Factors responsible for the prolonged stay of surgical neonates in intensive care units

The length of hospital stay [HS] for patients is a major concern due to its social, economic and administrative implications; this is particularly important for neonates admitted to intensive care units [ICUs]. This study aimed to determine the factors responsible for prolonged HS in surgical neonates. This retrospective study was conducted at Sultan Qaboos University Hospital, in Muscat, Oman. The medical records of 95 neonates admitted to the neonatal ICU who underwent general surgical procedures between July 2009 and June 2013 were reviewed. Mann-Whitney U and Pearson's Chi-squared tests were used for non-parametric numerical and categorical variables, respectively. A multiple regression analysis was performed to find a relationship between the variables and to detect the most important factor responsible for prolonged HS. A P value of <0.05 was considered statistically significant. Gestational age, birth weight, number of days on a ventilator and postoperative morbidity were associated with prolonged HS. Furthermore, the age of neonates at first full enteral feed was associated with increased HS using both independent and multiple regression analyses. Prolonged HS can occur as a result of many factors. In this study, a number of factors were identified, including low gestational age, low birth weight, increased number of days on a ventilator and postoperative morbidity. Additionally, neonate age at first full enteral feeds also correlated with increased HS. Further research on this topic is suggested to explore this correlation in more detail and to inform future practices

Early versus late parenteral nutrition in very low birthweight neonates: a retrospective study from Oman

The aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight [VLBW] neonates receiving early versus late parenteral nutrition [EPN versus LPN]. A retrospective study was undertaken in the level III Neonatal Intensive Care Unit at Sultan Qaboos University Hospital, Oman: from January 2007 to October 2008 [LPN group, n = 47] and from January 2009 to June 2010 [EPN group, n = 44]. Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia [12.7% versus 6.8%] and non-oliguric hyperkalemia [12.7% versus 6.8%] in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age [CGA] of 34 weeks [40 in LPN and 41 in EPN], revealed a reduction in metabolic bone disease [osteopenia of prematurity [OOP], 17.5% versus 7.3%] and the need for phosphate supplementation [22.5% versus 7.3%] in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation

Acute massive feto-maternal hemorrhange: a challenge to the neonatologist

Acute Feto-Maternl hemorrhage [FMH] is an unexpected medical emergency. The diagnosis should be considered in all cases of unexplained fetal deaths, fetal distress, in severe asphyxia, in non-immune hydrops fetalis, neonatal shock, severely pale baby, and in non-hemolytic anemia presenting in the newborn period. Prognosis remains poor with mortality around 50%. Anticipation, ideal aggressive management of the newborn and successful outcome in such cases remains even today a real challenge for the neonatologist

Sextuplets in Oman

Use of ovulation inducing agents has increased the incidence of high order multifetal gestation. Such pregnancies are associated with increased maternal morbidity and poor perinatal outcome especially due to prematurity. Here, we report a case of sextuple pregnancy following ovulation induction with gonadotrophins. This is the first reported case of sextuplets from Oman

Prazozin - a first line drug in scorpion envenomation

Scorpion envenomation is an acute life-threatening medical emergency. Prazosin as a first line of drug can easily reverse the alpha receptor stimulation and the resultant autonomic stom witnessed in scorpion envenomation. Here we present a case of a one-and-a-half-years old. Omani girl who presented with multiple scorpion stings and severe envenomation but effectively managed with prazosin and anti-venom without any cardiac and pulmonary problems

Common presentation of an uncommon disorder: a case of intractable congestive cardiac failure in a neonate

We report a case of a neonate who presented with signs of severe congestive cardiac failure due to A.V malfunction involving the vein of Galen