Comparison of Continuous and Intermittent Feeding Methods in Low Birth Weight Infants
Ahmad S
Farhat
Neonatal Research Center, school medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Ali
Khakshour
Assistant professor, Northern Khorasan University of Medical Sciences
author
Zhila
Hosseini
Neonatal Research Center, school medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2011
eng
Objective About 1 % of infants are of very low birth weight. However, they comprise about 50% of infant mortality. We compare the effects of continuous versus intermittent feeding on physical growth, gastrointestinal tolerance and macronutrient retention in low birth weight infants (Methods A prospective randomized trial clinical trial was performed from 2004-2005. Very low birth weight neonates (n=73) stratified by birth weight were randomly assigned to either the continuous (24- hour) pump group (n=37) or intermittent (every 2 hours) nasogastric tube feeding group (n=35). Weight was measured and recorded on the 3rd , 7th , 10th ,13th ,16th ,19th ,22nd day and at discharge. Data was analyzed via SPSS software, t-student and chi-square tests. Results There were no significant differences in birth weight, gestational age, first feeding age and weight at beginning study. Of the 73 neonates, 61 neonates were discharged from hospital, 11 neonates died and one of them dropped out of the study because of early discharge. There were no significant differences in weight gaining, feeding tolerance, discharge weight (p=0.33) or severity of respiratory distress between the groups. Conclusion This study showed that there were no differences in infant growth relative to the type of feeding.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
8
11
https://ijn.mums.ac.ir/article_5127_7af1b8582425ec78dc7f8db8ca4d2a8f.pdf
dx.doi.org/10.22038/ijn.2011.5127
Common Complications of Endotracheal Intubation in Newborns
Seyedeh Fatemeh
Khatami
Department of pediatric, Devision of neonatology, Tehran University of Medical Sciences, Iran
author
Pouya
Parvaresh
Department of Internal Medicine, Faculty of Medical Sciences Szeged, Medical University Szeged, Hungary
author
Shahin
Behjati
Department of pediatric, Devision of neonatology, Tehran University of Medical Sciences, Iran
author
text
article
2011
eng
Objective The purpose of this study was to assess the frequency of complications of endotracheal intubation (ETI) in neonates.
\Methods The newborns that were admitted and needed urgent or semi-urgent intubation were enrolled in this study over a 1 year period. Route for intubation in all cases were orotracheal. Cases were not routinely sedated or paralyzed. The patients were clinically and radiographically assessed.
Results Of 233 newborn infants who were admitted to the neonatal intensive care unit (NICU) at the Children’s Medical Center, 60 infants were intubated. A total of 131 attempts were documented. Unsuccessful attempts with difficult intubation were 17(13%); successful intubation attempts were 114(87%). Complications were detected in 69 cases (61%). The most common complication was laryngeal injury (24%). Accidental extubation was the most frequent event (12%).Tube blockage 7% and endotracheal tube (ETT) malposition was 3%. The complications were less during placement of ETT (12%), but were high during maintenance (61%) and removal of the endotracheal tube (28%). 47% of patients required repeated intubation. There was a significant statistical difference between complications of medicated and unmedicated patients. There was no significant statistical difference relative to gestational age, route of delivery, sex, birth weight, and length of time the ETT remained in place.
