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J Chinese Med Assoc, 2008 Sep; 7(9): 4814
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صفحه اصلی | پست الکترونیک | العربیه | English
مرکز تحقيقات نوزادان
مركز تحقيقات نوزادان>خبرنامه شماره8
امتیاز کاربران
مركز تحقيقات نوزادان>خبرنامه شماره8
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اقدامات تشخيصي در مشكلات اينترسكس در نوزادان
نويسنده: دكتر غلامرضا فعال
دستيار فوق تخصصي نوزادان |
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امتیاز کاربران
مركز تحقيقات نوزادان>خبرنامه شماره 6
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اكسيژن درماني در نوزادان |
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دكتر غلامحسين فيروزي
دستيار فوق تخصصي نوزادان
 • اكسيژن درماني در نوزادان در مقايسه با كودكان بزرگتر:
- در نوزادان ذخيره اكسيژن كم است
- مقدار مورد نياز اكسيژن بر حسب كيلو گرم وزن بدن بيشتر است
- تغييرات كم در FIO2 باعث تغييرات بزرگ در Pao2 مي شود.
- مصرف نامحدود اكسيژن خطرات ريوي و خارج ريوي دارد.
•اهميت اكسيژن در احياء نوزادي
در حال حاضر توصيه به استفاده از اكسيژن صددرصد مي باشد ولي يك ايده ي در حال رشد براي جايگزيني احيا در هواي اتاق به جاي اكسيژن مي باشد. مطالعات نشان داده اند كه احياء در هواي اتاق مي تواند مزاياي زير را داشته باشد.
1- زمان كوتاهتر تا اولين تنفس و اولين گريه
2- مرگ و مير مختصري كمتر
3- هيچ عارضه اي ديده نشده است
در هر حال هنوز اطلاعات براي توصيه به احياء در هواي اتاق ناكافي است
•ارزيابي نياز به اكسيژن درماني:
- ارزيابي باليني: سيانوز، براديكاردي، تلاش تنفسي شديد، تون عضلاني
- مانيتورينگ: پالس اكسي متري Po2<50- ، ABG,SPO2<85
•روش هاي اكسيژن درماني:
- وسايل با جريان كم شامل كانولاي بيني و كاتتر نازوفارنژيال
- وسايل با جريان زياد شامل : ماسك و اكسي هود
- كانولاي بيني: ماكزيم فلو در نوزادان 3-2 ليتر در دقيقه است.
- كاتتر نازوفارنژيال: طول آن از پره بيني تا تراگوس گوش مي باشد. براي وجود پلاگ موكوسي بايد چك شود. بهتر است هر 24 ساعت تعويض شود. بيش از 3 ليتر در دقيقه در نوزادان داده نشود. كنترل و اندازه گيري غلظت اكسيژن مشكل است.
- ماسك: 5 ليتر در دقيقه غلظت 60-40 درصد ايجاد مي كند.نياز به حداقل اكسيژن جهت جلوگيري از تنفس مجدد CO2 دارد.
- اكسي هود: شروع اكسيژن درماني با حداقل 7 ليتر اكسيژن 100 درصد مي باشد. غلظت در حد 100-21 درصد ايجاد مي كند. اكسيژن كمتر از 4 ليتر در دقيقه مي تواند بدون مرطوب ساز استفاده شود.
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•وسايل مورد نياز:
- منابع اكسيژن شامل سليندر، اكسيژن مركزي
- وسايل كمكي شامل لوله اكسيژن، منبع جمع كننده آب
- مرطوب ساز
- مخلوط كننده
- فلوتر
- اناليزور اكسيژن
- مانيتورينگ غير تهاجمي
- محلول هاي نبولايزر ( آب مقطر يا نرمال سالين )
•اثرات ناخواسته اكسيژن درماني:
- ROP
- CLD
- HIE
- وابستگي به اكسيژن
- عفونت بيمارستاني
•نكات كليدي در اكسيژن درماني نوزادان:
- احياء نوزاد
- اگر اكسيژن در دسترس نبود هواي اتاق در 90 درصد موارد كافي است.
- براي نجات زندگي به ROP فكر نكنيد، در كوتاه مدت، بالا بودن اكسيژن شرياني قابل قبول است.
•بعد از دوره حاد:
- براي تشخيص ROP معاينه چشم در 6-4 هفتگي در نوزادان زير 32 هفته بايد انجام شود.
- مانيتورينگ دقيق فشار اكسيژن شرياني ضروري است.
- حداكثر جريان اكسيژن از كانول نازال بيش از 3 ليتر در دقيقه نباشد.
