Protective effect of topiramate on hypoxic-ischemic brain injury in neonatal rat

Objective:To explore protective effeet of topiramate(TPM) on hypoxic—ischemic brain injury.Methods:A total of 360 neonatal rats were seleeted then randomly divided into sham operation group,ischemia and hypoxia group,conventional treatment group and degradation therapy group(n=90).After surgical treatment,sham and ischemic hypoxia group were treat with normal saline:conventional treatment group was received Tl'M solution 100 mg/kg.2 times/d:degradation therapy group received TPM solution 150 mg/kg.2 times/d.per 3 d treatment each dosage was reduced 50 mg/kg.the lowest reduced to 50 mg/kg.Four groups received continuous treatment for 10 d.After treatment for 1 d.4 d.7 d.10 d the cercbral edema,neuron-specific enolase(NSE)and γ-aminobutyric acid(GABA) levels and cognitive abilities of four groups were observed.Results:After 1d.4d of treatment,the brain water conlenl and NSE levels in ischemia and hypoxia group,the conventional treatment group and the degradation therapy group were significantly higher than that in sham group(P<0.05),the brain water content and NSE levels of the conventional treatment group and the degradation therapy group were significantly lower than that in the ischemic hypoxia group(P<0.05).GABA levels and learning ability of the ischemia and hypoxia group,the conventional treatment group and degradation therapy group were significantly lower than the sham group(P<0.05).the GABA levels and learning ability of the conventional treatment group and degradation therapy group were significantly higher than the ischemia and hypoxia group(P<0.05).After 7d.10 d of treatment,the brain water content and NSE levels in the sham operation group,the conventional treatment group and degradation therapy group were significantly lower than the ischemia and hypoxia group(P<0.05).while the GABA levels and learning ability of these three groups were significantly higher than that in the ischemia and hypoxia group(P<0.05>.the GABA levels in the conventional treatment group were significantly higher than degradation therapy group(P<0.05);After 10 d of treatment,the GABA levels of the conventional treatment group were significantly higher than the sham group,the learning ability of the degradation therapy group and sham operation group were significantly higher than the conventional treatment group(P<0.05).Conclusions:The correct amount of short—term TPM has protective effect on hypoxic—ischemic brain injury,but long-term or excessive use may cause new damage to the brain and reduce the cognitive ability.

Study on the mechanism of Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules for neonatal jaundice treatment

Objective:To observe the mechanism of Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules for neonatal jaundice treatment and offer clinical help to neonatal jaundice treatment. Methods:80 children with neonatal jaundice were selected and randomly divided into groups:the observation group (40 children) and the control group (40 children). The patient in the control group were treated with blue light and the patients in the observation group were treated with Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules. Biochemical parameters [TBA (total bile acid), TSB (serum total bilirubin), DB (Direct bilirubin) and TCB (Percutaneous jaundice index)], nerve factor [NSE (neuronspecific enolase), Aβ(βamyloid protein) and S100B (Astrocyte derived protein)] and myocardial enzyme spectrum [LDH (lactate dehydrogenase), CK (creatine kinase) and CK-MB (isoenzymes of creatine kinase)], liver function [ALT (Alanine aminotransferase) and AST (glutamic-oxalacetic transaminase)] and renal function (BUN and Cr) were detected and analyzed before and after treatment. Results:The comparison of Biochemical parameters, nerve factor and myocardial enzymes, liver function and renal function in the two groups before treatment were not statistically significant (P>0.05). Biochemical parameters (TBA, TSB, TCB and DB), nerve factor (NSE, Aβand S100B) and myocardial enzyme spectrum (LDH, CK and CK-MB), liver function (ALT and AST) and renal function [BUN (urea nitrogen) and Cr (creatinine)] in both groups after treatment significantly decreased compared with that before treatment. The changes were statistically significant (P<0.05). Biochemical parameters (TBA, TSB, TCB and DB), nerve factor (NSE, Aβand S100B) and myocardial enzyme spectrum (LDH, CK and CK-MB), liver function (ALT and AST) and renal function (BUN and Cr) in observation group after treatment decreased more significantly compared with that in control group. The difference between two groups was considered to be statistically significant (P<0.05). Conclusions:Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules could regulate the Biochemical parameters, protect nerve function and cardiac muscle cells and improve liver and kidney function in newborns with jaundice. So it has a very important clinical significance of the treatment to neonatal jaundice.

