Correlation between Prolonged Hyperbilirubinemia and Serum Zinc Level in Term Neonates
Mousa
Ahmadpour-kacho
Non-Communicable Pediatric Diseases Research Center, Department of Pediatrics, Babol University of Medical Sciences, Babol, Iran.
author
Yadollah
Zahedpasha
Non-Communicable Pediatric Diseases Research Center, Department of Pediatrics, Babol University of Medical Sciences, Babol, Iran
author
Soryia
Khafri
Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran
author
Sajedeh
Omidbakhsh-Amiri
Department of Pediatrics, Amirkola Children’s Hospital, Babol University of Medical Sciences, Babol, Iran
author
Sadra
Tehrani
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
author
text
article
2019
eng
Background: Prolonged hyperbilirubinemia is defined as jaundice persisting more than two and three weeks of life in term and preterm neonates, respectively. In total, 15-40% of jaundiced neonates became prolonged. The most common causes of prolonged hyperbilirubinemia are breastfeeding, infection, hypothyroidism, and continued hemolysis. Given the fact that no study was conducted on the association between the serums zinc level and prolonged hyperbilirubinemia, this study aimed to compare the healthy neonates with newborns suffering from prolonged hyperbilirubinemia in terms of serum zinc level.Methods: This cross-sectional analytical descriptive study with a control group included all neonates who had a history of hospital admission and phototherapy due to hyperbilirubinemia at Amirkola Children’s Hospital, Babol, Iran. After discharge, on the 14th day of birth, all neonates followed up at the outpatient clinic. The serum bilirubin was checked and the neonates were assigned into the case (with prolonged hyperbilirubinemia) and control (without prolonged hyperbilirubinemia) groups. Both groups were matched regarding confounding factors. Serum zinc level was measured using the colorimetric method and the two groups were compared in this regard.Results: In total, 60 neonates in the case (n=30) and control (n=30) groups were investigated in this study. The serum zinc levels in the case and control groups were 83.7±35.35 and 92.73±38.13 μg/dl, respectively. There was no significant difference between the two groups in terms of the serum zinc level (P=0.34).Conclusion: There is no statistically significant correlation between the serum zinc level and prolonged hyperbilirubinemia in term neonates who had been treated with phototherapy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
1
5
https://ijn.mums.ac.ir/article_13801_3aeb52bd3750cc3824856f2e55b349ac.pdf
dx.doi.org/10.22038/ijn.2019.37384.1578
Correlation between Lead in Maternal Blood, Umbilical Cord Blood, and Breast Milk with Newborn Anthro-pometric Characteristics
Hossein
Dalili
Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Mamak
Shariat
Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Zeinab
Kavyani
Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Mojtaba
Fazel
Department of Pediatrics, Valiasr Hospital, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran
author
Farima
Raji
Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Fahimeh
Jamali
Department of Midwifery, Iran University of Medical Sciences, Tehran, Iran
author
Vafa
Ghorban-Sabagh
Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
text
article
2019
eng
Background: Breast milk can be a source of toxic material, along with the transfer of nutrients needed for infant growth. This study was conducted to measure the level of lead in maternal and neonatal blood and breast milk in Tehran, Iran.Methods: In this cross-sectional study, 150 mothers and their infants were studied. Samples of maternal blood, fetal umbilical cord blood, breast milk, and amount of lead measured by atomic absorption method were collected. Correlations between lead levels and demographic characteristics of mother and infants were assessed.Results: The mean levels of lead in maternal and neonatal blood and breast milk were 9.79±4.31, 8.29±4.83, and 8.65±3.67 μg/dl, respectively. The different levels of lead were associated with cord blood, maternal blood, and breast milk. No significant relationship was found between lead levels and neonatal parameters (i.e., weight, height, and head circumference). The Spearman's correlation also showed the association between different levels of lead with cord blood, maternal blood, and breast milk. Linear regression also did not show any relationship between lead levels in cord blood, milk, and mother blood with newborn growth parameters.Conclusion: The present study failed to find a significant correlation between lead and newborn birth parameters. In our study, lead levels in maternal blood, breast milk, and cord blood were lower, compared those of the previous years in Iran; however, it needs to decrease, because lead even at very low concentrations may also have adverse effects.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
