received the same diet supplemented with enzymes (250 g/ton). Addition of enzymes reduced significantly feed (p

INTRODUCTION: Respiratory Distress Syndrome (RDS) is the most common respiratory disorder among premature infants. The use of surfactant has significantly reduced respiratory complications and mortality. There are two conventional methods for administering surfactant: Intubate-Surfactant-Extubate (INSURE) and Less Invasive Surfactant Administration (LISA). This study aims to compare the effects of surfactant administration using these two methods on the treatment outcomes of premature newborns. MATERIALS AND METHODS: In this retrospective cohort study, we included 100 premature newborns with RDS and spontaneous breathing who were admitted to the Neonatal Intensive Care Unit of Besat Hospital in Sanandaj city in 2021. Exclusion criteria comprised congenital anomalies and the needing for intubation for resuscitation at birth. The outcomes of empirically treated with two methods were compared: the LISA (50 neonates) and the INSURE (50 neonates). Our interesting outcomes were needing for mechanical ventilation, duration of medical ventilation, pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia. Finally, we entered the data into STATA-14 statistical software and analyzed it using chi-square and t-tests. RESULTS: In this study, 69% of the neonates were boys. The LISA group exhibited significantly lower rates of need for mechanical ventilation (P = 0.003) and ventilation duration (P < 0.001) compared to the INSURE group. Conversely, there were no significant differences between the two groups (P > 0.05) in terms of pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia rates. CONCLUSION: The results of this study suggest that the LISA method is a safe and non-invasive approach for surfactant administration. Notably, it resulted in a reduced need for mechanical ventilation and decreased ventilation duration compared to the INSURE method. [ABSTRACT FROM AUTHOR]

In this study, the effect of the compaction velocity as well as the size and volume content of the reinforcing particles on the thermal properties of Mg-B4C composites were evaluated. B4C reinforcing particles at various percentages (0, 5, 10%) and two sizes (micron-scale and nanoscale) were added to the magnesium matrix using a planetary ball mill and compacted at 450 °C and three different compaction velocities. The Instron device was utilized for the quasi-static compaction of the powder particles while a drop-hammer and a Split-Hopkinson bar were used for the dynamic compaction of composite powders at medium and high strain rates, respectively. The thermal behavior of the composites was studied by measuring their thermal conductivity and coefficient of thermal expansion. The results showed improvement in dimensional stability of the composites with increasing the volume percentage of the reinforcing particles. Higher compaction velocities led to higher thermal conductivity and coefficient of thermal expansion. Besides, further addition of the reinforcing particles to the matrix resulted in a decrease in the thermal properties. Magnesium samples reinforced with B4C nanoparticles exhibited superior thermal properties compared to those reinforced with micron-sized particles. [ABSTRACT FROM AUTHOR]

In this study, three-dimensional simulations were conducted on a new passive micromixer to assess the thermal and hydrodynamic behaviors of Newtonian and non-Newtonian fluids subjected to low generalized Reynolds numbers (0.1 to 50) and shear-thinning properties. To acquire a more profound comprehension of the qualitative and quantitative fluctuations in fluid fraction using the CFD Fluent Code, the mass mixing index, rheological behavior, performance index, mixing energy cost, mass fraction distributions, temperature contours, and pressure drop were compared to illustrate the importance of the mixer geometry in the context of two miscible fluids with varying inlet temperatures. The selected geometry is characterized by a robust chaotic flow that substantially enhances thermal and hydrodynamic performance across all Reynolds numbers. A mass mixing exceeding 72.5% is obtained when Re = 5, reaching 93.5% when Re = 50. Furthermore, the evolution of thermal mixing for all behavior indexes reaches a step of 98% with minimal pressure losses. This work enabled the demonstration of a chaotic geometry in a highly efficient mixing system, leading to enhanced thermal performance for both Newtonian and non-Newtonian fluids. The results of the hydrodynamic and thermal characterization of the mixing of shear-thinning fluids within the micromixers under investigation are conclusive.

The objective of this paper focuses on optimizing the performance of solar systems. These systems play an essential role in the production of electricity worldwide. They are sources of clean energy which can be exploited in areas rich with solar potential. In this paper, the goal is to optimize the heat flow absorbed by the receiver. To do this, genetic algorithms are proposed as an approach able of solving the problematic subject with constraints that are countable and interlinked. These constraints are inspired from the energy balance of the solar tower concentrator under study. The results obtained by numerical analysis based on these constraints and the objective functions (maximizing the heat flow received and minimizing the losses of the heat flow) shows the existence of an optimal receiver efficiency value for the heliostat surface total, the receiver temperature, the molten salt temperature, the receiver opening surface, the receiver surface, the diameter, the thickness, the tubes thermal conductivity of the receiver and the steam flow at turbine inlet. In addition, the energy efficiency of the solar tower system improves better depending on the power cycle chosen such as the Hirn cycle with reheating and racking used in our case. [ABSTRACT FROM AUTHOR]