• Journal of Chest Surgery
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• v.28 no.5
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• pp.447-452
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• 1995

From January 1983 to December 1992, 116 patients under 10Kg of body weight were underwent open heart surgery in National Medical Center.There were 64 males and 52 females, and their mean age was 14 2.6 months, ranged from 3 days to 38 months. Their mean body weight was 7.4$\pm$1.2Kg, ranged from 2.4Kg to 10Kg which were less than 3 percentile of normal developmental pattern in 109 out of 116 cases.The composition of the patients was VSD[73 , TOF[18 , ASD[8 , ECD[5 , TGA[4 , PS[3 , TAPVC[2 , TA[1 , cardiac rhabdomyoma with ASD[1 , and Ebstein`s anomaly[1 . The overall surgical mortality was 17.2%.In acynotic group, 11 patients died among 91 patients and the mortality was 12.1%, in cyanotic group 9 patients died among 25 patients, the mortality was 36%.The surgical result of patients under 5Kg of body weight was worse than those over 5Kg of body weight. [56.2% versus 11% The surgical result in this period was improved year by year, but poor surgical results in the group of cyanotic, under 5Kg of body weight should be improved by means of more precise preoperative diagnoses, more advanced surgical techniques and more proper postoperative management.

• Health Policy and Management
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• v.30 no.3
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• pp.301-310
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• 2020

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

• Parasites, Hosts and Diseases
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• v.52 no.6
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• pp.639-644
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• 2014

Congenital malaria is assumed to be a risk factor for infant morbidity and mortality in endemic areas like Maumere, Indonesia. Infected infants are susceptible to its impact such as premature labor, low birth weight, anemia, and other unspecified symptoms. The aim of this study was to investigate the prevalence of congenital malaria and the influence of mother-infant paired parasite densities on the clinical outcome of the newborns at TC Hillers Hospital, Maumere. An analytical cross sectional study was carried out in newborns which showed criteria associated with congenital malaria. A thick and thin blood smear confirmed by nested PCR was performed in both mothers and infants. The association of congenital malaria with the newborn's health status was then assessed. From 112 mother-infant pairs included in this study, 92 were evaluated further. Thirty-nine infants (42.4%) were found to be infected and half of them were asymptomatic. Infected newborns had a 4.7 times higher risk in developing anemia compared to uninfected newborns (95% CI, 1.3-17.1). The hemoglobin level, erythrocyte amount, and hematocrit level were affected by the infants' parasite densities (P<0.05). Focusing on newborns at risk of congenital malaria, the prevalence is almost 3 times higher than in an unselected collective. Low birth weight, anemia, and pre-term birth were the most common features. Anemia seems to be significantly influenced by infant parasite densities but not by maternal parasitemia.

• Journal of Preventive Medicine and Public Health
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• v.51 no.3
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• pp.140-147
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• 2018

Objectives: Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures. Methods: This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships. Results: Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term. Conclusions: The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

• Journal of Life Science
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• v.21 no.3
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• pp.406-411
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• 2011

To investigate the effects of short-term treatment with tri-n-butyltin chloride (TBTCl) and bisphenol A (BPA) on the reproduction of striped field mice, the mice were intramuscularly injected with TBTCl or BPA immediately before the reproductive season and examined in the reproductive season after keeping them for 4 months. As a result, there were no differences between the control and the compound-treated groups regarding body weight in both sexes, the residual levels of the compounds in the adult males, and the gonadosomatic index (GSI) and the histological structures with LM and EM of the testes and epididymides in both the adult and young males. The infant mortality and abortion rate, however, were high in the TBTCl-treated groups and BPA-treated groups respectively, compared to the control group. Conclusively, it was suggested that short-term treatment with TBTCl or BPA in mice in the non-reproductive season might have inhibited the development of the uterine embryos or fetuses, although it did not induce accumulations of these compounds or affect the reproductive organs of adult and young (F1) males.

• Neonatal Medicine
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• v.28 no.3
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• pp.124-132
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• 2021

Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

• Clinical and Experimental Pediatrics
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• v.63 no.11
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• pp.433-437
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• 2020

Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.207-216
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• 1988

Premature rupture of membrane is the most frequent cause of low birth weight infant delivery which increase the maternal and fetal morbidity and perinatal mortality. A retrospective case-control study was performed on 315 mothers who delivered low birth weight infants($\leq$2.5kg) with premature rupture of membrane and as control group 546 mothers who delivered normal birth weight infants(2.9-3.7kg) without premature rupture of membrane were chosen. The results obtained from this study were as follows: 1. The proportion of low birth weight infants due to premature rupture of membrane among all low birth weight infant deliveries was 14.5%, and this is equivalent to 1.1% among all deliveries. 2. The most significant maternal risk factor of low birth weight infant deliveries with premature rupture of membrane was infections on vagina, cervix and uterus during pregnancy. Compared with control, adjusted odds ratio was 7.61(95% confidence interval(CI) 1.88-30.88, p=0.004). Other significant maternal risk factors were the history of induced abortion, spontaneous abortion, and the experience of premature delivery. The risk ratios were 1.82, 2.07, 4.42, respectively. 3. Breech presentation did increase the risk of low birth weight infant delivery with premature rupture of membrane compared with control(Adjusted Odds ratio=2.66, 95% CI 1.35-5.26, p=0.005). 4. Mothers who had not taken antenatal care were having higher risk of low birth weight infant delivery with premature rupture of membrane against control(Adjusted odds ratio=1.73, 95% CI 1.19-2.53, p=0.004). These study results show that maternal factors such as the infection of genital organs during pregnancy, the history of induced abortion and breech presentation are significantly associated with the premature rupture of membrane in the low birth weight deliveries, and that most of these risk factors are controllable ones through proper antenatal cares.

• Neonatal Medicine
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• v.25 no.1
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• pp.16-22
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• 2018

Purpose: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. Methods: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild ($100{\times}10^9/L{\leq}platelet<150{\times}10^9/L$), moderate ($50{\times}10^9/L{\leq}platelet<100{\times}10^9/L$), or severe (platelet<$50{\times}10^9/L$). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. Results: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. Conclusion: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.