- براي شروع اكسيژن درماني با اكسي هود حداقل 80-50 و اشباع شرياني 95-88 درصد نگهداري شود.
- اكسيژن يك دارو است فقط زماني كه واقعا لازم است بايد به كار رود. مثل هيپوكسي ثابت شده، ديسترس تنفسي و سيانوز
- وقتي اكسيژن تجويز مي شود بايد دز آن، وسيله تجويزي، مدت و مانيتورينگ مشخص شود.
- براي پيشگيري از عفونت بيمارستاني مراقبت هاي لازم در استفاده از وسايل بكار رود.
References:
1. Branson RD. Gas delivery system: regulators, flowmeters, and therapy devices.In: Branson RD, Hess DR, Chatburn RL, editors. Respiratory care equipment, 2nd. Philaderphia: Lippincott Williams & Wilkins; 1999:55-85.
2. Kumar H, Antony TJ, Sharma D. Oxygen therapy in pediatric practice. Indian pediatr 1993;30(1):117-121.
3. Monin P, Vert P. The management of nornchopulmonary dysplasia. Clin Perinatol 1987;14(3):531-549. |
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امتیاز کاربران
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مرکز تحقیقات نوزادان>فعالیت های آموزشی>خلاصه مقالات منتشر شده توسط اعضاء مرکز
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خلاصه مقالات منتشر شده توسط اعضاء مرکز
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International Journal of Pharmacology
Title: Effect of Cotoneaster tricolor Pojark Manna on Serum Bilirubin Levels in Neonates.
Author: AhmadShah Farhat , Ashraf Mohammadzadeh , Mehvar Amiri and Mohammad Ramezani.
Source: International Journal of Pharmacology,2006, 2 (4) : 455-458
Abstract :
The effect of cotoneaster discolor pojark manna know as shirkhesht in Iran (a remedy used in traditional medicine for the treatment of neonatal jaundice) in a double blind placebo controlled trial in subjects with neonatal jaundice was evaluated .One hundred and four neonates(50 and 54 in case and control groups, respectively) with jaundice who had bilirubin level of 18-29 mg dl-1 were included in the trial . Newborn with weight less than 2.5 Kg, renal failure , systemic infectionus diseases , prior use of cotoneaster manna , high bilirubin level who required transfusion were not included in the study . Patients received either a single dose of manna (6 g ) or placebo (starch in distilled water ,0.1%) in the first hour of trial in addition to phototherapy . The bilirubin level was determined in blood samples every 12 h until bilirubin level reduced to less than 15 mg dl-1 and 24 h after Phototherapy discontinued . Phototherapy was discontinued when bilirubin levels fell below 15 mg dl-1 . The results indicated that the bilirubin level drops from 23 mg dl-1 on third day of trial in both case and control groups in a similar manner . Therefore, it could be suggested that the administration of Cotoneaster manna did not have any effect on bilirubin lvel providing on basis for use of the drug in neonate jaundice.
Journal of Iran Univercity Of Medical Sciences
Title: Comparison Of Breast Feedingand Tube Feeding on O2 Saturation in Very Low Weight Infants
Author: A. Mohammadzadeh,MD, A.Shah Farhat,MD, M.Vahedian,Msc, M.Amiry,BSc
Source: Journal of Iran Univercity Of edicalSciences,2007,14(55) : 167-177
Abstract :
Backgrand : Preterm infants born at less than 34 weekُs postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking , swallowing ,and breathing .As a result , they are traditionally. gavage fed until they are able to oral feed successfully .The aim of study was comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant .
Method :All babies admitted in the neonatal research center of Emamreza HospitalMashhad for 4 month since 1.2.84 were elected . Criteria for entrance to study include birth weight ≤ 1500 grams , exclusive breastfeeding , had no special problem after 48 hours with receivinge only routine care and intake of milk was 100 cc / kg/day . Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon ‚ During which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonate were monitored , and in case of hypothermia , bradycardia ( Less than 100 per minut ) or apnea the feeding discontinued and the study repeated the following day .
Results :fifty neonates were studied . The average birth weight was 1267.20 + 165.42 grams and average gestational age was 31.81 +1.92 and female / male ratio was 1.2 . There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon . ( p= 0.16 in the morning and p=0.6 in the afternoon ). There was no complication of apnea , hypothermia or bradycardia .
Conclusion : There was no significant statistical difference between the two methods in arterial oxygen saturation , it seems that oral feeding which is a natural route and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate and shorter period of stay in hospital is more preferred , and breast feeding should be started at the earliest possible time after birth .
