Evaluation of acute renal failure in neonates bedridden in Neonatal Intensive Care Unit [NICU] in Ghaem hospital

Acute renal failure [ARF] is defined as an abrupt severe decrease in glomerular filtration rate [GFR]. ARF is commonly seen in neonates admitted to neonatal intensive care unit. In this article, we have studied incidence, etiology, predisposing factors, management and mortality in neonates affected by ARF. A descriptive study was took placed at NICU of Qhaem hospital over a period of one year, between December 2005 and December 2006. 750 neonates were evaluated for ARF, according to having two of three following criteria: 1-oliguria: U/A<1/2cc/kg/h 2-BUN>20 mg/dl 3-Cr>1/2 mg/dl Patients were assessed for B.S [blood sugar], BUN, Cr, urine index [FENa, Uosm, BUN/cr, U/P osm, RFI, Una], ABG and kidney sonography. According to patient's response to the fluid therapy and kidney sonography, they were divided into two pre-renal and renal failure groups. Data were analyzed using descriptive statistics. From 750 neonates admitted in NICU, 38 patients [5%] demonstrated ARF. Pre-renal failure was found in 29 newborns [76.4%] and 9 neonates [23.6%]. Predisposing factors for ARF were as following: Asphyxia [42%], Respiratory distress syndrome [RDS] [26.7%], sepsis [13%], sever dehydration [13%] and congenital heart disease [CHD] [5%]. Nine infants [23.6%] were died. Mortality was significantly higher in intrinsic renal failure [88%]. ARF is still an important etiology of mortality in newborns. Diagnosis of predisposing factors [prematurity, asphyxia, RDS, ventilation and careful kidney control in newborn is essential in this problem

Congenital dislocation of the hip in newborns in the city of Mashhad

Developmental dysplasia of the hip [DDH], formerly known as congenital dislocation of the hip [CDH] is a common congenital malformation which occurs worldwide with variable frequencies in respect to the race and geographic distribution. To determine the incidence of DDH, its predisposing factors and the diagnostic value of click for its detection. In a cross-sectional study of over 9-month duration, all of neonates born in the four teaching hospitals of Mashhad were examined during 48 hours after birth by Ortolani test. For all newborns with unstable joints, data regarding maternal history were collected. If clunk was felt on the first examination or click on repeated examinations, sonography was performed for more accurate diagnosis. All infants with definite CDH or unstable hip was referred to orthopedic clinic. A total number of 6576 newborns were examined over a period of nine months. Clunk or click was found in 3% [197 neonates]. Only 10 newborns had CDH by clinical and sonographic findings. Of these, eight had clunk at birth and two had persistent click on repeated examinations. These were finally diagnosed as CDH. Eleven neonates were born in breech position. CDH was bilateral in 60% of patients, and solely left-sided in 30%. The incidence of congenital dislocation of the hip was 1.5/1000. There was a significant association between the first parity and CDH [p<0.05], but not with maternal age. The incidence of CDH in the sample studied [1.5/1000] is similar to other studies reported so far. Many of unstable hips showed no abnormality or click on repeated examinations and were thus of no value in diagnosis of CDH