Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the ... more Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems globally. While the antibiotic resistance of clinically important bacteria is closely tracked in many developed countries, the types and levels of resistance and multidrug resistance (MDR) among pathogens currently circulating in most countries of sub-Saharan Africa are virtually unknown. Methods: From December 2013 to April 2014, we collected 93 urine specimens from all outpatients showing symptoms of urinary tract infection (UTI) and 189 fomite swabs from a small hospital in Bo, Sierra Leone. Culture on chromogenic agar combined with biochemical and DNA sequence-based assays was used to detect and identify the bacterial isolates. Their antimicrobial susceptibilities were determined using a panel of 11 antibiotics or antibiotic combinations. Results: The 70 Enterobacteriaceae urine isolates were identified as Citrobacter freundii (n = 22), Klebsiella pneumoniae (n = 15), Enterobacter cloacae (n = 15), Escherichia coli (n = 13), Enterobacter sp./Leclercia sp. (n = 4) and Escherichia hermannii (n = 1). Antimicrobial susceptibility testing demonstrated that 85.7 % of these isolates were MDR while 64.3 % produced an extended-spectrum ß-lactamase (ESBL). The most notable observations included widespread resistance to sulphonamides (91.4 %), chloramphenicol (72.9 %), gentamycin (72.9 %), ampicillin with sulbactam (51.4 %) and ciprofloxacin (47.1 %) with C. freundii exhibiting the highest and E. coli the lowest prevalence of multidrug resistance. The environmental cultures resulted in only five Enterobacteriaceae isolates out of 189 collected with lower overall antibiotic resistance. Conclusions: The surprisingly high proportion of C. freundii found in urine of patients with suspected UTI supports earlier findings of the growing role of this pathogen in UTIs in low-resource countries. The isolates of all analyzed species showed worryingly high levels of resistance to both first-and second-line antibiotics as well as a high frequency of MDR and ESBL phenotypes, which likely resulted from the lack of consistent antibiotic stewardship policies in Sierra Leone. Analysis of hospital environmental isolates however suggested that fomites in this naturally ventilated hospital were not a major reservoir for Enterobacteriaceae or antibiotic resistance determinants.
Background: One of the leading causes of neonatal mortality in low-and middle-income countries (L... more Background: One of the leading causes of neonatal mortality in low-and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. The study found 45 (39.8%) infants with early-onset sepsis. Acinetobacter was the most common isolated organism, while Enterobacter had the lowest isolation rate. Carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. Acinetobacter had the highest prevalence of carbapenem resistance, while Pseudomonas had the lowest. Mortality rates in infants infected with carbapenem resistance bacteria (CRB) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (CSB). Conclusions: The frequency of carbapenem-resistant Gram-negative sepsis in our ward was 1.52 percent of all admissions, and Acinetobacter bacteria was the most common cause of this type of neonatal sepsis. Infants infected with CRB had a higher mortality rate than those infected with CSB, 89.3% versus 10.7%.
Background: One of the leading causes of neonatal mortality in low- and middle-income countries (... more Background: One of the leading causes of neonatal mortality in low- and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical v...
Background: Neonatal jaundice is the most common complaint in the early days of birth that can po... more Background: Neonatal jaundice is the most common complaint in the early days of birth that can potentially results in important and irreversible effects. The aim of this study was to evaluate the severity and outcome of jaundice in newborns with ABO and Rhesus (Rh) incompatibility and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Methods: Data of this cross-sectional study was collected using medical records of neonates with diagnosis of jaundice, admitted in the neonatal ward of Abuzar Teaching Hospital, located in Ahvaz, Southwest Iran. Results: Out of 1119 neonates, 272 (24.3%), 11 (1%), and 112 (10%) had ABO incompatibility, Rh incompatibility, and G6PD deficiency respectively. There was no significant difference in neonates with ABO or Rh incompatibility, and G6PD deficiency with severe hyperbilirubinemia (P=0.04). A patient with ABO incompatibility and two neonates with Rh incompatibility and five neonates with G6PD deficiency were suffering the dire consequences of neo...
