Preterm infants are more liable to suffer from anemia, as 90% of extremely low birth weight infants receive red blood cell transfusion. When to receive red blood cell transfusion is not well defined until now, even the complications and hazards resulting from the transfusion of adult red blood cell into the premature circulation is still a matter of debate. In this review, fetal erythropoiesis and the unique pathophysiology of anemia of prematurity is discussed, different meta-analysis studies are presented regarding liberal (high hemoglobin threshold) or restrictive (low hemoglobin threshold) transfusion protocols, early or late transfusion preferences. To clarify the picture of this, everyday decision neonatologists need to take, whether or not to give this premature infant a red packed cell transfusion, which may affect the life of this infant indefinitely. Until now, no fixed guidelines are present regarding when to transfuse anemia and still dependent on expert opinion and center experience. In conclusion the decision of RBCT is a multifactorial expert needing opinion but may be the only treatment option when the preterm neonate reaches a critical oxygen point beyond their ability to cope. So, a judicious use of blood transfusions is recommended, by unit specific guidelines. One can limit donor exposure by using multiple small packs from a single donor to multi transfuse a preterm infant, thus reducing donor exposure.
{"title":"Red blood cell transfusion in preterm neonates: a huge debate on tiny patients","authors":"S. Omar","doi":"10.21608/anj.2020.67438","DOIUrl":"https://doi.org/10.21608/anj.2020.67438","url":null,"abstract":"Preterm infants are more liable to suffer from anemia, as 90% of extremely low birth weight infants receive red blood cell transfusion. When to receive red blood cell transfusion is not well defined until now, even the complications and hazards resulting from the transfusion of adult red blood cell into the premature circulation is still a matter of debate. In this review, fetal erythropoiesis and the unique pathophysiology of anemia of prematurity is discussed, different meta-analysis studies are presented regarding liberal (high hemoglobin threshold) or restrictive (low hemoglobin threshold) transfusion protocols, early or late transfusion preferences. To clarify the picture of this, everyday decision neonatologists need to take, whether or not to give this premature infant a red packed cell transfusion, which may affect the life of this infant indefinitely. Until now, no fixed guidelines are present regarding when to transfuse anemia and still dependent on expert opinion and center experience. In conclusion the decision of RBCT is a multifactorial expert needing opinion but may be the only treatment option when the preterm neonate reaches a critical oxygen point beyond their ability to cope. So, a judicious use of blood transfusions is recommended, by unit specific guidelines. One can limit donor exposure by using multiple small packs from a single donor to multi transfuse a preterm infant, thus reducing donor exposure.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87917259","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}
Introduction: Jaundice is the most common condition that requires medical attention and hospital readmission in newborns. Objective: To evaluate the efficacy of oral use of fenofibrate, vitamin- D and other antioxidant vitamins (E and C) in treatment of full-term neonates with indirect hyperbilirubinemia. Patient and Methods: This is a prospective case control study carried on 80 full-term neonates suffering from unconjugated hyperbilirubinemia from January 2015 to May 2016. These neonates were randomly allocated into four groups. Group A; received only phototherapy as controls, group B received single oral dose of fenofibrate suspension in a dose 10 mg/kg beside phototherapy, group C received phototherapy and daily dose of vitamin D (400 IU/24h) and group D received phototherapy , daily dose of vitamin E (4 mg/day) and daily dose of vitamin C(40 mg/day). Results: The mean duration of stay at hospital of fenofibrate group was 2.6±0.7 days shorter than the mean duration of stay at hospital of control group which was 5.05±0.9 days (P value = 0.001*). Vitamin D group shows mean duration of stay at hospital 2.9±0.8 days shorter than that of control group which was 5.05±0.9 days ( P value =0.001*). The mean duration of stay at hospital of vitamin E & C group was 4.7±0.9 days, while mean duration of stay at hospital of control group was 5.05±0.9 days with no statistically significant difference (P value = 0.06). Conclusions: In conclusion, addition of single oral dose of fenofibrate in jaundiced baby receiving phototherapy in the first 24hours of treatment can significantly reduce the serum bilirubin levels in term newborns and duration of phototherapy.
