New predictors for advanced retinopathy of prematurity among neonates in Tehran/Iran

Since a new epidemic [third wave] of retinopathy of prematurity [ROP] sensed throughout the world in recent years, we aimed to assess newer risk factors for advanced ROP which needs treatment in Iranian neonates as a new target output of various neonatal care for this serious disease of newborn infants especially those born prematurely. In an analytic cross-sectional study all neonates <1500 g birth weight and/or <32 weeks gestational age admitted to our NICU as a tertiary level intensive care unit in Milad Hospital, Tehran, Iran during June 2006-June 2007 were included. All data were extracted from medical records and compared in two groups with or without treatment. Seventy one neonate infants entered our study. Twelve neonates [16.9%] progressed to advanced ROP. Final multivariate analysis model revealed that mean leukocyte counts during first 14 days of life [P=0.04], transfusions number [P=0.01] and hypocapnic episodes during first 14 days of life [P=0.02] were significantly different between the two groups of infants independently, even after simultaneous adjustment. Based on our findings, more amenable risk factors should be approached regarding more careful modulation of such overlooked risk factors which may lessen the burden of prematurity

Evaluation of the possible antioxidative role of bilirubin protecting from free radical related illnesses in neonates

There are disparate data regarding whether bilirubin is protective or toxic during free radical related illness among neonates. Seventy one infants with gestational age [GA] of<32 weeks and/or birth weight [BW] of<1500 g, who survived beyond 4 weeks and completed physical examinations were enrolled in this study. The infants were divided into two groups based on the presence or absence of advanced retinopathy of prematurity [ROP], grade III intraventricular hemorrhage [IVH], grade III necrotizing enterocolitis [NEC], respiratory distress syndrome [RDS], bronchopulmonary dysplasia [BPD], sepsis or severe fungal infection [SFI]. The mean of total serum bilirubin [TSB] of the first 14 days of life were measured and compared between these two groups. A significant lower TSB were found in severe form of ROP [P<0.001], grade III NEC [P=0.008], grade III IVH [P=0.021], SFI [P=0.003] and sepsis [P=0.007] in comparison to mild or disease free status. Moreover, the cut-off point of 5.1 mg/dl for the mean of TSB had the sensitivity of 88.1% and specificity of 84.6% to detect severe grades of ROP. Also the cut-off point of 3.25 mg/dl had 97.2% sensitivity and 100% specificity in order to distinguish SFI. It is concluded that bilirubin may play an antioxidant role in vivo as in vitro; and protect preterm infant against these free radical related disorders. Our findings suggest that not only the upper limits of serum bilirubin, but also the lower limits must be taking into account in order to both preventing from neurotoxic effects and free radical based illnesses, respectively

[Clinical, epidemiological, and molecular evaluation of SMA type I in Iran [a pilot study]]

Spinal muscular atropies are common [genetically determined] disorders. They are heterogeneous both in genetic and phenotypic characteristics. Prevalence of disease was reported between 1 in 6000 to 1 in 25000 in different populations. So, carrier frequency should be 1 in 40 to 1 in 80 in those people. Deletion of both copies of SMA, gene was detected in more than%90 of SMA patients. According to present data there were not any epidemiological study and data in Iran regarding SMAs. So, we do not have accurate information about prevalence, incidence of disease and its carrier frequency. Because of high rate of consanguinity it should be high. With this background, we decided to carry this pilot study out, to determine prevalence, incidence, carrier rate, along with consanguinity rate, clinical spectrum, and molecular abnormality in the affected cases. In a 2 years period, 30734 live-born babies followed, 4 patient affected to SMA type I were detected. Prevalence of SMA I in this population was 1 in 7683, and carrier frequency was 1 in 43. At least 2 third of the newborn babies were product of consanguineous marriages