Introduction:The Clinical and radiological manifestations of newborns with severe VDD have not been studied well.Materials and Methods:We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT) newborns (6: M, 4: F) infant presented to with symptomatic hypocalcemia (seizure) secondary to vitamin D deficiency (VDD) during the first 10 days of life are described. All were exclusively breastfed since birth. All their mothers have low 25 hydroxy vitamin D (25OHD) level <10 ng/mL and were not taking vitamin supplements during pregnancy.Results:FT newborns with hypocalcemia secondary to VDD presented with generalized convulsions (10/10) and craniotabes (8/10), but none had rachitic chest rosaries or joint broadening. Cranial ultrasonographic evaluation was normal. Serum 25OHD concentrations were low in these newborns (13.2 ± 3.8 ng/mL) and their mothers (8.1 ± 1.5 ng/mL). A total of 60% of them had increased parathormone (PTH) concentrations (>60 ng/mL) and 60% had decreased magnesium (Mg) concentrations (<0.7 mmol/L). Their alkaline phosphatase (ALP) concentrations were significantly higher than normal newborns. All other laboratory results (liver function tests, urea and electrolytes, C reactive protein, lumbar puncture, blood culture, and lactate) were normal. In all patients, seizures ceased within 2 days of starting treatment with alphacalcidol and calcium. Radiological manifestations included metaphyseal band of relative lucency (osteopenia), just under the line of provisional calcification, within distal radius (7/10), femur (4/10), and tibia (3/10), mild cupping and haziness of distal radius (2/10).Discussion:Newborns with VDD had significantly lower serum calcium, ALP and PTH and higher phosphate concentrations, compared to older infants with VDD rickets. In newborns with VDD, serum calcium levels were correlated significantly with 25OHD (r = 0.597, P < 0.001), Mg concentrations (r = 0.436, P < 0.001) and negatively with ALP concentrations (r = −0.451, P < 0.001). Serum PTH concentrations were correlated significantly with serum Mg (r = 0.78, P < 0.0001) but not with serum calcium (r = −0.103, P = 0.3) or 25OHD (r = −0.03, P = 0.7) concentrations.Conclusion:The clinical, biochemical, and radiological manifestations of VDD in newborns indicate that they are less adapted to VDD compared to older infants. VD supplementation for mothers and newborns should be considered to avoid short-term complications of VDD in the neonatal period and on the growing infants especially in countries with high prevalence of VDD.
Human growth is a continuous process. Studies defining placental effect on prenatal and postnatal human growth are few. We studied the anthropometric data of hundred mothers who gave birth at term after an uncomplicated singleton pregnancy, and their infants in relation to their placental weight using linear regression analysis. Mother weight, placental weight, and infant length (BL), weight (BW), and head circumference (HC) were obtained at birth and during childhood period (4.5 ± 2 years) of age. At birth, placental weights were correlated significantly with maternal weights (r = 0.21, P = 0.031). Placental weights were significantly correlated with growth parameters of the child at birth and during childhood. Infant BW (r = 0.71, r < 0.001), body mass index SDS (BMI SDS) (r = 0.589, P < 0.001), length SDS (LSDS) (0.567, P < 0.001) and HC (r = 0.699, P < 0.001). During childhood, placental weights were correlated with BMI SDS (r = 0.296, P = 0.002) and HtSDS = (r = 0.254, P = 0.009). LSDS at birth was correlated significantly with HtSDS during childhood (r = 0.445, P < 0.001). Placental weight represents a good marker of fetal growth (at birth) and significantly correlates with early childhood growth in full-term infants.
Stridor presenting soon after birth due to bilateral abductor vocal cord paralysis (VCP) is rare. We report a family with bilateral VCP affecting four male members in two generations and hence suggesting X-linked recessive inheritance. Severe stridor in the neonatal period requires meticulous airway evaluation, and tracheostomy in 35-70% cases. The current trend is towards conservative management and tracheostomy is avoided unless respiratory distress is severe or life-threatening. Neonatal VCP can be an isolated finding, or it can be familial with or without syndromic features. There are very few reports of non-syndromic familial cases. Unlike the cases reported previously, none of our patients required prolonged intubation or tracheostomy suggesting an excellent prognosis in such cases. This is the first case study of congenital familial non-syndromic VCP reported from the Middle East.
Background: Feeding intolerance (FI) is common in preterm infants leading to feeding and gastrointestinal disruptions. FI in newborns can be a sign of a variety of problems, ranging from minor, self-limiting illnesses to serious ones. Many causes are found to cause FI such as low intestinal motility, bacterial colonization, hormonal response, and local immunity response. We aim to find out the characteristics of full-term neonates with FI during the neonatal hospitalization period.Methods: This is a descriptive study that was conducted at King Hamad University Hospital in Bahrain. Our targeted population included neonates with FI. Full-term neonates (gestational age, GA >36 weeks) with lower than 1 week of age were included. Data were investigated and compared with the mode of delivery.Results: In this study, 46 neonates were included and their characteristics of FI were evaluated. The most common symptoms observed in neonates with FI were vomiting (91.3%) and abdominal distension (8.7%). Of the total cases, 52.2% of neonates were born through Cesarean section (C-section), while 47.8% had a vaginal delivery. All the neonates had normal APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores. C-section cases had more vomiting problems than vaginal delivery cases. Abdominal distention was noted more in neonates born via vaginal delivery when compared to C-section.Conclusion: During hospitalization after birth, refusal to feed with frequent vomiting or abdominal distension is a common characteristic of FI in neonates. Newborns with this condition require constant monitoring and supportive care from competent nurses.
Ultrasonographic (US) evaluation of spinal anomalies is limited. MRI is increasingly being used in the diagnosis of spinal anomalies. MRI has been able to show clearly the detailed anatomy of this rare case of type II diastematomyelia with triple splitting of the cord.
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