Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.53102.1962
N. Khalesi, S. Mohammadian, N. Hooman, M. Khodadost, L. Allahqoli
Background Urine calprotectin significantly elevates in acute kidney injury (AKI) in adult and pediatric patients. The present study aimed to assess the accuracy of urine calprotectin as a diagnostic marker for (AKI) in neonates.Methods This cross-sectional study assessed urine calprotectin in 100 neonates (80 newborns with confirmed AKI and 20 healthy ones). Random urine calprotectin was measured by Enzyme-linked Immunosorbent Assay (ELISA) and then compared between the two groups. We included the neonates who had received at least 48 h of intravenous fluid and met the inclusion and exclusion criteria. Receiver-operating characteristic (ROC) curve was used to set a cut-off point for urine calprotectin for the prediction of AKI. The overall accuracy and Kappa coefficient were used to assess the agreement between the two methods. A p-value less than 0.05 was considered statistically significant.Results Urine calprotectin levels were not significantly higher in neonates with AKI, as compared to those in the healthy ones (146.2 versus 142.4; P=0.1). The results pointed to an optimal cut-off value of 123.5 mg/dl for urine calprotectin with the area under the curve of 0.515 (the sensitivity, specificity, positive predictive value, and negative predictive value were obtained at 77.5%, 40%, 83.7%, and 30.7%, respectively). The overall accuracy and Kappa agreement coefficient were reported as 70% and 0.15, r (P=0.11).Conclusion As evidenced by the results of the resent study, although urine calprotectin level elevates in AKI in neonates, it is not more sensitive than gold standards to predict AKI.
背景:成人和儿童急性肾损伤(AKI)患者尿钙保护蛋白显著升高。本研究旨在评估尿钙保护蛋白作为新生儿AKI诊断标志物的准确性。方法采用横断面研究方法对100例新生儿(确诊AKI 80例，健康20例)进行尿钙保护蛋白测定。采用酶联免疫吸附试验(ELISA)随机测定尿钙保护蛋白，并比较两组间的差异。我们纳入了接受过至少48小时静脉输液且符合纳入和排除标准的新生儿。采用受试者工作特征(ROC)曲线设定尿钙保护蛋白预测AKI的分界点。用总体精度和Kappa系数来评价两种方法之间的一致性。p值小于0.05被认为具有统计学意义。结果AKI新生儿的尿钙保护蛋白水平与健康新生儿相比没有显著升高(146.2 vs 142.4;P = 0.1)。结果表明，尿钙保护蛋白的最佳临界值为123.5 mg/dl，曲线下面积为0.515(敏感性为77.5%，特异性为40%，阳性预测值为83.7%，阴性预测值为30.7%)。总体准确度和Kappa一致系数分别为70%和0.15,r (P=0.11)。结论本研究结果表明，虽然尿钙保护蛋白水平在新生儿AKI中升高，但其预测AKI的敏感性并不高于金标准。
{"title":"Accuracy of Urine Calprotectin in the Diagnosis of Acute Kidney Injury in Neonates: A Cross-Sectional Study","authors":"N. Khalesi, S. Mohammadian, N. Hooman, M. Khodadost, L. Allahqoli","doi":"10.22038/IJN.2021.53102.1962","DOIUrl":"https://doi.org/10.22038/IJN.2021.53102.1962","url":null,"abstract":"Background Urine calprotectin significantly elevates in acute kidney injury (AKI) in adult and pediatric patients. The present study aimed to assess the accuracy of urine calprotectin as a diagnostic marker for (AKI) in neonates.Methods This cross-sectional study assessed urine calprotectin in 100 neonates (80 newborns with confirmed AKI and 20 healthy ones). Random urine calprotectin was measured by Enzyme-linked Immunosorbent Assay (ELISA) and then compared between the two groups. We included the neonates who had received at least 48 h of intravenous fluid and met the inclusion and exclusion criteria. Receiver-operating characteristic (ROC) curve was used to set a cut-off point for urine calprotectin for the prediction of AKI. The overall accuracy and Kappa coefficient were used to assess the agreement between the two methods. A p-value less than 0.05 was considered statistically significant.Results Urine calprotectin levels were not significantly higher in neonates with AKI, as compared to those in the healthy ones (146.2 versus 142.4; P=0.1). The results pointed to an optimal cut-off value of 123.5 mg/dl for urine calprotectin with the area under the curve of 0.515 (the sensitivity, specificity, positive predictive value, and negative predictive value were obtained at 77.5%, 40%, 83.7%, and 30.7%, respectively). The overall accuracy and Kappa agreement coefficient were reported as 70% and 0.15, r (P=0.11).Conclusion As evidenced by the results of the resent study, although urine calprotectin level elevates in AKI in neonates, it is not more sensitive than gold standards to predict AKI.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"50 1","pages":"8-14"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85437022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.54250.1997
Kenza Hattoufi, M. Obtel, H. Aguenaou, A. Kharbach, A. Barkat
Background: Early-onset neonatal sepsis remains a common and serious problem for neonates. The clinical manifestations of neonatal sepsis are nonspecific and have varied clinical features. Therefore, their diagnosis is based on a combination of clinical presentation, the use of biological tests, and anamnestic arguments. The purpose of this study was to describe the infection risk factors and clinical, paraclinical and evolutionary characteristics of newborns admitted for suspicion of early-onset neonatal sepsis, and to highlights the importance of C-reactive protein to diagnose neonatal sepsis. Methods: This retrospective and analytical study was conducted from January 1 to December 31, 2016, at the National Reference Center for Neonatology and Nutrition at Children's Hospital, University Hospital Centre Ibn Sina of Rabat. Results: During that period, 1199 newborns met the inclusion criteria. At admission, 52% of the cases were under the age of one day. Symptomatic newborns represented 67.4% of the cases. The hospitalized cases with one or more infectious risk factors were represented 80.3% of cases. The C-reactive protein was positive (> 20 mg/L) in 698 (58%) newborns. Univariate analysis showed that C-reactive protein value was significantly associated with age groups (p<0.001), presence of at least one infectious risk factor (p<0.001), and the presence of respiratory (p<0.001), cutaneous (p<0.001), circulatory (p=0.02), and neurological (p=0.008) symptoms. The diagnosis of early-onset neonatal infection with a meningeal, pulmonary, or ocular location was retained in 5, 2, and 0.2% of the cases, respectively. The mortality rate was 7%. Conclusion: Screening, management, and reduction of early early-onset neonatal infection remain a crucial challenge, which requires coordination between pediatricians and obstetricians to obtain reliable data and identify newborns at risk.
{"title":"Early-Onset Neonatal Sepsis: A Retrospective Study among 1,119 Moroccan Newborns Admitted to the National Reference Center in Neonatology and Nutrition, Rabat, Morocco","authors":"Kenza Hattoufi, M. Obtel, H. Aguenaou, A. Kharbach, A. Barkat","doi":"10.22038/IJN.2021.54250.1997","DOIUrl":"https://doi.org/10.22038/IJN.2021.54250.1997","url":null,"abstract":"Background: Early-onset neonatal sepsis remains a common and serious problem for neonates. The clinical manifestations of neonatal sepsis are nonspecific and have varied clinical features. Therefore, their diagnosis is based on a combination of clinical presentation, the use of biological tests, and anamnestic arguments. The purpose of this study was to describe the infection risk factors and clinical, paraclinical and evolutionary characteristics of newborns admitted for suspicion of early-onset neonatal sepsis, and to highlights the importance of C-reactive protein to diagnose neonatal sepsis. \u0000Methods: This retrospective and analytical study was conducted from January 1 to December 31, 2016, at the National Reference Center for Neonatology and Nutrition at Children's Hospital, University Hospital Centre Ibn Sina of Rabat.\u0000Results: During that period, 1199 newborns met the inclusion criteria. At admission, 52% of the cases were under the age of one day. Symptomatic newborns represented 67.4% of the cases. The hospitalized cases with one or more infectious risk factors were represented 80.3% of cases. The C-reactive protein was positive (> 20 mg/L) in 698 (58%) newborns. Univariate analysis showed that C-reactive protein value was significantly associated with age groups (p<0.001), presence of at least one infectious risk factor (p<0.001), and the presence of respiratory (p<0.001), cutaneous (p<0.001), circulatory (p=0.02), and neurological (p=0.008) symptoms. The diagnosis of early-onset neonatal infection with a meningeal, pulmonary, or ocular location was retained in 5, 2, and 0.2% of the cases, respectively. The mortality rate was 7%.\u0000Conclusion: Screening, management, and reduction of early early-onset neonatal infection remain a crucial challenge, which requires coordination between pediatricians and obstetricians to obtain reliable data and identify newborns at risk.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"24 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75938345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.46291.1781
B. Lubis, O. R. Ramayani, R. A. Ganie, G. D. Tjipta, S. H. Effendi
