Aymen Eshene

Thanks for the information. Do you know how much does it cost?

Hello Dear i have one baby delievered to a mother with active chickenbox lesion which was appeared 4 days before delievery. baby asymptomatic and we dont have VZIG ( not in libya, not in tunisea). what can i do ? oral acyclovir ? iv acyclovir or just observation?

Hello Dear I would like to share with you this photo for a 28 preterm baby aged now 30 days. Commenting on a abdominal x ray a bit challenging for me and i want you kindly to comment on this x ray. please if you have an x ray at your PC OR Phone upload them and let us make this post a reference for NEC X rays. X RAY S0 I0.BMP

can you post here the pain score you are using >??

Thank you very much. unfortunately, family centered care is still far away from our hands. I hope one day it will thanks a lot and keep the good work up.

Hello, Thank you for your reply. Its mainly based on two thing 1- Clinical condition and respiratory distress which need M.v as Respiratory support ( Spo2,Co2). 2- Radiological finding of infiltrates that is more localized and doesn't fit a classical TTN. I appreciate any input regarding the above mentioned point of veiw.

Hello dear where i work, i have seen a lot of babies admitted and treated for pneumonia and a significant number of them have had no maternal risk factors for infection. this point is making a lot of of argument and discussion between us and the obs-gyn team. usually we look for PROM, UTI, Meconium, GBS, prematurity, Chorio. Also we take into consideration other risks like the need for resuscitation and apgar score. Recently , i red an article about the role of multiple vaginal examination as a risk for infection and in another article they were discussing the possibility of vernix as a main factor leading to pneumonia . Now i will formulate my questions What are the unusual risk factor for infection ? Do you do a tracheal aspirate or gastric aspirate as a part of your workup ? In which cases you add antiviral or antifungal to the treatment plane?

Hello my colleagues . My case for today is a term male baby born to multiparous mother . healthy , well . on examination he has this mass which is somehow semisolid , movable , pedunculated . it doesn't interfere with feeding or breathing . His investigation was normal . So i referred him to a pediatric surgery and iam waiting for updated . i took two pic ( permition of course had been taken ) . So , What is next ?

Thanks a lot for your help . your article is of great help . thanks for your time and support . Thank you for your very useful information . Waiting for U/s results .

Hello . I would like to share with you these pictures for a term baby who was born in a good condition after uneventful pregnancy . So , what to do next ? Imaging for head and abdomen ? ( permition taken ) Thanks .

Hello . I would like to ask your help to get this assessment tool . its a 74 questions that measures the basic knowledge of a neonatal nurse . i couldn't find it on the net . so any one of you have a soft copy (pdf format ) ? thanks in advance.

Hello every one I hope you all doing very well i want to talk with you about an important topic in our daily work . Stress with Nicu . we all face difficult time , difficult parents as well , but i want to share these two stories which give you a clear view about the massive stress we are facing here in libya . the first story about abnormal baby delivered to a commander of a strong militia who pointed his gun toward my head when his sun passed away in his first day of life . he refused the congenital abnormality we had discovered about the baby and insisted that it is a medical mistake that caused the death . i escaped the clinic that day and saved my life ! Police intervened very late but a father's relative had successfully convinced him about the abnormality ( CCHD ) . The second baby is the one i wrote about in the virtual Nicu here in our forum few weeks back . a suspected case of perrie robin sequence who had pneumonia since birth but didn't respond to many antibiotic he stayed in our Nicu for 32 days (m.v) then passed away . His clinical course complicated by sepsis and Vap . what we are nowadays is accusation about the possibility Nosocomial infection and the whole family is asking for indemnity because they said there wasn't sepsis initially . we have an infection control team who are doing there best in fighting infections but cases and incidents happen from time to time . those two cases i have shared is just an example for a routine challenges feeling pain and lost is a routine here . sometimes i feel very depressed and it affect my life in every aspect . i have a wife and two kids . my wife praying every duty to god for me not to have any trouble so i can come back to the home psychologically sound . My country in a state of chaos since 2011 and i don't expect it to be any better in the near future . so , What is the most difficult situation you been through ? ofcourse related to nicu ? To what extent theses challenges affect your personal life ?

Hi How are you all is there any chances for fellowship in neonatology where do you work ? whats the requirement of acceptance for a physician from overseas countries ? i am a certified Arab broad specialist , i have a 3 years experience working in a level 3 Nicu in for a clinic with around 300 delivery per month . I've heard about the MTI program in uk , so do you know any information about it ? or any other similar program ? Thank you

Application of EEG monitoring in Nicu

hi .. i want to know if any one have a job description for neonatal intensive care unit physicians and nurse ??? please send if you have

thank you very much its great to have them online iam watching ..

thanks tarek for your answer .. so .. i want to take these course. also .. i want to become instructor is it the same ?? i mean how many steps does it take ?? its ok for me to travel to saudi arabia its not that difficult .. waiting for reply

Hi Every one .. My question is about observership programme .. These kinds of programmes is new for me and i know someone who took it for 2 month in USA when i talked to him he said that was an awesome experience as allowed him to have a closer look on how things done and various issues in Nicu ( Exposure to different cases and new method of management - NO Cooling ..ect ) .. So do you have this programme in your hospital ? if so whats the Pre-requisite ? thank you .

Hi Every one .. thanks for your reply in advance .. I want to ask about NRP instructor / provider courses .. In libya we ve established our neonatal society this year and we are looking to train some members to be a certified trainee , in order to expand the neonatal resuscitation knowledge and skills all over the country as future target . so as the Country is not very stable now , we think about sending members outside libya to the nearby country ( egypt / tunisia / jordan ) . do you have any idea how much does is take ( Time & fee ) any one of our 99nicu memeber who is a Certified NRP here may have things to add iam waiting for your response ..

hi >> thanks in advance for your help and responses i know i ve asked a big question but i will tell you in the meanwhile in my country libya we are having a real challenges and obstacles ( mean income for a physician now in libya 170 dollars , and most of embassy are closed so its a dream to travel outside and attend conferences ) as a physician interested in the neonate i want to attend conferences and to participate in activities to update my knowledge and to improve level of care provided for the babies . so .. i was looking for websites / online conferences / webinars / ...ect so if you have any website or if you have any previous online activity regarding neonatal care let me know

how can i participate ,?? online ???

thanks a lot for your help >>

morphine/ midazolam or fentanyl + ms relaxant .. this combination or using of of them is the most cimmon among different protocoles what we use is midazolam+ atracur. it works well but in terms of evidnce based practice , i dont know which is the best .

thanks a lot for a reply . iam going to give a lecture to new residents about how can we found a trustable info ? what is the best websites in pediatrics ? the hierarchy of evidence ? i didnt write dowen my objectives yet , but u think i will focus on : evidence based medicine hierachy of evidence trust it or trash it ( the quality o info) how know the good websites ect hopefully clarify it enough ? so any ideas to make a great lecture!

hi ,, i want to prepare a lecture about this subject any help ??