fariba hemmati

Understanding and teaching geographical concepts require tools that can present the spatial complexities and interconnections between geographical phenomena in a tangible and comprehensible manner. Photography, as one of these tools, plays a significant role in facilitating the learning process and deepening the understanding of geographical concepts.This article, using a descriptive-analytical method and library-documentary sources, examines the positive impacts of photography on spatial learning and understanding of geographical concepts, demonstrating how images can serve as an effective communication tool in geography education.The research findings indicate that photography and imagery have an inseparable link with geography and are currently utilized by many organizations or research and educational institutions, such as National Geographic, in various fields including oceans, earth, wildlife, cultures, historical sites, human ingenuity, and tourism for educational and research purposes.The study also shows that the use of photographs in the geography education process helps individuals better understand the complexities of geographical concepts and the relationships between them. Additionally, this method provides a real and visual experience of geographical areas and phenomena, creating stimulation and motivation for the individual.By creating a collection of images from different regions and experiencing the environment, this method offers a direct experience of geographical concepts and phenomena.

Land subsidence is a natural hazard characterized by gradual movement, resulting in financial losses and, occasionally, loss of life. This research employs interferometric radar techniques to study morphological changes in the Kahrez Plain aquifer. The extent of land subsidence in the Kahrez Plain aquifer is investigated using Sentinel-1 satellite imagery from 2014 to 2023. This aquifer is situated in the western subsidence of Lake Urmia and is predominantly composed of limestone lithology. The geological structure in the area comprises inclined layers and the effects of fault activity. Microscopic examinations of rocks from the region reveal dual fractures, displacement, collision, and simultaneous rotational phenomena, indicating the role of tectonics in shaping the existing structures in the area. According to the interferometric analysis results, no land subsidence has been observed in the Kahrez Plain aquifer during the study period, and the uplift ranges from 0.34 to 1.51 meters. Regional deformation, resulting from changes in landforms such as earthquakes or tectonic activities, could be a significant factor contributing to the notable uplift.

Exchange transfusion (ET) is an effective treatment for acute bilirubin encephalopathy and extreme neonatal hyperbilirubinemia (ENH). It can reduce mortality and morbidity. This study aimed to investigate the trends and risk factors of ENH requiring ET in hospitalized neonates in Iran. A retrospective analysis of medical records of neonates who underwent ET due to ENH was conducted from 2011 to 2021, in Shiraz, Iran. Clinical records were used to gather demographic and laboratory data. The quantitative data were expressed as mean±SD, and qualitative data was presented as frequency and percentage. P<0.05 was considered statistically significant. During the study, 377 ETs were performed for 329 patients. The annual rate of ET decreased by 71.2% during the study period. The most common risk factor of ENH was glucose-6-phosphate dehydrogenase (G6PD) deficiency (35%), followed by prematurity (13.06%), ABO hemolytic disease (7.6%), sepsis (6.4%), Rh hemolytic disease (6.08%), and minor blood group incompatibility (3.34%). In 28.52% of the cases, the cause of ENH was not identified. 17 (5.1%) neonates had acute bilirubin encephalopathy, of whom 6 (35.29%) had G6PD deficiency, 6 (35.29%) had ABO incompatibility, and 2 (11.76%) had Rh incompatibility. Although the rate of ET occurrence has decreased, it seems necessary to consider different risk factors and appropriate guidelines for early identification and management of neonates at risk of ENH should be developed. The findings of the study highlighted the important risk factors of ENH in southern Iran, allowing for the development of appropriate prevention strategies.

With the growth of population and urbanization, the urban managers are concerned with optimal waste management besides problems such as traffics, various types of pollutions, slums, etc. Nowadays the development of cities, growth of income average and welfare of society, and accelerated social and economic developments in the countries have led to a rapid increase in waste production, and a change in the consumption pattern resulted in a change in the quality of solid waste.

Site Selection for the Waste Landfills the City of Eyvan-e Gharb.

In the present study, the required maps and information were collected from various resources and transformed into data layers to be used in the ArcGIS software environment with respect to the effective factors in site selection. AHP was employed as a decision-making technique due to its prevalent and effective application for assessing the suitability for landfill.

Studied Areas: 

The city of Eyvan location falls at 33° 50' N, 46° 20'.

