Background: Although the incidence of neonatal hemochromatosis (NH) is not known exactly, it is one of the causes of acute liver failure in the NEWBORNs. NH is a rare iron metabolism disease characterized by excessive iron accumulation in the tissues that onsets in-utero. Here, a patient diagnosed with NH who developed ascites while investigating the etiology of cholestasis has been presented. Case report: A 35-week-old premature female baby was referred us to investigate the etiology of cholestasis. She had a sibling who died at 34 days of age due to liver failure. Abdominal examination revealed a palpable liver 4 cm from the costal margin. On laboratory, aspartate transaminase was 111 U/L (range 9-80), alanine transaminase 62 U/L (range 8-32), total bilirubin 12. 6 mg/dL, and direct bilirubin 5 mg/dL. Prothrombin time was 18. 4 sec (range 10-14) and INR 1. 86 (range 0. 8-1. 2). Magnetic resonance imaging revealed a diffuse reduction in liver density due to iron accumulation. Focal iron accumulation consistent with NH was observed in hepatocytes in liver biopsy. In the clinical follow-up, the patient developed abdominal distension. Abdominal ultrasonography showed excessive fluid accumulation in the abdominal cavity. Following intravenous immunoglobulin (1g/kg, single dose) and antioxidant cocktail, her abdominal distension subsided and liver function tests regressed. The patient has been discharged on the postnatal 67th day with planned liver transplantation. Conclusion: Neonatal hemochromatosis should definitely be kept in mind in NEWBORNs with hepatic failure. As seen in this case, NH should also be considered in the differential diagnosis of ascites in NEWBORN INFANTs.

Non-ketotic hyperglycinemia (NKH) is a rare autosomal recessive disorder affecting glycine metabolism that is a rare metabolic disorder in INFANTs. The clinical manifestations of poor sucking, hypotonicity, lethargy, hiccups, and seizures develop within six hours to eight days of the birth of an otherwise healthy NEWBORN. The present study introduced a NEWBORN girl with poor feeding and hypotonia in the first day after birth with NKH. In addition, the patient was evaluated regarding hypotonia and poor feeding. The neonatal-onset NKH was diagnosed based on a markedly elevated cerebrospinal fluid/plasma glycine ratio of 0. 32 and confirmed by the genetic test. It is extremely rare that NKH is manifested with poor feeding and hypotonia thus considering this diagnosis in INFANTs with poor feeding and hypotonia is highly important.

Division of Neonatology, Department of Pediatrics, University of California, Irvine (AD 980 to 1037), CA, USA A brief historical review of medicine during the fourth century Islamic civilization or eleventh century AD in Persia or Iran was undertaken with its focus on Avicenna. A physician–philosopher, named Ibn Sina or Avicenna (980 to 1037), followed and further expanded the tradition of western philosophy and medicine by Aristotle, Hippocrates and Galen. Avicenna, a physician, philosopher, astrologist, anatomist, pharmacologist, ethicist and poet wrote, the Canon of Medicine, the most comprehensive medical textbook of its time. This important textbook was extensively used in European medical schools for centuries after Avicenna’s death. In the Canon of Medicine, a chapter is dedicated to the care of the NEWBORN INFANT dealing with hygiene, breastfeeding and upbringing of the child.

We report a case of theophyline intoxication in a NEWBORN INFANT who was given a high dose of aminophyline inadvertently instead of calcium gluconate 10% solution because of similarity of labels and containers. The INFANT presented with jitteriness, hyperreflexia. spasticity. hyperthermia and uncontrolled seizures. The INFANT was managed by double volume exchange transfusion. The serum theophylline level was 24.4 micro g/ml before and 14.3 micro g/ml after exchange. The medical and nursing staff should be very careful in calculating and administering the doses of medications to the NEWBORN INFANTs in order to avoid potentially lethal problems which could happen following inadvertent overdosing of medications. The pharmaceutical companies should use different containers and labels for different medications. The pediatricians should always consider drug intoxication in NEWBORN INFANTs whenever they present with unusual signs and do not respond to the treatment.

Background and Objectives: Approximately 9% of NEWBORNs require some assistance to begin breathing at birth. Considering to prevalence of high risk neonates, the aim of this study is to determine causes of low apgar neonatal birth.Materials and Methods: In this retrospective study, 150 neonates with apgar score less than 7 at 1st minute and 150 neonates with normal apgar were considered randomly from 2003/08/23 to 2004/08/22 in Alzahra hospital which is the main referral center of high risk pregnancy in the north west of Iran and also 20-25 childbirth take place every day.Results: The most important cause of low apgar score in neonates Preterm labor (case 48/6%, control 11/3%, P<0/001); Congenital anomalies (case 26%, control 2/66%, P<0/001); use of general anesthesia in caesarean section (case 32/8%, control 10/4%, P=0/006); Vaccum extraction (case 8%, control 0/7%, P<0/002); Breech presentation (case 17/3%, control 4/7%, P<0/001); Prolonged labor (case 16/7%, control 3/3%, P<0/001); Aloruptio Placenta (case 0%, control 15/4%, P<0/001); PROM (case 19/3%, control 3/3%, P<0/001).Conclusion: It was concluded that low apgar score is significantly associated with a number of fetus, maternal and delivery factors. Findings demonstrated that the main related factors to low apgar score are preterm labor, and utilization of general anesthesia in caesarean labor. The support of vaginal labor, local anesthesia instead of general anesthesia as well as prevention of preterm labor is the practical ways to prevent from low apgar score of NEWBORN INFANTs.

Background: Cerebral arteriovenous malformations are rare congenital anomalies presenting as different symptoms depending on their size and the age of patient.Congestive heart failure is a rare condition in neonatal period and is most common due to structural heart defects, but rarely may be a result of peripheral shunts such as cerebral arteriovenous malformation.Case presentation: A term male NEWBORN INFANT who was delivered by Caesarean Section in Chamran Hospital, Ferdows, South Khorasan Province, June 2016. The INFANT was admitted to neonatal care unit due to nonreactive nonstress (NST) with normal Apgar score. In first postpartum visit, a systolic heart murmur was detected.Echocardiography showed small atrial septal defect secundum type and patent foramen ovale (PFO). He presented clinical manifestations of heart failure after 72 hours of birth. Antibiotic and treatment of heart failure was started. Following excluding most common etiologies of heart failure such as sepsis, anemia and arrhythmias, for detecting less common conditions such as cerebral vascular aneurism a transfontanelle ultrasonography was performed which showed dilated cerebral venous system.Magnetic resonance imaging (MRI) and Magnetic resonance venography (MRV) revealed a large congenital cerebral arterio-venous malformation (CAVM), in right cerebral hemisphere. Finally, he was expired 9 days after birth due to severe heart failure before any definitive treatment for closing CAVM could be done.Conclusion: CAVM are extremely rare vascular anomalies in NEWBORNs which may present occasionally as congestive heart failure in neonatal period. So after excluding other most common etiologies of heart failure such as structural heart defects, screening CAVMs should be done. Inspite of early diagnosis, usually they have extremely poor prognosis.

The present report describes a male NEWBORN with a pulsatile structure beneath the sternum. Echocardiography showed common atrium, a single ventricle, mitral atresia, double outlet right ventricle, subpulmonary stenosis, small pulmonary artery branches, and a thin walled ventricular diverticulum suggestive of Cantrell's syndrome. The diverticulum was resected to prevent life threatening events such as arrhythmias, thrombogenicity, and spontaneous rupture of diverticulum. Maternal use of carbamazepine during pregnancy seems to be the etiologic factor.