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NEONATAL JAUNDICE WITH URINARY TRACT INFECTION

Authors: Shatha H. Ali شذى حسين علي --- Deia K. Khalaf ضياء خلف --- Sinan A. Ibrahim سنان ابراهيم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 1 Pages: 45-49
Publisher: Al-Nahrain University جامعة النهرين

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Background:Urinary tract infection is a common and serious clinical problem in newborns. Renal scarring, hypertension, and even kidney failure can be prevented by early diagnosis and treatment of urinary tract infection. Jaundice is an important and sometimes the presenting feature of urinary tract infection.Objectives:To evaluate the frequency and bacterial profile of urinary tract infection in full term and preterm newborns with hyperbilirubinemia in the first two week of life, and the relation with some demographic parameters.Methods:Seventy two jaundiced neonates were studied. Hematocrit, white blood cell count, reticulocyte count, blood group and Rh, bilirubin (direct and total), Coombs test, and glucose 6-phosphate dehydrogenase level were evaluated. Septic screen and thyroid function test, urinalysis and culture for all patients.Results:Twenty two (30%) out of 72 complain from urinary tract infection. Majority of them were full term 15 (68%), and Body weight > 2.5 Kg 12 (54%), fifteen delivered by normal vaginal delivery (68%). Breast feeding was recorded in 12 (54%), total serum bilirubin level above 20 mg/dl was found in 19 (86%). Gestational age, Normal Vaginal Delivery, Type of feeding, and total serum bilirubin level more than 20 mg/dl had significant correlation with urinary tract infection in jaundiced neonates, while birth weight was not significant. Commonest isolated bacteria was Escherichia coli in 11 (50%), staphylococcus infection in 2 cases (9.1%) have significant correlation with male gender. Ultrasound result was only positive in one (4.5%) neonate and showed pelvi-calceal obstruction.Conclusion:Urinary tract infection is common among jaundiced neonates particularly in males. Escherichia coli is the commonest causative bacteria. Gestational age, normal vaginal delivery, type of feeding, and total serum bilirubin level more than 20 mg/dl had significant correlation with urinary tract infection in jaundiced neonates, while birth weight was not significant.Key word:Neonatal jaundice, hyperbilirubinemia, UTI


Article
The Study of the effect of serum zinc level in the mothers and Neonates on neonatal jaundice in al-diwanyia
دراسة تأثير مستوى الزنك في المصل لدى الأمهات وحديثي الولادة على اليرقان الولادي في الديوانية

Author: Nasma N. Al-Hajjiah نسمة ناجي الحجية
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2018 Volume: 14 Issue: 25 Pages: 88-102
Publisher: Al-Qadisiyah University جامعة القادسية

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Zinc has a role in normal growth and development during pregnancy, childhood, and is needed for the proper sense of taste and smell. Studies on animals, adolescents and low birth weight neonates showed that oral zinc salt intake decreased serum bilirubin level, probably through inhibition of the bilirubin enterohepatic circulation.Objective :To study the effect of serum zinc level of the newborn and their mothers on neonatal jaundice.Patient and methodsA case control study included a total 130, 65 with jaundice and 65 healthy neonates with their mothers. The study was carried out from May to October 2016 at ALhussein hospital for children in Al-Diwanyia city. For all neonates serum zinc, total serum bilirubin, hematocrit, blood group typing and Rhesus were carried out. Serum zinc for the mothers also was measured .Results :Serum zinc in jaundiced neonates was significantly lower than non jaundiced neonates (P<0.05). One hundred and nine mothers out of 130 mothers have low serum zinc. In multipara, zinc deficiency was more frequent in the mothers of both groups and P value (0.69).There was no significant difference was in mean serum zinc level when gestational age was taken into consideration (full term versus pre-term) (P>0.05).Conclusions :This study showed that serum concentration of zinc in neonates with jaundice was significantly lower than that in healthy control.

