فهرست مطالب

  • Volume:11 Issue: 2, 2020
  • تاریخ انتشار: 1399/01/29
  • تعداد عناوین: 9
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  • Fahimeh Ehsanipour, Elahe Norouzi *, Nastaran Khosravi, Hosna Mirfakhraee Page 1
    Background

    Neonatal jaundice is a common major problem; on the other hand, it is suggested that there is a correlation between plasma magnesium concentrations and hyperbilirubinemia during the neonatal period.

    Objectives

    The study aims to validate a previously reported risk index for predicting the magnesium level of plasma for moderate to severe hyperbilirubinemia in infant neonates.

    Methods

    A cross-sectional correlation study was performed on 93 term newborns with indirect hyperbilirubinemia admitted in neonatology unit of a children hospital and plasma magnesium level of moderate to severe Neonatal hyperbilirubinemia were determined, and statistical analysis was performed.

    Results

    Authors did not find any statistically meaningful positive or negative correlation between plasma Mg level and bilirubin in patients studied; however, comparison of Mg level in two groups of severe and moderate hyperbilirubinemia showed decreased dispersion of medium Mg level in the severe group.

    Conclusions

    Serum magnesium concentration is not useful in anticipation of which newborn infant will develop hyperbilirubinemia.

    Keywords: Newborn, Magnesium, Hyperbilirubinemia, Bilirubin, Jaundice
  • Mehri Ayati, Ziba Mosayebi, Amir Hossein Movahedian* Page 2
    Background

    Perinatal risk factors may contribute to the development of childhood type 1 diabetes.

    Objectives

    This study aimed to evaluate the possible correlation between some perinatal risk factors and the development of diabetes in children.

    Methods

    A case-control study was designed in a Children’s Medical Center. We enrolled 100 children aged 2 - 15 years with the diagnosis of type 1 diabetes and the equal number of age and sex-matched healthy children. We used a questionnaire to collect data regarding some perinatal risk factors such as gestational diabetes mellitus, parental history of diabetes, parental age, preeclampsia, parental smoking, mode of delivery, gender, birth weight, gestational age, order of birth, type of feeding in neonates, and history of prior admission in hospitals during the neonatal period.

    Results

    Children who were exposed to maternal gestational diabetes and preeclampsia were at the increased risk of developing type 1 diabetes with odds ratios of 3.789 and 3.150, respectively. Children with a birth weight of above 4 kg had an increased risk of childhood diabetes with an odds ratio of 4.25. There was no significant association between the other risk factors and the development of childhood diabetes.

    Conclusions

    Avoidance of predisposing factors, appropriate prenatal care, educational programs for improving awareness and knowledge in parents are simple, effective preventive strategies to reduce the risk of type 1 diabetes in children.

    Keywords: BirthWeight, Gestational Diabetes, Perinatal Risk Factors, Preeclampsia, Type 1 Diabetes
  • Nastaran Khosravi, Abulhassan Divband, Nasrin Fathabadi, Nasrin Khalesi, Manije Sahlani , Monireh Monfaredi, Arash Bordbar * Page 3
    Background

    Mercury is a one of the pollutant that can cross the placenta. Contamination by mercury in mothers and their neonates is associated with many problems.

    Objectives

    This study aimed to compare mercury levels of cord blood in term and preterm neonates in Akbarabadi Hospital, Tehran, Iran, 2014.

    Methods

    In this analytical cross-sectional study, we evaluated 50 term and 50 preterm neonates who were born in Akbarabadi Hospital in 2014. Necessary information including mother’s age, location, mother’s job, use of amalgam, use of fish, use of blood products and level of mercury were collected. Data were entered into SPSS V.16 and analyzed.

    Results

    Mean age of mothers was 30.1 (SD = 6.4) years. Location in 86 (86%) were Tehran and in 14 (14%) were out of Tehran. Mean of mercury in neonatal cord blood was 2.7 (SD = 1.3) g/L. There was significant difference between this mean in term and preterm neonates (P value = 0.009), while mean of mercury level in term neonates was 2.3 (SD = 0.7)g/L and in preterms was 3 (SD = 1.7)g/L. Mean of using fish in term neonates was1.2 (SD = 1.3) and in preterms was 1.6 (SD = 2.5). We could not find any significant difference between mercury level and using amalgam, fish and blood products in term and preterm neonates (P value > 0.05).

    Conclusions

    Mercury level of cord blood in our study was higher compared to other studies, although it is not in the level of toxicity. Also we found that mercury level in preterm neonates is significantly higher than term neonates, therefore evaluating factors affecting mercury levels in neonates is essential.

    Keywords: Neonate, Term, Preterm, Mercury
  • Reza Aminnejad *, Hamed Shafiee **, Amrollah Salimi, Mohammad Reza Hoseini Amini Page 4

    Gastric rupture is responsible for 7% of all gastrointestinal perforations in neonates and has a poor outcome and it can be lethal. There are many situations such as prematurity, asphyxia, excessive respiratory resuscitations and other conditions leading to this condition. We introduce a 2-day-old premature neonate (male) with abdominal distension following nutrition and then we will discuss the anesthetic care for him.

    Keywords: Gastric Rupture, Spontaneous Perforation, Stomach, Neonate, Anesthetic Care
  • Iraj Sedighi, Shahla Nouri, Mohammad Kazem Sabzehei*, Mahta Sangestani, Younes Mohammadi, Jalaledin Amiri, Behjat Qazanfarzadeh Page 6
    Background

    Congenital anomalies are considered as one of the major causes of neonatal death. The prevalent pattern of congenital anomalies may vary diachronically or geographically. With regard to the pervasiveness of under-five mortality (probability of dying between birth and exactly 5 years old) in Hamadan province in the recent years, the present study intended to determine the risk factors of congenital anomalies of newborns in Hamadan province in 2017.

