satyen75

Which neurological exam is currently folllowed by forum members for babies examination before disharge and why ? Have seen dubowitz examination and feel that will be most acurate.Kindly share your thoughts.

Yes , I do feel that is the case. Maybe the anatomy is also slightly malformed and it will need more pathological details .

Dear SIr, Thanks for sharing this. Is this strategy developed by you . Please clarify how you will give 8 ml say for 2 kg baby. Regards Dr Satyen

Yes, adhesion happen leading to second or third surgery due to the obstruction they produce. So i want to know what is the reason in some baby they are abundant and recurrent whereas in some it is negligible. ? If we know this may be some method can be looked for reducing the recurrence and chances of second surgery due to adhesions.

I have been intrigued by 2 cases of adhesions , One in a patient operated for ileal atresia and the other with NEC. What is the pathology behind this? Does the type of intestinal surgery or any defect ( vascular , chemical , duration of surgery) affect occurence of adhesions? Is there any way to protect it during surgery ? And any ways to conservatively manage and till when surgery can be delayed? Kindly post your opinions and evidence for this.

Yes, It is not pathognomic of NEC . A holisitic picture if it fits along with Xray should be considered to label NEC.

Wonderful Stefan, Have registered. Just told the way to update on recent evidence. THANKYOU.

Stefan you have raised a very important finding and its management. We do face this problem. A lot of time this is also due to retained meconium which mimics like pneumatosis and if the baby is fine continuing the feeds is important. So it is important to differentiate the two. IF there are other radiological features suggestive of NEC and pneumatosis like dialted bowel loops, bowel wall thickening and clinical features we also do take conservative approach and also involve the pediatric surgeon right away so that he is aware incase the worsening happens and the kid needs surgery at any point. It is also a good idea to look at the electrolytes and blood gas and cbc to look at hidden deterioration.

I have used LMA once for a difficult airway where Bag and mask ventilation was ineffective and baby had Pierre robin syndrome. Intubation was difficult but my senior colleague had come and intubated and we gave surfactant only after intubation. The baby was around 1.8 kg or so.

I have heard many speakers about the resuscitation trolly on which baby can be resuscitated while cord is not clamped . I want to know what is the status as of now, is it being in development phase, which company is making it and has some research /data come on this. Also is umbilical cord milking feasible or advisable when the baby is born non vigorous and practically ( in terms of amount of blood transferred /time required ) what is the difference between the two methods

congratulation... nice concept of solo speaker conference . We call it CME here though.

what is the cost of this course and any special charges for members from the developing countries.

steffan If you have returned back to clinical work please post the milk analysis report. Any other unit with research interest who are practicing this targeted fortification that you are aware of , please let me know Regards Dr Satyen

I would like to know if anyone is using the human milk analyser for macronutrient analysis of the preterm breast milk and accordingly fortification of the milk according to individual newborns needs . what has there experience been with the equipment by MIRIS ? Is it user friendly and requiring low maintenance ? What is the utility of this equipment in preterm care. Regards Dr Satyen K Hemrajani

Dear Stefan Are these curves not different from AAP curves in terms of the threshold they give for term babies for Exchange transfusion. I remember one baby within 24 hrs of life where we were contemplating exchange and on comparison we found that the NICE curves are more liberal for exchange transfusion at a younger age. My question is for term and > 35 week babies should we not follow the AAP ? And are these NICE curves based on some evidence and data or they are just presumptive charts based on certain specialists opinion. Regards Dr Satyen K Hemrajani