Key word : V.L.B.W , O2 saturation , breast feeding , tube feeding
International Journal of Hematology and Oncology
Title:The Effect of Iron Deficiency Anemia ( IDA) on the HbA2 Level and Comparison of Hematologic Values Between IDA and Thalassemia Minor
Author: M. Reza KERAMATI, N. Tayyebi MAYBODI
Source: International Journal of Hematology and Oncology,2007 ,14(3)
Abstract :
The most common hypochrom microcytic anemia are iron deficiency anemia (IDA) and thalassemia minor (TM). Theresults of some studies have shown that IDA can cause misdiagnosis of heterozygote .-thalassemia due to decreasein HbA2 level. Our aim in this study was evaluating the effect of IDA on HbA2 levels; Furthermore hematolagic val-ues in CBC of these two diseases will be compared. In this study 291 individuals including normal control group, heterozygote . and .-thalassemia minor, IDA and coin-cident .-thalassemia and IDA patients were under investigation. CBC, serum ferritin, iron, and TIBC levels and hemo-globin electrophoresis in alkaline PH was managed for every subjects. They were then put into groups according todiagnostic criteria and were analyzed applying SPSS software (version 11.5) and statistical tests especially t- test.HbA2 levels were 2.9%±0.4 in normal group, 2.7%±0.6 in IDA patients, 5.6%±0.9 in .-thalassemia minor, 4.7%±1in coincident IDA and .-thalassemia minor. Above mentioned significant differences in HbA2 values are between nor-mal and IDA individuals, also between .-thalassemia minor and coincident .-thalassemia and IDA patients. RBCcounts, Hb, Hct, MCH, MCHC values were significantly higher in b- thalassemia minor comparing with IDA patientsbut MCV showed no significant difference in these two groups. RDW was increased in both, but it was higher in IDA.IDA can cause a decrease in HbA2 level. This point sometimes leads misdiagnosis particularly in coincident IDA and.-thalassemia minor. Therefore in suspicious cases of .-thalassemia trait in IDA background, it is better to do hemo-globin electrophoresis after treatment of IDA.
Clinical Toxicology
Title: Blood lead concentration in one to seven year old children in mashhad,Iran.
Author: AhmadShah Farhat ; Mohammad javad parizadeh; Ghlam Reza Khademy ; Mahdi Balali-Mood
Source: Clinical Toxicology, 2007 ,45:7 , 812-813
To the Editor :
In spite of the reported studies on blood lead level (BLL) of children in various countries, to the best our knowledge there has been on report on BLL in children of I.R. Iran. We studied the BLL of children in the emergency pediatric ward and out patient clinic of Imam Reza Hospital, Mashhad University of Medical Sciences (MUMS) between march 2003 and February 2004. The hospital is a specialty center in Khorassan province and serves a population of around 2.5 million people.
The Investigational Review Board and the Medical Ethics Committee of MUMS approved the study. Informed consents were obtained from the parents of children prior to study. Both symptomatic (convulsive only) and healthy children were studied. Venous blood samples (3 ml) were drawn in standard EDTA tubes. BLL was determined by an atomic absorption (Perkin Elmer Model 3030) using heated graphite atomization technique with a detection limit of 10 µg/L in the Toxicology Laboratory of the hospital within a week.
BLL of 206 children aged 1-7 years were determined. The mean age (± SD) of the children was 40.40 (± 18.66) months. The mean (± SD) BLL was 12.19 (± 3.35) µg/dl with a minimum of 1.3 µg/dl and maximum of 24.7 µg/dl. The majority of children (59.2%) had BLL of 10-15 µg/dl and 16.6% had BLL over 10 µg/dl .
The blood lead concentration in different age groups of the children are shown in the table . there were no statistically significant differences in BLL among the age groups.
Table 1 . Blood lead level (BLL) in different age groups of children in Imam Reza Hospital of Mashhad,Iran
It is also noteworthy that there was no significant correlation between the age groups and BLL of the children.
In a much larger study conducted in California involving 5115 children aged one to six years old ,only 7.2% had BLL of over 10 µg/dl (1). In Uruguayan children aged less than 14 years, 36% had BLL over 10 µg/dl and the mean was 9.6 µg/dl (2). In city of Wuxi, China , 27.3% of 117 children were reported to have BLL of above 10 µg/dl and the mean was 8.2 µg/dl (3). A study in Vancouver , Canada of 177 children aged between two and three years old , 8.1% had a BLL higher than 10 µg/dl (4).