{"title":"The effect of Fenofibrate and Antioxidant Vitamins [D, E and C] in Treatment of Uncomplicated Neonatal Hyperbilirubinemia.","authors":"Sawsan M. Al-Banna, Asmaa Riad, Sozan S. Anes","doi":"10.21608/anj.2019.45669","DOIUrl":"https://doi.org/10.21608/anj.2019.45669","url":null,"abstract":"Introduction: Jaundice is the most common condition that requires medical attention and hospital readmission in newborns. Objective: To evaluate the efficacy of oral use of fenofibrate, vitamin- D and other antioxidant vitamins (E and C) in treatment of full-term neonates with indirect hyperbilirubinemia. Patient and Methods: This is a prospective case control study carried on 80 full-term neonates suffering from unconjugated hyperbilirubinemia from January 2015 to May 2016. These neonates were randomly allocated into four groups. Group A; received only phototherapy as controls, group B received single oral dose of fenofibrate suspension in a dose 10 mg/kg beside phototherapy, group C received phototherapy and daily dose of vitamin D (400 IU/24h) and group D received phototherapy , daily dose of vitamin E (4 mg/day) and daily dose of vitamin C(40 mg/day). Results: The mean duration of stay at hospital of fenofibrate group was 2.6±0.7 days shorter than the mean duration of stay at hospital of control group which was 5.05±0.9 days (P value = 0.001*). Vitamin D group shows mean duration of stay at hospital 2.9±0.8 days shorter than that of control group which was 5.05±0.9 days ( P value =0.001*). The mean duration of stay at hospital of vitamin E & C group was 4.7±0.9 days, while mean duration of stay at hospital of control group was 5.05±0.9 days with no statistically significant difference (P value = 0.06). Conclusions: In conclusion, addition of single oral dose of fenofibrate in jaundiced baby receiving phototherapy in the first 24hours of treatment can significantly reduce the serum bilirubin levels in term newborns and duration of phototherapy.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"29 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83522426","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}
Introduction: Vitamin D deficiency is a worldwide problem associated with wide spectrum of diseases, ranging from neurological disorders to chronic inflammatory conditions. Objectives: This is a cross sectional case control study performed to compare vitamin D serum levels between full term neonates with hypoxic ischemic encephalopathy (HIE) and normal healthy neonates and to determine if there is an association between serum vitamin D levels and neonatal hypoxic ischemic encephalopathy (HIE). Patients and methods: This study included 60 full term neonates; 30 of them had the criteria of moderate to severe HIE encephalopathy and the others is clinically free. We measured the serum levels of vitamin D using ELISA in both groups and the mothers of diseased neonates. Results: Neonates with hypoxic ischemic encephalopathy had a significant lower (25(OH) vitamin D) than controls (P-value ≤ 0.001), half of them (50%) had deficient levels of vitamin D, 23.3% had insufficient levels and 26.7 had normal levels of vitamin D. The control group had normal level in 90% and only 10% had insufficient levels of vitamin D and there were significant lower levels in serum maternal vitamin D below normal. Conclusion: Full-term neonates with HIE had lower serum levels of vitamin D than healthy neonates with positive correlations between neonatal serum vitamin D levels and their maternal levels.
{"title":"The status of vitamin D in neonates with hypoxic ischemic encephalopathy","authors":"Salah M. Saleh, N. Sabry, Zeinb A. Nasef","doi":"10.21608/anj.2019.45666","DOIUrl":"https://doi.org/10.21608/anj.2019.45666","url":null,"abstract":"Introduction: Vitamin D deficiency is a worldwide problem associated with wide spectrum of diseases, ranging from neurological disorders to chronic inflammatory conditions. Objectives: This is a cross sectional case control study performed to compare vitamin D serum levels between full term neonates with hypoxic ischemic encephalopathy (HIE) and normal healthy neonates and to determine if there is an association between serum vitamin D levels and neonatal hypoxic ischemic encephalopathy (HIE). Patients and methods: This study included 60 full term neonates; 30 of them had the criteria of moderate to severe HIE encephalopathy and the others is clinically free. We measured the serum levels of vitamin D using ELISA in both groups and the mothers of diseased neonates. Results: Neonates with hypoxic ischemic encephalopathy had a significant lower (25(OH) vitamin D) than controls (P-value ≤ 0.001), half of them (50%) had deficient levels of vitamin D, 23.3% had insufficient levels and 26.7 had normal levels of vitamin D. The control group had normal level in 90% and only 10% had insufficient levels of vitamin D and there were significant lower levels in serum maternal vitamin D below normal. Conclusion: Full-term neonates with HIE had lower serum levels of vitamin D than healthy neonates with positive correlations between neonatal serum vitamin D levels and their maternal levels.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78817309","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}
