Springer Science and Business Media LLC

To estimate the incidence of blood exchange and determine causes and complication of blood exchange and identify strategies for risk reduction of Kernicterus in newborn with jaundice. From march 2004 to march 2006 in neonatal Department in children hospital, medical center Tehran, Iran,346 neonates were admitted as neinatal jaundice without sign and symptoms of infections. We identified causes and complications of exchange. Of 346 infants with jaundice who received phototherapy. 50, 14.45 percent cases underwent exchange transfusion with mean age 9.38+5.75 days. The mean total Serum billirubin level was 29.39+6.13mg/dl. ABO incompatibility was the most common cause for hyperbillirubinemia.the incidence of apnea was 12% there was no direct death from exchange transfusion. To make payment women aware to cbserve jaundice regularly after birth of their child and short breast feeding to control dehydretion.

To generate consensus on the assessment of hypotonia in the pediatric population, more specifically with respect to the clinical characteristics and first line tests and methods to be used to assess these characteristics. Consensus methodology was used. A sample of experts was recruited based on specific inclusion criteria. A two-round Delphi process was conducted electronically, which was based on a prior literature appraisal and survey amongst a cohort of clinicians. An a priori threshold margin error of 70 ± 5 % was pre-determined, with Cronbach’s α measuring the level of internal consistency. The 2-round iteration was useful in establishing consensus on clinical characteristics and tests /methods in the assessment of low muscle tone in the pediatric population (2–5 y age band). Twenty-four clinical characteristics, organized into 11 clusters were determined as relevant for inclusion. For each characteristic, one test (as a first line assessment method) had been identified with consensus after two rounds. Additionally, consensus on the importance of collateral sources was determined. The ranking order of importance of characteristics however revealed variations. The results of this study have displayed that Delphi, if executed with available guidelines, may be a useful technique in moving towards consensus on issues that may be contentious and have assisted in providing initial data to move towards consensus on the assessment of hypotonia in children.