Conclusion Trauma to the larynx and vocal cords were the most common complications. Difficult and repeated intubation played a major role. Premedication for non-urgent or semi-urgent intubation was safer and more effective than awake intubation. We did not assess long-term outcomes associated with endotracheal tube intubation; this was a limitation of the present study. Operator skill and postoperative care are confounding variables that may influence the results.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
12
17
https://ijn.mums.ac.ir/article_5130_21971d1b6aeb96a1cb0aeaec685c61f3.pdf
dx.doi.org/10.22038/ijn.2011.5130
Clinical Effects of Carnitin Supplementation on Hypoglycemia, Apnea and Sepsis in Very Low Birth Weight Neonates
Ashraf
Mohammadzadeh
Neonatal Research Center, School of Medicine, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Ahmad Shah
Farhat
Neonatal Research Center, School of Medicine, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Rana
Amiri
Masters of pediatric nursing, Neonatal Research Center, School of Medicine, Mashhad, University of Medical Sciences, Mashhad, Iran
author
Habibollah
Esmaeli
Neonatal Research Center, School of Medicine, Mashhad, University of Medical Sciences, Mashhad, Iran
author
text
article
2011
eng
Background Systemic carnitine deficiency may present with apnea, hypotonia, and poor growth. Premature infants often manifest these symptoms and are at risk of developing carnitine deficiency because of immaturity of the biosynthetic pathway, lack of sufficient predelivery transplacental transport, and lack of sufficient exogenous supplementation. Objective This study was undertaken to examine the effect of carnitine supplementation on hypoglycemia, apnea and sepsis in premature infants. Methods In this clinical study 60 preterm infants less than <1500 g birth weight were enrolled. The subjects in the carnitine group received 20 mg/kg/day oral supplemental by nasogastric tube in addition to routine nursing care within 96 hours of birth. Episodes of apnea, hypoglycemia and sepsis were the primary outcome measures recorded. The control group received routine nursing care. Results Episodes of apnea and the hypoglycemia were similar between the two groups. (P=0.55 and 0.69 respectively). Conclusion: In this study treatment with carnitine supplementation had no effect on apnea, hypoglycemia and sepsis in very low birth weight neonates.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
18
21
https://ijn.mums.ac.ir/article_5132_8e72f85d0a08f8cfbdac2adf030d0b1c.pdf
dx.doi.org/10.22038/ijn.2011.5132
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
2011
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
2
v.
1
no.
2011
22
25
https://ijn.mums.ac.ir/article_5135_45463c7911b17256bb6dbfc131e7c4a9.pdf
dx.doi.org/10.22038/ijn.2011.5135
Maternal and Neonatal Zinc and Copper Levels and Birth Weight
Gholamali
Maamouri
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Hassan
Boskabadi
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mehran
Noria
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Hosein
Ayatollahi
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Majid
Ghayour-Mobarhan
Department of nutrition and biochemistry, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Abbas
Heshmati
Cardiovascular Research Center, Avicenna (Bu-Ali) Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
author
Zohre
Samirad
Head of Educational and Student Services
author
Hosein
Mohsenzade
Resident of pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2011
eng
Introduction Minerals and trace elements such as zinc and copper have significant influence on development and growth of the fetus and newborn. The purpose of this study was to determine the relationship between low birth weight and maternal and neonatal zinc, copper levels. Materials and Methods This case – control study was done from September 2006 to Sep 2007 consisted of 65 infants with birth weight < 2500 g and 65 infants weighing ≥ 2500g. Cord and maternal blood samples collected at delivery were analyzed by atomic absorption spectrophotometry for zinc and copper levels.
Results Mean serum zinc levels in maternal (P=0.001) and the cord blood (P=0.49) were 6.35 ± 2.09 µmol/l, 12.77±3.83 mol/l and 7.57±1.75 µmol/l , 13.18±2.69 µmol/l of cases and control groups ,respectively.The mean copper levels in maternal (P=0.62) and cord blood (P=0.005) were 21.82±4.45 µmol/l, 5.12±1.54 µmol/l and 21.19 ± 5.34 µmol/l and 3.65±2.04 µmol /l of control and case group, respectively.
Conclusion This study indicated that there is a relationship between birth weight less than 2500 gr and maternal zinc levels (P<0.001). Mothers with zinc levels less than 6.4 mol/l were 3.8 time more at risk of having an infant with birth weight less than 2500 g. Lower maternal weight (less than 55kg), was associated with 4.2times increase risk of having low birth weight infants.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
26
31
https://ijn.mums.ac.ir/article_5138_d9c7969dfc648f452f5bad24cb84d903.pdf
dx.doi.org/10.22038/ijn.2011.5138
Hemolytic Events in Rh Positive Neonates Born to Rh Negative Mothers
Farhad
Heydarian
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mahmood Reza
Mohajer Kohestani
Neonatal Research Center, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2011
eng
Background One of the most important cause of severe neonatal hyperbilirubinemia is hemolysis including Rh incompatibility. The aim of this study was to assess the rate of hyperbilirubinemia due to hemolysis in Rh positive neonates born to Rh negative mothers.
