Intervention Bundle for Optimization of Procedural Sedation for Newborns Undergoing Magnetic Resonance Imaging: A Single-Center Quality Improvement Project in Qatar.

Introduction: Magnetic resonance imaging (MRI) is a common procedure in tertiary care neonatal intensive care units (NICUs). MRIs aid in detailing structural anatomy and are increasingly utilized for prognostication. Keeping babies calm and motion-free in the MRI suite is challenging, and various approaches have been adopted to obtain the best image quality.

Ineffective ventilation in a very low birth weight infant with H-type Tracheoesophageal Fistula with bilateral chemical pneumonitis. A lesson learned.

Tracheoesophageal fistula (TEF) with or without associated esophageal atresia (EA) in the neonate is challenging to diagnose and manage its complications like aspiration, respiratory distress, and other associated anomalies. To stabilize, ventilate and prepare for surgical correction, understanding the H-nature of disease and anticipation of problems and their management will improve survival. We present a newborn with tracheoesophageal fistula without atresia from resource-limited settings and lessons we learned from the case.

Interventions to Reduce Severe Brain Injury Risk in Preterm Neonates: A Systematic Review and Meta-analysis.

Importance: Interventions to reduce severe brain injury risk are the prime focus in neonatal clinical trials.

Objective: To evaluate multiple perinatal interventions across clinical settings for reducing the risk of severe intraventricular hemorrhage (sIVH) and cystic periventricular leukomalacia (cPVL) in preterm neonates.

Data Sources: MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases were searched from inception until September 8, 2022, using prespecified search terms and no language restrictions.

Effect of Optimizing Oxygen Saturation Targets on the Incidence of Retinopathy of Prematurity in a Quaternary NICU.

Introduction: Retinopathy of prematurity (ROP) is a multifactorial disease and a preventable cause of blindness in childhood. Hyperoxia and hypoxia can cause retinal neovascularization resulting in retinal detachment and blindness if left untreated. Besides oxygen treatment, other reasons for ROP development are well known.

Hypernatremia in Newborns: A Practical Approach to Management.

Hypernatremia is a potentially serious condition in both term and preterm babies, which can lead to severe and permanent neurological damage. There are many physiological changes in sodium homeostasis that occur soon after birth. Understanding this physiological process, early anticipation of hypernatremia and familiarization with the neonatal management of hypernatremia can prevent mortality and long-term morbidity associated with this condition.

Comparison of the Efficacy of Continuous Femoral Nerve Block With Epidural Analgesia for Postoperative Pain Relief After Unilateral Total Knee Replacement.

Introduction With recent developments in postoperative pain management after total knee replacement (TKR), the continuous femoral nerve block is becoming a common practice. The purpose of this study was to compare a femoral nerve block with time-tested epidural analgesia in a tertiary care setup in a developing country. Methodology A randomized control trial took place at Shifa International Hospital (SIH), Islamabad, Pakistan.

Quality of Neonatal Care: A Health Facility Assessment in Balochistan Province, Pakistan.

Introduction Balochistan is the largest of Pakistan's four provinces, yet it is also the poorest and most impoverished, particularly in terms of neonatal healthcare. In order to build and tailor strategies to improve neonatal outcomes, it is necessary to identify barriers and facilitators for interventions. Therefore, we conducted this study to provide an overview of neonatal healthcare quality and assess the structural capacity for the improvement and further development of neonatal healthcare facilities in Balochistan.

Recurrence Rate of Trigeminal Neuralgia With the Use of Percutaneous Stereotactic Continuous Radiofrequency Ablation at 80°C for 90 Seconds: A Single-Center Study.

Introduction With recent development in the treatment of trigeminal neuralgia (TN), percutaneous stereotactic rhizotomy is being widely used as an interventional technique. The purpose of this study was to find the recurrence rate of TN in patients who were treated with stereotactic rhizotomy at 80°C for 90 seconds, in a tertiary care set up in a developing country. Methodology A retrospective cohort study was conducted at Shifa International Hospital, Islamabad, Pakistan from September 2016 to August 31, 2021.

Amplitude-Integrated Electroencephalography: A Primer for Neonatologists and Practitioners in the NICU.

Amplitude-integrated electroencephalography (aEEG) is an essential tool used in the NICU to monitor infants with central nervous system pathology and encephalopathy. This review provides a summary of aEEG, including clinical indications, interpretation of different tracing patterns, and seizure identification, which are essential skills for teams caring for sick newborns. We also discuss the limitations of the clinical application of aEEG in this population.

C-reactive protein as a predictor of meningitis in early onset neonatal sepsis: a single unit experience.

Objectives To determine whether there is a cut off value of serum C-reactive protein (CRP) associated with a higher risk of meningitis in suspected early onset sepsis (EOS) (onset birth to 7 days of life). Methods A retrospective cohort study on neonates admitted in neonatal intensive care unit at McMaster Children's Hospital from January 2010 to 2017 and had lumbar puncture (LP) and CRP for workup of EOS. Included subjects had either (a) non-traumatic LP or (b) traumatic LP with cerebral spinal fluid (CSF) polymerase chain reaction or gram stain or culture-positive or had received antimicrobials for 21 days.

Association of Low Umbilical Cord pH and Hypoglycemia in Healthy Term Newborns: Should it Be a Part of Postnatal Screening?

Hypoglycemia may lead to neurological impairment; therefore, high-risk newborns are screened postnatally. However, hypoglycemia monitoring protocols often do not include cord blood acidosis as a risk factor. The study aimed to find an association between asymptomatic cord blood acidosis and hypoglycemia.

Maternal body mass index and smoking during pregnancy do not affect the proportional sexual dimorphism for birth weight- an analysis of the German Perinatal Survey.

Male sex has been reported as a risk factor for perinatal mortality. It can be hypothesized that smoking during pregnancy and low maternal pre-pregnancy body mass index (BMI) would lead to a higher proportion of growth restricted male compared to female newborns. The objective of the study was to analyze sex-specific differences in birth weight related to smoking and maternal BMI.

Neonatal respiratory outcomes in pregnancy induced hypertension: introducing a novel index.

To evaluate short-term respiratory outcomes, mortality and bronchopulmonary dysplasia (BPD) in preterm infants born to mothers with and without pregnancy induced hypertension (PIH). Exposed infants <33 weeks' gestation were matched to controls in a 1:2 ratio, based on gestation, sex and antenatal steroid exposure in this retrospective cohort study. Primary outcomes were a novel cumulative respiratory index (cRI) (product of mean airway pressure-hours and FiO-hours while on invasive ventilation during first 72 hours), mortality and BPD.