Prognostic Factors and Mortality Rate in Neonates with Acute Renal Injury in NICU

How to Cite This Article: Esfandiar N, MohkamM, Afjeii A, et al. Prognostic Factors and Mortality Rate in Neonates with Acute Renal Injury in NICU. J Ped. Nephrology 2013 July;1(1):32-36.Introduction: Acute Renal Injury (AKI) is a frequent clinical condition in the Neonatal Intensive Care Units (NICUs). Most AKI causes are preventable; performing rapid preventive, diagnostic, and therapeutic measures could prevent the potential complications. The present study was conducted to define the risk factors and mortality rates of neonates with and without AKI admitted in the NICU of a tertiary care hospital. Materials and Methods: Demographic and biochemical data of NICU of Mahdieh Hospital were collected and analyzed. More than twofold increase in normal serum creatinine level or >0.8 mg/dl (for infants > 4 days age) was defined as AKI. All newborns were divided into two groups: with and without AKI. Risk factors and mortality rates were compared in the 2 groups. Results: The mortality rate of newborns with AKI was 4.5%. The other risk factors for mortality in neonates with AKI were as follows: Hyaline Membrane Disease (HMD) (P <0.03), using mechanical ventilation (P <0.041), using surfactant (P <0.04), first minute Apgar score <5, PCO2 >60 mmHg (P <0.035), birth weight < 2500 g (P <0.003) and serum creatinine (SCr) level >1 mg/dl (P <0.003). ROC Curve revealed that low birth weight was the most significant risk factor for mortality of neonates with AKI admitted in the NICU. Conclusions: Mortality related to AKI was associated with HMD, using mechanical ventilation, the need to surfactant use, low Apgar score, high blood PCO2, high serum creatinine level, and low birth weight. Keywords: Acute Kidney Injury; Prognosis; Hospital mortality; Intensive Care Units; Neonate

Digital monitoring of weight-bearing improves success rates and reduces complications in lower extremity surgeries

The aim of this study is to develop a digital monitoring system to track weight and evaluate its impact on postoperative outcomes after lower extremity surgeries (LES). This parallel randomized controlled trial enrolled 266 patients who underwent LES (fracture or joint replacement) at our medical center between March 11, 2022, and January 10, 2023. Patients were randomly assigned to the intervention and control groups in a 1:1 ratio. The intervention group (n=116) used a cane and shoes equipped with a weight-bearing system after lower limb surgery, while the control group (n=116) used a simple cane and shoes without a weight-bearing system. The primary outcomes included callus formation, duration of union, and success rate of union in the two groups. The intervention group had a significantly higher rate of complete surgical success than the control group (93.9% vs. 79.3%, p=0.001). The intervention group also had a significantly lower risk of non-union than the control group (OR: 2.33, 95% CI: 1.14, 3.48, p=0.001). The mean duration of surgery until the time of union and the meantime of callus formation was significantly lower in the intervention group (p=0.01). The use of a digital monitoring system for weighing in LES significantly increased the success rate and reduced post-operative complications. Therefore, incorporating this system can enhance the rehabilitation process and prevent revision surgeries in patients with LES

Prevalence Study of Femoral Head Avascular Necrosis and Evaluating Mutual Connection between Injury and Viral Infections: Clinical Analysis and Brief Review

Avascular necrosis (AVN) could remain with negligible clinical symptoms, but it would get worsen over the time if it’s left untreated and at the most cases will require surgical treatment. Prevalence of femoral head AVN is almost 0.45% among HIV patients which is approximately 45 times more than the rest of Society. AVN occurs 0.088%-1.33% annually among HIV victims. Avascular necrosis of the femoral head is a bone deteriorating plight. At this study, the clinical prevalence of it has been analyzed among a group of 180 patients at Rasool-e-Akram Hospital (Iran, between 2008 and 2016). Patients were including 121 men and 59 women. Analysis results showed that the prevalence of HCV, HBV, and HIV was 1.7%, 1.1%, and 1.1% respectively. It was found that 63% of patients was currently using immunosuppressive drugs. 17% had a history of drug abuse among which 3.3% were using IV drugs. It was concluded that femoral head AVN is more common among hepatitis and HIV patients.</jats:p

