Background: Heart rate monitoring has become a ubiquitous part of fetal and neonatal assessment, and has made detection of bradycardia in the fetal and neonatal periods a frequent occurrence. Evaluation of a fetus or neonate with bradycardia requires an understanding of the mechanisms of bradycardia as well as the cardiac and non-cardiac causes of bradycardia. The mechanisms of bradycardia include sinus bradycardia, abnormalities of sinus node function and abnormalities of atrioventricular conduction. In the instances where sinus bradycardia is pathologic, it usually results from non-cardiac disease. Sinus node dysfunction is rare early in life but can arise from surgical interventions, congenital heart disease, or endovascular manipulations. Abnormalities of atrioventricular conduction have a similar etiology but are more common than sinus node disease. Atrioventricular nodal disease can also result from maternal collagen vascular disease, even in the absence of symptoms in the mother. In these cases, epidemiological issues such as heart block in subsequent pregnancies and the maternal risk of developing symptomatic collagen vascular disease become important. The approach to treatment and long-term prognosis for bradycardia in the neonate is highly dependent on the underlying etiology and on the presence of concurrent factors such as structural heart disease.

BACKGROUND AND OBJECTIVE: Vascularization of the developing vertebrate brain occurs exclusively via angiogenesis and formation of new blood vessels from existing vasculature capillaries originating in the cortical brain perineural vascular plexus. In this study, vasculogenesis in cerebral cortex of rat NEWBORNS was investigated.METHODS: NEWBORNS Wistar rat (among 5-15 days after birth) were used. After fixation, the brain of all specimens was processed, serially sectioned and vasculogenesis process by using morphometrical methods and histological studies were carried out. The brain blood volume density was measured and after that data were analyzed.FINDINGS: Our findings revealed that in the first phase of vasculogenesis, endothelial cells formed uncanalized buds which grew out from the body of a principal artery (PA) and extended to same bud in other blood vessel. Later, primitive vascular lumen developed to a sufficient size to allow for the circulation of blood cells. These processes increased continuously until 8 postnatal days.CONCLUSION: These data suggested that in the vasculogenesis of cerebral cortex, there are two steps. In the first phase, there is a migration and translocation endothelial cell during vascular bud forming and lead to cellular cords and in the second phase, the primary vascular cords change to vascular endothelial cell chaining and occurring a canalization process among them for blood circulation.

Background: congenital foot deformities are among the most common congenital abnormalities causing morbidities, disturbing the normal gait and affecting patients’ quality of life. The aim of our study was to find out the prevalence of such abnormalities in neonates born at a referral center in northern Iran. Methods: This study was a descriptive cross-sectional study on the neonates born in Imam Khomeini hospital of Sari in a two-year period. The variables considered in our study were gestational age at the time of delivery, medical conditions complicating the pregnancy including diabetes, chronic hypertension, obstetrical complications like olygohydramnios, polyhydramnios, and malpresentations, mothers' age, chronic diabetes, hypertension, mothers' addiction, sex and birth weight of the newborn, history of having a child with congenital limb anomaly and the type of delivery. Photography of NEWBORNS' feet was taken on first day of birth to be assessed by an orthopaedic surgeon. In addition, the babies were examined the day after birth by one of the two neonatologists and the suspicious cases were referred to the orthopedic surgeon. Statistical analysis was performed by SPSS software. Results: From 2025 neonates studied, 210(10. 4%) calcaneovalgus, 7 (0. 3%) clubfoot, 156(7%) cases of ''PesVarus'', 22 cases of (1. 1%) metatarsus adductus, and 1 case of polydactyl were recognized. Among all variables, only mothers' age and cigarette smoking during pregnancy had association with congenital foot abnormalities. Conclusion: The most prevalent congenital abnormalities in our study was Pes Calcaneovalgus and a positional mild ''Pes Varus''. The low rate of club foot, polydactyly and metatarsus adductus are notable,

Objective: Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in NEWBORNS under mechanical ventilation.Methods: This descriptive cross sectional study was performed in 400 NEWBORNS under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered.Findings: Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax (26%). Fifty six (54.9%) of them were boys and 46 (45.1%) girls.54.9% of NEWBORNS with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs.32% of NEWBORNS without pneumothorax. The most common type (62.7%) of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV). Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different (P=0.017).Conclusion: In NEWBORNS surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation.

