Mechanistic understanding of asphaltene precipitation and oil recovery enhancement using SiO2 and CaCO3 nano-inhibitors.

Asphaltene precipitation in oil reservoirs, well equipment, and pipelines reduces production, causing pore blockage, wettability changes, and decreased efficiency. Asphaltenes, with their unique chemical structure, self-assemble via acid-base interactions and hydrogen bonding. Nano-inhibitors prevent asphaltene aggregation at the nanoscale under reservoir conditions. This study investigates the effect of two surface-modified nanoparticles, silica, and calcium carbonate, as asphaltene inhibitors and oil production agents. The impacts of these nano-inhibitors on asphaltene content, onset point, wettability, surface tension, and oil recovery factor were determined to understand their mechanism on asphaltene precipitation and oil production. Results demonstrate that these nano-inhibitors can significantly postpone the onset point of asphaltene precipitation, with varying performance. Calcium carbonate nano-inhibitor exhibits better efficiency at low concentrations, suspending asphaltene molecules in crude oil. In contrast, silica nano-inhibitor performs better at high concentrations. Wettability alteration and IFT reduction tests reveal that each nano-inhibitor performs optimally at specific concentrations. Silica nano-inhibitors exhibit better colloidal stability and improve oil recovery more than calcium carbonate nano-inhibitors, with maximum oil recovery factors of 33% at 0.1 wt.% for silica and 25% at 0.01 wt.% for calcium carbonate nano-inhibitors.

QT Interval Changes in Children With Febrile Convulsion Compared With Healthy.

Introduction: Febrile seizure is a temperature-related seizure that affects the QT interval. The purpose of this study was to evaluate the changes in the QT interval caused by febrile convulsion (FC) compared with healthy children. Methods: This case-control study examined 180 children equally distributed between patients and controls. The study was conducted at the Ali Ebne Abi Talib Hospital in Zahedan City, Iran. The disease was diagnosed and confirmed based on standard definitions of FC. QT interval was measured by ECG and interpreted by a pediatric cardiologist, and collected data were analyzed using SPSS software, version 19 with a 0.05 significant level. Results: Among the ECG parameters, HR, R in aVL, S in V3, LVM, QTd, QTc, and QTcd were significantly different in children with FCs compared to their peers. From those who had abnormal QTd, FC children were more frequent which was not significant (χ2=1.053, P=0.248), while children with FC had significantly more abnormality regarding QTc (χ2=13.032, P<0.001) and QTcd (χ2=21.6, P<0.001). In children with FC, those who were less than 12 months had the highest level of HR which was not significant (χ2=4.59, P=0.101). Similar trends occurred for R in aVL and S in V3 that were higher in the age group >24 months (P>0.05). Children in the age group of >24 months had significantly had the highest LVM (χ2=52.674, P<0.001) and the other QT parameters were the same in FC children with different age groups (P>0.05). Conclusion: It is concluded that dispersion corrected QT, corrected QT, and dispersion QT changed significantly in children with FC in comparison with the healthy children with constant values in children with FC in different age groups. Highlights: Corrected QT, dispersion QT and corrected-dispersion QT changed in children with febrile convulsion.Among the children with abnormal dispersion QT, febrile convulsion were not seen more when children with febrile convulsion (FC) were more in abnormality levels of QTc and QTcd. Plain Language Summary: The study aimed to evaluate changes in electrocardiography parameters in children with febrile convulsion and found positive correlation.

Aortic elasticity changes in thalassemia due to heart and liver iron deposition.

Background: Iron overload is connected with an expanded prevalence of thalassemia due to heart impairment. This considers pointing to survey changes in thalassemia's aortic elasticity due to iron deposition in the heart and liver of children. Methods: This case-control study was performed on 80 healthy and 160 thalassemia patients. The subjects gathered from educational pediatric hospital of Ali Asghar in Zahedan, Iran, from 2019 to 2021. Echocardiography parameters were measured. Ferritin, lipids profile, cardiac and liver MRI T2 * measured in patients only. Aortic elasticity parameters were aortic strain, aortic stiffness ß index, aortic distensibility and pressure strain elastic modulus. Data analyzed by SPSS,p< 0.05 was considered as significant. Results: Diastolic blood pressure (p<0.001), aortic diameter in diastole (p<0.001), aortic diameter in systole (p<0.001), ferritin (p<0.001), aortic strain (p<0.001), aortic distensibility(p<0.001), pressure strain elastic modulus (p<0.001) and aortic stiffness ß index (p<0.001) were changed significantly in thalassemia patients compared to controls. From these variables, AoD, AoS, ferritin, AS and AD increased in thalassemia. Ferritin was higher in thalassemia patients with abnormal heart iron deposition (2131.89±1992.74 v.s 4887.66±3122.59 ng/ml). Considering the level of liver iron deposition, ferritin did not change in patients. Our highlighted variables did not change in patients based on the groups of ferritin. Conclusion: Concluded that AoD, AoS, ferritin, AS and AD increased in thalassemia patients. Ferritin increased in thalassemia with abnormal iron overload in the heart but did not change in the liver. Recommended MRI T2* to evaluate dynamic functions of liver and heart in thalassemia patients.

