No abstract

Wrapping premature infants with gestational age <34 weeks in polyethylene plastics immediately after birth is associated with lower incidence of hypothermia.

Objectives To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction. Design A prospective observational study.Setting In the labour room, operation theatre, postnatal wards and neonatal intensive care unit (NICU) of a tertiary teaching hospital. Population All infants born in the hospital with a history of exposure to vacuum extraction.Methods A prospective observational study carried out over a 26-month period. All eligible infants were examined at birth and during the first 24 hours of life. Main outcome measures A diagnosis of SAH was based on detection of a tender fluctuant scalp swelling that crossed the skull suture lines of infants. Results Of 10,066 infants born in the hospital during the study period, 338 (3.4%) had exposure to vacuum extraction. SAH was detected in 71 (21.0%) of them. Forward multivariate logistic regression analysis showed that five factors were significantly associated with development of SAH: maternal nulliparity (adjusted odds ratio

Kiwi Omnicup is an effective alternative to the currently available Malmstrom metal cup for vacuum assisted delivery with no increase in maternal or neonatal morbidity or mortality.

Low dose streptokinase infusion was effective and safe in thrombolysing UAC-associated aortic thrombi.

Introduction: Medical and allied health educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. Without a doubt, appraisal of the educational climate has been emphasized as a key to the delivery of high quality medical education. In addition, the appraisal provides useful feedback to particular institution to improve their curriculum. Objective: This study was employed as part of the School of Medical Sciences (SMS) Universiti Sains Malaysia curriculum review process. It aimed to explore the strengths and weaknesses of the current medical curriculum thus could provide useful information to guide the curriculum review committee during the review process. Method: A cross sectional study was conducted on a total of 656 medical students from the first, third and fifth year of study. Purposive sampling method was applied. DREEM was administered to the medical students to evaluate the educational climate in the studied medical school. Result: A total of 511 (77.9%) medical students completely responded to the 50 statements of DREEM. The mean global score across phases of medical training was 128.36/200. The global scores for year 1, year 3 and year 5 were 138.94/200, 122.27/200 and 125.49/200 respectively. Results showed that; 1) the medical school had reasonably level of educational climates across phases of medical training; 2) the medical teachers were knowledgeable and well prepared for the teaching; 3) the students were overloaded with factual knowledge; 4) the medical teachers were quite harsh to students during teaching session especially in clinical phase; 5) students experienced a significant amount of stress that led to poor memory; 6) the learning process was inclined toward teacher-centered rather than student-centered learning; 7) students had a considerable healthy social relationships with peers as well as others; and 8) academic dishonesty became more apparent in the clinical phase. Conclusion: The medical school's educational environment across different phases of study was more positive than negative. However, there are plenty of rooms for improvement as perceived by the medical students. The medical school should address various important issues highlighted in this article during the curriculum review process.

Background: Therapeutic hypothermia provides up to 30% neuroprotection in moderate to severe hypoxic ischemic encephalopathy (HIE). Additional neuroprotection may be achieved by using concomitant pharmacologic neuroprotective agents. Aim: The aim was to evaluate the safety of concomitant neuroprotective therapy of therapeutic hypothermia and magnesium sulfate (MgSO 4) in the management of moderate and severe HIE in term and near-term infants. Study Design: Multicenter double-blind randomized controlled trial. Methodology: Term and near-term newborn infants (≥35 weeks) with a clinical diagnosis of moderate or severe HIE were randomized to either Arm A (therapeutic hypothermia plus MgSO 4) or Arm B (therapeutic hypothermia plus placebo) using a net-based randomization system. Both groups received, within 6 h of birth, standard hypothermia therapy (72 h of cooling to 33.5°C followed by slow rewarming over a period of 8 h) plus either MgSO 4 (250 mg/kg/dose ×3 doses) or placebo (normal saline). The groups were compared for short-term predischarge adverse outcomes. Results: A total of 60 patients were randomized (29 in Arm A and 31 in Arm B). Both groups had similar baseline characteristics (P > 0.05) including severity of HIE. There were no differences in the short-term adverse outcomes (death, seizures, thrombocytopenia, coagulopathy, renal failure, elevated liver function test's, hypotension, intracranial hemorrhage, necrotizing enterocolitis, pulmonary hemorrhage, persistent pulmonary hypertension, and pulmonary air leak syndromes) between the two groups (P > 0.05). Conclusions: The combined use of therapeutic hypothermia and MgSO 4 appears to be safe particularly with respect to maintaining normal blood pressure and coagulopathy. Long-term survival and neurodevelopmental outcomes remain to be evaluated.

Combined use of polyethylene body wrap and polyethylene cap was associated with a significantly higher mean post-stabilization temperature compared with polyethylene body wrap and cotton cap.