Introduction: Congenital anomalies (CAs) are a worldwide problem and an important cause of childhood death, chronic illness, and disability. They result from defective embryogenesis or intrinsic abnormalities in the development process and often lead to long-term disability, which may have significant impacts on individuals, families, health-care systems, and societies. The most common, severe congenital anomalies include heart defects, neural tube defects and the Down syndrome. Although congenital anomalies may be the result of one or more genetic, infectious, nutritional or environmental factors, it is often difficult to identify the exact causes. Some congenital anomalies can be prevented,timely vaccination of the mother, adequate intake of folic acid or iodine through fortification of foods or supplementation during pregnancy, and adequate antenatal care are just 3 examples of primary preventive methods. Physicians involved in the provision of health care for children and adolescents, need a basic understanding of how to evaluate and when to refer children and adolescents with congenital anomalies to the respective subspecialty. Therefore, the aim of this article is to review the incidence, and different patterns of birth defect or congenital anomalies in several Eastern Mediterranean developing countries. Materials and Methods: In this study, the terms Birth Defects, Congenital Anomalies and Congenital Malformations are synonymous and have been used interchangeably throughout this article. Conclusion: This study provides useful information about the extent and range of congenital malformations diagnosed immediately after birth in infants and highlighted the prevalence and types of congenital malformations. Maternal vaccination, adequate intake of folic acid or iodine through fortification of main foods or supplements during pregnancy, and adequate prenatal care are just three examples of contraceptive methods.

Background: The COVID-19 infection, which has been a pandemic since early 2020, can occur in pregnant women and transmit to the baby after birth. There are few reports of this transmission in NEWBORNS. Regarding the effect of multiple causes of respiratory symptoms in a neonate, it is difficult to diagnose COVID19 infection in the newborn. In this regard, the evaluation of antibodies in the blood umbilical cord may be an option. We studied the COVID-19 infection in NEWBORNS. Materials and Methods: In this longitudinal follow-up study, pregnant mothers who had suspicious symptoms of coronavirus infection before or after childbirth were consulted by the medical team for neonatal infection. NEWBORNS were evaluated for respiratory symptoms. PCR test for coronavirus was performed on a pharyngeal swab or tracheal tube sample of the NEWBORNS. Results: Twenty-five pregnant women with symptoms of suspicious coronavirus infections were consulted by a team of specialists from March 15 to April 15, 2020. After delivery, their babies were carefully examined and followed up. Four neonates had coronavirus confirmed by the PCR test. Conclusion: Our study shows that neonates can become infected with Covid-19. This issue should be considered among various differential diagnoses of neonatal respiratory diseases.

Introduction & Objective: One of the standard therapies in neonates with severe respiratory distress syndrome (RDS) is surfactant administration in early course of therapy that cause reduction in mortality, pneumothorax and need to mechanical ventilation. In this study that was carried out in Aliasghar Hospital NICU in 1994-1995 & 2001-2002, the goal was to compare two groups of neonates with severe RDS that had been ventilated in the first 24 hours but one group had received surfactant and the other group (7 years ago) was deprived of this substance.Materials & Methods: In our study, 36 neonates that received surfactant and 52 neonates with only mechanical ventilation therapy were compared. Data collected and analyzed using SPSS.Results: We found that mortality in patients with surfactant administration was significantly lower compared to the second group who did not receive surfactant. There were not any significant differences in incidences of HIV, pneumothorax, sepsis, and PDA and also course of hospitalization and need to ventilation between two groups.Conclusion: As a result, all of these findings reflect obligatory surfactant administration in sever RDS in NICU under observation of an educated expert.

Bakground: Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia as well as the management of subsequent complications in the newborn. However, this treatment modality may itself result in the development of hypocalcaemia and create serious complications including convulsion and related conditions. Objective: This study was under-taken to investigate phototherapy– induced hypocalcemia in hyperbilirubinemic neonates. Methods: 63 healthy term NEWBORNS of >2.5 kg undergoing phototherapy were selected. Plasma bilirubin and calcium levels were determined before and after termination of phototherapy. Results: The difference between pre- and post-phototherapy plasma calcium levels were found to be statistically significant (p<0.05). The decline in plasma calcium level at times reached hypocalcemia threshold. Conclusion: Phototherapy in icteric neonates lowers serum calcium level.

Nephrolithiasis and nephrocalcinosis are common in both term and premature infants who have had difficult neonatal courses. Multiple factors may contribute and being born from a diabetic mother Is one of them.This case is about a neonate with nephrocalcinosis. she is followed to 9months and remained healthy during a 9 month follow up.