يلعب الزنك دورًا في النمو والتطور الطبيعي أثناء الحمل والطفولة ، ويلزمه الشعور بالشعور بالذوق والشم. أظهرت الدراسات التي أجريت على الحيوانات والمراهقين وحديثي الولادة الذين يعانون من انخفاض الوزن عند الولادة أن تناول ملح الزنك عن طريق الفم قلل من مستوى البيليروبين في المصل ، ربما من خلال تثبيط الدورة الدموية المعوية للكبد.هدف :لدراسة تأثير مستوى الزنك في المصل من حديثي الولادة وأمهاتهم على اليرقان الوليدي.المريض والأساليبوشملت دراسة مراقبة الحالات ما مجموعه 130 ، 65 مع اليرقان و 65 الولدان الأصحاء مع أمهاتهم. أجريت الدراسة في الفترة من مايو إلى أكتوبر 2016 في مستشفى الحسين للأطفال في مدينة الديوانية. لجميع حديثي الولادة الزنك المصل ، نفذت مجموع البيليروبين في الدم ، الهيماتوكريت ، وكتابة فصيلة الدم وريسوس بها. كما تم قياس الزنك المصل للأمهات.النتائج :كان مصل الزنك عند الولدان المصابين باليرقان أقل بكثير من الولدان غير المصابين باليرقان (P <0.05). مائة وتسع أمهات من بين 130 أمهات لديهن نسبة منخفضة من الزنك في الدم. في النتوءات المتعددة ، كان نقص الزنك أكثر شيوعًا في أمهات المجموعتين وقيمة P (0.69). لم يكن هناك اختلاف كبير في متوسط ​​مستوى الزنك في المصل عند أخذ عمر الحمل في الاعتبار (المدى الكامل مقابل ما قبل الأجل) (P> 0.05).الاستنتاجات:أظهرت هذه الدراسة أن تركيز مصل الزنك في الولدان المصابين باليرقان كان أقل بكثير من تركيزه في التحكم الصحي.


Article
Comparison between continuous and intermittent phototherapy in the management of neonatal jaundice
مقارنة بين العلاج بالضوء المستمر والمتقطع في إدارة اليرقان الوليدي

Author: Muyesser Abdul-Kareem
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2011 Volume: 15 Issue: 2 Pages: 40-44
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objectives: Since 1950s, phototherapy had been the treatment of choice for neonatal jaundice. Continuous phototherapy was the pattern used for many years; however intermittent phototherapy was also used with conflicting and controversial results. This work aim is to assess intermittent phototherapy for the treatment of neonatal jaundice in comparison with continuous phototherapy.Methods: In a prospective clinical study all newborns with neonatal jaundice admitted to neonatology department of Raperin hospital in Erbil, between August 2009 and February 2010, for phototherapy were included in the study. The patients were randomly divided into 2 groups. In the control group continuous phototherapy defined as two hours on and half an hour off was used while in the study group intermittent phototherapy defined as one hour on and one hour off was used. Mean total serum bilirubin level in both continuous and intermittent phototherapy groups were compared after each12, 24, 36, 48, and 72 hours of commencing phototherapy. The effect of biodemographic characteristics (gender, gestational age, birth weight, age in hours, and bilirubin levels at admission) were also studied.Results: There was no any significant difference between the two groups regarding mean total serum bilirubin measured at every 12 hours. There was no any significant difference between the 2 groups regarding biodemographic characteristics (p> 0.05).Conclusion: Intermittent phototherapy is as effective as continuous one in the treatment of indirect hyperbilirubinemia in full term infants and in the absence of hemolytic causes.


Article
Neonatal jaundice in Mosul
اليرقان الوليدي في الموصل

Authors: Hazem A. Mohammed --- Akram J. Ahmed --- Sura K. Mohi aldeen
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2008 Volume: 1 Issue: 141 Pages: 192-195
Publisher: Tikrit University جامعة تكريت

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Abstract

The current study includes 102 neonates with neonatal jaundice (NNJ) who were referred to the laboratory of Department of Biochemistry-Mosul College of Medicine, during a period of one month from 1st of July to 1st of August 2005, All neonates were full- term and presented with jaundice in the first week of life. Measurement of serum bilirubin (SB) concentrations by colorimetric method was done to know the most common type of jaundice that affects the neonates during the first week of life in Mosul city. One hundred two neonates were diagnosed as NNJ, 96 (94,12%) were physiological jaundice (PJ), while 5(4.9 %) were of pathological jaundice. Breast milk jaundice (BMJ) was only the cause of jaundice in one neonate (0.98%). PJ was the most common type of NNJ in Mosul. Moreover, pathological and BMJ were rarely responsible for NNJ