The Criteria for this study are as follows: Land use, soil type and land capability, quality and depth of groundwater, geology, the intensity of rainfall, heights, grading, distance from the city, distance from the village, distance from the fault, distance from the river, distance from the road, distance from power transition lines, distance from well and fountain, distance from protected areas.

The most suitable location included 7.98% of the area of the region.

are connected at the end of the basin and form the Darbadam River. According to the results obtained for the central angle, in the first part between 2010 and 2021, the Meandri River pattern was developed and there was no change in the pattern class, but in the second and third parts in 2010, the river pattern is not developed meandering, which in 2021 has become the developed meandering river patternBased on the average curvature coefficients in all three sections studied, the Darbadam River has a meandering pattern. Due to the characteristics of the region, such as the presence of resistant rock layers, the high slope of the region and also the mountainous topography, has led to low transverse displacement of meander in the region. However, in some parts of the river, due to human activities, including land use change, vegetation degradation and overgrazing, there has been a change in the river pattern.

As one of the global dilemmas that inflicts heavy human, financial and economic losses on an annual basis, study of mass movement has special importance, particularly with the increase in population and settlements over steep slopes prone to mass movement. International statistics related to human and financial losses caused by this phenomenon are steadily increasing. Frequent landslide events, their daily expansion in many parts of Iran in recent years and their destructive effects have attracted greater interest in responsible authorities, especially landslide experts, than ever before. Identifying and zoning areas susceptible to landslides is necessary for reducing losses. Since preparation of landslide susceptibility maps substantially improves land use planning, it can serve as an efficient method for decreasing human and financial losses resulting from landslides. Correct and systematic landslide hazard zonation and factors influencing it can be useful and effective in making decisions for containment, control and reduction of losses caused by this phenomenon

The Abgalal Watershed is located in Khuzestan Province, southwestern Iran. It forms one of the sub-watersheds of the Zard River. The physical tools used in the study included the 1:100,000 geological map, the 1:50,000 topographic map, the 30 m digital elevation model and the precipitation data obtained from the Meteorological Organization. GIS was used to measure the shapes and geomorphological parameters. Fuzzy logic evaluates the probability a pixel would be assigned to fuzzy sets considering the fuzzy membership function. Fuzzy sets do not have clear boundaries and membership or non-membership in a specific fuzzy set is a gradual process. There are two common methods for defining fuzzy sets: in the form of a function or in numbers. In the former, the degree of membership is presented as a function and in the latter specific degrees of membership are assigned to discreet values.

Following preparation of the distribution map of landslide prone areas, the distribution of these areas was studied in the form of nine factors influencing landslide occurrence. Each information layer (elevation classes, slope, orientation of slope, distance from fault, distance from river, precipitation, land use and lithology) were classified into five categories each receiving a score of 1 to 5 based on degree of susceptibility to landslides. The category with highest degree of susceptibility to landslide received a score of 5. The factor maps were combined with the landslide distribution map to determine the relationship between landslides and factors influencing its occurrence and also to prepare the landslide hazard zoning map.

This research studied the landslide-prone areas in the Abgalal Watershed using a fuzzy logic model. Using field studies, geological and topographic maps, reviewing the previous research conducted on this subject, and also investigating the existing conditions in the study region, eight factors (elevation classes, slope, direction of slope, lithology, distance from fault, distance from river, land use and precipitation) were studied as the factors influencing landslide occurrence. Following the fuzzification stage, landslide zoning maps were prepared using fuzzy gamma operators (for gamma values equal to 0.7, 0.8 and 0.9). The results of the qualitative addition method revealed that the fuzzy gamma operator ( at gamma=0.9) was more suitable than the others. Finally, the obtained map was classified into the very high, high, moderate, low and very low susceptibility categories, with 1.6% and 94% of the study region in the high and very low susceptibility zones, respectively. These results demonstrated that the study region had high potential for landslide occurrence due to the presence of a river network, precipitation, rangelands, urban areas, and weak lithology. Moreover, large areas lying south of the study region also have high potential for sliding movement.

