---

Introduction: It is well recognized that hearing is critical to speech and language development, communication, and learning. Otoacoustic emission (OAE) is an efficient and sensitive method to identify subjects at risk for auditory impairment. Infants who require admission to neonatal intensive care unit are reported to be at 10-20 times greater risk for hearing impairment. The porpuse of this study was to investigate the incidence of hearing impairment in neonates screened by OAE. Materials and Methods: In a cross-sectional study, 148 newborns having risk factors for hearing impairment reffering to Taleghani hospital of Arak and Aboozar hospital of Ahwaz were evaluated. All clients had normal otoscopic findings. Transient evoked (TEOAE) and distortion-product otoacoustic emissions (DPOAEs) were measured in both ears. If the results of otoacoustic emissions were not normal, these tests were repeated one month later. Patients who did not pass the second stage were reffered for comprehensive auditory evaluations. Data analysis was performed using Kolmogrov-Smirnov and t-tests. Results: 41 and 28 cases could not pass the examining test at the first TEOAE and DPOAE examination, respectively. Also, 23 and 16 cases did not pass the examining test at the second TEOAE and DPOAE evaluations, respectively. These participants underwent auditory brainstem response evaluation and 11 of them had abnormal responses. In 5 cases of confirmed ones, hearing impairment was due to aminoglycoside side effects. Conclusion: OAE hearing screening of at-risk newborns is a clinically beneficial approach to early detection of hearing impairment. Regarding the high prevalence of hearing loss in our subjects (7.43%), prevention of its complications is highly recommended in this population.

---

Background: Oetection of congenital hypothyroidism (CH) in Arak has begun since 2006. The aim of this study was to investigate on recall rate (RR) and the incidence of this disease in Arak. Materials and Methods: In this descriptive study, according to the national screening program for CH in Iran, heel blood samples of 3-5 day- old neonates were taken on special filter paper and TSH values were measuned using ELISA method. TSH values bigger than 5mu/lit were recalled and thyroid function tests (TSH, T4 and T3RUP) were done on venous blood samples and assayed using ELISA method. Neonates with TSH values >10 mu/lit, T4<6.5 ug/dl were viewed as patients. Data related to neonates born up to the end of March 2009 were recorded in special forms. Results: Of 25685 screened neonates, 608 newborns were recalled. RR was estimated to be 2.36%. TSH values in 3.78% were less than 5, in 83.55% between 5-9.9, in 7.56% between 10-19.9 and in 5.09% more than or equal to 20. Eighty six neonates had CH (1/300 live births). Disease rate in recalled neonates was 14.2%. In 80.26 percent of neonates, sampling was done between 3-5 days while the times of sampling in 18.5 and 1.1 percents of the newborns were in days 6-21 and after day 22, respectively. Conclusion: The incidence of CH in Arak is remarkably higher than national and international rates. RR in Arak is higher than the national but lower than the international rates. Also, the ratio of the disease to the recalled neonates is low.

---

Background: Multiple sclerosis, an immune-mediated demyelinating disorder, is one of the most common diseases of the central nervous system. Two-thirds of patients with multiple sclerosis are women in their child bearing age, 20s and 30s. Multiple sclerosis is followed by neurological disability in young people. The purpose of this study was to determine pregnancy outcomes in patients with multiple sclerosis and compare them with healthy pregnant women. Materials and Methods: In this cohort study,37 pregnant women with multiple sclerosis and 73 healthy pregnant women were compared in terms of pregnancy, child birth, and infant variables. Patient information was collected through questionnaires and evaluated using independent t-test, Chi-square, and Mann-Whitney test. Results: The results showed that pregnancy complications like preeclampsia and gestational symptoms in women with multiple sclerosis were higher than the control group (p=0.001). Instrumental delivery was more in women with multiple sclerosis (p=0.05) and there was not a significant difference between the two groups in terms of neonatal outcomes. Conclusion: The resultsof this study show that some of the complications of pregnancy are higher in women with multiple sclerosis. Also, normal delivery and instrumental vaginal delivery were more in women with multiple sclerosis that couldbe due to fatigue in this population. Hence, these findings should be taken into consideration in planning andmanaging pregnant patients.

---

background: Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province.

Materials and Methods: In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012,127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH&ge5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment.

Results: From127112 screened neonates, 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was . Recall rate was 4.8%. In 94.4% of patients, treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program.

Conclusion: Recall rate and the incidence of CH were higher than those in other studies, both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.