اسدالله تناسان

Due to the prevalence of myocardial dysfunction and Patent Ductus Arteriosus (PDA) in a large number of preterm neonates, the prognosis of these infants is highly related to their early diagnosis and treatment. In this regard, the present study aimed to determine the relationship between troponin T level and the prognosis of premature neonates admitted to the Neonatal Intensive Care Unit (NICU) of Fatemieh Hospital in Hamadan.

In this cross-sectional study, a certain number of infants who underwent serum levels of troponin T from 72 hours to one week after birth were assessed for demographic information, length of hospital stay, complications during hospitalization, acidosis, inotropic agents, recovery, and mortality, as well as their relationship with troponin level.

Out of 61 neonates, 22 patients had large PDA with a troponin level of 436±50.2 pg/ml, 14 patients had a small PDA with a troponin level of 260.5±89.8 pg/ml, and 25 patients were without PDA with a troponin level of 277.1±229.7 pg /ml (P = 0.203). There was no statistically significant difference between the three groups. The mean levels of troponin were 423±521 and 274±154 pg/ml in deceased and surviving neonates, respectively (P=0.194). Inotropic was significantly higher in deceased patients (P=0.003), and troponin T level was statistically significant (P=0.008). The relationship between troponin level and severe acidosis (P=0.051) was not significant, with a small difference that could be clinically valuable.

Serum troponin T level was higher in preterm neonates with large PDA and deceased ones who received inotropic agents due to hemodynamic disorders and severe acidosis.

Congenital heart disease is one of the most common congenital anomalies in children. The purpose of this study was the evaluation of social support in parents of children with congenital heart disease.

This was a descriptive correlational study. The study population included 200 parents of children with congenital heart disease who referred to Imam Khomeini Clinic in Hamedan in 2020 via available sampling method and using the demographic information questionnaire, social support questionnaire Zimat. Data was analyzed using descriptive and inferential statistics.

The mean and standard deviation of the total score of social support 41.4 ± 5.61. The highest social support 15.71 ± 2.23 was related to the family dimension and the lowest social support 12.17 ± 2.39 was related to the dimension of friends. The results of this study showed that the average total score of social support in terms of all demographic variables of parents except maternal occupation has a statistically significant difference (P < 0.05).

Social support is tool that improves the quality of life in parents of children with congenital heart disease, so it is recommended to develop a comprehensive care plan for these patients alongside, increasing their parent's social support.

: The Patent Ductus Arteriosus (PDA) occurs in 50% of infants under 1000 g and 30% of infants less than 1500 g. Treatment failure can exacerbate respiratory distress and its complications. Acetaminophen is a new drug with fewer side effects. The present study was designed and performed to evaluate the effect of this drug  and  intravenous ibuprofen on the treatment of Patent Ductus Arteriosus.

In this case-control study, 50 preterm infants who were less or equal to 14 days of age and diagnosis  of PDA   by echocardiographic were included and randomly divided into two groups. The first group was treated with intravenous ibuprofen and the second group was treated with intravenous acetaminophen for three days. At the end, the necessary information, including echocardiographic findings were analyzed using SPSS software version 16.

The findings of the present study showed that both ibuprofen and acetaminophen had equal effect in the closing of PDA in preterm infants.There was no significant difference in the duration of  hospitalisation between two  groups (P = 0.259). Possible side effects include intra-ventricular hemorrhage, thrombocytopenia, serum creatinine greater than 1.5 mg / dl, decreased urinary volume, necrotizing enterocolitis, positive blood culture and bronchopulmonary dysplasia were not significantly different between the two groups. The only significant complication was gastrointestinal bleeding, which was almost equally prevalent in both groups.

Acetaminophen  such as ibuprofen is effective as the main treatment of patent ductus arteriosus (PDA) and it could be a safe alternative to ibuprofen.

Congenital heart disease is one of the most common congenital anomalies in infants and is the leading cause of death from congenital diseases. The purpose of this study was to determine the prevalence and risk factors of congenital heart disease (CHD) and its outcome in infants admitted to NICU.

In this cross-sectional retrospective study, all infants who were admitted to the NICU of Besat Hospital from 2012 to 2017 with diagnosis congenital heart disease were studied. Demographic data of mothers and infants were collected. Data were analyzed using SPSS software version 16.

Of 2800 hospitalized infants, 97 (96.3%) infants suffered from congenital heart disease that 60 of them (61.9%) were males. The mean birth weight of infants was 2568.81±524.30 g and the mean gestational age of newborns was 36.66±2.62 weeks. 22 percent of the parents were relatives, in 20% of infants there was a family history of congenital heart disease and 50% of mothers had an underlying disease. The most common congenital heart diseases were ventricular septal defect (VSD) (37.1%), an atrial septal defect(ASD)(28.8%), and patent ductus atreiousus (PDA) (8.28%). 15 (15.5%) of the infant died.

