Pub Date : 2021-01-01DOI: 10.22038/IJN.2020.49825.1879
E. Khodashenas, R. Saeidi, N. Ghasemi
Background: Herpes simplex virus (HSV) is one of the main causes of neonatal meningitis; nonetheless, it usually goes unreported. A lumbar puncture is needed to accurately differentiate between viral and bacterial meningitis. The cerebrospinal fluid can be analyzed to exclude bacterial meningitis; nevertheless, the identification of the specific viral cause may be beneficial. Viral diagnosis determines prognosis, improves the care of the patient, decreases hospitalization duration, and reduces unnecessary use of antibiotics. In young infants, the herpes simplex virus infection is responsible for serious complications leading to morbidity, mortality, and permanent sequelae in survivors. The clinical findings of this infection usually include tremors, seizures, lethargy, irritability, poor feeding, temperature instability, and a bulging anterior fontanel, which are common in almost all forms of meningitis. These similarities make the differential diagnosis rather difficult. Case report: We report and discuss the case of an an11-day-old neonate girl who presented with fever and negative test results, as well as our challenges that finally led to the diagnosis of HSV-related meningitis and its management. Conclusion: It could be managed to reach a firm diagnosis confirming the initial differential diagnosis through additional and repetitive testing. Therefore, it is concluded that clinical judgments may be more reliable than paraclinical results in the individual approach for each patient. Furthermore, HSV infection should also be considered for patients with a persistent fever of unknown origin. It is also recommended to adopt separate procedures for the suspicion of HSV type 1 and HSV type 2. Keywords: Herpes simplex virus, Infantile fever, Meningitis
{"title":"Infantile Herpes Simplex Virus Meningitis: A Case Report","authors":"E. Khodashenas, R. Saeidi, N. Ghasemi","doi":"10.22038/IJN.2020.49825.1879","DOIUrl":"https://doi.org/10.22038/IJN.2020.49825.1879","url":null,"abstract":"Background: Herpes simplex virus (HSV) is one of the main causes of neonatal meningitis; nonetheless, it usually goes unreported. A lumbar puncture is needed to accurately differentiate between viral and bacterial meningitis. The cerebrospinal fluid can be analyzed to exclude bacterial meningitis; nevertheless, the identification of the specific viral cause may be beneficial. Viral diagnosis determines prognosis, improves the care of the patient, decreases hospitalization duration, and reduces unnecessary use of antibiotics. In young infants, the herpes simplex virus infection is responsible for serious complications leading to morbidity, mortality, and permanent sequelae in survivors. The clinical findings of this infection usually include tremors, seizures, lethargy, irritability, poor feeding, temperature instability, and a bulging anterior fontanel, which are common in almost all forms of meningitis. These similarities make the differential diagnosis rather difficult. Case report: We report and discuss the case of an an11-day-old neonate girl who presented with fever and negative test results, as well as our challenges that finally led to the diagnosis of HSV-related meningitis and its management. Conclusion: It could be managed to reach a firm diagnosis confirming the initial differential diagnosis through additional and repetitive testing. Therefore, it is concluded that clinical judgments may be more reliable than paraclinical results in the individual approach for each patient. Furthermore, HSV infection should also be considered for patients with a persistent fever of unknown origin. It is also recommended to adopt separate procedures for the suspicion of HSV type 1 and HSV type 2. Keywords: Herpes simplex virus, Infantile fever, Meningitis","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"35 1","pages":"89-95"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73355062","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 : 2020-11-22DOI: 10.22038/IJN.2020.43810.1753
Ramy Saleh Morsy, Magda Mahmoud Sedky, R. Said, Aliaa A Ali, W. Abuelhamd
Background and Aim of work: To support breathing of premature infants, there has been a trend toward less tracheal intubation, less mechanical ventilation, and more nasal respiratory support which can result in the improvement of successful extubation rate. The two types of nasal respiratory support after extubation, which are most known, are the nasal CPAP and High flow nasal cannula. The objective of current study is to investigate and compare successful extubation by using high-flow nasal cannulae (HFNC) versus conventional NCPAP after a period of endotracheal positive pressure ventilation. Patients and methods: This prospective study was conducted in the NICU of Gynecology and Obstetrics department of Kasr El Aini hospital on 210 preterm infants. Post extubation failure rates were compared between both groups (HFNC) and (NCPAP). The collected data were analyzed by SPSS program version 20.Results: Neonates who needed reintubation within 72 hour after initial extubation were higher in HFNC group (72.7%) versus (27.3%) in CPAP group (P-value 0.063) and (45.8%) of neonates in HFNC group needed re-intubation within one week of initial extubation versus (54.2%) in CPAP (P-value 0.970). Mean duration of respiratory support using HFNC was 3.7 days compared with 6.5 days using CPAP (p-value 0.001). Among neonates who suffered nasal trauma 90.6% of infants belong to CPAP group 12.5% while 9.4% belong to HFNC group (p-value 0.001). Conclusion: The use of CPAP and HFNC after extubation of preterm mechanically ventilated neonates was statistically equal regarding extubation failure.