Abdel-Azeem M. El-Mazary, A. Abdel-Fadel, Walid Abdel-Hamid, Hussein Hussein
{"title":"Effect of Intensive Phototherapy Treatment of Neonatal Jaundice on CD4 and CD8 T-Lymphocyte subsets","authors":"Abdel-Azeem M. El-Mazary, A. Abdel-Fadel, Walid Abdel-Hamid, Hussein Hussein","doi":"10.21608/anj.2019.45668","DOIUrl":"https://doi.org/10.21608/anj.2019.45668","url":null,"abstract":"","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76876346","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}
Introduction:Neonatal hyperbilirubinemia is defined as a total serum bilirubin level above 5 mg per dl (85 μmol / L). Jaundice is an important problem in the first week of life. It is a cause of concern for the physician and a source of anxiety for the parents. Objective:The aim of this work was to measure the serum levels of vitamin B12 in neonates with indirect hyperbilirubinemia and to compare them with that of apparently healthy neonates. Subjects and Methods:This study included 80 full term neonates divided into 2 groups: Group I: 40 full term neonates with indirect hyperbilirubinemia (23 females and 17males) aged 3-7 day's admitted to neonatal unit of Minia university hospital during the period from July to December 2017. Group II: 40 apparently healthy full term neonates as controls (20 males and 20 females) of matched age and weight. Results:the vitamin B12 serum levels were significantly lower than in neonates with indirect hyperbilirubinemia than controls (P-value = 0.001*). No statistically significant difference regarding age, sex, mode of delivery, gestational age or weight between patients and controls as were present. Also No statistically significant difference regarding the hemoglobin levels, platelets count, WBCS count or neutrophils count between cases and controls. Conclusion:Full term neonates with indirect hyperbilirubinemia had lower serum levels of vitamin B12 than healthy full term neonates.
{"title":"Assessment of serum levels of vitamin B12 in full term neonates with indirect hyperbilirubinemia","authors":"G. B. Mohamed, R. Abdel-Salam, R. Mortada","doi":"10.21608/anj.2019.45667","DOIUrl":"https://doi.org/10.21608/anj.2019.45667","url":null,"abstract":"Introduction:Neonatal hyperbilirubinemia is defined as a total serum bilirubin level above 5 mg per dl (85 μmol / L). Jaundice is an important problem in the first week of life. It is a cause of concern for the physician and a source of anxiety for the parents. Objective:The aim of this work was to measure the serum levels of vitamin B12 in neonates with indirect hyperbilirubinemia and to compare them with that of apparently healthy neonates. Subjects and Methods:This study included 80 full term neonates divided into 2 groups: Group I: 40 full term neonates with indirect hyperbilirubinemia (23 females and 17males) aged 3-7 day's admitted to neonatal unit of Minia university hospital during the period from July to December 2017. Group II: 40 apparently healthy full term neonates as controls (20 males and 20 females) of matched age and weight. Results:the vitamin B12 serum levels were significantly lower than in neonates with indirect hyperbilirubinemia than controls (P-value = 0.001*). No statistically significant difference regarding age, sex, mode of delivery, gestational age or weight between patients and controls as were present. Also No statistically significant difference regarding the hemoglobin levels, platelets count, WBCS count or neutrophils count between cases and controls. Conclusion:Full term neonates with indirect hyperbilirubinemia had lower serum levels of vitamin B12 than healthy full term neonates.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74009778","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}
Gehan Abdel-Hakim, N. Shehata, W. Abdel-Hameed, N. Wahab
IntroductionThe purpose of this study was to evaluate accuracy of cord blood interleukin-6 (IL-6) as an early marker of early onset neonatal sepsis (EOS) in neonates with maternal risk factors.. Objectives: To evaluate accuracy of cord blood IL-6 as a predictor of early onset neonatal sepsis (EONS) in neonates with prenatal risk factors for sepsis. Patients and methods: The study included 80 neonates divided into two groups. Group(I) included 25 full-term and 25 preterm neonates. Group (II) included thirty healthy age and sex matched controls with mean gestational age 35.2±3.8. All patients were subjected to adequate history taking, full clinical examination, complete blood count, blood culture, cord blood interleukin-6 and serum high sensitive CRP for elevated IL-6 level. Results:IL-6 level was significantly higher in the group (I) compared with group(II). No significant correlation between gestational age and level of IL-6. The best cutoff value for serum interleukin-6 as a marker for early detection of neonatal sepsis is ≥50 pg/ml with sensitivity 96 % and specificity 100%. Conclusion: Cord blood IL-6 can be a sensitive predictor of early onset sepsis for neonates with high risk of sepsis.