Effect of ursodeoxycholic acid combined with bifidobacterium quadruple preparations on myocardial enzyme, immune function and inflammatory response of hyperbilirubinemia neonatal

Objective: To investigate the effects of myocardial enzyme, immune function and inflammatory response by ursodeoxycholic acid combined with bifidobacterium quadruple preparations on hyperbilirubinemia neonatal. Methods: A total of 100 cases of neonatal hyperbilirubinemia in our hospital from June 2016 to May-2017 were selected and divided into control group and observation group by random number table, 50 cases in each group. Two groups of neonatal were given routine symptomatic treatment. The control group was treated with ursodeoxycholic acid and the observation group was treated with Bifidobacterium tetralogy of live bacteria on the basis of the control group. The two groups of neonatal were both treated for 7 d. The serum levels of CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α were measured before and after the treatment of the two groups. Results: Before treatment, there was no significant difference in serum CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α levels between the 2 groups. After treatment: 2 groups of serum CK-MB, CK, LDH, AST, CD8+, CRP, TNF-α levels significantly decreased compared with the group before treatment, CD3+, CD4+ and CD4+/CD8+ levels were significantly increased after treatment, and the observation group with serum CK-MB, CK, LDH, AST, CD8 +, CRP, TNF-α levels were significantly lower than the control group, CD3+, CD4+ and CD4+/CD8+ levels were significantly higher than the control group, the differences were statistically significant. Conclusion: Ursodeoxycholic acid combined with Bifidobacterium quadruple viable tablets can can reduce the activity of myocardial enzyme, improve the state of spectrum index of neonatal hyperbilirubinemia.

Epidemiological, Diagnostic and Evolutionary Profile of Seizures in Young Infants at Albert Royer (Dakar/Senegal)

Introduction: Seizures are one of the most common neurological complications in the infant period. The aim of our study was to describe the epidemiological, clinical, therapeutic and prognostic features of seizures in infants at the Albert Royer Children’s Hospital (Senegal). Materials and Methods: This was a retrospective, descriptive study from 1 January 2012 to 30 September 2018 of infants aged 0 days to 2 months who presented with seizures. Results: The hospital rate was 8.5%. Almost all the mothers (99.1%) had undergone at least 3 antenatal visits. Urogenital infection, gestational arterial hypertension and funicular anomalies were the main pregnancy-related pathologies. Delivery was vaginal in the majority of cases (80.9%). Most infants (43.6%) had not cried at birth. The majority of infants (63%) were born at term. Trophicity was normal in 68% of cases. The average age of the infants was 6.7 days. The main causes of seizures were hypoxic-ischemic encephalopathy (48.7%), metabolic disturbances (48.1%) and central ոеrvοսѕ system infections (15.6%). Phenobarbital was the 1st-line anticonvulsant. The case fatality rate was 39.5%. The main sequela observed were delayed psychomotor development (20.6%). Conclusion: Optimal management of infant seizures requires early diagnosis and etiological treatment by improving the quality of perinatal care to ensure better management of risk factors, as well as increasing the availability of neuroimaging equipment.

Oeis Syndrome (Cloacal Exstrophy): About Two Cases Treated at the Mother and Child Teaching Hospital in Cotonou (Benin)

Introduction: OEIS syndrome, the most severe form of exstrophy-epispadias complex, is characterized by the existence of an omphalocele, a bladder exstrophy, an anal imperforation and a spina bifida. Case Presentation: Two clinical cases admitted at the first day of life in neonatology department are reported;one was born by caesarean section, weighing 2500 g and the other one vaginally with a weight at 1890 g. The first child’s mother was a primigravid, primiparous and the second mother was multiparous. Prenatal ultrasound was performed in one case. The clinical examination found two exstrophied hemi-bladders with two productive ureteral meatus, separated by a double intestinal orifice, a manifestation of anal imperforation, omphalocele, spina bifida and lumbar vertebral malformations;which corresponds to a typical form of OEIS syndrome. One of the babies had an associated clubfoot. The karyotype could not be performed. Both were dead;the first in the early postoperative period, the second one at 16 days of life without surgery. Conclusion: OEIS syndrome is a rare condition and represents a therapeutic challenge in developing countries. Promoting prenatal diagnosis is essential.

Psychomotor Development of Low Birth Weight Infants at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville

Introduction: Low birth weight is a key indicator of newborn health. The objective of this study was to contribute to the reduction of low birth weight-related morbidity and mortality. Patients and Methods: cohort study conducted from January 2019 to July 2020 at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville. All newborns with a birth weight 2500 g were included. The clinical data of patients were studied. They were followed over a period of 12 months and assessed psychomotorly by the Brunet-Lézine scale. Results: 1260/9035 births of low birth weight (14.0%) were observed, and 300 among them were included. The mortality rate was 27.0% (81) and 219 were followed for 12 months. The sex ratio was 0.8, the average birth weight was 2008.6 ± 215.2 g. The average gestational age was 34 ± 12 weeks with 75.3% prematurity. An infant disease was observed in 61.6% of cases and respiratory pathologies were more observed except at 3 months of age where the proportion of digestive pathologies was 20.5%. At the time of the last consultation at 12 months of life, 76.2% of infants had no pathology. The quotients of postural development, language and coordination were normal (between 110 - 70) respectively in 75.4%, 99.1% and 68% of cases at the age of 12 months. The psychomotor development quotient was correlated with the birth weight in the language area r = 0.15 (p = 0.024), posture r = 0.15 (p = 0.015) and coordination r = 0.15 (p = 0.026) respectively. Conclusion: Low birth weight is a public health problem at UHCME-JEF. Despite the fact that psychomotor development can be said to be satisfactory, many efforts remain to be made to reduce low birth weight levels and improve survival.

