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Background: Respiratory distress syndrome (RDS) is a common lung problem in neonates born before 28 weeks of pregnancy. The current study aimed to assess the clinical outcomes of Nasal Continuous Positive Airway Pressure (NCPAP), as compared to humidified high flow nasal cannula (HHFNC) in the treatment of premature neonates with RDS.Methods: This randomized control trial was conducted on 60 preterm neonates (gestation Results: There were no significant differences in primary and secondary outcomes, including pneumothorax, patent ductus arteriosus (PDA), chronic lung disease, surfactant injection, tracheal intubation, death, necrotizing enterocolitis (NEC), days of delay in establishing full enteral feeds, duration of hospitalization, and the number of the days for oxygen requirement between NCPAP and HHFNC groups.Conclusion: HHFNC and NCPAP techniques have the same efficacy in the treatment of RDS in neonates, and there was no difference between the two techniques in terms of treatment failure and clinical outcomes. Since HHFNC is less invasive with the same efficacy compared to CPAP, we recommend that it can be used as a primary modality in preterm neonates with RDS.

Background: Critical congenital heart diseases (CCHDs) are among the most common birth malformations. This study aimed to determine the cardiac and noncardiac diseases in the Iranian healthy newborns using pulse oximetry (POX) as a suggested screening method.Methods: In this cross-sectional study, healthy term and near term neonates who were born from October 2017 to March 2018 were evaluated. Preductal and postductal POX was performed in all asymptomatic healthy newborns after 24 hours of life or at any time before discharge from the nursery. Oxygen saturation (SPO2) was considered normal if SPO2 was  95%, and the difference between preductal O2 saturation and postductal POX was obtained at ≤ 3%. The POX was repeated after 2 hours for abnormal patients. In the case of the same results in both repeated measures, echocardiography, chest X-ray, sepsis screening, and blood glucose were conducted.Results: A total of 413 asymptomatic healthy term and near term neonates underwent the pulse oximetry screening (POX). The mean birth weight and gestational age of the neonates were 3256.31±509.62 gr and 38.2 weeks, respectively. The POX was performed averagely 19.5 hours after birth. Finally, a total of 10 cases were detected with abnormal POX. Among these 10 patients, three cases had cardiac diseases (i.e., transposition of the great arteries, ventricular septal defect/pulmonary atresia, and ventricular septal defect/pulmonary hypertension), three cases had noncardiac diseases (i.e., esophageal stenosis, hypoglycemia, and persistent pulmonary hypertension/sepsis), and four subjects were healthy.Conclusion: The obtained findings showed that routine pox, along with clinical examinations could be applied, especially in developing countries for the early detection of cardiac and noncardiac diseases in asymptomatic newborns.

Background: The outcome of congenital diaphragmatic hernia depends on associated anomalies, degree of pulmonary hypoplasia, and hypertension. We evaluated the postnatal prognostic factors which can be used to predict the outcome. Methods: This study was conducted at a tertiary center (Vali-e-Asr Hospital, Imam Khomeini Complex, Tehran, Iran) during 2013-2019. The predictors of survival were evaluated. Results: A total of 49 infants with congenital diaphragmatic hernia were born during 2013-2019. The patients’ mean gestational age and weight at birth were 37.51±1.75 weeks and 2871±562 g, respectively. The mortality rate in patients with surgery (n = 41) was 31.3% and eight patients died before surgery. Mortality had significant relationships with five-minute Apgar score, peak inspiratory pressure before and after surgery, partial pressure of arterial oxygen (PaO2), and pH during first 24 hours after birth (p= 0.01, 0.001, and 0.01, respectively). The predicted and true survival rates in the patients were 66% and 52%, respectively (p= 0.001). Conclusion: Predicting survival rate after birth is remarkable but controversial. This estimate should not affect patient care and should only help parents in the process of decision-making.