The aim of this study was to determine the fit of teachers 'emotional-social competence model based on individual and contextual factors and its effect on students' sense of belonging to school. The present study is a descriptive correlational study and the statistical population consisted of all teachers working in schools (elementary, junior high and high school) and students studying in the same schools in District 2 of Dehloran city in the academic year of 1997-98. Among them, 150 teachers and 150 students were selected and studied as a sample group. The research instruments included teachers' emotional-social competency questionnaire, burnout scale, emotional intelligence scale and school sense questionnaire, and the obtained data were examined in two descriptive and inferential sections. The results showed that individual factors have a direct effect on teachers' emotional-social competence, contextual factors have an inverse effect on teachers' social and emotional competence, social emotional competence has a direct effect on students' sense of belonging. After that, tissue factors had the greatest effect the variable of social emotional competence (β = -0.37). The study model fit indices indicates the model has a good fit with the data. Based on the findings of this study, it can be said that individual and tissue factors had effect teachers' social and emotional competence, which the effect of direct individual factors and the effect of inverse tissue factors. Also, teachers 'social-emotional competence had a direct effect on students' sense belonging, and then contextual factors had the greatest impact the social-emotional competence variable.

Neonatal jaundice is an almost common problem among neonates that may cause complications such as kernicterus in severe cases. Since early diagnosis and proper treatment of neonatal jaundice is vital to prevent the related complications, it is necessary to check bilirubin before discharging the neonates. There are several evaluating and diagnostic methods to measure the level of bilirubin. Thus, this study aimed to compare the transcutaneous method versus measurement of serum bilirubin, using spectrophotometry for jaundice screening of full-term neonates before discharge from hospital.

This observational analytic study was conducted on six hundred neonates with birth weight more than 2000 grams and gestational age more than 35 weeks from September 2012 to March 2013 in Hafez hospital, Shiraz University of Medical Sciences. Parameters such as bilirubin level of neonates were measured and compared, using spectrophotometry and transcutaneous by Bili check with multi waves.

Six hundred neonates were enrolled in this study. The Pearson correlation test showed that there was a significant correlation between the two methods of the transcutaneous versus measurement of serum bilirubin, using spectrophotometry (r=0.63), (P>0.05). There was no significant difference between the mean of measured bilirubin, using each method in some demographic variables such as the different groups of gender (P=0.896), birth weight (P=0.419), and type of feeding in neonates (P=0.323), but it was significant in other demographic variables such as the different groups of gestational age and post-neonatal age (P<0.0001). Also, the results revealed that there was a significant correlation between two methods of the trans cutaneous versus measurement of serum bilirubin, using spectrophotometry based on demographic variables (P<0.0001).

In general, the bilirubin measurement using trans-cutaneous method may estimate bilirubin significantly less than the serum bilirubin measurement method, and this difference can be more obviously noticeable in infants with less gestational age and also less post-natal age.

The infants born before the 37th week of gestation are considered as preterm. Premature birth may have several consequences including low birth weight (LBW). Infants born with the weight below 2500 g are known as LBW. Birth weight can be a proper characteristic of healthy neonate. Integrated interventions, including massage, simulate uterus environment for direct growth of an infant through the target route; hence, such interventions can be beneficial to the premature infant.

Therefore, the current study aimed at comparing the effects of massage therapy with or without physical exercises on the weight of premature infants admitted to the neonatal intensive care unit (NICU).

The current randomized, clinical trial was conducted on 45 neonates born at 30th to 36th weeks of gestation with the weight below 2500 g admitted to the NICU of Shohada Hospital in Bandar Lengeh, Iran in 2017. Infants were classified into three groups of 15 as massage, massage with physical exercise, and control. Infants in the massage group were massaged with olive oil in the morning and noon after feeding. The massage took 15 minutes and was repeated for five consecutive days. The massage with exercise group received extension and flexion for five minutes after the massage. The control group received no treatment intervention. All the infants weighed the day before as well as the 5th day of the intervention using a fixed scale. The weights were recorded and analyzed using SPSS version 22. Paired and independent samples t-tests and analysis of variance were used for data analysis. The P value less than 0.05 was considered statistically significant. The study protocol was registered in the Iranian Registry of Randomized Clinical Trials (ID: IRCT20170520034039N3).

