Syndrome Infants Research Articles

Rhizobium and Mycorrhizal Fungal Species Improved Soybean Yield Under Drought Stress Conditions

Food insecurity is a serious threat due to the increasing human population particularly in developing countries and may be minimized by the use of microbial inoculants. Also, the problems of excessive use of chemical fertilizers including the fact that most of the fertilizers are relatively non-affordable and that they also contaminate underground and surface water, which can increase the risk of blue baby syndrome in infants and stomach cancer in adults. There is therefore the need to harness a more cost-effective, eco-friendly and beneficial biological agents to improve crops productivity especially under drought conditions. Thus, in this study, the ability of rhizobia species and arbuscular mycorrhizal fungi (AMF) to enhance soybean tolerance to drought stress under water regimens of 100, 70 and 40% field capacity (FC) was investigated. It was observed that co-inoculation of soybean with Rhizobium spp. (R1+R3) as well as with Rhizobium spp. and mycorrhizal consortium (R1+R3MY) had significant impacts (P < 0.05) on soybean leaf relative water content and electrolyte leakage, respectively. The levels of proline increased mainly in microbially amended soybean exposed to drought stress. Plants inoculated with R1+R3MY showed the highest number of spore and % mycorrhization in all the water regimes. At 40% FC, R1+R3MY treatment was found to promote soybean growth compared to the non-inoculated plants. Similarly, at 40% FC, R1+R3MY inoculum had the greatest impacts on soybean pod number, seed number, seed fresh weight, highest seed number per pod and seed dry weight while at 70% water stress, significant impacts of R1MY inoculation were observed on pod number, pod fresh weight and seed dry weight. These results revealed that co-inoculation of rhizobia and mycorrhizal fungi can be harnessed biotechnologically to proffer solution to food insecurity.

New kid on the block: NOS1AP is a newly recognized genetic cause of steroid-resistant nephrotic syndrome in infants

Steroid-resistant nephrotic syndrome (SRNS) is a rare but important cause of chronic kidney disease and kidney failure in children. Mutations in podocyte genes explain more than two-thirds of early-onset SRNS presenting in the first year of life.1 In a recent publication in Science Advances, Majmundar et al. identified recessive mutations in nitric oxide synthase 1 adaptor protein (NOS1AP) as another genetic cause of early-onset SRNS.2

Association of different stages of histological chorioamnionitis with respiratory distress syndrome in preterm infants with a gestational age of < 32 weeks

OBJECTIVE To study the association of different stages of histological chorioamnionitis (HCA) with the incidence rate and severity of respiratory distress syndrome (RDS) in preterm infants. METHODS Related data were collected from the infants and their mothers who were treated in the Neonatal Intensive Care Unit of Qingdao Women and Children's Hospital, Qingdao University, from January 2018 to June 2020. According to the presence or absence of HCA and its stage, the infants were divided into four groups: control (n=109), early-stage HCA (n=126), middle-stage HCA (n=105), and late-stage HCA (n=36). The four groups were compared in terms of gestational age, birth weight, sex, maternal age, placental abruption, prenatal use of antibiotics, and incidence rate of RDS. The correlation between HCA stage and RDS severity was analyzed. RESULTS Compared with the control and late-stage HCA groups, the early-stage HCA group had a significantly lower incidence rate of placental abruption and a significantly higher rate of prenatal use of antibiotics (P 0.05). CONCLUSIONS Early-, middle-, and late-stage HCA can reduce the incidence rate of RDS in preterm infants. HCA stage may not be correlated with RDS severity in preterm infants, which needs to be verified by further research.

The Effect of Foot Reflection Massage on the Reduction of Respiratory Distress Syndrome in Premature Infants Under Non-Invasive Ventilation in the Neonatal Intensive Care Unit

The Effect of Foot Reflection Massage on the Reduction of Respiratory Distress Syndrome in Premature Infants Under Non-Invasive Ventilation in the Neonatal Intensive Care Unit

IPEX Syndrome: Genetics and Treatment Options.

