Caspian Journal of Pediatrics
Year:2021 | Volume:7 | Issue:2|Papers Count:10

Background and Objective: Neonatal sepsis is a systemic infection occurring in the first 28 days of life and is a leading cause of disease and death of neonates. It accounts for five million newborn deaths the objective of this study was to assess prevalence and determinants of neonatal sepsis among admitted neonates at in Hiowt-Fana Specialized Referral Hospital, Harar, Ethiopia, 2019. Methods: Hospital-based cross-sectional study with a retrospective chart review method was conducted in Tertiary Hospital in Harar town. Data were collected from April 1 to May 30, 2019. The sample size was calculated by using single population proportion sample formula and the final sample size was 292. Data were collected using a checklist and analyzed through SPSS-20. Binary and multiple logistic regressions were applied to find the association between independent and dependent variables. Findings: In general, the prevalence of neonatal sepsis in this study was 52. 7%. This study indicated that prolonged rupture of membranes (PROM) of the mother (P-value=0. 002, AOR=2. 74 (95% CI: 1. 32, 4. 39)), gestational age of neonates (P-value=0. 001, AOR=0. 85(0. 34-0. 815)) and birth weight of the neonate (P-value=0. 001, AOR=0. 45(0. 04-0. 61)) were significantly associated with neonatal sepsis. Conclusion: The associated risk factors for neonatal sepsis were identified as PROM of the mother, gestational age of neonates and birth weight of the neonate. Therefore, service utilization of mothers, early detection of risky situations and appropriate practice of newborn care should be strengthened by training of health workers, provision of health care services as per standards, and monitoring and evaluation of obstetrical/neonatal care.

Background and Objective: Jaundice is one of the most common causes of hospitalization in newborns. The aim of the present study was to determine the causes of severe jaundice and its complications in neonates admitted to Mofid Children’, s Hospital of Tehran. Methods: Sixty-five neonates with severe indirect hyperbilirubinemia, admitted to the Neonatal ward of the Mofid Children’, s Hospital during the years 2018-2019 were investigated. Laboratory data, family socioeconomic status, parental awareness of jaundice and its consequences, neonatal delivery information and their prenatal conditions were collected during hospitalization. The neonates were followed up after discharge from the hospital for complications of jaundice by telephone calls and clinic referrals. Findings: In the 22 cases (33. 8%) of the neonates, the ABO setup, and in the 4 cases (6. 2%), the Rh setup between the mother and neonate were observed. A total of 25 neonates (38. 5%) had an average of 1. 2 times of blood transfusion. Twentyfour neonates (36. 9%) had bilirubin level of ≥, 25 mg/dl. There was a significant relationship between total bilirubin level and delivery type (P <0. 05) and between total bilirubin level and type of prenatal care (P = 0. 031). No complications of jaundice were reported during patient follow-up. Conclusion: Male gender, vaginal delivery, family delay in diagnosis and treatment of jaundice, positive history of jaundice in a previous baby, and prenatal care by someone other than a gynecologist are associated with more severe hyperbilirubinemia.

Background and Objective: Despite the value of the APGAR score in diagnosing neonates with fetal distress and intrauterine asphyxia, a low APGAR score does not necessarily indicate fetal asphyxia. The non-stress test (NST) is a method, monitoring the fetal health and providing data on the proper time for ending the pregnancy in emergent situations,however, sometimes it is not very accurate to diagnose hypoxia leading to unnecessary cesarean delivery. The aim of this study is evaluating of Umbilical cord PH and APGAR score of neonates born by cesarean section due to the fetal distress in NST. Methods: In this analytical cross-sectional study, all 139 neonates with an impaired NST were enrolled at 2018. In addition to information such as 1st and 5th minute APGAR scores and umbilical cord pH, the demographic data of mothers and neonates were gathered. Findings: In total, 252 impaired NST patterns were found in all studied neonates. Bradycardia and late decelerations had a significant relationship with acidosis. Moreover, late decelerations were associated with lower APGAR scores. Umbilical artery pH was significantly correlated with 1-minute (r=0. 34,P=0. 001) and 5-minute APGAR scores (r=0. 32,P=0. 001). Positive predictive value of NST was 48. 9%. Conclusion: The results showed that NST had a moderate positive predictive value for the diagnosis of fetal acidosis in neonates with tachycardia or non-reactive NST. There was a significant relationship between late deceleration and arterial acidosis with first and five minute APGAR score in neonates. The mean total arterial acidosis rate was significantly lower in the group with APGAR score less than 7.

