Does transport affect the incidence of intraventricular hemorrhage in preterm infants?
Narjes
Pishva
Pediatrics Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
author
Maziar
Mortazavi
Pediatrics Department, Abozar Hospital, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
author
text
article
2010
eng
Objective: Preterm infants are prone to intraventricular hemorrhage. They may suffer from significant morbidity and mortality particularly in those with high-grade hemorrhage. Our objective was to determine the incidence of intraventricular hemorrhage in premature infants transported to a tertiary center compared with those delivered at the level III facility. Methods: We evaluated all premature infants admitted to neonatal intensive care units affiliated with Shiraz University of Medical Sciences from April 2008 through April 2009. Neonatal transports from 20 facilities were compared with those delivered at the same centers’ level III facility with respect to intraventricular hemorrhage. Serial neonatal brain sonographies were performed on admission, 7th and 30th day post - admission. Results: From a total of 161 premature neonates, 96 were inborn and 65 were outborn. Intraventricular hemorrhage was significantly higher in transported infants ( 24 of 96 inborn infants or 25% and 36 of 65 outborn neonates or 55.4% ) This difference was statistically significant (p< 0.001) Conclusion: We found that transported neonates had a higher risk for intraventricular hemorrhage compared to those born at the level III facility. Our data emphasizes the importance of improving teams for neonatal transfer. Ideally, high-risk pregnant women should be transferred before delivery to a perinatal center capable of caring for both the mother and infant.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
8
12
https://ijn.mums.ac.ir/article_5099_bae91ab2e1b2b58792008815b9ad3244.pdf
dx.doi.org/10.22038/ijn.2010.5099
Effect of aloe vera gel on nipple sores
Reza
Saeidi
Pediatrics Department Neonatologist Research Center, school of medicine, Mashhad University of Medical Sciences
author
Mahbobeh
Gholami Robatsangi
Midwifery Department - Azad Islamic University - Neyshabur Branch,
author
Mahin
Tafazoli
Midwifery Department - School of Nursing & Midwifery Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2010
eng
Objective: It is estimated that 80-90% of breastfeeding women experience nipple soreness. In this study we evaluated the effect of Aloe Vera gel compared with breast milk on nipple sores.
Methods: This clinical trial study was performed in the neonatal ward of the Ghaem Hospital in Mashhad (Iran) from June 2009 to December 2009. Mothers were divided randomly into two groups: Aloe Vera application and breast milk application. After feeding their babies, the mothers used the preparation on their nipples 3 times a day and then let to dry without washing until the next feeding for 7 days. Breasts were examined before treatment, 3 and 7 days after treatment and graded using a scale and interview. Then data was analyzed with SPSS 11.5 software and MannWhitney, t student and paired t-tests.
Results: A total of 100 patients were enrolled (50 in each group). In the Aloe Vera group sore nipple scores decreased significantly on days 3 and 7 versus pretreatment (p= 0.000) compared to the breast milk group (p= 0.028).
Conclusion: Aloe vera was more effective than breast milk on nipple sores.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
13
14
https://ijn.mums.ac.ir/article_5101_0d53fcc6c601638c3d21efd2ab5d76fd.pdf
dx.doi.org/10.22038/ijn.2010.5101
Efficacy of high-dose oral erythromycin on enhancement of feeding tolerance in premature neonates
Marjaneh
Zarkesh
Pediatrics Department,17 Shahrivar Hospital,Guilan University Of Medical Science, Rasht, Iran
author
Katayoon
Haryalchi
17 Shahrivar Hospital, Guilan University Of Medical Science, Rasht, Iran
author
Ahmad
Madani
Pediatrics Department, Namazi Hospital, Shiraz University Of Medical Science, Shiraz, Iran
author
Narjes
Pishva
Pediatrics Department, Namazi Hospital, Shiraz University Of Medical Science, Shiraz, Iran
author
Shahnaz
Poorarian
Pediatrics Department, Namazi Hospital, Shiraz University Of Medical Science, Shiraz, Iran
author
text
article
2010
eng
