Department Of Neonatology Research Articles

Risk Factors of Birth Defects: A Case-control Study in a Tertiary Level Hospital

Worldwide birth defects are one of the main causes of morbidity and disability among children. The risk factors vary significantly by geography, depending on local environmental and genetic factors. Our aim was to ascertain the local risk factors for birth defects, which is the first step toward devising preventive policies. From February 2018 to October 2019, this case-control study was undertaken at Sir Salimullah Medical College and Mitford Hospital, Dhaka, in the Department of Neonatology and Obstetrics. During this period 49 admitted newborns with birth abnormalities were selected as cases, and children of similar gestational age, sex, and post-natal age were selected as controls for each case. To determine the risk factors for birth abnormalities, in-depth interviews with mothers regarding their demographic and obstetric histories were recorded and analyzed. We found that mothers aged 26-30 years had a significantly increased risk of birth defects (p = 0.01). Additionally, mothers who had a history of diabetes had a considerably higher risk of delivering a child with birth defects (p = 0.03). During the pregnancy period, mothers who attended <4 antenatal care (ANC) visits and mothers who did not take iron or folic acid supplementation had a higher risk of birth defects (p = 0.02 and p <0.01, respectively).We found out that the majority of birth defect risk factors are preventable or controllable. By promoting appropriate antenatal care and educating mothers about relevant regional risk factors, the occurrence of birth defects can be lowered significantly. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 33-39

Maternal and Neonatal Risk Factors for Developing Early Onset Newborn Sepsis (EONS) in a Tertiary Care Hospital in Bangladesh

Background: Globally, sepsis is still one of the major causes of morbidity and mortality in neonates, in spite of recent advances in health care units.
 Objective: To identify maternal and neonatal risk factors for developing early onset newborn sepsis (EONS) in a tertiary care hospital in Bangladesh.
 Methods: This cross-sectional study was carried out in the Neonatology department of Mugda Medical College Hospital (MuMCH) between November 2021 to April 2022 among the neonates who had clinical features of sepsis developed within 72 hours of postnatal age. After taking informed written consent from the parents the clinical profile and risk factors (both maternal and neonatal) were noted in a preformed data collection sheet. Blood for septic screening and C/S were done to confirm the diagnosis.
 Results: Majority (90.0%) newborns had maternal risk factors of sepsis whereas 6(10.0%) had not any maternal risk factors of sepsis. Mothers of majority (80.0%) newborns with sepsis had PROM>18 hours. One third had UTI/ lower abdominal pain/ fever within last 2 weeks of delivery. In more than half (56.7%) of the newborn septic cases their mothers had prolonged labour. More than half (58.2%) newborns belonged to gestational age less than 37 completed weeks. About two third (66.7%) newborns belonged to birth weight less than 2500 gm. Almost one third (30.0%) newborns had prelacteal feeding. More than two third (70.0%) newborns were given 7.1% chlorohexidin. Six (10.0%) newborns required resuscitation by bag mask at birth.
 Conclusion: For newborn sepsis maternal risk factors PROM>18 hours, prolonged labour, P/ V examination more than 3 times were more common. Neonatal risk factors include prematurity, low birth weight, prelacteal feeding.
 Bangladesh J Obstet Gynaecol, 2022; Vol. 37(2): 132-138

The indicators of value consistency and interpersonal conjugation of values of employees with executive as a foundation of personnel management in medical organization

The article presents results of diagnostics of value consistence and interpersonal value conjugation in employees of medical organization. Purpose of the study is to identify the value consistence index and interpersonal value conjugation of employees of different departments of medical organization and on this basis to develop recommendations for executives concerning performance of their managerial functions. The study covered 284 employees of "The Municipal Clinical Hospital № 40 of the Moscow Health Care Department". The "Sh. Schwartz Value orientations" questionnaire was applied. The mean and centered values were calculated for each value index at both levels of values representation. At the level of normative ideals dominant value the first place in all departments except obstetrics, gynecology, and neonatology takes universalism. The employees of maternity hospital positioned safety on the first place. The second place was given to hedonism in departments of oncology, surgery and internal medicine; to kindness in departments of obstetrics, gynecology and neonatology, to achievement in department of intensive care; stimulation in department of diagnostic; safety in non-medical departments. The third place was given to safety in department of oncology, surgery and therapy; to conformity in departments of obstetrics, gynecology and neonatology; and to hedonism in non-medical departments. The comparison of value profiles of behavioral priorities established that in all departments one of the three dominant ranked values was power, in four departments - hedonism, in five departments - stimulation, in four - achievement, in one - tradition. The qualitative assessment of personality value profiles identified four types of department employees: mobile, sensitive, rational and stable one. Based on quantitative data of the Department Value Profile chart executive can develop management strategies using socio-psychological methods of personnel management.

