Changes of blood sugar and total calcium in hyperbilirubinemic neonates after exchange transfusion

Exchange transfusion is a therapeutic method for immediate treatment of hyperbillirubinemia to prevent kernicterus, but it has some complications including hypoglycemia and hypocalcemia. This study was performed to find the changes of blood sugar and calcium after blood exchange and their possible correlation with weight, blood incompatibility and bilirubin decrease rate. Thirty-six neonates with blood exchange were evaluated over a period of 6 months. Blood samples were collected from umbilical vein catheter, before and 6 hours after the exchange transfusion, and their total calcium, bilirubin and blood sugar were measured. Following every 100 ml of blood exchange, 1 ml of calcium gluconate (10%) was infused slowly. Our results showed that, 6 hours after exchange transfusion, the total calcium level was decreased. There was no significant correlation between calcium decrement and weight. Also, no significant correlation was found between blood incompatibility and bilirubin decrement. There was no significant alteration of blood sugar 6 hours after exchange transfusion. We recommend using of calcium gluconate during exchange transfusion and serial measurement of calcium level until its level is stable

Effect of shir-e-khesht (billinaster drop) consumption by the neonates or their mothers on the neonatal icter

زمینه و هدف: زردی یکی از مشکلات شایع دوران نوزادی است که برای درمان آن از نور درمانی، دارو درمانی، تعویض خون و یا طب سنتی استفاده می کنند. در طب سنتی ایران از ماده ای به نام شیر خشت، (استخراج شده از گیاهان جنس Cotoneaster) جهت درمان زردی نوزادی استفاده می گردد. هدف این تحقیق تعیین تاثیر مصرف شیر خشت (قطره بیلی ناستر) توسط نوزاد یا مادر در بهبودی زردی نوزادان تحت فتوتراپی بود. روش بررسی: در این مطالعه کارآزمایی بالینی 120 نوزاد مبتلا به زردی مراجعه کننده به بخش اطفال بیمارستان هاجر شهرکرد بر اساس روش در دسترس انتخاب و به ترتیب مراجعه در 4 گروه قرار داده شدند. در گروه اول مادر شیر خشت، در گروه دوم مادر و نوزاد هر دو شیرخشت، در گروه سوم نوزاد شیرخشت و درگروه چهارم نوزاد فقط پلاسبو (آب مقطر) دریافت کرد. فتوتراپی در شرایط یکسان برای تمام نوزادان انجام شد. آزمایشات لازم جهت رد نمودن عامل پاتولوژیک زردی انجام گرفت. داده ها به کمک آزمون های آماری کای دو، آنالیز واریانس مشاهدات تکرار شده، آنالیز واریانس، دانت و کروسکال والیس بین گروه ها مقایسه شد. یافته ها: میــزان بیلی روبین طی مطالعه در هر 4 گروه کاهش معنی داری داشت (05/0

Age of Menarche and Its Related Factors in School Girls of Shahrekord

Abstract Background: Considering different effective factors in age of menarche in different geographical areas and the necessity of determining a reliable and upto-date reference in this field, the aim of this study was to determine the mean age of menarche in 11-18 years old school-girls of Shahrekord. Methods: This was a descriptive cross-sectional study among 778 school girls aged 11-18 years of Shahrekord which were selected by clustering method among 8163 students. Data was collected using a questionnaire about demographic ..

A case report: An atypical Kawasaki syndrome following aseptic meningitis in a 9-month old infant

چکیده: مقدمه: بیماری کاوازاکی، التهاب عروق (Vasculitis) حاد و وسیع در اعضای مختلف بدن می باشد. سن شیوع بیماری کاوازاکی بین 1 تا 5 سالگی است و زمانی که خارج از این محدوده باشد، تشخیص آن دشوار و شانس عوارض بیماری بخصوص عوارض قلبی افزایش می یابد. معرفی بیمار: شیرخوار 9 ماهه ای بود که با علایم مننژیت در بخش اطفال بیمارستان هاجر شهرکرد بستری و پس از دریافت درمان دارویی و بهبود علایم، مجدداً در روز هشتم بستری دچار تب بالا، فارنژیت و اسهال و بی قراری گردید. در معاینه بیمار کنژنکتیویت غیر چرکی دو طرفه، ترک خوردگی لب ها، لنفادنوپاتی و دیگر علایم تیپیک کاوازاکی را نداشته ولی قلب تاکی کارد و سرعت سدیمانتاسیون اریتروسپتی (ESR) بیمار نیز افزایش یافت. کودک با تشخیص بیماری کاوازاکی آتیپیک تحت درمان ایمونوگلوبولین وریدی قرار گرفت، پس از 24 ساعت تب بیمار کاهش و علایم بالینی وی بهبود یافت. ESR بیمار ده روز پس از ترخیص mm/hr10 گزارش گردید. نتیجه گیری: بر اساس این گزارش بالینی در زمان ابتلا به مننژیت باکتریال اگر مجدداً بیمار دچار تب بالا و افزایش ESR گردید باید بیماری کاوازاکی، علاوه بر دیگرعوارض مننژیت مد نظر باشد

Case Presentation of a 23-Month-old Herpes Simplex Virus-infected Girl with Brain and Oesophageal Involvement.

