Neonatal bacteriemia isolates and their antibiotic resistance pattern in neonatal insensitive care unit [NICU] at Beasat hospital, Sanandaj, Iran

Bacteremia continues to result in significant morbidity and mortality, particularly among neonates. There is scarce data on neonatal bacteremia in among Iranian neonates. In this study, we determined neonatal bacteremia isolates and their antibiotic resistance pattern in neonatal insensitive care unit at Beasat hospital, Sanandaj, Iran. During one year, all neonates admitted to the NICU were evaluated. Staphylococcal isolates were subjected to determine the prevalence of MRS and mecA gene. A total of 355 blood cultures from suspected cases of sepsis were processed, of which 27 [7.6%] were positive for bacterial growth. Of the 27 isolates, 20 [74%] were Staphylococcus spp as the leading cause of bacteremia. The incidence of Gram negative bacteria was 04 [14.8%]. The isolated bacteria were resistant to commonly used antibiotics. Maximum resistance among Staphylococcus spp was against Penicillin, and Ampicillin. In our study, the isolated bacteria were 7.5% Vancomycin and Ciprofloxacin sensitive. Oxacillin disk diffusion and PCR screened 35% and 30% mec a positive Staphylococcus spp. The spectrum of neonatal bacteremia as seen in NICU at Beasat hospital confirmed the importance of pathogens such as Staphylococcusspp. Penicillin, Ampicillin and Cotrimoxazol resistance was high in theses isolates with high mecA gene carriage, probably due to antibiotic selection

Evaluation of the preventive effects of purgative manna on neonatal icterus in Sanandaj

Herbal medicines have been used commonly as a traditional therapeutic method for treatment of medical disorders. Previous studies had shown that purgative manna [Shirkhesht] can be used for the treatment of infantile icterus, however no study has been performed on the preventive effects of this herb on infantile icterus. This study was conducted to evaluate the preventive effects of purgative manna on neonatal icterus. This was a double blind clinical trial and included neonates born in Besat Hospital, in Sanandaj. Patients were divided into two groups on the basis of blocked randomization. Twenty four hours after birth, five drops of oral purgative manna drop [BiliNaster produced by Sobhan Co.] was given to the intervention group three times a day, for three days and a placebo produced by the same company was given to the infants in the control group with the same dose for three days. Bilirubin was measured every day from the third to fifth days. This study included 140 neonates. Intervention and control groups had no significant difference in regard to basic variables such as sex, type of birth, and billirubin. 11 neonates [15.7%] in purgative manna group and 15 neonates [21.4%] in placebo group had developed icterus which showed no significant difference [p=0.38]. In addition, the mean values of billirubin measured in the control and intervention groups from the third to fifth days were 12.2 mg/deciliter [ +/- 2] and 12.5 mg/deciliter [ +/- 1.9] respectively which had no significant statistical difference [p=0.54]. According to the results of this study, use of five drops of purgative manna three times a day, for three days, did not have any preventive effect on neonatal icterus between the third and fifth days after birth. Some studies have showed the effectiveness of this drug in preventing neonatal icterus, but we did not observe such effect in our study

Congenital hypothyroidism screening program in Kurdistan, Iran

Congenital hypothyroidism [CH] represents one of the most common preventable causes of mental retardation. The fetal hypothalamic-pituitary-thyroid axis begins to function by midgestation and is matured in the term infant at delivery. If fetal hypothyroidism develops effects may be demonstrated in certain organ systems, including the central nervous system and skeleton.neonatal screening of hypothyroidism is one of the preventive programs that cost-benifit is positive. In this study, we analized the data obtained retrospectively from CH screening from all of the health centers in Kurdistan, Iran from January 2006 to June 2008. From the 50539 neonates referred for CH screening 122 neonates were diagnosed with CH, showing an overall incidence of 1/414 live birth. In 50539 screened neonate 24806 were girls [49.1%] and 25733 [50.9%] were boys. Over all 49576 neonate have TSH<5 and 777 neonate have 510. Screening coverage was 97% of live birth and 122 neonate recognized with CH. Of these, 118 were treated before 28[th] day of bith, 4 neonates were treated in 28-40. Positive predictive value of this screening test was overall 13.3%. The incidence of CH in Kurdistan province seems high

