Frequency and Causes of Hypotonia in Neonatal Period with the Gestational Age of More Than 36 Weeks in NICU of Mofid Children Hospital, Tehran, Iran During 2012-2014

How to Cite This Article: Seyed Shahabi N, Fakhraee H, Kazemian M, Afjeh A, Fallahi M, Shariati M, Gorji F. Frequency and Causes of Hypotonia in Neonatal Period with the Gestational Age of More Than 36 Weeks in NICU of Mofid Children Hospital, Tehran, Iran During 2012-2014. Iran J Child Neurol. Winter 2017; 11(1):43-49. AbstractObjectiveHypotonia is a serious neurologic problem in neonatal period. Although hypotonia is a nonspecific clinical finding but it is the most common motor disorder in the newborn. The objective of this study was to determine the frequency of neonatal hypotonia then to ascertain of the most common causes.Materials & MethodsThis cross –sectional prospective study was carried out on the 3281 term infants hospitalized in conventional and NICU of Mofid Children Hospital, Tehran, Iran during 2012-2014. Diagnosis was made by history, physical & neurological examination and accessible diagnostic tests.ResultsFifty nine hypotonic neonates were identified, forty seven (79.66%) had central hypotonia (Hypoxic ischemic encephalopathy (n= 2), other causes of encephalopathy (n=2), intracranial hemorrhage (n=4), CNS abnormalities (n= 7), chromosomal disorders (n=4), syndromic–nonsyndromic (n=8), and metabolic diseases (n=8). Peripheral hypotonic recognized in 6 infants (10.17%); spinal muscular atrophy (n= 1), and myopathy (n= 5). Six cases (10.17%) remained unclassified. Twelve infants had transient hypotonia. In final study, 18 of 59 infants (30%) died, nearly 90% before one year of age. Twenty-eight (47%) infants found developmental disorders and only 13 (22%) infants achieved normal development in their follow up.ConclusionNeonatal hypotonia is a common event in neonatal period. A majority of diagnosis is obtained by history and physical examination. Neuroimaging, genetic and metabolic tests were also important in diagnosis. Genetic, syndromic–nonsyndromic, and metabolic disorders were the most causes of neonatal hypotonia.References1.Miller VS, Delgado M, Iannaccone ST. Neonatal hypotonia Seminar in neurology 1993; 13 (1):73-83.2. Laugal V, Cossee M, MJ. de Saint –Martin A, Echaniz- Laguna A, Mandel JL, Astruc D, Messer FMJ. Diagnostic approach to neonatal hypotonia: retrospective study on144neonates.Eur J Pediatr 2008; 167:517-523.3. Birdi K, Prasad C, Chodirker B, Chudly AE, The floppy infant: retrospective analysis of clinical experience (1990-2000) in a tertiary care facility. J Chlid Neurol 2005; 20: 803-808.4. Johnston HM.The floppy weak infant revisited. Brain Dev 2003; 25:55-58.5. Crawford TO. Clinical Evaluation of the Floppy infant. Pediatric Annal 1992;16:348-354.6. Richer LP, Shevell MI, Miller SP. Diagnostic profile of neonatal hypotonia; An 11 year study. Peditric Neurol 2001; 25:32-37.7. Paro–Panjan D. Congenital hypotonia is there an algorithm. J Child Neurology 2004;19 (6):439-442. 8. Griggs RC, Mendell JR, Miller RG. Cngenital myopathies.in: Evaluation and treatment of myopathies. Philadelphia:FA Davis C; 1995:211-469. Nada Zadeh and Louanne Hudgings. The Genetic Approach to hypotonia in the neonate. NeoReviews 2009; 10; e600-e607.10. Bodenstiener JB. The evaluation of the hypotonic infant Seminar in PediatricNeurology 2008;15:10-20.11. Dubowitz V. Thomas NH. The natural history of type 1(severe) spinal muscular dystrophy. Neuromuscular Disord. 1994;4:497-50212.12. Jimenez E, Garcia – Cazoria A, Colomer J, Nascimento A, Ieiondo M, Compistol J. Hypotonia in the neonatal period: 12 years experience.[Article in Spanish] Rev Neurol 2013 Jan16:56 (2):72-8

