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Introduction: Glucose Six Phosphate Dehydrogenase (G6PD) catalyses the first step in pantose phosphate pathway to produce NADPH. NADPH plays an important role in oxidation and reduction of hemoglobine and reduces H202 level. However, in absence of G6PD, NADPH also will be decreased, as a result of severe defect in function of red blood cells occurred. So we decided to survey is prevalence in our region by studying on the umbilical cord blood. Material and Methods: Our study were descriptive-analytic and samples were gathered by Simple Sampling Method. EDTA was used as an anticoagulant. Enzyme activity was measured with the method of Fluorescent spot Test (FST). Chi-Square and logestic regression were used to analyses the data and P<0.05 was considered as significant. Result: From a total of 2160 neonates, 1103 case (51.1%) were male and 1057 case (48.9%) were female. 3.5% of the males and 0.8% of females and over all 2.2% of the neonates were G6PD deficient. Due to chi-square analyses and logestic regression, positive RH increases the risk by 1.6 as compare to negative RH. However we could not find any significant relationship between blood groups and prevalence of G6PD. Conclusion: As our results showed, the G6PD deficiency is more common in male than female. Relation between positive RH and G6PD deficiency were significantly increased. Prevalence of G6PD in Arak City showed 2.2% which is lower than that of north our country (8.7%) as well as lower than other part of the world (10-14.9%). We suggest using the screening umbilical cord blood test on the neonates to diagnose the G6PD deficiency and to promote the primary health care quality and public as well as reduction the social and economical problem of the society.

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Introduction: The use of complementary and alternative therapy is increasing and touch is one of them but several studies have indicated that premature neonates hospitalized in neonatal intensive care unit receive very little touch. The purpose of this research was to determine the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome. Materials and Methods: This is a clinical trial with repeated measures that was performed on 37 neonates with respiratory distress syndrome. An information record form was used for data collection. The information record form was consisted of two parts: demographic information and a table for recording oxygen saturations. Oxygen saturation was measured by Nelkor pulse oxy meter. Information was collected in 3 sequential days. Arterial blood oxygen saturation was controlled 5 minutes before touch, then samples undergone 5 minutes touch and then in 5 and 15 minute intervals arterial blood oxygen saturation was controlled again. Data was analyzed using repeated measure ANOVA. Results: Findings showed that in the first day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/67, 95/91, 96 respectively. In second day, arterial blood and oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/72, 96/05, 96/08 respectively. In third day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/75, 96/16, 96/13 respectively. Arterial blood oxygen saturation in 5 and 15 minutes after touch were more than 5 minutes before touch in each 3 day(p<0.01). But there was no significant difference between 5 and 15 minutes after touch. Data analysis also showed no significant difference comparing arterial blood oxygen saturation in the 3 days. Conclusion: Findings suggested that premature neonates physiologically responded to touch. Nurses working in NICUs must be educated about the importance of touch in providing care for these neonates. Findings showed that touch is useful for premature neonates and this fact can be a start point for other investigations.

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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.

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Background: Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Results: In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Conclusion: Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.

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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.

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Background: Gastric perforation is a rare occurrence in newborns with unknown etiology and risk factors. This study reports a case of acute gastric perforation in a preterm neonate and its risk factors. Case: The patient was a preterm neonate (26 weeks) with NG tube feeding with GI bleeding. The patient underwent abdominal surgery and gastric perforation in the anterior wall was reported. The risk factors for gastric perforation in this neonate were probably prematurity, low birth-weight, N-CPAP, and frequent insertion of NG tube. Conclusion: It can be concluded from this study that identification of risk factors and reducing or eliminating them are vital to the prevention of this complication.

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Background: There is priority for evaluation of micronutrients (vitamin A) in the world, especially in develpoing countries like Iran. Vitamin A has an essentiall role in growth, reproduction, and maintenace of epithelial cells. Vitamin A, especially retinoic acid,  acts like a hormone for gene expression. Vitamin A is necessary for growth of bones and immune system. The role of vitamin A in reducing mortality rates of neonates is well recognized. The aim of research is to evaluate this micronutrient (vitamin A) and the rate of transportation from mother to fetus and its positive effects on birth weight.

Materials and Methods: In this descriptive study, 90 pregnant mothers were selected from private and public hospitals in Arak. Data were gathered through a questionnaire including general information concerning pregnant mothers and also their nutritional diet. The analysis of dietary intake was done by Nutritionist IV software. The measurements of serum and cord blood retinol samples were carried with reverse phase HPLC. Data analysis was done by Pearson correlation.

Results: The results indicated a positive and significant correlation between cord blood retinol of mothers and birth weight of neonates (r=0.22) (p&ge0.05). There was not a significant correlation between serum retinol of the mothers and birth weight of the neonates. Also, there was no significant correlation between retinol intakes of the mothers and birth weight of the neonates.

Conclusion: Improvement of the retinol status of mothers has an effective role in normal birth weight of neonates.

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