addition to surfactant on the clinical course of newborns with respiratory distress syndrome: a c... more addition to surfactant on the clinical course of newborns with respiratory distress syndrome: a clinical trial
Background: Early-onset neonatal sepsis (ENOS) is one of the most common causes of mortality in n... more Background: Early-onset neonatal sepsis (ENOS) is one of the most common causes of mortality in neonates. The bacteria causing ENOS are generally transferred from the mother to the infant before or during labor. Objectives: This study aimed to determine the prevalence rate of nasopharyngeal colonization with common bacterial agents causing ENOS and their relationship with blood culture outcomes in neonates. Methods: All neonates transferred to the neonatal intensive care unit were included in the study. Posterior pharynx secretions were swabbed and cultured in blood agar and MacConkey agar. Also, a blood specimen from each neonate was inoculated into a blood culture bottle. The grown bacteria were identified by biochemical standard tests. The antibiotic sensitivity test was performed by the disk diffusion method using Mueller-Hinton agar, and the results were evaluated according to the CLSI guidelines. Results: The pharyngeal specimens collected from 114 newborns were positive in 83...
Introduction: Patent ductus arteriosus (PDA) is a common disorder in premature infants which caus... more Introduction: Patent ductus arteriosus (PDA) is a common disorder in premature infants which causes heart failure. Platelets and C-reactive protein (CRP) play an important role in closure. Objectives: The purpose of this study was to evaluate serum CRP and plasma platelet count in preterm infants with PDA compared to infants without PDA. Patients and Methods: This case-control study was conducted on premature infants with PDA admitted to Imam Khomeini hospital in Ahvaz, Iran (2020-2021). A group of 120 infants with inclusion criteria was selected and divided into two groups of 60 subjects. The preterm infant with PDA and without PDA was defined as the case and control group, respectively. Platelet count, serum CRP, and an echocardiogram were assessed in all infants. The subjects were matched by gender, gestational age, and birth weight. Results: The mean platelet count was 194.67±74.03 (×103 /mm3 ) in the neonate with PDA, and it was significantly lower than in neonate without PDA (...
International Journal of Pediatric Otorhinolaryngology, 2022
Among the problems faced by premature infants after birth are weakness in oral-motor skills and a... more Among the problems faced by premature infants after birth are weakness in oral-motor skills and an inability to achieve oral feeding independence. The Early Feeding Skills (EFS) Assessment is a tool for identifying infant's feeding ability level and determining the levels at which an infant requires support for safe and efficient feeding. Given the effective role of mothers and their involvement in taking care of premature infants and the importance of examining the psychometric properties of tools used for assessing infant's feeding, this study aimed at evaluating inter-rater reliability (between mother and rater) using the EFS Instrument. This is a cross-sectional study. Participants in this study included 30 mothers with premature infants admitted to the NICU ward of Imam Khomeini Hospital in Ahvaz, Iran. To evaluate the inter-rater reliability of the "Early Feeding Skills (EFS) Assessment Instrument", feeding skills of the infants were evaluated by the mother and a rater. Statistical analysis was carried out using Intraclass Correlation Coefficients (ICC) in SPSS software (Ver. 22). The inter-rater reliability of the total score for each section of the EFS Instrument was good (ICC >0.75). ICC values for inter-rater agreement in assessing Oral Feeding Readiness, Ability to Maintain Engagement in Feeding, Ability to Organize Oral-Motor Functioning, Ability to Coordinate Swallowing, Ability to Maintain Physiologic Stability, and Oral Feeding Recovery were 0.87, 0.94, 0.91, 0.85, 0.95 and, 0.80, respectively. If mothers are appropriately trained on the EFS assessment, they can actively participate with the health care professionals providing care to their children. Furthermore, remote participation is possible. The findings of this study revealed significant inter-rater reliability.