In another survey on 436 children aged 6 months to 6 years old in Massachusetts, 22% of the subjects had BLL higher than 10 µg/dl (5). In North Carolina, 20.2% out of 20,720 children between 6 months to 6 years old were found to have a BLL of more than 10 µg/dl (6). The mean BLL in 397 children aged 2-6 years of Jakarta, Indonesia was 86 µg/dl (7) . The higher BLL in our sample might be due to more environmental lead pollution. For instance, we found lead inthe gasoline samples collected in Mashhad a few months ago, despite the formal announcement a few years ago that the gasoline is unleaded.
Based on the results of this pilot study, there is a need for a more comprehensive study on BLL of children both in Mashhad and throughout the country, and investigations into the sources of lead exposure are also required.
International Journal of Hematology and Oncology
Title:The comparison effect of oral and intramuscular injection vitamin K on PT and APTT in neonates.
Author: Mohsen Jafarzadeh,Ashraf Mohammadzadeh,Ahmad S. Farhat,Mohammad R. Keramati,Mohammad Khajedaluei
Source: International Journal of Hematology and Oncology,2008,18(2):74 - 78
Abstract :
The aim of this study was to determine the effect of oral versus intramuscular vitamin K on PT( Prothrombin time) and APTT (Activated partial thromboplastin time ) in neonates .
Ninthy five healthy term live born neonates with birth weight more than 2500 grams who delivered in Mashhad Emmamreza hospital since 6 feb 2006 . They were divided in two groups . The injection group( no=45) that recived 1 mg vitamin K ( Phytonadion ) intramuscularly and oral group ( no=50 ) 2mg vitamin K Per oral in first 6 hours of age . PT and APTT was measured 12 hours after vitamin K prescription .
PT and APTT was measured at 24.78 ± 9.95 hours after vitamin K injection and 22.16 ± 7.4 hours in oral groups ( P=0.14 ) . Mean PT in injection group was 16.77±4 second and in oral group was 16.39±2.98 second ( P=0.38) . Mean APTT in injection and oral group were 37.73±22.25 and 34.95±7.73 respectivly ( P=0.69 ) .As classic form ofhemorraghic disease of the newborn is prevented with vitamin K.
This study showed that there were not significant differences in PT and APTT between two groups . Therefore both oral and intramuscular vitamin K can prevent classic hemorraghic disease of the newborn , but for showing prevention effect of oral vitamin K in late onset vitamin K further study is needed for targeting of newborns .
Keyword : Vitamin K deficency , Newborn , PT , APTT
Journal of Chinese Clinical Medicine
Title:Prophylactic effect of clofibrate in low birth weight neonates' hyperbilirubinemia
Author: Mohammadzadeh A, Farhat A sh, Jafarzadeh M,Esmaeli H, Amiri R
Source: Journal of Chinese Clinical Medicine, 2008,3(3): 140 - 144
Abstract :
Objective: Hyperbilirubinemia is a common problem in newborn infants. It can progress to kernicterus in severe forms, unless an intervention is initiated. Numerous drugs may be reducing serum bilirubin concentration in newborn infants. At this study we determine the prophylactic effect of clofibrate in low birth weight infants' hyperbilirubinemia.
Methods: In a randomized double blind clinical trial 52 low birth weight infants were elected. Infants with hemolysis, infection, congenial anomalies and metabolic diseases were excluded. Study participants received either single dose clofibrate 100 mg/kg (clofibrat group n=26) or sterile water as volume as clofibrate (control group n=26) by Orogastric tube. Serum bilirubin levels were measured at entrance, 24, 48, 72 and 96 hours of study.
Results: Serum bilirubin was significantly decreased only after 24 hours in clofibrate group (p=0.045). Duration of phototherapy in clofibrate group was significantly shorter than control group (p=0.001). There were no significant difference between two groups in mean total serum bilirubin at entrance (P=0.771). Based on physical exam and liver function tests no side effects were seen. Data was analyzed with T– student, Mann-Whitney and chi – square tests.
Conclusion: These findings suggest that clofibrate has prophylactic effect on total serum bilirubin in first 24 hours after drug administration and decreased duration of phototherapy in low birth weight infants. Further studies with different doses and interval are required to suggest the prophylactic effect of clofibrat in low birth weight neonates' hyperbilirubinemia.
Keywords: Clofibrate, hyperbilirubinemia, low birth weight neonates.
Iranian Red Crescent Medical Journal
Title:Comparison between Two and Twenty- four Hours Salt Powder in Treatment of Infant Umbilical Granuloma
Author:AS Farhat* , A Mohammadzadeh
Source: Iranian Red Crescent Medical Journal, 2008,10(4):267 -269
Abstract :
Objective: One of the most common umbilical abnormalities in neonates is umbilical granuloma, causing inflammation and drainage. The common treatment is application of a 75% silver nitrate stick. This study was carried out to compare the effect of 2 and 24 hours salt (NaCl) in treatment on infant umbilical granuloma.
