فهرست مطالب kamyar kamrani

Cardiac troponin I (cTn I) has been demonstrated as a possible useful biomarker for myocardial injuries. The present study aimed to evaluate potential relationships between this biomarker and neonatal morbidities among preterm neonates.

This cohort study was carried out at an Iranian Hospital (Tehran-Iran; 2021). Newly-born preterm neonates entered the study. Blood sampling was performed immediately after neonatal intensive care unit (NICU)  admission and sent to the laboratory to detect levels of plasma cTnI. The correlations between the levels of plasma Tn I and each neonatal outcome were evaluated as the primary outcome.

A total of 101  NICU hospitalized neonates with the mean gestational age, 1st, and 5th minutes Apgar scores of 33.750±2.125 (Range: 29-37) weeks, 7.6471±1.766, and 9.188±1.205 entered the study. The mean and median of Troponin I levels were 0.131±0.126 and 0.0920 ng/ml. The results pointed out that neonates who died during hospitalization or required CPR (cardiopulmonary resuscitation) had lower troponin I in comparison with their controls; nonetheless, the differences were not significant (P=0.950 & P=0.557). The mean±SD of troponin I was not significantly different between neonates with and without PDA (p=0.741), asphyxia (P=0.298), and intubation (P=0.212). The occurrences of necrotizing enterocolitis, respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, and sepsis were not also significant factors for the alteration of troponin I (P>0.05).

Since there were no relationships between cTn I and neonatal outcomes, great caution should be implemented regarding the use of single cTn I value as a diagnostic marker for short-term neonatal adverse outcomes. Further investigations with larger sample sizes are strongly suggested.

Neuro-developmental delay (NDD) is a chronic neurologic problem that adversely affects the quality of life of affected individuated. The aim of this study was to compare magnetic resonance imaging (MRI) findings in patients with global developmental delay (GDD) and Isolated NDD and evaluate their efficacy in diagnostic approach to children with NDD.

A cross-sectional study was designed to enroll all patients with static developmental delay who had been referred to outpatient neurology clinic at Bahrami hospital, Tehran, Iran, between Feb 2012-Feb 2013. Neurologic examination results and the presence of GDD or Isolated NDD in patients were recorded using of a pre-prepared questionnaire, Bayley Scales for Infants and Toddler-4th edition and Denver Developmental Screening Test.

Totally 140 patients with developmental delay were enrolled during the study. 70 patients (50%) had global developmental delay (GDD), and 70 cases (50%) had Isolated NDD. In addition, abnormal associated neurological symptoms were present in 67.9% of patients. Patients whit GDD had significantly probability of abnormal MRI compare to patients with isolated NDD (P<0.001). Furthermore, a great proportion of positive MRI findings was reported from patients with Isolated motor NDD (P=0.007). Microcephaly was the most abnormal neurologic finding in patients with GDD (P=0.04).

A significant proportion of abnormal MRI findings in patients with global developmental delay, confirms the necessity of imaging diagnostic tool, especially brain MRI, in diagnostic approach to patients with GDD. In addition, the benefit of brain MRI in diagnostic approach to children with isolated NDD seems to be low.

Background The esophageal atresia (EA) is the most common esophageal congenital anomaly. The aim of this study was to evaluate the predictive factors in the survival of newborns with esophageal atresia. Materials and Methods This was a descriptive-analytic cross-sectional study performed on newborns with esophageal atresia who were admitted at Bahrami children’s hospital, Tehran-Iran, during 7 years (2009-2015). The patient’s information was collected from their medical records and recorded in a checklist. The variables of the checklist included: age, sex, gestational age, birth weight, congenital anomalies, duration of mechanical ventilation, duration of hospitalization, respiratory distress syndrome (RDS), and age at surgery, complications, and cause of death. Then, the relationship between different variables was evaluated with mortality and morbidity and the factors that had the greatest impact on patients' prognosis were identified. The study included 95 neonates with EA. Fifty-three (55.8%) were male. The most common anomalies were cardiac (38.9%), renal (15.8%), and skeletal (9.5%). The most common postoperative complication was pneumothorax (31.6%), pneumonia (25%), and stenosis at the site of anastomosis (21.1%). In this study, 15 children died (mortality rate 15.7%), and the most common cause was sepsis. There was a significant relationship between birth weight and death, pneumothorax (P=0.008, and P=0.037, respectively). There was no significant relationship between gestational age and mortality (P>0.05). There was a significant relationship between major cardiac anomalies and duration of mechanical ventilation and mortality (P= 0.043, and P<0.001, respectively). Conclusion This study showed that neonates with esophageal atresia, low birth weight, major cardiac anomalies and the need for prolonged mechanical ventilation are poor prognosis predictor factors.

