Cup feeding has been suggested as an alternative to bottle feeding to help promote breastfeeding by avoiding nipple confusion. To demonstrate the possibility and utility of cup feeding, records of 59 preterm and low birthweight babies (born before 37 weeks' gestation) admitted to a neonatal intensive care unit (NICU) from May 1995 to April 1996 were analyzed. Feeding was initiated on cup if swallowing was present and cup feeding was possible as early as 29 weeks' gestational age with a birthweight of 900 g. In the case of five infants (38 per cent) in the gestational age group 28-30 weeks, 19 infants (52 per cent) in the 31-34 weeks' gestation group, and six (56 per cent) in the 35-37 weeks' gestation group, feeding could be commenced directly with a cup. Out of 59 infants, 33 infants (56 per cent) could be discharged on exclusive breastfeeding. It was concluded that cup feeding is a useful alternative to bottle feeding and an effective method of feeding preterm and small infants in NICU. Cup feeding allows successful breastfeeding without causing 'nipple confusion'.
Introduction: Endovascular repair of aortic aneurysms with difficult anatomy is challenging. There is no consensus for planning such procedures. Methods: Six cases of aortic aneurysms with challenging anatomical features, such as short, angulated, and conical necks and tortuous iliacs were harvested. The computed tomography (CT) scans were anonymized. Lifesize 3-dimensional (3-D) printed models were created of the lumen. Endovascular operators were asked to review the CT angiography (CTA), make a management plan, and give an indication of their confidence. They were then presented with the equivalent model and asked to review their decision. Their attitudes to such models were briefly surveyed. Results: A total of 28 endovascular operators reviewed 144 cases. After review of the physical model, the management plan changed in 29 (20.1%) of 144 cases. Initial plan after CTA review was endovascular 73.6%, open repair 22.9%, and second opinion 3.5%. After model review, this became endovascular 67.4%, open repair 19.4%, and second opinion 4.8%. Although the general trend was toward more open procedures, off-label techniques reduced from 19.4% to 15.2% following model review. When the management plan did not change, level of confidence did increase in 37 (43.5%) of 85 cases. The majority of operators stated that they would find models useful for planning in some procedures. For 1 case, the change in the percentage of participants being sure in the management plan was statistically significant (P ¼ .031). Conclusion: The 3-D printed models may be potentially useful in planning cases with EVAR. It is a paradigm that warrants further investigation.
a b s t r a c tLocked-in syndrome is one of the most disabling states characterized by the preservation of conscious mind within a quadriplegic and anarthric body. Recently, there has been increased public awareness about this rare condition, and more cases are reported. The commonest causative lesion is bilateral ventral pontine damage secondary to vertebrobasilar artery occlusion. Clinicians need to be familiar with the condition because there is a high chance of erroneous diagnosis, such as coma or vegetative state, after a prolonged unconscious state. It is often the relatives or carers who recognize the conscious state first and report that the patient can communicate through his eyes. Because of complications, such as aspiration and sepsis, about 40e70% of sufferers die in acute phase of illness. However, advancements in medical care, rehabilitation, and communication technology have enabled many chronic locked-in syndrome patients to lead meaningful lives in the society with the help of family and friends.
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