The three groups were homogenous in terms of birth weight, gestational age, and newborn age. After the 5th day of the intervention, the results of the two groups of massage and exercise-massage were compared with that of the control. It was observed that those two groups gained more weight in comparison with the control group. More weight gain was also observed in the exercise-massage group compared with the massage group, but the differences were not statistically significant (P = 0.65).

The results of the current study showed that massage with or without exercises may lead to gaining weight in LBW infants. Massage may lead to weight gain; therefore, knowledge about this issue might be useful in the weight gain of the neonates.

At present, the question of identification, control, and prevention of human, economic, and social losses resulting from natural events such as earth tremors, floods, and earthquakes have attracted special interest in scientific-research communities and in responsible authorities of most countries around the world. In recent decades, considering the upward trend in losses and damages caused by natural events (especially landslides), prediction of damages and losses and introduction of solutions and methods for controlling and avoiding them have been addressed in earnest. This research evaluated the region around the Benaravan fault using logistic regression (logit regression or logit model) to determine regions that face slope instability hazard. Field surveys were made, previous research was reviewed, and the prevailing conditions in the region was studied first and, using the Idrisi software, it was found that the nine factors of altitude class, slope, dip direction, lithology, distance from the fault, distance from the waterway, distance from the road, land use, and vegetation influenced occurrence of slope instability. After performing slope instability hazard zonation, percentages of slope instability in each class were calculated. Results indicated that areas with high hazard zonation in the study region constituted the smallest part of it. In this research, which used logistic regression, the elevation factor with the highest coefficient was the best variable for predicting the occurrence probability of slope instability in the region. The highest incidence of slope instability occurred at high altitudes with slopes of 23-32 degrees because of gravity force.

Neonatal jaundice resulting from raised blood bilirubin levels is one of the most common clinical conditions that needs medical attention. To initiate appropriate management that can both prevent and treat severe neonatal jaundice, screening methods that measure bilirubin level are warranted. In this study, we present an Android OS-based application for detecting neonatal jaundice. We used the application to detect jaundice in 113 neonates. Our smartphone-based estimation of bilirubin levels depends on a smartphone, a color calibration card, and a 100X zoom microscope clip. Our application was designed to acquire images of the newborn’s forehead skin in a standardized manner, estimate the average R, G, B scores of the images that have been taken from the forehead skin and calibration card, and then convert them to hue, saturation, intensity (HSI) parameters. All these are performed offline; in this application, we used offline machine learning and regression techniques for analysis Our smartphone-based estimation of bilirubin levels had a sensitivity of 68% and specificity of 92.3% for estimating the bilirubin levels of less than 10 mg/dL and sensitivity of 82.1% and specificity of 100% for estimating the bilirubin levels of less than 15 mg/dL. Our application-based estimation of bilirubin levels had the correlation of 0.479 with the total serum bilirubin values. Our results suggest that our smartphone-based application can serve as a promising screening tool for neonatal jaundice, and it can aid in determining neonates requiring a blood draw for measuring total serum bilirubin level.

Benarvan Fault with the length of more than 20km is one the most important faults existing in Azarbaijan region which is located on the southern flank of Bozghoush Mount of Azarbaijan with the general orientation of southwest- northeast. In this research seismicity and seismic risk were determined by deterministic and probabilistic methods and the obtained results were analyzed. To do so, first, existing seismic sources and faults of the region and surrounding regions were identified and investigated in a radius of about 100 km and their characteristics such as length, orientation and distance from the center of Benarvan Village were determined. Then the maximum credible earthquake resulting from the activities of these faults was calculated by using deterministic and probabilistic methods. The Gutenberg-Richter Method was applied for calculating the return period of earthquake magnitude, as well. In fact, in this section the magnitude return period was calculated for the 100 km extent of the region by using the statistical methods. The results of the calculation of return periods for various magnitudes showed that the return period for an M7 earthquake was about 107 years.