Assessment of aortic elasticity parameters in obese and overweight children.

BACKGROUND: Aortic elasticity is a predictor and recognized factor for future cardiovascular events in children. The aim of the study was to evaluate the aortic stiffness in obese and overweight children compared to healthy ones. METHODS: The study evaluated 98 sex matched children aged 4 to 16 years that were equally distributed in asymptomatic obese or overweight and healthy children groups. All the participants were free of any heart diseases. Arterial stiffness indices were determined using two-dimensional echocardiography. RESULTS: The mean ages in the obese and healthy children were 10.40±2.50 years and 10.06±1.53 years, respectively. Aortic strain was significantly higher in obese children (20.70±5.04%), compared to healthy (7.06±3.77%) and overweight children (18.59±8.08%, p < 0.001). Aortic distensibility (AD) was significantly higher in obese children (0.010±0.005 cm < sup > 2 < /sup > dyn-1x10-6), compared to healthy (0.0036±0.004 cm < sup > 2 < /sup > dyn-1x10 < sup > -6 < /sup > ) and overweight children (0.009±0.005 cm < sup > 2 < /sup > dyn-1x10 < sup > -6 < /sup > , p < 0.001). Aortic strain beta (ASß) index, was significantly higher in healthy children (9.26±6.17). Pressure-strain elastic modulus (PSEM) was significantly higher in healthy children (7.52±4.76 kPa). Systolic blood pressure increased with body mass index (BMI) significantly (p < 0.001) but diastolic blood pressure did not change (p=0.143). BMI had significant effect on arterial stiffness (AS) (ß=0.732, p < 0.001), AD (ß=0.636, p < 0.001), ASß index (ß=-0.573, p < 0.001) and PSEM (ß=-0.578, p < 0.001). Age had significant effect on systolic diameter of the aorta (ß=0.340, p < 0.001) and diastolic diameter of the aorta (ß=0.407, p < 0.001). CONCLUSIONS: We concluded that aortic strain and aortic distensibility increased in obese children when aortic strain beta index and PSEM decreased. This result suggests that, as atrial stiffness is a predictor for future heart diseases, dietary treatment for children with overweight or obese status is important.

Discharge against medical advice in paediatric patients.

OBJECTIVES: Discharge against medical advice (DAMA) from the hospital may negatively impact patients' well-being. The present study aimed to investigate the main reasons for DAMA among parents of children admitted to the paediatric ward of the Ali Ebne Abitaleb Hospital in Zahedan, Iran. METHODS: Participants in this case-control study included 130 children who had been admitted to the hospital's paediatric ward. Participants were divided into two equal groups: (1) those with incomplete treatment and (2) those who stayed in the hospital until the completion of their management and followed regular discharge procedures. A self-administered questionnaire was utilised for data collection. RESULTS: Participants included 130 children aged <1-18 years with an average of 3.3 ± 3.7 years; 51.5% (67) were girls, and 48.5% (63) were boys. The results showed a significant relationship between DAMA and the father's level of education (p < 0.05), length of hospitalization (p < 0.001), and duration of treatment (p = 0.027). No significant correlation was found for other factors (p > 0.05). CONCLUSION: This study found that the key reasons for DAMA were as follows: lack of satisfaction with physicians and hospital staff, family disturbance due to the presence of other children at home, inadequate economic situation, and being away from home. Providing professional education to parents and expressing the benefits and disadvantages of refusing complete treatment may help parents make better decisions.

Comparing the Effect of Clonidine and Dexmedetomidine on Intraoperative Bleeding in Spine Surgery.