Herpes simplex virus (HSV) is the most common identifiable cause of serious or life threatening sporadic, endemic encephalitis. Typical HSV encephalitis in patients outside neonatal age is caused by HSV-1. A 23-month-old girl was referred to our hospital with a three-day history of fever, listlessness, slurred speech, and suspicious oesophageal foreign body impaction. Laboratory evaluations showed white blood cell count of 10900 /mm3 with 65% neutrophils. Upper endoscopy revealed diffuse severe ulceration in middle to distal third of oesophagus and no foreign body was found in oesophagus or stomach. Parenteral acyclovir was prescribed for herpes encephalitis in addition to antibiotics for central nervous system infection. Chest X-ray and brain MRI was unremarkable. Lumbar puncture revealed normal protein and glucose with 10 white cell count. She developed a raising liver enzyme tests. Total and direct bilirubin was 1.2 mg/dc and 0.2 mg/dc respectively. Because of neurological symptoms, acyclovir was adopted for our patient from the beginning. The girl did not respond to medication and died after 28 days. Progression of her disease prior to referral appears to contribute to the administered treatment inefficacy. Severe rapid progression of disease prior to referral and potential resistance to acyclovir could cause treatment failure

A case report on an 8-month infant about zona infection in ocular members due to exposure to intrauterine varicella

Background and aims: Primary varicella infection which is rarely seen among infants appears as chicken pox in children and zona in adults due to its reactivation. Considering its rarity in infants, an 8-month case infected with varicella due to reactivation of intrauterine primary infection is reported. Case report: An 8-month infant with 3200gr weight at a vaginal delivery was hospitalized for erythematous lesion around the left eye, diagnosed as orbital cellulitis initially. The lesion spread rapidly to 8×14cm and several fluid -filled vesicules (which then turned into yellow) developed. Referring to case history, the mother was infected to varicella with generalized macrovesicular lesions involving stomach, face, and limbs. Infant tests of varicella zoster virus about the existence of immunoglobulin M were positive. Treatment was done by cephalotine, acyclovir, and sulfacetamide eye drop. The lesions disappeared within one week. Conclusion: In this patient, because of exposure to varicella infection in utero period, reactivation of primary infection after birth in 8-month appeared herpes zoster symptoms. After diagnosis, the treatment was successful

The effect of zinc sulphate syrup on children's respiratory tract infections

BACKGROUND AND OBJECTIVE: After Iron, zinc is the second most abundant trace element in the body that is present in all organs, tissues and body fluids. It is a necessary component for maintaining immunological integrity antioxidant activity, and has critical role in the control and prevention of infection. The aim of this study was to investigate the effect of zinc sulphate syrup in treatment of children with respiratory tract infection. METHODS: In this randomized clinical trial study, one hundred and twenty four children with respiratory infection (62 in case and 62 in control group) from pediatric ward of Hajar hospital of Sharekord university enrolled. Both groups received standard treatment. In addition to, zinc sulphate syrup was given to case group and placebo to control group. Respiratory rate, bed and cough and fever duration were compared between the case and control groups (IRCT: 201103025951N1). FINDINGS: The mean duration of fever in the case group was 2.6±0.82 days and in the control group 4±1.5 days (p<0.001). The mean of bed duration in the case group was 4.7±1.5 days and in the control group 5±1.8 days (p=0.42). The mean of cough duration in the case and control groups was 3.4±1.3 and 4.7±1.6 days respectively (p=0.09). Respiratory rate in the case group was 28.3±4.3 and in the control 28.1±4.9 (p=0.77). CONCLUSION: The study showed that zinc supplementation has a beneficial effect in decreasing the fever duration in children with respiratory infection. But there was no significant effect on respiratory rate, duration of bed and cough

Influential factors on growth parameters in infants using quantile regression analysis

