Impact of intermittent kangaroo mother care on weight gain of neonate in nicu: Randomized control trial.

OBJECTIVE: To measure the impact of intermittent kangaroo mother care on weight-gain of neonates in a neonatal intensive care unit. METHODS: The randomised controlled trial was conducted at the Department of Neonatology, the Children Hospital and the Institute of Child Health, Lahore, Pakistan, from March to October, 2018, and recruited newborns admitted to the neonatal intensive care unit. The subjects were randomised into case and control groups. Intermittent kangaroo mother care was given in the case group for seven days. Data was collected and analysed using SPSS 23. RESULTS: Of the 153 neonates, 140(91.5%) were included; 70(50%) in each group. The most common reason for admission was bronchopneumonia 49(35%). In the case group, average weight gain was 10.22±1.65 grams/kg/day compared to 7.87±1.71 in the control group (p=0.0001). The average length of stay in the case group was significantly low compared to the control group (p=0.003). Multivariate analysis determined the effect of kangaroo mother care therapy as effective (p<0.0001). CONCLUSIONS: Intermittent kangaroo mother care was found to be effective for improving weight-gain in neonates in addition to the conventional treatment.

Targeted monitoring of nosocomial infections in a neonatal intensive care unit / 现代临床护理

Objective To explore the incidence of nosocomial infection in a neonatal intensive care unit(NICU) so as to come out with scientific and effective measures for infection control. Method Real-time monitoring system was used for investigating nosocomial infection of ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), and central-line associated bloodstream infection (CLABSI) in NICU. Results Among 2 836 patients, 28 patients were infected, with the rate of 0.99%and the case-time infection rate of 1.09%. The nosocomial infection manifested to be blood infection with the rate of 35.48%, and 10%of main pathogens were gram-negative bacteria. Conclusions Targeted monitoring in NICU can make the nosocomial infection information acquired timely, objectively and accurately. The strict and intensified prevention and control program should be adopted to reduce the neonatal nosocomial infection.

The prevalence and pathogenic bacteria and their antibiotic susceptibility of urinary tract infections in NICU / 中国小儿急救医学

Objective To study the constituent ratio and antimicrobial susceptibility patterns of pathogenic bacteria in patients with urinary tract infection (UTI) in NICU. Methods Data were collected retrospectively of neonates who admitted to NICU in St. Louis Children' s Hospital in Washington University School of Medicine between Jan 1 ,2005 and Dec 31,2006. Results The prevalence of UTI in NICU was 6. 5%. Gram-negative organisms were the most common agents of UTI in NICU,of which Ecoli ranked highest ,followed by Klebiella and Enterobacter cloacae. Of gram-positive organisms Enterococcus species and Coagulase-negative Staphylococci were the most common agents. Cefepime and gentamycin showed high activity against gram-negative organisms. Overall, non-E. coli microorganisms showed more resistances compared with Escherichia coli. The best susceptible antibiotics for gram-positive organisms were vancomycin and rifampin. Almost all gram-negative bacteria showed resistant to ampicillin and all of gram-positive bacteria resistant to penicillin and oxacillin. Conclusion Gram-negative organisms were the most common agents of UTI in NICU in this study. The drug resistance of bacteria is severe,especially to ampicillin and penicillin,which will be no longer the first choice clinically. So urine culture should be examined when initiating antibiotics treatment for UTI.

Pregnancy outcome of gestational diabetic mothers: experience in a tertiary center.

BACKGROUND: Carbohydrate intolerance is the most common metabolic complication of pregnancy. Gestational Diabetes Mellitus (GDM) poses numerous problems for both mother and fetus. The objectives of this study are to find out the incidence of gestational diabetes mellitus in pregnant women and their pregnancy outcomes. It was also to discover the risk factors for the admission of neonates to the Neonatal Intensive Care Unit (NICU). DESIGN AND PATIENTS: A hospital-based prospective study performed at King Khalid University hospital (KKUH), where 685 pregnant women who were diagnosed with gestational diabetes mellitus, out of 8000 pregnant women registered between January 2000 - December 2001, were followed and their outcomes studied. RESULTS: The incidence of gestational diabetes mellitus was found to be 8.6% (95% C.I: 8.1, 9.3). There were 511 (74.6%) spontaneous vertex deliveries, and 148 (21.6%) were delivered by lower segment cesarean section. Maternal morbidity in these women was 1.2%. A total of 697 babies were delivered by these 685 women, out of whom 675 were singleton pregnancies, 9 sets of twins and one set of quadruplets. Six-hundred-eighty-seven babies were born alive, 7 babies died in utero and 3 died in the neonatal period. The incidence of neonatal intensive care admission was 4.9%. The mean length of stay in the NICU was 16 days. The commonest cause of neonatal NICU admission was hyperbilirubinemia (41.2%). The risk factors for NICU admission were delivery by non SVD procedure (RR: 4.6, 95% C.I:2.8, 7.7), preterm deliveries, (RR: 4.6, 95% C.I.:2.7, 7.7), and induction of labor (RR: 2.5, 95% C.I: 1.4, 4.5). CONCLUSION: The observation and quantification of maternal outcomes with gestational diabetes mellitus are necessary, so that proper measures could be taken to reduce complications during delivery and the neonatal period and thereby, minimize particularly NICU admission rate.