Tehran University Medical Journal

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The aims of this study were to determine incidence and types of observable congenital abnormalities among births of Mirza Kochak-Khan, Imam Khomeni and Shariatti hospitals between first of Novermber 2000 to the end of September 2001.
Materials and Methods: We used neonates that survived for 24 hours after delivery. A questionnaire was specially designed to explore each of the objectives for our study. A group of experts that were thoroughly trained to completed questionnaires by interview to mothers and evaluation of neonates. Data analysis was performed and by Excel and SPSS.
Results: Results showed that congenital abnormalities were present in 205 (3.2 %) of 6424 neonates, from 3 hospitals. The most frequent abnormalities consisted of musculoskeletal defects (37.3 %), Nervous system defects (24.7 %), urogenital defects (24.3 %) head and neck defects (13.6 %).
Conclusion: The result of this study showed that incidence of visible congenital abnormalities ratio in contrast to other countries have not significant difference but the types abnormalities were significant.

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Background and Aim: In obstetrics, calcium antagonists, in particular nifedipine, have become increasingly popular for the management of preterm labor and are more effective tocolytic agents than beta 2-sympathomimetics. Our aim was to evaluate the effects of oral nifedipine therapy on ultrasonographic cord blood flow parameters in pregnant women with short cervical length.

Materials and Methods: In a case-series study, 20 patients at risk of preterm labor with shortening cervix in serial examinations were included. Patients received oral nifedipine administered 40 mg per day until 37w of gestational age (GA). Umbilical artery Doppler parameters including systolic/diastolic ratio (SD) and pulsatility index (PI) were recorded before and biweekly after nifedipine prescription.

Results: The mean of age was 25.55±4.58 years. The mean cervical length was 19.68±6.32. nifedipine consumption was initiated at the 26.4±4.12w and was terminated at 36.10±2.65w. The side effects of nifedipine were occurred in 2 patients (10%). In no patient no SD and PI measure get out of normal values. In contrast to PI, after nifedipine consumption SD was significantly higher than before (2.28±0.45 vs. 2.65±0.21). Two neonates (10%) were delivered before 37w and less than 2500gr. Just one neonate needed NICU stay.

Conclusion: Oral nifedipine can be used as a safe and effective tocolytic treatment in patients at risk of preterm labor with shortened cervical length.

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Background: Mongolian spots are the most frequently encountered pigmented lesions in newborns. The patches appear at birth or shortly there after, rarely later the MS in term newborns in always present at birth. The shape of MS was commonly either irregular or indefinite, with its borders gradually blending with the surrounding skin. The color most frequently observed in all ethnic groups was blue- green. For the Negro population the color was commonly greenish– blue the next most common color in the total population was blue- gray. Brown coloration in the form of brown specks on a back ground of blue was present in ten percent Negro Newborns. The most common location is the sacragluteal region, which frequently is the only part affected. MS occasionally are found in the extremities in those cases with extensive involvement, particularly in the shoulders. The presence of MS in the head or neck has been called aberrant Mongolian spot. The macula has been variously described as irregularly round, oval, roughly triangular, heart shaped, resembling a tennis racket, and angular. The size may vary from a dot of a few millimeters to six or more centimeters in diameter the mark of ten disappears during the first or second year of life. Those marks distant from the sacral region are said to be more apt to persist than the typical sacral one and the buttocks was the site of predilection. Its incidence varies from over 80% in Asians (Mongolian and Chinese) to 10% of white infants. Only a limited number of studies were carried out in Iran. Our objective was to study Mongolian spots incidence and common locations in newborns at Shariati hospital.
Methods: During 2004-06, 2305 consecutive newborns were examined at Shariati hospital. Diagnosis of Mongolian spot was based on clinical impression with Pediatricians.
Results: Mongolian spot was observed in 11.4% neonates. The most frequent site of involvement is the sacral, followed by the gluteal area. Mongolian spot did not show a significant relationship to sex, gestational age, mother’s age groups and delivery type (p>0.05) but the relationship between Mongolian spot and birth weight groups was significant (p<0.05).
Conclusion: Incidence of mongolian spots in our patients was simila