工作背景和目的:为了支持早产儿的呼吸，减少气管插管，减少机械通气，增加鼻呼吸支持已成为趋势，这可以提高拔管成功率。拔管后最广为人知的两种鼻呼吸支持方式是鼻CPAP和高流量鼻插管。本研究的目的是调查和比较在气管内正压通气一段时间后使用高流量鼻导管(HFNC)和传统NCPAP成功拔管的情况。患者和方法:本前瞻性研究在Kasr El Aini医院妇产科NICU对210名早产儿进行研究。比较两组(HFNC)和(NCPAP)拔管后失败率。收集的数据用SPSS软件进行分析。结果:HFNC组新生儿首次拔管后72小时内需要再插管的新生儿占72.7%，高于CPAP组(27.3%)(p值0.063);HFNC组新生儿首次拔管后1周内需要再插管的新生儿占45.8%，高于CPAP组(54.2%)(p值0.970)。HFNC组呼吸支持的平均持续时间为3.7天，而CPAP组为6.5天(p值0.001)。发生鼻外伤的新生儿中，90.6%属于CPAP组，12.5%属于HFNC组，9.4%属于HFNC组(p值0.001)。结论:早产儿机械通气拔管后使用CPAP与使用HFNC在拔管失败方面具有统计学意义。
{"title":"A Comparative Study between Postextubation of Preterm Infants into High-Flow Nasal Cannulae versus Nasal Continuous Positive Airway Pressure","authors":"Ramy Saleh Morsy, Magda Mahmoud Sedky, R. Said, Aliaa A Ali, W. Abuelhamd","doi":"10.22038/IJN.2020.43810.1753","DOIUrl":"https://doi.org/10.22038/IJN.2020.43810.1753","url":null,"abstract":"Background and Aim of work: To support breathing of premature infants, there has been a trend toward less tracheal intubation, less mechanical ventilation, and more nasal respiratory support which can result in the improvement of successful extubation rate. The two types of nasal respiratory support after extubation, which are most known, are the nasal CPAP and High flow nasal cannula. The objective of current study is to investigate and compare successful extubation by using high-flow nasal cannulae (HFNC) versus conventional NCPAP after a period of endotracheal positive pressure ventilation. Patients and methods: This prospective study was conducted in the NICU of Gynecology and Obstetrics department of Kasr El Aini hospital on 210 preterm infants. Post extubation failure rates were compared between both groups (HFNC) and (NCPAP). The collected data were analyzed by SPSS program version 20.Results: Neonates who needed reintubation within 72 hour after initial extubation were higher in HFNC group (72.7%) versus (27.3%) in CPAP group (P-value 0.063) and (45.8%) of neonates in HFNC group needed re-intubation within one week of initial extubation versus (54.2%) in CPAP (P-value 0.970). Mean duration of respiratory support using HFNC was 3.7 days compared with 6.5 days using CPAP (p-value 0.001). Among neonates who suffered nasal trauma 90.6% of infants belong to CPAP group 12.5% while 9.4% belong to HFNC group (p-value 0.001). Conclusion: The use of CPAP and HFNC after extubation of preterm mechanically ventilated neonates was statistically equal regarding extubation failure.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82703263","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 : 2020-11-22DOI: 10.22038/IJN.2020.39688.1631
A. Shahfarhat, Abolfazl Nosrati Tirkani, Dariyush Hamidi Alamdari, محمدحسن ارجمند
Background:Asphyxia is the medical situation resulting of deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm usually to the brain. Human umbilical cord blood (UCB) is a well-established source of hematopoietic stem/progenitor cells (HSPCs) for allogeneic stem cell transplantation. Low level of O2 in infants with asphyxia during labor can influence on proliferation and differentiation of stem cells in cord blood. Method:The quality and colony forming unit of hematopoietic stem cells in cord blood of infants with severe asphyxia with Apgar score 3-5or need to cardiac pulmonary resuscitation five minutes after delivery were compared with the normal group with normal Apgar score.Afterward, hematopoietic stem cells were isolated and cells were cultured in enrichedmedia (MethoCult H4435) special for HSPCs for 7 days to assessment growth and colony formation. Results: There was a significant difference in the number of RBC (P=0.0016) and WBC precursor’s colonies (P = 0.006), in plate with 104 cord blood hematopoietic stem cells in infants who exposed to hypoxemia during labor.Conclusion: Umbilical cord blood is valued for its content of stem cells.Severehypoxia in the perinatal period does not have negative influence on viability of UCB hematopoietic stem cells to growth and formation colonies.Based on our research transient severe asphyxia does not have negative effects on HSPCs to save and banking for likely problems in future
