Aymen Eshene

Hi - as you know , most bacteremia in NICU related to staph.epidermidis , which lives on baby skin and of course improper hygienic measures at time of invasive procedure lead to to such a complications. what i want to know : 1st - do we have to cover the catheterized umbilicus or leav it to air ? is there any study adressing the difference in colonization and infection between two practices (cover or donr cover ) . 2nd question : what is the daily care to uvc ? clean or wipe with N/S - Alcohol or bethidine ? any information thanks

Hi .. we i work , we dont see cases of neonatal tetanus , possibly because of effevctive immunization programme and hyigenic precaustion taken during delivery . but not uncommonly we see cases of normal babies delivered at home and their umbilical cord cut by non sterile knife ( often scissor) . so in such cases >> what should we do ??

Very Informative ,, thanks a lot

Hi >> in case you found MRSA in rectal swab , in otherwise healthy baby .. what is the managment plane? we dont have chlorohexidine powder .. is there any alternative ? how many decolonization attemp should we try ?

We don,t lock CVS

thanks a lot ,,

hi .. thanks for the information , we get used to change to meronam and vancomycin , ans as you said its too big decision for most of nicu admition .

i want to ask about chlorohexidine powder , is there any role for it in nicu ?

hi every one , on which base you choose one antibiotic over the other ? is there any local activity should be done with the help of microbiologist in order to formulate some combination which suit Nicu enviroment?? i know that most nicu choose ampicillin and claforan or gentamicin as first line of defense , but in case of failed therapy and no supportive information gained by blood culture , how can we choose the second line ??? where i do work we move ((empirically ) to our second line meronam and vancomycin but i feel this combination is to stronge to be used as second line and iam wondering what other combination can be used instead of this powerfull antimicrobe(fear of resistance of course) . our third line is amikacin and ceftazidine , but again , usualy we jump to this line with full of hope to kill the microbs but as you know hope alone is not microbicidal !! so is there any universal roles to be followed or ita based mainly on clinical background and the available data ? any answers on questions ?? thanks in advance

Hi every one >> i want to ask about long term effect of ucv and in specific on the liver .. ita not uncommon for the uvc to be placed in the liver , usualy we take it out and (if possible ) inserting another one (hopefully in the right position ) but some Neonatologist advice to leave it if the only solution passing through it is N/s (for couple of days) so .. is there any study done to adress the long term effect on the liver in case of wrong placement ? some times i dont feel in hurry to change it , so how serous is the wrong uc placement >?? thanks in advance

hi every one i want to ask about some practical point in managing hypotention . and here is the situations iam facing in every day practice : - delayed perfusion: ( septic chils or R.D ...etc) we dont wait to document hypotention in order to start therapy .. we give N/s then if no improvment we start iontrops so is it ok to manage and to start dopamine while the baby is still normotensive ??? - M.v babies on sedation Iv , we start dopamine to counter its effect even before documented delayed perfusion or hypotention so is it evidence based practice ? we dont have a protocol to follow , instead we adopt a managment plane in different setting from a personell (consultant) who got their training outside libya (UK, USA) . so any advice ??

hi every one i want to ask questions regarding shock therapy in cardiogenic shock .. i know its beyond the scope of this forum , but iam looking for an expert answer (practical not theoritical) during my cardiology rotation. ive seen a lot of cases in late neonatal peroid or , more commonly early infancy, knowing or suscpected to have cardiological problem coming in compensated shock phase (tachycardic' poor perfusion , normal bl.p weak pulses , sweating and cold extr) , when i examined the liver, frequently i found it enlarged. some has adviced me to give lasix then fluid 10cc /kg .and here i want to ask whats the best approach in this situation .?? aggressive fluid may overload the weak heart and lasix my cause hypotention (the last desired thing ) iam confused .. any helpfull inf

Hi how are you >> its first time to celebrate the world prematurity day in our hospital and our consultants are asking us for active participations so any ideas ? iam thinking of preparing lectures on : KMC , Nutritional support for Pt babies , golden hour .. we dont have a good protocol to follow in these topics so it will be of great value so any help ?

thanks for your input

hello every one ,, iam now working in the cardiology department and i see a lot of cases with congenital heart disease what we dont have here in my country is a program to enhance nutrition in these ill kids .. so almost for every case we diagnose for ex with big VSD ,, we know for sure that he will be a malnourished child in the next few months my question may be beyond the scoop of this forum but i hope i could find some resources to help me address this problem my goal is to help establishing a program in our unit to maximize the nutrition quality which is definitely will affect the outcome . how can i start ?? do i have to make a study over a certain population to have a data to be considered a cornerstone to any furthur steps ? please help

hello every one .. i found this words ( lung recruitment) difficult to understand and to apply in the real practice any one has experience to aplly the manuever? thanks

hello every one ,, i wonder if there is any techniques that would increase the chances for more successful UVC insertion ? we use feeding tube as UVC tube ( lack of facility ) , some drs, (especially in good sized baby) and in order to avoid placement of the tube in the liver , they put the first tube and advance it slowly , but if they feel any resistance , they put another tube (now we have 2 ) , the reason behind this technique is the first one stuck at the liver and the second one has no where to go so the only remained tract is toward the heart. i don't feel its right to do this , so any one has some answers ,,, if there is some useful techniques to improve the chances of optimum UVC ? and what about our technique??

can i apply to attend the conference?

accu check by roch >> we use heel prick .

hi >> sorry for late replying >> i have my area of interest regarding my research , i do need some help . anyway my research field is the factors affecting mother choice to breast ot bottle feed her baby ? so what is helpful now ? questionnaire ? how many parents do i need to make my study sounds good (scientificly).

Iam working now in pediatric endocrine OPD , so i have the chance to choose in which field my research will be but unfourtunatly i cant figure our anything iam not trained to do research and its a bit difficult to have a free supervisor to guide . any helpfull idea ?

yes ,, libyan council for medical specialization.

hello everyone >> iam preparing for the second part arabic board , and its mandatory to do research ... iam interested to expand my knowledge in this area but i dont know from where to start ? in my country (Libya ) we have sever data deficiency syndrome !! iam interested in the neonatal field ... so do you have an idea that help in this circumstances ???

thanks >