Changing perspectives of medical staff after Human Milk Bank opening. A single-center retrospective study of a tertiary neonatal unit.

Breast milk is an exceptional source of nutrients for neonates, delivering a unique composition of bioactive ingredients such as immunoglobulins, hormones and oligosaccharides. Our research aimed to understand the attitude of medical staff towards milk donation and its use in the NICU (Neonatal Intensive Care Unit) and to determine the influence the milk bank has had on the feeding practices of our patients after the introduction of local Human Milk Bank (HMB). Twelve closed-question questionnaires were distributed among employees from the Department of Neonatology and Obstetrics before and after (identical set of questions) the implementation of the HMB. The attitudes of staff towards different aspect of milk banking were recorded. We obtained 67 fully answered questionnaires in 2019 and 48 questionnaires in 2021. After comparing the responses, the analysis of how staff's attitudes have changed was performed. As a second step, four hundred sixty-eight neonates born consecutively in December 2018 (N.=171) and then in December 2019 (N.=297), before and after the HMB introduction, respectively, participated in the study at the Medical University of Gdańsk, Poland. Patients' medical charts were retrospectively analyzed. Since the assemblage of the HMB, there has been a significant improvement in the staff's attitude towards the use of donor milk (DM) (68.7% before, 93.8% after HMB) and its safety (65.7% before, 97.9% after HMB). There was also a significant increment in feeding newborns using breast milk compared to formula milk. HMB allows for the collection of donor milk, matching mother's-own-milk by gestational age and stage of lactation, ensuring adequate composition for the targeted nutritional requirements of premature infants. These findings support the relevance of our study, highlighting the importance and benefits of expanding HMB worldwide and increasing education for mothers and medical staff regarding donor milk.

Immediate Outcome of Intrauterine Growth Restricted Infants

Background: Intrauterine growth restriction (IUGR) is one of the major public health issues in developing countries like Bangladesh. IUGR has got significant importance due to its approach towards post neonatal, infant and childhood mortality and morbidity. Objective: To identify immediate outcome of IUGR infants. Methods: This case control study was conducted in department of Neonatology at BSMMU, Dhaka from August 2015 to July 2016, where 98 newborns in the NICU during study period were the study population. All the IUGR babies were labeled as case (Group- A), n=49 and the babies of the same gestational age were labeled as control (Group-B), n=49. The outcome was observed by the caution and careful NICU follow up of the baby. After collection, data were entered into a personal computer and were edited, analyzed, plotted in graphs and tables. Data were analyzed by chi square test, Mann Whitney U tests, using the statistical package for social sciences (SPSS) version 20. P values less than 0.05 (95% CI) were considered statistically significant. Result: During the study in case group, hypoglycemia (p=0.007) & hyperbilirubinemia (P=<0.001) were statistically significant complication. Length of hospital stay was more (P=0.001) in IUGR group which was also significant. Death was more in IUGR than AGA group. Conclusion: From our result, we can conclud e that Hypoglycemia and hyperbilirubinemia were significant complication of IUGR babies. IUGR babies had longer hospital stay than AGA babies. Death were more in IUGR babies but was not statistically significant. Sir Salimullah Med Coll J 2023; 31: 9-12

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Introduction. Healthcare-associated infections (IAAS) increase neonatal morbidity and mortality. Identifying the microbiological profile and sensitivity of the microbiota allows us to reduce infection rates, rationalize the use of antibiotics and improve neonatal survival. Objectives. To know the environmental microbiota and antimicrobial sensitivity in the Department of Neonatology (DN). Methods. Observational, descriptive, cross-sectional study, carried out between April and May 2021, in the Intensive Care, Intermediate and Immediate Care services of the DN of the Instituto Nacional Materno Perinatal, a reference center for maternal and neonatal care. 144 surfaces were selected from the hospitalized patient environment. Using swabbing technique, samples were obtained and then seeded in common and selective culture media. Sensitivity was determined using Kirby-Bauer diffusion disks, the analysis of variables was performed with SPSS version 22.0 Results. Of 147 samples, 67% gave positive cultures with pathogenic bacteria. In immediate care 50% tested positive, in intermediate care 46.5% and in NICU 39.7%. The 100% contaminated surfaces were fan screens, electroencephalogram monitor, chart holders and scales. Of 41 hands of health personnel, 29.3% were contaminated: 54.5% nursing technicians, 30% doctors and 23% nursing graduates. The isolated germs were SCN (67%) sensitive to vancomycin, Enterococcus (16.5%) sensitive to ampicillin and vancomycin, Pseudomonas (8.2%) to meropenem, Escherichia coli (2.4%) to gentamicin and amikacin, Klebsiella (1.2%). Conclusion. Pathogens causing IAAS were isolated on surfaces in the environment of our patients. The bacterial agents found have high antimicrobial resistance and virulence.

Comparison of Derangement of Cerebrospinal Fluid Markers in Neonates with Early and Late-Onset Sepsis

Objective: To compare derangement of cerebrospinal fluid markers in neonates with early and late-onset sepsis managed at the Neonatal Intensive Care Unit. Study Design: Comparative cross-sectional study. Setting and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Jun 2022. Methodology: This study was conducted on neonates managed at our Neonatal Intensive Care Unit for late or early-onset sepsis. A consultant neonatologist diagnosed neonatal sepsis based on clinical and laboratory findings. The cerebrospinal fluid routine examination was performed on all the study participants, and the derangement of various markers was compared in neonates with early and late-onset sepsis. Results: A total of 348 neonates admitted to the neonatal intensive care unit with sepsis were included in the final analysis. The mean age of the newborns included in the study was 5.38±4.53 days. Out of all the neonates in the study, 194(55.7%) had early-onset sepsis, while 154(44.3%) neonates had late-onset sepsis. All the cerebrospinal fluid markers were statistically significantly deranged in patients with late-onset sepsis (p-value<0.005). Conclusion: Derangement of cerebrospinal fluid markers was seen more in patients with late-onset neonatal sepsis admitted to the neonatal intensive care unit. Emphasis should be laid on performing this necessary investigation timely in neonates with late-onset sepsis as chances of meningeal involvement are higher in this group.

Climatic factors and prolonged neonatal jaundice

Prolonged neonatal jaundice (PrNJ) in full-term newborns(NB) is defined if it persists beyond the 14th day after birth. Clinical experience shows that seasons of the year influence the frequency and severity of neonatal jaundice (NJ). Objective: To establish the role of climatic factors on PrNJ expression in term neonates. Material and methods: The study was conducted at the Neonatology Department of University Hospital "Medica Ruse" with 92 full-term newborns who were with PrNJ. The follow-up of NJ was carried out with transcutaneous bilirubinometry. The NBs are residents of Ruse region, Republic of Bulgaria. Results: We found that air temperature directly affects the levels of bilirubin(BR) for the entire neonatal period and the duration of PrNJ. The amount of rainfall during the first two weeks after birth directly correlated with bilirubinemia at end of neonatal period and the duration of PrNJ. A higher level of atmospheric pressure during the early neonatal period was associated with lower BR levels at the same and a shorter duration of PrNJ. The degree of cloudiness after postnatal day 14 is inversely related to the levels of BR and the duration of the PrNJ. Sunshine during the first two weeks affects the levels of BR on the end of neonatal perod and the prolongation of PrNJ. Conclusion: According to our data climatic factors: air temperature, amount of rainfaull, atmospheric pressure, degree of cloudiness, duration of sunshine affect the degree of manifestation and duration of PrNJ.

PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS

PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS

Omeprazole activates aryl hydrocarbon receptor to reduce hyperoxia-induced oxidative stress in the peripheral blood mononuclear cells from premature infants

