Current Issue : April - June Volume : 2021 Issue Number : 2 Articles : 5 Articles
Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants....
Background: Mechanical ventilation (MV) is one of the most common therapies in the neonatal Intensive Care Unit (NICU) and is associated with increased morbidity and mortality. MV is a complex and highly specialized area in neonatology that has several complications related to different modes, techniques, and devices. Aim of the Study: To detect the causes of morbidity and mortality in mechanically ventilated neonates and to correlate the neonatal morbidity and mortality with gestational age, birth weight and duration of MV. Patients and Methods: This prospective observation analytical study was carried out on 110 neonates who were admitted to NICU at Al-Zahraa university hospital on MV during the period from March 2019 to March 2020. All neonates were followed up till the time of discharge with record of any complications during mechanical ventilation. Detailed medical history, examination to detect indication of MV and laboratory, radiological investigations were recorded. As regard the general characterization of studied neonates, 64 (58.2%) were males while the rest 46 (41.8%) were females, 50 (45.4%) were full term (37 - 42 wks), 42 (38.18%) were early preterm (28 - 33 wks), 18 (16.3%) were late preterm (34 - 42 wks). Results: Among (110 mechanically ventilated neonates, 58.2% were males, 41.8% were females. The most common indication for MV in the studied cases was respiratory distress syndrome (RDS) in 30% neonates. Ventilator associated pnemonia and Devices associated infection were the most common complications related to MV (19.1% and 11.8% respectively). While septic shock and multiorgan failure were the most common complications related to the underlying disease (24%). There is a significant negative association between gestational age, birth weight and mortality in mechanically ventilated neonates. the overall recovery was 59.1% among studied neonates. Conclusion: Respiratory disorders were the commonest indication of MV in NICU mostly RDS. Ventilator associated pneumonia and devices associated infection are common complications. Preterm and low birth weight neonates are vulnerable group for need of mechanical ventilation....
Background: Postoperative bleeding is a major problem in children undergoing complex pediatric cardiac surgery. The primary aim of this prospective observational study was to evaluate the effect of an institutional approach consisting of early preventive fibrinogen, prothrombin complex and platelets administration on coagulation parameters and postoperative bleeding in children. The secondary aim was to study the rate of re-intervention and postoperative transfusion, the occurrence of thrombosis, length of mechanical ventilation, ICU stay and mortality. Methods: In fifty children (age 0–6 years) with one or more predefined risk factors for bleeding after cardiopulmonary bypass (CPB), thrombelastography (TEG) and standard coagulation parameters were measured at baseline (T1), after CPB and reversal of heparin (T2), at sternal closure (T3) and after 12 h in the ICU (T4). Clinical bleeding was evaluated by the surgeon at T2 and T3 using a numeric rating scale (NRS, 0–10). Results: After CPB and early administration of fibrinogen, prothrombin complex and platelets, the clinical bleeding evaluation score decreased from a mean value of 6.2 ± 1.9 (NRS) at T2 to a mean value of 2.1 ± 0.8 at T3 (NRS; P < 0.001). Reaction time (R), kinetic time (K), maximum amplitude (MA) and maximum amplitude of fibrinogen (MA-fib) improved significantly (P < 0.001 for all), and MA-fib correlated significantly with the clinical bleeding evaluation (r = 0.70, P < 0.001). The administered total amount of fibrinogen (mg kg− 1) correlated significantly with weight (r = − 0.42, P = 0.002), priming volume as percentage of estimated blood volume (r = 0.30, P = 0.034), minimum CPB temperature (r = − 0.30, P = 0.033) and the change in clinical bleeding evaluation from T2 to T3 (r = 0.71, P < 0.001). The incidence of postoperative bleeding (> 10% of estimated blood volume) was 8%. No child required a surgical re-intervention, and no cases of thrombosis were observed. Hospital mortality was 0%. Conclusion: In this observational study of children with an increased risk of bleeding after CPB, an early preventive therapy with fibrinogen, prothrombin complex and platelets guided by clinical bleeding evaluation and TEG reduced bleeding and improved TEG and standard coagulation parameters significantly, with no occurrence of thrombosis or need for re-operation....
The Helicobacter pylori (Hp) infection is a public health problem, especially in developing countries. However, the responsibility of Hp for the occurrence of recurrent abdominal pain is still unclear. Objectives: To determine the prevalence of Helicobacter pylori (Hp) infection in children with recurrent abdominal pain (RAP) in Brazzaville and to establish the relationship between Hp infection and RAP. Patients and Methods: We conducted a cross-sectional case-control study, between March and September 2018, including 106 children with RAP and 218 children without RAP, aged 2 to 17 years old, received in health centres in Brazzaville. All the children were subjected to detection of Hp fecal antigen by qualitative immuno-chromatography in the faeces. Results: The prevalence of Hp infection among children with RAP in Brazzaville was 43.4%. The female sex was most represented in both populations, with a sex ratio of 0.84 in the infected population. Compared with controls, these were children with a mean age of 8.13 ± 4.57 years. Infected children with RAP were unschooled in 66.7% (n = 31) of cases (p < 0.05). Those using potty were 63% (n = 29). Handwashing before meals and after using the toilet was not done in 66.7% (n = 31) and 56.5% (n = 26) of cases, respectively. The proportions were almost similar in the control population. The epigastric site of pain was found in 51.8% of children infected with RAP, the association between Hp infection and the site of pain was statistically significant (p = 0.009). The epidemiological factors influencing Hp infestation in children were identical in both groups, those factors were: age (OR = 0.61; p < 0.04), education level (OR = 0.35; p < 0.01) of the children and guardian’s age (OR = 1.22; p < 0.03), type of toilet (OR = 2.37; p < 0.02) and hand washing (OR = 1; p < 0.01). No statistically significant association was found between Hp infection and RAP (p = 0.10). Conclusion: Hp infection is common among children with RAP in Brazzaville. It is favoured by young age and lack of hygiene. The cause and effect relationship between Hp and RAP has not been found. Nevertheless, the search for Hp fecal antigen in children with RAP should be recommended in order to improve the management of this pathology....
Prematurity is the most common direct cause of newborn mortality that can be reduced by improving the care for premature baby in Neonatal Care Units. Nursing staff working in such units must be highly qualified to avoid complications which lead to the increase of disability and death rate. This study aimed to evaluate the effect of intervention on Nurse’s Performance regarding feeding premature baby in Neonate Care Unit. Interventional Study design with pre and posttest was used. The study was carried out at neonatal care units of Organization of AL-Thora Public Hospital and AL-Slkhana Hospital for Maternal and childhood in Hodeida city in Yemen. Method: Total coverage of 50 nurses in the previously mentioned settings. Three tools were used tool viz. the Structured questionnaire including two parts for Demographic data of nurses and level of basic nurse’s knowledge tool, the Observation Check list, and the training program procedure which consists of 4 phases: Phase (1) Pretest for the existing knowledge for nurses using the questionnaire format; Phase (2) Orientation to the educational program; Phase (3) close supervision to the participants while applying the nursing practice; Phase (4) Posttest at the end of the program (the same questionnaire and the observation check list format were used). Results: The results showed that the total knowledge and practice skills of the nurses were higher in the posttest than the pretest. There was a statistical significance correlation between the total nurses’ knowledge and their total practice’s skill in the posttest (p < 0.05). Conclusion: Most of the study participants attained a score less than “good” in the levels of knowledge and practical skills in the pretest which became “very good” to “Excellent” after the educational....
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