Hypernatremia might lead to neurological and developmental disabilities. This study aimed to determine the frequency, risk factors, and one-year neurological prognosis of hypernatremia in newborns. The findings of the present study may assist the prevention of hypernatremia mortality and complications.
This cross-sectional study was conducted on all neonates admitted to the neonatal ward and the Neonatal Intensive Care Unit (NICU) of Bahrami Children's Hospital, Tehran, Iran from September 2013 to September 2014. All the newborns, who were diagnosed with hypernatremia (serum sodium>150 mEq/L) were included in this study. The data were collected using a form, which included clinical symptoms and risk factors for neonatal hypernatremia in addition to the laboratory data. Additionally, the patients were subjected to the developmental examination for one year. Another form was used during the follow-up period to collect all the relevant data.
A total of 1,923 newborns were examined in the present study. The results demonstrated that 74 (3.8%) neonates had sodium levels of >150 mEq/L. Furthermore, jaundice was found to be the most prevalent presentation of hypernatremia, which was reported in 57% of the admitted neonates. Additionally, weight loss was the most common observation on the follow-up examinations. Neonates admitted at older ages (>7 days) had higher sodium levels (160.71±8.98 mEq/L). There were 18 neonates with seizures before or during the hospitalization and 19 (25.7%) cases showed abnormal development during the one-year follow-up. Moreover, a statistically significant relationship was observed between the abnormal development and the presence of seizure (OR: 2.543, CI: 1.358-4.763).
The findings of the current study demonstrated the critical role of weighing the newborns 72-96 h after birth and monitoring for jaundice in the prevention of the neonatal hypernatremia. Furthermore, seizures in these patients were associated with an increased risk of future developmental problems; however, more studies are required in this regard

Evaluation of magnesium levels in serum and cerebrospinal fluid of patients with febrile convulsion (FC) hospitalized in Bahrami hospital in Tehran in 2010-2011. In the past, decreased levels of magnesium in serum and CSF of patients with FC were reported. The purpose of this study was to identify the possible role of magnesium in febrile seizures in children. Identifying this condition, we may control seizures and also prevent subsequent convulsion. In this cross-sectional study, inclusion criteria were the existence of convulsion due to fever and exclusion criteria were having a known neurological disease which could induce a seizure, and children younger than one month. In each group (cases include children with febrile convulsion and controls include febrile children without convulsion), Mg was measured in blood, and cerebrospinal fluid of 90 children and then they were compared. The data were analyzed by SPSS (α=0.05). The mean serum and CSF levels of Mg in case and control groups were equal (P<0.87 and P<0.22 respectively). There was no difference between two groups in terms of sex, but mean age was significantly different (P<0.003). There was not an association between serum and CSF levels of magnesium and the presence of FC. Therefore, it’s not suggested to measure the level of magnesium in serum or CSF in children with fever routinely.

Altered mental status is a common cause of intensive care unit admission in children. Differentiating structural causes of altered mental status from metabolic etiologies is of utmost importance in diagnostic approach and management of the patients. Among many biomarkers proposed to help stratifying patients with altered mental status, spinal fluid lactate dehydrogenase appears to be the most promising biomarker to predict cellular necrosis. In this cross sectional study we measured spinal fluid level of lactate dehydrogenase in children 2 months to 12 years of age admitted to a single center intensive care unit over one year. Spinal fluid level of lactate dehydrogenase in 40 pediatric cases of febrile seizure was also determined as the control group. The study group included 35 boys (58.3%) and 25 girls (41.7%). Their mean age was 2.7+/-3 years and their mean spinal fluid lactate dehydrogenase level was 613.8+/-190.4 units/liter. The control group included 24 boys (55.8%) and 19 girls (44.2%). Their mean age was 1.3+/-1.2 years and their mean spinal fluid lactate dehydrogenase level was 18.9+/-7.5 units/liter. The mean spinal fluid lactate dehydrogenase level in children with abnormal head CT scan was 246.3+/-351.5 units/liter compared to 164.5+/-705.7 in those with normal CT scan of the head (p=0.001). Spinal fluid lactate dehydrogenase level is useful in differentiating structural and metabolic causes of altered mental status in children.

Dicephalic parapagus tribrachius conjoined twin is a very rare condition.We present a case of 5-days-old male dicephalic parapagus conjoined twins. The conjoined twins were diagnosed in 4th month of pregnancy by ultrasonography. The pregnancy terminates at 36 weeks by cesarean section and triplets were born. The babies were male conjoined twins and another healthy male baby. Many congenital defects of interest can now be detected before birth. Sever form of this malformation precludes postpartum life. It is supposed that with advances in screening methods for prenatal diagnosis these cases are terminated in first or second trimester of pregnancy.

Cutis laxa (CL) is a rare congenital and acquired disorder characterized by loose and redundant skin with reduced elasticity. Three types of congenital cutis laxa have been recognized. Other findings are pulmonary emphysema, bronchiectasia, hernia and diverticulosis. We describe a female neonate involved by cutis laxa syndrome and a positive family history. We focus on the radiologic findings of this case such as multiple bladder diverticulosis, GI diverticulosis and very rare accompanying hypertrophic pyloric stenosis (HPS)..