Objective: Most neonates admitted to neonatal wards do not tolerate sufficient milk. Recently the effect of erythromycin on increasing feeding tolerance in neonates has been studied. In this study the effectiveness of oral, high dose Erythromycin a prokinetic agent was used to enhance feeding tolerance in these neonates. Methods: This prospective randomized controlled clinical trial was conducted on 60 premature neonates with birth weight< 1800 g at Hafez and Namazi hospitals in Shiraz during a 13- month period. Those neonates who did not tolerate milk more than 75 cc/kg/day five days after starting feeding, were chosen for the study. A total of 60 neonates were studied who were divided randomly into two equal groups (control and study), and were similar in sex, birth weight, gestational age, apgar score, route of delivery, oxygen need, type of milk and corticosteroid therapy in the antepartum period. Oral erythromycin (ethyl succinate suspension) was given in a dose of 12.5mg/kg/dose every 6 hours for a maximum of 10 days, or until they tolerated full enteral feeding (150 cc/kg/day). One neonate in the erythromycin group and two neonates in the control group expired during the study. Results: Oral erythromycin was effective on enhancement of feeding tolerance in premature neonates with gestational age equal to or more than 32 weeks (p= 0.031) and lead to earlier discharge of these neonates from hospital (p= 0.003). Also oral erythromycin was relatively effective in enhancement of feeding and early discharge of neonates with birth weight equal to or greater than 1500 g. Erythromycin was not effective for neonates less than 32 weeks of age (very preterm). In this study, no adverse effects (necrotizing enterocolitis, sepsis, O2 dependency, patent ductus arteriosus, high-dose positive stool culture or prolonged QT interval) were observed following erythromycin usage. Conclusion: High-dose oral erythromycin in premature neonates of gestational age equal to or greater than 32 weeks with feeding intolerance is effective for increasing feeding tolerance and earlier hospital discharge. However, routine use is not suggested.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
14
19
https://ijn.mums.ac.ir/article_5102_ae7316122600d87b6ff037428a17edff.pdf
dx.doi.org/10.22038/ijn.2010.5102
Mirror covered tunnel phototherapy increases the efficacy of phototherapy for neonatal jaundice
Farhad
Salehzadeh
Pediatrics Department, BouAli Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
author
Mehrdad
Mirza Rahimi
Pediatrics Department, BouAli Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
author
Sepideh
Janhangiri
BouAli Hospital, University of Medical Sciences, Ardabil, Iran
author
Shahram
Habibzadeh
Emam khoumiany Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
author
Nayyereh
Amini Sani
Faculity of medicine, Ardabil University of Medical Sciences, Ardabil, Iran
author
Morteza
Samshirgara
BouAli Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
author
Afsham
Sharghi
Faculity of medicine, Ardabil University of Medical Sciences, Ardabil, Iran
author
text
article
2010
eng
Objective: Neonatal jaundice (NJ) is one of the most common cause of neonatal hospital admission. Phototherapy is the main therapy for hyperbilirubinemia of neonatal jaundice. The efficacy of phototherapy depends on the dose and wavelength of light used and the surface area exposed. We increased photons in mirror covered tunnel phototherapy (MCTP) by putting mirrors behind the lamps (mirror covering), without raising the temperature or risk of hyperthermia. This study evaluates the efficacy of this modification.
Methods: In this randomized clinical trial study, during a 6-month period 30 neonates were treated for NJ; 60 neonates who had uncomplicated neonatal jaundice requiring only phototherapy were used as controls for the study by the convenience sampling method. The controls received single phototherapy by tunnel phototherapy while the study group underwent MCTP.In this set we put mirrors which were mercury coated 3 mm thick glass behind the bulbs of the set. Serum bilirubin was measured at admission, 24 hr and 48 hr after initiation of treatment, then daily and 24 hr after discharge. Independent sample t-test was used in SPSS version12 software for data analysis .
Results: Mean duration of admission in the study group was significantly lower than controls (p= 0.027). Likewise the mean decrease in bilirubin level after 24 and 48 hr of phototherapy were significantly lower than controls (p= 0.005 and p= 0.036).