وكان جميع الولدان الدراسة الحالية تضم 102 حديثي الولادة مع اليرقان الوليدي (NNJ) والذين احيلوا الى المختبر من قسم الكيمياء الحيوية والموصل كلية الطب، وذلك خلال فترة شهر واحد من 1 يوليو إلى 1 أغسطس 2005، فترة ولاية كاملة وعرض مع اليرقان في الأسبوع الأول من الحياة. وقد تم قياس تركيزات مصل (SB) البيليروبين بواسطة طريقة اللونية لمعرفة النوع الاكثر شيوعا من اليرقان الذي يصيب حديثي الولادة خلال الأسبوع الأول من الحياة في مدينة الموصل. وتم تشخيص واحد مائتي حديثي الولادة كما NNJ، 96 (94،12٪) من اليرقان الفيزيولوجي (بي جي)، في حين أن 5 (4.9٪) كانوا من اليرقان المرضية. وكان سرطان الثدي يرقان حليب (BMJ) فقط سبب اليرقان في واحدة الوليد (0.98٪). وكان PJ النوع الاكثر شيوعا من NNJ في الموصل. وعلاوة على ذلك، كانت مرضية والمجلة الطبية البريطانية المسؤولة عن نادرا NNJ


Article
Outcome of Neonatal Jaundice In ABO Incompatible Pregnancies

Authors: Shatha Hussain Ali --- Kamal Ismail Mashallah --- lamia Abdul Karrim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 680-687
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Blood group mismatch between the mother and newborn carries substantial risk for neonatal jaundice OBJECTIVE: To study the outcome of neonatal jaundice due to ABO hemolytic disease of the newborn (ABO HDN) and study the relation of epidemiological risk factors and laboratory findings with it´s severity. PATIENTS AND METHODS: In this prospective study, 64 neonates with neonatal jaundice associated with ABO incompatibility were studies. Cases of ABO HDN were diagnosed as those with anemia, reticulocytosis and spherocytes or polychromasia on blood film with or without positive direct Coombs test. Severity of jaundice was regarded according to the type of treatment (phototherapy or exchange transfusion).RESULTS: Forty two patients (65.6%) were males, 46 patients (71.9%) were full term infants, 6 patients (9.4%) had family history of neonatal jaundice treated by exchange transfusion.Only 9 patients (14.1%) presented with TSB level ≥ 20 mg/dl, 8 patients (12.2% ) had PCV level < 45%, 8 patient (12.5%) had reticulocyte count ≥ 5%. Direct Coombs test was negative in all the patients. Twelve patients (18.8%) had abnormal blood film findings . Eight cases (12.5%) had the features of ABO HDN and represented 2.9% from the total admitted cases of neonatal jaundice.Full term babies, positive family history of exchange transfusion, abnormal blood film findings and reticulocyte count were found as significant risk factors for the severity of the jaundice, while gender, body weight, blood group, mode of delivery and parity of the mothers had no significant effect on the severity of the jaundice.CONCLUSION: Not all the cases of ABO incompatibility developed ABO HDN, so laboratory confirmation is required.


Article
Extensive Versus Traditional Phototherapy in Treatment of Neonatal Jaundice

Author: Hayder Hadi Al-Momen*, Muthanna Falah Athab**, Anwer Sabeeh Al-Zubaidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 4 Pages: 390-396
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Neonatal jaundice affects more than 60% of neonates. Phototherapy is the main treatment, and its effectiveness is directly related to the duration of exposure, exposed surface area of the infant, and intensity of light used for phototherapy.OBJECTIVE:To determine the role of extensive phototherapy in the treatment of neonatal jaundice and to compare efficacy of extensive phototherapy with traditional phototherapy.PATIENTS AND METHODS:Over a period of one month occupying throughout April 2017, 100 cases of neonatal jaundice whom either term or preterm, near term (≥ 35 weeks of gestational age), visited Al-Elwiya Pediatrics Teaching Hospital were collected from day zero age, precisely from 1st hour till 240 hours of age. Half of them were put on traditional phototherapy and other half were on extensive phototherapy depending on clinical grounds and their total serum bilirubin levels according to American Academy of Pediatrics guidelines, where a cutline total serum bilirubin (TSB) level of 20-25 mg/ dl was used to identify a phototherapy type.RESULTS:Percentage of improvement in neonates whose treatment included extensive (intensive) phototherapy was 72% compared to 40% for traditional phototherapy, with full term neonates` relative risk (1.9) was higher than preterm (near term babies) (1.7), also males` relative risk (1.84) was higher than females` (1.78), but no significant difference was seen regarding both (gestational age and sex). Breast fed, bottle fed, and mixed fed newborns were improved better in extensive than traditional phototherapy (87.50% vs 41.20%, 55% vs 36.36%, 78.57% vs 45.45%, respectively). Extensive phototherapy was more frequently associated with lethargy as a side effect (12% vs 10%).CONCLUSION:Extensive phototherapy was more effective in treating neonatal hyperbilirubinemia (significant p value= 0.0012), but with a slightly higher percentage of lethargy as a side effect (12% vs 10%).KEY WORDS: neonatal jaundice, traditional phototherapy, extensive phototherapy.


