A budget impact analysis of exclusive human milk diet in very low birth weight infants in United Arab Emirates.

Introduction: Very low birth weight (VLBW) infants have the highest rate of neonatal intensive care unit (NICU) admissions owing to the higher comorbidities associated with premature birth and long hospital stays. VLBW infants fed a bovine (BOV)-based diet have higher mortality rates, necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and other comorbidities than those fed 100% human milk-based products. This study aims to evaluate the budgetary impact of adopting an exclusive human milk diet (EHMD) instead of a BOV-based diet in VLBW infants from Al-Ain Hospital, Sheikh Shakhbout Medical City, and Dubai Health Authority (DHA) in the United Arab Emirates (UAE).

Noninvasive hemodynamic monitoring of septic shock in children.

Septic shock in children is associated with high mortality and morbidity. Its management is time-sensitive and must be aggressive and target oriented. The use of clinical assessment alone to differentiate between cold and warm shock and to select the appropriate inotropic and vasoactive medications is fraught with errors.

Effect of Growth Hormone on Final Height in Children with Idiopathic Short Stature: A UAE, Eastern Region Experience.

Objectives: The use of growth hormone (GH) in idiopathic short stature (ISS) has been a subject of debate for the past two decades. We sought to assess the effect of GH on final height (FH) in patients with ISS in our region, which has a high consanguinity rate, and compare it to the effect observed in GH deficient (GHD) patients.

Methods: We conducted a retrospective chart review from 1 January 2005 to 31 December 2013 for patients with ISS or GHD from the local United Arab Emirates population who received GH treatment and were followed-up regularly in our clinic.

Conjugated hyperbilirubinemia presenting in first fourteen days in term neonates.

Aim: To describe the etiology and characteristics of early-onset conjugated hyperbilirubinemia (ECHB) presenting within 14 d of life in term neonates.

Methods: Retrospective review was performed of term infants up to 28-d-old who presented with conjugated hyperbilirubinemia (CHB) at a tertiary center over a 5-year period from January 2010 to December 2014. CHB is defined as conjugated bilirubin (CB) fraction greater than 15% of total bilirubin and CB greater or equal to 25 μmol/L.

Demographics and co-occurring conditions in a clinic-based cohort with Down syndrome in the United Arab Emirates.

The majority of studies describing demographics and co-occurring conditions in cohorts with Down syndrome come from regions outside of the Middle East, mainly from Europe and North America. This paper describes demographics and co-occurring conditions in a hospital-based cohort of individuals with Down syndrome living in the Middle Eastern country of the United Arab Emirates (UAE). The first dedicated Down syndrome clinic in the UAE was established in 2012 at Tawam Hospital in Al Ain.

Neurally adjusted ventilator assist in very low birth weight infants: Current status.

Continuous improvements in perinatal care have resulted in increased survival of premature infants. Their immature lungs are prone to injury with mechanical ventilation and this may develop into chronic lung disease (CLD) or bronchopulmonary dysplasia. Strategies to minimize the risk of lung injury have been developed and include improved antenatal management (education, regionalization, steroids, and antibiotics), exogenous surfactant administration and reduction of barotrauma by using exclusive or early noninvasive ventilatory support.

Prevalence of autoantibodies in type 1 diabetes patients and its association with the clinical presentation - UAE Eastern Region experience.

Background: Positive autoantibodies and its association with the clinical course of type 1 diabetes mellitus (T1DM) have been reported worldwide, however, no such data have been reported in United Arab Emirates population.

Objectives: To study the prevalence of positive autoantibodies in T1DM pediatric patients and its association with the clinical presentation.

Methods: Descriptive retrospective chart review of all new cases of pediatric T1DM at Tawam Hospital.

Perinatal outcome of congenital heart disease in a population with high consanguinity.

Objective: To report the perinatal pattern and outcome of fetuses with congenital heart disease (CHD) in consanguineous marriages.

Methods: Retrospective chart review was performed for fetuses undergoing fetal echocardiography (FE) in our institution. The primary outcome was survival at 28 days after birth.

Fibrochondrogenesis: prenatal diagnosis and outcome.

We studied 20 cases with fibrochondrogenesis (FCG) diagnosed prenatally. Four cases were diagnosed at our fetal unit, and 16 cases were identified through a review of literature (in English). The prenatal diagnosis of FCG was made in 4/20 (20%).

Risk factor assessment of young patients with acute myocardial infarction.

Unlabelled: The Middle East represents an attractive area for young individuals to seek employment, where they are exposed to numerous environmental conditions. The pursuit of a better standard of living has driven hundreds to the Middle East over the recent decades. This influx has also resulted in a predisposition to premature coronary artery disease (CAD).

Palivizumab prophylaxis during nosocomial outbreaks of respiratory syncytial virus in a neonatal intensive care unit: predicting effectiveness with an artificial neural network model.

Study Objective: To identify subgroups of premature infants who may benefit from palivizumab prophylaxis during nosocomial outbreaks of respiratory syncytial virus (RSV) infection.

Design: Retrospective analysis using an artificial intelligence model.

Setting: Level IIIB, 35-bed, neonatal intensive care unit (NICU) at a tertiary care hospital in the United Arab Emirates.