Conclusion: Our results show that the use of mirrors behind the bulbs in tunnel phototherapy units can safely increase the efficacy of phototherapy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
20
23
https://ijn.mums.ac.ir/article_5105_a47da961a2906d271ae4f3c951b0b2cf.pdf
dx.doi.org/10.22038/ijn.2010.5105
Association between serum interleukin-1β levels and perinatal asphyxia
Hassan
Boskabadi
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Gholamali
Maamouri
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical
author
Jalil
TavakolAfshari
Immunology Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mohammad
Taghi Shakeri
Community Medicine Devision, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2010
eng
Objective: Asphyxia is a major cause of acute mortality and chronic neurologic disability in neonates. We sought to define the predictive values of serum concentrations of interleukin-1β in newborns with perinatal asphyxia to see if there is a relation between interleukin-1β (IL-1β) levels to the short term neurological deficit. Methods: This was a prospective (case-control) study conducted between June 2007 and July 2008, at the Neonatal Intensive Care Unit, Ghaem Hospital, Mashhad, Iran. Serum IL-1β levels were measured at birth, 24 and 48 h post-partum in 38 consecutive uninfected neonates with perinatal asphyxia(blood pH< 7.2, low Apgar score , signs of fetal distress) and 41 randomly selected healthy newborns (normal infants free of a postnatal clinical event during the first weeks of life). Receiver-operating characteristic (ROC) curves were used for the determination of thresholds for the asphyxiated group versus healthy neonate group. Results: A total of 79 infants were studied. Serum interleukin-1β concentrations in the infants who developed hypoxic-ischemic encephalopathy was 6 folds higher as compared to values in the normal infants (p< 0.006) and 5-folds higher compared to infants with asphyxia who did not subsequently develop hypoxic-ischemic encephalopathy (p< 0.006). There was also a significant relationship between serum IL-1Β and outcome at the time of discharge. Conclusions: Serum levels of IL-1Β are increased substantially in neonates with asphyxia, and this is most pronounced in neonates with poorer prognosis.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
24
29
https://ijn.mums.ac.ir/article_5106_0408cada495621fd491e851abba4c40a.pdf
dx.doi.org/10.22038/ijn.2010.5106
Effect of hemolysis and hyperbilirubinemia in glucose-6-phosphate dehydrogenase-deficient neonates
Marjaneh
Zarkesh
Pediatrics Department,17 Shahrivar Hospital, Guilan University Of Medical Science, Rasht, Iran
author
Maryam
Jafroodi
Pediatrics Department,17 Shahrivar Hospital, Guilan University Of Medical Science, Rasht, Iran
author
Mohammad
Mehdi Karambin
Pediatrics Department,17 Shahrivar Hospital, Guilan University Of Medical Science, Rasht, Iran
author
Tahereh
Rostami
Pediatrics Department,17 Shahrivar Hospital, Guilan University Of Medical Science, Rasht, Iran
author
text
article
2010
eng
Objective: Recently, the role of hemolysis in the pathophysiology of hyperbilirubinemia in glucose-6phosphate dehydrogenase (G6PD) deficient neonates has been questioned and decreased bilirubin conjugation has been suggested. We conducted a study to evaluate the effect of hemolysis on these neonates at the 17-Shahrivar Children Hospital in Rasht.
Methods: In this cross-sectional study, from March 2007 to September 2008, 483 healthy term neonates with icter who were admitted to our hospital were assessed. Sex, gestational age, mode of delivery, kind of milk (breast milk or formula), blood group and RH of mother and newborn, Coombs test (both direct and indirect), hemoglobin level at admission, reticulocyte count, total and direct bilirubin at admission, peripheral blood smear, G6PD activity and duration of admission, were evaluated. They were divided into two groups :G6PD deficient group and G6PD with normal activity group. The afore-mentioned variants were compared between the two groups. The results were analyzed by chi-square, t-test and Pearson’s correlation test, via SPSS version 15 software.
Results: G6PD deficiency was significantly more common in male neonates than females(p< 0.001). Hemoglobin level at admission was significantly lower in G6PD deficient group (p< 0.001). Mean serum bilirubin at admission in G6PD deficient neonates was higher than normal neonats ( 18.48 3.65 versus 17.93 2.58 mg/dl) but this difference is not significant (p= 0.289) Also there was strong positive correlation between direct and total bilirubin in both groups. Severe anemia was not reported in either group.
Conclusion: Hemolysis is the main mechanism of hyperbilirubinemia in G6PD deficient neonates and there were no findings of diminished bilirubin conjugation in our study.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
30
33
https://ijn.mums.ac.ir/article_5116_d41d8cd98f00b204e9800998ecf8427e.pdf
dx.doi.org/10.22038/ijn.2010.5116
Docosahexaenoic acid level of breast milk of iranian women in low fish – consuming and high fish – consuming regions
Ahmad S
Farhat
- Neonatal Research Center, school medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mojgan
Mirzaeian
Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
author
Hadi
Mirzaeian
Mehr Hazrat Abbas Hospital, Mashhad, Iran
author
B
Holub
Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
author
Ashraf
Mohammadzadeh
- Neonatal Research Center, school of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2010
eng
Objective: Sufficient intakes of docosahexaenoic acid (DHA) via breast milk are required for optimizing visual and neural development at early stages of life. Little or no information is available on DHA intakes and levels found in breast milk in Iranian women and surrounding regions. In this study we measure the DHA in the breast milk of lactating Iranian women from low and high – fish-eating regions and estimate their DHA intakes.