Kolm village is considered as a sustainable development for tourism. In the persent study attemts have been made so that Reynard geotourism model be used in particular areas in geomrphological area to be assessed. Geomrphologic places like the new ones with new scientific cultural beauty and economic values put much more emphasis on tourism which are of high importance in the earth history to evaluate the potentialities of the area with regard to the map topography and field data as well as the questionnaire were used and Rinata model was the basis of the study. The result of the study revealed that the scientific value from the highest to the lowest were 2.5 and 5.3.Mean while the whole average of values was 3.93.This shows the significance of Kolm village for the high value in comparison to other criteria. This area is of great importance for having characteristics such as high natural beauty as well as cultural and other aspects for tourism. The lack of comprehensive planning in adequate advertisement in national and international levels and frustration particularly in tourism aspect are the main reason for the geotourism not being developed in this area.

Maple syrup urine disease (MSUD) is an inherited branched-chain amino acid metabolic disorder caused by the deficiency in the branched-chain alpha-keto acid dehydrogenase (BCKD) complex. In MSUD, elevation of the branched-chain amino acids, such as alpha-keto acid and alpha-hydroxy acid, occurs due to the BCKDC gene deficiency, appearing in the blood, urine, and cerebrospinal fluid, which leads to neurological damage and mental retardation. MSUD phenotypically penetrates due to the mutations in the coding genes of four subunits of the BCKD complex, including the BCKDHA, BCKDHB, DBT, and DLD genes.
Case report: We aimed to report the cases of three families whose children were affected by MSUD and presented with symptomatic features during the first week of birth, which were identified by mass spectrometry. DNA study was performed as a diagnosis panel containing four encoded BCKDC subunit genes.
In the current study, DNA analysis and phenotypic manifestations indicated a novel mutation of c.143delT, p.L48Rfs*15 in the BCKDHA gene in a homozygous state, which is a causative mutation for the classic MSUD phenotype. Early diagnosis and neonatal screening are recommended for the accurate and effective treatment of this disease

Cranial ultrasound is considered as the method of choice for early evaluation of neonatal ventricular system. Since premature neonates are susceptible to intra-ventricular hemorrhage and hydrocephaly, it is essential to have normal values of parameters as reference ranges.
To provide native information of ventricular sizes in normal premature infants in our area for screening policy.
This Multicenter prospective study was conducted on normal premature babies with a gestational age of 26 to 35 weeks, from February to September 2014, in the South of Iran. Patients were divided into 10 groups according to their weeks of gestational age and each group was separately studied during the first 3 days of life. Statistical package for the Social Sciences version 16.0 software package [SPSS Inc, Chicago, Illinois] was used for statistical analysis. Continuous variables were described by mean with standard deviations (SD) and categorical variables by numbers and percentage appropriately. A 95% confidence interval was supposed for all ventricular parameters (5, 50 and 95 percentile). Each parameter that was above the 95 percentile for GA or birth weight was considered abnormal. Comparison between groups was done by Pearson correlation and Mann-Whitney and Wilcoxon Signed Ranks tests as appropriate. P value ≤ 0.05 was regarded as statistically significant.
177 premature neonates were evaluated. The mean of ventricular index was 11.7 mm ± 1.5 SD. The mean of anterior horn width and thalamo-occipital distance were 1.8 mm ± 0.7 SD and 15 mm ± 2.7 SD, respectively. Ventricular index was gradually increased as the gestational age and birth weight increased, however, there was no obvious relationship between these and 2 other dimensions. There was no significant difference in dimensions between boys and girls, and also between normal vaginal delivery and cesarean section.
This study provides native normal reference values for lateral ventricular size in preterm infants in Iran. It helps physicians better understand the normal and abnormal size of the lateral ventricle in preterm neonates and improves both early diagnostic and therapeutic approaches.

Geo-tourism is a combination of geography and tourism. In this sense, geo-tourism encompasses biodiversity, cultural diversity, beautification, community-based tourism, and even local food movement, and homogeny and similarity are considered its enemies. Geo-tourism is a form of tourism which is defined to ensure the establishment and improvement of geographical features such as the environment, culture, landmarks and legacies and well-being of residents. With this approach, Deira catchment area in Gilangharb Township located in 215 km of Kermanshah, was chosen because of its natural resources for Geo-tourism assessment and was analyzed according to obtained data from library and literature studies and field studies using Pereira. Although the region attracts hordes of tourism annually, yet its economic position in tourism industry is not founded. In this research we try to assess Geo-tourism capabilities related to available landforms in the region in addition to identify geomorphological shapes and forms in the region and explore its features. The results of this study showed that the geomorphic location of Galin has high capability in the field of tourism attraction with 345/5 geomorphology value and managerial value of 5 in Deira catchment area. The geomorphological shapes and forms of the region have high capability in the field of tourism due to high ability in the field of geosciences education, and feature and attributes such as beauty, ease of access, and natural and cultural attractions.