Background and Objective: There is some evidence of a relationship between attention-deficit/hyperactivity disorder (ADHD) and functional defecation disorders (FDDs), both of which are common in childhood. The aim of the study was to investigate the frequency of ADHD in children with fecal incontinence (FI) and functional constipation (FC). Methods: This cross-sectional study was conducted on 99 children aged 4-14 years who met the Rome IV criteria to diagnose pediatric chronic FC with FI from January to May 2020. The ADHD was then assessed by the child and adolescent psychiatrist via clinical visits, DSM-5 and Conners Rating Scale (CRS). Pearson’, s Chi-Square test and Mann-Whitney’, s test were used to compare children with and without ADHD. A P value <0. 05 was considered statistically significant. Findings: According to DM-V and clinical visits, about 24 (24. 2%) children with FC and FI were diagnosed with ADHD. Moreover, six and one of their relatives had anxiety/depression and schizophrenia, respectively. Children with ADHD were significantly male (83%, p= 0. 009), older (p= 0. 003), heavier (p= 0. 005), first born (79%, P < 0. 001) and premature (37%, P=0. 01) with older mothers (p=0. 01). Conclusion: This study showed that there was a high prevalence of ADHD in children with FC and FI. Therefore, screening of suspected children is recommended.

Context: Retinopathy of prematurity (ROP) is known as the abnormal growth of retinal blood vessels in premature and very low birth weight (VLBW) infants that can be caused by exposure to high oxygen pressure through oxidative damage and inflammation. Evidence Acquisition: In this review, the keywords zinc deficiency, iron deficiency, and retinopathy of premature was first searched in databases including Scopus, Google Scholar, and PubMed. There were no time limitations for the search. Full-text articles in the English language were included in this study. Searching with these keywords did not yield any results. In the next step, preterm neonate, preterm infant and VLBW infants were added to the keywords. Findings: The results showed that iron and zinc deficiencies are very common in premature and VLBW infants. VLBW and preterm birth are also risk factors for ROP. In addition, the use of zinc and iron supplements in low birth weight and premature infants is also commonly necessary to maintain normal growth and development. Conclusion: It can be concluded that premature infants receiving high doses of zinc and adequate doses of iron inhibited not only inhibit oxidative damage and inflammation caused by hypoxia but also vascular endothelial growth factor (VEGF) expression. In support of this mechanism, our results showed that premature infants receiving high doses of zinc and adequate doses of iron significantly reduce the ROP process. Therefore, monitoring serum zinc and iron levels and normalizing them may play an important preventive role in the development of ROP.

Background and Objective: Although awareness of the importance of breast milk and breastfeeding has increased, the prevalence of exclusive breastfeeding during the first six months of an infant's life is not optimal. The aim of this study was to determine the frequency of exclusive breastfeeding and factors affecting it among infants under 6 months of age in Bushehr, Iran. Methods: This cross-sectional study was conducted in 2018 on 403 mothers whose children were under one year of age and referred to health centers in Bushehr Iran. Ten health centers were randomly selected as a sample. Participants completed a questionnaire providing demographic information, information on exclusive breastfeeding and reasons for discontinuation of breastfeeding. Data were analyzed using SPSS software at a significance level of 0. 05. Findings: The frequency of exclusive breastfeeding in this study was 33. 7%. Maternal literacy level (P<0. 001), father's employment (P=0. 018) and the interval between pregnancies (P=0. 041) were significantly related to exclusive breastfeeding. The most common reasons for discontinuing exclusive breastfeeding were advice from others (31. 9%), infant crying (19%) and mother's perception that her milk was not enough (14. 1%). Conclusion: The results of this study showed that the frequency of exclusive breastfeeding was low in Bushehr. The main reasons for discontinuing exclusive breastfeeding were the advice of others and the mother's mistaken belief that her milk was insufficient. Educational programs to promote breastfeeding should involve not only mothers, but also other caregivers of infants.