(1) Background: IPEX (immune dysregulation, polyendocrinopathy, enteropathy, X-linked) syndrome characterizes a complex autoimmune reaction beginning in the perinatal period, caused by a dysfunction of the transcription factor forkhead box P3 (FOXP3). (2) Objectives: Studies have shown the clinical, immunological, and molecular heterogeneity of patients with IPEX syndrome. The symptoms, treatment, and survival were closely connected to the genotype of the IPEX syndrome. Recognition of the kind of mutation is important for the diagnostics of IPEX syndrome in newborns and young infants, as well as in prenatal screening. The method of choice for treatment is hematopoietic stem cell transplantation and immunosuppressive therapy. In children, supportive therapy for refractory diarrhea is very important, as well as replacement therapy of diabetes mellitus type 1 (DMT1) and other endocrinopathies. In the future, genetic engineering methods may be of use in the successful treatment of IPEX syndrome. (3) Conclusions: The genetic defects determine a diagnostic approach and prognosis, making the knowledge of the genetics of IPEX syndrome fundamental to introducing novel treatment methods.

СИНДРОМ ВНУТРИЧЕРЕПНОЙ ГИПЕРТЕНЗИИ И ДЕФИЦИТ ЖЕЛЕЗА У МЛАДЕНЦЕВ, ПЕРЕНЕСШИХ ЦЕРЕБРАЛЬНУЮ ИШЕМИЮ В НЕОНАТАЛЬНОМ ПЕРИОДЕ

Objective of the research: to study the relationship between severity of clinical manifestations of intracranial hypertension (ICH) syndrome of perinatal genesis and red blood counts in infants who underwent cerebral ischemia (CI) at birth. Materials and methods: 94 children with ICH syndrome of perinatal posthypoxic genesis at the age of 6 months of corrected age were examined: 1st group – with normal hemoglobin (Hb) level, 32 children (34%); 2nd group – with reduced Hb level, 62 children (66%). Researchers used anamnestic, clinico-neurological (assessment of the somatic and neurological status with objectification of ICH severity using a specially developed 60-point «Assessment of intracranial hypertension severity» (AIHS) scale in children aged 1 month to 1 year), laboratory study of Hb level on an automated hematological analyzer Sysmex XE2100, Sysmex, Germany, and ferritin level on a modular analytical system Сobas8000, Roche, Denmark) and statistical methods of research. Results: 77% of children (72 children) were diagnosed with mild ICH, 22% (21 children) had moderate severity, and one child (1%) had severe ICH. A strong negative relationship was obtained between the severity of ICH syndrome (the number of points on AIHS scale) and the Hb level (R=–0,72): the lower the Hb level, the more pronounced the clinical manifestations of the ICH syndrome. The ferritin content turned out to be reduced in 83% (78 children), an average negative correlation was found between the severity of the ICH syndrome (the number of points on AIHS scale and ferritin values (R=–0,55): the lower the ferritin content in the blood, the more severe the clinical manifestations of ICH syndrome. Conclusion: in infants with ICH syndrome in the residual period of neonatal IC, a relationship was found between the severity of clinical and instrumental manifestations of ICH syndrome with red blood parameters (Hb and serum ferritin). In this regard, the participation of latent iron deficiency in the pathophysiological processes of the formation and course of ICH syndrome in infants is not excluded.