6
11
https://ijn.mums.ac.ir/article_13804_df23be200e66c3c030d60b45d05d18f6.pdf
dx.doi.org/10.22038/ijn.2019.38763.1610
Relationship between Ureaplasma urealyticum Colonization and Bronchopulmonary Dysplasia in Very Low Birth Weight Premature Infants: A Prospective Cohort Study
Majid
Mahallei
Pediatric Health Research Center of Tabriz, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
author
Mohmmad Bagher
Hosseini
Pediatric Health Research Center of Tabriz, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
author
Heidar
Esmaili
Department of Pathology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
author
Golam Reza
Asadi
Department of Pediatric, Tabriz Branch, Islamic Azad University, Tabriz, Iran
author
text
article
2019
eng
Background: Bronchopulmonary dysplasia (BPD) is the second prevalent lung disease and one of the care challenges of premature newborns. Different risk factors play an important role in the development of this disease. Therefore, the aim of the present study was to investigate the relationship between colonization with Ureaplasma urealyticum and BPD.Methods: This prospective cohort study was conducted in 2017 in the neonatal intensive care unit of Alzahra Hospital in Tabriz, Iran. The samples included newborns weighing less than 1500 g with the gestational age of less than 32 weeks who required intubation within 72 h after birth. Following recording the initial information, the secretions within the trachea were aspirated and Ureaplasma urealyticum was detected in reference laboratory by polymerase chain reaction. Afterwards, we completed a follow-up of 28 days after birth for BPD.Results: Our findings demonstrated that out of 82 infants, 21 cases (26.3%) were excluded from the study due to discharge from hospital or death before the age of 28 days. Among the rest (61 newborns), three cases (4.3%) were shown to have secretions infected with Ureaplasma and 33 cases (54.1%) suffered from BPD. All the three newborns infected with Ureaplasma had BPD. However, no significant relationship was observed between Ureaplasma infection and BPD (P=0.24).According to the analysis of data, the most important factors contributing to BPD among the patients were the gestational age and birth weight. In other words, for one week increase in the age of pregnancy and for each 100 g increase in birth weight, the likelihood of BPD is reduced by 55% and 1%, respectively. In the present study, no relationship was found between Ureaplasma infection and BPD, which might be due to the low prevalence of this infection. Nonetheless, prematurity and low birth weight could be regarded as the two considerable risk factors for BPD.Conclusion: In order to perfectly determine the role of bacterial colonization within the trachea in BPD, collecting and analyzing various samples for the existence of other bacteria are recommended.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
12
18
https://ijn.mums.ac.ir/article_13802_28f0c2c8ce161d368759bca58e85d083.pdf
dx.doi.org/10.22038/ijn.2019.38304.1602
Clinical Assessment of Nursing Care Regarding Prevention of Ventilator-associated Pneumonia in Neonates
Leila
Khanali Mojen
School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Maryam
Rassouli
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Saleheh
Tajalli
Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
author
Ahmad Reza
Baghestani
Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Zahra
Jafari
School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
text
article
2019
eng
