فهرست مطالب fariba tarhani

Newborn infants routinely may undergo invasive procedures، even after uncomplicated birth. Evidence shows that neonates do feel pain and may even have increased sensitivity to pain and to its long term effects compared with older infants. Non pharmacologic interventions are valuable for pain relief during minor procedures in neonates. The aim of this study was to asses the effectiveness of expressed breast milk)EBM (in reducing pain due to venipuncture and its comparison with formula and 50% dextrose solution. A clinical trial study was conducted in 30 term neonates. Each infant received 3 treatments with EBM، formula and 50% dextrose solution during consecutive venus blood sampling and their responses were measured by behavioral acute pain rating scale for neonates (DAN Score). This study was done in form of double blind and observers were unaware of the prescribed matter. This study showed that pain score significantly is lower in neonates who received EBM (P<0. 001). There was no statistical relationship between age، sex and weight with pain score. Expressed breast milk effectively reduces pain of venipuncture in term neonates and it could be natural، noninvasive and available analgesic particularly when mother can not be present to breastfeeding.

Hemifacial microsomia or Goldenhar syndrome is a congenital abnormality that it's main features are an one-sided under development of ear (or Artesia), jaw and neck. This syndrome is associated with additional anomalies and from view point of phenotype is highly variable. Case Report: The case was a one day old girl born to a 30 years old woman by normal vaginal delivery. Congenital abnormalities were noted on physical examination and included right microtia with ear canal Artesia, hypertelorism, micrognatia, defect between the right ear and lip and cardiac murmur.

Goldenhar Syndrome is a congenital abnormally which manly affects face, but another organs involvement should be considered. Cardiac problems are the main causes of death in these patients.

Sirenomelia is a very rare anomaly with incidence rate of one in every 100000 births. With fused legs and other different anomalies that cant be alive more than few days after birth. Etiology of Sirenomelia is unknown, Maternal diabetes mellitus and embryonic exposure with teratogenic agents have been proposed as possible causative factors. We report a case of sirenomelia was born from a diabetic mother.

Hyperbilirubinemia is a common and usually a benign problem of neonates that affect on 80% immature and 60% term of them. Oral administration of nonabsorbable substances that bind to bilirubin in the intestinal lumen and reduce enteric absorption of bilirubin may reduce peak serum bilirubin. Activated charcoal, agar and cholestramin have been used but further study of this type of therapy is needs. In this study we assess efficacy of oral Taranjabin (mann), one of the traditional treatment in our area, in neonatal hyperbilirubinemia. This clinical trial study was conducted in 86 neonates (41 and 45 newborns respectively in case and control groups). Subjects were selected among full term neonates whose weight were over 2500 gram and non of them suffered from any risk factor such as hemolysis, sepsis etc. case group (41 neonates) received oral suspension 30gr of Taranjabin 1 cc/kg q12hr pluses phototherapy and control group put under phototherapy alone. Blood sample were taken from them before treatment and once every 24 hours. Data were analyzed by SPSS variance test and T-test software. Results showed that there were no significant between two groups in total bilirubin level in the first and second day after Taranjabin administration and in hospitalization period in both groups (p=0.04%). The efficacy of phototherapy in decreasing the serum bilirubin in neonatal jaundice cannot be augmented by oral Taranjabin, on the contrary of peoples’ belief.

The number of invasive procedures performed in newborns admitted in neonatal units is very high. Nonpharmacologic interventions are valuable alternatives for pain relief during minor procedures in neonates. The aim of this study was to assess the analgesic effect of orally administered glucose with different concentration in neonate using a validated behavioral acute pain rating scale. A clinical trial study was conducted in 65 neonates. Each infant received 3 treatments with sterile water, 30% Dextrose Solution and 50% solution during consecutive Venus blood sampling and their responses was measured by behavioral acute pain rating scale for neonate (DAN score). This study was done in form of double blind and observer was unaware. Data analysis was perform using SPSS software. Results of this study showed that pain score significantly is lower in neonates that received sweet solution. Mean of pain scores for sterile water, Dextrose 30% and Dextrose 50% solutions, respectively were 8.74, 6.9 and 5.48. There was no statistical relationship between sex, gestational age and weight with pain score. A small dose (0.5ml) of 30% or 50% of oral glucose have an analgesic effect in neonates during Venus blood sampling. This effect is higher in 50% glucose solution and it can be detected by a behavioral pain rating scale.

Disseminated bacilli calmette-Guerin (BCG) infection after inoculation with live vaccine is considered to result from impaired immunity of the child. However, half of the cases are regarded as idiopathic because no well-defined immunodeficiency condition can account for the infection. Case report: An 8-month-old male infant was admitted with an ulcer on his left arm at the site of a BCG inoculation received five mounths previously. He also had a fever, productive cough and respiratory distress for two weeks prior to admission and the patient received a broad–spectrum antibiotic without any response. A clinical examination revealed a 3×3 cm mass in the upper, left quadrant of the patient’s chest. A chest X-ray showed widespread reticulation and corrosion on the seventh rib. The patient died from cardiopulmonary arrest 12 days post admission. In the antopsy of the patient, samples taken from several organs of he body showed a collection of acid–fast bacilli and a spread of tuberculoid infection (BCGosis). Although the BCG vaccine has been in use since 1921 and its protective effect for disseminated, meningial and pulmonary tuberculosis is clear, controversy continues around its use. The most serious complication of BCG vaccine is a disseminated BCG infection that may lead to death.

Urinary tract infection is a common bacterial infection in childhood. Approximately 3-5% of girls and 1% of boys acquire a urinary tract infection (UTI). The management of UTI is complicated by the increasing prevalence of antibiotic- resistant strains and over the - counter antibiotics empiric therapy with antibiotics such as ampicillin, amoxicillin and cotrimoxazole world cost more and lead to widespread antibiotic resistance. In this study we aimed at assessment of prevalence of antibiotic resistance in 127 patients with positive urine culture based on antibiogram results. This cross- sectional study was performed in Khorramabad Madani hospital during 2001-2002. 62/2% of the patients were female and 37.8% were male. Culture results were: Ecoli (73.3%), proteus (12.6%), klebsiela(9/4%), Entrobacter(3.1%), Citerobacter (0.8%), Yersinia (0.8%). Overall antibiotic resistance was 96.9% and resistance to antibiotics, were: Ampicillin(88.2%), Amoxicillin (86.6%), Cotrimoxazole (75.6%), Nitrofurantoin (18.9%), Nalidixic acid (10.2%), Cefixim (4.7%), Ceftriaxon (3.1%) Gentamicin (11.8%), Amikacin (3.1%). Results showed that antibiotic resistance for over- the counter antibiotics was significant.