Novel molecular insights and new therapeutic strategies in osteosarcoma

Abstract Osteosarcoma (OS) is one of the most prevalent malignant cancers with lower survival and poor overall prognosis mainly in children and adolescents. Identifying the molecular mechanisms and OS stem cells (OSCs) as new concepts involved in disease pathogenesis and progression may potentially lead to new therapeutic targets. Therefore, therapeutic targeting of OSCs can be one of the most important and effective strategies for the treatment of OS. This review describes the new molecular targets of OS as well as novel therapeutic approaches in the design of future investigations and treatment

Evaluation of the Etiologies of Implant Fracture in Patients With Fractures of the Implants of Lower Limbs' Long Bones

BACKGROUND: Orthopedics implants are important tools for treatment of bone fractures. Despite available recommendations for designing and making the implants, there are multiple cases of fracture of these implants in the body. Hence, in this study the frequency of failure of implants in long bones of lower extremities was evaluated. METHODS AND MATERIALS: In this cross-sectional study, two types of fractured implants in the body were analyzed and underwent metalogical, mechanical, and modeling and stress-bending analysis. RESULTS: The results revealed that the main cause of fractures was decreased mechanical resistance due to inappropriate chemical composition (especially decreased percentages of Nickel and Molybdenum). CONCLUSIONS: It may be concluded that following the standard chemical composition and use of optimal making method are the most important works for prevention of failure of implants

Reporting Outcome and Evaluating the Efficacy of Biplanar Lateral Distal Femoral Osteotomy: Two Years Follow up Study

Introduction: Genu valgum could be approached by uniplanar or biplanar osteotomy in which site union and postoperative knee range of motion play important roles in technique selection.&#x0D; Methods: Study was performed on 30 cases including 14 males and 16 females. Two of them had severe genu varum deformity and 28 had genu valgum. Participants underwent biplanar lateral distal femoral osteotomy. Osteotomy requirement was assessed by Lateral distal femoral angle measurement.&#x0D; Results: Thirty patients underwent the biplanar procedure over the 4 years. Two years follow up showed complete union, full knee range of motion and within the acceptable alignment.&#x0D; Conclusion: Biplanar osteotomy is an effective method to create the wider inner cancellous surface to achieve better osteotomy site union and knee range of motion.</jats:p

A Single Center Report of Vitamin D Deficiency among Young Orthopaedic Patient in Iran

Background: Orthopaedic patients are at risk of having irregular levels of vitamin D and calcium due to lack of motility and sun light exposure. Among entire population of patients, Juvenile members of society are considered high-risk groups for vitamin D inadequacy. By considering the high prevalence of this complaint according to domestic studies in Iran, this study aims to provide a report of vitamin D and related factors among orthopaedic patients in Iran.&#x0D; Methods: Participants were selected based on simple non-probable sampling method. Variables were including age, gender, the serum level of vitamin D, calcium, phosphorus, concurrent diseases, and history of taking nutritional supplements. Results were analysed using SPSS software (version 22, USA).&#x0D; Results: 696 patient with mean age 15.5±1.8 were involved among which 440 participants were male and 256 cases were female. Mean of vitamin D calcium, phosphorous serum level was 12.1±4.3, 9.7± 0.5 and 4.3±0.8 respectively. 208 cases were living at urban and 488 members were living at rural locations. 176 cases had degrees of muscular pain, and 72 patients were suffering from developmental problems, and 32 patients were presenting obvious skeletal deformities.&#x0D; Conclusion: Vitamin D deficiency is a common issue among orthopaedic patients. Young patients are in a high danger for consequence of vitamin deficiency in orthopaedic ward due to critical age of bone formation and growth.</jats:p