Background: Ventilator-associated pneumonia (VAP) is the second common nosocomial infection in NICUs leading to some complications. Nurses are one of the main resources in health care that directly influence neonatal health care. Responsibility of most of preventive strategies related to VAP complications lies with nurses; therefore, nursing care should be assessed until the nurses show standard level of performance in hospitals. The aim of this cross-sectional study, conducted within 2015-2016, was to assess nursing care regarding VAP prevention in neonatal intensive care units (NICUs) in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences.Methods: In this descriptive cross-sectional study, 100 observations of nursing care regarding VAP were selected by convenience method in NICUs of Mahdiyeh, Mofid, and Imam Hossein hospitals affiliated to Shahid Beheshti University of Medical Sciences within 2015-2016. The data collection tools included demographic information questionnaire and a developed checklist related to VAP prevention. The observations were assessed and documented with two sampling methods, including time and event sampling. The data were analyzed in SPSS software (version 16).Results: According to the results of the current study, the rate of compliance of nursing care with the standards for prevention of VAP in neonates under mechanical ventilation in NICU with developed standards was estimated at 62.81 percent.Conclusion: Authorities should pay more attention to nursing cares especially incompetent cares explained in this study to increase the health of hospitalized neonates, decrease complications, length of stay, and costs. Moreover, future research is needed to investigate the reasons of this incompetency.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
19
24
https://ijn.mums.ac.ir/article_13806_31d306f032b76f69eb629da7000aff96.pdf
dx.doi.org/10.22038/ijn.2019.37550.1581
Comparison of the Effect of Yakson Touch and Oral Glucose on the Severity of Phlebotomy Pain in Preterm Infants
Khadijeh
Dehghani
Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Akram
Bagheri Ahmadabadi
Neonatal Intensive Care, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Hossein
Fallahzade
Research Center of Prevention and Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Tahere
Salimi
Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
text
article
2019
eng
Background: Infants are exposed to different painful procedures during hospitalization in the neonatal intensive care unit (NICU). Due to the harmful effects of pain on infants, NICUs require methods by the aid of which the pain in infants can be controlled. Yakson touch and oral glucose are among non-pharmacological methods for pain relief in infants. In this regard, the present study was conducted to compare the effect of Yakson touch and oral glucose on the severity of phlebotomy pain in preterm infants.Methods: In this randomized clinical trial, 99 preterm infants hospitalized in NICU were randomly allocated to three groups, including Yakson touch (n=33), oral glucose (n=33), and control (n=33). In the oral glucose group, 1 cc of 50% glucose was orally given to the infants 1 min before phlebotomy. In the Yakson touch group, touching was performed for 5 min, and then the phlebotomy was performed. The infants in the control group did not receive a specific treatment. Infant pain level was determined before and after the phlebotomy using video recording based on Neonatal Infant Pain Scale. The data were analyzed using the analytical statistical tests, including the analysis of variance, Chi-square, Wilcoxon, and Kruskal-Wallis, in SPSS software (version 20).Results: The mean scores of pain in the two experimental groups were significantly lower than that of the control group (P=0.001), but there was no significant difference between the two experimental groups (P>0.05).Conclusion: According to our findings, both two methods (i.e., Yakson touch and oral glucose) can reduce phlebotomy pain in preterm infants hospitalized in intensive care unit. It is recommended to use Yakson touch in case of lack of access to glucose.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
25
32
https://ijn.mums.ac.ir/article_13805_dca8697f25fa2f01e8b20a855846307e.pdf
dx.doi.org/10.22038/ijn.2019.38769.1614
Determination of the Frequency of Microbial Agents and Drug Susceptibility Pattern of the Neonatal Sepsis in the Neonatal Intensive Care Unit at Alzahra Hospital, Tabriz, Iran
Mohammad Bagher
Hosseini
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Shahram
Abdoli Oskouei
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Fariba
Heidari
School of Medicine, Department of Community and Family Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
author
Amin
Sadat Sharif
School of Medicine, Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
author