BACKGROUND: Discopathy is one of the most common spinal surgeries. Hemodynamic control is important in bleeding reduction during the surgery. Clonidine and dexmedetomidine both are α2 agonists that help stabilize hemodynamics and prevent the increase of intraoperative bleeding. OBJECTIVES: In this study, the effects of clonidine and dexmedetomidine were compared in bleeding reduction during spinal surgery. METHODS: This randomized, double-blind clinical trial was conducted in 120 patients aged 20 to 50 years with ASA class I or II, undergoing spinal surgery. Patients were randomly divided into three groups. Group C received oral clonidine 0.2 mg, 90 minutes before entering the room. Group D received dexmedetomidine 0.5 µ/kg 15 minutes before anesthesia induction and 0.25 µ/kg/h infusion during operation. Group P received placebo as the control group. RESULTS: There was a significant reduction in intraoperative blood loss in patients who received clonidine (289 ± 130) and dexmedetomidine (344 ± 145) compared to the control group (462 ± 15) (P < 0.05), with a more dramatic reduction in the clonidine group (P < 0. 001).

Bone Metabolism Disorder in Epileptic Children.

OBJECTIVE: There are frequent anti-epileptic drugs used in management of epilepsy. Anti-epileptic drugs may have some complications on bone and vitamin D metabolism. This study aimed to comparison the bone metabolism disorder in epileptic children with healthy child in Zahedan, eastern Iran from Jul 2014 to Jun 2015. MATERIALS & METHODS: This case-control study was performed on bone metabolism disorder in epileptic children between 2014-2015. Forty epileptic children were enrolled based on accessibility scheme and 40 participants randomly selected for control group from those referred to the pediatric ward and clinic of Ali Ebn Abi Talib Hospital and Ali Asghar Clinic in Zahedan City, Sistan & Baluchestan Province, eastern Iran. Blood samples were collected from all participants to assess serum calcium, phosphorus, parathyroid hormone, magnesium, vitamin D, serum albumin, creatinine random urine. RESULTS: Of 40 epileptic children, 23 (57.5%) and 17 (42.5%) were male and female respectively, The prevalence of lower mean vitamin D levels was 37.5% for patients compared to 12.5% for controls (chi-square=6.667 and P=0.010). Of 80 participants, 15 individuals had abnormal PTH levels detected of 2 and 13 for patients and control groups, respectively (chi-square =9.928 and P=0.002). Serum calcium and magnesium levels were comparable in both groups. The status of the parameters in the classification of normal and abnormal assessed based on number of medications intake resulted that number of medications intake had no effect on the status of the parameter. CONCLUSION: The frequency of hyperparathyroidism and vitamin D deficiency is increased in epileptic children.

Comparison between brain natriuretic peptide and calcitonin gene-related peptide in children with dilated cardiomyopathy and controls.

BACKGROUND: Dilated cardiomyopathy (DCM) is revealed with the left ventricular dilatation and systolic dysfunction. OBJECTIVE: This study was performed to determine the level of calcitonin gene-related peptide (CGRP) and brain natriuretic peptide (BNP) in children with DCM and controls and comparison of these two biomarkers in patients. MATERIALS AND METHODS: This study was performed from April 2014 to March 2015 on patients with DCM. The levels of BNP and CGRP were measured by ELISA, and final amounts of biomarkers were compared with the echocardiographic finding. RESULTS: In this study, the mean age was 10.567 ± 5.50 and 12.135 ± 4.626 years for controls and cases, respectively (P = 0.321). The majority of echocardiographic indices in the left and right heart had different means in cases and controls (P < 0.05). Means of BNP were 213.814 ± 309.601 and 2.76 ± 1.013 for case and control, respectively (P < 0.001). Means of CGRP were 2.278 ± 1.586 and 1.488 ± 0.501 for cases and controls, respectively, (P = 0.001). In the patients group, however, no significant relationship was observed between CGRP level and Ross classification but observed a direct relationship of Ross classification with BNP (χ2 = 15.845, P < 0.05). CONCLUSIONS: The present research was performed on DCM patients and showed that most echocardiographic parameters, mean of CGRP and mean of BNP increased in patients compared to healthy children. The severity of illness based on the Ross classification showed significant and positive correlation with BNP level but not with CGRP. Probably, it could be concluded that BNP would be a better biomarker in DCM patients.