{"title":"Asphyxia effects on colony forming ability of hematopoietic stem cell of cord blood","authors":"A. Shahfarhat, Abolfazl Nosrati Tirkani, Dariyush Hamidi Alamdari, محمدحسن ارجمند","doi":"10.22038/IJN.2020.39688.1631","DOIUrl":"https://doi.org/10.22038/IJN.2020.39688.1631","url":null,"abstract":"Background:Asphyxia is the medical situation resulting of deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm usually to the brain. Human umbilical cord blood (UCB) is a well-established source of hematopoietic stem/progenitor cells (HSPCs) for allogeneic stem cell transplantation. Low level of O2 in infants with asphyxia during labor can influence on proliferation and differentiation of stem cells in cord blood. Method:The quality and colony forming unit of hematopoietic stem cells in cord blood of infants with severe asphyxia with Apgar score 3-5or need to cardiac pulmonary resuscitation five minutes after delivery were compared with the normal group with normal Apgar score.Afterward, hematopoietic stem cells were isolated and cells were cultured in enrichedmedia (MethoCult H4435) special for HSPCs for 7 days to assessment growth and colony formation. Results: There was a significant difference in the number of RBC (P=0.0016) and WBC precursor’s colonies (P = 0.006), in plate with 104 cord blood hematopoietic stem cells in infants who exposed to hypoxemia during labor.Conclusion: Umbilical cord blood is valued for its content of stem cells.Severehypoxia in the perinatal period does not have negative influence on viability of UCB hematopoietic stem cells to growth and formation colonies.Based on our research transient severe asphyxia does not have negative effects on HSPCs to save and banking for likely problems in future","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78355726","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 : 2020-10-05DOI: 10.22038/IJN.2020.47630.1814
H. Boskabadi, G. Maamouri, N. Behgam
Background: Excessive hyperbilirubinemia is potentially neurotoxic and can lead to long-term complications in neonates. Exchange transfusion (ECT) is one of the important treatments for hyperbilirubinemia. The main goal of this study is to determine the maternal and neonatal characteristics of hyperbilirubinemia in infants in need of exchange transfusion.Methods and materials: This cross-sectional study was performed on 380 infants over 35 gestational weeks, 2 to 14 days old, with bilirubin above 17 mg/dl who had undergone ECT at Ghaem Hospital of Mashhad from 2010 to 2020. In this study, neonates in need of ECT were selected using available sampling method. The checklist form was designed based on neonatal examination, maternal (maternal age, parity), and neonatal status (age, sex, weight) and serial laboratory tests before and after ECT (total bilirubin, hematocrit, and platelet). Then, these variables were compared based on the cause of hyperbilirubinemia.Results: The mean bilirubin serum level was 28.5 mg/dl in male and 26.5 mg/dl (P = 0.096) in female infants, 29.5 mg/dl in the C-section and 28.1 mg/dl (P = 0.458) in normal vaginal delivery. Sixty percent of the neonates suffered from weight loss and 22% had more than 3% daily weight loss. In our study, infants first presented RH incompatibility and then ABO incompatibility and finally G6PD deficient neonates.Conclusion: Overall, these finding suggest that normal vaginal delivery, repeated breastfeeding, prevention of severe weight loss, early detection of RH & ABO incompatibility and G6PD deficiency, as well as appropriate management of hyperbilirubinemia may reduce both the need for ECT and alleviate complications of neonatal hyperbilirubinemia.