Environmental protection in rural areas is of the necessities in rural development. One of the important issues in rural areas is to find the appropriate landfill site. In this article, in order to assess the proper places for landfill in Lighvan village, corresponding geomorphological factors are provided and analyzed. In evaluating landfill site, GIS software and network analysis process modeling (ANP) are used. Five human-economic key factors of topographicalmorphology, climate-hydrology, soil-vegetation and geology are considered. These factors produce 12 layers of land use, distance from residential areas, and distance from the lines of communication, distance from fault, distance from the river, slope, elevation classes, and direction of slope, climate, soil, vegetation and the lithology. The appropriate landfill site is identified by using the layers and models in Arc Map. Results show that proper places allocate 23.87 and improper places allocate 21.13 percentage of the desired area. By zoning plan, appropriate places in the entire Lighvan village are introduced which can be used in future planning.

Considering the increasing rates of early hospital discharge and kernicterus in healthy full term newborns, timely identification of neonates at risk of severe hyperbilirubinemia is of great significance. The aim of this study was to investigate the predictive value of umbilical cord serum (UCS) bilirubin level for subsequent hyperbilirubinemia. Moreover, we compared the predictive value of UCS bilirubin with that of risk factor assessment and predischarge bilirubin level.
In this prospective, cohort study, 450 healthy neonates born at the gestational age of ³ 35 weeks were included. UCS bilirubin concentration, direct Coombs test results, and blood group were determined in the newborns. Total serum bilirubin level was re-assessed before hospital discharge. The subjects were followed-up for 1-4 days after discharge and the total serum bilirubin level was measured in neonates with clinical jaundice. Results of the assessment of risk factors for hyperbilirubinemia were recorded.
In total, 319 newborns were followed-up within the study period. The mean UCS bilirubin level in non-icteric and icteric neonates was 2.35 and 2.49 mg/dl, respectively. No significant relationship was found between UCS bilirubin level and development of hyperbilirubinemia (P=0.30), whereas a significant correlation was detected between predischarge bilirubin level and development of jaundice (P=0.009). Gestational age, birth weight, history of jaundice in siblings, and mode of delivery were the clinical risk factors which showed a significant correlation with postnatal hyperbilirubinemia.
Based on the findings, UCS bilirubin level could not predict subsequent hyperbilirubinemia. Therefore, the best predictive marker for neonatal jaundice is the assessment of clinical risk factors and predischarge bilirubin level.

Premature infants are among high-risk groups in community who need to be hospitalized at intensive care units for survival and receiving basic or special care. Hospitalization at neonatal intensive care units (NICUs) unsettles the family and leads to the separation of parents from their infants. This study aimed to determine the effects of maternal attachment behaviors on the behavioral responses of premature infants, hospitalized at NICUs. In this randomized clinical trial, 64 premature infants, who were hospitalized at NICUs and were eligible for the study, were randomly allocated to study and control groups. Attachment behaviors including touching, massage and kangaroo care were applied for the study group, while the conventional attachment method was adopted for the control group. Behavioral responses were evaluated two hours before and two hours after training attachment behaviors. Data were analyzed, using Chi-square and student’s t-test. The mean difference in the duration of deep sleep and consciousness was more significant in the study group, compared to the control group. Furthermore, the duration of drowsiness was significantly less in the study group, compared to the control group. The implementation of attachment training at NICUs decreased the time of drowsiness and improved behavioral responses, deep sleep time and consciousness.

Although metabolic diseases individually are rare, but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding, persistent vomiting, cholestasis, intractable seizure, decreased level of consciousness, persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Organic acidemia with 40 cases (42%) was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism (30%), 15 patient had classic galactosemia (GALT<5%). Methyl Malonic acidemia and propionic acidemia were the most common, they become symptomatic from three days to several months after birth. The most common symptoms in these patients were repeated vomiting, respiratory distress and lethargy. Most patient had repeated hospitalization even on special formula. Disorder of amino acid metabolism also is not uncommon (17%) in this high risk population, MSUD was the most common. Metabolic diseases are not rare in Iranian populations. Consequently, sensitive methods for prompt diagnosis and treatment are required in our country.