Background and Objective: Hypomagnesemia can lead to bronchial smooth muscle contraction and is associated with wheezeing, airway hyperactivity and impairment of lung function. The aim of this study was to compare serum magnesium levels between asthmatic and healthy children. Methods: This case-control study was performed from September 2018 to February 2019. Totally, 125 children (78 asthmatic and 47 healthy non-asthmatic children) aged 3-14 years referred to Amirkola Children's Hospital in Iran were entered to the study. Sampling was done using the available method based on inclusion criteria. Serum magnesium levels were measured in all children in the laboratory of Amirkola Children's Hospital. P<0. 05 was considered a significant level. Findings: The mean age of children was 81. 21±, 35. 45 months, among them, 77 (61. 6%) and 48 (38. 4%) were male and female, respectively. The mean serum magnesium level of children was 2. 08 and 2. 04 mg/dl in the control and asthma groups, respectively and there was no statistically significant difference between the two groups (p=0. 49). Conclusion: Based on the findings of this study, there is no significant difference between serum magnesium levels in asthmatic patients and the control group and it is not necessary to routinely measure magnesium levels in these patients.

Background and Objective: Intraventricular hemorrhage (IVH) is a major cause of brain injury in preterm infants. Considering the high prevalence of IVH in preterm infants and the importance of determining the risk factors, this study was done to evaluate the prevalence of various grades of IVH and identify the different associated factors and short-term complications. Methods: In this retrospective study, the medical records of 54 preterm infants (26-37 weeks gestational age) admitted to the neonatal intensive care unit (NICU) of Bahrami Hospital, Tehran, Iran (2015-2018) were examined. Cranial ultrasonography was performed in all patients, and IVH was classified into 4 grades. A checklist was prepared and filled them out, and then the data were analyzed using SPSS-21. Findings: Out of all subjects, IVH was found in 11 infants (20. 4%). The most frequent IVH grades were 1 and 2. The most common Apgar scores in the fifth minute was 6. The mean weight of infants and Apgar score in patients with IVH was significantly lower than that of those without IVH. In multivariate logistic regression analysis of factors affecting IVH, Apgar score was the only significant independent predictor of IVH, such that with each number increase in Apgar score, the risk of IVH decreased (up to 100%). Conclusion: Based on the results of this study, birth weight, gestational age and fifthminute Apgar score were associated with IVH. Prevention of preterm birth and other preventive measures can reduce the complications of this disease.

Background: Subcutaneous fat necrosis is a rare form of adipose tissue inflammation in neonates that results from certain predisposing factors such as asphyxia at birth. Case Report: This report introduces a male neonate born at 38 weeks gestation with hypoxic-ischemic encephalopathy. The patient presented with an extensive erythematous skin lesion and subcutaneous nodules on the back and shoulders at four days of life. The baby had severe hypertriglyceridemia (834 mg/dl) after developing the lesion, which raised the diagnostic suspicion of subcutaneous fat necrosis. The hypertriglyceridemia resolved Over the next four and six months (82, 75 mg /dl, respectively). He had no other neurologic or metabolic abnormalities associated with subcutaneous fat necrosis. Conclusion: Although subcutaneous fat necrosis is self-limited and has a benign course, it can be associated with severe hypertriglyceridemia requiring careful investigation and monitoring.

Background and Objective: Scorpion envenomation (SE) is a common health problem in some regions of the world, especially in children. The aim of the current study was to evaluate the epidemiological and clinical features as well as outcomes of SE patients. Methods: In this retrospective study, the information of 46 children with scorpion sting, referred to Gandhi memorial hospital, India were assessed for 8 months (1st April 2018 to 30th November 2018). The SE recognition was based on a history of scorpion stings. The clinical characteristics and severity (Abroug’, s classification) of the disease were checked. The data were analyzed using SPSS 22. Findings: Most children were 1-5 years old. Most of the stings were seen in exposed extremities (85. 4%), generally in the upper limbs (44 local pains, hyperemia itching, dry mouth, swelling, malaise and sweating) and thirst was the most frequent problem of the Local and autonomic nervous system. There were 11 (26. 8%) and 17 patients (41. 4 %) in the grade III and II groups, respectively. At the end of the study, 2 (5%) children died from scorpion stings. Conclusion: This analysis showed that intoxications caused by scorpions were mostly seen in hot summer months, in labor class people and people living in rural areas. In clinical assessment, local and systemic effects were found. We propose that this information is beneficial for health education and the prevention of scorpion sting cases.