Article
Knowledge regarding neonatal jaundice among a sample of mothers attending some Primary Health Care centers /Baghdad
المعرفة حول اليرقان الولادي لدى عينة من الامهات المراجعات لبعض مراكز الرعاية الصحية الاولية في بغداد

Author: Maral F Thabit مرال فتح الله ثابت
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2019 Volume: 17 Issue: 1 Pages: 77-84
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Neonatal jaundice is most common condition requiring medical evaluation in a newborn and it is yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. Objective: To assess the knowledge regarding neonatal jaundice in a sample of mothers attending some Primary Health Care centers, Baghdad.Patients and Methods: A cross-sectional study was conducted including 265 mothers attending some primary health care centers in Baghdad during November and December 2016. They were subjected to previously structured questionnaire covering many aspects of neonatal jaundice distributed in 3 main domains and the mother's responses were gathered and then statistically analysed by frequency, percentages and percent score for each question responses and domain and the overall knowledge mean score. Results: Family and relatives were the main source of information 39.7% and the results revealed that the mean percent score for knowledge responses was 74% for definition of jaundice, 68% for complications of jaundice and 71% for ways of treatment.The mean overall percent score for knowledge was 71%.Conclusion

خلفية الدراسة: اليرقان الولادي هو الحالة الاكثر شيوعأ التي تتطلب التقييم الطبي عند الوليد وهو التلون الاصفر للجزء الابيض من العينين والجلد عند الوليد بسبب ارتفاع مستويات البيلوروبين.اهداف الدراسة: لتقدير المعارف للامهات يخصوص اليرقان الولادي من خلال عينة من الامهات المراجعات لبعض المراكز الرعاية الصحية الاولية في بغداد.المرضى والطرائق: انجزت دراسة مقطعية شملت (265) من الامهات المراجعات ليعض مراكز الرعابة الصحية في بغداد خلال شهر تشرين الثاني وكانون الاول 2016 تم عرض عليهن استمارة استبيان معدة مسبقا تغطي جوانب متعدده لليرقان الولادي في ثلاثة محاور رئيسيه ومن ثم جمع استجابات الامهات ومن ثم تحليل البيانات احصائيأ باستخدام التكرار والنسب المئوية للاجابات لكل سؤال والمعدل المئوي لكل محور والمعدل المئوي الاجمالي للمعارف.النتائج: العائلة والاقارب هما المصدر الرئيسي للمعلومات في 39.7%..كما اظهرت النتائج بان المعدل المئوي للمعارف هو74% لتعريف المرض ،68% لمضاعفاته و 71% لطرق العلاج بينما كان المعدل المئوي الاجمالي جيدأ 71%.الاستنتاجات : مستوى المعارف كان جيدأ بالنسبه لليرقان الولادي عند عينه البحث.


Article
ABO incompatibility in newborn babies
اختلاف مجاميع ABO بين الام والطفل عند حديثي الولادة

Authors: Afrah A. Salih افراح احمد صالح --- Hanaa N. Jehad هناء جهاد --- Numan N. Hameed نعمان نافع حميد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 4 Pages: 353-357
Publisher: Baghdad University جامعة بغداد


Article
Urinary tract infection and prolonged neonatal jaundice in term infants during the first two months of life: a descriptive study
عدوى المسالك البولية واليرقان الوليدي المطول في الرضع الناضجين خلال الشهرين الأولين من الحياة: دراسة وصفية

