A cross-sectional study on the correlation between blood phosphorus level with sepsis and associated prognostic factors in neonates.

Objective: Neonatal sepsis is one of the most critical causes of infant mortality. Alteration in phosphorous levels is known to be associated with sepsis. The aim of this study is to evaluate the level of blood phosphorus in neonates admitted to ICU and its relation with different factors and prognosis of patients. Methods: In this cross-sectional study, all neonates admitted to the intensive care unit diagnosed with neonatal sepsis were included. Serum phosphorus levels were evaluated along with c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and urine and blood culture. Demographic data along with clinical findings were collected in a research questionnaire for all the patients. Results: Of 211 neonates, 98 (46.4%) were female and 113 (53.6%) were male, and the mean age of the patients was 10.51 days. The mean phosphorus level was 4.39 ± 0.67 mg/dL. The mean phosphorus levels among girls and boys was significantly different, p = 0.001 (4.23 ± 0.62 vs 4.53 ± 0.69 mg/dL). The mean phosphorus among positive and negative blood culture patients was also significant, p < 0.001 (4.74 ± 0.67 vs 4.29 ± 0.64 mg/dL). However, type of feeding, ESR, urine culture and CRP status was not associated with phosphorus levels, p > 0.05. Conclusion: The alterations in phosphorous levels among neonatal sepsis patient is likely to be correlated with gender and blood culture status. Other prognostic markers might not have an effect on phosphorous levels in these patients.

Clinical Signs, Prevention and Treatment of Viral Infections in Infants.

Certain infectious diseases are more common in infants than any other age groups and are associated with morbidities in childhood and adulthood, and even mortality in severe cases. Environment, epidemic and maternal immunity are the main causes of these infections. Early diagnosis using molecular methods and treatment is therefore important to prevent future complications. Vaccines are recommended during infancy and childhood to prevent these infections. This review highlights some of the most commonly reported viral infections in children, their clinical signs, prevention and treatment.

Congenital Heart Disease in Non-Diabetic Large-for-Gestational-Age (LGA) Neonates.

BACKGROUND: Congenital heart diseases are the most prevalent congenital abnormalities in the neonates, caused by environmental and genetic factors and contributing to the leading cause of death. This study aims to evaluate the relationship between neonates with large for gestational age and increased risk of congenital heart diseases among non-diabetic mothers. METHODS: In this study, 179 neonates with large gestational age in Khorramabad were enrolled where heart abnormalities were evaluated using echocardiography. RESULTS: 87 neonates had more than 4000 g of birth weight with no heart abnormalities and 92 (51%) macrosomic neonates had congenital heart diseases. Statistical analysis revealed a significant relationship between birth weight and increased risk of acquiring congenital heart disease between the two groups. There was no significant relationship between birth weight, maternal age, gender, labor type and blood group between the two groups. The highest incidence of congenital heart anomalies was related to 38% of arterial septal defect (ASD) and 15.2% of ASD and VSD, respectively. CONCLUSION: The most prevalent abnormality was arterial septal ASD. None of these abnormalities were associated with maternal age, birth weight and neonate gender. Future studies for congenital heart disease and neonatal birth weight are, therefore, recommended.

Antibiotic Susceptibility Evaluation of Bacterial Agents Causing Infection in Children with Acute Tonsillopharyngitis.

BACKGROUND: The aim of this study is to evaluate the prevalence of group A beta-hemolytic pharyngitis by assessing the outcome of the culture and the resistance and sensitivity of group A beta hemolytic Streptococcus to antibiotics. METHODS: This cross-sectional study was conducted on 170 patients aged 3-15 years, referred to the clinic with complaints of sore throat. Patients' history was collected and physical examination was performed and was score based on clinical findings. Patients with other underlying pathologies and those taking antibiotics prior to the study were excluded from our study. Antimicrobial susceptibility test was performed by disk diffusion method against cephalexin, cefazolin, erythromycin and amoxicillin. RESULTS: A total of 170 patients were reported with sore throat. Patients with positive culture results were 60% male and 40% female. Amoxicillin resistance was the greatest (5%) in the culture. All isolated bacteria were sensitive to amoxicillin, cephalexin, cefazolin and erythromycin. Patients with McIssac score ≥ 6 showed clinical sensitivity 75% specificity 61% negative predictive value 94.8% and positive predictive value 20.3% for Group A beta-hemolytic streptococcal pharyngitis. CONCLUSION: The results showed the higher the clinical score, the greater the chance of positive throat culture.

Genetic Anomalies of Growth Hormone Deficiency in Pediatrics.

Several different proteins regulate, directly or indirectly, the production of growth hormones from the pituitary gland, thereby complex genetics is involved. Defects in these genes are related to the deficiency of growth hormones solely, or deficiency of other hormones, secreted from the pituitary gland including growth hormones. These studies can aid clinicians to trace the pattern of the disease between the families, start early treatment and predict possible future consequences. This paper highlights some of the most common and novel genetic anomalies concerning growth hormones, which are responsible for various genetic defects in isolated growth and combined pituitary hormone deficiency disease.

Effect of Phototherapy on Stroke Volume in Newborn Infants with Jaundice.

One of the rare complications associated with phototherapy include redistribution of blood flow that can alter cardiac output in infants. The aim of this study was to evaluate the effects of phototherapy on left ejection fraction in infants with jaundice. Twenty-nine infants admitted in Shahid Madani Children Hospital for receiving phototherapy were included in this study. Echocardiography was performed in the participants, immediately before and 24 hours after the treatment. Nineteen infants were reported to have decrease in the stroke volume following the treatment. The mean levels of stroke volume before and after phototherapy were 6.99 ± 2.17 and 6.55 ± 1.85 L/m 2 , respectively ( p = 0.011). Phototherapy can reduce left ejection fraction in newborn infants with hyperbilirubinemia.

Levofloxacin based vs clarithromycin based sequential therapy in helicobacter pylori eradication; a randomized clinical trial.

AIM: This study was aimed to evaluating the efficacy of levofloxacin based sequential therapy vs clarithromycin based sequential therapy in h.pylori (HP) eradication. BACKGROUND: Several therapeutic regimen were investigated to treat HP infection. Sequential therapy is an alternative to classic triple therapy. METHODS: In this randomized clinical trial, 200 HP infected patients randomly divided into two therapeutic groups .1-Levofloxacin based sequential regimen (group A); omeprazole and amoxicillin for 7days followed by omeprazole, amoxicillin and levofloxacin for 7days. 2-clarithromycin based sequential regimen (group B): omeprazole and amoxicillin for 7days followed by omeprazole, amoxicillin and clarithromycin for 7days. HP eradication was evaluated with urea breath test with carbon 13 (UBT) 6 weeks after the end of treatment. RESULTS: Per protocol eradication rates of group A and B were 87.6% and 76% respectively. By intention to treat analysis, eradication rate of group A and B groups were 85.1% and 73% respectively. Levofloxacin based sequential regimen was more effective than clarithromycin based sequential regimen (Pv=0.028). Adverse events were seen in 19.6% and 15.6% in group A and B respectively. Drug compliance was 97% in group A and 96% in group B. There was no significant difference between two groups in term of adverse events (p=0.470) and compliance (p=0.651). CONCLUSION: Levofluxacin based sequential therapy was more effective than Clarithromycin based sequential therapy in HP eradication. The suggested Levofluxacin based sequential therapy could be an alternative therapy in area with high clarithromycin resistance. Further studies are needed to confirm these findings.