Background: Despite significant progress in medicine and increasing survival rate of preterm infa... more Background: Despite significant progress in medicine and increasing survival rate of preterm infants, these infants still suffer from abnormal development and neurobehavioral deficits. The present study aimed to investigate the effects of developmental care on neurobehavioral function and health promotion of preterm infants hospitalized at Neonatal Intensive Care Units (NICUs). Methods: This study was a clinical trial conducted on 66 preterm infants hospitalized in NICU who were divided into three groups mother's presence (n=22), mother's voice (n=22) and nurse's voice (n=22) by convenience sampling technique. The respiratory rate of infants in all groups were recorded by the monitoring system in a 5-min interval for 30 minutes in three phases (10 minutes before, 10 minutes during, and 10 minutes after the intervention) within 3 consecutive days. Results: In mother's voice group, the Mean±SD of respiratory rate (49.58±0.97) were higher during the intervention compar...
Diabetes during pregnancy has considerable adverse effect son the mother and her fetus or neonate... more Diabetes during pregnancy has considerable adverse effect son the mother and her fetus or neonate. Mothers hyperglycemia may induce hyper insulinemia and pancreatic Beta cells hyperplasia in fetus. Excess Insulin secretion in fetus blood may cause macrosomia, increase basal metabolism rate, increase oxygen consumption and even fetus hypoxemia. Fetal hypoxia may fallow by erythropoietin over production, red blood cell hyperplasia and increased hematocrit level. Polycythemia may enhance blood circulation and cause hyper bilirubinemia. On the other hand hyperglycemia may cause exaggerate d production of oxygen radicals in mitocondrias and produce hydroperoxides which are prostacyclin inhibitors. Erythropoietin excess and polycythemia induce catecholamine release, hypertension and myocardial hypertrophy respectively. The last may be one of the etiology of still birth in poor control diabetic pregnancies. Rigorous glycemic control before and during pregnancy may decrease the prevalence o...
Background: More than 15 million premature infants are born worldwide each year who in average, u... more Background: More than 15 million premature infants are born worldwide each year who in average, undergo 10-16 painful procedures every day. Repeated painful procedures early in life can have adverse effects on nervous system development and pain response. Several factors may influence the response of premature infants to painful stimuli and the knowledge of these factors can lead to proper pain assessment. The aim of this study was to investigate the effects of sleep and awake states on pain responses in premature infants.
Introduction and importance: Limited data are available about various effects of COVID-19 on preg... more Introduction and importance: Limited data are available about various effects of COVID-19 on pregnancy. On the other hand, the COVID-19 pandemic could exacerbate anxiety or schizophrenia symptoms. Case presentation The patient is a 5-day-old newborn, whom his mother suffers from schizophrenia, depression and anxiety disorders. The young pregnant mother gets delusions of being infected with Covid-19, thus attempts suicide with Sertraline, Clonazepam, Quetiapine and Rispeirdone, although she was in the last week of pregnancy. The newborn baby referred to our neonatal ward with seizure and apnea. Phenytoin and caffeine were administered leading to some degree of symptom relief, but due to the dermatologic reactions of phenytoin, they were replaced with levetiracetam. Clinical discussion The Covid-19 may increase levels of anxiety and depression or exacerbation of schizophrenia symptoms, especially in pregnant women suffering from mental disorders. In addition, there are evidence supporting the occurrence of neonatal malformations as a result of exposure to antipsychotic drugs during the first trimester of pregnancy. Conclusion Investigating the role of antidepressant and antipsychotic drugs in the perinatal period, especially near delivery has received less attention so far; thus further studies are required to determine the safety of these drugs.
This study was performed to compare the levels of pain experienced by young infants undergoing ei... more This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants’ faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P=0.1). The mean (SD) of the PIPP pain scores did not differ bet...
Journal of Mazandaran University of Medical Sciences, 2016
Background and purpose: Hypoglycemia is an important problem in newborns which requires early dia... more Background and purpose: Hypoglycemia is an important problem in newborns which requires early diagnosis and treatment. Laboratory testing of blood glucose level and glucometer readings are used to detect hypoglycemia but sometimes the results are given late. This study aimed at evaluating the accuracy of glucometer in detection of hypoglycemia in newborns at neonate intensive care unit (NICU), 2014-2015. Materials and methods: A diagnostic study was performed in which 408 blood samples (glucometer capillary and venous derived samples) were obtained from 204 neonates in NICU within two hours after birth. Blood glucose concentrations were measured by glucose oxidase and photometric analysis. The mean values for blood glucose level, correlation coefficient, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Data analysis was performed in SPSS V.19. Results: The mean neonatal weight was 2915 ± 840 gr. In our study, 92 neonates...
There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can in... more There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations
OBJECTIVES: Despite extensive caffeine use in preterm infants, the pharmacokinetics (PKs) data ar... more OBJECTIVES: Despite extensive caffeine use in preterm infants, the pharmacokinetics (PKs) data are limited because of the studies are complicated to do in these patients. This research was investigated the PK profile of two various dosages of caffeine in premature neonates. MATERIALS AND METHODS: The PK values of caffeine in premature neonates with Apnea were predicted by using all of computer-based simulation (Simcyp®), population-based PK, and modeling (P-Pharm®). We assayed the plasma levels of caffeine in two groups. The information was analyzed utilizing nonlinear mixed-effects modeling approach. The PK parameters were assessed simulating virtual clinical considers with subjects got 20 mg. kg−1 of caffeine in both groups, which was followed by a 5 mg. kg−1 once daily in Group 1 or 2.5 mg. kg−1 twice daily in Group 2. All statistical analysis was executed utilizing SSPS issue 19 and a P value of 0.05 was chosen significance. RESULTS: In the present study, the means CL, volume of...
Journal of Mazandaran University of Medical Sciences, 2014
Congenital hyperinsulinism is a rare disorder can be associated with serious brain damage and neu... more Congenital hyperinsulinism is a rare disorder can be associated with serious brain damage and neurodevelopmental delay in neonates. This disorder is an uncommon cause of neonatal hypoglycemia and most of the affected newborns are results of term pregnancies. In this paper, we report a case of persistent hypoglycemia due to congenital hyperinsulinism in a preterm neonate who also had hypertrophic cardiomyopathy. We describe the importance of early diagnosis and intervention in neonates who have persistent hypoglycemia unresponsive to medical treatments and we recommend performing of echocardiography in these patients.
Medical Journal of the Islamic Republic of Iran, 2013
Harlequin ichthyosis is a rare and the most severe form of congenital ichthyosis. Although prenat... more Harlequin ichthyosis is a rare and the most severe form of congenital ichthyosis. Although prenatal diagnosis isdifficult for this disorder, recently, this obstacle has markedly improved with the use of DNA-based prenataldiagnosis. Here in, we presented a neonate with harlequin ichthyosis born by assisted reproductive technology(ART). In this case, the diagnosis of harlequin ichthyosis was not established by conventional prenatal screening.
Journal of Islamic and Iranian Traditional Medicine, 2016
Background and Purpose: Those who inherit medical history of Iran have the crucial responsibility... more Background and Purpose: Those who inherit medical history of Iran have the crucial responsibility of transferring the scientific findings of traditional medicine to modern medicine through a scientific experimental process. Cotoneaster, scientifically known as purgative manna, is an herb with the capacity of being used both in traditional and in modern medicine. This study was conducted to review active ingredients of cotoneaster in Iranian traditional medicine. Material and methods: This library study was performed through a narrative review of books on traditional medicine and searching databases such as Google scholar, Pubmed, Magiran, SID, and Science Direct. Results: First, traditional medicine references and experiences of hakims on cotoneaster are presented, and then, new findings of modern scientists about medicinal properties of cotoneaster and its active ingredients. The last section of this study briefly describes the specific use of cotoneaster for treatment of infant ja...
Patient is a 10 days old female neonate who referred to our center because of darkening of the sk... more Patient is a 10 days old female neonate who referred to our center because of darkening of the skin, lethargy and poor feeding. She was born by C-section at 38 weeks of gestation and had history of admission in another maternal hospital due to hypoglycemia and jaundice during first 5 days of life. Birth weight was 2760 gr and height was 50cm. Parents were relative and had a light colored skin. Mother had a history of abortion in previous pregnancy. In physical examination generalized skin and mucosal hyperpigmentation and hypotonia had been observed (Figures 1,2). Genitalia had a normal female appearance but hyperpigmented. Vital signs and blood pressures were normal. Laboratory findings showed low blood glucose (36mg/dl) and cortisol levels (0.5ug/dl), high adrenocorticotropic hormone (ACTH>1000ng/l) and normal aldosterone levels (500pg/ml). level of 17-OH-Progesteron was normal (1ng/ml).Other investigations such as blood gases, serum electrolytes and abdominal ultrasonography w...
