Iranian Journal of Neonatology
Volume:7 Issue: 3, Summer 2016

Ophthalmia neonatorum (ON) also known as neonatal conjunctivitis is inflammation of the conjunctiva caused by aseptic or septic factors. It commonly affects newborns usually within the first month of life. This study aimed to determine the prevalence and socio-demographic characteristics of ON in Calabar, Nigeria.
We retrieved all the clinical case notes with diagnosis of ON from the Neonatal Unit of University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria, during 1st January 2012-31st December, 2014. The extracted information included age at presentation, gender, socio-demographic characteristics, conducted investigations, treatment, and outcome. Data was analyzed using SPSS, version 20.
Out of a total of 3198 admissions, 34 (1.1%) had ON, most of whom were females (58.8%), and 21(61.8%) of the cases were admitted to the out-born neonatal unit. Eye swabs were taken from only 18 (52.9%) cases for microscopy, culture, and sensitivity prior to antibiotics initiation, from which no organism was isolated. Parents of the studied neonates were mainly from low and middle socioeconomic classes.
Determination of organisms responsible for ON is of paramount importance. Therefore, hospital delivery and maternal education on this condition should be considered as priorities. In addition, clinicians are suggested to take regular eye swabs for microbiological investigations prior to initiation of treatment.

Clofibrate is a pharmacological agent, which affects the lipid metabolism. This compound could be involved in bilirubin accumulation and excretion process. Therefore, this study aimed to evaluate the effect of oral clofibrate intake on total serum bilirubin (TSB) of neonates hospitalized at Khatam Hospital.
This clinical trial was conducted on 73 neonates with hyperbilirubinemia. Samples were divided into clofibrate (n=41) and control (n=32) groups. In the Clofibrate group, samples were given a single oral dose of 100 mg/kg clofibrate, whereas the control group received distilled water in an equal amount and color as placebo. Birth weight, type of delivery, gender, age and primary TSB level were recorded prior to the intervention and TSB was measured 24, 48 and 72 hours after the intervention.
In this study,no significant difference was observed between the groups on the first and third day of intervention in terms of mean TSB in neonates. However, a significant reduction was found on the second day in mean TSB of neonates, who received clofibrate (P=0.04).
According to the results of this study, application of clofibrate was associated with faster alleviation of mean TSB and shorter duration of hospital stay without major side effects. Therefore, it is recommended that clofibrate be only used for clinical management of neonatal hyperbilirubinemia.

Thyroid function disorders, particularly congenital hypothyroidism (CHT), are important endocrine dysfunctions associated with permanent morbidities. CHT is more prevalent among preterm low-birth-weight neonates compared to term infants with normal weight.
This prospective cohort study was conducted on 126 very-low-birth-weight (VLBW) neonates referred to the neonatal intensive care units (NICUs) of two tertiary referral hospitals affiliated to Isfahan University of Medical Sciences in Isfahan, Iran during 2012-2014. On day five of birth and two, four, and six weeks after birth, blood samples were collected from the infants to determine thyroid function disorders, including transient hypothyroxinemia, neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia.
In total, 126 infants with mean gestational age of 30.5±2.29 weeks and mean birth weight of 1246.90±193.58 g were enrolled in this study. Thyroid-stimulating hormone (TSH) level of
According to the results of this study, thyroid function disorders are relatively common in preterm VLBW neonates, and serum T4 level is correlated with gestational age in these infants. Therefore, thyroid function tests with a consistent protocol are required for premature infants. It is recommended that further research be performed on larger sample sizes to investigate the prevalence of thyroid function disorders in preterm infants.

Propranolol has been recently indicated to inhibit the rapid growth and involution of infantile hemangioma. In the present study, we investigated the efficacy and safety of propranolol in Iranian infants.
A total of 30 infants with indications for medical intervention, such as large hemangiomas, wounds with or without secondary infection, or active trauma-induced bleeding, were selected. First, a total concentration of 1 mg/kg/day was orally administered to the infants; the dosage further increased (2-3 mg/kg/day) in case the infants experienced no adverse effects. Following weekly (one month after treatment) and monthly (up to six months) follow-ups, hemangioma activity score (HAS) was calculated to evaluate swelling, color of the lesion, and ulcer size.
In the present study, infants with the mean age of 5.33±3.50 years received therapy. Improvement was observed in the lesions of all patients, characterized by a significant decline in size, change in color, and reduction in ulcer size (P It seems that propranolol can be considered as an efficacious and safe alternative to other pharmaceutical and surgical interventions for infantile hemangiomas in Iranian infants.