Methods: From January 2004 to January 2006, at Neonatal ICU and Infant Follow-up Clinic of Imam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran, two groups including 20 infants with umbilical granuloma undergoing a 24 hours treatment with salt as the case group and 20 infants undergoing a 2 hours treatment with salt as the control group were compared.
Results: There were18 boys and 22 girls. The treatment days in case and control groups were 1.2+0.6 and 2.1+0.4, respectively and the difference was statistically significant. In either group, there were no significant differences between sex, birth weight, time of umbilical separation and age of enrollment.
Conclusion: 24-hours treatment of umbilical granuloma with salt was shown to be more effective than the 2- hours treatment method
Keywords: Granuloma; Salt; Infant; Treatment
Journal of Chinese Clinical Medicine
Title: Relationship between low birth weight neonate and maternal serum copper level
Author: Farhat A sh,Mohammadzadeh A,Valaee L, Khadem N,Khajedaluee M,Parizadeh S.M.R
Source: Journal of Chinese Clinical Medicine, 2008,3(12):685 - 690
Abstract:
Introduction:Trace element deficiencies have been documented to play animportant role in determination of the fetal outcome. It has been reported that the pregnant women in developing countries consume diets with a lower density of minerals and vitamins. Copper is an essential trace element and its deficiency can lead to a variety of nutritional and vascular disorders.
Methods:We conducted a case-control study on women who delivered low birth weight infants (Cases), and women with normal birth weight infants (Controls). We collected blood samples from all women within 24 hours of delivery, and assessed the concentration of copper using flame atomic absorption spectroscopy (AAS). We compared serum concentration of copper between the two groups. Multiple linear regression analysis was performed to control of potential confounding variables.
Results: Atotal of 117 mothers were studied, of them 65 Cases with a low birth weight infants (1845 ± 472 g) and 52 Controls (birth weight = 3166± 435 g). Mothers in the Cases and Controls groups did not differ in age (24± 4 vs. 24.7 ± 5.4 years), body mass index (23.4 ± 3.4 vs. 22.9± 3.2), and socioeconomic or demographic factors. Maternal copper concentration (μg/dl) did not differ between Cases and Controls; 1158.35 ± 299.57 μg/dl vs. 1187.11 ± 249.59μg/dl respectively. Maternal copper did not differ between premature and full term deliveries. It also did not differ when newborns were small for their gestational or not.
Conclusion:Maternal copper concentration has no impact on neonatal birth weight or premature deliveries.
Key word:Copper-Low birth weight- Normal birth weight -Maternal serum
Journal of Chinese Clinical Medicine
Title: Should urine culture be considered in the hyperbilirubinemia workup of neonate
Author: Jafarzadeh M,Mohammadzadeh A
Source: Journal of Chinese Clinical Medicine, 2009,4(3): 136-138
Abstract :
Objective:Jaundice is one of the presenting signs of urinary tract infection (UTI). Prevalence of UTI in febrile infants is between 5% and 11%. Previous studies have shown that jaundice may be one of the presenting signs of sepsis or urinary tract infection in newborns. The goal of this study was to determine the prevalence of UTI in asymptomatic jaundiced neonates.
Method: Eighty five asymptomatic unexplained jaundiced neonates evaluated for evidence of UTI by suprapubic bladder aspiration. Urinary tract infection was defined as one colony forming units per milliliter of urine. Questionnaire was recorded by a single resident include demographic information.
Results: Seven (8.2%) of 85 infants had UTI. Isolated pathogens included E coli, kelebsiella, Entrococcous , Coagulase negative staphylococcus and Entrobacter Aerogenese . There were no correlation between total and direct serum bilirubin level in positive urine culture (P=0.78 and P=0.44 respectively).
Conclusion: Urinary tract infection was found in 8.2% of asymptomatic unexplained jaundiced neonate. More studies are necessary to answer this question: should urine culture be considered in asymptomatic jaundiced neonate?