Searching a biomedical database from Bulgaria : the ABS database

The University of Sofia, Bulgaria, disseminates local biomedical literature (1994 to present) through a free online database, ABS. We systematically searched ABS to identify citations to controlled trials and find what proportion of these studies are to be found on MEDLINE. We searched using Bulgarian and English phrases; manually selected citations of controlled trials and sought these citations on MEDLINE. Using the two languages we found a total of 628 unique citations, of which 47 of which seem to be relevant controlled trials (precision 7.48%, 13% of ABS citations were found on MEDLINE). The trials in ABS commonly focused on evaluation of care for people with cardiovascular or urological problems

Searching a biomedical database from Bulgaria : the ABS database

The University of Sofia, Bulgaria, disseminates local biomedical literature (1994 to present) through a free online database, ABS. We systematically searched ABS to identify citations to controlled trials and find what proportion of these studies are to be found on MEDLINE. We searched using Bulgarian and English phrases; manually selected citations of controlled trials and sought these citations on MEDLINE. Using the two languages we found a total of 628 unique citations, of which 47 of which seem to be relevant controlled trials (precision 7.48%, 13% of ABS citations were found on MEDLINE). The trials in ABS commonly focused on evaluation of care for people with cardiovascular or urological problems

Searching a biomedical bibliographic database from the Ukraine: the Panteleimon database

The Panteleimon database is available via the Internet and is a public access, database, capable of being searched in English, Russian and Ukrainian, covering medical, pharmaceutical, and chemical publications, published in he Ukraine and Russia from 1998. Describes the formulation of a search strategy for the Panteleimon database, for the identification of citations to randomized controlled trials (RCTs), and the comparison of the search results with records included in the Cochrane Library's Cochrane Central Register of Controlled Trials (CENTRAL) database, to evaluate how comprehensive the coverage of the CENTRAL database is for the literature of the Ukraine. The results indicated that Panteleimon is an easily accessible bibliographic database offering easy access to the Ukrainian biomedical literature. The English language retrieval functions picked up most of the reports of RCTs/CCTs (91 per cent precision but the lower recall of 55 per cent indicates the need to search using Russian and Ukrainian terms for completeness. The overall precision of 26 per cent compares favourably with a search for RCTs in EMBASE, carried out by the UK Cochrane Centre, where 70,000 reports of RCTs were identified from 300,000 records down-loaded (precision 23 per cent). (Quotes from original text

Liver transplantation for type IV glycogen storage disease

TYPE IV glycogen storage disease is a rare autosomal recessive disorder (also called Andersen's disease1 or amylopectinosis) in which the activity of branching enzyme alpha-1, 4-glucan: alpha-1, 4-glucan 6-glucosyltransferase is deficient in the liver as well as in cultured skin fibroblasts and other tissues.2,3 This branching enzyme is responsible for creating branch points in the normal glycogen molecule. In the relative or absolute absence of this enzyme, an insoluble and irritating form of glycogen, an amylopectin-like polysaccharide that resembles plant starch, accumulates in the cells. The amylopectin-like form is less soluble than normal glycogen, with longer outer and inner chains. © 1991, Massachusetts Medical Society. All rights reserved

The outperformance of family firms: the role of variance in earnings per share and analyst forecast dispersion on the Swiss market

Recent studies provide empirical evidence that family firms are outperforming their non-family counterparts in terms of stock market performance. For the Swiss stock market we find that family firms indeed outperform their non-family counterparts after controlling for firm size and beta. In addition, our data shows that family firms display more stable earnings per share in contrast to their non-family counterparts. Furthermore we find that the variance of earnings per share positively affects analyst forecast dispersion. According to anomaly literature, lower analyst forecast dispersion has been found to induce higher excess return, which our data supports for the Swiss stock market. By linking variance of earnings per share, analyst forecast dispersion and stock performance we provide an insightful explanation for the excess stock market returns of family firms. In addition, our text extends the theory of dispersion effect with an additional empirical element, the variance of earnings per shar