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Hypothermia at Birth and its Associated Com- plications in Newborn infants: a Follow up Study
F Nayeri,F Nili
Iranian Journal of Public Health , 2006,
Abstract: Hypothermia is one of the main causes of neonatal mortality in developing countries. The aim of this prospective study was to determine the relationship between hypothermia at birth and the risk of mortality or morbidity among neonates born in Imam Hospital in Tehran, Iran. During a one-year period, body temperature was taken from all newborns using a low-reading rectal thermometer, immediately after their admission into the Neonatal ward of the above hospital. A temperature less than 36.5 C was considered as hypothermia. A questionnaire was filled for each subject. Using logistic regression the risk of development of respiratory distress in the first six hours of birth, hypoglycemia, metabolic acidosis, hyperbilirubinemia, scleroderma, pulmonary hemorrhage, Disseminated Intravascular Coagulopathy (DIC) in the first three days of birth were assessed and compared with the hypothermic and normothermic newborn infants. Nine hundred and forty neonates were enrolled into the study. A significant relationship was found between hypothermia and respiratory distress in the first six hours of birth and death, as well as with jaundice, hypoglycemia and metabolic acidosis in the first three days of birth (P=0.0001). Logistic regression showed that, regardless of weight and gestational age, hypothermia at birth alone could increase the risk of neonatal death (OR=3.64, CI=1.85-7.18), Respiratory distress (OR=2.12, CI=1.53-2.93), metabolic acidosis (OR=2.83, CI=1.74-4.59) and jaundice (OR=2.01, CI=1.45-2.79). Neonatal hypothermia at birth increases mortality as well as significant morbidity and hospitalization period.
A Brief Report on IPM School on Cosmology 1999
F. Nasseri,A. Nayeri
Physics , 1999,
Abstract: A brief report on the first IPM School on Cosmology 1999 is given. The School on "Large Scale Structure Formation" was held for the first time in Kish University, Kish Island, Iran. The next IPM School on Cosmology will be held in 2002 on "High z-Universe" and "CMBR".
Incidence of cleft lip and palate in Tehran
Jamilian A,Nayeri F,Babayan A
Journal of the Indian Society of Pedodontics and Preventive Dentistry , 2007,
Abstract: The purpose of this study was to assess the epidemiology and some of the possible risk factors causing oral cleft in Tehran. The study was a 7-year retrospective study from March 1998 to March 2005. Twenty-five live births with cleft lip and/or palate (CL ± P) were born between 20 March 1998 and 20 March 2005 from the total of 11,651 live births in a maternity hospital in Tehran. After recognizing the child as a cleft patient, previous and following children born were recognized as a noncleft sample. Cleft and noncleft samples were compared for variables such as gender, mother′s age, parity, consanguineous marriage and infant′s weight, and then analyzed with Chi-square. The overall incidence was 2.14 per 1000 live births. CL+ P is more prevalent, which was 52% and the least incidence was for "only cleft lip′′ patients, which was 12%. This study reveals that the incidence of oral clefts in Tehran is higher than many other countries. Consanguineous marriage and low birth weight in cleft group were significant statistically from those of noncleft group.
Prevalence of Anaerobic and Aerobic Bacteria in Early Onset Neonatal Sepsis
F Nili,SM Saleh Tabib,E Amini,F Nayeri
Iranian Journal of Public Health , 2008,
Abstract: "nBackground: To determine prospectively the prevalence of anaerobic and aerobic infection in early onset (during 72 hours of age) neonatal sepsis, in Tehran Vali-e-Asr Hospital."nMethods: Among all the live birth, neonates suspecting of having septicemia were investigated for isolation of micro-organisms. Culture bottle containing enriched tryptic soy broth was used for standard blood culture system to detect aerobes and an ANAEROBIC/F bottle was inoculated using BACTEC 9120 continuous monitoring blood culture system to deter-mine the growth of anaerobic bacteria. Among 1724 live births, 402 consecutive neonates suspecting of having septicemia were investigated for isolation of micro organism."nResults: A total of 27 episodes of early onset neonatal sepsis occurred with an incidence of 15.66 (11.6 aerobe + 4.0 anaer-obe) per 1000 live births. Aerobic bacteria were the major etiological agents, accounting for 20 cases. 7 (26%) cases had posi-tive blood cultures with anaerobic bacteria. Propionibacterium and Peptostreptococccus (amongst anaerobic) and coagu-lase-negative staphylococci and staphylococcus aureus (amongst aerobic) were the most commonly isolated organisms. Compari-son of clinical findings and demographic characteristics between aerobic and anaerobic infection did not have a signifi-cant statistical difference."nConclusion: Our impression is that while anaerobic bacteremia in the newborn infants can occasionally cause severe morbid-ity and mortality, majority of cases experience a self limited illness with transient bacteremia.