Emergency Airway Obstruction in Newborn Due to Congenital Saccular Cyst

Laryngeal cyst causing neonatal airway obstruction during labor is a very rare condition [1]. Congenital laryngeal cysts are a rare cause of neonatal airway obstruction. Traditionally, these cysts have been treated surgically by endoscopic excision or marsupialization. However, the cyst often extends beyond the larynx. We describe a case of a newborn that, during delivery, became cyanotic due to airway obstruction and respiratory distress. To the best of our knowledge this is the first report of a saccular cyst obstructing airway during birth prior to intubation. The immediate and late treatments together with a literature review are described.

Effects of montelukast sodium combined with pidotimod on acute phase protein and immune function in children with acute bronchitis

Objective: To observe the effects of montelukast sodium combined with pidotimod on acute phase protein (APP) and indexes of immunologic function in pediatric acute bronchitis treatment. Methods: A total of 180 cases children with acute bronchitis acted as research objects were randomly divided into control group (n=65) and observation group (n=63). On the basis of conventional therapy, control group was treated by plus pidotimod. On this base, observation group was treated with montelukast sodium. The changes of acute phase proteins (CRP, HP, a1-AAG and CER) and immune function (CD3+, CD4+, CD8+ and CD4+/CD8+) levels before and after treatment were observed after 2 months. Results: Before treatment, CRP, HP, a1-AAG, CER, CD3+, CD4+, CD8+ and CD4+/CD8+ levels of two groups had no statistically significant difference;CRP, HP, a1-AAG, CER, and CD8+ levels of control and observation groups decreased significantly after treatment, the decreases of observation group were more obvious than that of control group, and the levels after treatment were significantly lower than that of control groups. The levels of CD3+, CD4+ and CD4+/CD8+ in two groups after treatment were significantly higher than those before treatment. For observation group, the levels of CD3+, CD4+ and CD4+/CD8+ increased more significantly after treatment, which were significantly higher than that of the control group. Conclusion: Using Montelukast sodium combined with pidotimod can effectively reduce the children's acute phase protein levels, improve immune function, which has clinical value for the treatment of children with acute bronchitis.

Antibiotic usage in Chinese children: a point prevalence survey

Background Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. Methods A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and chil-dren in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https ://pidrg -datab ase.sgul.ac.uk/redca p/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. Results The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently pre-scribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibi-tors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children). Conclusions Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropri-ate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.

Portal venous gas resulting from umbilical vein catheterization in a very-low-birth-weight infant with no interruption in early feeding

Introduction Portal venous gas(PVG)is common in necrotizing enterocolitis and occasionally occurs in neonates after umbilical vein catheterization(UVC).Therefore,determining the cause of PVG requires further clinical evaluation in these cases.Case presentation We report the case of a very-low-birth-weight infant who underwent UVC after birth.PVG was an unexpected finding on ultrasound following catheterization.The UVC was immediately removed and replaced with a peripherally inserted central catheter.The infant’s physical examination was unremarkable.Bedside X-ray revealed neither PVG nor pneumatosis intestinalis,which would indicate the onset of necrotizing enterocolitis.After full evaluation,breastfeeding was started on the same day.The infant did not develop feeding intolerance,necrotizing enterocolitis,or other disorders.Conclusion PVG occasionally occurs in neonates who undergo UVC and is considered to be caused by exogenous gases.PVG is more easily detected with ultrasound than with X-ray and does not affect early feeding in premature infants.

Prevalence of congenital heart disease among live birth in Hainan,China

Background The prevalence and risk factors of congenital heart disease in Hainan is currently unknown.Methods This study enrolled 117005 consecutive neonates born at delivery institutions of 17 urban and rural regions in Hainan from January 1,2020 to December 31,2020.Cases of CHD were identified by pulse oximetry(POX)combined with auscultation screening,echocardiography,and follow-up.Results A total of 572 newborns(50.7%males)were diagnosed with CHD,providing an overall CHD prevalence of 4.89 per 1000 live births in Hainan,and the prevalence of insignificant,significant,serious and critical CHD was 2.13,2.25,0.28 and 0.23 per 1000 live births,respectively.The most common congenital heart lesion was atrial septal defect(ASD),at a prevalence of 1.889 per 1000.Compared with those without CHD,the proportion of preterm births was obviously higher among the newborns with CHD,especially the newborns with significant and critical CHD.Compared with those without CHD,The proportion of low birthweight infants was obviously higher among the newborns with CHD(serious and critical).In comparison to the Chinese Han population,some other ethnic groups(Miao,Hani and Mi)showed an obviously higher prevalence of CHD.Correlation analysis showed that the prevalence of CHD was positively correlated with altitude(r=0.513,P=0.035).Conclusions Pulse oximetry(POX)combined with auscultation is suitable for CHD screening in remote areas.Premature birth,low birth weight and the rise of altitude were risk factors for CHD.This study obtained accurate data on the prevalence and risk factors of CHD in Hainan,which provided the epidemiological information of CHD in Hainan,China.