Serum Levels of Tumor Necrosis Factor-α and Interleukins in Children with Congenital Heart Disease.

Background: Levels of anti-inflammatory cytokines in blood have a positive relationship with congenital heart disease (CHD). We sought to assess the difference in serum cytokines levels between children with and without CHD.  Methods: We recruited 60 patients with CHD and 30 healthy children, from 2013 to 2014. Patients with primary pulmonary hypertension; metabolic diseases; renal, endocrine, and chronic inflammatory diseases; fever; infection in the preceding 3 weeks; and malnutrition were excluded. Participants' demographic data were measured, and their cardiac diseases were diagnosed via echocardiography. Serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-18 were measured via ELISA. Results: Mean age of the participants was 4.28 ± 3.44, 3.12 ± 3.87, and 3.30 ± 3.61 years in the cyanotic, acyanotic, and control groups, respectively (p value = 0.414). Mean values of TNF-α (p value < 0.001), IL-6 (p value < 0.001), IL-18 (p value = 0.030), right ventricular pressure (p value < 0.001), and pulmonary pressure (p value = 0.015) were higher in the case group, while the BMI was higher in the controls (p value < 0.001). Mean values of TNF-α (p value < 0.001), IL-6 (p value < 0.001), and right ventricular pressure (p value < 0.001) were significantly higher in the cyanotic children, whereas the BMI was higher in the controls (p value < 0.001). Levels of TNF-α and IL-6 had significant correlations with right ventricular pressure.   Conclusion: The present study showed a differed serum cytokines levels between children with and without CHD.

Evaluation of serum level of tumor necrosis factor-alpha and interleukin-6 in patients with congenital heart disease.

BACKGROUND: The objective of the study is to assess the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in patients with congenital heart diseases (CHDs) and control. PATIENTS AND METHODS: In this case-control study, sixty patients with CHD with ages of 1 month to 15 years and thirty healthy subjects were assessed. All objects measured in height, weight, age, sex, and body mass index (BMI). Patients diagnosed by echocardiography and patients' blood samples were 3 ml and taken in the catheterization laboratory through catheter and kept for 60 min at a room with normal temperature and separated serum has been held. All samples in compliance with the cold chain carried out to biochemistry laboratory and finally the levels of serum TNF-α and IL-6 were measured by Elisa Kit. Data were analyzed with Statistical Package for Social Sciences version 20. Nonparametric tests by considering 95% confidence interval were applied. RESULTS: The mean of age in cyanotic patients was 4.28 ΁ 3.44 years, a cyanotic was 3.12 ΁ 3.87 years and for the control group was 3.30 ΁ 3.61 years. Comparison of TNF-α (Mann-Whitney U-test = 56.62, P < 0.001), IL-6 (Mann-Whitney U-test = 313.5, P < 0.001), right ventricular (RV) pressure (Mann-Whitney U-test = 27, P < 0.001), pulmonary artery (PA) pressure (Mann-Whitney U-test = 618, P = 0.015), and BMI (Mann-Whitney U-test = 214.5, P < 0.001) in the case and control groups resulted in significant differences. To compare TNF-α (Chi-square = 57.82, P < 0.001), IL-6 (Chi-square = 54.70, P < 0.001), RV pressure (Chi-square = 71.35, P < 0.001), PA pressure (Chi-square = 5.92, P = 00.052), oxygen saturation (Chi-square = 74.70, P < 0.001), and BMI (Chi-square = 34.90, P < 0.001) in cyanotic, acyanotic, and control groups resulted that there were significant differences between these three groups except PA pressure. CONCLUSION: The findings of this study showed that in patients with CHD, serum levels of TNF-α increased but IL-6 not changed when compared to control and this increase in necrosis tumoral factor-α would be related with hypoxia and remarkable left to right shunt and caused growth retardation in these patients.

The perception of primiparous mothers of comfortable resources in labor pain (a qualitative study).