{"title":"Cord Blood Interleukin-6 as a Predictor of Early Onset Sepsis in High Risk Neonates","authors":"Gehan Abdel-Hakim, N. Shehata, W. Abdel-Hameed, N. Wahab","doi":"10.21608/anj.2019.45813","DOIUrl":"https://doi.org/10.21608/anj.2019.45813","url":null,"abstract":"IntroductionThe purpose of this study was to evaluate accuracy of cord blood interleukin-6 (IL-6) as an early marker of early onset neonatal sepsis (EOS) in neonates with maternal risk factors.. Objectives: To evaluate accuracy of cord blood IL-6 as a predictor of early onset neonatal sepsis (EONS) in neonates with prenatal risk factors for sepsis. Patients and methods: The study included 80 neonates divided into two groups. Group(I) included 25 full-term and 25 preterm neonates. Group (II) included thirty healthy age and sex matched controls with mean gestational age 35.2±3.8. All patients were subjected to adequate history taking, full clinical examination, complete blood count, blood culture, cord blood interleukin-6 and serum high sensitive CRP for elevated IL-6 level. Results:IL-6 level was significantly higher in the group (I) compared with group(II). No significant correlation between gestational age and level of IL-6. The best cutoff value for serum interleukin-6 as a marker for early detection of neonatal sepsis is ≥50 pg/ml with sensitivity 96 % and specificity 100%. Conclusion: Cord blood IL-6 can be a sensitive predictor of early onset sepsis for neonates with high risk of sepsis.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91234204","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}
Salah M. Saleh, Abdel-Azeem M. El-Mazary, E. Mohammed
Introduction: Ventilatory assistance allows for the recovery and maintenance of the patient with cardiorespiratory failure. Thanks to this intervention, many neonatal patient`s lives are saved in the neonatal intensive care units (NICUs). Objectives: This study is a prospective study to analyze the rate of failure and response of management of those patients on mechanical ventilation and relation between the response of cases on MV and different studied demographic, clinical and laboratory data. Patients and methods: All neonates with respiratory distress admitted from February 2018 to February 2019.Clinical response of mechanical ventilation cases was observed. Demographic and clinical data of neonates included in the study were collected and analyzed. Results: Among of 316 neonates, 162 cases (51.26%) treated with o2 only, 28 cases (8.86%) treated with bubble CPAP ,126 cases (39.87%) treated with mechanical ventilation. The cases on MV who survived were (23%) and cases who died were (77%). Low birth weight <2.5 kg: outcome is poor for VLBW and ELBW than NBW and LBW. Small gestational age < 34 weeks GA showed higher mortality .RDS were the most common cause for usage of MV. In MV settings with initial high Fio2 and PEEP were more in died group. Sepsis, shock and pulmonary hemorrhage were most common complications and both are associated with higher risk for mortality than other complications. Conclusion: It was found that predictors of mortality in mechanically ventilated neonates concluded from this study were: low birth weight <2.5 kg with poorer outcome for VLBW and ELBW than NBW and LBW also small gestational age with poor outcome for neonates below 34 weeks GA especially with lack of use of lung surfactant in cases with RDS in VLBW and ELBW.
