Neonatal seizures

Neonatal seizures frequently indicate significant neurologic dysfunction or damage to immature nervous system. Therefore, aggressive approach to diagnosis and treatment is warranted. Although, mortality has decreased, the incidence and prevalence of neonatal seizures and neurological sequelae have not dramatically reduced. The decision to continue anticontivulsants after discharge remains controversial and varies among neurologists. However, when using phenobarb for a prolonged period, its effect on brain maturation of neonate should be kept in mind. Outcome varies with aetiology, seizure type and background seizure activity, and seems worse with hypoxic-ischemic encephalopathy, cerebroventricular haemorrhage and malformations

Necrotizing enterocolitis in infants weighing 2000 g

Over a 4 year period, nine of 180 [5%] infants weighing less than 2000 G. admitted to the Aga Khan University Hospital [AKUH] developed necrotizing enterocolitis [NEC]. An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patent ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. Six infants had positive blood and/or peritoneal fluid cultures [66%] compared to only five [16%] in the control group [P < 0.01]. Our data suggests that prematurity and sepsis are important predisposing factors for development of NEC