Neurally adjusted ventilatory assist (NAVA) mode as an adjunct diagnostic tool in congenital central hypoventilation syndrome.

A full term female newborn was admitted to the neonatal intensive care unit (NICU) for continuous observation of apnea. Infant was noted to have apnea while asleep requiring intubation and mechanical ventilation. A video EEG was performed which demonstrated normal awake background without any seizure activity.

Screening for neonatal hearing loss in the Eastern region of United Arab Emirates.

The incidence of sensorineural hearing loss among infants in the neonatal intensive unit (NICU) is higher than in normal infants. This study determined the rate of hearing loss in healthy newborns and in NICU patients before hospital discharge at a single institution in the Eastern region of the United Arab Emirates; 96.5% of all eligible infants were screened.

Renal biomarkers for assessment of kidney function in renal transplant recipients: how do they compare?

Accurate assessment of renal function is of key importance, given its prognostic value. However, gold standard measures are cumbersome, and serum creatinine itself is an insensitive predictor, especially in renal transplant recipients. Though GFR-estimating formulae have been relied upon, they do have their own limitations.

Congenital epulis.

Epulis is a rare tumour, with female preponderance that is only seen in the newborns. It arises from the mucosa of the gingiva and protrudes out of the infant's mouth. It can potentially obstruct the airways and may require an EXIT (ex-utero intrapartum treatment) procedure which involves establishing an airway before the feto-maternal circulation is interrupted.

Neurally adjusted ventilatory assist mode used in congenital diaphragmatic hernia.

A term baby with congenital diaphragmatic hernia (CDH) underwent surgical repair on the second day of life. Postoperatively; the oxygenation index increased to 85 despite high pressure ventilation with HFOV (high frequency oscillator ventilation) and inhaled nitric oxide therapy. Oxygenation index above 70 carries a mortality rate of 94% and merits starting extracorporeal membrane oxygenation (not available in the UAE).

Fetal echogenic cardiac foci: prospective postnatal electrocardiographic follow-up.

Objective: To determine postnatal electrocardiographic abnormalities in fetuses with echogenic cardiac foci (ECF) and no congenital heart disease (CHD).

Study Design: A total of 41 fetuses with ECF and no CHD, were prospectively followed after birth with serial echocardiograms, electrocardiogram (ECG) and 24-h ECG (Holter). The primary outcome was presence of significant abnormalities in the ECG or Holter.

Stuve-Wiedemann syndrome: a skeletal dysplasia characterized by bowed long bones.

Objective: To describe the prenatal sonographic features of Stuve-Wiedemann syndrome (SWS).

Methods: A retrospective review of all cases of confirmed SWS during an 8-year period was conducted. Clinical and historical data and outcome of the pregnancies were noted.

Molecular and clinical analysis of Ellis-van Creveld syndrome in the United Arab Emirates.

Background: Ellis-van Creveld (EvC) syndrome is an autosomal recessive chondrodysplastic condition with clinical manifestations that include short-limbs and ribs, postaxial polydactyly and dysplastic nails and teeth. In about two thirds of patients, mutations in either EVC or EVC2 genes have been found to be the underlying cause.

Methods: In this paper, we describe the molecular (DNA sequencing) and clinical analysis of six children diagnosed with EvC from four different families from the United Arab Emirates (UAE).

The significance of fetal renal pelvic dilatation as a predictor of postnatal outcome.

Objectives: To define the clinical outcome of fetal renal pelvic dilatation (FRPD) in cohort of infants in United Arab Emirates.

Study Design: Data were collected from all fetuses having FRPD from January 2005 to February 2008. FRPD was graded as normal (<5 mm), mild (5-9 mm), moderate (10-15 mm), and severe (>15 mm).

Is isolation of outborn infants required at admission to the neonatal intensive care unit?

Background: To measure the rate of colonization of outborn infants with methicillin-resistant Staphylococcus aureus (MRSA) to evaluate the need for Contact Precautions (including isolation) at the time of admission to the neonatal intensive care unit (NICU).

Methods: All 239 consecutive infants referred from the neonatal units of other hospitals to a tertiary NICU in Al Ain, United Arab Emirates, between January 2000 and December 2007 were screened for MRSA colonization. Swabs from the ear, nose, rectum, axillae, and groin were obtained from each patient, and the rates of colonization were calculated retrospectively.

A newly identified splice site mutation in ZMPSTE24 causes restrictive dermopathy in the Middle East.

Restrictive dermopathy (RD) is a severe neonatal inherited skin syndrome of which children die shortly after birth. Clinical features include intrauterine growth retardation, taut translucent and easily eroded skin, multiple joint ankylosis and distinct facial features. RD is usually caused by homozygous or compound heterozygous mutations in ZMPSTE24, predicted to cause loss of function of the encoded zinc metalloproteinase STE24.

Short-term outcome of very low birth weight infants in a developing country: comparison with the Vermont Oxford Network.

Objectives: To determine the outcome of very low birth weight infants (VLBWI) admitted to a level III NICU in UAE and compare the results to percentiles published by the Vermont Oxford Network (VON).

Method: Outcome data were collected retrospectively, using standard definitions, on a cohort of VLBWI 500-1500 g admitted between January 2004 and December 2006.

Results: Of the 173 infants weighing 501-1500 g at birth, 85.