maulikdr

Thanks @stefan...!

I am looking for deffination of still born...Do we have any reference related to those who are born almost like a still born(with 10-20 heart rate) and could not be resuscitated by NRP protocol effectively in next 20 minutes or so...are they also in still born category ? Kindly provide reference.

Its Aplasia Cutis Congenita (ACC) Read more on this on : http://www.easypeds.com/2012/08/a-ra...sia-cutis.html

Its Aplasia Cutis Congenita (ACC) Read more on this on : http://www.easypeds.com/2012/08/a-rare-case-aplasia-cutis.html

We recently had a full term normal vaginal delivered baby. Who had bilaterally on flanks scar like marks(see photo). His antenatal history and other examination is unremarkable. No associated anomaly as well. Don't know what it is at 'zero' hours of life...! Please share your views.

dear friends presenting you an eye opener. The baby came to us on day 5 of life. Paents applied the glove on baby's hand. The glove had string on the end to fix the glove on wrist. Unknowingly the string might have been tightened a bit more & it led to tremendous pressure on radial-ulnar arteries so much enough to generate ischemia of the hand. The baby had the glove on for 24 hrs. The parents recognised it only when baby started crying the next day and they opened the glove just in attempt to remove clothes and bath the baby..! The hand was red inflammed and in pre-gangrenous changes...! the string application had made a tight band like strip on wrist...! this is an eye opener for every one not to use string application gloves or foot socks. Accidently they may lead to ischemic injuries.

Very Novel idea. Experience can not be beaten by books or degrees...! We should request senior members to do something on it. DR.MAULIK SHAH

many issues have been debated on NRP'S NEW VERSION here are few comments from Dr.Ashok Deorari and Dr.Deepak Chawala (as displayed on : http://www.newbornwhocc.org/forthcomingevents/news-oct.html) The American Heart Association (AHA) and American Academy of Pediatrics (AAP) have recently published the neonatal resuscitation guidelines 2010 , as a part of the international consensus on cardiopulmonary resuscitation and emergency cardiovascular care. These neonatal resuscitation guidelines undoubtedly incorporate complete and most recent evidence on various aspects of resuscitation. The current guidelines have proposed paradigm changes with respect to the existing practices based on AHA/AAP 2005 recommendations like - use of room air for resuscitation, monitoring of oxygenation with pulse oximetry even in term babies, underplaying the role of assessment of color, endorsing delayed cord clamping and therapeutic hypothermia etc, which are enumerated below (Table 1). Unfortunately the AHA and APA in their quest for evidence-based medicine have partly ignored the feasibility and scalability of these guidelines in resource-limited settings, which bear the maximum burden of intrapartum related neonatal deaths. The current guidelines, in its present form are tailor-made for guiding resuscitation in tertiary care centers, with limited practical applicability in resource(financial and manpower)-crunched low- and middle-income countries, primarily due to recommending use of costly equipments like pulse oximetry, blenders for graded increase in supplemental oxygen etc, thereby making the whole process complex and less user friendly. However there are positive welcome changes like use of room air for initiation of resuscitation and less vigorous push for tracheal suctioning in non- vigorous neonates born through meconium-stained amniotic fluid. There is an urgent need for policy makers and stakeholders in resource-limited settings to generate simpler, less technology-driven recommendations for newborn resuscitation, keeping in mind the larger interests and needs of their countries. These recommendations should provide a middle path between the current AHA/AAP resuscitation guidelines and the Helping Babies Breathe resuscitationalgorithm5 for peripheral health workers. what are your views....? Dr. Maulik Shah neonatologist Jamnagar (gujarat-india)