زمینه و هدف: یکی از مسایل مهمی که بر سلامت جامعه تأثیر می گذارد، سلامت رشد کودک می باشد. بر این اساس شناخت عوامل موثر بر رشد جسمی کودکان و نیز شناخت اقدامات لازم برای حفظ و ارتقای سلامت آن ها بسیار مهم است. هدف از مطالعه حاضر تعیین عوامل مؤثر بر شاخص های رشد شیرخواران شامل قد، وزن و دور سر در شیرخواران با استفاده از تحلیل رگرسیون چندک می باشد. روش بررسی: در این مطالعه توصیفی- تحلیلی از اطلاعات مطالعه کوهورت انجام شده، در گروه تحقیقات طب اسلامی دانشگاه علوم پزشکی شهرکرد، از ماه مبارک رمضان سال 1385 تا 1388، استفاده شده است. 92 نوزاد سالم که دارای شرایط ورود به مطالعه بودند، مورد بررسی قرار گرفتند. اثرات عوامل موثر برروی شاخص های رشد، وزن، قد و دور سر، در چندک ‌های مختلف با استفاده از مدل رگرسیون چندک مقایسه شد. یافته ها: بر اساس نتایج، شاخص های رشد با وزن ابتدای تولد رابطه مستقیم دارد. تأثیر مستقیم سن مادر نیز تا 6 ماه برای وزن و دور سر کاملاً مشهود بود. رتبه تولد روی شاخص های رشد اثری معکوس داشت. مصرف آهن در چندک های 20 و 40 قد و مصرف شیر مادر در دهک دوم دور سر معنی دار بود (05/0>P). نتیجه گیری: نتایج به دست آمده از روش رگرسیون چندک به خاطر برازش خطوط رگرسیونی مختلف جامع تر از روش رگرسیون خطی بود و اثرگذاری متغیرهای تحصیلات پدر، رتبه تولد، شاخص توده بدنی مادر، تعداد اعضای خانواده، مصرف آهن، ویتامین و شیر مادر توسط رگرسیون خطی یافت نشد. در ضمن توجه بیشتری نسبت به شاخص های رشد دختران خصوصاً تا بعد از 6 ماه باید صورت گیرد

Correlation of transcutaneous and serum bilirubin levels in infants with neonatal jaundice hospitalized in Hajar Hospital in Shahrekord

Background and Aim: Bilirubin level measurement through BiliCheck device can be a useful method in diagnosing neonatal jaundice due to no need for frequent blood-taking. Thus, the present study aimed to compare serum and transcutaneous bilirubin levels in infants with neonatal jaundice hospitalized in Hajar Hospital in Shahrekord. Materials and Methods: In this descriptive-correlation study, 417 infants with neonatal jaundice were examined. A questionnaire including demographic information (age and weight of infant at the time of reception, weight at the time of birth, age of pregnancy, and infant sex) was completed. As the infants were hospitalized, the blood-taking were done to control serum bilirubin based on the routine stages of the unit and transcutaneous Bilirubin level was controlled by BiliCheck device and the data were recorded. Pearson coefficient and independent t-test statistical analysis were used through SPSS software. Results: From the total of 417 infants under this study, 322 infants were term and 95 infants were preterm. 51.3% were male and 48.7% were female. Weight average of term infants was 3081467.88 and in the preterm infants, it was 2335572.44 gram. The results indicated the linear coefficient was direct and meaningful between the serum and transcutaneous bilirubin levels in term and preterm infants. ‍Conclusion: The findings suggested that mean difference of bilirubin levels on these two methods of measurement in term infants in different days were meaningful while there is no significant mean difference in preterm infants indicating the efficacy of this device in measuring bilirubin levels in preterm infants

Cotoneaster: A safe and easy way to reduce neonatal jaundice

Introduction: Consumption of cotoneaster may reduce neonatal jaundice. Aim: Hence this study was undertaken to determine the effect of mothers’ cotoneaster consumption on treatment of their neonates’ jaundice. Materials and Methods: In this randomized clinical trial study, 120 neonates with jaundice referred to a hospital in southwest Iran were enrolled by nonprobability sampling and divided randomly into four groups. In the first group both mothers and neonates received cotoneaster; in the second group only mothers; in the third group only neonates; and in the fourth group the neonates received distilled water as placebo. Phototherapy was done under the same condition for all neonates. Results: The reduction of bilirubin was significantly higher in treatment groups compared to control group (p<0.05). Bilirubin in the group of neonates whose mothers consumed cotoneaster was less compared to control group at 24 and 36 hours (p<0.05) and the highest reduction in bilirubin was observed in the first group. The mean duration of hospitalization was longer for the control group (p<0.05). Conclusion: Consumption of cotoneaster by both mothers and neonates caused a decrease in neonatal jaundice more rapidly compared to other groups and decreased the duration of hospitalization. Cotoneaster consumption by mothers, neonates, or both may be useful in treatment of neonatal jaundice. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved