tarek

Diaphragmatic disease usually manifests as elevation at chest radiography. Functional imaging with fluoroscopy (or ultrasonography or magnetic resonance imaging) is a simple and effective method of diagnosing diaphragmatic dysfunction, which can be classified as paralysis, weakness, or eventration. Diaphragmatic paralysis is indicated by absence of orthograde excursion on quiet and deep breathing, with paradoxical motion on sniffing. Diaphragmatic weakness is indicated by reduced or delayed orthograde excursion on deep breathing, with or without paradoxical motion on sniffing. Eventration is congenital thinning of a segment of diaphragmatic muscle and manifests as focal weakness. see the video E51_DC1_Movie4.mp4

@Andrej Vitushka There is By flouroscopy

I think this isveventration of the diaphragm and not diaphragmatic hernia There is no problem to start feeding as we can see all the gut below the diaphragm If you are not going to operate now and patient RR is showing tachypnea start with OGT according feeding protocols regarding his weight If he is tolerating this eventration and not tachypnic start oral feeding if his wt> 1.5 kg and increase gradually Dig for the history as it may be traumatic delivery Check his moro reflex nicely to r/o Erb's

What about his ECHO finding still have severe PHTN or improving from last ECHO If he is improving wait and see continue your weaning trials X ray chest is there is improvement in the hypoplastic side take care of sildenafil as some times causing lung collapse Just be patient

@rehman_naveed http://neonatal.cochrane.org/what-has-cochrane-neonatal-done-babies-download-site

Thanks too much Naveed I was following what i will post now because this was very big dilemma and i find this helpful for me If you kindly read it and give me your valuable comments https://uichildrens.org/health-library/fluid-and-electrolyte-management-newborn

@bimalc One of my friends in Minnesota i discussed this issue with her they are starting with 80 ml/kg and checking of sodium ,uop and adjust ivf accordingly so not all in US starting with 100 ml/kg And i am in favour of restricted intake initially and adiustement according UOP ,Na and Urea More fluids more IVH PDA and pulmonary hge So the most important is follow up and adjust accordingly allowing for physiological wt loss in the first 5 days

Thanks a lot @Hamed really its great help Thanks a lot @Stefan Johansson

IVH and ELBW It is really a bad experience having a 600 gms baby with IVH grade 3 or 4 What is your best practice to minimize the risk of IVH? Management of hypotension and risk of IVH Intubation and IVH who should intubate it is not always the most expert will be there Delayed cord clamping really we should not miss its benifits Painful procedures and IVH is it helpful to give morphine before any painul and irritant procedure like suctioning PDA and IVH should i give prophylactic endomethacin in first few hours of life

Transfusion guidlines in neonates Ultrasound chest and TTN diagnosis(double lung point) Prevention of IVH in ELBW

Sorry for delay i did not see the reply First you should be a provider NRP provider after that you will do the instructor course Regarding travel i think is not difficult I will ask my Boss for the course and i will let you know about her reply

Really i wish i could attend this conference Please,Can you tell me how much it will cost for 3 days

Hello Aymen I am NRP certified instructor in SNRP Saudi neonatal resuscitation program It is one day course Fees 500 Saudi Ryals for doctors 400 SR for sisters This for MOH doctors and sisters

Dear Aymen very good question One of the important web sites that i think helped me a lot to improve myself and my practice is NICUniversity you will find what you want . And may Allah bless you and all people in Lebya

Very good shift although whatsapp is also very good alternative