Zakeiye
Salimi
Neonatal Intensive Care Unit, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
author
Seyed Amir Abbas
Sharif
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
text
article
2019
eng
Background: Neonatal sepsis is one of the most important causes of infant mortality in developing countries. The causative organisms for sepsis are various in different regions across the world. The aim of this study was to determine the frequency of microbial agents and drug resistance pattern of the neonatal sepsis in newborns admitted to the neonatal intensive care unit (NICU) at Alzahra Hospital Tabriz, Iran.Methods: This descriptive cross-sectional study was carried out from December 2016 to January 2018 in the NICU at Alzahra Hospital Tabriz, Iran. The medical records of all neonates admitted to the NICU were investigated using the convenience sampling method. The data were collected using a two-part demographic form. Subsequently, the data were analyzed in SPSS software (version 22.0).Results: Out of 174 positive blood culture, 52.4% (n=92) and 46.6% (n=82) of Gram-negative (G) and Gram-positive (G) bacteria accounted for the cause of sepsis, respectively. The most common cause of early- and late-onset sepsis was Coagulase-Negative Staphylococci (CoNS), and the most common G-negative and G-positive bacteria were Acinetobacter and CoNS, respectively. The G-positive bacteria showed the most antibiotic susceptibility to Vancomycin (81.45%), Ampicillin (52.15%), and Imipenem (47.32%). On the other hand, the highest drug susceptibility in G-negative bacteria was related to antibiotics, such as Amikacin (73.64%), Imipenem (56.36%), and Ciprofloxacin (52.44%). Moreover, the most antibiotic resistance was associated with Oxacillin (100%), Tetracycline (100%), and Ciprofloxacin (44.4%).Conclusion: The CoNS is the main cause of early- and late-onset sepsis among the neonates admitted to the NICU at Alzahra Hospital, Tabriz, Iran. G-positive and G-negative as causative agents of sepsis showed the highest susceptibility to Vancomycin and Amikacin, respectively.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
33
40
https://ijn.mums.ac.ir/article_13807_07681d4422b01be6c637940034403542.pdf
dx.doi.org/10.22038/ijn.2019.37288.1574
Pattern and Outcome of Newborn Emergencies in a Tertiary Center, Lagos, Nigeria
Patricia
Akintan
Lagos University Teaching Hospital, Lagos, Nigeria/
University of Lagos, College of Medicine, Lagos, Nigeria
author
Iretiola
Fajolu
Lagos University Teaching Hospital, Lagos, Nigeria/
University of Lagos, College of Medicine, Lagos, Nigeria
author
Babyemi
Osinaike
Lagos University Teaching Hospital, Lagos, Nigeria
author
Beatrice
Ezenwa
Lagos University Teaching Hospital, Lagos, Nigeria/University of Lagos, College of Medicine, Lagos, Nigeria
author
Chinyere
Ezeaka
Lagos University Teaching Hospital, Lagos, Nigeria/University of Lagos, College of Medicine, Lagos, Nigeria
author
text
article
2019
eng
Background: Neonatal mortality had not changed significantly in the last decade in African countries particularly in Nigeria; however, under-five mortality had reduced significantly. Nigeria with a quarter of maternal and under-five mortality is among ten countries with the highest neonatal mortality. Previous studies had shown patterns of newborn morbidity and mortality; however, no study has been conducted in this regard recently. The present study aimed to ascertain the current patterns of newborn morbidity and mortality.Methods: A retrospective review of records of all newborn admissions over a period of one year was carried out. Extracted data include age, gender, diagnosis on admission outcome, and cause of mortality. The frequency of morbidity and outcome variables were analyzed and then calculated.Results: The major reason for admission was jaundice 29.6% followed by asphyxia 25%, sepsis 16.1%, and prematurity 9%. The neonatal mortality rate was 12.5% with more than half of the deaths occurring within 24 hours and almost all within 72 hours. Causes of death were asphyxia 58.2%, jaundice 16.4%, sepsis 10 .4%, and prematurity 3%. More than half of the neonates with asphyxia were likely to die within 24 hours.Conclusion: Asphyxia, jaundice, sepsis, and prematurity were the major causes of morbidity. In addition, asphyxia is still a major cause of preventable death in newborns in Nigeria.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
41
46