Methods In this retrospective study from March 1998 to February 2003, 60 icteric Rh positive newborns that were born to Rh negative mothers, were studied. The data of patients were gathered from questionnaires sheets.
Results The rate of hemolysis due to Rh incompatibility was 18.3%. The mean age of mothers was 31.9 years (SD:4.6). The mean level of hemoglobin in these patients was significantly lower (P=0.009) and serum bilirubin levels higher than nonhemolytic icteric neonates (P=0.007). The mean age of onset of jaundice in hemolytic neonates was 1.55 days (SD: 618) and in nonhemolytic patients 2.08 (SD:1.03) days. Exchange blood transfusion was performed for 23 neonates (38.3%). In 61.7% of cases no history of anti-D immunoglobulin given during pregnancy or at delivery was present.
Conclusion Due to poor prenatal care consisting of inadequate provision of anti-D immunoglobulin in Rh negative mothers, sensitization to Rh antigen in our Rh negative mothers was considerably high.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
32
34
https://ijn.mums.ac.ir/article_5139_44768f311c4461be9bfe6bce1685feac.pdf
dx.doi.org/10.22038/ijn.2011.5139
The effect of Ophthalmic Patch on Conjunctiva of Neonates under Phototherapy
Mojgan
Bayatmokhtari
- Department of pediatrics, Mashhad Branch , Islamic Azad University, Mashhad, Iran
author
Gholamali
Maamouri
Neonatal Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Jamshid
Yousefi
Department of pediatrics, Mashhad Branch , Islamic Azad University, Mashhad, Iran
author
Mojtaba
Meshkat
Department of Biostatistics, Mashhad Branch, Islamic Azad University, Mashhad, Iran
author
mohammad
hoseyni nia
Mashhad Branch, Islamic Azad University, Mashhad, Iran
author
text
article
2011
eng
Objective Conjunctivitis is a common disease in neonates. Several bacterial and viral infectious agents may cause it. Tear circulation and blinking has protective effects from bacterial colonization in the conjuntival sac. Reduced blinking increases the possibility of bacterial conjunctivitis. We studied the effect of eye patches on bacterial colonization of the conjunctival sac.
Methods In 100 icteric neonates who needed phototherapy and occlusive patches for their eyes during the procedure we did conjunctival bacterial culture before and after 48 hrs after occlusive patches. The results of two cultures were analyzed with statistical tests, McNemar, chi- square and, binominal with SPSS V18 software.
Results In 100 neonates there were 51 (51%) males 49 (49%) females. The mean birth weight was 2578±736 g. Culture before ophthalmic patches showed 20 (20%) cases with positive conjunctival cultures and 76 cases (76%) with positive culture 48 hrs after use of eye patches.
Conclusion Eye patches during phototherapy increase bacterial colonization in the conjunctival sac. We must be aware of this complication during phototherapy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
35
37
https://ijn.mums.ac.ir/article_5140_a83ff60ea9d1488fdd95fc66b2446049.pdf
dx.doi.org/10.22038/ijn.2011.5140
Prevalence of Preterm Neonates and Risk Factors
Azam
Mohsenzadeh
Department of Pediatrics, Madani Children's Hospital. Lorestan University of Medical Sciences, Iran
author
Sasan
Saket
Department of Pediatrics, Madani Children's Hospital. Lorestan University of Medical Sciences, Iran
author
Atusa
Karimi
Department of Obstetrics & Gynecology, Asali Hospital. Lorestan University of Medical Sciences, Iran
author
text
article
2011
eng
Introduction Preterm birth is still a major health problem throughout the world. Preterm birth results in 75% of neonatal mortality. We sought to identify risk factors which cause preterm birth.
Materials and Methods This cross-sectional study assessed all preterm neonates born in Asali Hospital in Khorram Abad (either by NVD or C/S) during the first 6 months of 2007. Sampling method was census. Fetal sex, maternal disease, maternal addiction to cigarettes, maternal age, placental problems, number of gravidities, PROM, preeclampsia, multifetal gestation, Apgar score, uterine anomaly were the variables studied in this survey. Questionnaires were used to collect the data and the data was analyzed with SPSS software.
