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The relationship between magnesium levels and complications of jaundice in infants
Razieh Sangsari, Maryam Saeedi, Malihe Kadivar, Mahsa Niknam,
Volume 78, Issue 5 (August 2020)
Abstract
Background: The effects of magnesium physiology are contradictory to the neurotoxic effect of bilirubin, but the relationship between magnesium level and hyperbilirubinemia in neonates has not been well studied. In this study, we investigated the relationship between serum magnesium level and hyperbilirubinemia and hyperbilirubinemia complications at the Children’s Medical Center.
Methods: In this cross-sectional and prospective study, 100 neonates who were admitted to the Children's Medical Center from October 2018 to 2019 due to neonatal jaundice were enrolled. Neonates were divided into two groups: serum bilirubin levels 16-20 mg/dl were included in the moderate hyperbilirubinemia group and bilirubin >20 mg/dl into severe hyperbilirubinemia group. Serum magnesium levels and clinical complications of hyperbilirubinemia including fever, seizure, apnea, bradycardia, and abnormal neurological examinations were recorded in these infants.
Results: In this study, 100 neonates were evaluated. The mean serum magnesium level in these patients was 2.32 mg/dl. This rate was significantly higher in neonates with seizure (P=0.038), hyperbilirubinemia fever (P=0.048), and neonates with chronic encephalopathy (P=0.003). The mean serum magnesium level was significantly higher in severe hyperbilirubinemia (P<0.001). Serum Magnesium in complications of chronic encephalopathy (P=0.007), Fisting (P=0.001), retrocoli (P=0.001), hypertonia (P=0.004), hypotonia (P=0.001) and seizures (P=0.030) were significantly different. The serum magnesium levels were positively correlated with total bilirubin (r=0.443, P<0.001). The magnesium levels correlated with the chronic encephalopathy (OR: 4.15, P=0.040) and it was observed that magnesium levels above 2.15 could predict chronic encephalopathy with a sensitivity of 100%, the specificity of 47.82%, a negative predictive value of 100% and a positive predictive value of 14.28%.
Conclusion: The results of this study showed that serum magnesium levels significantly correlated with serum total bilirubin and magnesium cutting points above 2.15 mg/dl in patients with jaundice could predict chronic encephalopathy.

Clinical manifestations of Hirschsprung in infants in Iran
Razieh Sangsari, Kayvan Mirnia, Maryam Saeedi, Nazi Dezvaree, Fatemeh Kazerooni,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Hirschsprung's disease is a major cause of functional intestinal obstruction, mainly affecting the distal region of the large intestine. Risk factors for this disease include a family history of the disease, being male, and the presence of other conditions such as cardiac or chromosomal abnormalities.
Methods: Infants admitted to Children's Medical Center Hospital, Tehran university of medical science between April 2017 to April 2021 with a diagnosis of Hirschsprung's disease were included in this study. Demographic information, clinical and radiological findings, and complications were recorded on customized forms.
Results: In this study, 29 neonates were included. The clinical manifestations of Hirschsprung in this study were failure to defecation in the first two days of birth, abdominal distention, and bilious vomiting. The most common complaint at the time of visit was constipation and vomiting, and the most common clinical finding at the time of hospitalization was abdominal distension. The most common radiological manifestation in the simple X-ray of affected neonates was the dilation of the intestinal loops and in the barium enema transitional zone. In the delayed X-ray, the delay in emptying the barium was observed. in neonate with Hirschsprung's disease Heart disease was a common comorbidity (27.2%). The most common heart disease was Atrial Septal Defect (ASD). The most histological involvement was in the rectal and rectosigmoid areas. The most common complication of Hirschsprung in the follow-up of neonates until at least 6 months of age was poor weight gain, constipation and fecal incontinence. We had three deaths, one case with Small intestine, one case with heart disease and one case with multiple anomalies.
Conclusion: The results of this study are consistent with previous research showing that genetic variations do not have a major impact on the clinical presentation of newborns with Hirschsprung's disease. While diagnostic methods like x-ray and contrast enema can be useful, biopsy is the most reliable way to confirm a diagnosis of Hirschsprung's disease. Physicians should consider performing a biopsy when evaluating a suspected case of this condition.

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