Cotoneaster is a plant from Rosaceae family and produces a sugary secretion (manna). Manna is the... more Cotoneaster is a plant from Rosaceae family and produces a sugary secretion (manna). Manna is the most important constituent of species of this plant. Manna consists of different types of carbohydrates, and other phytochemicals. Sugar characterization, including reducing sugar was assayed by cupric/sodium carbonate spectrophotometric method. In addition, the composition of individual sugars was also determined using high-performance liquid chromatography (HPLC) coupled with a refraction index (RI) detector, with mannitol being the most abundant sugar. Also, amount of essential microelements was determined using flame atomic absorption spectrometry. Finally, total flavonoid content in all Cotoneaster species was determined using the aluminum chloride method. According to HPLC-RI data, C. nummularioides manna has a high percentage of mannitol (88.69±0.05) and low amount of sucrose (5.37±0.01). Total reducing sugar of the C. discolor is the lowest and in C. nummularius is the highest a...
Background and purpose: Low birth weight (LBW) is a serious health problem of neonates in the wor... more Background and purpose: Low birth weight (LBW) is a serious health problem of neonates in the world. Most of these babies need to stay in hospital and may not have enough calories and protein intake that leads to inappropriate weight gain. This study aimed at investigating the amount of calories and protein intake in neonates admitted in neonatal intensive care unit (NICU) in Sari Bu-Ali Sina Hospital. Materials and methods: This cross sectional study was carried out in 100 newborns admitted to NICU in 2015. All information including relevant demographic characteristics and calories, dextrose and lipid intake was calculated. SPSS V.16 was used for data analysis. Results: The newborns were 68% male and 32% female. Exclusively breastfed infants included 51% of the cases and 42% had combination feeding (dietary supplements and breast milk). Mean intake of daily calorie was 63.2± 22.6 calories per kilogram per day. Conclusion: Despite the efforts of NICU staff to promote breastfeeding, ...
Background: Despite significant progress in medicine and increasing survival rate of preterm infa... more Background: Despite significant progress in medicine and increasing survival rate of preterm infants, these infants still suffer from abnormal development and neurobehavioral deficits. The present study aimed to investigate the effects of developmental care on neurobehavioral function and health promotion of preterm infants hospitalized at Neonatal Intensive Care Units (NICUs). Methods: This study was a clinical trial conducted on 66 preterm infants hospitalized in NICU who were divided into three groups mother's presence (n=22), mother's voice (n=22) and nurse's voice (n=22) by convenience sampling technique. The respiratory rate of infants in all groups were recorded by the monitoring system in a 5-min interval for 30 minutes in three phases (10 minutes before, 10 minutes during, and 10 minutes after the intervention) within 3 consecutive days. Results: In mother's voice group, the Mean±SD of respiratory rate (49.58±0.97) were higher during the intervention compar...
Diabetes during pregnancy has considerable adverse effect son the mother and her fetus or neonate... more Diabetes during pregnancy has considerable adverse effect son the mother and her fetus or neonate. Mothers hyperglycemia may induce hyper insulinemia and pancreatic Beta cells hyperplasia in fetus. Excess Insulin secretion in fetus blood may cause macrosomia, increase basal metabolism rate, increase oxygen consumption and even fetus hypoxemia. Fetal hypoxia may fallow by erythropoietin over production, red blood cell hyperplasia and increased hematocrit level. Polycythemia may enhance blood circulation and cause hyper bilirubinemia. On the other hand hyperglycemia may cause exaggerate d production of oxygen radicals in mitocondrias and produce hydroperoxides which are prostacyclin inhibitors. Erythropoietin excess and polycythemia induce catecholamine release, hypertension and myocardial hypertrophy respectively. The last may be one of the etiology of still birth in poor control diabetic pregnancies. Rigorous glycemic control before and during pregnancy may decrease the prevalence o...
Background: More than 15 million premature infants are born worldwide each year who in average, u... more Background: More than 15 million premature infants are born worldwide each year who in average, undergo 10-16 painful procedures every day. Repeated painful procedures early in life can have adverse effects on nervous system development and pain response. Several factors may influence the response of premature infants to painful stimuli and the knowledge of these factors can lead to proper pain assessment. The aim of this study was to investigate the effects of sleep and awake states on pain responses in premature infants.
