Journal of World Journal of Peri and Neonatology
Volume:5 Issue: 2, Summer-Autumn 2022

 Missed nursing care can cause considerable problems in patients’ treatment processes. One way to reduce it and patient safety is teamwork training for nurses. This study aimed to determine the effect of teamwork training on missed nursing care among the nurses in Neonatal Intensive Care Unit (NICU).

 This quasi-experimental study was performed in 2021 (during the COVID-19 pandemic) on 20 nurses working in NICU. Teamwork training was done using the Team STEPPS method. The missed nursing care questionnaire was completed before, immediately and one month after the intervention.

 The mean score of missed nursing care decreased from 72.7 ± 4.78 before the intervention to 53.5 ± 6.81 immediately after that, and the difference was statistically significant (P < 0.01). The mean score of missed nursing care was 58.2 ± 5.51 one month after the intervention, which was significantly different from that immediately after the intervention (P < 0.02).

 Teamwork training had a considerable impact on reducing missed nursing care during the COVID-19 pandemic in NICU. Also, too many processes related to admission and discharge is the most important factor that resulted in missed nursing care. We suggest that other tools be utilized to measure the amount of teamwork among nurses in the future. It is recommended to consider teamwork training courses for nurses as a necessary part of in-service training. Conducting teamwork training workshops for nursing students can provide them the knowledge necessary to use teamwork strategies and tools to meet those challenges.

 Hypertrophic cardiomyopathy (HCM) is known to be the most common cardiac disorder in fetuses of diabetic mothers, especially when diabetes is not controlled in pregnancy. This study aimed as to estimate the prevalence of HCM in neonates born to diabetic mothers and to evaluate therapeutic interventions with follow-up after six months. We also focused on the possible association of neonatal HCM with the maternal type of diabetes.

 A cross-sectional study was conducted between October 2016, and September 2017, in the Cardiac Clinic of Yazd, a city in the center of Iran. The subjects were 150 neonates of mothers with diabetes. We determined HCM through fetal echocardiography before treatment and assessed the maternal and fetal factors. Finally, after a 6-month follow-up period, the data were analyzed statistically.

 According to the results, the prevalence of HCM in neonates of diabetic mothers was 14% (P < 0.0001). The results showed that there is a relationship between maternal uncontrolled diabetes and the incidence of HCM in the infant (P < 0.0001), but there is no relationship between the type of diabetes and the incidence of HCM. Our results also showed that propranolol was effective in improving HCM, and spontaneous recovery of HCM was low in infants.

 We concluded that controlling maternal diabetes has the greatest effect on the prevention of HCM in neonates. Also, neonates of diabetic mothers need more heart tests and follow-ups. Therefore, more studies on the effects of maternal diabetes-induced HCM in neonates are needed.

 The incidence of Gestational diabetes mellitus (GDM) is increasing worldwide. The exact prevalence of GDM in Iran is unknown. This study aimed to identify the incidence of GDM and the risk factors based on a cohort study in Yazd.

 This is a prospective cohort study involving 3110 pregnant women attending prenatal clinics in Yazd, Iran between 2015 and 2020. GDM was diagnosed using an Oral Glucose Tolerance Test (OGTT) for each participant at 24-28 weeks of gestation. Demographic information was collected at enrollment and during pregnancy. The multivariate logistic regression models were used to identify risk factors for GDM.

 The overall incidence of GDM was 10.93% in this study. The incidence of GDM in the first, second and third trimesters were 5.65, 2.25 and 3.11%, respectively. The mean age of mothers was calculated to be 28.64 ± 5.53 years. By logistic regression, significant factors associated with GDM were age, Preeclampsia, Pregnancy High blood pressure, history of diabetes mellitus (DM) and obesity.

 In this population, the incidence of GDM was 10.93%, which was high. The significant risk factors for GDM were age, BMI, smoking, smoking exposure in the current pregnancy and history of GDM and DM. Also, GDM pregnancies have a higher risk of preeclampsia and gestational hypertension. Therefore, considering the high incidence of GDM in Yazd, general screening is highly recommended and more studies are needed in other parts of Yazd province.

 The aim of this study is to analyze the positive predictive value (PPV) of trisomies 21, 18 and 13 at first and second trimester using amniocentesis for clinical practice.

 : This is a descriptive cross-sectional study in which data were extracted from a cohort project of mother and infant conducted between March 2016 and February 2021 among 3110 pregnant women in Yazd city.

