Some risk factors for neontal sensorineural hearing loss in a neonatal care unit

Background: The sensorineural hearing loss incidence ranges from 1 to 3 per 1.000 live births in term healthy neonates, and 2-4 per 100 in high-risk infants, a 10-fold increase

Objective: To estimate the incidence of SNHL among newborns in NICU at Al Monira Hospital, Cairo, Egypt; The neonates in the study were 710 [401Males and 309 Females] and had birth weight ranging from 680 to 5500 gm and the mean gestational age was 35.8+/-3 weeks. All the cases were screened for hearing loss using the transient evoked otoacoustic emission device, followed by a second stage screninf for those who failed and cases given a refer then undergo an Atomated Aditory Brainstem Response test

Results: In the studied cases, 76.7% had hyperbilirubinemia, 8.73% were of low birth weight [<1500 g], and 15.5% were on mechanical ventilation. In the fist screening phase, 80% were given a Pass response and 20% were given a Refer response for the right ear. In the second screening phase, 91% were given a Pass, 9% were given a Refer

Conclusion: A comprehensive intervention and mangement program must be an integral part of screening programs in the postnatal period. Awarenedd about the value of hearing screening is important. Further assessment of high prevalence of hyperbilirubinemia are needed

Measurement of carnitine in preterm neonates suffering respiratory distress syndrome and the effect of its supplement

Background: Respiratory distress syndrome [RDS] is among the most common diseases of preterm infants. RDS is caused by a decreased production or secretion of pulmonary surfactant. Numerous causes of RDS have been identified, and the factors suspected to be involved in the pathogenesis of RDS are numerous, Carnitine is essential for the fetus and is provided via placental transport. As the gestational age increases, fetal tissues store increasing amounts of carnitine, therefore, preterm infants require exogenous carnitine supplementation for carnitine homeostasis. Treatment with carnitine has shown benefit in the respiratory status of ventilator- dependent adults, as well as stabilization of respiratory parameters and increased physical performance in adult patients with chronic respiratory insufficiency

Objective: The present study was designed to measure the level of free carnitine in preterm neonates with RDS and to evaluate the efficacy of L-carnitine therapy on those neonates

Patients and Methods: Forty preterm infants, including 14 females and 26 males. Study group were divided in to 2 groups, group A: received L-carnitin in a dose of 30 mg/kg/ day for 7 days and group B: did not receive supplementation

Results: our results show non statistically significant difference between group A [with Carnitine supplementation] and group B [no supplementation] at day 1. There was statistically significant higher serum carnitine level in group A compared to group B at day 7 [after supplementation]. Seven neonates [35%] in group A, and 13 [65%] in group B, needed surfactant administration and MV after 24 hours from admission and this difference was statistically significant. Dose of surfactant was statistically significant lower in group A compared to group B [P=0.001] and duration of mechanical ventilation was statistically significant lower in group A compared to group B [p=0.03]

Conclusion: L-carnitine is more deficient in preterm with RDS than preterm without RDS and its supplementation can reduce the need and duration of MV and/ or need and dose of surfactant