Background Premature birth is linked to neonatal morbidity and mortality worldwide. Neuregulin (NRG) is a trophic factor from the growth factor (GF) of a transmembrane polypeptide, encoded by four different genes, including NRG-1 which acts as an endogenous protector in fetal development. Decreased levels of NRG-1 affect several organs. The relationship between NRG-1 polymorphism and the outcome of neonatal development has been widely studied. There are no studies that have assessed NRG-1 levels and NRG-1 rs35753505 C/T polymorphism in preterm neonates, as well as its association with short-term morbidities in Indonesia.Methods This cross-sectional study was conducted on preterm neonates with the gestational age of 32-36 weeks in Medan, North Sumatera, Indonesia, from December 2017 to December 2018. It aimed to evaluate the association of NRG-1 levels and NRG1 polymorphism with short-term morbidities. Samples were obtained from cord blood specimens. Enzyme-linked immunosorbent assay (ELISA) was used to determine NRG-1 levels, and NRG-1 polymorphism was sequenced by polymerase chain reaction (PCR). Observations in preterm neonates were made during the first 72 h to assess short-term morbidities.Results During the study period, 48 cord blood specimens from preterm neonates were found eligible for analysis. Preterm neonates with low NRG-1 levels had a 10-times higher risk of developing short-term morbidities. The presence of CC and CT genotypes increased the risk of developing short-term morbidities 13.33 times (P=0.003) and 6.19 times (P=0.019), respectively. The presence of the C allele in subjects' genotype increased the risk of short-term morbidities 4.04 times (P=0.001), compared to those with T allele.Conclusion As evidenced by the obtained results, preterm neonates with low NRG-1 levels had a higher risk of developing short-term morbidities. Furthermore, there was a significant association between NRG-1 rs35753505 C/T polymorphism and short-term morbidities.
{"title":"Association of Neuregulin Levels and Neuregulin-1 Polymorphism with Short-term Morbidities in Preterm Neonates","authors":"B. Lubis, O. R. Ramayani, R. A. Ganie, G. D. Tjipta, S. H. Effendi","doi":"10.22038/IJN.2021.46291.1781","DOIUrl":"https://doi.org/10.22038/IJN.2021.46291.1781","url":null,"abstract":"Background Premature birth is linked to neonatal morbidity and mortality worldwide. Neuregulin (NRG) is a trophic factor from the growth factor (GF) of a transmembrane polypeptide, encoded by four different genes, including NRG-1 which acts as an endogenous protector in fetal development. Decreased levels of NRG-1 affect several organs. The relationship between NRG-1 polymorphism and the outcome of neonatal development has been widely studied. There are no studies that have assessed NRG-1 levels and NRG-1 rs35753505 C/T polymorphism in preterm neonates, as well as its association with short-term morbidities in Indonesia.Methods This cross-sectional study was conducted on preterm neonates with the gestational age of 32-36 weeks in Medan, North Sumatera, Indonesia, from December 2017 to December 2018. It aimed to evaluate the association of NRG-1 levels and NRG1 polymorphism with short-term morbidities. Samples were obtained from cord blood specimens. Enzyme-linked immunosorbent assay (ELISA) was used to determine NRG-1 levels, and NRG-1 polymorphism was sequenced by polymerase chain reaction (PCR). Observations in preterm neonates were made during the first 72 h to assess short-term morbidities.Results During the study period, 48 cord blood specimens from preterm neonates were found eligible for analysis. Preterm neonates with low NRG-1 levels had a 10-times higher risk of developing short-term morbidities. The presence of CC and CT genotypes increased the risk of developing short-term morbidities 13.33 times (P=0.003) and 6.19 times (P=0.019), respectively. The presence of the C allele in subjects' genotype increased the risk of short-term morbidities 4.04 times (P=0.001), compared to those with T allele.Conclusion As evidenced by the obtained results, preterm neonates with low NRG-1 levels had a higher risk of developing short-term morbidities. Furthermore, there was a significant association between NRG-1 rs35753505 C/T polymorphism and short-term morbidities.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"112 1","pages":"22-29"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80736164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/ijn.2021.53317.1989
M. Zarkesh