Clinical Features of Apert Syndrome in Infancy: A rare case in Indonesia

Background: Apert syndrome is characterized by several malformations of cranial-facial and syndactyly. The incidence of Apert syndrome was reported at approximately 1 per 65,000 live births, globally. Fibroblast Growth Factor 2 (FGFR2) is believed to hold a key role in the syndrome. Objectives: This case report is aiming to describe the information on a rare incidence of craniosynostosis syndromes on Indonesian infants. Case Illustration: One month old female baby was admitted to the hospital due to the breastfeeding difficulty caused by cleft palate. The patient was known to experience defects of face-head features and syndactyly since birth. This patient was observed and controlled to undergo nasogastric feeding until meet the appropriate age for surgical therapy. Discussion: Mutation of Ser252Trp and Pro253Arg was found in the patient. Based on this finding, this case report may strengthen the statement about the correlation between Ser252Trp and cleft palate whereas Pro253Arg is linked with syndactyly in individuals with the syndrome. Conclusion:. This case may give beneficial information for clinicians when they receive a patient with the same clinical features. However, further investigation to know this syndrome still needs to be developed. Keywords: Apert Syndrome, FGFR2, palate cleft, Pro253Arg, Ser252Trp Latar Belakang: Pasien dengan sindroma Apert memiliki fitur karakteristik berupa malformasi kepala dan wajah disertai syndactyly. Insidensi sindroma ini berkisar 1 per 65.000 kelahiran hidup secara global. Etiologi kelainan ini dikatikan dengna mutase pada Fibroblast Growth Factor 2 (FGFR2). Tujuan: Laporan kasus ini bertujuan untuk mendeskripsikan kejadian langka dari sindroma craniosynostosis pada bayi Indonesia. Ilustrasi Kasus: Bayi perempuan usia 1 bulan dibawa ke rumah sakit dengan masalah menyusui akibat palatoschizis. Pasien memiliki riwayat defek wajah dan kepala disertai syndactyly sejak lahir. Pasien ini kemudian diobservasi melalui diet per nasogastric tube sampai siap dilakukan terapi pembedahan. Pembahasan: Mutasi pada Ser252Trp dan Pro253Arg ditemukan pada pasien ini. Sehingga, laporan kasus ini mungkin memperkuat temuan mengenai korelasi Ser252Trp dan palatoschizis sedangkan Pro253Arg dikaitkan dengan syndactyly. Kesimpulan: Kasus ini mungkin dapat memberikan informasi tambahan sebagai referensi untuk klinisi ketika menerima pasien dengan gejala klinis serupa. Namun, studi terkait perlu diperdalam untuk mengetahui lebih jauh mengenai sindroma serupa. Kata Kunci: FGFR2, palatoschizis, Pro253Arg, Ser252Trp, sindroma Apert

Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study.

Cardiac surgery employing cardiopulmonary bypass exposes infants to a high risk of morbidity and mortality. The objective of this study was to assess the utility of clinical and laboratory variables to predict the development of low cardiac output syndrome, a frequent complication following cardiac surgery in infants. We performed a prospective observational study in the pediatric cardiovascular ICU in an academic children’s hospital. Thirty-one patients with congenital heart disease were included. Serum levels of nucleosomes and a panel of 20 cytokines were measured at six time points in the perioperative period. Cardiopulmonary bypass patients were characterized by increased levels of interleukin-10, -6, and -1α upon admission to the ICU compared to non-bypass cardiac patients. Patients developing low cardiac output syndrome endured longer aortic cross-clamp time and required greater inotropic support at 12 h postoperatively compared to bypass patients not developing the condition. Higher preoperative interleukin-10 levels and 24 h postoperative interleukin-8 levels were associated with low cardiac output syndrome. Receiver operating characteristic curve analysis demonstrated a moderate capability of aortic cross-clamp duration to predict low cardiac output syndrome but not IL-8. In conclusion, low cardiac output syndrome was best predicted in our patient population by the surgical metric of aortic cross-clamp duration.

COHESION: core outcomes in neonatal encephalopathy (protocol)

