Neonatal mortality risk factors in a rural part of Iran: a nested case-control study

Due to complex causal framework of neonatal mortality, improvement of this health indicator is quite gradual and it's decreasing trend is not as great as other health indicators such as infant and under 5 mortality rates.This study was conducted to evaluate neonatal mortality risk factors based on nested case-control design. The study population was 6900 neonates who were born in rural areas of Kohgiluyeh and Boyerahmad province [South of Iran]. They were under follow up till the end of neonatal period and the outcome of interest was neonatal death. By using risk set sampling method, 97 cases and 97 controls were selected in study cohort. Prematurity [OR = 5.57], LBW [OR= 7.68], C-section [OR = 7.27], birth rank more than 3 [OR = 6.95] and birth spacing less than 24 months [OR = 4.65] showed significant statistical association [P < 0.05] with neonatal mortality. The Population Attributable Fraction [PAF] was 0.45 for LBW, 0.40 for prematurity, 0.28 for C-section, 0.30 for birth rank more than 3, and 0.16 for birth spacing less than 24 months. Prematurity, low birth weight, C-section, birth spacing less than 24 months and birth rank more than 3 are important risk factors for neonatal mortality

Evaluation of the growth parameters in major thalassemic patients

Thalassemia major is the most severe identified hemolytic anemia and the most common single gene abnormality. This disease is very common in Iran and that is why there should be a careful investigation into it. Not treated properly, growth faliure is one of the most important complications of this disease. This study was designed to evaluate the growth parameters in thalassemic children and to compare the obtained data with normal children. This cross-sectional, descriptive and analytical study was carried out on 121 thalassemic patients who received blood transfusion therapy in Yasuj, with respect to the physical growth parameters such as height, weight, sitting height, and arm circumference. Collected data were compared with data from normal children [who were chosen from the same sex, age and socioeconomic groups]. According to statistical analysis, weight of 53.7% of thalassemics and 17.1% of non-thalassemics, for the same age group, was under 5 percentile [p<0.0001]. These measurements for height and mid arm circumference were 66.9% v/s 17.1%, and 72.7% v/s 32.5% under percentile respectively [p<0.0001]. Considering the growth retardation of thalassemic patients, we recommend regular follow-up for confirming the blood transfusion and desferal injection with exact interval

[ effect of herbal drugs on neonatal jaundice]

Using herbal drugs is the common way for treatment of diseases in traditional and alternative medicine. These drugs have important role and strong cultural background among people in treatment of hyper-billirubinemia. It is necessary to evaluate the effect of herbal drugs by scientific methods. The goal of this study is to investigate the in vitro effect of common herbal drugs used traditionally in management of neonatal hyperbillirubinemia. in this study 0.5 cc of 5 common herbal drugs [Cichorium intybus, Fumaria parviflora, Zizyphus jujuba, Alhagi pseudoalhagi and Purgative manna] which are obtained by hydrochloric instillation were added to 1 ml of serum of jaundiced neonates and then the level of billirubin determined by Diazo blank method. This study revealed that only Cichorium intybus extract decreases the level of bilirubin significantly [p<0.05]. Other herbal drugs may decrease billirubin level with other mechanisms, for example by cathartic effect or activating of liver enzymes, but this study revealed that Cichorium intybus is the only drug that has direct decreasing effect on billirubin. For further investigation, we recommend to separate the effective substance of Cichorium intybus and determine its effectiveness in vivo