Coronavirus disease 2019 (COVID-19) directly increases the risk of preterm delivery. Furthermore, the COVID-19 pandemic may indirectly impact the health status of preterm infants. In the present study we noted several views regarding the negative effects of this viral disease on postnatal health that need much consideration. Methods: A short communication study was carried out in 2020. Literatures indicating several adverse effects of COVID 19 pandemic on health of preterm neonates were reviewed. Results: Literature review has revealed that regarding the protecting newborns from infectious risk in the neonatal intensive care units (NICU), several policies have been implemented. Isolation of ill COVID-19 positive mother, mother-infant separation, interruption of skin to skin contact and breastfeeding, restrictions associated with the presence of parents in the NICUs are some of them. Moreover, postponing the follow-up consultations and lack of healthcare services are also other influencing problems. Conclusion: It seems urgent measures must be implemented to protect preterm neonates and their parents against severe consequences. Providing adequate and professional human resources in the NICUs, improvement of virtual communication for parent's involvement in the NICU admission period and postnatal follow-up appointments, promotion of exclusive breastfeeding for subjects without any contraindication, reminding vaccination schedule by calling or texting, reducing the family's financial burden by governmental support, improving mother-infant bonding with respiratory and hand hygiene are a few recommendations that could be beneficial.
{"title":"Impacts of the COVID-19 pandemic on health of preterm infants in Iran","authors":"M. Zarkesh","doi":"10.22038/ijn.2021.53317.1989","DOIUrl":"https://doi.org/10.22038/ijn.2021.53317.1989","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) directly increases the risk of preterm delivery. Furthermore, the COVID-19 pandemic may indirectly impact the health status of preterm infants. In the present study we noted several views regarding the negative effects of this viral disease on postnatal health that need much consideration. \u0000Methods: A short communication study was carried out in 2020. Literatures indicating several adverse effects of COVID 19 pandemic on health of preterm neonates were reviewed. \u0000Results: Literature review has revealed that regarding the protecting newborns from infectious risk in the neonatal intensive care units (NICU), several policies have been implemented. Isolation of ill COVID-19 positive mother, mother-infant separation, interruption of skin to skin contact and breastfeeding, restrictions associated with the presence of parents in the NICUs are some of them. Moreover, postponing the follow-up consultations and lack of healthcare services are also other influencing problems. Conclusion: It seems urgent measures must be implemented to protect preterm neonates and their parents against severe consequences. Providing adequate and professional human resources in the NICUs, improvement of virtual communication for parent's involvement in the NICU admission period and postnatal follow-up appointments, promotion of exclusive breastfeeding for subjects without any contraindication, reminding vaccination schedule by calling or texting, reducing the family's financial burden by governmental support, improving mother-infant bonding with respiratory and hand hygiene are a few recommendations that could be beneficial.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82454339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.55001.2020
A. Taksande, R. Rao
Background: Neurosonography has commonly used for screening in a tertiary level hospital with a neonatal intensive care unit (NICU), for early detection of Central Nervous System (CNS) defects like intra-ventricular haemorrhage (IVH), hydrocephalus, cerebral edema or any structural anomalies. in the neonates brain. Aim: To study the detection of Central Nervous System (CNS) abnormality by neurosonography in critically ill neonates. Materials and methods: This was a cross sectional study done in NICU, AVBRH, Sawangi Meghe. By taking detailed maternal history and clinical examination, neonate is described as “critically ill”. These neonates subjected to neurosonogram (NUSG) according to the inclusion and exclusion criteria as per the protocols and various anomalies noted. Gestational age, birth weight, clinical examination, investigation, neurosonography finding and outcome were evaluated. Results: Neurosonography performed in 105 critically ill neonates. Out of that, 21 had abnormal neurosonography finding. There was no significant correlation of birth weight and