[Evaluation of relationship between neonatal jaundice and incidence rate of congenital hypothyroidism in newborns at selected educational hospitals in Mashhad, Iran]

Congenital hypothyroidism [CH] is one of the most urgent diseases of the newborns; with preventable complications, such as mental retardation, by early diagnosing and treatment. It is often asymptomatic, but it can induce severe and or prolonged jaundice. We aimed to assess relationship between neonatal jaundice, as a nonspecific clinical sign, and incidence rate of CH. This cross-sectional study was performed on 140 healthy term newborns affected jaundice that admitted to 4 selected educational Hospital in Mashhad, Iran. As CH causes both prolonged and severe hyperbilirubinemia, all 1-28- day old newborns with various causes of jaundice with total serum bilirubin values of > 10 mg/dl were included and evaluated for thyroid function tests. Thyroid-stimulating hormone [TSH]> 10 mu/l and thyroxin [T4] <7 microg/dl were considered as CH. Serum value of T4 was normal at 97.86% and low at 2.14%. 1.43% of newborns had serum level of TSH >10 mu/l. More investigation reavealed the incidence rate of hypothyroidism at approximately 1 case in 140 birth which means 7 cases in 1000 birth [7:1000]. In present study, the incidence rate of CH was 7:1000. As usual, there is no clinical finding in CH at birth, so more attention should be paid to nonspecific signs of hypothyroidism that one of the earliest is severe or prolonged jaundice. Also, follow up should be considered for these newborns

Estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava in pediatric patients

Paucity of data exists between mean right atrial pressure [RAP] and inferior vena cava [IVC] size and collapsibility in pediatric patients with congenital heart disease. In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96 +/- 4.05 years [30 male and 20 female]. Patients were categorized into two groups according to their right atrial pressure [RAP] as measured by cardiac catheterization: Group 1 [40 patients] were those with mean RAP <8 mmHg and group 2 [10 patients] who had a mean RAP> 8 mmHg. In M-mode echocardiography IVC size was statistically different [P=0.004 and 0.009] in inspiration and expiration in the two groups. Mean RAP was estimated to be > 8 mmHg when IVC diameter in inspiration was >3.6 [sensitivity of 100%, specificity of 47.5%, +LR=1.9] or if IVC diameter was >6mm in expiration [sensitivity of 70%, specificity of 87%, +LR=4.67]. This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure