الفهرس 
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Abstract
Neonatal crying can have a prominent effect on the stability of the family. So we conclude that the parents who find their babies with persistent crying must consult the pediatricians who must consider the following - :(A) Physiological causes:-Hunger, wet or soiled diaper, want to suck on something, want to move, want to be bundled, hole of the milk bottle teat, wind or gas formation in stomach, exposure to noise, discomfort with atmosphere, lonely baby, sun in the eyes, tired baby, tight clothing, mosquitoes bite, tense mother, habitual crying, mother’s diet, infantile colic and neonatal pain during procedures.(B) Pathological causes:-A. Head.(traumatic skull fracture / subdural hematoma)B.Eyes. (glaucoma and corneal abrasion).C.Ears.(otitis media and otitis externa).D.Mouth and throat. (URTI and common cold and oral thrush/stomatitis/pharyngitis).E.Cardiovascular.(anomalous coronary artery).F. Pulmonary. (neonatal pneumonia).G.Gastrointestinal. (gastroesophageal reflux/esophagitis,constipation, anal fissure, intestinal obstruction, volvulus, necrotizing enterocolitis(NEC), meconium plug syndrome, Hirschsprung disease, spontaneous intestinal perforation (SIP), focal small bowel perforation, duodenal atresia, Meckels diverticulum, pseudo-obstruction, imperforate anus, bleeding conditions, acute appendicitis, gastroenteritis and cow milk allergy and intolerance).H.Genitourinary.(neonatal testicular torsion, torsion ovarian cyst in the newborn, urinary retention secondary to posterior urethral valves (PUV), meatal ulceration and stenosis, urinary tract infection and balanitis).I.Musculoskeletal.(acute osteomyelitis, septic arthritis and discitis, bone injury, IV infiltration injuries, and hair tourniquet syndrome (encircling finger, toe, penis, and clitoris).J.Neurological.(intracranial hemorrhage, shaken baby syndrome, neonatal meningitis, neonatal abstinence syndrome).K. Dermatologic.(nappy rash , drug reactions).L.Metabolic/ Electrolyte abnormalities.(hypoglycemia, phenylketonuria, hypocalcaemia, hypernatremia, neonatal thyrotoxicosis and cri du chat syndrome).Approach to diagnosis and management A) History: Description of the pattern and type of cry will detect a fussy infant.- History about feeding and bowel habits of the baby - High pitched cry may indicate cerebral irritation (meningitis) severe crying with pulling at the ears may indicate acute otitis media.- Persistent crying with irritability and grunting may indicate respiratory distress.- History of recent immunization (BCG) or circumcision in male infants.B) Physical examination: It requires special skill to examine a crying child. Observation of the child for a few minutes will enable us to locate any acute illnesses. Examination should include looking for any insect bite marks, feeling the anterior fontanelle, otoscopic examination, rapid review of the respiratory, cardiac systems, neurologic examination (for meningeal signs), abdominal examination (for Masses, distention due to over feeding ), rectalexamination, extremities examination and back examination.C) Investigations included (for some pathological causes that need investigations): CBC: done by automated cell counter (swelab).- CRP: done by latex agglutination.-Chest X-ray: done by digital x-ray unit (Toshiba). D) Management: Whenever there is an identifiable cause the management is directed towards it, if necessary a referral may be required if acute illness as mentioned above is detected or suspected.The aim of this work was to know what the causes of neonatal crying are and how to diagnose and manage.This study include 300 single newborn full term infants of 40 weeks’ gestation attending El-Bagour outpatient clinic complaining of neonatal crying due to any cause from the beginning of January 2014 till the end of July 2014.All studied cases were subjected to the following: full History, anthropometric measures, thorough clinical examination and investigations included (for some pathological causes that need investigations).The results of the present study showed that, there is high significant relation between illiterate mother education and pathological causes of crying and high significant relation between secondary mother education and physiological causes of neonatal crying.There is high significant relation between low Socio-economic level and pathological causes of crying.There is significant relation between intermediate Socio-economic level and physiological causes of neonatal crying.There is significant relation between physiological and pathological causes of neonatal crying and both artificial feeding and siblings beyond the first one. There is non-significant relation between causes of neonatal crying both primary and university mother education, Intermediate and high socio-economic level mother occupation, parity of the mother, mother’s food and Mode of delivery and non-significant relation between sex of the baby and breast feeding of the baby and causes of crying.
Based on the findings of the present study, we can conclude that, physiological causes of crying (76%) were much more common than pathological causes of crying (24%), hunger was the most common cause of physiological crying (30%) and neonatal infections were the most common cause of pathological crying (14%), there is significant relation between pathological causes of crying and illiterate mother education, low Socio-economic level, artificial feeding and siblings beyond the first one and there is significant relation between physiological causes of crying and secondary mother education, intermediate Socio-economic level, bottle feeding and siblings beyond the first one.from this study we recommend that, parents should know that physiological causes of neonatal crying are more common than pathological causes. Hunger is the most common cause of neonatal crying. After exclusion of physiological causes of neonatal crying, parents must seek medical advice as this neonatal crying may be caused by dangerous disease. The pediatricians must examine every system in the body seriously because early diagnosis may be life saving for the crying newborn and newborn checklist can be used for rapid diagnosis of the causes of neonatal crying.