https://ijn.mums.ac.ir/article_14099_72288698bac086884912865a0c65168e.pdf
dx.doi.org/10.22038/ijn.2019.38272.1612
Assement Efficacy and Complication of the Distance between Phototherapy Lamps and Neonate’s Body Level on Serum Bilirubin Decrease and Phototherapy Complications in Neonatal Hyperbilirubinemia
Roghayeh
Zardosht
Department of Operative Room and Anesthetics, Iranian Research Center on Healthy Aging. School of paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
Ahmad
Shah Farhat
Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Reza
Saeidi
Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Fatemeh
Parvin
Nursing and Midwifery School, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
text
article
2019
eng
Background: Jaundice is one of the most leading causes of neonate hospitalization (51.8%) during the first four weeks of life, and phototherapy is one of the most common and safest methods for the treatment of jaundice. Different results have been obtained from the studies conducted on the investigation of factors affecting increased phototherapy effect on the reduction of neonatal jaundice. However, there still exist many questions concerning the methods that maximize the effect of phototherapy.The current research aimed to determine the effect of the distance between phototherapy lamps and neonate's body on the reduction of serum bilirubin and phototherapy complications in the neonates with physiologic jaundice.Methods: The study was carried out on 60 newborns with jaundice. The neonates in the intervention group were put under phototherapy within a distance of 20 cm, and the ones in the control group underwent phototherapy within a distance of 40 cm. Daily bilirubin was measured at times 0, 12, and 24, and the neonates were examined in terms of serum bilirubin reduction and phototherapy complications.Results: The obtained results revealed that phototherapy within the distance of 20 cm causes more reduction in the total bilirubin 12 and 24 hours after phototherapy. However, there was no significant difference between bilirubin 48 hours after phototherapy and phototherapy duration and the complications between the two groups.Conclusion: Based on the results, the method of phototherapy distance reduction could be used as a safe and effective way for the quicker reduction of serum bilirubin level, prevention of hyperbilirubinemia complications and complications of blood transfusion in neonates with physiologic jaundice.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
47
52
https://ijn.mums.ac.ir/article_14035_cb0c6f9cc13d9754dbf84324fc202358.pdf
dx.doi.org/10.22038/ijn.2019.38470.1607
Neonatal Respiratory Distress in Misan: Causes, Risk Factors, and Outcomes
Hussein Fadhil Musa
Aljawadi
Pediatrics Department, College of Medicine, Misan University, Misan, Iraq
author
Esraa Abd Al-Muhsen
Ali
Pediatrics Department, College of Medicine, Misan University, Misan, Iraq
author
text
article
2019
eng
Background: Respiratory distress is considered one of the most frequent causes of admission in the neonatal unit. Additionally, it is the leading cause of neonatal morbidity and mortality. This study aimed to determine the incidence of neonatal respiratory distress and its causes, risk factors, and outcomes to have a baseline data about the magnitude of respiratory distress with a further step toward the development of the neonatal field.Methods: This cross-sectional study was conducted in the neonatal care unit of Misan Hospital for Child and Maternity in Misan, Iraq, during one year. All the neonates who developed respiratory distress were included in this study according to the World Health Organization criteria.Results: The total number of neonatal admission during the study period was 870 cases among whom 738 (84.8%) subjects developed respiratory distress. The fatality rate was 21%, and the majority of deaths were found in respiratory distress syndrome (RDS) (67.1%). The RDS, transient tachypnea, and birth asphyxia were the major causes of neonatal respiratory distress. Statistically, prematurity, type of delivery, and number of babies at the delivery time were significantly associated with respiratory distress development.Conclusion: The incidence rate of neonatal respiratory distress was apparently high in Misan forming the most common cause of neonatal admission associated with a high mortality rate. Efforts toward preventing the causes and risk factors for neonatal respiratory distress, as well as, improving the efficacy of neonatal care unit are the significant challenges to improve the neonatal care and outcome.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
