COVID-19 pandemic due to the new corona virus 2019 is an important cause global problems. This infection begins with symptoms such as fever, cough, anorexia, malaise, sore throat, and can progress to acute respiratory disease syndrome (ARDS) and necessitating intensive care unit (ICU) admission with an estimated mortality rate of 3%. There is no confirmed specific antiviral treatment despite different treatment protocols. Supportive care especially Fluid therapy plays a very important role in this disease. The aim of this review is to Institute effective strategies for effective Fluid therapy in critically ill pediatric patients admitted to ICU.

Background: Vitiligo is an acquired multifactorial disorder. Different treatments are used for it and all of them have adverse side-effects. Vitiligo is an autoimmune disease associated with other autoimmune diseases such as hypothyroidism, hyperthyroidism, rheumatoid arthritis, diabetes mellitus, and so on. In these diseases, deficiency of vitamin D and B12 are proposed. So in this study, treatment response and remission in patients taking oral vitamin D and B12 was administered.Methods: 60 patients with active vitiligo were randomly divided into three groups. Group I received topical PUVA for 6 months; group II received topical PUVA and 1 cc oral drops of vitamin D3 daily for 2 months, and then topical PUVA alone for following 4 months; and group III received topical PUVA and 1 cc oral drops of vitamin D3 daily and sublingual tablets of vitamin B12 daily for 2 months, and then treated with topical PUVA for following 4months. Cure rate and side effects were evaluated using Vitiligo Area Scoring Index (VASI) at the third and sixth months. Findings: In each of the three treated groups at different times, the average changes in the area and extent of the lesion were not significantly different. Pruritus and erythema occurred in some patients.Conclusion: In this study, the reduction in the extent and area of lesions in the group receiving vitamin D compared to the control group were higher that indicated the role of vitamin D in preventing progression of active vitiligo.

Introduction: Traumatic brain injury (TBI) represents a critical medical condition imposing a substantial disease burden globally. Appropriate Fluid resuscitation is essential for trauma recovery. This study evaluated optimal Fluid strategies for TBI patients.Methods: This cross-sectional study examined 358 traumatic brain injury patients admitted to the emergency department of a hospital in Mashhad from June 2018 to June 2021. Patients were categorized into four groups per total pre-hospital Fluid volume received, five groups per Fluid type received, and three groups per pre-hospital transport times. Variables, such as the Glasgow Coma Scale (GCS), blood pressure, mortality, and morbidity, were recorded.Results: In patients with normal blood pressure, there was no difference in outcomes between normal saline versus balanced crystalloids. In hypotensive or severely injured patients with injury severity scores greater than 16, 1-2L normal saline was associated with shorter hospital stays than >2L Fluids. Pre-hospital transport times < 15 minutes were correlated with lower mortality and shorter hospitalizations versus > 15 minutes.Conclusion: Fluid volume impacts outcomes in traumatic brain injury. In hypotensive or severely injured patients (ISS>16), 1-2L normal saline was linked to shorter hospital stays versus >2L Fluid volumes. The type of crystalloid did not affect outcomes in normotensive patients. Minimizing pre-hospital transport times below 15 minutes may improve patient survival and recovery. Optimizing Fluid resuscitation protocols has the potential to improve traumatic brain injury prognosis.

Introduction: Use of an adhesive with a suitable composite resin is an important factor in tooth-colored restorations and increasing marginal sealing ability. The aim of this study was to evaluate the microleakage of various adhesives with composite resins using Fluid filtration and dye extraction techniques and assessment of the correlation between these two techniques.Materials and Methods: In this in vitro study, class II cavities were prepared on the proximal surfaces of 48 extracted sound human premolar teeth, measuring 1.5±0.5 mm in gingival width, 4 mm in occluso-gingival height and 1.3 of the inter-cuspal distance in width. The samples were divided into four groups (n=12). Group 1; OptiBond Solo Plus adhesive/Herculite XRV composite resin; Group 2: OptiBond Solo Plus adhesive/Master Dent composite resin; Group 3: Prime & Bond NT adhesive/Herculite XRV composite resin; Group 4: Prime & Bond NT adhesive/Master Dent composite resin. Microleakage was assessed primarily by Fluid filtration and then by dye extraction techniques. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests, with Bonferroni correction and Spearman's rho correlation test at 95% confidence interval.Results: The minimum and maximum mean microleakage values were recorded in Fluid filtration and dye extraction techniques groups 1 and 4, respectively. There were significant differences between the experimental groups in microleakage with the two methods of leakage assessment (p value=0.001). Spearman's rho revealed a strongly direct correlation between the two methods (r=0.797, p value=0.000).Conclusion: In both methods of microleakage assessment, use of ethanol-based in comparison to acetone-based adhesive resulted in microleakage reduction. Application of light-cured composite resin contrary to self-cured composite resin with both types of adhesives increased marginal sealing ability.

Intraoperative Fluid equilibrium is a decisive matter in perioperative anesthesia management, because most of evaluation studies consider intraoperative Fluid administration as a major participating agent in improving or worsening patient outcomes after surgery and it revolves within the responsibility of an anesthesiologist. The understanding of Fluid physiology in the human body, clinical features of available intravenous Fluid, and nature of surgery indeed will contribute to the success plan of management. Maintaining of patients’ physiological milieu by preserving normal extracellular volume, adequate tissue perfusion, and a balanced acid base condition are the main goals of intraoperative Fluid infusion. This review was conducted to overview fundamental basics of Fluid therapy during the intraoperative period. Due to the dearth of supporting data for appropriate volume and the available definitions of restrictive and liberal are diffident, the polemic about which particular method of volume expansion still exists. Colloid versus crystalloid controversy in surgical patients is still going on and this would again be encouraged to be a topic for many clinical trials in the future. The current findings’ trend prefers guided and restricted intraoperative Fluid therapy with isotonic balanced crystalloids because such Fluids are cost effective and have fewer side effects than other Fluids.

Introduction: Jaundice is one of the most common problems of neonatal period. It is important because of toxic effect of unconjugate bilirubin on brain and its many severe complications so that invention of a new approach to achieve earlier recovery has always been an issue.Objective: The purpose of this study was to determine the effect of intravenous Fluid therapy in addition to phototherapy in reduction of serum bilirubin of affected neonates admitted in hospitals.Materials and Methods: The present study was carried out on 60 neonates with indirect hyperbilirubinemia, weighting over 2500 grams, age over 72 hours, total serum bilirubin 17-25 mg/dl, direct bilirubin < 2mg/dl and without systemic and hemolytic diseases (except for glucose-6-phosphotase deficiency) in Imam Sajjad Hospital of Yasuj from May to September 2001.Patients were randomly divided into the study group and control group. In control group, only conventional phototherapy was used and in the study group, intravenous Fluidtherapy dextrose water 10%,1.5 times as much as maintenance requirement with NaCl 3 meq/100 cc Fluid for a 24 - hour duration, in addition to conventional phototherapy. The patients were discharged when their serum bilirubin reached 12 mg/dl.Results: Statistically, no significant difference was found between the two groups in terms of age, weight and level of serum bilirubin in admission time. The mean duration of admission in study group was 3.23 days and in control group 4.53 days (P=0.00005). Also the mean of total serum bilirubin in control and study groups after 24 and 48 hours following treatment were reduced to 16.27 mg/dl and 15. 18 mg/dl (P=0.039) and 14.29 mg/dl and 12.65 mg/dl (P=0.0006), respectively.Conclusion: Maintaining adequate hydration with Fluids containing 10% dextrose for infants receiving phototherapy results in faster decline in serum bilirubin level and, therefore, earlier discharge from hospital.