فهرست مطالب morteza danaeian

Life-threatening intracardiac thrombosis is rare. Intracardiac thrombosis may affect neonates from the first months of life. Because of the potential risk of serious bleeding, the use of recombinant plasminogen activator (rt-PA) in neonates along with heparin is controversial.

 We reported a 37- day- old term infant presented with fever, restlessness, malaise, and respiratory acidosis. Right atrial thrombose was identified by ECHO, results of laboratory tests, and examination. She was successfully treated with rt-PA and rivaroxaban.

Early echocardiographic detection before the clot grows large and organized, allows complete, safe, and rapid thrombolysis with rt-PA and rivaroxaban.

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.

To evaluate fetal cardiac changes in gestational diabetic mothers, compared to healthy ones by means of different indices and to determine which index can first represent the alterations. The study was conducted as an observational cross-sectional study, including 25 pregnant women with gestational diabetes as the cases and 50 healthy pregnant women as the controls. The preload index, left and right side myocardial performance index (MPI), Interventricular septal hypertrophy, the left and right side cardiac output were assessed in all the patients. The gestational ages were 31.65 ± 8.02 and 31.64 ± 5.37 weeks in case and control group respectively, without any significant difference. Both of the left and right ventricular MPI did not differ statistically between the case and controls. The cases had a greater Interventricular septal hypertrophy but the cardiac output was similar. The preload index was higher in the fetuses of the gestational diabetic mothers. In our study, the MPI did not show any difference between the fetuses of the gestational diabetic mothers and non-diabetic ones; but, fetuses of gestational diabetic mothers had a greater value of PLI, representing early diastolic function changes in right heart even before the overt heart failure occurred. This could be a sign of vasculopathy in gestational diabetic mothers.

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.