gestational age of high-risk neonate with abnormal neurosonograpy (p=0.538 & p=0.130). The most frequent clinical manifestation was RDS followed by neonatal seizure. The mean HR,RR, SBP,DBP and SpO2 were 140±19.81, 54.08±13.07, 90.96±8.66, 54.13±8.39 and 94.39±6.93 respectively. There was no statistically significant correlation between the vital parameters and the presence of abnormalities on neurosonography. On neurosonography, 20% of neonates had abnormal findings. About 8.57% of these had hydrocephalus, 6.6% Intraventricular haemorrhage, 1.90% has periventricular echogenicity, 0.95% had cerebral oedema, 0.95% had germinal matrix haemorrhage and 1% had brain abscess. Seventy-two neonates (68.57%) participate had positive outcome at the time of NICU discharge and 19(18.10%) were died. Conclusion: Neurosonography is a useful tool in NICU. It is acceptable and reliable modality to screen critically ill neonates and aid in early detection and management of these ill neonates.
{"title":"Early detection of Central Nervous System (CNS) abnormality by Neurosonography in critically ill neonates.","authors":"A. Taksande, R. Rao","doi":"10.22038/IJN.2021.55001.2020","DOIUrl":"https://doi.org/10.22038/IJN.2021.55001.2020","url":null,"abstract":"Background: Neurosonography has commonly used for screening in a tertiary level hospital with a neonatal intensive care unit (NICU), for early detection of Central Nervous System (CNS) defects like intra-ventricular haemorrhage (IVH), hydrocephalus, cerebral edema or any structural anomalies. in the neonates brain. Aim: To study the detection of Central Nervous System (CNS) abnormality by neurosonography in critically ill neonates. Materials and methods: This was a cross sectional study done in NICU, AVBRH, Sawangi Meghe. By taking detailed maternal history and clinical examination, neonate is described as “critically ill”. These neonates subjected to neurosonogram (NUSG) according to the inclusion and exclusion criteria as per the protocols and various anomalies noted. Gestational age, birth weight, clinical examination, investigation, neurosonography finding and outcome were evaluated. Results: Neurosonography performed in 105 critically ill neonates. Out of that, 21 had abnormal neurosonography finding. There was no significant correlation of birth weight and gestational age of high-risk neonate with abnormal neurosonograpy (p=0.538 & p=0.130). The most frequent clinical manifestation was RDS followed by neonatal seizure. The mean HR,RR, SBP,DBP and SpO2 were 140±19.81, 54.08±13.07, 90.96±8.66, 54.13±8.39 and 94.39±6.93 respectively. There was no statistically significant correlation between the vital parameters and the presence of abnormalities on neurosonography. On neurosonography, 20% of neonates had abnormal findings. About 8.57% of these had hydrocephalus, 6.6% Intraventricular haemorrhage, 1.90% has periventricular echogenicity, 0.95% had cerebral oedema, 0.95% had germinal matrix haemorrhage and 1% had brain abscess. Seventy-two neonates (68.57%) participate had positive outcome at the time of NICU discharge and 19(18.10%) were died. Conclusion: Neurosonography is a useful tool in NICU. It is acceptable and reliable modality to screen critically ill neonates and aid in early detection and management of these ill neonates.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86314321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.50324.1881
Hosein Mahmoodzade, S. Mafinejad, H. Ehteshammanesh, G. Bayani
Primary craniosynostosis is a from of premature fusion of the cranial sutures, an event which usually occurs prenatally. Both syndromic and nonsyndromic forms exist. Most cases are of unknown etiology; genetic syndromes account for 10%–20% of cases, of which Apert, Crouzon and Pfeiffer syndromes are the most common. Scaphocephaly occurs from premature closer of the sagittal suture and is the most common form of craniosynostosis. Frontal plagiocephaly is the next most common form and results from premature fusion of a coronal and sphenofrontal suture. Palpation of the suture at birth often reveals a bony ridge. Skull radiograph or head CT may be considered. Certain genetic forms of craniosynostosis are caused by mutations in TWIST, FGFR1, FGFR2, or FGFR3. Apert syndrome is a rare congenital disorder characterized by craniosynostosis (such as cone-shaped calvarium) and severe symmetrical syndactyly of the hands and feet. We have aimed to present a newborn male patient having all the features of classical Apert syndrome.