Introduction and importance: Limited data are available about various effects of COVID-19 on preg... more Introduction and importance: Limited data are available about various effects of COVID-19 on pregnancy. On the other hand, the COVID-19 pandemic could exacerbate anxiety or schizophrenia symptoms. Case presentation The patient is a 5-day-old newborn, whom his mother suffers from schizophrenia, depression and anxiety disorders. The young pregnant mother gets delusions of being infected with Covid-19, thus attempts suicide with Sertraline, Clonazepam, Quetiapine and Rispeirdone, although she was in the last week of pregnancy. The newborn baby referred to our neonatal ward with seizure and apnea. Phenytoin and caffeine were administered leading to some degree of symptom relief, but due to the dermatologic reactions of phenytoin, they were replaced with levetiracetam. Clinical discussion The Covid-19 may increase levels of anxiety and depression or exacerbation of schizophrenia symptoms, especially in pregnant women suffering from mental disorders. In addition, there are evidence supporting the occurrence of neonatal malformations as a result of exposure to antipsychotic drugs during the first trimester of pregnancy. Conclusion Investigating the role of antidepressant and antipsychotic drugs in the perinatal period, especially near delivery has received less attention so far; thus further studies are required to determine the safety of these drugs.
This study was performed to compare the levels of pain experienced by young infants undergoing ei... more This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants’ faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P=0.1). The mean (SD) of the PIPP pain scores did not differ bet...
Journal of Mazandaran University of Medical Sciences, 2016
Background and purpose: Hypoglycemia is an important problem in newborns which requires early dia... more Background and purpose: Hypoglycemia is an important problem in newborns which requires early diagnosis and treatment. Laboratory testing of blood glucose level and glucometer readings are used to detect hypoglycemia but sometimes the results are given late. This study aimed at evaluating the accuracy of glucometer in detection of hypoglycemia in newborns at neonate intensive care unit (NICU), 2014-2015. Materials and methods: A diagnostic study was performed in which 408 blood samples (glucometer capillary and venous derived samples) were obtained from 204 neonates in NICU within two hours after birth. Blood glucose concentrations were measured by glucose oxidase and photometric analysis. The mean values for blood glucose level, correlation coefficient, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Data analysis was performed in SPSS V.19. Results: The mean neonatal weight was 2915 ± 840 gr. In our study, 92 neonates...
There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can in... more There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations
OBJECTIVES: Despite extensive caffeine use in preterm infants, the pharmacokinetics (PKs) data ar... more OBJECTIVES: Despite extensive caffeine use in preterm infants, the pharmacokinetics (PKs) data are limited because of the studies are complicated to do in these patients. This research was investigated the PK profile of two various dosages of caffeine in premature neonates. MATERIALS AND METHODS: The PK values of caffeine in premature neonates with Apnea were predicted by using all of computer-based simulation (Simcyp®), population-based PK, and modeling (P-Pharm®). We assayed the plasma levels of caffeine in two groups. The information was analyzed utilizing nonlinear mixed-effects modeling approach. The PK parameters were assessed simulating virtual clinical considers with subjects got 20 mg. kg−1 of caffeine in both groups, which was followed by a 5 mg. kg−1 once daily in Group 1 or 2.5 mg. kg−1 twice daily in Group 2. All statistical analysis was executed utilizing SSPS issue 19 and a P value of 0.05 was chosen significance. RESULTS: In the present study, the means CL, volume of...
Journal of Mazandaran University of Medical Sciences, 2014
Congenital hyperinsulinism is a rare disorder can be associated with serious brain damage and neu... more Congenital hyperinsulinism is a rare disorder can be associated with serious brain damage and neurodevelopmental delay in neonates. This disorder is an uncommon cause of neonatal hypoglycemia and most of the affected newborns are results of term pregnancies. In this paper, we report a case of persistent hypoglycemia due to congenital hyperinsulinism in a preterm neonate who also had hypertrophic cardiomyopathy. We describe the importance of early diagnosis and intervention in neonates who have persistent hypoglycemia unresponsive to medical treatments and we recommend performing of echocardiography in these patients.