53
60
https://ijn.mums.ac.ir/article_13799_d5c8d076e545360c2e292bb0bb7d23fd.pdf
dx.doi.org/10.22038/ijn.2019.39348.1626
Knowledge, Attitude and Practice of Mothers about Exclusively Breastfeeding in Sabzevar in 2017
Aghil
Keykhosravi
Department of Pediatrics, Nephrology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
Bita
Barghamadi
Department of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
Rozita
Sabzevari
Department of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
Mohammad
Neamatshahi
Department of Anesthesia, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
Mahboubeh
Neamatshahi
Department of Community Medicine, Faculty of Medicine, Research Center Social Determinants Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
author
text
article
2019
eng
Background: Exclusive breastfeeding is one of the most important issues for public health and Pediatricians in developing countries. Despite the importance of exclusive breastfeeding, only 39% of children in the world are breastfed during the first six months of life.Methods: This study was a Cross-sectional descriptive-analysis conducted on a total number of 396 breastfeeding mothers in 2017.The data collection tool was a structured questionnaire, including demographic information, questions about knowledge and attitude, and performance. We collected the data through face-to-face interview.Results: Based on our results mean and standard deviation of knowledge score of exclusive breastfeeding, attitude, and performance were reported as 7.6±2.4, 43.1±3.3, and 5.1±0.9, respectively.Frequency rates of participants who had high performance, knowledge, and attitude level were, 93.4 % (370), 26 % (103), and 98.5 % (390), respectively.Conclusion: The present study indicated that the majority of mothers had a positive attitude and practice desired however knowledge score was low. Maternal education and relatives was one of the important determinants of exclusive breastfeeding. Health care professionals have important roles in providing suitable fields for these interventions. Using open and extensive questions in other studies can help in finding the causes of breastfeeding cessation during infancy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
61
66
https://ijn.mums.ac.ir/article_13800_e0bb8923eed7b939d6494af7b642bb25.pdf
dx.doi.org/10.22038/ijn.2019.35597.1543
Assessing the Performance of Nurses in the Proper Adjustment of Monitoring Instruments in the Neonatal Intensive Care Unit
Ahmad
Shah Farhat
Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Ashraf
Mohammadzadeh
Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Reza
Saeidi
Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Fatemeh
Chitgar Rahimi
Head Nurse of Neonatal Intensive Care Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Abdul Raouf
Forough
Abu Ali Sina Hospital, Mazarsharif, Afghanistan
author
Azra
Izanloo
Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
author
text
article
2019
eng
Background: Monitoring serves to maintain physiologic variables within normal limits and when a parameter crosses a set threshold, an alarm is triggered. Therefore, this study aimed to determine whether alarm limits are properly adjusted in the neonatal intensive care unit (NICU) by nursing staff or not.Methods: The data concerning alarm limits corresponding to the three shifts of nursing work were recorded for the newborns with cardiorespiratory problems, such as hyaline membrane disease, transient tachypnea of the newborns, and pneumonia, who were admitted to the NICU of Imam Reza Hospital, Mashhad, Iran during March 2016-December 2016.Results: The findings of this study showed that 75.1% of the 95 subjects of this study were preterm infants, while the others were cases with a gestational age of more than 37 weeks. The mean birth weight of the neonates was 1939.15±899.2 g. The upper alarm limit of pulse oximetry (95%) had been set correctly just in almost 26% of the patients. On the other hand, only at about 21% of all the cases, a normal lower alarm limit (85%) was observed for this variable. Compliance with the normal lower and upper limits of alarm for heart rate (i.e., 90 and 180 beats/min, respectively) was reported only in 10.46% and 18.6% of the infants, respectively.Conclusion: This study revealed that the alarm limits in NICU for unstable neonates were frequently set outside the normal range.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