BackgroundNeonatal encephalopathy is a complex syndrome in infants that predominantly affects the brain and other organs. The leading cause is a lack of oxygen in the blood reaching the brain. Neonatal encephalopathy can result in mortality or complications later in life, including seizures, movement disorders and cerebral palsy. Treatment options for neonatal encephalopathy are limited mainly to therapeutic hypothermia, although other potential treatments are emerging. However, evaluations of the effectiveness of treatments are challenging because of heterogeneity and inconsistency in outcomes measured and reported between trials. In this paper, we detail how we will develop a core outcome set to standardise outcomes measured and reported upon for interventions for the treatment of neonatal encephalopathy.MethodsWe will systematically review the literature to identify outcomes reported previously in randomised trials and systematic reviews of randomised trials. We will identify outcomes important to parents or caregivers of infants diagnosed with and who have received treatment for neonatal encephalopathy. We will do this by conducting in person or by video teleconferencing interviews with parents or caregivers in high-income and low- to middle-income countries. Stakeholders with expertise in neonatal encephalopathy (parents/caregivers, healthcare providers and researchers) will rate the importance of identified outcomes in an online Delphi survey using either a three-round Delphi survey or a “Real-Time” Delphi survey to which stakeholders will be allocated at random. Consensus meetings will take place by video conference to allow for an international group of stakeholder representatives to discuss and vote on the outcomes to include in the final core outcome set (COS).DiscussionMore research is needed on treatments for neonatal encephalopathy. Standardising outcomes measured and reported in evaluations of the effectiveness of interventions for the treatment of neonatal encephalopathy will improve evidence synthesis and improve results reported in systematic reviews and meta-analysis in this area. Overall, this COS will allow for improved treatments to be identified, heterogeneity in research to be reduced, and overall patient care to be enhanced.Trial registrationThis study is registered in the Core Outcome Measures for Effectiveness (COMET) database http://www.comet-initiative.org/Studies/Details/1270.

Surveillance guidelines for children with trisomy 18

Trisomy 18 is the second most common aneuploidy syndromes in live born infants. It is associated with high mortality rates, estimated to be 75%-95% in the first year of life, as well as significant morbidity in survivors. The low survival is largely due to the high prevalence of severe congenital anomalies in infants with this diagnosis. However, interventions to repair or palliate those life-threatening anomalies are being performed at a higher rate for these infants, resulting in increased rates of survival beyond the first year of life. While it is well documented that trisomy 18 is associated with several cardiac malformations, these patients also have respiratory, neurological, neoplastic, genitourinary, abdominal, otolaryngologic, and orthopedic complications that can impact their quality of life. The goal of this review is to present a comprehensive description of complications in children with trisomy 18 to aid in the development of monitoring and treatment guidelines for the increasing number of providers who will be caring for these patients throughout their lives. Where the evidence is available, this review presents screening recommendations to allow for more rapid detection and documentation of these complications.

ABCA3 gene mutations shape the clinical profiles of severe unexplained respiratory distress syndrome in late preterm and term infants.

BackgroundThe majority of unexplained respiratory distress syndrome (URDS) cases in late preterm and term infants are caused by genetic abnormalities, with the most common of these being ABCA3 gene mutation. At present, it is unclear to neonatologists whether URDS patients with ABCA3 mutation have similar or more challenging clinical profiles to those without any defined genetic abnormalities. Our study aimed to answer this question by comparing the clinical characteristics of severe URDS patients with homozygous or compound heterozygous ABCA3 mutations, a single ABCA3 mutation, or no defined genetic abnormalities.MethodsThis retrospective cohort study involved 39 late preterm and term infants with URDS underwent a clinical exome sequencing at a tertiary neonatal intensive care unit between January 2013 and December 2019. Based on the sequencing result, the study subjects were classified into the homozygous or compound heterozygous mutations, single ABCA3 mutation, or no defined genetic abnormalities groups. The major outcomes, including mortality, the age of symptom onset and development of severe RDS, and the radiological score, were compared between the groups.ResultsA novel splicing site (c.3862+1G>C) was identified in one twin with homozygous expression. Patients with homozygous or compound heterozygous ABCA3 mutations exhibited symptom onset and development of severe respiratory distress syndrome (RDS) earlier than those with a single mutation or no genetic abnormalities (P<0.05). These patients also had higher mortality rates than those without genetic abnormalities (P=0.029). The total radiological scores were 51.14±4.91, 44.20±6.54, 35.91±4.42 for patients with homozygous or compound heterozygous mutations, a single mutation, and a wild-type gene, respectively, with significant differences between the groups observed by pairwise comparison (all P<0.05).ConclusionsLate preterm or term infants with URDS due to homozygous or compound heterozygous ABCA3 mutations exhibited more challenging clinical profiles than those without genetic abnormalities. However, whether this relationship exists between patients with a single ABCA3 mutation and those without genetic abnormalities warrants further study.

