- Triage flow chart for assessing oral feeding risks in newborn.

Triage flow chart for assessing oral feeding risks
Assess	Classify	Treat-Manage
< 32 wks GA severely ill very immature clinically unstable	High risk	NPO OG/NG GT
32–34 wks GA Clinically unstable	Moderate risk	Tube feeding nonnutritive sucking
≥ 35 wks GA Medically stable	Low risk	PO/tube feeding breastfeeding

Adapted from Guidelines for Acute Care of the Neonate, 21st Edition, 2013–14, James M. Adams, Caraciolo J. Fernandes.Chapter 13—Nutrition Support, p.g 125

- Tools commonly used in neonatal ICU.

NICU Tools

(Tools commonly used in neonatal ICU)

• GIR.
• Sodium replacement formula
• Plasma osmolalit
• Half correction of Bicarbonate
• UVC length
• ETT Size
• ETT length at lip
• ETT length at nares
• Dopamine / Dobutamine calculation
• Creatinine clearance (Schwartz formula)
• Exchange transfusion

For all click here

- The Fenton growth chart for preterm infants.

The Fenton growth chart for preterm infants.

  “The Fenton growth chart for preterm infants has been revised to accommodate the World Health Organization Growth Standard and reflect actual age instead of completed weeks, in order to improve preterm infant growth monitoring.”

These growth charts:
Are: “commonly used in NICUs today” -  American Academy of Pediatrics 2014 Nutrition Handbook 

To download PDFs of growth CHARTS..  
2013 Preterm Growth Chart for Girls 
2013 Preterm Growth Chart for Boys 

Adapted from 2013 GROWTH CHART

- How to use an accuhaler?

How to use an accuhaler for bronchial asthma

- Shorter Antibiotic Treatment for Otitis Media!

Shorter Antibiotic Treatment for Otitis Media!

- Wolf-Hirschhorn Syndrome.

Wolf-Hirschhorn Syndrome

*Pathophysiology:-
results from deletion of the distal short arm of chromosome no 4 (1).

* Clinically, the minimal diagnostic criteria for Wolf-Hirschhorn syndrome (ie, ‘‘core’’ phenotype) consists of typical facial appearance , mental retardation, growth delay, hypotonia and seizures (or EEG anomalies)(2).

* Different categories of the Wolf-Hirschhorn syndrome phenotype are defined according to the extent of the chromosome.4 deletion(2):-

• 1st category :- caused by small deletion that is usually associated with a mild phenotype, lacking major malformations. This category is likely under-diagnosed.
• 2nd category :- caused by large deletions that cause the widely recognizable Wolf-Hirschhorn syndrome phenotype.
• 3rd category :- caused by very large deletions that cause a severe phenotype that can hardly be defined as typical Wolf-Hirschhorn syndrome.

- Down Syndrome.

Down Syndrome.

-History:-
English physician John Down first characterized Down  syndrome as a distinct form of mental disability in 1862 due to  his perception that children with Down syndrome shared physical  facial similarities (epicanthal folds) with those of Mongolian race.

-Incidence:-

• In general population 1:660.
• It is the most common Autosomal abnormalities.
• It has equal sex distribution.

-Causes (cytogenic types):-

1-Complete Trisomy 21 (non disjunction):-

• Incidence:- 95%.
• Due to non-disjunction of chromosome 21 during meiotic division (  (i.e failure of a chromosome 21 pair to separate) so an ovum with 24 chromosomes when fertilized by a sperm carrying 23 chromosomes lead to formation of a fertilized ovum with 47 chromosome.
• It occur during oogenesis more than spermatgenesis.
• The risk increases with age of the pregnant mother especially  over 40years as the primary oocytes of the mother have satyed in the prophase for a long time ( 40 years or more).
• Karyotyping:- 

47,xx+21(female down).
47,xy+21(male down).
(+ means that an extra chromosome is present).