Background Neonatal adrenal hemorrhage (NAH) is an almost infrequent phenomenon (0.2–0.55%). Mechanical compression and alterations of venous pressure during delivery are considered the most probable explanations. Approximately 10% of the cases might have bilateral involvement. Clinical symptoms include abdominal mass, poor feeding, vomiting, prolonged jaundice, and anemia. Subgaleal hemorrhage (SGH) is one of the most clinically remarkable and potentially hazardous postnatal cranial injuries. Case presentation An early-term Iranian male neonate who was born through spontaneous vaginal delivery and experienced shoulder dystocia was diagnosed with bilateral NAH leading to adrenal insufficiency requiring glucocorticoid and mineralocorticoid supplementation. The SGH and jaundice were other postnatal complications. Serial monthly abdominal and brain ultrasound revealed complete regression of lesions after 70 days. However, after 16 months, the neonate has been still treated with hydrocortisone and fludrocortisone for the adrenal insufficiency diagnosis. He has a lower limit weight for age; however, developmental milestones have been appropriate for age. Discussion and conclusion Adrenal hemorrhage and SGH should be examined and looked for, particularly with proven evidence of difficult delivery and asphyxia in at-risk newborns. Clinical and ultrasound follow-up is mandatory for the assessment of hemorrhage resolution and conservative management. The early detection and treatment of adrenal insufficiency by laboratory examination is strongly recommended in bilateral cases. Furthermore, the early recognition of postnatal SGH to prevent clinical and neurological outcomes seems essential.
Background: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing a significant public health disaster. Objectives: The present study aimed to evaluate the clinical features and laboratory data of neonates born to mothers with COVID-19. Methods: A retrospective multicenter cohort study was conducted from March 20 to September 5, 2020, on all neonates born to mothers with positive real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 or clinically suspected COVID-19. Neonates enrolled in this study were from five different hospitals affiliated with the Tehran University of Medical Sciences. All the newborns were tested for SARS-CoV-2 using nasopharyngeal swabs during the first 24 - 48 hours of life, and a second-time swabbing was performed as indicated at subsequent visits. All categorical data were manifested as frequency (%), and continuous data were shown as mean ± SD. Results: Forty-four neonates born to 39 infected mothers were evaluated during the study period. Nineteen women had complications during pregnancy, including hypertensive disorders, gestational diabetes, preterm labor, etc. Besides, 54.5% of the neonates were born preterm. The mean gestational age and birth weight were 35.11 ± 4.01 weeks and 2,567 ± 898 g, respectively. Fifteen (34.1%) neonates were symptomatic at birth, and during the observation, more neonates became symptomatic. Finally, 27/44 (61.3%) neonates became symptomatic, and 17/44 remained asymptomatic. The most common clinical manifestations were respiratory distress (77.7%), followed by fever or hypothermia (18.5%), gastrointestinal problems (14.8%), and neurologic findings (3.7%). Also, the most common clinical feature of eight neonates with positive RT-PCR was respiratory distress, followed by neurologic symptoms, temperature instability, and gastrointestinal disorder, in sequence. Few abnormalities were seen in laboratory findings. Chest X-rays were abnormal in 22.2% of the neonates. Conclusions: The SARS-CoV-2 infection during pregnancy may cause severe maternal and neonatal morbidities. Neonates with positive SARS-CoV-2 may demonstrate a spectrum of clinical features. The most common feature of neonates born to mothers with COVID-19 was respiratory distress.
Background: Postpartum depression (PPD) is a common psychiatric disorder with a prevalence rate of 10 - 15%. Postpartum depression may have significant adverse effects on infants’ growth and development and mothers’ health status. Virtual cognitive behavior therapy (VCBT) has been introduced as a new therapeutic method. Objectives: The current study was carried out to determine the effect of VCBT versus conventional medical therapy in PPD subjects. Methods: In this randomized clinical trial conducted in 2020 in the postpartum ward of Ziaeean Hospital, 102 women with singleton delivery within one week diagnosed with PPD (Edinburgh questionnaire score of over 9) were randomly considered to receive either medical treatment (sertraline 50 mg/day) or VCBT (training for controlling and confronting depression through social media five days a week for four months) groups. Postpartum depression and infants’ weight were compared at delivery, in the second month, and at the end of the study. Results: According to repeated-measures ANOVA, Edinburgh’s depression scale score did not differ significantly between the groups (P > 0.05), whereas their children’s weight differed significantly between the groups (P = 0.041). The VCBT group showed a better weight gain than those subjected to conventional medical treatment. Conclusions: In this study, there was no significant difference between cognitive behavioral therapy based on virtual content and drug treatment in postpartum healing and the improvement of children’s weight index at two and four months old. Both groups were improved. However, children’s weight gain at four months of age was higher in the group treated with cognitive-behavioral therapy based on virtual content than in the drug-treated group. This suggests that cognitive behavioral therapy based on virtual content, due to the increased awareness of mothers and behavioral changes, may be helpful, especially for women with postpartum depression with low-birth-weight children. This method can be applied in a flexible treatment manner for all women with postpartum depression, which will make women more involved in treatment, and the barriers to their treatment will be greatly eradicated.
Background: Adolescents’ exposure to new communication systems via the Internet and mobile phone can be detrimental if cyberbullying is the case. Objectives: The present study aimed to investigate the prevalence of cyberbullying and detect its contributing factors. Materials and Methods: This cross-sectional study was performed in four girls’ and boys’ high schools in District 17, Tehran, Iran. The research sample was selected using the simple random sampling method. The research instrument was a researcher-made questionnaire encompassing three sections (namely, the experience of being cyberbullied, the experience of attempts at cyberbullying, and close friends’ exposure to cyberbullying). Results: Eighty-five of the respondents (29.82%) had experienced being cyberbullied, 89 persons (30.90%) had made attempts at cyberbullying, and 117 individuals (40.62%) had friends being cyberbullied. Female gender and secondary high school education significantly increased the likelihood of attempts at cyberbullying and being cyberbullied (P < 0.001). Moreover, there was a significant relationship between an increase in time to use virtual tools per week and aging with attempts at cyberbullying (P < 0.001). There was also a significant relationship between being cyberbullied and attempts at cyberbullying (P < 0.001). Conclusions: According to the study findings, the authorities are recommended to implement appropriate educational programs to increase adolescents’ awareness of cyberbullying and culturalization to exploit new communication tools at the school and community levels.
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