Methods: This is a cross-sectional and prospective study done in two cities of Iran (Mashhad and Amol); 10 ml of mature breast milk were obtained from 40 healthy lactating women (selected randomly) at Imam Reza Hospital of Mashhad (a low fish-consuming area) and Amir Kola Children Hospital of Amol city (a high fish-consuming area). The data were analyzed in two samples by using t- independent test and Mann-Whitney test via SPSS version 11.5 software.
Results: The breast milk DHA levels of mothers living in the high fish-consuming area (Amol) were significantly higher than mothers living in the low fish-consuming area (Mashhad, p< 0.01). It can be estimated that the average DHA intake of lactating Iranian women is approximately 184 mg/dl in Mashhad and 307 mg/dl in Amol.
Conclusion: The DHA content of breast milk was higher in high-fish consuming area in comparison to the low-fish consuming area in Iran indicating that the DHA levels of breast milk are influenced by fish consumption.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
34
37
https://ijn.mums.ac.ir/article_5118_3712acb86798b99d8578cd280931dd31.pdf
dx.doi.org/10.22038/ijn.2010.5118
Association of vertebral, anal, cardiac, tracheoesophageal, renal and limb anomalies with auricle atresia; a case report
Sedigeh
Jahanshahifard
Non-communicable Pediatric disease research center, AmirKola Children Hospital, Babol University of Medical Sciences, Babol, Iran
author
Hossein
Saadat
Non-communicable Pediatric disease research center, AmirKola Children Hospital, Babol University of Medical Sciences, Babol, Iran
author
Mousa
Ahmadpour-Kacho
Non-communicable Pediatric disease research center, AmirKola Children Hospital, Babol University of Medical Sciences, Babol, Iran
author
Sohail
Osia
Non-communicable Pediatric disease research center, AmirKola Children Hospital, Babol University of Medical Sciences, Babol, Iran
author
Yadolla
zahedpasha
Non-communicable Pediatric disease research center, AmirKola Children Hospital, Babol University of Medical Sciences, Babol, Iran
author
text
article
2010
eng
Association of vertebral, anal, cardiac, tracheoesophageal, renal and limb anomalies (VACTERL) is rare anomaly with an incidence of 1.6 per 10000 births. This condition is a combination of anomalies recognized as a hereditary entity with poor prognosis. Herein, we report VACTERL association presenting with auricle atresia. A male neonate with a birth weight of 2690 grams, head circumference 34 cm, full term, delivered via Cesarean section (C/S) to a 23 year-old mother G2P2L2A0 is presented. The patient was born with APGAR score 7/10 in 1 and 5 minutes. He had multiple congenital anomalies including sacral agenesis, anal atresia, and heart murmur compatible with the diagnosis of patent ductus arteriosus, TEF, multicystic kidney disease, atresia of both auricles and external ear canal. He had characteristics of the VACTERL association, In addition to this combination of malformation, we found him to have ear anomalies.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
38
41
https://ijn.mums.ac.ir/article_5119_64bfac2a409c856f8aef28d76cc531b6.pdf
dx.doi.org/10.22038/ijn.2010.5119
Testicular torsion in a neonate; a case report
Maliheh
Kadivar
Department of Pediatrics, Division of Neonatology, Tehran University of Medical Sciences, Tehran Iran
author
Sharareh
Anari
Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
author
Bahar
Ashjaei
-Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
author
text
article
2010
eng
The testicular torsion which is typically seen in prepuberty is very rare in the early neonatal period; prenatal diagnosis is difficult. Herein, we report a five day-old male neonate with swelling and erythema of the right scrotum. Following Doppler ultrasound suggestive of testicular torsion, surgical exploration was undertaken. There was gangrene of the right testis with discoloration and necrosis due to complete extravaginal torsion. Right orchidectomy, along with a fixation of the left testis was performed. While perinatal testicular torsion is a rare condition, if a case is found it should be considered as an emergency situation. Treatment in the neonatal period is mandatory.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
1
v.
1
no.
2010
42
44
https://ijn.mums.ac.ir/article_5120_8ec2382b06421da06d71fb40fc1c7edf.pdf
dx.doi.org/10.22038/ijn.2010.5120