Retinopathy of prematurity (ROP) remains a painful examination, despite the common application of local anesthetic eye drops. This study aimed at examining the analgesic effects of 25% glucose in a premature infant pain profile (PIPP) in the first eye examination of infants with ROP. This three-group, randomized clinical trial was conducted from March to February 2017. One oral dose of 25% glucose solution (1 cc/kg) was administered one minute before the first examination of ROP. Mydriatic and anesthetic eye drops were locally instilled in the eyes before the examination for each group. Then, comparisons were made with the control group, which did not receive oral glucose (B), as well as the group which received 1 ml/kg of distilled water (C). The main investigator, who was blinded to the groups, evaluated pain using PIPP at one minute before, during, and one and five minutes after the procedure (ethics code: IR.TUMS.MEDICINE.REC.1396.3130). The baseline characteristics were comparable between the groups. During the procedure, the group receiving oral 20% glucose showed significantly lower PIPP scores (13.8±1.39) compared to the other groups (group B: 15.95±1.27 and group C: 15.10±1.19) (P=0.001). The positive effects persisted for five minutes in this group after the procedure (7.6±1.26), compared to the other groups (P=0.034). During and after ROP screening, oral 25% glucose in combination with local anesthetic eye drops can cause a significant reduction in pain.

Background Coronavirus disease 2019 (COVID-19), a highly contagious viral disease has spread from Wuhan, Hubei Province, China to all over the world from its first recognition on December 2019. To date, only a few neonatal early-onset sepsis by SARS-COV-2 has been reported worldwide. Case presentation In this report, we present two seriously ill neonates who were born from mothers with stablished COVID-19 pneumonia. Laboratory tests showed lymphopenia with high LDH and hypocalcemia right after the birth. They had fever for days without responding to antibiotics and despite ruling out other potential causes. Both patients had positive RTPCR for SARS-COV-2 in the second round of testing but the first assay tested was negative. Hydroxychloroquine was used to treat both patients; the first patient was treated with it over a period of 14 days before showing signs of improvement. The second patient responded to the treatment over a period of 5 days. Conclusion Although based on the available evidences, vertical transmission of COVID-19 is less likely, many aspects of pathogenesis and transmission of this novel virus are still unclear. Therefore we cannot rule out the vertical transmission totally. Further investigations are warranted to determine the exact mechanisms and routes of transmission.

Background: Since the intraventricular hemorrhage (IVH) is still a serious problem in premature infants associated with poor neurodevelopmental outcomes, there is a need for an accessible tool in order to identify these at high risk neonates. Objectives: To determine if high mean platelet volume (MPV) within 24 hours of birth can identify preterm infants prone to IVH as a simple accessible test. Methods: One hundred premature infants with gestational age (GA) of < 34 weeks with respiratory distress syndrome (RDS) were eligible in this study and were divided into two groups based on the diagnosis of IVH. Measurements of MPV and platelet counts

To estimate the incidence of blood exchange and determine causes and complication of blood exchange and identify strategies for risk reduction of Kernicterus in newborn with jaundice. From March 2004 to March 2006 in neonatal Department in children hospital, medical center Tehran, Iran, 346 neonates were admitted as neonatal jaundice without sign and symptoms of infections. We identified causes and complications of exchange. Of 346 infants with jaundice who received phototherapy. 50, 14.45 percent cases underwent exchange transfusion with mean age 9.38 + 5.75 days. The mean total Serum bilirubin level was 29.39 + 6.13 mg/dl. ABO incompatibility was the most common cause for hyperbilirubinemia. The incidence of apnea was 12% there was no direct death from exchange transfusion. To make payment women aware to observe jaundice regularly after birth of their child and short breast feeding to control dehydration.

Objective Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition with high mortality and morbidity rates in neonatal intensive care unit (NICU) admitted neonates due to severe hypoxemia. The aim of this study was to evaluate red cell distribution width (RDW) as a biomarker of hypoxemia and determine the optimal cutoff point of RDW for identifying neonates with PPHN. Study Design All PPHN diagnosed, NICU admitted term infants with hypoxemia after birth from May 2014 to September 2016 were enrolled as case control and healthy term infants with nonhemolytic jaundice who were admitted for phototherapy on the second or third day of birth were the control group. Blood samples were collected. Multiple logistic regression modeling was used to examine the association between PPHN and RDW. Results Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cutoff point of RDW for identifying neonates with PPHN. RDW was higher in the PPHN group compared with the control group (p < 0.001). Significant predictors of PPHN were mother's underlying disease (p = 0.01) and RDW (p < 0.001). The optimal RDW cut point for prediction of PPHN by the ROC curve analysis was 17.9 (sensitivity = 85.71%). RDW's area under the curve was 0.9197 (p < 0.001). Conclusion RDW may be a simple, valuable, accessible marker for predicting PPHN before performing echocardiography in hypoxemic NICU admitted neonates.

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BackgroundThe survival of neonates who have been admitted to the NICU, especially premature infants with few mortality and morbidity, is the most important attitude.ObjectivesWe presumed whether urinary uric acid/creatinine (UUA/Cr) ratio can be a marker of mortality and adverse outcome in neonates which were admitted to the NICU.Patients and MethodsAll preterm infants admitted to our NICU after birth from March 2014 to April 2015 were enrolled in this prospective cohort study. UUA/Cr was measured during the first day of life. The severity of diseases (indicated by the need for high set-up of mechanical ventilation, complications of prematurity, and duration of stay in the NICU) and neonatal death were considered to be the final unfavorable outcomes. The relationship between the Log-transformation (Ln) urinary uric acid/creatinine ratio and the Apgar score at the first and 5th minute after birth and the duration of stay were analyzed by using linear regression. Statistical analysis was done by using STATA version 11 (STATA Corp, TX, USA). A P < 0.05 was considered to be statistically significant.ResultsA total of 362 preterm infants with a mean gestational age of 32.7 (± 3.9) weeks were admitted to the NICU, out of whom 64 (17.6%) had severe disease and 43 (11.8%) died. The mean UUA/Cr ratio was significantly higher in the admitted neonates (3.30 ± 1.95 vs. 1.36 ± 0.42. P = 0.0001). There was a negative correlation between the UUA/Cr ratio and the 1-minute Apgar score (r = -0.17, P = 0.006) and the 5-minute Apgar score (r = -0.19, P = 0.003). The 1-minute Apgar scores were negatively correlated with the outcome (OR = 0.68; P < 0.001) and the duration of stay (β = -.28; P < 0.001). There was no significant correlation between 5-minute Apgar scores and the outcome. There was a significant positive correlation between the UUA/Cr ratio and an unfavorable outcome (OR = 1.24; CI %95: 1.06 to 1.43, P = 0.006) and increasing duration of stay (β = 0.17; P = 0.009).ConclusionsThe urinary uric acid/creatinine ratio can be used as a simple, noninvasive parameter of the severity of disease and mortality in NICU-admitted neonates.