comparison of transcutaneous and total serum bilirubin in Egyptian neonates

Previous studies have suggested that transcutaneous bilirubinometry [TcB] may provide a useful method for screening for significant jaundice, thereby reducing unnecessary blood tests. The present study aimed to evaluate the validity of TcB versus serum bilirubin [TSB] measurements in Egyptian full term babies. Babies born at more than 34 weeks gestation who had not previously been exposed to phototherapy and were requiring blood sampling in the first week of life were inducted in the study. TcB measurements were made at the same time as. SB for 150 neonate [57% males and 43% females]. There was a significant positive correlation between SB and TcB measurements [n = 150, p < 0.0001] and TcB was more accurate in serum bilirubin level more than18mg/dl. Bilirubin can be measured accurately by TcB, but before hospital admission or exchange transfusion, SB should be done. Further studies should be done on neonates with different skin color and preterm babies

Predictors of neonatal mortality in intensive care unit in children's Hospital, Cairo University

Variations in mortality rates are important because they permit inferences about quality of care. Examination of care practices associated with variations in mortality rates can provide insights into how care practices might be changed to improve outcomes. The purpose of this study is to determine and report important causes of admission, incidence and causes of death for a large group of infants admitted to our neonatal intensive care unit [NICU]. The study comprised all 826 infants admitted to our tertiary-level NICU from April 2003 to October 2004. Data of newborns admitted to the NICU were analyzed retrospectively. Overall, the most prevalent indications of admission to our NICU were neonatal jaundice [n=296 [35.8%], infection [n=186 [22.5%], prematurity [n=162 [19.6%]], hypoxic-ischemic encephalopathy [HIE] [n=101[12.2%]], respiratory distress syndrome [RDS] [n=79 [9.6%], congenital heart disease [CHD] [n=44 [5.3%]], transient tachypnea of the newborn [TTN] [n=40[4.8%]], chromosomal or congenital anomalies [n=40[4.8%]]. The overall mortality rate was 29.1% [240 deaths]. The mortality rate was 69.4% for infants with birth weight less than 1000 g. 2.1% of the deaths = [n=5] occurred within the first 24 hours of NICU admission, 15.8% [n=38] within 2 days and 29.2% [n=70] within 3 days, and 91.3% [n=219] within 12 days. Only 8.75% of deaths [n=21] occurred after the fist month of NICU admission. The most prevalent conditions associated with death in The NICU were infection [135deaths [56.25%], RDS [64 deaths [26.7]], HIE [45deaths [18.8%], CHD [25 deaths [10.4%] and chromosomal or congenital anomalies [18 deaths [17.5%]]. Sex was not a significant predictor of death on multivariate analysis. Mortality rate in the NICU still unacceptably high, these results highlight the fact that many causes of neonatal deaths may be preventable

outcome of neonatal admissions to the intermediate care unit in new children hospital, Cairo University

Neonatal morbidity and mortality is a public health problem in developing countries. The neonatal period is considered a highly vulnerable time for an infant, who is completing many of the physiological adjustments required for extra uterine existence. This retrospective study was conducted over a period of one year in the New Children Hospital of Cairo University. The aim of our work was to identify the morbid conditions that affect the admitted cases, to calculate morbidity and mortality rates during the study period and to compare the collected data of this work with data of a previous study of the year 1998/1999. This comparison will be used as a tool to show variation in hospital quality of care. The total number of patients was 210 infants, number of males was 126 [60%] and number of females was 84 [40 %]. Mortality was influenced by gestational age i.e. the higher the gestational age the lower the mortality. Mortality was also influenced by birth weight as follows: In neonates weighing from 1001-1499 gm, the mortality rate was 76.9%, in neonates weighing from 1500-2499 gm, the mortality rate was 35% while in neonates weighing more than 2500 gm, the mortality rate was 27%. In addition, mortality is also related to diagnosis, as the highest mortality was seen in cases of respiratory diseases [33.9%] while the lowest mortality was seen in infants of diabetic mothers [1.5%]

Anthropometric determination in children with chronic liver disease

Assessment of nutritional status of 50 patients with chronic liver disease [CLD], was attempted using anthropometric techniques [weight, height, mid-arm circumference and triceps skin fold]. Its relation to the histopathological diagnosis of liver disease was also studied. According to the results of liver biopsy, patients were divided into 4 groups: chronic active hepatitis [CAH], chronic persistant hepatitis [CPH], cirrhosis and Bilharzial hepatosplenomegaly [Bil. HSM]. Results revealed that all parameters were affected in all forms of CLD. Weight was particulary affected among patients with CAH. Height and mid-arm circumference were most affected in cases of Bil. HSM whereas triceps skin fold thickness was mainly affected among cirrhotic patients. We believe that nutritional assessment as part of the routine examination of patients with CLD is mandatory for early intervension with possible reversing of nutritional deficiency and improving the quality of life of those patients particularly with likelyhood liver transplantation

Disseminated neonatal candidiasis in the neonatal intensive care unit

The study included 50 critically-ill newborns with clinical features of neonatal sepsis, selected when having a minimum of 2 of the risk factors known to enhance the development of systemic candidiasis namely, prematurity or low birth weight [90%], prolonged antibiotic therapy [80%], prolonged insertion of intravascular cannulae [70%], gastrointestinal surgery or diseases [38%], use of aminophylline [32%] or steroids [16%] and/or prolonged endotracheal intubation [16%].Candida albicans could be isolated in only one of 35 urine specimens obtained by suprapubic bladder aspiration. All blood samples [obtained from 50 newborns] and CSF samples [from 13 newborns] were negative for C.-albicans inspite of prolonged culture on appropriate media. Disseminated neonatal candidiasis seems to affect a minority [2%] of high risk critically ill neonates. In highly suspicious cases different specimens [Blood, Urine and CSF] should be cultured since the organism may be grown in only one of these specimens