Authors: Qusay F. Hassan قصي فرحان حسن --- Nariman F. Ahmed نريمان فهمي --- Numan N. Hameed نعمان نافع
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 2 Pages: 162-168
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Several causes stand behind prolonged neonatal Jaundice (Jaundice that persists more than 2 weeks). Objectives: To find out the frequency of association between Urinary tract infections (UTI) and prolonged neonatal jaundice in term infants during the first two months of life. Patients and methods: We conducted an observational prospective study in children welfare teaching hospital, Medical City Complex, Baghdad. Fifty term infants, less than two months of age, with clinically evident jaundice that has persisted for more than 14 days of life were enrolled; UTI was confirmed by urine culture and sensitivity. Demographic features, historical characteristics, laboratory investigations, abdominal ultrasound findings recorded and analyzed for each patient.Results: UTI was confirmed by urinary culture in 6 infants (12%). E. coli was the most common isolated microorganism. UTI was more common in female patients during the first 2 months of life (66%). Irritability was the most common associated clinical feature (83%). Conjugated bilirubin was found to be the most raised fraction among jaundiced infants with UTI. Jaundice resolved gradually upon treating UTI with proper antibiotics.Conclusions: UTI was found in 12% of infants of less than two months of age with prolonged neonatal jaundice; urine culture should be considered as a part of the diagnostic evaluation for any infant with prolonged neonatal jaundice beyond 14 days of life with unexplained etiology.Key words: Neonatal jaundice, Urinary tract infection (UTI), infants

مقدمة: هناك عدة أسباب تقف وراء اليرقان الوليدي المطول( اليرقان المستمر لاكثر من أسبوعين).الأهداف : لمعرفة العلاقة بين التهابات المسالك البولية ( UTI) و اليرقان الوليدي المطول في الرضع الناضجين خلال الشهرين الأولين من الحياة المرضى والطرق : أجريت هذه الدراسة الاستطلاعية في مستشفى الاطفال التعليمي ، مجمع مدينة الطب في بغداد. تم جمع خمسون رضيع ناضجين ، وأقل من شهرين من العمر، مع يرقان واضحا سريريا مستمر لاكثر من 14 يوما ؛ تم تاكيد التهاب المسالك البولية من خلال زرع البول واجراء فحص حساسية المضادات الحياتية. تم تسجيل الميزات الديموغرافية و الخصائص التاريخية والتحقيقات المختبرية، و نتائج الموجات فوق الصوتية للبطن وتحليلها لكل مريض.النتائج :لقد وجد التهاب المسالك البولية في 6 رضع ( 12 ٪ ) . اى كولاي كانت اكثر الكائنات الحية الدقيقة المعزولة شيوعا. وكان أكثر شيوعا في المرضى الاناث خلال الشهرين الأوليين من الحياة ( 66 ٪ ) .وكان التهيج العلامة السريرية الأكثر شيوعا ( 83 ٪ ) . وكان البيليروبين المباشر اعلى في معظم الرضع المصابين باليرقان مع التهاب المسالك البولية . وقد تحسن اليرقان تدريجيا عند علاج التهاب المسالك البولية بواسطة المضادات الحيوية المناسبة.الاستنتاجات :تم العثور على التهاب المسالك البولية في نسبة 12% بين الاطفال الذين يعانون من اليرقان الوليدي المطول ؛ فحص زرع البول ينبغي اعتباره جزءا من التقييم التشخيصي لأي رضيع مصاب باليرقان الوليدي المطول لاكثر من 14 يوما من الحياة مع المسببات غير المبررة .الكلمات الرئيسية : اليرقان الوليدي ، التهاب المسالك البولية ( UTI) ، الرضع


Article
Assessment of the Role of Gender in the Expression of UGT1A1 Gene in Hyperbilirubinemic Neonates

Author: Hussein Hameed Hassan Mudhaji حسين حميد حسن
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1780-1785
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Neonatal jaundice (NJ) is a significant disease among neonates in Najaf province. It manifests 19% of the total deliveries and 50% of the in-patients, and affects about 60% of term and 80% of preterm neonates during the first week of life. UGT1A1 is a cause of concern in NJ, because it is the most important underlying cause of unconjugated hyperbilirubinemia.Methods: A cohort of 85neonate sorted into three groups according to the TSB level. Group 1 (TSB<5mg/dl), group 2 (TSB 5-15 mg/dl) and group 3 (TSB <15mg/l). UGT1A1expression and TSB level was assessed for both males and females in each group.Results & Discussion: Results showed high inverse correlation between UGT1A1expression and the ratio of males (r= -0.99, P<0.01), while females ratio ex-pressed high direct correlation with UGT1A1 expression level with correlation coeffi-cient of (r=0.99, P<0.01).This might due to physiological maturity differences of liver between both sexes, and the plasma growth hormone (GH) pulses frequencies (released by the pituitary gland) which affects the expression of liver enzymes. It's found that GH pulses are higher in females than in males. Conclusion: concluding that mean UGT1A1 expression level in females is more than that in the males during neonatal period therefore females are less vulnerable to NJ than males.Aim: The aim of this study is to qualify the UGT1A1 gene expression in both males and females therefore determining health and health care requirements.

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