67
70
https://ijn.mums.ac.ir/article_13295_0ca47b90119bb509c98c5825a17a89cb.pdf
dx.doi.org/10.22038/ijn.2019.32615.1458
Prediction of Respiratory Morbidities in Late Preterm Neonates Using Cord Blood Arterial Lactate and Base Excess
Farooq
Syed
Department of Paediatrics, Kodagu Institute of Medical Sciences and Teaching Hospital, Madikeri, Karnataka, India
author
Sandesh
Kini
Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
author
Leslie
Edward Lewis
Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
author
Ramesh
Bhat Y
Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
author
Jayashree
Purkaystha
Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
author
text
article
2019
eng
Background: Late preterm neonates may have the external appearance and behavior similar to their counterparts.However, they are susceptible to various neonatal morbidities , due to their physiological and metabolical immaturity.To assess the correlation between cord blood arterial lactate levels and base excess with the development ofrespiratory distress in late preterm neonates.Methods: All inborn neonates born at Kasturba hospital Manipal, satisfying the criteria of late preterm infants (34 -366/7 weeks) were included in this prospective observational study.The data recorded included gender, birth weight,multiple births, presence of major congenital anomalies, mode of delivery, APGAR score at minute 5, need forresuscitation, admission to the neonatal intensive care unit (NICU), and days of hospitalization. Lactate and base excesswere estimated using blood obtained from umbilical artery sampling. The primary outcome assessed was therequirement of delivery room resuscitation. The secondary outcomes assessed were the development of respiratorydistress, requirement of invasive/non- invasive ventilation, and respiratory support.Results: Cord blood base excess levels were significantly higher in late preterm neonates requiring delivery roomresuscitation compared to those who did not require resuscitation (median: -8 vs -4mEq/L, p-value: 0.002).In terms ofrespiratory morbidities, cord blood base excess levels were significantly higher in neonates with respiratory distresssyndrome (RDS)(median: -8.5 vs -3.4 mEq/L, p-value 0.001), and transient tachypnea of newborn (TTNB) (median: -8vs -3.4 mEq/L, p-value 0.004), compared to those without RDS and TTNB.However,there was no signi icant associationbetween cord blood lactate levels and the outcomes assessed.Conclusion: Estimation of arterial base excess levels obtained from umbilical cord blood sampling during delivery mayserve as a sensitive marker for predicting respiratory morbidities in late preterm neonates.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
71
75
https://ijn.mums.ac.ir/article_13798_22145d514d9a18ecd9e5ea87949e2b4d.pdf
dx.doi.org/10.22038/ijn.2019.39551.1628
The Incidence and Risk Factors Associated with Posttraumatic Stress Disorders among Parents of NICU Hospitalized Preterm Neonates
Azam
Tofighi Naeem
Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Mamak
Shariat
Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Mohammad Reza
Zarkesh
Department of Neonatology, Yas Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
author
Nasrin
Abedinia
Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Sara
Teimoory bakhsh
Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
Fatemeh
Nayeri
Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
author
text
article
2019
eng
Background: Parents of preterm neonates are exposed to great stress that can lead to posttraumatic stress disorder. The current study aimed to assess the incidence of posttraumatic stress disorders (PTSD) in both mothers and fathers of preterm infants.Methods: A prospective cohort study was done at two Iranian hospitals in 2016. One hundred and sixty parents of preterm neonates entered the study. A questionnaire related to acute stress disorder (ASD) was completed for parents at days 3-5 after birth. One month later, the parents were asked for the second interview. Prenatal posttraumatic stress questionnaire (PPQ) for mothers and posttraumatic stress disorder checklist (PCL) for fathers were completed. Prevalence of PTSD among the mothers and fathers was compared.Results: According to the