Ventricular septal defect and atrial septal defect were the most common congenital heart disease in newborns which may be related to maternal use of antihypertensive drugs during pregnancy.

Cardiac auscultation is one of the most useful investigative tools that the physician may use at the bedside to detect alterations in cardiovascular anatomy and physiology. However، the sensitivity and specificity vary substantially with the expertise of the examiner. The aim of this study comparing the initial evaluations of heart murmurs in neonates between neonatologist and pediatric cardiologist. This cross-sectional study was conducted on 108 neonates admitted in Be’sat and Fatemieh Hospitals of Hamadan، Iran، in 2010. First، a neonatologist recorded their clinical evaluation (Pathologic، Likely pathologic، Innocent). Then، a Pediatric cardiologist recorded the infants’ clinical evaluation. Finally، echocardiography study was performed by the cardiologists for final diagnosis. The data were analyzed by SPSS version 16 and the using Chi-square. In this study، 67 patients (62%) had pathologic murmur. Clinical findings of pathological murmur by neonatologist and cardiologist are 98% sensitivity versus 87/2%; 84/2% specificity vs. 100%; 94/1% the positive predictive value vs. 100%; and 94% negative predictive value vs. 85. 4%، respectively. Evaluations of examination show no significant difference between neonatologists and cardiologists. Hence، echocardiography is the standard for establishing the cause of murmur.

Pneumonia is one of the most common infections during childhood. In children with recurrent bacterial pneumonia complete evaluation for underlying factors is necessary. The most common underlying diseases include: antibody deficiencies, cystic fibrosis, tracheoesophageal fistula and increased pulmonary blood flow. Vascular ring and its pressure effect is a less common cause of stridor and recurrent pneumonia. Congenital abnormalities in aortic arch and main branches which form vascular ring around esophagus and trachea with variable pressure effect cause respiratory symptoms such as stridor, wheezing and recurrent pneumonia Case Report: A 2 year old boy was admitted in our hospital with respiratory distress and cough. Chest x-Ray demonstrated right lobar pneumonia. He had history of stridor and wheezing from neonatal period and hospitalization due to pneumonia for four times. The patient received appropriate antibiotics. Despite fever and respiratory distress improvement, wheezing continued. Review of his medical documents showed fixed pressure effect on posterior aspect of esophagus in barium swallow. In CT angiography we confirmed double aortic arch. Double aortic arch is one of the causes of persistant respiratory symptom and recurrent pneumonia in children for which fluoroscopic barium swallow is the first non-invasive diagnostic method.

Background and Growth defect is one of the prevalent problems in pediatric. Ïn addition to the significant effect of protein and lack of calory on growth, zinc is also reported as effective factor in growth of milk feeded infants. Ïn this study the effect of zinc sulfate supplement on weight and hieght of the infants referring to the pediatric endocrine disease clinic of Boalo hospital was studied in the years 2001-2002. This was a double-blind placebo controled clinical trial done on the infants being referred from the sari health centers due to growth disorders. The subjects were divided in three groups as follow: severe malnutrition (SDS<-3), moderate mulnutrition (with SDS between 2-3) and normal infants or mild malnutrition (SDS>-2). Ïn order to neutralize the interfering factors, they were divided in 3 groups of bad, moderate and good on the basis of socio economic status. Ïn general, the subjects were created in 9 frames and randomly were divided in two case and control groups. Both of the groups were instructed about the need for energy and protein, and also for reduction of taking less nutritional food stuff. Ïn the case group zinc sulfate with dose of 5 mg/kg (1 mg/kg/zinc) was given dailty. Weight and height of the infacts prior and after interferance was compared, and serum zinc level prior to and after interferance was controled. T-test, X2 and paired-t test were used for comparison of the obtained results. 44 infants (23 girls and 12 boys) were under study. 21 persons were in case and 23 persons in control group. Both of the groups had similar basic features. Duration for administration of the drug was 3.3 months and followed up for 4.7 months. The obtained results are indicater of increasing in weight (P<0.02) and hieght (P<0.001) in both of the groups, but the differance between the above groups has not been significant. Most increase in weight was observed in group two (with moderate malnurition) P<0.0005. Âlso zinc sulfate reduced onset of gastroenteritis in case group (P<0.005).Çonclusion : Zinc sulfate had no effect on weight gain in the subjects under study. Ït seems that growth indexes have improved due to amendment of nutritional status and provision of energy and protein. May be administration of zinc would reduce gastroenteritis. Similar study in the province with zinc difficiency is recommended.