Keywords: Neonatal jaundice, Urine culture, Urinary tract infection
Journal of Neonatal - Perinatal Medicine
Title: Maternal serum selenium and low birth weight nenonates
Author: A Mohammadzade,, AS Farhat, L Valaee, N Khadem, M Khajedaluee, S.M.R Parizadeh
Source: Journal of Neonatal - Perinatal Medicine, 2009,2(2): 103-107
.Abstract:
Introduction: Selenium is an essential element for the protection against oxidative stress in different biological materials. Excessive or insufficient intake of selenium can lead to clinically relevant disturbances in tissue functions. Selenium status is particularly important for neonates, and infants. Therefore, the aim of this prospective study was to examine the relationship between the concentration of serum selenium in pregnant women and the incidence of low birth weight (<2500 g) in their newborns.
Method: We conducted a case-control study on women who delivered low birth weight infants (Cases), and women with normal birth weight infants (Controls). We collected blood samples from all women within 24 hours of delivery, and assessed the concentration of selenium using electrothermal atomic absorption spectrometry. We compared serum concentration of selenium between the two groups. Multiple linear regression analysis was performed to control of potential confounding variables.
Results: A total of 123 mothers were studied, of them 70 Cases with a low birth weight infants (1845 ± 472 g) and 53 Controls (birth weight = 3166± 435 g). Mothers in the Cases and Controls groups did not differ in age (24± 4 vs. 24.7 ± 5.4 years), body mass index (23.4 ± 3.4 vs. 22.9± 3.2), and socioeconomic or demographic factors. Maternal selenium concentration (μg/l) did not differ between Cases and Controls; 118.8 ± 24.5 μg/l vs. 122.5 ± 29.3 μg/l respectively. Maternal selenium did not differ between premature and full term deliveries. It also did not differ when newborns were small for their gestational or not.
Conclusion: In our study population,maternal selenium concentration had no impact on neonatal birth weight or premature deliveries.
Keyword: Selenium, maternal, low birth weight, small for gestation, prematurity.
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امتیاز کاربران
مركز تحقيقات نوزادان>فعالیت های آموزشی>خلاصه مقالات منتشر شده توسط اعضاء مرکز
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خلاصه مقالات منتشر شده توسط اعضاء مرکز
Abstract of recent pablication |
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Journal of Chinese Clinical Medicine
Title:Incidence and etiology of hypoglycemia in neonatal intensive care unit admissions
Author: Ghaemi N,Mohammadzadeh A, Farhat A sh.
Source:Journal of Chinese Clinical Medicine, 2009,4(6): 321 - 324
Abstract
Objective: Hypoglycemia is a common problem in newborns and can cause many undesirable neurological effects such as seizures,psychomotor retardation and decreased IQ.The aim of this study was to determine the incidence and etiology of hypoglycemia in neonatal intensive care unit(NICU)admissions.
Methods: This descriptive study was performed on 927 neonates admitted to NICU of Emamreza Hospital belonging to neonatal research center of Mashhad University of Medical Sciences since 23th July 2007 for one year.After admission in NICU blood sugar was tested with glucometer and if it was less than 40 mg/dl and was confirmed by laboratory,the patient entered to study.According to history and physical examination more diagnostic studies were performed to determine the etiology of hypoglycemia.
Results: During one year study 927 neonates admitted in NICU,109 of them(11.76%)had hypoglycemia.The most common causes of hypoglycemia were prematurity,asphyxia and small for gestational age.Conclusion This study showed that the incidence and etiology of neonatal hypoglycemia in our NICU was as same as western countries and less than the incidence of hypoglycemia in developing country.
Keyword : hypoglycemia; etiology; incidence; newborn
International Journal of Hematology and Oncology
Title:Treatment Effect of Clofibrate in Jaundiced Low Birth Weight Neonates
Author:Ashraf Mohammadzadeh,Ahmad S. Farhat,Rana Amiri,Habibolah Esmaily, Sepide Bagheri.
Source: International Journal of Hematology and Oncology,2009,19(2):100 -105
Abstract:
In this study we determined the treatment effect of clofibrate in low birth weight neonate with hyperbilirubinemia. In a randomized double blind placebo - controlled study, 60 low birth weight neonates who were jaundiced and had hyperbilirubinemia were selected. The treatment group received a single oral dose of clofibrate (100 mg/kg) and the control group received sterile water as placebo. Also both group received Phototherapy in addition of the treatment. Serum bilirubin level was measured at entrance to study and 12, 24, 48 and 72 hours of study. Serum bilirubin decreased in 72 hours in clofibrate group that it was nearly significant (p= 0.061), but there were no significant difference between two groups in 12, 24, 48 hours of study (p= 0.7, p= 0.22, p= 0.19 respectively). Duration of phototherapy in clofibrate group was significantly shorter than control group (p= 0.023). Based on physical exam and liver function tests no side effects were seen.