{"title":"Analytical study for neonates with respiratory distress on mechanical ventilation admitted to NICU - Minia University Hospital","authors":"Salah M. Saleh, Abdel-Azeem M. El-Mazary, E. Mohammed","doi":"10.21608/anj.2019.45814","DOIUrl":"https://doi.org/10.21608/anj.2019.45814","url":null,"abstract":"Introduction: Ventilatory assistance allows for the recovery and maintenance of the patient with cardiorespiratory failure. Thanks to this intervention, many neonatal patient`s lives are saved in the neonatal intensive care units (NICUs). Objectives: This study is a prospective study to analyze the rate of failure and response of management of those patients on mechanical ventilation and relation between the response of cases on MV and different studied demographic, clinical and laboratory data. Patients and methods: All neonates with respiratory distress admitted from February 2018 to February 2019.Clinical response of mechanical ventilation cases was observed. Demographic and clinical data of neonates included in the study were collected and analyzed. Results: Among of 316 neonates, 162 cases (51.26%) treated with o2 only, 28 cases (8.86%) treated with bubble CPAP ,126 cases (39.87%) treated with mechanical ventilation. The cases on MV who survived were (23%) and cases who died were (77%). Low birth weight <2.5 kg: outcome is poor for VLBW and ELBW than NBW and LBW. Small gestational age < 34 weeks GA showed higher mortality .RDS were the most common cause for usage of MV. In MV settings with initial high Fio2 and PEEP were more in died group. Sepsis, shock and pulmonary hemorrhage were most common complications and both are associated with higher risk for mortality than other complications. Conclusion: It was found that predictors of mortality in mechanically ventilated neonates concluded from this study were: low birth weight <2.5 kg with poorer outcome for VLBW and ELBW than NBW and LBW also small gestational age with poor outcome for neonates below 34 weeks GA especially with lack of use of lung surfactant in cases with RDS in VLBW and ELBW.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91173649","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}
Abdel-Azeem M. El-Mazary, M. Sayed, Hazem M. Ali, Waleed Abdel Hameed, Nancy Tawadros
Introduction: Diabetes is one of the commonest and important metabolic disorder that affects the health of pregnant women and infants. MCP-1 in the myocardium was correlated with the degree of impairment of cardiac function and HbA1c concentration is also regarded as a treatment marker in patients with diabetes.Objectives: The study aimed at measure the levels of cord blood Hemoglobin A1c and MCP-1 and correlate their levels with echocardiographic findings in infants of diabetic mothers (IDMs) in comparison to healthy neonates of healthy mothers.Patients and methods: The current study was a descriptive cross-sectional comparative one included 110 full term neonates divided in to two groups, the first group included 70 full term neonates born to diabetic mothers and the second group included 40 full term apparently healthy neonates born to healthy mothers as a control group. This study was conducted from April 2016 to April 2017 at Maternal and Children Hospital of El Minia. All Patients were assessed during the first week of life, this assessment included complete medical history, thorough clinical examination with stress on cardiac examination, and laboratory investigations included CBC and neonatal blood sugar as a routine investigations& HbA1c and MCP-1 as a specific investigations and echocardiographic assessment.Results: IDMs have increased cardiac dimensions, impaired diastolic function and lower fractional shortening compared to control group. There was a strong positive correlation between levels of cord blood MCP-1 and echocardiographic measurements in IDMs. There was a strong positive correlation between levels of cord blood HbA1c and echocardiographic measurements in IDMs.Conclusion: HbA1c and MCP-1 were good predictors for occurrence of cardiomyopathy in Infants of diabetic mothers with gestational diabetes.
{"title":"Cord Blood Hemoglobin A1c and MCP-1 as Predictors for Cardiomyopathy in Infants of Mothers with Gestational Diabetes","authors":"Abdel-Azeem M. El-Mazary, M. Sayed, Hazem M. Ali, Waleed Abdel Hameed, Nancy Tawadros","doi":"10.21608/anj.2019.45815","DOIUrl":"https://doi.org/10.21608/anj.2019.45815","url":null,"abstract":"Introduction: Diabetes is one of the commonest and important metabolic disorder that affects the health of pregnant women and infants. MCP-1 in the myocardium was correlated with the degree of impairment of cardiac function and HbA1c concentration is also regarded as a treatment marker in patients with diabetes.Objectives: The study aimed at measure the levels of cord blood Hemoglobin A1c and MCP-1 and correlate their levels with echocardiographic findings in infants of diabetic mothers (IDMs) in comparison to healthy neonates of healthy mothers.Patients and methods: The current study was a descriptive cross-sectional comparative one included 110 full term neonates divided in to two groups, the first group included 70 full term neonates born to diabetic mothers and the second group included 40 full term apparently healthy neonates born to healthy mothers as a control group. This study was conducted from April 