Measurement of the urinary lactate/creatinine ratio for early diagnosis of the hypoxic-ischemic encephalopathy in newborns

Hypoxic ischemic encephalopathy [HIE] is a major cause of permanent neurological disabilities. Perinatal asphyxia may induce neonatal mortality after birth or neurological impairment among survivors. There are no reliable methods for identifying infants at risk for this disorder. We measured the ratio of lactate/creatinine [L/C] in urine by proton nuclear magnetic resonance spectroscopy within 6 and 24 hours after birth in 50 normal infants and 50 infants with asphyxia who developed hypoxic-ischemic encephalopathy. The study was performed from September 2006 to May 2007. For statistical analysis, the SPSS software was used. Group comparisons were performed with chi-square and t-test. L/C ratio was 3.3 +/- 2 among asphyxiated neonates in the first six hours after birth which was 11 folds greater than in normal neonates [0.3 +/- 0.08, P=0.0001]. This ratio decreased to 1.5 +/- 0.55 for asphyxiated cases in the first 24 hours after birth, which was 5 folds greater than in control group [P=0.0001]. Asphyxiated neonates were subdivided into Group A with mild asphyxia and L/C ratio 2.5 +/- 0.5; Group B with moderate asphyxia and L/C ratio 4.2 +/- 1.5; and Group C with severe asphyxia and L/C ratio 3.4 +/- 3.3. The severity of asphyxia correlated with the greater L/C ratio among our cases and was significant [P=0.0007]. The sensitivity and specificity of L/C ratio in cut off point of 0.48, was 96.1% and 100% respectively. Measurement of the urinary L/C ratio soon after birth maybe a promising tool to identify asphyxiated neonates and also to predict the severity of asphyxia

[Reports of children with Kawasaki disease hospitalized in pediatric units in Besat and Taminjtemaee hospitals in Sanandaj]

Kawasaki disease is an acute febrile systemic vasculitis mainly affecting children under 5. Its etiology is still unknown. Kawasaki disease can only be diagnosed clinically as there exists no specific laboratory test that can tell if someone has it. The cardiac complications are, by far, the most important aspect of the disease. This study reports the signs and the symptoms of patients with Kawasaki disease hospitalized in pediatric units in Besat and Taminejtemaee hospitals. In this was a retrospective study of medical record of 20 patients with Kawasaki disease admitted to the pediatric units of Besat and Taminejtemaee hospitals from 2001 to 2005. Were evaluated and analyzed by statistical methods. 60% patients [12 cases] were male and 75% [15 cases] were aged between 2 and 5. The typical clinical manifestations were seen in 14 cases [70%]. The most common sign was mucosal changes [85%]. CRP was positive in 17 cases [85%]. Cardiac valvular dysfunction was reported in 4 cases [20%] yet no aneurysm was reported. For 6 patients, the problem had started in summer. Two patients [10%] had hemoglobin < 10 mg/dl with WBC under 10.000 in 8 cases [40%]. IVIG and aspirin were administered for 15 patients [75%]. Our report shows a higher prevalence of atypical Kawasaki disease in these two hospitals compared to other areas. The fact that diagnosis is only clinical with no specific laboratory test to detect the disease emphasized the importance of accurate clinical examinations during early stages which in turn will prevent future complications

[ effect of zinc supplementation in acute diarrhea among 4-24 months old children]

Zinc is one of the micronutrient with many roles in health, especially among the growing children. It has been thought that Zinc deficiency cause diarrhea, and Zinc supplementation can prevent it in children. This study was carried out to determine the effect of Zinc sulphat on 4-24 month old children dirrahea. This clinical trial study was done double blind, the sample were study 4-24 month old afflicted with acute diarrhea in pediatric ward of Besat Hospital in Sanandaj, Iran during 2006. The sample size was 40 and mached by Blocks Randomization. The children in case group [intervention] received Zinc sulfate [9mg/kg/day] during ten days. In the Control groups they there given distilled water instead. The data was analyzed, using t-test and manwitney test. During ten days of monitoring there was not significant differences between two groups. Duration of diarrhea in case and control groups was 5.72 +/- 3.15 and 5.32 +/- 2.58 days respectivley this diffence was not significant. This study showed that Zinc sulfate has no benefit on acute diarrhea in childhood