{"title":"APERT SYNDROM case report","authors":"Hosein Mahmoodzade, S. Mafinejad, H. Ehteshammanesh, G. Bayani","doi":"10.22038/IJN.2021.50324.1881","DOIUrl":"https://doi.org/10.22038/IJN.2021.50324.1881","url":null,"abstract":"Primary craniosynostosis is a from of premature fusion of the cranial sutures, an event which usually occurs prenatally. Both syndromic and nonsyndromic forms exist. Most cases are of unknown etiology; genetic syndromes account for 10%–20% of cases, of which Apert, Crouzon and Pfeiffer syndromes are the most common. Scaphocephaly occurs from premature closer of the sagittal suture and is the most common form of craniosynostosis. Frontal plagiocephaly is the next most common form and results from premature fusion of a coronal and sphenofrontal suture. Palpation of the suture at birth often reveals a bony ridge. Skull radiograph or head CT may be considered. Certain genetic forms of craniosynostosis are caused by mutations in TWIST, FGFR1, FGFR2, or FGFR3. Apert syndrome is a rare congenital disorder characterized by craniosynostosis (such as cone-shaped calvarium) and severe symmetrical syndactyly of the hands and feet. We have aimed to present a newborn male patient having all the features of classical Apert syndrome.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86888520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.51887.1918
H. Babaei, M. Khosravifar
Abstract Introduction: Lumbosacral agenesis or caudal regression syndrome (CRS) is a rare congenital malformation that is represented with symmetrical sacrococcygeal or lumbosacrococcygeal agenesis with a varied incidence between 1 per 25000 live birth to 2.5 per 100000 live birth. Additionally, manifold abnormalities may associate CRS e.g. spinal cord malformations, cardiac malformations, lipomyelomeningocele, orthopaedic deformities, renal agenesis and neurogenic bladder, tethered-cord, sacral agenesis, and anorectal atresia Case Presentation: We report a case of a male neonate delivered to a 28-year-old diabetic mother at 38 weeks’ gestation diagnosed with CRS. In this case lumbosacral agenesis, hip dislocation, and club foot deformities along with cardiac abnormalities including, small patent dactus arteriosus (PDA), atrial septal defect (ASD), hypertrophic cardiomyopathy (HCM) without left ventricular outlet obstruction were presented. Conclusions: Having the 200-fold increased relative risk of developing CRS in infants of diabetic mothers in mind, this case report provides evidence that uncontrolled diabetes might increase the chance of CRS in the infants.