2016 to April 2017 at Maternal and Children Hospital of El Minia. All Patients were assessed during the first week of life, this assessment included complete medical history, thorough clinical examination with stress on cardiac examination, and laboratory investigations included CBC and neonatal blood sugar as a routine investigations& HbA1c and MCP-1 as a specific investigations and echocardiographic assessment.Results: IDMs have increased cardiac dimensions, impaired diastolic function and lower fractional shortening compared to control group. There was a strong positive correlation between levels of cord blood MCP-1 and echocardiographic measurements in IDMs. There was a strong positive correlation between levels of cord blood HbA1c and echocardiographic measurements in IDMs.Conclusion: HbA1c and MCP-1 were good predictors for occurrence of cardiomyopathy in Infants of diabetic mothers with gestational diabetes.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88316539","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}
S. Abd-Allah, Abdel-Azeem M. El-Mazary, N. Okaily, E. Hassan, A. Amin
Introduction:Using nasal continuous positive airway pressure (CPAP) for neonatal respiratory support is highly increasing in low and middle-income countries. It reduces the needs for mechanical ventilation in neonates with respiratory distress (RD) in tertiary hospitals. Objectives:This is a prospective non-randomized study aims to evaluate the role and efficiency of bubble CPAP in treatment of neonatal respiratory distress and correlation of bubble CPAP failure with different studied demographic, clinical and laboratory variable data. Patients and methods: The study included all neonates with respiratory distress admitted to neonatal intensive care unit (NICU) Minia University hospital from 1st of January to 31st of December 2017.The study analyzed the rate of failure and response of management of those patients on bubble CPAP and compared them with other different treatment modalities according to variable recorded demographic, clinical and laboratory data. Results: Among the 280 cases, 149 patients (53.2%) were treated with oxygen, 52 patients (18.6%) needed to be treated with bubble CPAP, 79 patients (28.2%) needed to be intubated and mechanically ventilated (MV). Our study showed more incidences of bubble CPAP therapy of RD cases with higher gestational ages and birth weight, milder grades of RD, absence of sepsis in comparison with mechanical ventilation and vice versa for comparison with nasal oxygen therapy. Conclusion:CPAP is an effective treatment of RD leading to significant improvement of outcome reducing hospital stay, need for invasive mechanical ventilation with its harmful adverse effects and thus the case fatality rate of RD cases and so the overall mortality rate of the NICU.
{"title":"Analytical study for neonates with respiratory distress on Bubble Continuous Positive Airway Pressure admitted to NICU of Minia University Hospital","authors":"S. Abd-Allah, Abdel-Azeem M. El-Mazary, N. Okaily, E. Hassan, A. Amin","doi":"10.21608/anj.2019.45817","DOIUrl":"https://doi.org/10.21608/anj.2019.45817","url":null,"abstract":"Introduction:Using nasal continuous positive airway pressure (CPAP) for neonatal respiratory support is highly increasing in low and middle-income countries. It reduces the needs for mechanical ventilation in neonates with respiratory distress (RD) in tertiary hospitals. Objectives:This is a prospective non-randomized study aims to evaluate the role and efficiency of bubble CPAP in treatment of neonatal respiratory distress and correlation of bubble CPAP failure with different studied demographic, clinical and laboratory variable data. Patients and methods: The study included all neonates with respiratory distress admitted to neonatal intensive care unit (NICU) Minia University hospital from 1st of January to 31st of December 2017.The study analyzed the rate of failure and response of management of those patients on bubble CPAP and compared them with other different treatment modalities according to variable recorded demographic, clinical and laboratory data. Results: Among the 280 cases, 149 patients (53.2%) were treated with oxygen, 52 patients (18.6%) needed to be treated with bubble CPAP, 79 patients (28.2%) needed to be intubated and mechanically ventilated (MV). Our study showed more incidences of bubble CPAP therapy of RD cases with higher gestational ages and birth weight, milder grades of RD, absence of sepsis in comparison with mechanical ventilation and vice versa for comparison with nasal oxygen therapy. Conclusion:CPAP is an effective treatment of RD leading to significant improvement of outcome reducing hospital stay, need for invasive mechanical ventilation with its harmful adverse effects and thus the case fatality rate of RD cases and so the overall mortality rate of the NICU.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82415868","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}
{"title":"An image for Deferential Diagnosis","authors":"M. Okasha, Abdel-Azeem M. El-Mazary","doi":"10.21608/anj.2019.45820","DOIUrl":"https://doi.org/10.21608/anj.2019.45820","url":null,"abstract":"","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73934159","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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