Medical Journal of the Islamic Republic of Iran, 2013
Harlequin ichthyosis is a rare and the most severe form of congenital ichthyosis. Although prenat... more Harlequin ichthyosis is a rare and the most severe form of congenital ichthyosis. Although prenatal diagnosis isdifficult for this disorder, recently, this obstacle has markedly improved with the use of DNA-based prenataldiagnosis. Here in, we presented a neonate with harlequin ichthyosis born by assisted reproductive technology(ART). In this case, the diagnosis of harlequin ichthyosis was not established by conventional prenatal screening.
Journal of Islamic and Iranian Traditional Medicine, 2016
Background and Purpose: Those who inherit medical history of Iran have the crucial responsibility... more Background and Purpose: Those who inherit medical history of Iran have the crucial responsibility of transferring the scientific findings of traditional medicine to modern medicine through a scientific experimental process. Cotoneaster, scientifically known as purgative manna, is an herb with the capacity of being used both in traditional and in modern medicine. This study was conducted to review active ingredients of cotoneaster in Iranian traditional medicine. Material and methods: This library study was performed through a narrative review of books on traditional medicine and searching databases such as Google scholar, Pubmed, Magiran, SID, and Science Direct. Results: First, traditional medicine references and experiences of hakims on cotoneaster are presented, and then, new findings of modern scientists about medicinal properties of cotoneaster and its active ingredients. The last section of this study briefly describes the specific use of cotoneaster for treatment of infant ja...
Patient is a 10 days old female neonate who referred to our center because of darkening of the sk... more Patient is a 10 days old female neonate who referred to our center because of darkening of the skin, lethargy and poor feeding. She was born by C-section at 38 weeks of gestation and had history of admission in another maternal hospital due to hypoglycemia and jaundice during first 5 days of life. Birth weight was 2760 gr and height was 50cm. Parents were relative and had a light colored skin. Mother had a history of abortion in previous pregnancy. In physical examination generalized skin and mucosal hyperpigmentation and hypotonia had been observed (Figures 1,2). Genitalia had a normal female appearance but hyperpigmented. Vital signs and blood pressures were normal. Laboratory findings showed low blood glucose (36mg/dl) and cortisol levels (0.5ug/dl), high adrenocorticotropic hormone (ACTH>1000ng/l) and normal aldosterone levels (500pg/ml). level of 17-OH-Progesteron was normal (1ng/ml).Other investigations such as blood gases, serum electrolytes and abdominal ultrasonography w...
Cotoneaster is a plant from Rosaceae family and produces a sugary secretion (manna). Manna is the... more Cotoneaster is a plant from Rosaceae family and produces a sugary secretion (manna). Manna is the most important constituent of species of this plant. Manna consists of different types of carbohydrates, and other phytochemicals. Sugar characterization, including reducing sugar was assayed by cupric/sodium carbonate spectrophotometric method. In addition, the composition of individual sugars was also determined using high-performance liquid chromatography (HPLC) coupled with a refraction index (RI) detector, with mannitol being the most abundant sugar. Also, amount of essential microelements was determined using flame atomic absorption spectrometry. Finally, total flavonoid content in all Cotoneaster species was determined using the aluminum chloride method. According to HPLC-RI data, C. nummularioides manna has a high percentage of mannitol (88.69±0.05) and low amount of sucrose (5.37±0.01). Total reducing sugar of the C. discolor is the lowest and in C. nummularius is the highest a...
Background and purpose: Low birth weight (LBW) is a serious health problem of neonates in the wor... more Background and purpose: Low birth weight (LBW) is a serious health problem of neonates in the world. Most of these babies need to stay in hospital and may not have enough calories and protein intake that leads to inappropriate weight gain. This study aimed at investigating the amount of calories and protein intake in neonates admitted in neonatal intensive care unit (NICU) in Sari Bu-Ali Sina Hospital. Materials and methods: This cross sectional study was carried out in 100 newborns admitted to NICU in 2015. All information including relevant demographic characteristics and calories, dextrose and lipid intake was calculated. SPSS V.16 was used for data analysis. Results: The newborns were 68% male and 32% female. Exclusively breastfed infants included 51% of the cases and 42% had combination feeding (dietary supplements and breast milk). Mean intake of daily calorie was 63.2± 22.6 calories per kilogram per day. Conclusion: Despite the efforts of NICU staff to promote breastfeeding, ...
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