{"title":"Caudal regression syndrome: A case report and literature of review","authors":"H. Babaei, M. Khosravifar","doi":"10.22038/IJN.2021.51887.1918","DOIUrl":"https://doi.org/10.22038/IJN.2021.51887.1918","url":null,"abstract":"Abstract\u0000Introduction: Lumbosacral agenesis or caudal regression syndrome (CRS) is a rare congenital malformation that is represented with symmetrical sacrococcygeal or lumbosacrococcygeal agenesis with a varied incidence between 1 per 25000 live birth to 2.5 per 100000 live birth. Additionally, manifold abnormalities may associate CRS e.g. spinal cord malformations, cardiac malformations, lipomyelomeningocele, orthopaedic deformities, renal agenesis and neurogenic bladder, tethered-cord, sacral agenesis, and anorectal atresia\u0000Case Presentation: We report a case of a male neonate delivered to a 28-year-old diabetic mother at 38 weeks’ gestation diagnosed with CRS. In this case lumbosacral agenesis, hip dislocation, and club foot deformities along with cardiac abnormalities including, small patent dactus arteriosus (PDA), atrial septal defect (ASD), hypertrophic cardiomyopathy (HCM) without left ventricular outlet obstruction were presented. \u0000Conclusions: Having the 200-fold increased relative risk of developing CRS in infants of diabetic mothers in mind, this case report provides evidence that uncontrolled diabetes might increase the chance of CRS in the infants.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81042182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.56074.2048
F. R. Sharbaf, M. Ghaemi, M. Shirazi, Behrokh Sahebdel, M. Haghiri, F. Golshahi
Objective: To evaluate the outcome of radiofrequency ablation of the umbilical cord in the reduction of Twin Reversed Arterial Perfusion (TRAP) sequence or acardiac twin in monochorionic diamniotic pregnancies. Material and methods: In this prospective study, 25 cases of monochorionic diamniotic pregnancy with one acardiac twin underwent selected reduction using radiofrequency ablation (RFA) in the second trimester of gestational age, from 2018 to 2019 in a tertiary referral hospital affiliated to Tehran University of Medical Sciences. Results: The overall survival rate was 84%. The mean±SD of gestational age at the time of the procedure and delivery were 20.0±3.8 and 35w±6.0 days respectively. Nine neonates were admitted to the neonatal intensive care unit (NICU) and 4 miscarriages were recorded in less than 24 weeks. The procedures in all cases were technically successful in achieving selective termination. Conclusion: Radiofrequency ablation for fetal reduction in acardiac twins in monochorionic pregnancies appears to be a safe and reasonable option.
{"title":"Radiofrequency Ablation of Umbilical Cord for Reduction of Twin Reversed Arterial Perfusion Sequence: A Case Series","authors":"F. R. Sharbaf, M. Ghaemi, M. Shirazi, Behrokh Sahebdel, M. Haghiri, F. Golshahi","doi":"10.22038/IJN.2021.56074.2048","DOIUrl":"https://doi.org/10.22038/IJN.2021.56074.2048","url":null,"abstract":"Objective: To evaluate the outcome of radiofrequency ablation of the umbilical cord in the reduction of Twin Reversed Arterial Perfusion (TRAP) sequence or acardiac twin in monochorionic diamniotic pregnancies.\u0000 Material and methods: In this prospective study, 25 cases of monochorionic diamniotic pregnancy with one acardiac twin underwent selected reduction using radiofrequency ablation (RFA) in the second trimester of gestational age, from 2018 to 2019 in a tertiary referral hospital affiliated to Tehran University of Medical Sciences. \u0000Results: The overall survival rate was 84%. The mean±SD of gestational age at the time of the procedure and delivery were 20.0±3.8 and 35w±6.0 days respectively. Nine neonates were admitted to the neonatal intensive care unit (NICU) and 4 miscarriages were recorded in less than 24 weeks. The procedures in all cases were technically successful in achieving selective termination.\u0000Conclusion: Radiofrequency ablation for fetal reduction in acardiac twins in monochorionic pregnancies appears to be a safe and reasonable option.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75091143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.22038/IJN.2021.55472.2034
Nilesh Jain, J. Prajapati, Pramila Ramawat, D. Singh
Objective :To evaluate the effectiveness of therapeutic hypothermia(TH) among asphyxiated newborns for reducing mortality, adverse clinical events, and short-term outcomes in comparison to asphyxiated newborns treated with standard therapy. Material and method: Non-randomised cohort study at the tertiary care center. Study population: Asphyxiated newborns admitted in NICU within 24 hrs of life meeting the lab and/or clinical criteria of Severe Birth Asphyxia. Eligible newborns who received TH were labeled as recipients and newborns who received standard care were labeled as non-recipient. Results: Out of 176 infants studied, 89 newborns received TH, and 87 newborns received standard care. Recipients of TH had 15.3% lower mortality than non-recipients (P<0.05). The incidence of adverse clinical events was similar among both groups. At discharge 73.2% among recipients vs 56.8% non recipients were neurologically normal( p=0.01). 92.6% among recipients vs 70.1% non recipients were able to breast feed (p<0.05), 30.4% of recipients vs 46.2% non-recipients required anti-epileptics(p<0.05). Conclusion: TH is effective and feasible with a decrease in the rate of death, better neurological status at discharge, and less need for anti-epileptics without increasing adverse clinical events at limited-resource settings using low-cost devices.
