Surfactant administration via thin endotracheal catheter (Tec) seems to be less invasive than InSurE method .We analyzed data obtained from multicenter hospitals. This multi center randomized clinical trial study was conducted concomitant within NICU of three university hospitals of Tabriz, Isfahan and Mashhad for a period of 20 months on neonates with gestational age of 27-32 weeks. All infants received nCPAP before administration of surfactant. If we required fio2>30%to maintain spo2 >85% then surfactant was administered. A 5f vascular catheter was placed through 1 to 2 cm below the vocal cords and surfactant was administrated slowly. Mean gestational age in TEC was 29.6 weeks and in InSurE was the same. Mean weight in TEC was 1339 grams and in InSurE was 1304 gram. Surfactant was administered to 66 preterm via TEC method and to 70 infant via InSurE. Mortality in TEC group was significantly lower than InSurE. P<0.01RR=0.56, CI, 95(0.42-0.76). NEC reduced in TEC. CPAP duration decreased in two centers, p<.05 but increased in another center. Fio2 decreased rapidly and HCO3 increased 2 hours after surfactant P<0.03 in TEC. The average mean of Oxygen supplementation, BPD, Mechanical ventilation between two groups was not statistically significant. TEC method was effective in treating RDS. Mortality was significantly decreased in TEC group. As TEC procedure is a new method of surfactant administration and there are few studies about it, so it is too early to be certain about all aspects of this procedure.

Heavy metals cause considerable environmental pollution due to their extent and non-degradability in the environment. Analysis and trace levels of arsenic, lead, mercury, and cadmium as the most toxic heavy metals show that they can cause various hazards in humans’ health. To achieve rapid, high-sensitivity methods for analyzing ultra-trace amounts of heavy metals in different environmental and biological samples, novel biosensors have been designed with the participation of strategies applied in nanotechnology. This review attempted to investigate the novel, sensitive, efficient, cost-benefit, point of care, and user-friendly biosensors designed to detect these heavy metals based on functional mechanisms. The study’s search strategies included examining the primary databases from 2015 onwards and various keywords focusing on heavy metal biosensors’ performance and toxicity mechanisms. The use of aptamers and whole cells as two important bio-functional nanomaterials is remarkable in heavy metal diagnostic biosensors’ bioreceptor design. The application of hybridized nanomaterials containing a specific physicochemical function in the presence of a suitable transducer can improve the sensing performance to achieve an integrated detection system. Our study showed that in addition to both labeled and label-free detection strategies, a wide range of nanoparticles and nanocomposites were used to modify the biosensor surface platform in the detection of heavy metals. The detection limit and linear dynamic range as an essential characteristic of superior biosensors for the primary toxic metals are studied. Furthermore, the perspectives and challenges facing the design of heavy metal biosensors are outlined. The development of novel biosensors and the application of nanotechnology, especially in real samples, face challenges such as the capability to simultaneously detect multiple heavy metals, the interference process in complex matrices, the efficiency and stability of nanomaterials implemented in various laboratory conditions.

Objectives There are several types of research on the COVID-19 disease which have been conducting. It seems that prevailing over the pandemic would be achieved only by mastering over the virus pathophysiology. We tried to categorize the massive amount of available information for useful interpretation. Evidence acquisition We searched databases with different keywords and search strategies that focus on virulence and pathophysiology of COVID-19. The present review has aimed to gather and categorize all implemented drugs based on the susceptible virulence mechanisms, and the pathophysiological events in the host cells, discussing and suggesting treatments. Results As a result, the COVID-19 lifecycle were categorized as following steps: “Host Cell Attachment” which is mainly conducted with ACE 2 receptors and TMPRSS2 from the host cell and Spike (S) protein, “Endocytosis Pathway” which is performed mainly by clathrin-mediated endocytosis, and “Viral Replication” which contains translation and replication of RNA viral genome. The virus pathogenicity is continued by “Inflammatory Reactions” which mainly caused moderate to severe COVID-19 disease. Besides, the possible effective therapeutics’ mechanism and the pharmaceutical agents that had at least one experience as a preclinical or clinical study on COVID-19 were clearly defined. Conclusion The treatment protocol would be occasional based on the stage of the infection and the patient situation. The cocktail of medicines, which could affect almost all mentioned stages of COVID-19 disease, might be vital for patients with severe phenomena. Graphical abstract The classification of the possible mechanism of medicines based on COVID-19 pathogenicity

: Neonates are vulnerable to COVID-19 infection. Its estimated rate in this age group is unknown. There is a robust transmission of COVID-19 from human-to-human. The result of all COVID-19 PCR tests on the amniotic fluid, placenta, cord, and breast milk was negative. The nasopharyngeal swab test of COVID-19 PCR in 56% of neonates was positive. 46.6% of neonates were asymptomatic, and in the others, the most common symptoms were: shortness of breath, tachypnea, cough, apnea, temperature instability, tachycardia. The possibility of vertical transmission (maternal-fetal) of COVID-19 is unknown. Because the most infected neonates with COVID-19 are asymptomatic, the transmission of the disease to other family members is very likely.