Neonatal weaning from ventilator: PSV versus SIMV mode
Nayeri F,Goodarzi R,Amini E,Nili F
Tehran University Medical Journal , 2009,
Abstract: "nBackground: The use of synchronized intermittent mandatory ventilation (SIMV) and pressure support ventilation (PSV) have been used for older children and adults. The purpose of this study was to compare PSV and SIMV modes in weaning from mechanical ventilation in neonate with respiratory failure. "nMethods: A randomized clinical trial study carried out in NICU ward of Valiasr hospital Imam Khomeini Hospital complex, Tehran, Iran. Thirty neonates enrolled in two groups of 15. At the weaning time they randomly assigned to SIMV or PSV. They compared for tidal volume (VT), peak inspiratory pressure (PIP), incidence of pneumothorax, weaning failure and duration of weaning. For two groups to be homogeneous, maternal disease during pregnancy were also considered. "nResults: In this study, VT, PIP, incidence of pneumothorax and weaning failure did not differ between groups; duration of ventilation of the two methods (hours) and duration of hospitalization (days) were separately calculated. The only meaningful difference in two groups were due to weaning duration. The neonates weaned by PSV mode experienced shorter weaning time. (6.05 hours). The weaning time in SIMV mode was longer (45 hours) (P=0.006). There were no other meaningful differences between the two groups "nConclusions: According to the results of this study there were no advantage using PSV over SIMV except that the weaning time were shorter in PSV. This decrease in weaning time causes less dependence of the neonate to the ventilator and as a result secure them from complications.
The Effects of Temperature and Birth Weight on the Transition Rate of Hypothermia in Hospitalized Neonates Using Markov Models
A Akbarzadeh Baghban,S Jambarsang,H Pezeshk,F Nayeri
Tehran University Medical Journal , 2012,
Abstract: Background: Hypothermia is an important determinant of survival in newborns, especially among low-birth-weight ones. Prolonged hypothermia leads to edema, generalized hemorrhage, jaundice and ultimately death. This study was undertaken to examine the factors affecting transition from hypothermic state in neonates.Methods: The study consisted of 439 neonates hospitalized in NICU of Valiasr in Tehran, Iran in 2005. The neonates' rectal temperature was measured immediately after birth and every 30 minutes afterwards, until neonates passed hypothermia stages. In order to estimate the rate of transition from neonatal hypothermic state, we used multi-state Markov models with two covariates, birth weight and environmental temperature. We also used R package to fit the model.Results: Estimated transition rates from severe hypothermia and mild hypothermia were 0.1192 and 0.0549 per minute, respectively. Weight had a significant effect on transition from hypothermia to normal condition (95% CI: 0.1364-0.4165, P<0.001). Environmental temperature significantly affected the transition from hypothermia to normal stage (95% CI: 0.0439-0.4963, P<0.001).Conclusion: The results of this study showed that neonates with normal weight and neonates in an environmental temperature greater than 28 °C had a higher transition rate from hypothermia stages. Since birth weight at the time of delivery is not under the control of medical staff, keeping the environmental temperature in an optimum level could help neonates to pass through the hypothermia stages faster.
A comparison between the growth trend of normal and low birth weight newborns during the first year of life
Nayeri F,Kheradpisheh N,Shariat M,Akbari Asbagh P
Tehran University Medical Journal , 2009,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Low-birth-weight (LBW) children are at higher risk for failure to thrive. The aim of the study was to establish the trend of physical growth in Until now their growth was evaluated with normal birth weight baby's chart."n"n Methods: In this cohort study we investigated demographic characteristics and growth trend during the first of life 406 newborn divided into three groups: LBW (Low Birth Weight) n=103, VlBW (Very Low Birth Weight) n=20 and NBW (Normal Birth Weight) n=303. Body weight, length and head circumference were measured at the time of birth and several follow ups until 12 months of chronological age."n"n Results: NBW growth trend adopts the standard chart. Significant differences in terms of physical growth (weight- height- head circumference) were seen between the two groups of preterm (LBW & VLBW) and NBW children. Although it was demonstrated that growth velocity of preterm & NBW children were the same. Significant differences for weight was seen between VLBW and LBW group only until 6 months after birth. This difference was seen for height and Head circumference until the end of the first year of life. "n"nConclusions: VLBW and LBW babies need special growth charts. But the adjustment method of anthropometric traits to gestational age may be useful to evaluate LBW baby's growth.
