[Prevalence of congenital toxoplasmosis in two university hospitals: a brief report]

The incidence and clinical presentation of congenital toxoplasmosis in our newborns was not studied until yet. Goal of study is to evaluates the newborns for congenital Toxoplasma. Gondii infection and describe the clinical presentation from birth and follow up them. We conducted a prospective study upon 270 newborns were born in two university hospitals in Tehran [Rasoul akram and Akbar Abadi] during 2011-2012. Cord blood sample obtained from the newborns during labour. The samples centrifuged, transported and restored in -80 centigrade freezer in our Research Laboratory. Specific T.Gondii- antibodies [IGG, IGM] evaluated by ELISA methods. Neonates with positive T.Gondii- IGM diagnosed and studied as infected cases. The infected cases treated and followed for progression of disease. Gestational age of newborns was between 28-41 weeks. Positive T.Gondii - IGM and T.Gondii -IGG determined in 1.5%, 44.1% of cases respectively. The most common clinical presentation in seropositive cases was eye involvement [50%], and brain disorders [50%]. Positive PCR had not found in cerebrospinal fluids of seropositive [IgM] cases. One and a half percent of newborns were seropositive for T.Gondii. Wide variation of clinical presentation and early diagnosis of infected newborns in our country is so important. Adding the serologic tests [IGM] to neonatal screening test is recommended strongly.

[Total serum magnesium level in icteric neonates before and after phototherapy]

Deposition of bilirubin in neurons causes permanent neuronal injury. Bilirubin exhibits an affinity for the phospholipids of plasma membrane like N-methyl-D-aspartate [NMDA] receptors. Magnesium is an NMDA antagonist and it acts against the neurotoxic effects of bilirubin. We compared pre-and post-phototherapy serum magnesium level of neonates with hyperbilirubinemia to find the best time of discharge and evaluate new management techniques such as magnesium supplementation. In this semi-experimental study, we evaluated neonates admitted in Ali Asghar Children's Hospital in Tehran, Iran with signs of icter from 2009 to 2010. The inclusion criteria included age less than four weeks, no history of magnesium sulfate administration in the mother and absence of sepsis. From 106 patients with icter, 50.9% were male and 49.1% were female neonates. Their mean gestational age was 37.34?1.286 [33-41] weeks and the mean birth weight was 3172.12?436.936 [2022-4300] grams. The frequency of underlying causes of hyperbillirubinemia included: ABO mismatch 9.34%, Rh incompatibility 4.7%, breastfeeding 16% and breast milk 44.3%. There was a significant difference [P?0.001] between serum magnesium levels before [2.24mg/dl] and after phototherapy [2.12mg/dl]. There were no significant differences between serum magnesium values in the two sexes [male=2.28, female=2.19], among different gestational age groups [<34 wks=2.35, 35-37 wks=2.27,>38 wks=2.17], between different birth weight groups [1500-2500 g=2.4 and>2500 g=2.23] or severity of hyperbilirubinemia [mild=2.23, moderate=2.21 and severe=2.29]. Phototherapy decreases the total magnesium concentration and magnesium administration will prevent bilirubin neurotoxicity in icteric neonates

Congenital arhinia: case report of a rare congenital anomaly

Congenital absence of the nose or arhinia is a rare defect of embryogenesis often associated with other anomalies. Arhinia is a life-threatening condition that requires a highly skilled neonatal resuscitation team in the delivery room. The associated anomalies often have a significant effect on the immediate as well as long-term outcome of the neonate. This report presents a case of congenital arhinia and reviews the management of such cases

Comparison of post-operative neurological complications between on-pump and off-pump coronary artery bypass surgery

To assess neurological impairment after the off-pump and On-pump techniques in patients with first-time isolated coronary artery bypass graft surgery. One hundred twenty patients undergoing first-time isolated coronary artery bypass graft surgery prospectively at Baqiatallah University Hospital, Tehran, Iran were randomised to the off-pump or on-pump technique. Change in NIHSS score was measured at 30 days postoperatively. The on-pump group showed a significantly greater deterioration in scores than the off-pump group. The incidence of TIA at 30 days postoperatively was 15.3% [9 out of 60] in the on-pump group and 5% [3 out of 60] in the off-pump group. [P=0.05]. The incidence of Stroke at 30 days postoperatively was 3.4% [2 out of 60] in the off-pump group, while no one from off-pump group suffered from stroke. [P=0.05] Off-pump coronary artery bypass graft surgery results in less neurological impairment than the on-pump technique

Clinical outcomes of patients with isolated atherosclerotic lesion of proximal left anterior descending coronary artery who underwent coronary angioplasty with stenting

The atherosclerosis of left anterior descending [LAD] coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty [PTCA] with stenting for treatment of proximal LAD disease. In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing [ETT] by Bruce protocol was performed before angioplasty and at the end of follow up period as well. There were 44 [58.7%] males, and 31 [41.3%] females. The mean age of patients was 59.4 [range, 39 to 83 yrs]. Clinical outcomes of 73 [97.3%] patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome