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sameera_reddy

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Everything posted by sameera_reddy

  1. Mild variants of bronchomalacia, even borderline hypocalcemia may produce such symptoms
  2. Want to know if plain Amphotericin B can be used in preterms without sonication
  3. 1.7kg neonate born to non consanguineous parents,one of the twins with antenatal diagnosis of intestinal obstruction was operated on day 2 of life.A jejunal web was found intraoperatively. Baby tolerated procedure well. Post-op baby was on antibiotics of piperacillin and Tazobactum, Amikacin and metrogyl.Baby was started on PICC line for Tpn.septic parameters were negative. Baby was started on feeds after 8 days and slowly escalated. After 3 wkd post op CRP became positive and blood culture grew coagulase negative Staph. Picc line removed Baby was started on Vancomycin . CRP though showed a downward trend in the first 5 days suddenly increased 4 fold.Again thorough evaluation was done for sepsis and started on fluconazole,Amikacin and Piptaz was restarted.Serial CRP monitoring showed downward trend for a week and again started going up and this time baby develops thrombocytopenia 63,000/mm3.Now clinically baby has pallor, active on full breast feeds and ashen grey hue to skin colour.Baby has been gaining wt slowly and though baby is a month old it has not regained birth weight and she is now 1.6kg on supplements . I would request you all for your opinions regarding further management.
  4. In extremely premature neonate s we do see these kind of burns with the same kind of soft foam wrapping probed
  5. Baby's renal functions are normal. Parathormone and Vit D levels are low normal.During the initial days baby had very bad subacute fat necrosis/sclerema which we are supposing to be the cause. Baby is sucking well at breast, fair activity levels with no hypertension now
  6. How is neonatal hypercalcemia >17 managed in a term LGA perinatal asphyxia child aged 25 days ?.Is Ethidronate routinely used after normal saline and frusemide infusions.Opinions on using sc calcitonin. Child is on full feeds.He had elevated blood pressures with LVH in 2nd week of life managed with frusemide infusions.
  7. I would be great full sameeranaveen @ gmail. com
  8. Usually larger babies are difficult to manage on CPAP with out sedation and smaller ones tolerate quite well with out sedation.We also debate multiple times on the nature of sedation to be given and some times we trick the babies with a oral pacifier and rarely we use Oral Pedichloryl
  9. I need charts which have both gestation and Weight criteria basically for preterms
  10. Can some one provide me the link for Cockington charts used as a guide for use of phototherapy in the management of neonatal hyperbilirubinemia published in journal of pediatrics 1979,95:282-285
  11. Thank u for the guidelines in term healthy babies.Kindly provide me the guidelines for preterms who stay in NICU for longer periods.Any experiences with stainless steel kindly share
  12. Kindly advise me what is the ideal material to be used for containers in which expressed breast milk can be stored in refrigerators.I am aware that glass is ideal but it is practically difficult. I am using stainless steel containers as of now.Is plastic any way superior to it.Kindly also suggest me the references. The reason for the question is problems of rusting with stainless steel material
  13. If the neonate coming into NICU IS EXTREMELY PRETERM,Surgically high risk,MAS,PPHN as a practice we insert a peripheral arterial line in the left hand for sampling and ABG AND ALSO FOR IBP monitoring.By doing this ,many access sites are saved of a puncture.We secure a PICC line for TPN administration.And lastly we do something without evidence based that is to provide magsulph dressing to the IV site as soon as the canula is removed,this helps us for recycling the sites in the near future 3-5days
  14. When mothers were treated with MgSO4 for eclampsia/preeclampsia we had many a occasions babies were born asphyxic and after resuscitation and infusion with calcium they improved but MgSO4 AS TREATMENT FOR Asphyxia no experience
  15. Gastric emptying is not required at birth.The reason we put a tube in is to rule out TOF but we dont lavage the contents.The calories in Gastric aspirate work as initial energy for the newborn.If baby cries well at birth no need to do even suction.
  16. The clinical condition of the baby was X-Ray still showing RDS but lung volumes are better,RR50-60/MIN,no signs of sepsis.I am very much aware that SIMV is superior in the context but the hitch is the weight of the baby.Being small the tiring out phenomenon is a higher risk here and also the possibility of an IVH if distress continues.When we talk about VG-Volume guarantee we are directly targetting the minute volume and infact that is the reason why we use VG.We have been using both these modes successfully on many neonates(>1000 of them) in the past 7 years and we have also been using PSV and SNIPPV also in different groups. The reason for this discussion is to have suggestions from the experienced forum if any thing regarding the inspiratory time,flow could be altered in SIPPV to counter the hypocarbia happening to prevent PVL in future
  17. Which is a better mode of ventilation SIMV+VG or SIPPV+VG in a 1 kg 28 week neonate post Surfactant with Fi O2 > O.5 and PaCO2 of 34
  18. Hai, During the care of preterms 29-32wks after the initaial days of Early NEC IS DONE WITH ,we encounter problems of feed residues(upto20-30-%).We initially start them on Domperidone0.1-0.2ml/kg/dose and if still present add up Omeprazole1mg/kg/day and if still persistent add up Erythromycin.There are conflicting dosage schedules here though we start at 10mg/kg/dose qid.I want to know from the forum whether such high dose will not result in gastritis though I have never encountered the same problem and also whether the dosing is correct:)
  19. In preterms we always use 0.45%NS for boluses if they require and also the same for hypernatremia.If the drop is too rapid with this under strict observation we use Normal saline and we usually encounter a problem of hyponatremia compared to hypernatremia in this ELBW'S
  20. In CVL if colonisation occurs it leads to formation of microcalyx at different sites which are very resiatant to action from any infusate and in that situation how can infusing antibiotics through these lines be of any help.Can some one in infection control department help in addressing this
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