To assess role of staffing in nursing productivity: a qualitative research
Dehghan nayeri N,Nazari A,Salsali M,Ahmadi F
Hayat Journal of Faculty of Nursing & Midwifery , 2006,
Abstract: Background & Aim: Nurses have the major role at care continuity and health promotion. They frequently affect total productivity in a organization. However, the nurses believe that due to several barriers they have not desire productivity, therefore the health care have been left at level of quality. The aim of this research are assessing nurses' view about productivity and role of human resource on it. Methods & Materials: This study has been done based on grounded theory method. Open interviews has been used for gathering of data. Sampling was purposive in beginning study but so that study was proceeding and categories were completed, it changes to theoretic sampling. Constant comparative analysis was method of data analyses. Results: Essential themes emerged from the data in human resource category. These are: systemic calculating number of staff, accurate staff select and use criteria for them, provide adequate staff from various categories in total year's day, accept patient when as coordinate to in charge nurse and well communication. These make necessary groundwork for productivity. Then accidents that emerged from inappropriate quantity and quality of human resource will be decreased. These enhance nursing productivity the biggest group of health care services. Model of Productivity and human resource effects on it’s, from nurses' view, has concluded of this research. Conclusion: In nurses' view that participates in this research, human resource can affect on productivity process and improve it, then it lead to develop quality care- health care vision and goal.
Life expectancies and outcomes in extremely low birth weight neonates
Nayeri F, Amini E, Shariat M, Mansoori B
Tehran University Medical Journal , 2008,
Abstract: "n Background: Much has changed in neonatal care for extremely low birth weight (ELBW; birth weight <1000g) infants over the recent years in Iran, resulting in an increase in their survival rate. We determined neonatal survival and short-term morbidity rates among ELBW infants, and the correlation of these factors with mortality risk. "n"nMethods: All single live-born ELBW babies delivered at Vali-e-Asr Hospital over a four-year period were identified. Data that were prospectively collected included: maternal age, prenatal and perinatal complications, antenatal steroid use, birth weight, gestational age, route of delivery, sex, need for resuscitation, APGAR score, need for mechanical ventilation, and complications including respiratory distress syndrome (RDS), sepsis, jaundice, intraventricular hemorrhage (IVH), necrotizing entrocolitis (NEC) metabolic and hematologic and cardiac disorders. Information was statistically analyzed and a probability value of <0.05 was considered significant. "n"nResults: A total of 93 neonates were included in the study. The survival rate in the delivery room was 36.6%. The lowest birth weight was 400g, with a mean birth weight of 850.43(±136.48)g, and the lowest gestational age was 22 weeks. The mean gestational period was 28.31(±2.77) weeks. The most frequent complication after birth was RDS(69.89%) and the least frequent was NEC (6.4%). Short and normal gestation was observed in 44.08% and 48.4% of the neonates, respectively. There was a significant relationship between neonatal mortality and the need for resuscitation after birth, RDS and need for a respirator (p<0.05). "n"nFurthermore, there was significant increase in mortality among neonates with gestational age <30 weeks, birth weight under 750g and lack of steroids before birth (p<0.05). "n"nConclusions: To enhance perinatal and neonatal care and decrease the rate of preterm labor, improved standard resuscitation and increased administration of antenatal steroids and respirators are required.
Evaluation of the Cause and Pedisposing Factors in Neonatal Mortality by Using International Coding Diseases Version 10 in Valiasr Hospital
F Nayeri,E Amini,Z Oloomi Yazdi,A Dehghan Naieri
Iranian Journal of Pediatrics , 2007,
Abstract: Background: According to the fact that the reduction of Neonatal Mortality Rate is correspondent to improvements in health and hygienic status of the society, understanding the major neonatal mortality causes will help the society to plan better prenatal and neonatal care systems. Methods: On this retrospective study, the major causes of the mortality of the dead neonates were extracted from files of Vali-Asr hospital according to the International Coding of Disease Ver 10 (ICD10). Data were analyzed in proportion to gestational age , birth weight , gender and neonatal age. Findings: Mortality rate was higher during the first week of life (78%). Generally five main causes of death were; prematurity, respiratory distress syndrome, intra cerebral hemorrhage, multiple congenital anomalies and air leak syndromes. It was also revealed that the causes of death of low birth weight neonates were similar to those of premature neonates (respiratory distress syndrome, prematurity, intra cerebral hemorrhage, septicemia and air leak syndromes). Similarly there was no difference between the causes the of death in mature neonates and appropriate for growth age neonates. The main causes of death in these two groups were; congenital disease, infections (septicemia and Pneumonia), asphyxia, diffuse intra vascular coagulation, intra cerebral hemorrhage, meconium aspiration and complications of pregnancy. Data analysis indicated significant relationships between death and gestational age, neonatal age and birth weight (P=0.001) but it was not related to gender. Conclusions: With due attention to the easy application of ICD 10 for determining the major and underlying causes of death of neonates and the fact that autopsy is not routinely applicable in neonatology wards, routine using of ICD 10 for classifying the causes of death in death certificates is highly recommended.
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