BACKGROUND: Natural delivery is the most painful event that women experience in their lifetime. That is why labor pain relief has long been as one of the most important issues in the field of midwifery. Thus, the present study aims to explore the perception of primiparous mothers on comfortable resources for labor pain. MATERIALS AND METHODS: In the present study, qualitative content analysis technique was used. The participants had singleton pregnancy with normal vaginal delivery. These women referred to the Imam Javad Health Center within 3-5 days after delivery for screening thyroid of their babies. RESULTS: During the content analysis process, five themes emerged that indicated the nature and dimensions of the primiparous mothers' perception of comfortable resources. These themes were: "religious and spiritual beliefs," "use of analgesic methods" (medicinal and non-medicinal), "support and the continuous attendance of midwife and delivery room personnel," "family's and husband's support during pregnancy and in vaginal delivery encouragement," and finally "lack of familiarity with the delivery room and lack of awareness about structured delivery process." CONCLUSIONS: The results showed that mothers received more comfort from human resources than from the environment and modern equipment. Despite the need for specialized midwife with modern technical facilities, this issue shows the importance of highlighting the role of midwife and humanistic midwife care. Therefore, considering midwives and the standardization of human resources in health centers are more important than physical standardization. This will result in midwife interventions being performed with real understanding of the patients' needs.

Evaluation of oxidant-antioxidant balance and total antioxidant capacity of serum in children with urinary tract infection.

BACKGROUND: Urinary tract infection (UTI) is the most common bacterial infections in children. This studyaimed to investigate the oxidative and antioxidate status of plasma in patients with UTI and to compare them with those of the controls. METHODS: This case-control study of 50-75 children in the given order was performed in 2013 at the Pediatric Clinic of infections in Zahedan Hospital of Ali Ibn Abi Talib. The antioxidative status of plasma were evaluated by measuring the total antioxidant capacity (TAC) The oxidative status of samples was assessed by measuring the total peroxide and the oxidative stress index (OSI) levels. The means of the parameters were compared and the relationship among them was determined. Data were analyzed using SPSS 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). Student's t-test and Mann-Whitney U-test were applied in various situations of our questions; 95% confidence interval was considered for the level of significance. RESULTS: The results showed that total oxidant serum status in UTI patients was higher compared to controls when total antioxidant serum was lower. The balance of oxidant-antioxidant serum was in favor of oxidant serum and this term was confirmed by OSI. CONCLUSION: Our results showed that the plasma levels of TAC in patients with UTI were decreased compared to controls, and oxidant-antioxidant balance and OSI caused increased OS in patients.

Comparison between procalcitonin, brain natriuretic peptide, and uric acid in children with cardiomyopathy and controls.

OBJECTIVE: This study was performed to determine the level of procalcitonin, Brain Natriuretic Peptide (BNP), and uric acid in children with cardiomyopathy in comparison with controls and the association with echocardiographic findings. METHODS: The levels of BNP, procalcitonin, and serum uric acid were measured and the amounts of biomarkers compared with echocardiographic findings. RESULTS: In this study mean age of participants was the same (p=0.321). The majority of echocardiographic indices in left and right heart have different means in case and controls (p<0.05). Means of BNP, procalcitonin, and uric acid were 213.814 ± 309.601, 9.326 ± 3.881, and 6.846 ± 1.814 for case group and 2.76 ± 1.013, 1.851 ± 1.466, and 3.317 ± 0.924 for control (p<0.001), respectively. In the patients group there was relationship of Ross classification with BNP (χ (2) = 15.845, p<0.05) and with age (χ (2) = 8.946, p<0.05). For uric acid and procalcitonin no significant relationships were observed. CONCLUSIONS: Procalcitonin, uric acid, and BNP had significant relationship with many echocardiographic findings in participants. For patients, procalcitonin did not show correlation. The severity of illness based on the Ross classification showed significant correlation with BNP level and age in patients.

Combination of erythromycin and propranolol for treatment of childhood cyclic vomiting syndrome: a novel regimen.

AIM: This study aimed to evaluate the erythromycin efficacy in childhood cyclic vomiting syndrome. BACKGROUND: Cyclic vomiting syndrome (CVS) is an unusual cause of episodic emesis in children and erythromycin is an effective treatment. PATIENTS AND METHODS: In this prospective study, 301 patients with a final diagnosis of CVS enrolled in two separated groups. The first group received erythromycin for 7 days and propranolol for at least 9 months (n=155). The second group was treated with propranolol alone for at least 9 months (n=146). These two groups were compared for response to the treatment and the recurrence of symptoms after treatment completion. Relationship of response, recurrence, and characteristics of the disease was assessed. RESULTS: Both groups showed a significant difference in terms of response to treatment (P=0.002), however the recurrence after treatment completion had no considerable difference (P=0.563). There was no relationship between CVS characteristics and these two items (response and recurrence). CONCLUSION: In our point of view, the addition of erythromycin to standard propranolol treatment can improve the response to treatment, although it has no significant effect on recurrence of CVS symptoms. We suggest the use of erythromycin for 7 days in addition to CVS standard therapy.