Our result showed that there wasn’t significant difference between two groups after administration of single dose of clofibrate (100 mg/ kg) in 12, 24, 48 and 72 hour. Although effect of clofibrate on treatment of jaundice wasn't significant between two groups, duration of phototherapy has been decreased significantly in clofibrate groups. Journal of Chinese Clinical Medicine
Title:Prevalence of Glucose-6-Phosphate Dehydrogenated Deficiency in neonates of Northeast of Iran
Author: Ashraf Mohammadzadeh,Mohsen Jafarzadeh,Ahmad Shah Farhat,Mohammad Reza Keramati,Zahra Badiee,Habibolah Esmaily,Rana Amiri
Source:Journal of Chinese Clinical Medicine, 2009,4(8): 448-451
Abstract:
Objective:Glucose -6-phosphate deficiency is the most prevalent enzyme deficiency with an estimated 400 million people affected worldwide. It is inherited deficiency that may be the cause of neonatal hyperbilirubinemia. The incidence of G6PD deficiency varies among different countries and survey report rate of less than 1% to 35%. The aim of this study was to determine prevalence of Glucose -6-phosphate deficiency in newborns of Mashhad city, the center of Khorasan Razavi province located in Northeast of Iran.Methods:During the period of April 2006 to November 2006 we performed semi-quantitative red blood cell (RBC) G6PD assays in cord blood of 2570 male and female neonates. Blood sample was collected for each neonate from umbilical cord of placenta into ethylondiamentetracetic acid (EDTA) anticoagulated tubes in delivery room. Samples were tested by the florescent spot method for detect deficient types. Result:Of the 2570 newborns, 1307 (50.85%) were boys and 1263(49.14%) were girls. The incidence of G6PD deficiency was 0.8% in the total study population with confident interval of 0.5%-1%. G6PD deficiency is more common in male than female 1% vs. 0.5% and sex distribution was 30.6% in females and 69.4% in males (p<0.05). Conclusion:In our study prevalence of G6PD deficiency was fewer than other origin that may be related to demographic and geographical location of Mashhad city. Mashhad located in north eastern of Iran and incidence of G6PD in this area is lower.
Keyword:Glucose-6-Phosphate dehydrogenase Deficiency, newborn, prevalence
Chin Journal Contemp Pediatr
Title:Comparison of maternal and umbilical cord blood selenium levels in term and preterm infants
Author: Ramin Iranpour, Ali Zandian, Majid Mohammadzadeh, Ashraf Mohammadzadeh, Mahdi Balali-Mood, Mehnosh Hajiheydari
Source: Chin Journal Contemp Pediatr,2009,11(7):513-516
Abstract:
Objective: Selenium is an essential trace element and has a main role in cellular antioxidant defense system. In very preterm babies, low selenium is associated with an increased risk of complications such as chronic neonatal lung disease and retinopathy of prematurity. This study was designed to determine and compare maternal and umbilical cord blood selenium levels in term and preterm infants. Methods: From February 2008 to April 2008, 30 term (gestational age > 37 weeks) and 30 preterm infants (gestational age < 34 weeks) and their mothers were enrolled. Selenium concentrations in umbilical cord and maternal venous blood were measured by atomic absorption spectrometry. Results: The mean selenium concentration in term infants was higher than in preterm infants (124.80 ± 13.72 μg/L vs 100.30 ± 11.72 μg/L, P = 0.0001). The mean selenium concentration in mothers of term and preterm infants was not significantly different (117.03 ± 17.15 μg/L vs 110.56 ± 17.49 μg/L, P = 0.15). Cord selenium concentrations were strongly correlated with gestational age and birth weight (r = 0.66, P <0.0001 and r = 0.59, P <0.0001, respectively) when the data of all infants were analyzed together. None of the 60 women had a serum selenium level below the laboratory lower limit of normal (70.0 μg/L). Maternal selenium levels were correlated with cord selenium levels in their infants (r = 0.40, P < 0.001) when data of all newborn infants and mothers were considered together. Conclusions: Mothers have a relatively good selenium status and serum selenium is not a significant predictor of preterm delivery in Isfahan. The cord selenium concentration in term infants is significantly higher than in preterm infants, but the cord selenium concentrations in both groups are in a suggested normal range.
Keyword: Selenium, Umbilical cord blood, Preterm infant, Term infant
Iranaian Journal of Pediatrics
Title:Prevalence of Visual Impairment in Low Birth Weight and Normal Birth Weight School Age Children
Author:Ashraf Mohammadzadeh,Akbar Derakhshan, Ahmad S. Farhat,Rana Amiri,Habibolah Esmaily.