Objective To investigate the correlation between the aryl hydrocarbon receptor (AhR) and reactive oxygen species (ROS) in peripheral blood mononuclear cells (PBMCs) of premature infants, to demonstrate the protective role of AhR against hyperoxia-induced oxidative stress in premature infants and to provide a rational basis for the use of omeprazole (OM) as a new treatment for bronchopulmonary dysplasia (BPD). Methods From January 2021 to June 2021, 1–3 ml of discarded peripheral blood was collected from premature infants of gestational age less than 32 weeks who were not taking inhaled oxygen and were admitted to the Department of Neonatology of the Affiliated Hospital of Southwest Medical University. Using a random number table, the PBMCs were randomly assigned to each of the following groups: the control group, air + OM group, hyperoxia group, and hyperoxia + OM group. After 48 h of in vitro modeling and culture, PBMCs and the culture medium of each group were collected. Immunofluorescence analysis was used to examine ROS levels in PBMCs. A full-spectrum spectrophotometer was used to examine malondialdehyde (MDA) levels in the culture medium. Enzyme-linked immunosorbent assay (ELISA) was used to examine monocyte chemotactic protein 1 (MCP-1) levels in culture medium. Immunofluorescence analysis was used to examine the intracellular localization of AhR. Western blotting was used to examine the expression level of AhR in PBMCs. Results Compared with those in the control group, the levels of ROS, MDA, and MCP-1 and the cytoplasm-nuclear translocation rate of AhR in the air + OM group did not change significantly (p > 0.05), but the expression level of AhR increased significantly (p < 0.05). The levels of ROS, MDA, and MCP-1 and the cytoplasm-nuclear translocation rate of AhR significantly increased in the hyperoxia group (p < 0.05), and the expression level of AhR was significantly reduced (p < 0.05). Compared with those in the hyperoxia group, the levels of ROS, MDA, and MCP-1 in the hyperoxia + OM group were significantly reduced (p < 0.05), and the cytoplasm-nuclear translocation rate of AhR and the expression level of AhR were significantly increased (p < 0.05), but did not reach the level of the control group (p < 0.05). Conclusion OM can activate AhR to inhibit hyperoxia-induced oxidative stress in the PBMCs from premature infants.

Neugeborenen-Hörscreening in Deutschland – Ergebnisse der Evaluationen 2011/2012 und 2017/2018

ZusammenfassungHintergrundDas Neugeborenen-Hörscreening (NHS) wurde 2009 durch den Gemeinsamen Bundesausschuss (G-BA) mit Aufnahme in die Kinder-Richtlinie bundesweit eingeführt. Dabei wurden in der Kinder-Richtlinie auch Qualitätsziele festgelegt. Um die Qualität des NHS in Deutschland zu überprüfen, hat der G‑BA eine Bietergemeinschaft mit einer ersten Evaluation für die Jahre 2011/2012 und einer Folge-Evaluation für 2017/2018 beauftragt.MethodenGrundlage der Evaluationen waren Sammelstatistiken, die von allen geburtshilflichen und neonatologischen Abteilungen, als Leistungserbringer des NHS, geführt werden müssen und ggf. in Kooperation mit Hörscreening-Zentralen (HSZ) erstellt werden. Zusätzliche Daten wurden durch Fragebögen und Interviews erhoben und durch Routinedaten ergänzt, um den vollständigen Screeningprozess zu evaluieren.ErgebnisseIn 13 Bundesländern sind insgesamt 15 HSZ in den Screeningprozess eingebunden. Deutschlandweit wurde 2018 eine Screeningrate von 86,1 % (2012: 82,4 %) dokumentiert, die sich deutlich zwischen den Bundesländern unterschied. Die vorgegebenen Qualitätsziele konnten noch nicht überall umgesetzt werden. So erreichten nur knapp die Hälfte der Geburtsabteilungen die angestrebte Screeningrate von über 95 %. Beim Vergleich der Folge-Evaluation mit den Daten der ersten Evaluation konnte gezeigt werden, dass sich die Strukturqualität des NHS verbessert hatte, während die Prozessqualität eher gleich blieb oder schlechter geworden war, verdeutlicht insbesondere durch einen Anstieg der Refer-Rate (Kinder, die mit einem auffälligen Befund entlassen wurden) von 5,3 % auf 6,0 %.DiskussionZur Verbesserung der Qualität des NHS sollten flächendeckend HSZ etabliert und – wie in der Richtlinie vorgesehen – bei auffälligem Erstscreening ein zweites Screening noch vor Entlassung konsequenter durchgeführt werden.

SCIENTIFIC TRENDS IN PERINATAL MEDICINE AND NEONATOLOGY AT BUKOVINIAN STATE MEDICAL UNIVERSITY: ADVANCES AND PROSPECTS

Bukovinian State Medical University (BSMU) of the Ministry of Health of Ukraine (Chernivtsi, Ukraine), according to theranking criteria of the SciVerse Scopus database in 2023, is among the 10 best higher state educational institutions in Ukraine.In 2023, BSMU was ranked 2nd according to the Webometrics system. BSMU supports the implementation of the main provisions of Open Science in Ukraine, which is a priority for European research policy. BSMU started fi lling information data on the areas of open science in the National Electronic Research and Information System of Ukraine “URIS”, which is commissioned by the Ministry of Education and Science of Ukraine and the Ministry of Digital Transformation of Ukraine in accordance with the main provisions of the unifi ed national program “On the Implementation of the National Action Plan for Open Science in Ukraine”. Unfortunately, unfavorable demographic trends have recently persisted in Ukraine with a projected decline in the birth rate, an increase in mortality and forced migration as a result of military operations. aggression and genocide of the Ukrainian people. One of the key research areas is maternity and childhood, which has been the basis of scientifi c research at the Department of Paediatrics, Neonatology and Perinatal Medicine for many years. The aim of this research area is to improve the effi ciency of medical care for newborns, including full-term and premature infants born with various forms of perinatal pathology and intrauterine developmental disorders, by improving algorithms for predicting, diagnosing and treating organ system disorders under conditions of birth stress.

CLINICAL AND PARACLINICAL FEATURES AND PATHOPHYSIOLOGICAL MECHANISMS OF DIGESTIVE SYSTEM DISORDERS IN PREMATURE INFANTS WITH PERINATAL PATHOLOGY

CLINICAL AND PARACLINICAL FEATURES AND PATHOPHYSIOLOGICAL MECHANISMS OF DIGESTIVE SYSTEM DISORDERS IN PREMATURE INFANTS WITH PERINATAL PATHOLOGY

Prevalence, drug resistance, molecular typing and comparative genomics analysis of MRSA strains from a tertiary A hospital in Shanxi Province, China.

Staphylococcus aureus (S. aureus) is an important zoonotic pathogen that causes a high incidence rate and mortality worldwide. This study investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains in a tertiary A hospital in Shanxi Province, China, in order to determine the major epidemic clones as well as their antibiotic resistance and virulence characteristics. A total of 212 S. aureus strains were collected in this hospital, and were subjected to antimicrobial susceptibility testing, detection of virulence genes, resistance genes, and efflux pump genes. Among them, 38 MRSA strains were further subjected to detection of biofilm genes, assessment of biofilm formation ability, MLST, spa typing, SCCmec typing, and phylogenetic analysis. The majority of S. aureus strains came from the neonatology department, with secretions and purulent fluid being the main source of samples. The strains showed high resistance to penicillin (98.11%), erythromycin (64.62%) and clindamycin (59.91%), while being sensitive to vancomycin and linezolid. The detection rates of efflux pump genes and resistance genes were high, and there was a significant correlation between resistance gene types and phenotypes, with mecA showing a close correlation with oxacillin. The detection rates of virulence genes and the toxin gene profiles of MSSA and MRSA strains showed significant differences. And the detection rate of biofilm genes in MRSA strains was relatively high, with 13.16% of MRSA strains showing strong biofilm formation ability. The most common epidemic clone of MRSA was ST59-SCCmecIV-t437, followed by ST59-SCCmecV-t437. The former had a higher detection rate of resistance genes and a stronger biofilm formation ability, while the latter had a higher positive rate for pvl gene and stronger pathogenicity, making it more likely to cause systemic infections. Phylogenetic analysis showed that all MRSA strains in this study clustered into three major branches, with distinct differences in antibiotic resistance and virulence characteristics among the branches. ST59-MRSA strains from different species showed consistency and inter-species transmission, but there were differences among ST59-MRSA strains from different geographical locations. In general, most MSSA and MRSA strains exhibited multidrug resistance and carried multiple resistance genes, virulence genes, and biofilm formation genes, warranting further research to elucidate the mechanisms of drug resistance and pathogenesis.

Comparison of Bubble CPAP Versus Conventional Ventilation in Neonates Having Respiratory Distress

