Serum Vitamin D Deficiency in NICU Hospitalized Neonates and Its Association With Neonatal Outcomes.

Objective: Vitamin D deficiency is a major health problem in all age groups. In the present study, we aimed to determine the prevalence of vitamin D deficiency in neonates hospitalized in an intensive care unit (NICU) and its association with clinical neonatal outcomes. Materials and methods: A prospective cross-sectional study was carried out on all neonates hospitalized in the NICU of Children's Medical Center over a period of one year (January-December 2018). Immediately on admission, a serum sample for vitamin D measurement was obtained with another routine blood sampling. Demographic and clinical data including sex, gestational age, the season of birth, serum levels of vitamin D and calcium, the causes of hospitalization, age at admission and neonatal outcomes including length of hospital stay and mortality during hospitalization were assessed. Results: One hundred neonates entered the study. Vitamin D deficiency and insufficiency were present in 95% of neonates. There was a significant association between vitamin D status and birth during winter (p=0.014); hypocalcemia (p=0.025) and older age at NICU admission (p<0.001). The mean value of vitamin D in term neonates was significantly lower than in preterm neonates (p=0.031). There were no correlations between length of hospital stay and neonatal mortality rate with vitamin D status (p=0.876). Conclusion: Vitamin D deficiency and insufficiency were highly prevalent among NICU patients. Maternal vitamin D supplementation during pregnancy may prevent or reduce the risk of low levels of vitamin D in neonates.

Fournier's Gangrene in a Neonate With Acute Myeloid Leukemia: A Case Report.

INTRODUCTION: Fournier's gangrene is an infective necrotizing fasciitis of external genital and perineal region. Hematologic malignancies and immunocompromised status are predisposing factors. Simultaneous occurrence of Fournier's gangrene and congenital leukemia in neonates is extremely rare. CASE PRESENTATION: We present a case of Fournier's gangrene in a 4-day-old female infant with a necrotic lesion in perineum and no history of trauma or other predisposing condition. Focusing on high blast percentage in blood cell count she was affected by acute myeloid leukemia (M4 type). Pseudomonas aeruginosa was isolated from the blood and wound culture. She was treated with broad spectrum antibiotics and supportive care. The parents refused chemotherapy and the patient was discharged from hospital. Bleeding and DIC was the cause of death in a local hospital few days later. CONCLUSIONS: High index of suspicion is essential for diagnosis and appropriate treatment. Congenital leukemia should be considered in the differential diagnosis of a newborn with clinical features of sepsis and necrotizing fasciitis.

Evaluation of the Correlation Between Childhood Asthma and Helicobacter pylori in Kashan.

BACKGROUND: Asthma is a chronic inflammatory air-way disease with increasing prevalence rate during the recent years. There are studies about the relationship between asthma and infectious diseases, including the association between asthma and Helicobacter pylori. According to the latest studies, there is an epidemiological correlation between asthma prevalence and prevalence of H. pylori. OBJECTIVES: The aim of this research was to study the correlation between H. pylori and asthma by biopsy in five to eighteen year-old children who had undergone endoscopy at Shahid Beheshti Hospital. PATIENTS AND METHODS: Three hundred children (5 to 18 years old) undergoing endoscopy owing to gastro-intestinal problems at Shahid Beheshti Hospital were observed for childhood asthma using the Gina 2010 questionnaire which included 24 questions with "yes" and "no" answers to identify asthmatic patients with five positive answers. Next, the patients were referred to an allergy and asthma specialist for clinical examinations, spirometry and post bronchodilator test (Post BD). RESULTS: Among 138 H. pylori positive patients, eight cases (5.8 %) were asthmatic while of the 162 H. pylori negative patients 28 (17.3%) were asthmatic. This difference was statistically significant (P Value = 0.002). The correlation between H. pylori and asthma was studied after controlling the confounding variables including, gender, age and family history. The results obtained for the above-mentioned variables were significant (P Values of 0.004, 0.005 and 0.002, and Odd-Ratio Mantel Haenszel (ORMH) of 3.38, 3.24 and 4.06, respectively). CONCLUSIONS: Our findings showed that there is an inverse correlation between H. pylori and asthma. Performing more studies with larger sample sizes is necessary to confirm these results.