Neonatal Infection in Srinagarind Hospital, 1987-1990

 Three hundred thirty-eight episodes of severe systemic infections in neonatal ward were analysed between 1987 and 1990.  An incidence of 15.2:100 admissions or 10.4:1000 live births of neonatal infection were docomented.  There were 57.4% (194 espisodes) of neonatal septicemia, 34.3% (116 episodes) of clinical sepsis and 8.3% (28 episodes) of congenital pneumonia during the period.  Sixty-two per cent were male and 53.8% were premature infants.  Sixty-seven per cent were low birth weight with 22.8% had birth weight less than 1500 g. Only 58.9% were in the high risk group for infections.  Twenty-seven per cent of cases had surgical problems which needed operation.  Most common underlying condition was hyaline membrane disease.  Gram negative bacilli were still the most common causative agent.  Anemia was the common complication. Eventhough prompt antibiotics administration and appropriated supportive management, the mortality rate was still high (32.2%).  Increasing multiply resistant strain of bacteria is considered to be a problem.  Further evaluation of the role of neonatal management including antibiotics usage may decrease the mortality rate.

Conjoined twins : a case report

 Female conjoined twins were referred to neonatal intensive care unit, Srinagarind Hospital from Burirum Hospital.  They were joined anteriorly from sternum to umbilicus and died six day after birth because of septicemia.  They shared common heart and liver, and of each has only one side of lung, kidney and adrenal gland, of which revealed by autopsy finding.

Role of Vitamin E in the Neonates

 Vitamin E is one of the important nutritional requirements especially in very low birth weight infants. The medical uses of vitamin E in preterm babies were reviewed in the part of hematologic problems , in traventricular hemorrhage , retino pathy of prematurity and bronchopulmonary dysplasia.

Mocnium Aspiration Syndrome at Srinagarind Hospital : A review of five-year period

The infants with meconium aspiration over a five-year period at Srinagarind Hospital were retrospectively analysed. There were fifteen infants with 2,672 gm average birth weight and 39.12 weeks average gestational age. Forty percent were delivered by cesarean section due to fetal distress. Moderate to severe birth asphyxia was noted in 53 percent. Almost all of the patients manifested tachypnea with 33.33 percent abnormal lung signs and pulmonary infiltration were noted in 60 percent. There were only two infants who needed mechanical ventilation. One with bilateral pneumothorax required chest drainage and survived ; the other one was expired at 23 hours of age. Persistent hyperaeration of the right lung with mild sternal retraction were noted in one infant at 26 days old. We agreed and emphasized that immediate tracheal suction significantly lowers the morbidity and mortality of infants with meconium-stained amniotic fluid.