Background: Neonatal sepsis is considered one of the major causes of morbidity and mortality in NICUs. To avoid unnecessary treatment of non-infected neonates, emergence of multidrug resistance organisms, prolonged hospitalization and a considerable economic burden, particularly in developing countries with poorly-equipped NICUs, an early, sensitive and specific laboratory test would be helpful to guide clinicians in neonatal units to decide whether or not to start antibiotics. Objective: C-reactive protein (CRP), tumor necrosis factor-a (TNF), interleukin-6 (IL-6) and interleukin-1 (IL-1) were measured in an attempt to identify a set of tests which can confirm or refute the diagnosis of neonatal sepsis at an early stage before administration of antibiotics. Methods: Assessment of serum levels of CRP, TNF-a, IL-6 and IL-1 was done using quantitative enzyme immunoassay sandwich technique in 116 neonates (36 newborns with clinically suspected sepsis, 48 newborns with culture-proven sepsis and 32 infection-free neonates). Results: The cutoff levels for CRP at >12 mg/l had a sensitivity of 91% and specificity of 100%, for TNF-a at >113.2 ng/ml had a sensitivity of 83% and specificity of 100%, for IL-6 at >16.8 pg/ ml had a sensitivity of 100% and specificity of 47%, and for IL-1 at >15 pg/ml had a sensitivity of 100% and specificity of 47% for the diagnosis of infection before antibiotics. * Corresponding

Objective Maternal malnutrition with disturbed lipid metabolism during pregnancy may affect the fetal lipid profile. We aimed to detect the relation between maternal and neonatal serum lipid profile, as well as to detect the serum lipid profile difference between small for gestational age (SGA) infants and appropriate for gestational age (AGA) infants to disclose the impact of maternal malnutrition on birth weight. Study Design A cross-sectional study was conducted on 150 pregnant women coming to the labor room. Before delivery, maternal serum levels of high-density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TGs), and total cholesterol were assessed, then after delivery, cord blood samples were taken for assessment of the neonatal lipid profile. Birth weights were measured, then the neonates were divided into SGA and AGA groups. Results Serum levels of LDL, TGs, and total cholesterol in the SGA infants were lower than that in the AGA infants. A positive correlation between maternal and neonatal serum TGs levels was found. Besides, there was a positive correlation between birth weight and maternal serum levels of LDL, TGs, and total cholesterol. Conclusion Maternal serum lipid profile could be an indicator of the neonatal serum lipid profile and birth weight. Key Points

Providing sufficient information and increasing awareness of parents about the NICU in the form of a written guide is an effective way of improving communication between healthcare providers and parents.

Background: It has been hypothesized that phototherapy leads to increased calcium absorption by the bones through irradiating the pineal gland and reducing melatonin level. There is some evidence that the use of a stockinet cap to cover the head prevents phototherapy-induced hypocalcemia. Study design: This was a randomized controlled trial, including 124 full-term neonates, weighing .2,500 g, in the first 7 days of life, who developed a bilirubin level ranging from 15 to 20 mg/dL and needed treatment with phototherapy. Our neonates were divided into two groups: Group A without the hat, and Group B with the hat. We designed a dark-colored hat that covered the entire head, including the occipital area, ears, and neck, to prevent passage of light. The hat was used from the time of admission and for the 48 hours of treatment with phototherapy. Ca levels were measured on admission and after 48 hours of phototherapy. The variables were compared using Student's t-test, chi-square test, and the repeated-measures test. Results: There was no difference in the mean Ca levels in the two groups on admission. However, after 48 hours of phototherapy, there was a trend toward an increased Ca level in the group with the hat; 8.74±0.95 mg/dL vs 8.51±0.24 mg/dL in the control group. Moreover, there was a statistically significant decrease in the incidence of neonates with hypocalcemia in Group B (with hat) in only six cases (9.7%), compared to 15 cases (24.2%) in Group A (without hat; P=0.031). Conclusion: Phototherapy-induced hypocalcemia can be prevented by covering the head during phototherapy. This seems to be a safe, effective, and cheap method to prevent hypocalcemia and its complications, with no need for prophylactic administration of calcium.