The Role of Interleukin-6 in Predicting the Development of Meconium Aspiration Syndrome in Infants Born with Meconium-Stained Amniotic Fluid; A Retrospective Analytical Study

Background: Since it is not always possible clinically and radiographically to predict the development of meconium aspiration syndrome (MAS) in infants born with meconium-stained amniotic fluid, there is a need for biomarkers that may predict the development of MAS in these infants. Methods: The study was planned in Ankara Zekai Tahir Burak Gynecology Hospital. Among term infants (>37 gestational weeks) born from mothers who had Meconium-Stained Amniotic Fluid (MSAF), the files of 60 patients who met the criteria for inclusion were retrospectively reviewed between January 2014 and May 2014. Results: There was no statistically significant difference between the characteristic features of infants who developed and did not develop MAS. Of the acute phase reactants, CRP, leukocyte count, platelet count, and thetotal neutrophil count did not show a statistically significant difference in both groups. We found that IL-6 was significantly higher in infants who developed MAS. The cut-off value for IL-6 was 51 with 62% sensitivity and 96% specificity. Morbidities such as pneumothorax and persistent pulmonary hypertension were observed more frequently in newborns who developed MAS and required longer mechanical ventilation, surfactant therapy, nasal CPAP support, inotropic support, and free oxygen therapy. Conclusions: We found that interleukin 6 is a good marker in predicting the development of meconium aspiration syndrome. We believe that this biomarker can be very useful when assessed with clinical and radiographic findings.

Pathogenetic Reasoning for Use of Monteleukast (Singlon) in Acute Respiratory Viral Infections with Broncho-Obstructive Syndrome in Infants and Preschool Age Children

The Article considers the argumentative issues of the diagnosis of the virus-induced bronchial asthma and recurrent obstructive bronchitis in the children of infant and preschool age, the commonality of their pathogenesis, the feasibility and efficiency of their therapy using the monteleukast – the antileukotriene receptor inhibitor. Along with the anti-inflammatory properties of the monteleukast, the potential antiviral activity discovered in it was considered, in particular, against the SARS-CoV-2 virus, which causes COVID-19.

The severe epilepsy syndromes of infancy: A population-based study.

To study the epilepsy syndromes among the severe epilepsies of infancy and assess their incidence, etiologies, and outcomes. A population-based cohort study was undertaken of severe epilepsies with onset before age 18months in Victoria, Australia. Two epileptologists reviewed clinical features, seizure videos, and electroencephalograms to diagnose International League Against Epilepsy epilepsy syndromes. Incidence, etiologies, and outcomes at age 2years were determined. Seventy-three of 114 (64%) infants fulfilled diagnostic criteria for epilepsy syndromes at presentation, and 16 (14%) had "variants" of epilepsy syndromes in which there was one missing or different feature, or where all classical features had not yet emerged. West syndrome (WS) and "WS-like" epilepsy (infantile spasms without hypsarrhythmia or modified hypsarrhythmia) were the most common syndromes, with a combined incidence of 32.7/100000 live births/year. The incidence of epilepsy of infancy with migrating focal seizures (EIMFS) was 4.5/100000 and of early infantile epileptic encephalopathy (EIEE) was 3.6/100000. Structural etiologies were common in "WS-like" epilepsy (100%), unifocal epilepsy (83%), and WS (39%), whereas single gene disorders predominated in EIMFS, EIEE, and Dravet syndrome. Eighteen (16%) infants died before age 2years. Development was delayed or borderline in 85 of 96 (89%) survivors, being severe-profound in 40 of 96 (42%). All infants with EIEE or EIMFS had severe-profound delay or were deceased, but only 19 of 64 (30%) infants with WS, "WS-like," or "unifocal epilepsy" had severe-profound delay, and only two of 64 (3%) were deceased. Three quarters of severe epilepsies of infancy could be assigned an epilepsy syndrome or "variant syndrome" at presentation. In this era of genomic testing and advanced brain imaging, diagnosing epilepsy syndromes at presentation remains clinically useful for guiding etiologic investigation, initial treatment, and prognostication.

