Risk factors for neonatal sepsis in tertiary hospital in Jordan

To study incidence, mortality, maternal and neonatal risk factors and causative microorganisms for neonatal sepsis. A total of 60 neonates with sepsis were studied during the period between January and December 2005. The clinical presentations, maternal, and neonatal risk factors and the time of neonatal death were recorded. Four hundred ninety nine [10.2%] out of 4902 live neonates were admitted for various reasons to the neonatal intensive care unit at King Hussein Medical Centre. Sixty [12.0%] babies had proven sepsis, 28 [46.7%] of these with early onset and 32 [53.3%] with late onset sepsis. Maternal risk factors associated with neonatal sepsis were: cesarean section in 22 [36.7%] cases, premature rupture of membranes in 4 [6.7%] cases, eclampsia in 4 [6.7%] cases, and maternal urinary tract infection in 3 [5%]. Neonatal risk factors observed were: male gender in 40 [66.7%] cases, low birth weight in 38 [63.3%] cases, prematurity in 32 [53.3%] cases, low Apgar score in 10 [16.7%] cases, and mechanical ventilation in 12 [20.0%] cases. Gram positive bacteria were isolated in 44 [73.3%] cases of which four died. However gram negative sepsis was associated with higher morbidity and mortality rates. Twelve [20%] babies died, seven of them due to Klebsiella sepsis. Candida sepsis caused three cases of sepsis with one death. Most of deaths occurred out of working hours. Early recognition and prompt treatment of neonatal sepsis are of paramount importance particularly in the presence of risk factors

Acute disseminated encephalomyelitis

A 12-years-old female presented with clinical and radiological findings of acute disseminated encephalomyelitis, which is an inflammatory demyelinating disease of the central nervous system [few pediatric series have been published]. We report this case to stress the importance of early screening by magnetic resonance imaging and early therapeutic intervention in acute disseminated encephalomyelitis fin the prevention of high rates of morbidity and mortality

Effect of prematurity, intrauterine growth retardation on postnatal morbidity and mortality

To compare preterm small for gestational age [Intrauterine growth retardation] and preterm appropriate for gestational age on postnatal morbidity and mortality. This prospective study was conducted in Queen Alia hospital between June 2004 till end of March 2005 of total 100 premature infant [gestational age between 28-36 weeks], 50 premature small for gestational age [SGA] were match with 50 premature appropriate for gestational age [AGA] of same gestation and morbidity and mortality were recorded. There were no differences between the two groups regarding the characteristics except for finding of prolonged rupture of membrane. There was significantly higher proportion of SGA compared with AGA infant with 1-minute apgar score of 3 or less [31% and 15% respectively]. Hypogycemia was seen in 34% and 27% of SGA and AGA infants respectively. Hypotension occurred in 30% of SGA compared with 20% AGA. There was no difference in the frequency of respiratory distress syndrome, mechanical ventilation, infection or rate of congenital malformation. There was significantly higher mortality rate in SGA group [52%] compared with 28% for AGA. SGA had longer mean duration of stay of 54 days compared with 41 days in AGA. The higher mortality rate seen in SGA infants, appear to be due to poorer condition at birth. There is no evidence that SGA infants have more mature lung