{"title":"The maternal and neonatal characteristics of hyperbilirubinemia in need of exchange transfusion","authors":"H. Boskabadi, G. Maamouri, N. Behgam","doi":"10.22038/IJN.2020.47630.1814","DOIUrl":"https://doi.org/10.22038/IJN.2020.47630.1814","url":null,"abstract":"Background: Excessive hyperbilirubinemia is potentially neurotoxic and can lead to long-term complications in neonates. Exchange transfusion (ECT) is one of the important treatments for hyperbilirubinemia. The main goal of this study is to determine the maternal and neonatal characteristics of hyperbilirubinemia in infants in need of exchange transfusion.Methods and materials: This cross-sectional study was performed on 380 infants over 35 gestational weeks, 2 to 14 days old, with bilirubin above 17 mg/dl who had undergone ECT at Ghaem Hospital of Mashhad from 2010 to 2020. In this study, neonates in need of ECT were selected using available sampling method. The checklist form was designed based on neonatal examination, maternal (maternal age, parity), and neonatal status (age, sex, weight) and serial laboratory tests before and after ECT (total bilirubin, hematocrit, and platelet). Then, these variables were compared based on the cause of hyperbilirubinemia.Results: The mean bilirubin serum level was 28.5 mg/dl in male and 26.5 mg/dl (P = 0.096) in female infants, 29.5 mg/dl in the C-section and 28.1 mg/dl (P = 0.458) in normal vaginal delivery. Sixty percent of the neonates suffered from weight loss and 22% had more than 3% daily weight loss. In our study, infants first presented RH incompatibility and then ABO incompatibility and finally G6PD deficient neonates.Conclusion: Overall, these finding suggest that normal vaginal delivery, repeated breastfeeding, prevention of severe weight loss, early detection of RH & ABO incompatibility and G6PD deficiency, as well as appropriate management of hyperbilirubinemia may reduce both the need for ECT and alleviate complications of neonatal hyperbilirubinemia.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"57 9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83675890","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 : 2020-10-05DOI: 10.22038/IJN.2020.45914.1768
M. Moslehi, F. Fallahi
Objective: Respiratory disorders are an important cause of morbidity and mortality in neonates. Fiberoptic Bronchoscopy (FOB) is being increasingly used by pediatricians both for diagnostic and therapeutic indications in children. However, information on diagnostic utility and safety of FOB in neonates is limited. FOB remains relatively under-used in the care of neonates. This article provides a practical overview of the wide diagnostic aspects of the FOB in infants who are hospitalized in Neonatal Intensive Care Unit (NICU). Frequencies of common indications, their findings, and highlights contribute to quick managing of those neonates with respiratory disorders.Patients and Methods: This descriptive study was conducted in the NICU of Namazi hospital and included 150 neonates with various respiratory problems admitted over a 5-year period, from 2013 till 2018. All subjects underwent FOB and bronchoalveolar Lavage (BAL), using a bronchoscope of 2.8 (EVIS EXERA III Olympus bronchoscope).Results: The greatest indications for doing FOB were hyper Secretion in 138 (92%), prolonged mechanical ventilation in 108 (72%) and persistent radiological finding in 97 (64.6%). Bronchoscopy detected various airways anomalies such as Laryngomalacia (72%), Tracheobronchomalacia (64%), subglottic stenosis (26%), vocal cord paresis (18%), tracheoesophageal fistula (6.7%), laryngeal cleft (6%) and laryngeal web (4%). BAL results showed that the cultures were positive in 13.33% (20) of neonates. Acinetobacter was the most commonly reported bacterial infection, observed in 8% of neonates.Conclusions: Findings of this study demonstrate that FOB, when performed by an experienced and well-trained person and in an environment with appropriate facilities, can be a safe and useful tool for the early diagnosis of many of the airway disorders among neonates who are admitted in NICUs.
目的:呼吸系统疾病是新生儿发病和死亡的重要原因。纤维支气管镜检查(FOB)越来越多地被儿科医生用于儿童的诊断和治疗适应症。然而，对新生儿的诊断效用和安全性的信息是有限的。在新生儿护理中，FOB的使用仍然相对不足。这篇文章提供了在新生儿重症监护病房(NICU)住院的婴儿的FOB广泛诊断方面的实用概述。常见适应症的频率，他们的发现，并强调有助于快速管理这些新生儿呼吸系统疾病。患者和方法:本描述性研究在Namazi医院NICU进行，纳入了2013年至2018年5年间收治的150名患有各种呼吸问题的新生儿。所有受试者均使用2.8级支气管镜(EVIS extra III Olympus支气管镜)进行FOB和支气管肺泡灌洗(BAL)。结果:行体外通气的适应症主要为分泌过多138例(92%)，机械通气时间延长108例(72%)，影像学表现持续97例(64.6%)。支气管镜检查发现各种气道异常，如喉软化(72%)、气管支气管软化(64%)、声门下狭窄(26%)、声带轻瘫(18%)、气管食管瘘(6.7%)、喉裂(6%)和喉蹼(4%)。BAL结果显示13.33%(20例)新生儿培养阳性。不动杆菌是最常见的细菌感染，在8%的新生儿中观察到。结论:本研究结果表明，如果由经验丰富且训练有素的人员在适当的设施环境中进行FOB，可以作为早期诊断新生儿呼吸道疾病的安全和有用的工具。
