Jaafar Rohana

Randomized controlled trial of lung lavage with dilute surfactant for meconium aspiration syndrome.

OBJECTIVE To evaluate whether lung lavage with surfactant changes the duration of mechanical respiratory support or other outcomes in meconium aspiration syndrome (MAS). STUDY DESIGN We conducted a randomized controlled trial that enrolled ventilated infants with MAS. Infants randomized to lavage received two 15-mL/kg aliquots of dilute bovine surfactant instilled into, and recovered from, the lung. Control subjects received standard care, which in both groups included high frequency ventilation, nitric oxide, and, where available, extracorporeal membrane oxygenation (ECMO). RESULTS Sixty-six infants were randomized, with one ineligible infant excluded from analysis. Median duration of respiratory support was similar in infants who underwent lavage and control subjects (5.5 versus 6.0 days, P = .77). Requirement for high frequency ventilation and nitric oxide did not differ between the groups. Fewer infants who underwent lavage died or required ECMO: 10% (3/30) compared with 31% (11/35) in the control group (odds ratio, 0.24; 95% confidence interval, 0.060-0.97). Lavage transiently reduced oxygen saturation without substantial heart rate or blood pressure alterations. Mean airway pressure was more rapidly weaned in the lavage group after randomization. CONCLUSION Lung lavage with dilute surfactant does not alter duration of respiratory support, but may reduce mortality, especially in units not offering ECMO.

Randomized controlled study of the effects of different durations of light exposure on weight gain by preterm infants in a neonatal intensive care unit

A randomized controlled study was carried out on 96 preterm infants (>37 wk) with birthweight less than 2000 g admitted to a neonatal intensive care unit. The aim was to compare the weight gain between preterm infants exposed to 12 h cyclical lighting (intensity of light: 78.4 ± 24.7 lux, mean ± SD) and those exposed to a continuously dim environment (5.9 ± 1.9 lux). The exclusion criteria were infants with major congenital malformations or who needed continuous lighting for treatment procedure and care. From day 7 of life until discharge, 50 infants were randomized to receive 12 h cyclical lighting and 46 infants to a continuously dim environment. There was no significant difference in the mean birthweight (12 h lighting vs continuously dim: 1482 vs 1465 g, p= 0.8), mean gestational age (31.6 vs 31.4 wk, p= 0.6), median duration of hospital stay (28.5 vs 28.5 d, p= 0.8), mean age to regain birthweight (13.0 vs 12.9 d, p= 0.3), mean weight gained by day 14 (27.6 vs 36.2 g, p= 1.0), median weight gain per day (11.9 vs 12.2 g, p= 0.9) or median body weight on discharge (1800 vs 1800g, p= 0.4) between the two groups of infants.

Fluid recovery during lung lavage in meconium aspiration syndrome

Lung lavage using two aliquots of 15 mL/kg of dilute surfactant was performed in 30 ventilated infants with severe meconium aspiration syndrome (MAS). Mean recovery of instilled lavage fluid was 46%, with greater fluid return associated with lower mean airway pressure at 24 h and a shorter duration of respiratory support.

Pneumatocoele in a neonate with perinatal tuberculosis

Pneumatocoele, a rare complication of cavitary pulmonary tuberculosis (TB), had not been reported previously in neonates. We report here a premature infant of 28 weeks gestation weighing 1150 g who had pneumatocoele following pulmonary TB infection. He was diagnosed to have TB pneumonia at 2 weeks of age (figure 1A) when acid fast bacilli were isolated from his tracheal aspirate. Tracheal aspirate culture and polymerase chain reaction for Mycobacterium were also positive. He …

Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015

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Sudden infant death syndrome: Knowledge and practise in parents of preterm infants

Preterm infants are at higher risk of sudden infant death syndrome (SIDS) compared with term born infants and the risk is inversely proportional to the gestational age and birthweight. Parents of these infants should have adequate knowledge and practise the recommended SIDS risk reduction measures.

Polyethylene versus cotton cap as an adjunct to body wrap in preterm infants

Occlusive body wrap using polyethylene plastic applied immediately after birth had been shown to reduce hypothermia among preterm infants. Various adjunct methods have been studied in an attempt to further reduce the incidence of hypothermia. This study was conducted to determine whether polyethylene cap is more effective than cotton cap as an adjunct to polyethylene occlusive body wrap in reducing hypothermia in preterm infants.

Newborn screening of G6PD variants using long term storage of dried blood spot

Aims To establish a rapid and simple DNA extraction method from dried blood spot (DBS) by using an automation system and to evaluate the use of DBS specimens for G6PD single nucleotide polymorphism (SNP) genotyping. Methods 100 DBS (stored up to 1 year) were subjected to DNA extraction using Qiagen Mini Kit with QIAcube automation system. Eluted DNA was subjected to OD reading to determine the A260/A280 ratio. DNA from each sample were subjected to sequencing and genotyping using Taqman MGB genotyping analysis for 1376 G>T, 1388 G>A, 95 A>G, 1024 C>T, 871 G>A, 487 G>A, and 563 C>T, 392 G>T of G6PD gene. Results Ratio A260/A280 of all samples ranged from 1.7 to 1.9. All samples were able to be amplified and the types of variants were able to be identified respectively. Conclusion Our study clearly shows that genomic DNA in dried blood spot in proper storage is stable and easily to extract. This approach could be utilised in newborn screening for other genetics diseases that are amenable to DNA analysis. This method provides a useful alternative to conventional DNA isolation, especially in clinical settings, as it enables easy storage and transport of samples from the point of acquisition.