results, 32.5% of all mothers and 4% of all fathers showed ASD. After a month, 40% of the mothers and 21.5% of the fathers showed PTSD. A significant correlation was seen between PPQ and PCL scores (P<0.001). There were also significant correlations between both father’s and mother’s ASD scores with mother’s PPQ score (P=0.019, P<0.001). The PPQ scores among employed mothers and mothers with unemployed husbands were significantly higher than others (P=0.038, OR=2.46; P=0.02, OR=0.436). A history of an accident during recent years for mother could change both mother's ASD and PPQ scores (P=0.002, OR=0.133; P=0.002, OR=0.15). Both PPQ and PCL scores also increased by father's history of an accident during recent years (P=0.02, OR=0.541; P=0.01, OR=0.325).Conclusion: The ASD and PTSD among mothers were more frequent than in fathers. Fathers indicated delayed onset of PTSD in comparison with mothers.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
76
82
https://ijn.mums.ac.ir/article_13808_2916ca311eeff93fd2a352c4f7f3a1bf.pdf
dx.doi.org/10.22038/ijn.2019.38135.1597
Coarse Tremor as the Only Sign of Perinatal Hemorrhagic Stroke: A Case Report
Sina
Karamimagham
Neonatal Research Center, Shiraz University of Medical Science, Shiraz, Iran
author
Maryam
Poursadeghfard
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
author
text
article
2019
eng
Background: Tremor which is the most common abnormal movement in the neonatal period might be a benign condition or the result of pathologic events and is divided into two subtypes, namely fine tremor and coarse tremor. Fine tremor is usually benign and results from some metabolic disturbance, such as hypoglycemia. On the other hand, coarse tremor is an indicator of brain insult and should be regarded as a central pathology comparable to intracranial hemorrhage and hypoxic-ischemic encephalopathy and requires further evaluations. Stroke is one of the most important associated pathologies that are readily missed in the neonatal period. The possibility of stroke should be suspected in all newborns in the presence of coarse tremor.Case report: Here, we will present a newborn with perinatal hemorrhagic stroke who was in good condition after birth with Apgar score of 9 and normal vital signs, birth weight, head circumference, length, and primitive reflexes; however, he had coarse tremor in both upper extremities in physical examination as the only sign of the hemorrhagic stroke.Conclusion: It is recommended that neonates with coarse tremor be investigated more carefully to rule out the structural brain pathology.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
83
86
https://ijn.mums.ac.ir/article_14100_ea70b3ea698ca8dc5390d6e4533c42be.pdf
dx.doi.org/10.22038/ijn.2019.37692.1583
Sacrococcygeal Teratoma: A Case Report
Reza
Saeidi
Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Farnaz
Kalani-Moghaddam
Department of Neonatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Gholamali
Mamouri
Department of Neonatology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2019
eng
Background: Neonatal tumors are usually prenatally diagnosed or within the irst 30 days of life. The true incidence ofneonatal tumors is unknown as a great number of pregnancies with a prenatally diagnosed mass result in stillbirth ormiscarriage. Most solid neonatal tumors are benign whereas less than 50% of neonatal neoplasms are malignant;however, some tumors with malignant patterns may histologically show benign behaviors. The incidence of malignanttumors is 1 in every 12,500-27,500 live births, accounting for 2% of all childhood cancers. Teratomas are the mostcommon perinatal neoplasms, accounting for 25-33% of the cases. Around two-thirds of all sacrococcygeal teratomas(SCTs) are reported in the neonatal period but with a small risk of malignancy.Case report: Herein, we reported a case of SCT in a newborn leading to a complicated cesarean delivery.Conclusion: In general, teratomas are embryonic typically benign tumors arising from germ cells. They usually consistof various tissues originating from two or more embryonic layers. These tumors are believed to be the most commonneonatal germ cell tumors. The sacrococcygeal region is the most common site for extragonadal teratomas formation.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
10
v.
4
no.
2019
87
89
https://ijn.mums.ac.ir/article_14101_fea98a2382bf3ff14ed02f80ae9debb4.pdf
dx.doi.org/10.22038/ijn.2019.40339.1656