{"title":"Fiberoptic Bronchoscopy as a Diagnostic Tool in NICU: A Single Center Experience","authors":"M. Moslehi, F. Fallahi","doi":"10.22038/IJN.2020.45914.1768","DOIUrl":"https://doi.org/10.22038/IJN.2020.45914.1768","url":null,"abstract":"Objective: Respiratory disorders are an important cause of morbidity and mortality in neonates. Fiberoptic Bronchoscopy (FOB) is being increasingly used by pediatricians both for diagnostic and therapeutic indications in children. However, information on diagnostic utility and safety of FOB in neonates is limited. FOB remains relatively under-used in the care of neonates. This article provides a practical overview of the wide diagnostic aspects of the FOB in infants who are hospitalized in Neonatal Intensive Care Unit (NICU). Frequencies of common indications, their findings, and highlights contribute to quick managing of those neonates with respiratory disorders.Patients and Methods: This descriptive study was conducted in the NICU of Namazi hospital and included 150 neonates with various respiratory problems admitted over a 5-year period, from 2013 till 2018. All subjects underwent FOB and bronchoalveolar Lavage (BAL), using a bronchoscope of 2.8 (EVIS EXERA III Olympus bronchoscope).Results: The greatest indications for doing FOB were hyper Secretion in 138 (92%), prolonged mechanical ventilation in 108 (72%) and persistent radiological finding in 97 (64.6%). Bronchoscopy detected various airways anomalies such as Laryngomalacia (72%), Tracheobronchomalacia (64%), subglottic stenosis (26%), vocal cord paresis (18%), tracheoesophageal fistula (6.7%), laryngeal cleft (6%) and laryngeal web (4%). BAL results showed that the cultures were positive in 13.33% (20) of neonates. Acinetobacter was the most commonly reported bacterial infection, observed in 8% of neonates.Conclusions: Findings of this study demonstrate that FOB, when performed by an experienced and well-trained person and in an environment with appropriate facilities, can be a safe and useful tool for the early diagnosis of many of the airway disorders among neonates who are admitted in NICUs.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73752629","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 : 2020-10-05DOI: 10.22038/IJN.2020.47725.1816
E. Alaee, Maryam Koochaki, M. Besharat, Hassan Esmaeili
Background: The risk of developing metabolic syndrome and diseases as Diabetes mellitus have been raised as worldwide rise of obesity. Gestational diabetes (GDM) or maternal hyperglycemia is a risk factor for cardiac dysfunction in neonates. The present study compared QT interval in neonates with maternal gestational diabetes and healthy mothers.Patients and Methods: In this case-control study, term neonates with maternal GDM (case group, N = 42) and those with healthy non-diabetic mothers (control group, N=42) have been included from March 2016 to February 2017, in Sayyad-e-Shirazi hospital, Gorgan, Northeast of Iran. A pediatric cardiologist evaluated septal hypertrophy by Doppler echocardiography (Zonare ZS3) during first two weeks after birth. A standard 12-lead electrocardiogram was recorded for 10 seconds and corrected QT (QTc) value was calculated. Data were analyzed in latest version of SPSS using Chi-square and t-test to evaluate the differences in QT values and other indices between two groups. P-values less than 0.05 were considered statistically significant.Results: The present study showed congenital heart diseases in 6 neonates. Significantly higher QT (249±36 vs. 245± 28 ms) and septal thickness (6.09±1.07 vs. 5± 1 mm) and lower QTc value (382±44.06 vs. 392± 34 ms) were seen in case group compared to controls (P
背景:随着世界范围内肥胖的增加，发生代谢综合征和糖尿病等疾病的风险也在增加。妊娠期糖尿病(GDM)或母体高血糖是新生儿心功能障碍的危险因素。本研究比较了妊娠期糖尿病新生儿与健康母亲的QT间期。患者和方法:在本病例对照研究中，2016年3月至2017年2月，在伊朗东北部Gorgan的Sayyad-e-Shirazi医院，纳入了患有GDM的足月新生儿(病例组，N=42)和健康的非糖尿病母亲(对照组，N=42)。一位儿科心脏病专家通过多普勒超声心动图(Zonare ZS3)在出生后的前两周评估了室间隔肥大。记录标准12导联心电图10秒，计算校正后的QT (QTc)值。采用最新版SPSS软件对数据进行分析，采用卡方检验和t检验评价两组间QT值等指标的差异。p值小于0.05被认为具有统计学意义。结果:6例新生儿出现先天性心脏病。与对照组相比，病例组QT间期(249±36 vs 245±28 ms)和间隔厚度(6.09±1.07 vs 5±1 mm)显著增高，QTc值(382±44.06 vs 392±34 ms)显著降低(P < 0.05)
{"title":"Comparison of QT interval in neonates with maternal gestational diabetes and healthy mothers","authors":"E. Alaee, Maryam Koochaki, M. Besharat, Hassan Esmaeili","doi":"10.22038/IJN.2020.47725.1816","DOIUrl":"https://doi.org/10.22038/IJN.2020.47725.1816","url":null,"abstract":"Background: The risk of developing metabolic syndrome and diseases as Diabetes mellitus have been raised as worldwide rise of obesity. Gestational diabetes (GDM) or maternal hyperglycemia is a risk factor for cardiac dysfunction in neonates. The present study compared QT interval in neonates with maternal gestational diabetes and healthy mothers.Patients and Methods: In this case-control study, term neonates with maternal GDM (case group, N = 42) and those with healthy non-diabetic mothers (control group, N=42) have been included from March 2016 to February 2017, in Sayyad-e-Shirazi hospital, Gorgan, Northeast of Iran. A pediatric cardiologist evaluated septal hypertrophy by Doppler echocardiography (Zonare ZS3) during first two weeks after birth. A standard 12-lead electrocardiogram was recorded for 10 seconds and corrected QT (QTc) value was calculated. Data were analyzed in latest version of SPSS using Chi-square and t-test to evaluate the differences in QT values and other indices between two groups. P-values less than 0.05 were considered statistically significant.Results: The present study showed congenital heart diseases in 6 neonates. Significantly higher QT (249±36 vs. 245± 28 ms) and septal thickness (6.09±1.07 vs. 5± 1 mm) and lower QTc value (382±44.06 vs. 392± 34 ms) were seen in case group compared to controls (P","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74269556","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 : 2020-10-01DOI: 10.22038/IJN.2020.40780.1666