Results 183 of 2179 live neonates borne in Asali hospital were preterm (8.4%). The most common factors related to preterm birth were: Primigravidity(56.3%), PROM(35.5%), preterm labor pain(33.8%), maternal disease(22.4%), preeclampsia(21.9%), multifetal gestation(19.7%), previous abortion(18.6%), previous preterm delivery(9.8%), high risk maternal age(10.4%) and placental problems(7.7%). Preterm labor pain was significantly more common among multiparus women in comparison with nulipara ones(x2=16.5, p=0.000049) but occurrence of PROM(x2=0.57, p=0.45), preeclampsia(x2=0.8, p=0.37), maternal chronic disease(x2=0.55, p=0.46) and multifetal gestation(x2=0.01, p=0.91) was not significantly different among multipara and primipara women.
Conclusion Several factors related to preterm birth can be prevented by health modalities. Maternal education and giving advanced information to mothers in prenatal health care visits, preterm birth and its side effects may be reduced.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
38
42
https://ijn.mums.ac.ir/article_5152_11d974e9f6c4e334e442fcda7fb5bbaa.pdf
dx.doi.org/10.22038/ijn.2011.5152
Removal of an Umbilical Catheter Migrated into the Neck in a Neonate: Report of Case
Mehran
Hiradfar
Endoscopic and Minimal Invasive Research Center, School of Medicine, Mashhad University of Medical Sciences, mashhad, Iran
author
Marjan
Joodi
Endoscopic and Minimal Invasive Research Center, School of Medicine, Mashhad University of Medical Sciences, mashhad, Iran
author
Mohammad
Gharavi
Anesthesiologist, Endoscopic and Minimal Invasive Research Center, School of Medicine, Mashhad University of Medical Sciences, mashhad, Iran
author
Reza
Shojaeian
Resident of pediatric surgery, sheikh Hospital, Mashhad University of Medical Sciences, mashhad, Iran
author
text
article
2011
eng
Umbilical and supraumbilical catheter insertion is a common procedure performed in the NICU. It is a safe and usually easy procedure devoid of serious mishaps, morbidity and mortality. Complications such as hemorrhage, infection, hernia, evisceration, omphalitis, portal vein thrombosis and portal hypertension may occur after umbilical catheter insertion. Other uncommon and rare complications reported in the literature includes: Hepatic laceration, pleural effusion, necrosis of the buttock, severe ischemic injury of the extremities, gastric outlet obstruction, cardiac tamponade, pericardial effusion, atrial flutter, liver abscess, neonatal bladder rupture and intrahepatic hematoma. In this article we present a case of catheter migration in a preterm infant into the neck removed successfully via jugular venotomy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
43
45
https://ijn.mums.ac.ir/article_5153_3ff8ca833329a74954e28654de10c51c.pdf
dx.doi.org/10.22038/ijn.2011.5153
Treatment of a Giant Genital Wart in an Infant via Cryotherapy: Report of Case
Ahmad S
Farhat
Neonatal Research Center, School of medicine, Mashhad University of Medical Sciences, Mashhad,iran
author
Vahid
Mashayekhi
Neonatal Research Center, (Dermatologist) Mashhad University of Medical Sciences, Mashhad, Iran
author
Reza
Mahdavi
Urology Department Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
author
Navid
Daghighi
Neonatal Research Center (Medical student), Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2011
eng
Human papilloma virus (HPV) infection is a very common infection of skin and mucosa of children and adults (1- 6).Anogenital warts are a common type of HPV infection in sexually active adults, however it is seen in any age. The importance of presence of genital warts is different between adults and children in respect to differential diagnosis, associations, complications and also treatment options. We report a 3 month-old child with a giant genital wart treated via cryotherapy.
Iranian Journal of Neonatology
Mashhad University of Medical Sciences
2251-7510
2
v.
1
no.
2011
46
49
https://ijn.mums.ac.ir/article_5155_6968f4f14f0bfe806dd61b4bc474888c.pdf
dx.doi.org/10.22038/ijn.2011.5155