Background: Heel prick blood sampling is a painful and stressful procedure performed in NICUs (Ne... more Background: Heel prick blood sampling is a painful and stressful procedure performed in NICUs (Neonatal Intensive Care Unit) to collect blood samples for some diagnostic laboratory tests. The local cold is a simple, effective and safe analgesia in newborns. Due to the side effects of pharmacological methods of analgesia and also the relative impact of non-drug methods available, it can be a good alternative for them. Methods: The current study was a double-blind clinical trial, the infants were born in Imam Khomeini Ahvaz in 2016 and randomly assigned to the case and control groups. In the case group, 20 s after exposure to cold compress on the heels, samples were taken and the control group without exposure to cold compress samples were taken. Pain assessment was performed by CRIES (Pain Scales and Pain Assessment) scale. Data collected by SPSS software version 22 and T-test were analyzed statistically. Results: The current study was conducted on 68 infants assigned to the case and...
We aimed to study lipid levels in pregnant women and their neonates according to the presence or ... more We aimed to study lipid levels in pregnant women and their neonates according to the presence or absence of environmental tobacco exposure (ETS). The study was performed in 150 pair of mothers and neonates subjects who were divided into 2 groups: those who were exposed to ETS and those who were not. 300 blood samples were analyzed for total cholesterol, triglycerides, apolipoproteins A (Apo A) and B (Apo B), and C-reactive protein (CRP). Statistically significant differences were found in TG (60 ± 229 vs. 46 ± 204 mg/dl) and Apo A (30 ± 213 vs. 33 ± 192 mg/dl) levels between the mothers in the case group and the control group (p=0.036 and p=0.02, respectively). Apgar scores in neonates of mothers exposed to ETS were significantly lower (8 ± 1) than those for neonates of mother not exposed (9 ± 0.5) (p=0.038). Expose of pregnant women to ETS causes significant increases of their serum triglyceride and Apo A, while also increasing serum CRP and decreasing Apgar scores in their neonates.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Abstract Background: Respiratory distress syndrome (RDS) is one of the main causes of mortality i... more Abstract Background: Respiratory distress syndrome (RDS) is one of the main causes of mortality in premature neonates. Treatment of these neonates with invasive mechanical ventilation has side effects such as chronic pulmonary diseases. Noninvasive ventilation, such as nasal continuous positive airway pressure (NCPAP) and nasal high-frequency oscillation ventilation (NHFOV), has shown to reduce the burden of chronic lung disease. NHFOV is a promising new mode of noninvasive ventilation and may reduce the need for mechanical ventilation and reduce possible complications. In this study, we hypothesized that early NHFOV would reduce the need for invasive respiratory support in comparison to NCPAP in preterm neonates with RDS. Methods: One hundred twenty-four neonates between 28 to 34 weeks of gestational age (GA) with RDS hospitalized at Imam Khomeini Hospital, Ahvaz in 2016 were included in this randomized controlled study. The primary outcomes were the failure of NHFOV and NCPAP within 72 h after birth. The secondary outcomes were the duration of invasive ventilation and possible side effects. Results: Out of 124 neonates in this study, 63 and 61 neonates were studied in the NHFOV and NCPAP groups, respectively. There were no significant differences between NHFOV (6.5%) and NCPAP (14.1%) groups in terms of rates of primary consequences (p = .13). However, the duration of noninvasive ventilation in NHFOV was significantly less than that of NCPAP group (p = .01). Conclusion: In our study group, preterm infants from 28 to 34 weeks of GA, NHFOV did not reduce the need for mechanical ventilation during the first 72 h after birth compared to NCPAP; however, the duration of noninvasive ventilation in the NHFOV group was significantly shorter.
Background The most common cause of respiratory failure in premature infants is respiratory distr... more Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not ...
Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the ... more Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems globally. While the antibiotic resistance of clinically important bacteria is closely tracked in many developed countries, the types and levels of resistance and multidrug resistance (MDR) among pathogens currently circulating in most countries of sub-Saharan Africa are virtually unknown. Methods: From December 2013 to April 2014, we collected 93 urine specimens from all outpatients showing symptoms of urinary tract infection (UTI) and 189 fomite swabs from a small hospital in Bo, Sierra Leone. Culture on chromogenic agar combined with biochemical and DNA sequence-based assays was used to detect and identify the bacterial isolates. Their antimicrobial susceptibilities were determined using a panel of 11 antibiotics or antibiotic combinations. Results: The 70 Enterobacteriaceae urine isolates were identified as Citrobacter freundii (n = 22), Klebsiella pneumoniae (n = 15), Enterobacter cloacae (n = 15), Escherichia coli (n = 13), Enterobacter sp./Leclercia sp. (n = 4) and Escherichia hermannii (n = 1). Antimicrobial susceptibility testing demonstrated that 85.7 % of these isolates were MDR while 64.3 % produced an extended-spectrum ß-lactamase (ESBL). The most notable observations included widespread resistance to sulphonamides (91.4 %), chloramphenicol (72.9 %), gentamycin (72.9 %), ampicillin with sulbactam (51.4 %) and ciprofloxacin (47.1 %) with C. freundii exhibiting the highest and E. coli the lowest prevalence of multidrug resistance. The environmental cultures resulted in only five Enterobacteriaceae isolates out of 189 collected with lower overall antibiotic resistance. Conclusions: The surprisingly high proportion of C. freundii found in urine of patients with suspected UTI supports earlier findings of the growing role of this pathogen in UTIs in low-resource countries. The isolates of all analyzed species showed worryingly high levels of resistance to both first-and second-line antibiotics as well as a high frequency of MDR and ESBL phenotypes, which likely resulted from the lack of consistent antibiotic stewardship policies in Sierra Leone. Analysis of hospital environmental isolates however suggested that fomites in this naturally ventilated hospital were not a major reservoir for Enterobacteriaceae or antibiotic resistance determinants.
Background: One of the leading causes of neonatal mortality in low-and middle-income countries (L... more Background: One of the leading causes of neonatal mortality in low-and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. The study found 45 (39.8%) infants with early-onset sepsis. Acinetobacter was the most common isolated organism, while Enterobacter had the lowest isolation rate. Carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. Acinetobacter had the highest prevalence of carbapenem resistance, while Pseudomonas had the lowest. Mortality rates in infants infected with carbapenem resistance bacteria (CRB) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (CSB). Conclusions: The frequency of carbapenem-resistant Gram-negative sepsis in our ward was 1.52 percent of all admissions, and Acinetobacter bacteria was the most common cause of this type of neonatal sepsis. Infants infected with CRB had a higher mortality rate than those infected with CSB, 89.3% versus 10.7%.
Background: One of the leading causes of neonatal mortality in low- and middle-income countries (... more Background: One of the leading causes of neonatal mortality in low- and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical v...
Background: Neonatal jaundice is the most common complaint in the early days of birth that can po... more Background: Neonatal jaundice is the most common complaint in the early days of birth that can potentially results in important and irreversible effects. The aim of this study was to evaluate the severity and outcome of jaundice in newborns with ABO and Rhesus (Rh) incompatibility and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Methods: Data of this cross-sectional study was collected using medical records of neonates with diagnosis of jaundice, admitted in the neonatal ward of Abuzar Teaching Hospital, located in Ahvaz, Southwest Iran. Results: Out of 1119 neonates, 272 (24.3%), 11 (1%), and 112 (10%) had ABO incompatibility, Rh incompatibility, and G6PD deficiency respectively. There was no significant difference in neonates with ABO or Rh incompatibility, and G6PD deficiency with severe hyperbilirubinemia (P=0.04). A patient with ABO incompatibility and two neonates with Rh incompatibility and five neonates with G6PD deficiency were suffering the dire consequences of neo...