    Methods

    The present case-control study was conducted in the hospitals affiliated to Hamadan University of Medical Sciences for 6 months in 2017. The study targeted all the newborns from birth to hospital discharge. The neonatal cases with congenital anomalies were identified through clinical examination. A report sheet was assigned to a healthy newborn, as a control, per each case of congenital anomalies born on the same day and in the same hospital. Once data was collected, they were statistically analyzed by means of SPSS V. 16 software.

    Results

    According to the current results, the prevalence of congenital anomalies was 0.85% (8.5 per 1,000 live births). Genitourinary (40%), musculoskeletal (25.2%), eye, ear and neck (18.5%), chromosomal (5.9%), respiratory tract (3.7%) and cardiovascular system (2.2%) were the most common congenital anomalies, respectively. Consanguineous marriage, concomitant use of contraceptive methods and male sex were found to be the most important risk factors for congenital anomalies.

    Conclusions

    The present study aimed at identifying the various types and prevalence of congenital anomalies in Hamadan province. Regular prenatal examination and early diagnosis for prevention, early intervention and scheduled termination of pregnancy are recommended. Besides, public awareness of the disadvantages of consanguineous marriage and other pertaining risk factors affecting the incidence of congenital anomalies is also recommended.

    Keywords: Risk Factors, Congenital Anomalies, Newborns
  • Alireza Sadeghnia, Nasrin Hashemian Nejad, Shadi Noorizadeh, Ehsan Shahrestanaki, Zahra Jamshidi, Hassan Salehipoor *, Mohammad Sahebkar Page 7
    Objectives

    To compare the serum bilirubin level of neonates under phototherapy with two methods of transcutaneous (TcB) and total serum bilirubin measurement (TSB).

    Methods

    This descriptive-analytical study was conducted on the icteric term and late preterm neonates in Sabzevar, Iran between Oct 30, 2016, and Aug 7, 2018. Within 24 hours of birth, the TcB and then TSB of the neonates were measured before and after phototherapy. The TcB was performed using BiliCheck (KJ-8000 Transcutaneous Jaundice Meter) during phototherapy, at the forehead between the two eyebrows and the middle part of the sternum which were covered by a white 3 × 3 cm gauze.

    Results

    200 neonates were eligible, the bilirubin level of 50.5% of male infants were ranging from 15 to 18 mg/dL of serum. The correlation for serological-transcutaneous frontal tests was 0.74, 0.82, 0.76, and 0.55 for the first to the fourth day, respectively, versus to 0.71, 0.91, 92 0, and 0.69 for the mentioned days for serological-transcutaneous sternal tests. Based on Bland-Altman and intraclass correlation coefficient (ICC) methods for four days; although the correlation between the two methods is high on the first day in both areas, the value of reduction is greater on day four in the frontal area.

    Conclusions

    Our findings revealed that the covering of sternal and frontal areas does not affect the correlation between the TcB and TSB methods. Also, TcB in the absence of TSB could be a good alternative in order to measure the level of bilirubin.

    Keywords: Transcutaneous Bilirubin (TcB), Total Serum Bilirubin (TSB), Jaundice, Neonatal, Iran
  • Mojtaba Kamali Aghdam, Akefeh Ahmadiafshar, Kambiz Eftekhari Page 8
    Introduction

    Toxic Epidermal Necrolysis (TEN) is a severe disease with high mortality, which can occur following the administration of some drugs such as antibiotics, anticonvulsants and non-steroidal anti-inflammatory drugs (NSAIDs). The condition is rare in children; therefore, providing a therapeutic experience and methods of care can be very helpful in similar cases.

    Case Presentation

    A 32-month-old girl (2.8 years) was admitted at Mousavi Hospital of Zanjan (Iran) presenting weakness, illness, scattered macular lesions on the trunk and extremities, and several blisters on the trunk. He had a history of upper respiratory tract infection and had been administered a diclofenac suppository for fever. All the clinical manifestations appeared after diclofenac administration. The lesions rapidly progressed to extensive cutaneous necrosis with the involvement of more than 70% of the body surface. He was treated with high-dose intravenous immunoglobulin (IVIG), corticosteroid, and conservative management. Fortunately, the child was discharged in good general condition approximately one month after the onset of the illness.

    Conclusions

    Diclofenac can cause TEN in children, even in single doses and in suppositories. The most important prognostic factors include supportive therapy, contact isolation, hand hygiene, and administration of high dose IVIG for at least three days.

    Keywords: Children, Diclofenac Suppository, Toxic Epidermal Necrolysis Syndrome
  • Amir Pirooz, Gelareh Biazar *, Farnoush Farzi, Mohammad Reza Habibi Page 9

    Recurrent congenial diaphragmatic hernia (CDH) causes challenging conditions. In spite of several advantageous of laparoscopic surgery, this method is associated with the higher risk of recurrence. We described a three- month infant with a recurrent CDH following a successful laparoscopic repair. First, he did not have any specific symptoms and was at a high risk of misdiagnosis. He underwent an emergency surgery with proper surgical and anesthesia management. In order to achieve desired goals in CDH recurrence cases, an early diagnosis, urgent intervention, and a constant communication between the surgeon and the anesthesiologist are crucial. The parents should also be informed about the potential risks of recurrence after even a successful surgical repair.

    Keywords: Congenial Diaphragmatic Hernia, Recurrence, Repair