 Out of 3110 pregnant women, 84 mothers were at high risk in the screening tests of the first and second trimesters of pregnancy and therefore were candidates for amniocentesis. None of them were detected by the positive amniocentesis method. The mean age of mothers was 33.2 years. The causes of amniocentesis included old age (45.9%), positive results of Down syndrome screening (23%), high NT ultrasound (4.9%), and pathological results of anomaly scan sonography (3.8%).

 In this study, the PPV was zero and the number of false positives in screening tests was 84 (100%). This may be because our population was normal and had no history of genetic abnormalities or other special conditions.

 Studies investigating the association between ITPKC rs28493229 polymorphisms and Kawasaki disease (KD) risk found inconsistent data. Thus, we performed this meta-analysis to combine and analyze the available studies to get a precise estimation of the association.

 Relevant studies identified in the PubMed, Web of Science, Scopus, and CNKI databases were used to perform a meta-analysis. Pooled odds ratios (OR) with a 95% confidence interval (95% CI) were calculated under fixed- and random-effects models to appraise the association.

 A total of eight case-control studies with 2,721 KD cases and 5,307 controls were selected. The results showed a statistically significant association between ITPKC rs28493229 polymorphism and an increased risk of KD under all five genetic models, i.e., allele (C vs. G: OR = 1.434, 95% CI 1.209-1.700, P ≤ 0.001), homozygote (CC vs. GG: OR = 2.085, 95% CI 1.423-3.055, P ≤ 0.001), heterozygote (CG vs. GG: OR = 1.530, 95% CI 1.359-1.722, P ≤ 0.001), dominant (CC+CG vs. GG: OR = 1.490, 95% CI 1.229-1.806, P ≤ 0.001), and recessive (CC vs. CG + GG: OR = 1.799, 95% CI 1.231-2.629, P = 0.002) in the overall population. When stratified by country, there was a significant association among Taiwanese.

 Our meta-analysis results supported that the ITPKC rs28493229 polymorphism is strongly associated with susceptibility to KD.

 Neurocutaneous melanosis (NCM) and Dandy-Walker malformation (DWM) are two forms of rare congenital neurodysplasia. NCM is a rare dysmorphogenesis characterized by single or multiple giants pigmented cutaneous nevi and the involvement of benign and/or malignant melanocytic tumors of the leptomeninges. DWM is a rare congenital malformation of the brain. Cystic enlargement of the fourth ventricle is its characteristic that communicates with an enlarged posterior fossa, cerebellar dysgenesis, high tentorial insertion, and hydrocephalus. However, these two conditions are rare, and NCM associated with DWC is even more unusual.

Case Report: 

Here, we report a male newborn with macrocephaly and multiple pigmented nevi over his whole body with regular borders and normal weight, height, and spine. He was finally diagnosed as NCM in association with DWC.

 After diagnosing NCM in association with DWC, appropriate follow-up is recommended; however, there is no particular treatment to prevent the malignant change.

 Turner syndrome (TS) is the most common genetic disorder affecting only females. The criteria for diagnosis include the complete or partial absence of the second sex (x) chromosome (with or without cell line mosaicism) plus short stature and primary ovarian failure with or without the presence of other phenotypic TS features. The genotype in TS, as tested in peripheral blood, is most commonly 45xo. β-thalassemia major or transfusion-dependent thalassemia refers to severe β-thalassemia that requires early transfusion therapy. The association between Turner syndrome and thalassemia major is rare, which may result from transcription factor gene mutation.

Case Report: 

We report a girl with thalassemia major who was treated by recurring monthly transfusions since the age of six months. Short stature, triangular face, low set ear, hypertelorism, webbed neck, lordosis and genu valgum were observed in the examination. The patient was diagnosed with Turner syndrome, and her karyotype also was defined as 45xo.

 In the case of Turner syndrome and β-thalassemia major association, a mutation in the transcription factor gene is proposed, which can be confirmed by genetic testing.

 Conversion of glucose-6-phosphate to glucose is the final step in both glycogenolysis and gluconeogenesis. In glycogen storage disease type Ia (GSD type Ia), decreased activity of the enzyme glucose-6-phosphatase leads to an increased concentration of glucose-6-phosphate within the hepatocytes and shunting into alternative pathway with the following consequences: hyperlactatemia, hyperuricemia and hypertriglyceridemia. Patients develop hypoglycemia within 3 to 4 hours after a meal.

Case Report:

 We reported four patients with GSD type Ia with different clinical manifestations such as hypoglycemia, hepatomegaly, lactic acidosis, hyperchylomicronemia, and hyperuricemia and also described their prognosis.

 Previously, many children with GSD Ia died in infancy or early childhood. Recurrent severe hypoglycemia can cause brain damage, but the prognosis has improved dramatically with early diagnosis and long term maintenance of optimal metabolic control.