Source: Iranaian Journal of Pediatrics,2009,19(3):271-276
Abstract:
Objective:Studies demonstrated that 5-10% of preschool children have visual impairment. By age seven, up to 13% of children will have some defect in visual acuity. Both prematurity and low birth weight have been associated with an increased incidence of ophthalmic disorders. In this study we determined prevalence of visual impairment in low birth weight and normal birth weight school age children in Mashhad.Methods: This is a cross sectional study. The target population consisted of all children referred to educational organizations for screening before entering school in Mashhad, Iran. 2400 children enrolled in the study and were evaluated for amblyopia, refractive errors, color vision disturbance and optic nerve problems. Data were analyzed by SPSS.Findings: Prevalence of ophthalmic problems in all children was 5.43% and in low birth weight and normal birth weight 8.29% and 5.74% respectively. Incidence of ophthalmic problems was significantly (P=0.029) higher in low birth weight children than in normal birth weight children. The most common ophthalmic disease in both low birth weight and normal birth weight children was refractive errors 81.5% vs. 68.8 % (P<0.05). Prevalence of myopia, amblyopia and color vision disturbance was also higher in low birth weight than in normal birth weight children.Conclusion:Low birth weight children are at greater risk of the visual impairment that may occur at an early age and result in long term morbidity. Visual outcome of low birth weight neonates should be evaluated routinely.
Keyword: Visual impairment, Low birth weight, School age children, Refraction errors
Medical Journal of Islamic Repablic of Iran
Title:Birth weight and the risk of childhood hearing impairment
Author:Ashraf Mohammadzadeh,Ne'matollah Mokhtari, AhmadShah Farhat,Rana Amiri,Habibolah Esmaeli.
Source: Medical Journal of Islamic Repablic of Iran ,2009,23(2):70-74
Abstract
Background:Low birth weight neonates are confronted with some problems after birth; they should be followed up and evaluated at different ages of life. The aim of this study was to impact of birth weight on the risk of sensorineural hearing impairment on children.Methods:This cross sectional and retrospective study determined the prevalence of hearing problems in low birth weight and normal birth weight school age children. The sample was consisted of 2400 children who referred to especial educational organization for hearing screening before entrance to school in Mashhad- Iran between June 2005 and June 2006. Hearing problems were checked in all groups. Case definition was based on the mean sensorineural hearing loss of more than 35 decibel (DB) hearing level (HL) and in the better hearing ear averaged over the pure- tone hearing thresholds at 500, 1000, 2000 and 4000 Htz. The results were then compared the low birth weight and normal birth weight children.Results:This study showed that prevalence of hearing problems was 1.4%. The prevalence of hearing impairment in low birth weight (NBW) was 2.1% and 1.3% in normal birth weight (NBW). There was not significant difference in hearing impairment between two groups (P=0.255).Conclusion:In this study there was no significant difference between low birth weight and normal birth weight children in hearing impairment although other studies indicated that the risks of hearing impairment increase with the LBW and low gestational age neonates. More investigation is needed for detecting the subtle hearing problems in children.
Keywords: Hearing impairment, low birth weight, normal birth weight, school age children
Medical Journal of Islamic Repablic of Iran
Title:Effect of tactile-kinesthetic stimulation on weight gaining of preterm infants
Author:Ashraf Mohammadzadeh,Soheila Karbandi, Habibolah Esmaily,Mahdi Basiry
Source: Medical Journal of Islamic Repablic of Iran ,2009,23(3):148-153
Abstract
Background:The quality of life and standard of health care in a society measured by its preterm infant's mortality rate. The popularity and credibility of alternative treatment such as touch therapy may be effective in preterm and low birth weight infants in order to increase their survival rate. The aim of this study was to determine the effect of touch intervention on the weight gain of preterm infants who were admitted to the neonatal intensive care unite (NICU).Methods:This study was a randomized controlled trial performed in NICU of Emamreza hospital, Mashhad, Iran from July 2007 to November 2007. There were two groups (the control group and the case group) and one response variable (weight gain). Infants in the control group received routine nursing care. Infants in the case group in addition to the routine care received stroking/ passive limb movement therapy for three 15 minutes sessions per day for a 10 day period. Then weight gaining was compared between the two groups.Results:The weight gain data was analyzed by SPSS software. Over the 10 day study period, the case group gained significantly more weight compared to the control group (P<0.001).Conclusion:The data suggest that stroking/ passive limb movement can be an efficient and cost effective way of enhancing growth in stable preterm infants.
Keywords: preterm infants, tactile- kinesthetic stimulation, touch, weight gain
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