Investigation of the relationship between umbilical cord pH and intraventricular hemorrhage of infants delivered preterm

OBJECTIVE: We measured the level of pH gases in premature infants at birth, and examined the relationship between brain ultrasonography on the third and seventh day after birth. A case-control study conducted at the Neonatal Intensive Care Unit (NICU) of Shahid Akbar Abadi Hospital, Iran, during the years 2016-2017. METHODS: All premature infants who were admitted to NICU were enrolled in the current study. At birth, a blood gas sample was taken from the umbilical cord of the infants. On the third and seventh day after birth, an ultrasound of the brain of each neonate was performed by a radiologist. The umbilical cord was evaluated for blood gases in 72 neonates (mostly boys). RESULTS: Sixty-six newborns had normal sonography, and 16.7 (12 cases) had anomalies. A total of 75 of the 8 infants with intravenous bleeding were girls, which were significantly different from those in the non-hemodynamic group (62.5 male) (P 0.049). However, the type of delivery, mean weight, height, head circumference, the circumference of the chest, and Apgar score did not differ between the two groups. Mean pH, HCO3- and PCO2 in umbilical cord blood gas samples were not significantly different between the two groups with or without intraventricular hemorrhage (IVH). Although it was not related to gender and type of delivery in newborns. CONCLUSION: Blood gases do not help in determining the occurrence of IVH in infants. Nevertheless, it is associated with immaturity and fetal age

Prevalence of meningitis among hospitalized neonates with urinary tract infection

Background: Bacteremia is relatively common in children with urinary tract infection (UTI). The aim of the present study was to determine the frequency of bacterial meningitis among neonates with laboratory-confirmed UTI. Methods: This retrospective cross-sectional study was performed on 163 hospitalized neonates in Ali Asghar and Shahid Akbarabadi hospitals affiliated to Iran University of Medical Sciences in Tehran, Iran. The demographic and clinical data of hospitalized neonates due to UTI during the recent 6 years (2010-2016) who were aged < 28 days and had cerebrospinal fluid (CSF) culture via lumbar puncture were extracted from medical records and recorded in some checklists. Results: A total of 163 neonates with laboratory-confirmed UTI with the mean age of 18.25±5.41 days were included. In this study, 54 of the neonates were male. Out of all neonates, 23 (14.1) cases had positive blood culture. The positive CSF culture was observed in only two (1.2) neonates. Positive voiding cystourethrogram (VCUG) test was reported in 50 of the neonates with positive CSF culture (P=0.047). Although abnormal ultrasound findings related to the urinary tract in positive CSF neonates were higher by approximately twofold, compared to those reported for negative CSF neonates, this difference was not statistically significant (50 and 24.2, respectively; P=0.432). Conclusion: The frequency of the concurrent occurrence of UTI and meningitis in our neonates was 1.2. Out of all indicators associated with meningitis occurrence, positive VCUG may be a risk factor. Further prospective studies are needed to approve these results. © 2020 Mashhad University of Medical Sciences. All rights reserved

Value of physical examination in the diagnosis of developmental hip dislocation in preterm infants

Background: Developmental dislocation of the hip joint is among joint abnormalities and lack of its early diagnosis leads to irreversible complications and disabilities. Methods: The current cross sectional study was conducted on 210 eighteen - month - old premature infants. Premature infants at term gestational age were examined by a neonatologist and underwent a sonographic scanning by a skilled radiologist. The results of the physical examination and ultrasound reports were collected and analyzed. Results: In the clinical assessment, hip joint examination was diagnosed abnormal in 22 cases (10.4) and joint dislocation was diagnosed by ultrasonographic examination in 17 patients (8.1). In one high - risk case, despite normal clinical examination (0.48), the dislocation was diagnosed by ultrasonographic evaluation. There was a significant relationship between hip dislocation rate, and reduced mean gestational age and birth weight (P 0.05). In diagnosis of joint dislocation, clinical examination (the results of the Ortolani and the Barlow tests) had sensitivity of 94 and specificity of 97 compared with sonography; the positive and negative predictive values were 73 and 99, respectively. Conclusions: Clinical examination has high sensitivity and specificity for early diagnosis of developmental hip dislocation. If there are risk factors, ultrasonographic scanning is recommended despite normal physical examination, and ultrasound is not necessary in case of normal physical examination and the absence of risk factors. © 2018, Journal of Comprehensive Pediatrics

Is there any correlation between cerebrospinal fluid and serum c-reactive protein in neonates suspected to meningitis?

Background: Meningitis is a common life threatening infection in neonatal period. Diagnostic value of CSF-CRP level in bacterial meningitis in children and adults has been studied worldwide, but there are limited studies on CSF-CRP in neonatal meningitis. This study conducted to assess any relation between CSF-CRP and plasma CRP levels and abnormal CSF findings in neonates suspected to meningitis. Methods: Seventy five hospitalized neonates suspected to meningitis were enrolled in this cross sectional study. All infants were gone through a complete sepsis workup including blood and CSF CRP. Results: CSF-CRP level had statistically significant correlation with serum WBC (p= 0.048) and also poor correlation with CSF protein level (p= 0.054). Serum CRP level had statistically significant correlation with CSF WBC (p= 0.008). Conclusion: No correlation found between CSF and serum CRP levels of patients in this study. Although, CSF-CRP is a rapid and easy to interpret test, it can be performed alongside CSF cytology and biochemical analysis, smear and culture as a confirmatory test for definite diagnosis of neonatal meningitis. © 2020, Kerman University of Medical Sciences. All rights reserved

The First Case of Empyema Necessitatis Sustained by Nocardia Nova in Kidney Transplant Recipient

7nonenoneRostami Z; Cegolon L; Vahedi E; Kashaki M; Kachuei R; Jafari R; Javanbakht MRostami, Z; Cegolon, L; Vahedi, E; Kashaki, M; Kachuei, R; Jafari, R; Javanbakht,

A homozygous loss-of-function mutation in PTPN14 causes a syndrome of bilateral choanal atresia and early infantile-onset lymphedema: PTPN14 mutation in lymphedema-choanal atresia

A homozygous truncating mutation in nonreceptor tyrosine phosphatase 14 (PTPN14) has recently been associated with an extremely rare autosomal recessive syndrome of congenital posterior choanal atresia and childhood-onset lymphedema. PTPN14 has been shown to interact directly with the vascular endothelial growth factor receptor 3 (VEGFR3), a receptor tyrosine kinase essential for lymphangiogenesis. Here we present an Iranian family with a single child affected by high-arched palate, congenital hypothyroidism, dysmorphic face, bilateral choanal atresia and infantile-onset lymphedema. Screening of the PTPN14 revealed a novel homozygous frameshift mutation in exon 4 predicted to result in premature truncation of the polypeptide product, which segregated with the disease phenotype. To our knowledge, this is the second family with �choanal atresia and lymphedema syndrome� to be reported worldwide. In contrast to the first reported family that showed lymphedema in late childhood, the patient described here displays lymphedema in her lower limbs at early infancy associated with growth delay, mild facial swelling, congenital hypothyroidism and some minor developmental abnormalities. This report confirms the causality of PTPN14 loss-of-function mutations and further expands the clinical phenotype of this rare genetic syndrome. © 201