addition to surfactant on the clinical course of newborns with respiratory distress syndrome: a c... more addition to surfactant on the clinical course of newborns with respiratory distress syndrome: a clinical trial
Background: Early-onset neonatal sepsis (ENOS) is one of the most common causes of mortality in n... more Background: Early-onset neonatal sepsis (ENOS) is one of the most common causes of mortality in neonates. The bacteria causing ENOS are generally transferred from the mother to the infant before or during labor. Objectives: This study aimed to determine the prevalence rate of nasopharyngeal colonization with common bacterial agents causing ENOS and their relationship with blood culture outcomes in neonates. Methods: All neonates transferred to the neonatal intensive care unit were included in the study. Posterior pharynx secretions were swabbed and cultured in blood agar and MacConkey agar. Also, a blood specimen from each neonate was inoculated into a blood culture bottle. The grown bacteria were identified by biochemical standard tests. The antibiotic sensitivity test was performed by the disk diffusion method using Mueller-Hinton agar, and the results were evaluated according to the CLSI guidelines. Results: The pharyngeal specimens collected from 114 newborns were positive in 83...
Introduction: Patent ductus arteriosus (PDA) is a common disorder in premature infants which caus... more Introduction: Patent ductus arteriosus (PDA) is a common disorder in premature infants which causes heart failure. Platelets and C-reactive protein (CRP) play an important role in closure. Objectives: The purpose of this study was to evaluate serum CRP and plasma platelet count in preterm infants with PDA compared to infants without PDA. Patients and Methods: This case-control study was conducted on premature infants with PDA admitted to Imam Khomeini hospital in Ahvaz, Iran (2020-2021). A group of 120 infants with inclusion criteria was selected and divided into two groups of 60 subjects. The preterm infant with PDA and without PDA was defined as the case and control group, respectively. Platelet count, serum CRP, and an echocardiogram were assessed in all infants. The subjects were matched by gender, gestational age, and birth weight. Results: The mean platelet count was 194.67±74.03 (×103 /mm3 ) in the neonate with PDA, and it was significantly lower than in neonate without PDA (...
International Journal of Pediatric Otorhinolaryngology, 2022
Among the problems faced by premature infants after birth are weakness in oral-motor skills and a... more Among the problems faced by premature infants after birth are weakness in oral-motor skills and an inability to achieve oral feeding independence. The Early Feeding Skills (EFS) Assessment is a tool for identifying infant's feeding ability level and determining the levels at which an infant requires support for safe and efficient feeding. Given the effective role of mothers and their involvement in taking care of premature infants and the importance of examining the psychometric properties of tools used for assessing infant's feeding, this study aimed at evaluating inter-rater reliability (between mother and rater) using the EFS Instrument. This is a cross-sectional study. Participants in this study included 30 mothers with premature infants admitted to the NICU ward of Imam Khomeini Hospital in Ahvaz, Iran. To evaluate the inter-rater reliability of the "Early Feeding Skills (EFS) Assessment Instrument", feeding skills of the infants were evaluated by the mother and a rater. Statistical analysis was carried out using Intraclass Correlation Coefficients (ICC) in SPSS software (Ver. 22). The inter-rater reliability of the total score for each section of the EFS Instrument was good (ICC >0.75). ICC values for inter-rater agreement in assessing Oral Feeding Readiness, Ability to Maintain Engagement in Feeding, Ability to Organize Oral-Motor Functioning, Ability to Coordinate Swallowing, Ability to Maintain Physiologic Stability, and Oral Feeding Recovery were 0.87, 0.94, 0.91, 0.85, 0.95 and, 0.80, respectively. If mothers are appropriately trained on the EFS assessment, they can actively participate with the health care professionals providing care to their children. Furthermore, remote participation is possible. The findings of this study revealed significant inter-rater reliability.