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Tuberculosis is an important cause of death in some countries. The world health organization estimates that if stronger measures are not taken up to control the prevalence of this disease, from 2000 to 2020 a billion people will be infected by the bacterium. According to time consuming of common detection methods of Mycobact-erium tuberculosis such as culture, it is necessary to evaluate a rapid detection tests such as PCR. Rapid diagnosis of tuberculosis may have profound effects in patients' care According to importance of rapid detection and treatment of tuberculosis and for determine of sensitivity, specificity, positive predictive value and negative predictive value of PCR by using IS6110 this study was done in Kashan university of medical science.
Methods: A total of 248 sputum samples from patients suspected of mycobacterial diseases were studied. DNA was extracted by boiling method. IS6110 PCR method by a specific pair of primers designed to amplify 123bp and 245bp sequences of the insertion sequence, 6110, in the M. tuberculosis genome was used to analyze sputum samples.
Results: 32 out of 248 (12.9%) of samples had positive culture. PCR yielded a sensitivity of 93.8% and specificity of 99.1% for the diagnosis of TB patients with TB confirmed by culture. There were two out of 32 (6.3%) PCR-positive cases among the patients with non-TB disease.
Conclusion: The findings of the present study indicate that Multiplex PCR may provide a faster method of detecting tuberculosis, thus enhancing diagnostic procedures and we conclude that the performance of an IS6110 PCR assay is valuable in the rapid diagnosis of tuberculosis.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Cerebrovascular accidents are the most common complications in premature neonates (gestational age <37 weeks). Intraventricular hemorrhage (IVH) and hydrocephaly are the most common presentations of these accidents. Premature neonates less than 28 week age or 1000 gr have maximum risk of cerebrovascular accidents with prevalence of 30 percent. Early screening in high risk pregnancies with real-time ultrasonography can detect these lesions and affect on final prognosis. The purpose of this study is evaluation of brain ultrasonongraphic findings of 60 premature neonates born in Yazd University Hospitals, Yazd, Iran and relationship between these findings and delivery types.
Methods: In this descriptive cross sectional study 60 cases of premature neonates (less than 37 week) who were born from January to July 2007 in Yazd hospitals were evaluated ultrasonographically to detect cerebrovascular accidents.
Results: Among 60 premature neonates, 52(86.67%) were low birth weight and 8(13.33%) neonates weighted more than 2500gr. IVH was seen in five (9.6%) LBW neonates and hydrocephaly was seen in five (9.6%) LBW neonates. One LBW neonate (1.9%) had haloprocencephaly. Eight normal weight neonates had no abnormal ultrasonographic findings.
Conclusion: All factors that induce preterm delivery and high risk pregnancies can increase cerebrovascular accidents in premature infants. Neonatal weight had most powerful relationship with neonatal ultrasonograohic findings.

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Background: The relationship between season of birth and human diseases is well known and such a relationship could be mediated by seasonal and environmental effects on early events of extrauterine life Empirical neonatological experience suggests that prevalence and degree of neonatal jaundice might be dependent on seasonal variation, mainly due to the sunshine duration. However, evidence based data on this issue are scarce. Thus, we have analyzed the seasonal effect on the rise of serum bilirubin level during the neonatal period.
Methods: A prospective cohort study was done on a sample of 629 term and healthy  infants born consecutively in Shariati Hospital, Tehran, Iran, during the years 2008-2009. The cord bilirubin level and then the serum bilirubin level near to 48 hour of age were measured. Seasonal differences in rise of serum bilirubin were studied.
Results: Rise of serum bilirubin in spring was 3.951.4 mg/dl, in summer 3.761.69 mg/dl, in fall 3.511.60 mg/dl and in winter 4.791.99 mg/dl. Serum bilirubin level in cord blood did not appear to be correlated with season of birth. After correction for the possible effect of these variables the relation between season of birth and rise of serum bilirubin remained significant. The rise of serum bilirubin in winter was significantly higher than other season (P<0.0001).
Conclusion: Season acts as an independent etiological factor of neonatal hyperbilirubinemia. Mean rise of serum bilirubin in winter is higher than other season. This provided information to improve education for nurses in identifying risk factors and the prevention of hyperbilirubinemia readmissions.