[ effects of massage on intra ventricular hemorrhage in preterm infants in the neonatal intensive care unit]

Background and Aim: Massage can produce sense of security, enhanced physical growth, improved circulation and function of nervous system. It also can decrease sleep disorders and behavior disturbances. This study investigated the effect of massage on intra ventricular hemorrhage in premature infants in the neonatal intensive care unit [NICU] of Ghaem Hospital in Mashhad, Iran

Material and Methods: In this random clinical trial 60 stable preterm newborns were divided into intervention [n=30] and control [n=30] groups. The intervention group performed passive massage movements for three short periods [each period= fifteen minutes] in 3 consecutive hours for 5 days. The intervention and control groups were compared with each other in regard to the incidence of intra ventricular hemorrhage. Our tools for data collection included forms for sample selection and demographic characteristics, check lists to record data and pulse oximetry device. Using SPSS.16 software, data were analyzed by independent t-test, chi square test and odds ratio

Results: In our study experimental group showed a lower incidence rate of intra ventricular hemorrhage in comparison to the control group [P= 0.058]; however, it was not statically significant

Conclusion: According to the results of this study massage along with other methods can be an effective method for reducing the incidence of intra ventricular hemorrhage in stable premature infants

[Prevalence and etiology of prolonged neonatal jaundice]

Background and Aim: Prolonged jaundice [PJ] or hyperbilirubinemia usually persists beyond 14 days of age, with a prevalence of 15-40%. Effective control and decrease in the severity of jaundice can be achieved by recognition of the causes of PJ. The aim of this study was to evaluate the prevalence of PJ, its symptoms and predisposing factors in infants admitted to Ghaem Hospital in Mashhad

Material and Methods: This descriptive study we selected 413 infants with PJ in Ghaem Hospital in Mashhad by using convenience sampling method. After taking medical history and physical examination, necessary Labratory workups were performed. Using SPSS version 13.5, data analysis was performed by using mean and standard deviation

Results: The mean age of the study population was 19.5 +/- 4.7 days. The mean birth weight was 2900 +/- 600 gr, and the mean indirect bilirubin was 17.72 +/- 4.5 mg/dl. Causes of PJ were breast milk jaundice [%56.3], urinary tract infections [10.4%], blood group [ABO] incompatibility [6.9%], glucose-6-phosphate dehydrogenase deficiency [G6PDD] [5.9%], hypothyroidism [3.7%], Crikler- Najjar syndrome [2.1%], congenital heart disease [1.3%], and other causes [4.4%]

Conclusion: The results of this study showed that in the infants with prolonged jaundice after complete history and physical examination, detection and treatment of urinary tract infections, blood group incompatibility, G6PD deficiency and hypothyroidism should be taken into consideration. Severity of hyperbilirubinemia in UTI and hypothyroidism is low

study on the risk factors for obstetrical brachial plexus palsy

Considerable medical and legal debates have surrounded the prognosis and outcome of obstertrical brachial plexus injuries and obstetricians are often considered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy. During 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled. Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational therapy. They were examined ever 3 months for one year and limbs function was assessed according to Mallet scores; also, maternal and neonatal factors were collected by a questionnaire. There were 10 boys and 11 girls. Of all, 76.2% had Erb's palsy, 19% had total brachial palsy and 4.8% had klumpke paralysis. Risk factors including primiparity, high birth weight, shoulder dystocia, and prolonged second stage of labor were assessed. Electrophysiology studies showed neuropraxia in 52.4% and axonal injuries in 42.9% of the patients. At the end of the first year, 81% of the patients had functioned recovery around grade III or IV of Mallet scores. There were only significant relationships between functional improvement and neurophysiologic findings. Outcome of obstetrical brachial injuries has a close relationship to neurophysiologic study results than other risk factors