Background: Heel prick blood sampling is a painful and stressful procedure performed in NICUs (Ne... more Background: Heel prick blood sampling is a painful and stressful procedure performed in NICUs (Neonatal Intensive Care Unit) to collect blood samples for some diagnostic laboratory tests. The local cold is a simple, effective and safe analgesia in newborns. Due to the side effects of pharmacological methods of analgesia and also the relative impact of non-drug methods available, it can be a good alternative for them. Methods: The current study was a double-blind clinical trial, the infants were born in Imam Khomeini Ahvaz in 2016 and randomly assigned to the case and control groups. In the case group, 20 s after exposure to cold compress on the heels, samples were taken and the control group without exposure to cold compress samples were taken. Pain assessment was performed by CRIES (Pain Scales and Pain Assessment) scale. Data collected by SPSS software version 22 and T-test were analyzed statistically. Results: The current study was conducted on 68 infants assigned to the case and...
We aimed to study lipid levels in pregnant women and their neonates according to the presence or ... more We aimed to study lipid levels in pregnant women and their neonates according to the presence or absence of environmental tobacco exposure (ETS). The study was performed in 150 pair of mothers and neonates subjects who were divided into 2 groups: those who were exposed to ETS and those who were not. 300 blood samples were analyzed for total cholesterol, triglycerides, apolipoproteins A (Apo A) and B (Apo B), and C-reactive protein (CRP). Statistically significant differences were found in TG (60 ± 229 vs. 46 ± 204 mg/dl) and Apo A (30 ± 213 vs. 33 ± 192 mg/dl) levels between the mothers in the case group and the control group (p=0.036 and p=0.02, respectively). Apgar scores in neonates of mothers exposed to ETS were significantly lower (8 ± 1) than those for neonates of mother not exposed (9 ± 0.5) (p=0.038). Expose of pregnant women to ETS causes significant increases of their serum triglyceride and Apo A, while also increasing serum CRP and decreasing Apgar scores in their neonates.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Abstract Background: Respiratory distress syndrome (RDS) is one of the main causes of mortality i... more Abstract Background: Respiratory distress syndrome (RDS) is one of the main causes of mortality in premature neonates. Treatment of these neonates with invasive mechanical ventilation has side effects such as chronic pulmonary diseases. Noninvasive ventilation, such as nasal continuous positive airway pressure (NCPAP) and nasal high-frequency oscillation ventilation (NHFOV), has shown to reduce the burden of chronic lung disease. NHFOV is a promising new mode of noninvasive ventilation and may reduce the need for mechanical ventilation and reduce possible complications. In this study, we hypothesized that early NHFOV would reduce the need for invasive respiratory support in comparison to NCPAP in preterm neonates with RDS. Methods: One hundred twenty-four neonates between 28 to 34 weeks of gestational age (GA) with RDS hospitalized at Imam Khomeini Hospital, Ahvaz in 2016 were included in this randomized controlled study. The primary outcomes were the failure of NHFOV and NCPAP within 72 h after birth. The secondary outcomes were the duration of invasive ventilation and possible side effects. Results: Out of 124 neonates in this study, 63 and 61 neonates were studied in the NHFOV and NCPAP groups, respectively. There were no significant differences between NHFOV (6.5%) and NCPAP (14.1%) groups in terms of rates of primary consequences (p = .13). However, the duration of noninvasive ventilation in NHFOV was significantly less than that of NCPAP group (p = .01). Conclusion: In our study group, preterm infants from 28 to 34 weeks of GA, NHFOV did not reduce the need for mechanical ventilation during the first 72 h after birth compared to NCPAP; however, the duration of noninvasive ventilation in the NHFOV group was significantly shorter.
Background The most common cause of respiratory failure in premature infants is respiratory distr... more Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not ...
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