Objective: To compare the outcomes of bubble continuous positive airway pressure (B-CPAP) versus ventilator continuous positive airway pressure (V-CPAP) in neonates experiencing respiratory distress. Methodology: This randomized controlled trial was conducted at the Department of Neonatology, Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from March 1, 2021, to August 31, 2021. A total of 150 neonates of both genders who presented with respiratory distress and were delivered at &gt;32 weeks of gestation, weighing &gt;1500 grams. The neonates were then randomly allocated to two groups using a lottery method. Treatment failure was defined as a neonate's inability to maintain a SpO2 greater than 90% or an arterial partial pressure (PaO2) greater than 50 mmHg with a maximal CPAP of &gt;7 cm of water and a FiO2 greater than 0.6 or the necessity of mechanical ventilation. Results: Of these, 82 (54.7%) were male, and 68 (45.3%) were female, resulting in a male-to-female ratio of 1.2:1. The mean gestational age was 36±2.49 weeks in the B-CPAP group and 35.52±1.36 weeks in the V-CPAP group. The mean birth weight was 2381±506.4 grams in the B-CPAP group and 2187.3±427.49 grams in the V-CPAP group. Out of the 75 neonates in the B-CPAP group, 10 (13.3%) were classified as treatment failures, while 19 (25.3%) out of 75 neonates in the V-CPAP group met the criteria for treatment failure, according to our operational definition. Although the failure rate was slightly higher in patients receiving V-CPAP for the management of respiratory distress, these differences were not statistically significant (p-value= 0.052). Conclusion: In the treatment of neonatal respiratory distress, there was no significant difference in the failure rate between bubble CPAP and ventilatory CPAP. Regardless of the neonate's gender, birth weight, gestational age, or Silverman score, bubble CPAP may be considered as the primary mode of respiratory support for neonates with respiratory distress.

Frequency of hearing impairment in neonates born in a tertiary-care hospital of a developing country: A prospective-observational study.

Objective: To evaluate the frequency of hearing impairment and the prenatal, antenatal, and postnatal variables associated with hearing impairment in neonates at the Indus hospital in Karachi. Study Design: Prospective, Observational, Cohort study. Setting: Department of Pediatrics and Neonatology, Sheikh Saeed Memorial Campus (SSMC) of Indus Hospital and Health Network (IHHN) Karachi, Pakistan. Period: July 2020 to June 2022. Material &amp; Methods: We screened 426 neonates for hearing impairment utilizing otoacoustic emissions (OAEs) Auditory brainstem response test (ABR) and “brainstem auditory evoked response” (BERA). Babies who failed OAE and ABR test underwent BERA. Babies with abnormal BERA report were proven to have hearing impairment. Results: A total of 426 neonates were screened through the study period. Of these 426, 134 (31.5%) were unsuccessful and a second stage OAE test was conducted where 63 (47.0%) passed and 71 (53.0%) did not. The ABR test was administered to 71 neonates, 42 (59.2%) failed the test and received referrals for diagnostic BERA. Of those 42 neonates, 15 neonates tested positive for BERA, 10 of them were found to have sensor neural hearing loss while 5 had conductive hearing loss. Neonatal jaundice patients were more likely to experience hearing impairment (p=0.011). Family history of hearing loss (p=0.001) and fetal distress (p=0.043) were significantly related with hearing impairment. Conclusion: The result of our study has discovered a significant number of risk factors for hearing loss, which is crucial since it will allow for close monitoring of the kids who have these risk factors. Furthermore, our research emphasizes the need of newborn hearing screening in our country, since this screening is not generally carried out in all facilities.

Season of birth and neonatal jaundice

Neonatal jaundice (NJ) is a multifactorial condition specific to the neonatal age. Clinical experience shows that seasons of the year influence the frequency and severity of NJ. Objective: To investigate the influence of annual seasons on the frequency and severity of NJ. Material and methods: The study was conducted at the Neonatology Department of University Hospital "Medica Ruse" with 566 full-term newborns. The follow-up of NJ was carried out with transcutaneous bilirubinometry. The newborns are residents of Ruse region, Republic of Bulgaria. Results: We found a significant difference in bilirubin (BR) levels depending on the season of birth during the early neonatal period. Summer-borns had the highest average levels, followed by spring-borns, and autumn-borns had the lowest. Вorn in the spring had significantly high levels of BR at the end of neonatal period. Climatic factors average and maximum monthly temperature, average monthly rainfall and monthly sunshine duration had a significant influence on the levels of bilirubin on Day 4 (p=0.014), Day 5 (p=0.016) and Day 14 (p=0.004). Prolonged NJ is most commonly observed in summer-borns (p&lt;0.001). Conclusion: Birth season along with meteorological factors affects the frequency of pathological neonatal jaundice.

A 3D pose estimation framework for preterm infants hospitalized in the Neonatal Unit

AbstractInfant pose estimation is crucial in different clinical applications, including preterm automatic general movements assessment. Recent infant pose estimation methods are limited by a lack of real clinical data and are mainly focused on 2D detection. We introduce a stereoscopic system for infants’ 3D pose estimation, based on fine-tuning state-of-the-art 2D human pose estimation networks on a large, real, and manually annotated dataset of infants’ images. Our dataset contains over 88k images, collected from 175 videos from 53 premature infants born &lt;33 weeks of gestational age (GA), acquired within the Neonatology department of the Centre Hospitalier Universitaire de Saint Etienne, France, between 32 and 41 weeks of GA. This framework significantly reduced the pose estimation error compared to existing 2D infant pose estimation networks. It achieved a mean error of 1.72 cm on 18000 stereoscopic images in the 3D pose estimation task. This framework is the first 3D pose estimation tool dedicated to preterm infants hospitalized in the Neonatal Unit that does not depend on any visual markers or infrared cameras.

Clinical and genetic analysis of a very early-onset inflammatory bowel disease type 28 child with atypical clinical manifestation

To explore the clinical and genetic characteristics of a very early-onset inflammatory bowel disease (VEO-IBD) type 28 child with atypical clinical manifestations. A VEO-IBD type 28 child with atypical clinical manifestations admitted to the Department of Neonatology, Children's Hospital Affiliated to Shandong University on November 5, 2021 was selected as the study subject. Clinical data of the child was collected. Peripheral venous blood samples of the child and his parents were collected for high-throughput sequencing. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. The child, a 50-day-old male, had manifested bronchitis, ulcerative stomatitis, eczema and slightly loose stool. High-throughput sequencing revealed that he has harbored compound heterozygous variants of the IL-10RA gene, namely c.299T>G (p.V100G) and c.301C>T (p.R101W), which were inherited from his father and mother, respectively. Bioinformatic analysis showed that both variants have been recorded in the HGMD database, though the c.299T>G variant has not been included in the gnomAD, 1000 Genomes, ExAC and ESP6500 databases, while the c.301C>T variant has a low population frequency. Both variants were predicted to be deleterious by the online software including SIFT, PolyPhen-2 and Mutation Taster. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were predicted to be pathogenic (PS3+PM2_Supporting+PP3). The c.299T>G and c.301C>T variants of the IL-10RA gene probably underlay the VEO-IBD type 28 in this child. Above finding has expanded the phenotypic spectrum of VEO-IBD type 28 due to variants of the IL-10RA gene and provided a reference for the clinical diagnosis of this disease.

EXPERIENCE OF THE BUKOVINIAN STATE MEDICAL UNIVERSITY IN CONTINUOUS PROFESSIONAL DEVELOPMENT FOR MEDICAL PERSONNEL PERFORMING NEONATAL AND PEDIATRIC CARE IN UKRAINE

Continuous professional development of doctors and nurses using modern learning tools is the key to the quality andeffectiveness of neonatal and pediatric care in Ukraine, especially given the extremely difficult challenges of wartime. The basicprinciples of continuing professional development (CPD) of Ukrainian medical and pharmaceutical practitioners were approvedby the Resolution of the Cabinet of Ministers of Ukraine No. 725 "Regulations on the System of Continuing ProfessionalDevelopment of Medical and Pharmaceutical Workers" dated July 14, 2021.The article presents the experience of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University (BSMU) (Head - Doctor of Medicine, Professor Nechytailo Y. M.) in conducting CPD activities for medical staff providing neonatal and pediatric care in Ukraine. The Department hosts specialization and internship cycles in Neonatology and Pediatric Anesthesiology, as well as all kinds of professional seminars, workshops, simulation trainings and professional schools. The target group of the CPD activities is neonatologists, pediatric anesthesiologists, pediatricians, pediatric neurologists, family medicine doctors, emergency medicine doctors, etc.The educational activity is carried out on the basis of the Training Center for Modern Technologies of Perinatal Medicine(headed by Doctor of Medicine, Professor Yulija Godovanets), the Center for Simulation Medicine and Innovative TechnologiesCOSMIT of BSMU and clinical bases of the department. The training process involves the use of full-time and distance learning.Based on the current educational requirements and the Order of the Ministry of Health of Ukraine No. 2016 dated10.11.2022, the Department of Pediatrics, Neonatology and Perinatal Medicine of BSMU has launched CPD cycles for medicaland pharmaceutical staff with higher, entry-level (short cycle) and first (bachelor's) level of higher medical and pharmaceuticaleducation and Masters in Nursing.