Echocardiographic findings before and after surgical repair of Tetralogy of Fallot.

OBJECTIVE: To compare echocardiographic findings before and after surgical repair of Tetralogy of Fallot. METHODS: The interventional study was conducted in Ali-ebne-Abitaleb Hospital, Zahedan, Iran, from September 2008 to March 2010, and comprised patients undergoing surgical repair of Tetralogy of Fallot. Physical examination, chest radiography and electrocardiography were done before echocardiography. Data were analysed by using SPSS 20. RESULTS: Of the 30 patients, 10(33.3%) were girls and 20(66.6%) boys, with an overall pre-surgery mean age of 47.40±21.34 months and 74.46±20.63 months post-surgery (p=0.001). The mean duration of post-operative period was 37.86±18.27 months. The results for right heart showed that Z scores for peak E velocity, peak A velocity, pre-ejection period, isovolumic relaxation time, myocardial performance index and isovolumic contraction time were significantly different (p<0.05). In the left heart, aortic, left atrium, left ventricular end-systolic dimension, left ventricular end-diastolic dimension, deceleration time, Peak E velocity/Peak A velocity, Peak E velocity, Peak A velocity, pre-ejection period/ejection time, pre-ejection period, shortening fraction and ejection fraction had significant difference (p<0.05). CONCLUSIONS: Right ventricular performance indices can serve as valuable parameters in assessing cardiac performance.

Serological Evaluation of Celiac Disease in Children with Congenital Heart Defect; A Case Control Study.

BACKGROUND Due to the increased prevalence of celiac disease in chromosomal anomalies and other congenital anomalies, this study was conducted to evaluate the seroprevalence of celiac disease (CD) in patients with congenital heart defects (CHD). METHODS This case-control study was done on 1002 children in two groups of CHD patients (n=402) and controls (n=600). The serum tissue transglutamianse (TTG) levels were investigated. The two groups were compared in terms of TTG IgA levels and p<0.05 was considered as the significant level. RESULTS The means of serum TTG IgA levels in children with CHD and the control groups were 19.17±46.67 and 7.77±10.02 u/mL respectively (p=0.001). After ANOVA analysis a significant difference between two cyanotic and acyanotic subgroups of cases and control groups was observed (p=0.000). The follow up tukey test showed only non-significant difference between the cyanotic and acyanotic cases. The frequency of TTG IgA with the consideration of 20 u/mL as cut-off point showed a significant association with groups (X2=28.31 and p=0.000). CONCLUSION According to the results the serum TTG IgA levels were significantly higher in patients with CHD than normal children and screening for CD in children with CHD is recommended.

Clinical characteristics and mortality risk prediction in children with acute kidney injury.

BACKGROUND: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. OBJECTIVE: AKI is a serious condition in critically ill patients. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of AKI in the Pediatric Intensive Care Unit (PICU). MATERIALS AND METHODS: This prospective observational study was conducted in the PICU of a hospital in the South-east Area of Iran (Zahedan City), to study the clinico-etiological profile of AKI (defined according to the AKI network criteria). Over a period of 20 months from April 2012 to December 2014, 303 children were included in the study. Both the groups of patients, those who developed AKI and those who did not develop AKI, were then followed during the course of their hospital stay. RESULTS: There were 303 cases included in the study, with the incidence rate of AKI of 14.9% in PICU. The most common PICU admission diagnoses in AKI were neurologic 85 (%28.05), followed by heart diseases 52 (17.18%) and 31 (10.23%) for respiratory diseases. AKI was 43.5 and 5.4 times more prevalent in renal and endocrine patients compared to those with heart disease respectively. The mortality rate was estimated to be higher in patients with AKI compared to their counterparts (40% vs. 17.8%). Chance of death increased in patients with AKI (odds ratio = 3.04). CONCLUSION: AKI is a serious problem, but its true incidence is unknown. Understanding the epidemiology of AKI by using of standard definition help us to find high-risk children that are the first step to improve outcomes. The future multiple-center study may benefit by better identifying risk factors and early detection of AKI by using biomarkers novel to prevent the developing of AKI.