Sacral pit is a shallow or deep dimple in the lower sacral region, with a reported prevalence of 3-5% among newborns. The aim of the present study was to investigate spinal cord abnormalities in newborns with sacral pit via ultrasound examinations.
In this descriptive study, 3071 infants born at 34-42 weeks of gestation were studied in hospitals affiliated to Islamic Azad University of Mashhad, Iran during 2014-2015. Information including age, sex, and birth weight was recorded in a questionnaire. Infants with a sacral pit underwent ultrasonography; spinal shape and mobility in these infants were compared with their healthy counterparts. For statistical analysis, data were entered to Microsoft Excel software. Chi-square and student’s t-test were performed, using SPSS version 20.
Based on the findings, 1.6% of the studied infants were born with a sacral pit. The weight and age were not significantly different between healthy neonates and those with a sacral pit. The prevalence of sacral pit was higher in female cases (54.2%), although there was no significant difference between the genders. Ultrasound examination of the spinal cord revealed its normal position and motility in all newborns with a sacral dimple.
The present results showed the normal shape and motility of the spinal cord in newborns with a sacral pit. Therefore, there was no correlation between sacral pit as a cutaneous marker and neural tube defects.

Cutaneous manifestations are commonly observed in the neonatal period. It is important to differentiate physiologic skin lesions from pathologic ones to avoid parents’ concerns. Regarding this, the current study aimed to investigate the frequency and localization of salmon patch (SP) and Mongolian spot (MS) in Iranian newborns to assess the potential relationship between the neonatal and maternal characteristics.
This descriptive cross-sectional study was conducted on one thousand healthy infants born at Al-Zahra University Hospital in the northwest of Iran during August-September 2014. For the aims of the study, the neonates were examined by a pediatrician. The collected data included gender, gestational age, anatomical sites of the lesions (MS and SP), birth weight of the newborns, parental consanguinity, parity, and maternal age. The exclusion criteria included major known congenital chromosomal or metabolic abnormalities, stillbirths, and admission in the Sick Newborn Care Unit or Neonatal Intensive Care Unit.
According to the results of this study, the frequency rates of MS and SP among 1000 newborns were found to be 32.3% and 14.5%, respectively. Maternal age was the only variable which showed a statistically significant relationship with SP (P=0.024). In addition, sacral region and upper eyelid were found to be the most common site of MS and SP involvement, respectively.
MS and SP which are commonly observed in the routine neonatal examination may worry parents regardless of their association with an underlying systemic disorder. Regarding this, we recommend careful examination of the newborns’ skin by pediatrician in the neonatal wards.

Neonatal lupus erythematosus is an uncommon disease. Congenital complete heart block (CCHB) usually happens in neonates with maternal systemic lupus erythematosus. The most prevalent presentation of CCHBis bradycardiathatcanbediagnosed through an electrocardiogram.
Case report: Here in, we present the case of a full-term male neonate with gestational age of 37 weeks and birth weight of 2200 g, whose mother had positive anti-Ro/SSA antibodies. The mother was asymptomatic without any criteria of systemic lupus erythematosus. The newborn presented with bradycardia, respiratory distressand narrow QRS complex without structural heart disease. He was connected to mechanical ventilator and did not need pacemaker implantation.
This case report was conducted on a newborn with CCHB associated with pulmonary disorder. The newborn was intubated due to respiratory distress and did not need pacemaker implantation; however, after 8-month follow up, excellent outcomes were observed. It seems that atelectasis and mechanical ventilation can intolerance, and pacemaker implantation did not need in NLE with CCHB with narrowing QRS complex.

Apparent life-threatening event (ALTE) is a major cause of neonatal emergency visits. In this paper, we presented the case of a three-day-old neonate with multiple indications of ALTE. The patient was referred to the emergency department due to a cyanotic attack before admission. The neonate woke a few hours after breastfeeding and turned blue while crying, which was resolved spontaneously within a few seconds. During ALTE, moderate hypotonia was observed in the neonate, while the physical examination was not remarkable. Primary sepsis workup and electrolyte measurement were performed, the results of which were mostly within the normal limits, with the exception of low levels of calcium, magnesium, and vitamin D. Moreover, the infant had primary hypothyroidism and received treatment with intravenous antibiotics initially accompanied by magnesium and calcium for a few days. Treatment continued with vitamin D and levothyroxine, and the neonate was discharged from the hospital in good overall condition without further ALTE episodes. All infants must be evaluated in terms of common indications of ALTE, such as electrolyte imbalance. In addition, other probable causes of ALTE should be investigated through obtaining a detailed medical history and proper physical examination. According to the literature, neonates are likely to present with more than one manifestation of ALTE.