M. M. Rashed, Mona Maftouh, Seyyed Ali Alamdaran, Moloud Moghaddasi
Background: Paraurethral cyst or Skene’s gland cyst is a rare congenital abnormality and a rare cause of paraurethral cysts resulting from Skene’s gland, which has been reported in few studies so far. The Skene’s duct cyst can cause urinary retention or anuria; moreover, it can appear as an inter-labial mass in neonates.Case report: Our patient was a one-day-old female neonate presented with anuria and an inter-labial mass found in physical examination. The patient was referred by a pediatric surgeon to our department for sonographic evaluation. We did an ultrasound examination and made a tentative diagnosis of paraurethral cyst based on grayscale appearance and ultrasonographic criteria of the cystic lesion. The patient underwent surgery, a biopsy was obtained, and the specimen was sent for pathologic evaluation to a pediatric pathologist. The result confirmed our diagnosis as a Skene’s duct cyst.Conclusion: In this study, it was found that paraurethral cysts in newborns can be investigated using perineal ultrasound, which can eliminate the need for invasive surgeries.
{"title":"Role of Perineal Ultrasound in Differentiating Paraurethral Cysts in Newborns","authors":"M. M. Rashed, Mona Maftouh, Seyyed Ali Alamdaran, Moloud Moghaddasi","doi":"10.22038/IJN.2020.40780.1666","DOIUrl":"https://doi.org/10.22038/IJN.2020.40780.1666","url":null,"abstract":"Background: Paraurethral cyst or Skene’s gland cyst is a rare congenital abnormality and a rare cause of paraurethral cysts resulting from Skene’s gland, which has been reported in few studies so far. The Skene’s duct cyst can cause urinary retention or anuria; moreover, it can appear as an inter-labial mass in neonates.Case report: Our patient was a one-day-old female neonate presented with anuria and an inter-labial mass found in physical examination. The patient was referred by a pediatric surgeon to our department for sonographic evaluation. We did an ultrasound examination and made a tentative diagnosis of paraurethral cyst based on grayscale appearance and ultrasonographic criteria of the cystic lesion. The patient underwent surgery, a biopsy was obtained, and the specimen was sent for pathologic evaluation to a pediatric pathologist. The result confirmed our diagnosis as a Skene’s duct cyst.Conclusion: In this study, it was found that paraurethral cysts in newborns can be investigated using perineal ultrasound, which can eliminate the need for invasive surgeries.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"62 1","pages":"121-123"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88882794","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 : 2020-10-01DOI: 10.22038/IJN.2020.47926.1822
Harikrishnan Ramachandran, Jayashree Purkayastha, L. Lewis, Ramesh Bhat Yellanthoor, Apurv Barche, Sneha J. Andrade
Background: The quest persists for an ideal newer antiepileptic drug (AED) with better efficacy and tolerability. Levetiracetam (LEV) is one of these AEDs with a novel mechanism of action, good pharmacokinetic profile, acceptable tolerability, and side-effect profile. The present study assessed the safety and efficacy of intravenous levetiracetam as a first-line AED in neonatal seizures.Methods: This prospective observational study was conducted on all term neonates with seizures admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care center. Neonates with hypoglycemia, hypocalcemia, hypomagnesemia, inborn errors of metabolism, or those who received other AEDs prior to admission were excluded from the study. 20mg/kg Intravenous LEV was administered as first-line AED and graded up to 40mg/kg if seizures were not controlled in 2 h; thereafter, second-line AED was added.Results: Only 36.2% (21/58) of the cases responded to LEV as first-line AED. Hypoxic Ischaemic Encephalopathy(HIE) was the most common etiology of seizures (55.2%). Subtle seizures were most responsive to LEV (60%), while multifocal clonic seizures (22.3%) responded the least. No adverse effect of LEV was observed during the study period.Conclusion: Only 36.2% of the cases responded to LEV as first-line AED, and subtle seizures were the most responsive seizures. Therefore, the efficacy of LEV as first-line AED in neonatal seizures is yet to be proven by a larger study. There were no adverse effects of LEV during the study period indicating the relative safety of this drug.
