Introduction: Early diagnosis and treatment of congenital hypothyroidism before 6 weeks of birth and preferably at birth, prevents brain damage. Neonatal screening for CH is carried out routinely in developed countries. Overall, the incidence of CH is 1.4000 infants in average. The incidence is higher in iodine deficient areas; also more transient TSH elevation is observed in these districts. Objective: This study was conducted to clarify thyroid dysfunction in the neonates born in Rasht Alzahra Hospital, after elimination of Iodine deficiency in the province.Materials and Methods: All the newborns, up to 3000 neonates, born in one year were included in the study. TSH was measured in cord blood serum immediately after birth by IRMA method. TSH ≥ 20 mU/L was considered abnormal. Venous sampling for TSH & T4 was done on recalled patients. Neonates with T4 and TSH measurements <6.5 µg/dL & >10 mU/L respectively or TSH> 30 mU/L alone were considered hypothyroid. Hypothyroid neonates were evaluated for renal and cardiac anomalies by sonography and echocardiography.Results: 62 neonates had TSH≥ 20 mU/L. The mean of cord blood TSH was 32.5 mU/L, with a range of 20-123 mU/L. in recall, only 2 cases (one girl, one boy) had elevated TSH (TSH>10mu/L) and were considered hypothyroid. None of them had clinical findings of hypothyroidism, goiter and congenital anomalies.Conclusion: With respect to the high incidence of CH and transient TSH elevation (57 cases, 1.9%), supervision on production and consumption of iodide salts via periodic screening of population for iodine deficiency and neonatal screening for CH is strongly suggested.

Introduction: Hearing loss diagnosis solely by using the classical clinical methods in neonatal and infants seems to be difficult. Any delay in diagnosis results in reverse effects on speech, language and social cognitive developments. TEOAE and ABR tests are highly recommended to be performed at birth. The aims of this study were early diagnosis, intervention and prevention of linguistic delay that were performed in the three hospitals in mashhad city.Materials and Methods: This was a descriptive study and neonates in the first 24 hours were screened using the TEOAE test. The cases who failed the first time test were have been rescreened 3 weeks later. If the results in both sessions (screen and re-screen) failed in one or both ears the child would be referred for a complete diagnosis ABR test before 3 month of age. Confirming the presence of mono aural or biaural hearing loss using by the ABR test. Long term follow up and medical/rehabilitative interventions were been programmed and performed before the age of 6 month.Results: From 10016 screened new born 9615 individuals (96%) passed the tests and 401 individual (4%) were referred to the next step. Of those who were referred, only 289 individuals showed up for the re-screening test. From these only 23(8%) newborns were referred to ABR test. In this population the presence of hearing loss was only confirmed in 13 individuals (56%). Eight of them had profound hearing loss in cochlear, 2 of them had moderate hearing loss in Cochlea, and 3 newborn had sever conductive deficit.Conclusions: Because of the high prevalence of congenital hearing loss, the reverse effects on children development, the availability of accurate tests for diagnosis of hearing loss, and being cost effective, hearing screening of all the neonates are highly recommended at the birth.

Background: Newborn infants who are risk for severe hyperbilirubinemia and cared at home should be monitored for progression of jaundice. We aimed to verify if a smart phone application (BiliScan Inc), which uses automated imaging for bilirubin (AIB), can be used to estimate total serum bilirubin (TSB) levels at home. Methods: A convenience sample of 1038 “ healthy” infants in China were prospectively enrolled to a singlecenter study in 2016. Correlations between AIB and TcB measurements were correlated to TB measurements. Bias and imprecision of AIB measurements were determined using Bland-Altman analysis. The diagnostic value of AIB was compared by the area-under-curve (AUC) values of receiver operator characteristic (ROC) curves. Results: The best correlation and AUC for AIB were at the sternum, both with values of 0. 76. We truncated performances to 369 TB values >5 and <15 mg/dL, and sternal AIB showed the best correlation to TB (r =0. 5, P<0. 0001). The AUC for this range was 0. 54. However, from a subset of 200 AIB values >13. 5 mg/dL (n=369 babies), the sensitivity and negative predictive value (NPV) were 100% with a specificity of 50%. Furthermore, Bland-Altman analyses showed a bias and imprecision of AIB and TcB when TB was >13. 5 and <15 mg/dL. Conclusion: The use of AIB may be a potentially useful screening device for neonatal jaundice. Its performance requires additional improvements for accurate measurements across wider ranges of TB levels.

