Journal of Comprehensive Pediatrics
Volume:5 Issue: 4, Nov 2014

Streptococcus agalactiae is a commensal organism, but it may cause infection in susceptible hosts including newborns as well as in pregnant or postpartum women. Applying rapid, accurate and sensitive methods for detecting group B Streptococcus (GBS) and receiving intrapartum antibiotic prophylaxis (IAP) at delivery have been demonstrated to increase the treatment possibility of carrier pregnant women and decrease the rates of GBS vertical transmission to infants. The aim of this study was to compare the PCR assay results targeting 16S rRNA primers with the conventional culture method for direct detection of GBS in vaginal specimens of pregnant women at 35-37 weeks of gestation in Hamadan, Iran.Patients and A total of 203 vaginal specimens of pregnant women at 35-37 weeks of pregnancy from June 2013 through February 2014 were evaluated for detection of GBS, using culture method and polymerase chain reaction (PCR). The prevalence of GBS in the 203 collected samples was 7.39% using culture method and 19.70% using PCR. Twenty-five specimens had positive PCR results and negative cultures; two specimens were positive in culture and negative by PCR.A total of 42 specimens (20.69%) were considered as true positive. The PCR results in comparison with culture (as the gold standard) revealed sensitivity of 88.24%, specificity of 87.44%, positive and negative predictive value of 35.71% and 98.95% respectively, and accuracy of 87.50%. Performing only culture method led to missed false negative carriers. Therefore, it is recommended that both the PCR assay and conventional culture method be routinely performed to detect GBS in pregnant women accurately. PCR diagnosis demonstrated a shorter turnaround time when compared with the time consuming culture method.

Hyperlipidemia is an important risk factor for coronary artery disease. Detection of lipid profile in umbilical cord blood of term newborns could identify neonates with a higher risk of coronary artery disease. The aim of the present study was to improve the existing information about cord blood lipid profile of Iranian term newborns.Patients and This cross-sectional study was conducted on healthy term neonates born from healthy mothers between August and October 2009 in Zanjan, Iran. Ten milliliters of cord blood was collected from the placental end of umbilical vein immediately after the cord clamping. Total cholesterol (TC) and triglyceride (TG) were measured by enzymatic GOD-PAP method with Pars Azmoon kits. High-density lipoprotein-cholesterol (HDL-C) was measured after precipitation of Apo lipoproteins with phosphotungstic acid (PTA). Low-density lipoprotein-cholesterol (LDL-C) was calculated by Friedewald’s formula. Statistical Analysis was performed by the SPSS statistical package version 16.0 for windows. Of the 174 neonates, 97 were female. Vaginal delivery was recorded in 79.8%. There were no significant differences regarding demographic findings between male and female neonates. The mean values of TC, LDL-C, HDL-C and TG were 73.1 ± 26.5, 28.7 ± 11.1, 27.6 ± 10, and 81.4 ± 37.1mg/dL respectively, with no difference between the two sexes. We found a relatively high value of TC and TG in our study. Considering the relationship between high levels of lipids in the neonatal period and coronary artery disease in the adult population, we recommend future cohort studies for this statistical society.

The heel-lancing procedure is a common tissue damaging procedure routinely performed in premature neonates and causes pain. Therefore, efforts should be made to relieve this pain. This study aimed to assess the effect of kangaroo mother care (KMC) for a brief duration of 15 minutes on pain intensity of heel lance in preterm newborns admitted to neonatal intensive care units.Patients and In this clinical trial with crossover design, 64 vitally stable preterm neonates between 30-36 weeks of gestational age, who needed at least two heel lances, were randomly allocated to two groups. In group A, neonates received KMC 15 minutes before, during, and two minutes after the first heel lancing procedure. In group B, neonates were kept in prone position in incubator 15 minutes before lancing. For second heel lancing, the neonates in group A were put in incubator and group B received KMC. Premature Infant Pain Profile (PIPP) was scored during and within two minutes after finishing the procedure in both conditions. The mean score of pain intensity during the intervention was significantly lower in the KMC position (P < 0/000). Mean score of pain intensity at two minutes after intervention was also significantly lower in the KMC position (P < 0/000). KMC before and during heel lancing is a natural, easy to use, and cost-effective method to decrease pain in premature neonates. It is consistent with modern strategy of family-centered care in neonatal units.

Plasma neutrophil gelatinase associated lipocalin (NGAL) level is increased in sepsis irrespective of renal dysfunction. We investigated the effect of sepsis on the plasma level of NGAL in neonates. The aim of this study was to find whether serum NGAL is a reliable marker for early diagnosis of sepsis in neonates.Patients and We conducted a prospective observational study in a university hospital neonatal intensive care unit. Serum NGAL was measured in 120 neonates admitted to the neonatal intensive care unit. Neonates were classified according to the presence of sepsis. Fifty-two Patients had sepsis. The NGAL levels were significantly higher in septic neonates compared with non-septic neonates (102.9 ± 69.9 ng/mL versus 29.2 ± 13.3 ng/mL, P value = 0.0001). An optimal cut off-point of 48 ng/mL for serum NGAL could potentially detect neonates with sepsis with a sensitivity and specificity of 92% and 91%, respectively. Sepsis enhances the production of plasma NGAL in critically ill neonates. Thus Plasma NGAL can help clinicians diagnose sepsis in critically ill neonates during early phases.

Right atrial myxoma is a rare disease among children and its clinical presentation is not specific. We reported a four-year-old girl with exertional dyspnea in whom investigations revealed a huge right atrial myxoma. The evolution was quite unusual; the girl presented syncope secondary to an intermittent prolapse of the tumor through the tricuspid valve. After complete resection, her symptoms were relieved without any recurrence of the tumor. The authors emphasize on the rarity of this pathology among children, its clinical polymorphism, the necessity of a rapid diagnosis, and an appropriate treatment to avoid complications and recurrence of the tumor.