{"title":"Levetiracetam as the First-line Antiepileptic in Neonatal Seizures","authors":"Harikrishnan Ramachandran, Jayashree Purkayastha, L. Lewis, Ramesh Bhat Yellanthoor, Apurv Barche, Sneha J. Andrade","doi":"10.22038/IJN.2020.47926.1822","DOIUrl":"https://doi.org/10.22038/IJN.2020.47926.1822","url":null,"abstract":"Background: The quest persists for an ideal newer antiepileptic drug (AED) with better efficacy and tolerability. Levetiracetam (LEV) is one of these AEDs with a novel mechanism of action, good pharmacokinetic profile, acceptable tolerability, and side-effect profile. The present study assessed the safety and efficacy of intravenous levetiracetam as a first-line AED in neonatal seizures.Methods: This prospective observational study was conducted on all term neonates with seizures admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care center. Neonates with hypoglycemia, hypocalcemia, hypomagnesemia, inborn errors of metabolism, or those who received other AEDs prior to admission were excluded from the study. 20mg/kg Intravenous LEV was administered as first-line AED and graded up to 40mg/kg if seizures were not controlled in 2 h; thereafter, second-line AED was added.Results: Only 36.2% (21/58) of the cases responded to LEV as first-line AED. Hypoxic Ischaemic Encephalopathy(HIE) was the most common etiology of seizures (55.2%). Subtle seizures were most responsive to LEV (60%), while multifocal clonic seizures (22.3%) responded the least. No adverse effect of LEV was observed during the study period.Conclusion: Only 36.2% of the cases responded to LEV as first-line AED, and subtle seizures were the most responsive seizures. Therefore, the efficacy of LEV as first-line AED in neonatal seizures is yet to be proven by a larger study. There were no adverse effects of LEV during the study period indicating the relative safety of this drug.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"76 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86318860","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 : 2020-10-01DOI: 10.22038/IJN.2020.47189.1808
Z. Eskandari, F. Akrami, Mostajab Razavi Nejad, A. Almasi-Hashiani, M. Heidarzadeh
Background: Preterm deliveries and premature babies are among challenges for families and communities. A family-centered care model is a model that helps families become less challenged by preterm birth and learn how to care for their premature infants. The aim of this study was to evaluate the implementation of family-centered care in the Iranian neonatal intensive care units (NICUs).Methods: This national cross-sectional study was conducted on a total of 23 NICUs of 9 universities of medical sciences, where students were trained in the neonatology fellowship course, in seven provinces of Iran. Family-centered developmental care was assessed in six different domains, including the philosophy of nursery, family communication, family support, family resources, admission and discharge planning, and decision-making. In addition, a total of 29 items were asked. The data were analyzed using Stata software (version 13) using descriptive statistical tests.Results: The mean scores in all domains were weak, and the total score for all domains was 34.18 (95% CI: 33.75-34.60) out of 100. The mean scores were 30 in the philosophy of nursery, 43.47 in family communication, 26.71 in family support, 35 in family resources, 45 in admission and discharge planning, and 25 in decision-making. The lowest score was reported for decision-making, and the highest score was reported for admission and discharge planning.Conclusion: Since family-centered developmental care in Iran is not favorable, the obtained findings suggest the development of a suitable plan to upgrade family-centered developmental care as well as comprehensive NICU care, including developmental care, with regard to other domains.