The gold standard to assess jaundice in neonates is the serum bilirubin measurement. Blood sampling for the determination of total serum bilirubin (TSB) is painful for newborns and stressful for parents. The Bilicheck®, a new transcutaneous bilirubinometer, is considered as a more accurate measurement of bilirubin compared to the previous bilirubinometers courtesy of its advanced technology. The objective of this study was to evaluate the correlation between transcutaneous bilirubin (TcB) measurements using the Bilicheck® device and TSB in some Iranian neonates and to determine the most reliable cut-off value with the highest sensitivity and desirable specificity for bilirubin measured by the Bilicheck® on the forehead. This prospective observational study was conducted in 2011 on 560 healthy neonates with jaundice. TcB was measured using the Bilicheck® (Respironic, USA) within 30 minutes of TSB measurement via direct spectrophotometry. The results were assessed by simple linear regression analysis and receiver operative characteristic curve. There was good a correlation between TcB and TSB (r=0.969, r2=0.94), and this was not affected by sex, gestational age, postnatal age, and birth weight. TSB can be calculated through the measurement of TcB and use of the linear regression equation: TSB=-0.99+1.06TcB. Sensitivity and specificity of the Bilicheck® at the most reliable cut-off value (15 mg/dl) were 96.6% and 99%, respectively. The findings of the present study indicate that the Bilicheck® is a non-invasive, simple, easy, and reliable method for bilirubin measurement in neonatal jaundice, especially in neonates with bilirubin levels? 15 mg/dl.

Deafness is one of the most important sensory disturbances at birth. Hearing loss can affect the development of speaking and learning during life. Early diagnosis and intervention improve language outcome. The current study aimed to determine the frequency of profound congenital hearing loss in healthy newborn infants in Fars province. In a multicenter prospective study, from August 2010 to August 2011, 12573 newborns were screened for hearing loss prior to discharge from the wellborn nursery at nine teaching and private hospitals in Fars province. A three-stage hearing screening protocol using transient evoked otoacoustic emissions (TEOAE) screening with referral for diagnostic second TEOAE and auditory brainstem evoked response (ABER) assessment was employed. All neonates with abnormal initial TEOAE screening, followed with phone call for language outcome after one year. Newborns with hospital admission or drug administration excluded from the study. The overall pass rate in the initial screening was 91.8%, thus 1019(8.1/1000) neonates referred for diagnostic audiological assessments. Out of 1019 infants scheduled for follow-up study, only 619 neonates returned. Using follow-up letters and phone calls, it was managed to improve the response rate for language outcome after one year. Two infants were identified with profound bilateral congenital hearing impairment. These infants were immediately referred for cochlear implantation. Findings of the current study showed that the frequency of profound congenital hearing loss is 0.159/1000 normal newborn infants in Fars province. The initial TEOAE has high false positive that may be due to occlusion of external ear canal by vernix in the early postnatal period.

Today, Severe hyperbilirubinemia is the most common cause of neonatal readmissions. Identification of the cause of neonatal hyperbilirubinemia is useful in determining whether therapeutic interventions can prevent severe hyperbilirubinemia.. We conducted this study to estimate the incidence of severe hyperbilirubinemia in Fars province and to determine the underlying causes and risk factors, which would be of value in identifying and implementing strategies to prevent morbidity from this condition..Patients and All infants less than 28 days referred due to severe indirect hyperbilirubinemia were included. Complete history, physical examination and lab work up were performed. This is a longitudinal prospective study in 2009-2010.. More common causes of severe indirect hyperbilirubinemia were blood group incompatibility, G6PD deficiency, sepsis and unknown. Risk factors of severe hyperbilirubinemia were Male sex, previous siblings with severe hyperbilirubinemia, early discharge, NVD, Breast feeding and cultural background of mothers.. Our study showed severe neonate indirect hyperbilirubinemia is still prevalence in Fars province and ethnic and cultural background of the mothers was more effective than school education in preventing hyperbilirubinemia complication..