{"title":"Clinical profile, mortality and short term outcome in asphyxiated neonates treated with therapeutic hypothermia in limited-resource setting, a cohort study","authors":"Nilesh Jain, J. Prajapati, Pramila Ramawat, D. Singh","doi":"10.22038/IJN.2021.55472.2034","DOIUrl":"https://doi.org/10.22038/IJN.2021.55472.2034","url":null,"abstract":"Objective :To evaluate the effectiveness of therapeutic hypothermia(TH) among asphyxiated newborns for reducing mortality, adverse clinical events, and short-term outcomes in comparison to asphyxiated newborns treated with standard therapy.\u0000Material and method: Non-randomised cohort study at the tertiary care center. Study population: Asphyxiated newborns admitted in NICU within 24 hrs of life meeting the lab and/or clinical criteria of Severe Birth Asphyxia. Eligible newborns who received TH were labeled as recipients and newborns who received standard care were labeled as non-recipient.\u0000Results: Out of 176 infants studied, 89 newborns received TH, and 87 newborns received standard care. Recipients of TH had 15.3% lower mortality than non-recipients (P<0.05). The incidence of adverse clinical events was similar among both groups. At discharge 73.2% among recipients vs 56.8% non recipients were neurologically normal( p=0.01). 92.6% among recipients vs 70.1% non recipients were able to breast feed (p<0.05), 30.4% of recipients vs 46.2% non-recipients required anti-epileptics(p<0.05).\u0000Conclusion: TH is effective and feasible with a decrease in the rate of death, better neurological status at discharge, and less need for anti-epileptics without increasing adverse clinical events at limited-resource settings using low-cost devices.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86504047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.22038/IJN.2021.56277.2054
Samet Benli, A. Çaglar, E. Taşkin, M. Aydin
BackgroundThe oculo-auriculo-vertebral spectrum (OAVS) includes three closely related rare congenital diseases of different severity with an incidence of 1/3500-7000 individuals. The involvement is usually unilateral; however, bilateral involvement may also occur. In addition to craniofacial anomalies, defects in the cardiovascular, genitourinary, vertebral, and central nervous systems can be observed as well. The phenotype of the cases is highly variable. Goldenhar syndrome is the most severe form of this condition.Case reportIn total, three instructive cases of Goldenhar syndrome with different features have been reported in the present case study. The most common ear anomalies among these three cases included external auditory canal atresia, helix deformities, preauricular skin tag and/or ear pitting, microtia, and conductive hearing loss. The second case was presented with hemifacial microsomia on the more severely affected right side, and the third case had bilateral Brushfield spots and a dermolipoma ophthalmological findings.ConclusionBased on the findings of the present study, OAVS should also be considered in the differential diagnosis of the cases with facial and ear anomalies.
{"title":"Oculo-auriculo-vertebral Spectrum (Goldenhar Syndrome): Presentation of Three Cases","authors":"Samet Benli, A. Çaglar, E. Taşkin, M. Aydin","doi":"10.22038/IJN.2021.56277.2054","DOIUrl":"https://doi.org/10.22038/IJN.2021.56277.2054","url":null,"abstract":"BackgroundThe oculo-auriculo-vertebral spectrum (OAVS) includes three closely related rare congenital diseases of different severity with an incidence of 1/3500-7000 individuals. The involvement is usually unilateral; however, bilateral involvement may also occur. In addition to craniofacial anomalies, defects in the cardiovascular, genitourinary, vertebral, and central nervous systems can be observed as well. The phenotype of the cases is highly variable. Goldenhar syndrome is the most severe form of this condition.Case reportIn total, three instructive cases of Goldenhar syndrome with different features have been reported in the present case study. The most common ear anomalies among these three cases included external auditory canal atresia, helix deformities, preauricular skin tag and/or ear pitting, microtia, and conductive hearing loss. The second case was presented with hemifacial microsomia on the more severely affected right side, and the third case had bilateral Brushfield spots and a dermolipoma ophthalmological findings.ConclusionBased on the findings of the present study, OAVS should also be considered in the differential diagnosis of the cases with facial and ear anomalies.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"19 1","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81851846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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