{"title":"Assessing Family-Centered Care in Iranian NICUs from Perspective of Neonatal Individual Developmental Care","authors":"Z. Eskandari, F. Akrami, Mostajab Razavi Nejad, A. Almasi-Hashiani, M. Heidarzadeh","doi":"10.22038/IJN.2020.47189.1808","DOIUrl":"https://doi.org/10.22038/IJN.2020.47189.1808","url":null,"abstract":"Background: Preterm deliveries and premature babies are among challenges for families and communities. A family-centered care model is a model that helps families become less challenged by preterm birth and learn how to care for their premature infants. The aim of this study was to evaluate the implementation of family-centered care in the Iranian neonatal intensive care units (NICUs).Methods: This national cross-sectional study was conducted on a total of 23 NICUs of 9 universities of medical sciences, where students were trained in the neonatology fellowship course, in seven provinces of Iran. Family-centered developmental care was assessed in six different domains, including the philosophy of nursery, family communication, family support, family resources, admission and discharge planning, and decision-making. In addition, a total of 29 items were asked. The data were analyzed using Stata software (version 13) using descriptive statistical tests.Results: The mean scores in all domains were weak, and the total score for all domains was 34.18 (95% CI: 33.75-34.60) out of 100. The mean scores were 30 in the philosophy of nursery, 43.47 in family communication, 26.71 in family support, 35 in family resources, 45 in admission and discharge planning, and 25 in decision-making. The lowest score was reported for decision-making, and the highest score was reported for admission and discharge planning.Conclusion: Since family-centered developmental care in Iran is not favorable, the obtained findings suggest the development of a suitable plan to upgrade family-centered developmental care as well as comprehensive NICU care, including developmental care, with regard to other domains.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"35 1","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89402010","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 : 2020-10-01DOI: 10.22038/IJN.2020.44569.1738
M. Kadivar, Razieh Sangsari, K. Mirnia, Arash Abbasi, Motahareh Rabipour
Background: Peritoneal dialysis is an applicable method for children and even neonates. Moreover, it allows the quiet excretion of fluid and soluble substances without hemodynamic instability. Peritoneal dialysis can be continued easily in hospitalized infants. However, the question is whether peritoneal dialysis is an effective procedure to replace hemodialysis in neonates or not?Methods: The population of this study included all neonates who were admitted to the Neonatal Intensive Care Unit of Children's Medical Center Hospital, Tehran, Iran, and underwent peritoneal dialysis during 2012-17. The data were collected using a questionnaire. Subsequently, the underlying diseases, complications, and laboratory changes were determined before and after peritoneal dialysis.Results: In total, 29neonates who underwent peritoneal dialysis were evaluated in this study. Peritoneal dialysis was performed on 58.6% and 41.4 % of the cases for congenital metabolic disorder and extra body fluids, respectively. Moreover, electrolyte disorders and uremia were observed in 13.7% and 13.8% of the total cases, respectively. Several indications were seen in some infants. Dialysis failure was seen in 79.3% of the cases, most of which were due to dialysis catheter obstruction; however, the mean changes in potassium, sodium, urea, creatinine, acidosis, ammonia, and phosphorus were significant72 h after dialysis.Conclusion: This study showed that peritoneal dialysis faced several failures in newborns; however, metabolic disorders, electrolyte imbalance, uremia, and extra body fluid were resolved. Moreover, it is considered a vital and effective way for the treatment of newborns, especially in low-resource countries in which hemodialysis cannot be performed easily.
{"title":"Peritoneal Dialysis in Neonates: A Five-Year Experience","authors":"M. Kadivar, Razieh Sangsari, K. Mirnia, Arash Abbasi, Motahareh Rabipour","doi":"10.22038/IJN.2020.44569.1738","DOIUrl":"https://doi.org/10.22038/IJN.2020.44569.1738","url":null,"abstract":"Background: Peritoneal dialysis is an applicable method for children and even neonates. Moreover, it allows the quiet excretion of fluid and soluble substances without hemodynamic instability. Peritoneal dialysis can be continued easily in hospitalized infants. However, the question is whether peritoneal dialysis is an effective procedure to replace hemodialysis in neonates or not?Methods: The population of this study included all neonates who were admitted to the Neonatal Intensive Care Unit of Children's Medical Center Hospital, Tehran, Iran, and underwent peritoneal dialysis during 2012-17. The data were collected using a questionnaire. Subsequently, the underlying diseases, complications, and laboratory changes were determined before and after peritoneal dialysis.Results: In total, 29neonates who underwent peritoneal dialysis were evaluated in this study. Peritoneal dialysis was performed on 58.6% and 41.4 % of the cases for congenital metabolic disorder and extra body fluids, respectively. Moreover, electrolyte disorders and uremia were observed in 13.7% and 13.8% of the total cases, respectively. Several indications were seen in some infants. Dialysis failure was seen in 79.3% of the cases, most of which were due to dialysis catheter obstruction; however, the mean changes in potassium, sodium, urea, creatinine, acidosis, ammonia, and phosphorus were significant72 h after dialysis.Conclusion: This study showed that peritoneal dialysis faced several failures in newborns; however, metabolic disorders, electrolyte imbalance, uremia, and extra body fluid were resolved. Moreover, it is considered a vital and effective way for the treatment of newborns, especially in low-resource countries in which hemodialysis cannot be performed easily.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"2 1","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87237546","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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