Background: Early diagnosis and initiation of prophylactic penicillin and pneumococcal vaccine may reduce the risk of sickle cell complications that is a common hemoglobin disorder in Southwest Iran. This study aimed at determining the incidence of Sickle Cell Disease (SCD) and other Hemoglobinopathies in newborn being at risk based on ethnic origin.Materials and Methods: In this descriptive epidemiologic study, between September 2013 and September 2015, 8363 newborn blood samples were tested in four maternity units from Ahvaz, Khoramshahr, Sosangerd and Dezful. Complete cell count and cellulose acetate electrophoresis at pH 8.4 were performed on each blood sample. Parent's clinical status was also checked for more information. Presence of an abnormal band in the EDTA treated samples were further confirmed by citrate agar gel electrophoresis and automated high performance liquid chromatography (HPLC). Results were analyzed statistically by the One-Way ANOVA analysis.Results: Among 8363 screened samples, 118 (1.41 %) samples were heterozygous for Hb S, and four (0.047%) for Hb C; none of newborns were Hb SS homozygotes. The incidence of silent and alpha thalassemia minor based on RBC indices was nearly 10%.Conclusion: Present findings indicated the high quality and considerable impact of conducted screening program starting in 2007 at significantly decreasing the prevalence of SCD among newborns born between 2013 and 2015. The results also showed that the neonatal screening for SCD was not weighed to add as a new program in national health network.

Background: Galactosemia is a congenital metabolic disorder that can damage the health of a newborn. Screening is an important step to prevent and treat this condition. Due to increasing health care costs and limited financial re-sources of health systems, the most suitable economic analysis tool should be applied. The aim of this study was to analyze the cost-utility of neonatal screening program for diagnosing galactosemia in Fars province, Iran. Methods: In this cross-sectional study and cost-utility analysis in the cost of screening for galactosemia and its finan-cial effects, decision tree model and society’ s viewpoint were used. The population of study was 81837 infants referred to Neonatal Screening Laboratory (Nader Kazemi Clinic) affiliated to Shiraz University of Medical Sciences (SUMS), Iran, in 2010. Quality of life in two groups of patients was evaluated by using the time trade-off. The best intervention option was selected by using the Incremental Cost-effectiveness Ratio. Results: The estimated cost of diagnosed through screening and without screening were 43519911 and 130011168 Iranian Rails (4222. 00 $ and 12615. 00 $), respectively. Therefore, there was a saving of 201443240. 99 Iranian Rails (19641. 00 $), for each patient annually. Conclusion: The screening program can improve both the qualitative and quantitative lifestyle of people and increase savings in health care system. Policymakers could use the results to design new policies based on the necessity of screening.

Background: Hypothyroidism, a preventable cause of mental retardation, is one of the most common diseases of the endocrine gland in children. The disorder can be corrected if it is identified and treated within the first few days of birth. In Iran, hypothyroidism is estimated to affect one out of 400 to 900 neonates, which is much higher than the global average.Objectives: This article is conducted to investigate the most cost–utility option i.e. whether to implement the neonatal screening of genetic hypothyroidism or to merely treat such patients in the absence of the screening process.Patients and Methods: The present research is a cross-sectional, descriptive and analytical study. The provider perspective was employed to calculate the direct costs imposed on Shiraz University of Medical Sciences, insurance organizations, charities and patients concerning the implementation of screening program and the treatment of detected cases along with the direct costs related to patients treated in the absence of the screening process; costs related to death were excluded. The statistical population of the study consisted of all 81837 newborns referred to university laboratory in Shiraz in 2010. In order to measure the utility, time-trade-off method was employed to determine the life quality of patients.Results: The incremental cost-effectiveness ratios (ICER) of hypothyroidism, calculated through dividing the cost difference (ΔC) by utility difference (ΔQALY), indicated that screening saved a total of 13413 US. $.Conclusions: The economic evaluation (cost-utility analysis) resulted from the comparison of the above choices revealed that implementing the screening plan can actually be better and more cost-effective.

Introduction: Hearing loss is one of the most prevalent birth - defects. If remained unchecked it will probably cause delay in speech, language, and cognitive development. The screening Neonatal hearing as the most effective way of early detection of hearing loss is performed in most countries around the world.The main aim of this program was to screen neonatal hearing in 2 Tehran hospitals - namely, Milad and Hedayat hospitals.Material & Methods: During 12 months (from Oct 2002 till Oct 2003) 7718 neonates (3911 males and 3807 females) were screened. There were three stages in this project initial screening, prescreening and diagnostic tests.The first and second stages were performed by OAE screener and the last stage, ABR evaluation, done only for the neonates who were referred from initial and secondary screening. For statistical Analysis, SPSS Software was used and graphs were drawn by the Excel software.Results: 9 neonates out of 7718 (one per thousand) had hearing loss and were referred to related services. Prevalence of impaired hearing impair among neonates was similar to previous researches on this subject around the world.Conclusion: It seems that we must raise the level of public awareness about the importance of early detection and intervention for hearing loss. In general, we must establish appropriate infrastructures and background knowledge among those involved in this field, and in particular, we must gain the support of authorities.