Неинвазивная вентиляция легких при лечении респираторного дистресс- синдрома у новорожденных детей

Objective. To assess the effectiveness of differentiated approach and the safety of non-invasive ventilation in the DuoPAP mode in infants with respiratory distress syndrome and extremely low birth weight in the early neonatal period. Patients and methods. A retrospective and prospective analysis in the period from January 2018 to April 2020. 80 children were included in the study (46 girls and 34 boys), who were born prematurely at the gestational age of 24 to 29 weeks with a body weight of 700 to 999 grams and with the main clinical nosology of the early neonatal period – respiratory distress syndrome (68.7%; n = 55) and congenital pneumonia (31.3%; n = 25). Results. The clinical manifestations and features of the diagnosis of respiratory distress syn-drome in premature infants with extremely low body weight in the early neonatal period were studied. A differentiated approach to the tactics of conducting initial respiratory therapy in the ventilation mode with biphasic positive airway pressure was presented. Indications, contraindications and clinical and laboratory predictors of the effective and safe implementation of initial respiratory support in the DuoPAP mode (analogous to the BiPAP regimen) in premature infants with respiratory distress syndrome were formed. Conclusion. Generation of indications, contraindications and timely developed clinical and laboratory predictors make it possible to personify the initial tactics of respiratory therapy in premature infants with extremely low body weight in the conditions of neonatal intensive care unit. A differentiated approach to initial non-invasive ventilation in infants with respiratory distress syndrome is an important preventive tool to minimize ventilator-associated lung injury and intraventricular hemorrhage in the early neonatal period. Key words: premature birth, premature infants, extremely low body weight, respiratory support, respiratory distress syndrome in infants, non-invasive mechanical ventilation, surfactant

The behaviors and attitude of parents toward smoking in pediatric primary settings in Al-Hasa region: a cross-sectional study

Background: Children living with smoker parents are exposed to high rates of mixtures of nicotine, toxic, and carcinogenic substances. Secondhand smoke causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome in infants and children. Thereby, this study aimed to investigate the behavior and attitude of parents in Al-Hasa region toward smoking and also to assess their knowledge and awareness about e-cigarette smoking, second-hand third-hand smoking. Methodology: This cross-sectional study was conducted with parents of children below 18 years of age in Al-Hasa region, Saudi Arabia. The study was conducted through an online questionnaire survey. The survey included the demographics, behavior, and attitude of parents toward smoking. Results: Among 150 parents in this study, there were 52.67% of smoker parents. A large proportion of parents (45.29%) reported that they would accept the decision of their children, if the children began to smoke. Most parents had heard about third-hand smoking; 12.65% believed it had no effect on health, whereas 55.28% believed it was harmful to the health. There were 29.3% who thought e-cigarettes were less harmful than regular tobacco smoking. Conclusion: The study showed a high prevalence of parental smoking and a high proportion of heavy smokers, although parents knew that exposure to parental smoking is harmful to their children. The attitude and behavior of parents seem to negatively impact their and their children’s health; so, raising awareness and knowledge is necessary and counseling the smokers to quit smoking is important.

Safety of two ventilator weaning strategies after high-frequency oscillatory ventilation in preterm infants with respiratory distress syndrome: a prospective randomized controlled trial

Objective To study the safety of two ventilator weaning strategies after high-frequency oscillatory ventilation (HFOV) for the treatment of neonatal respiratory distress syndrome (NRDS) in preterm infants. Methods A prospective randomized controlled trial was conducted for 101 preterm infants with NRDS, with a gestational age of ≤32+6 weeks or a birth weight of ≤1 500 g, who were admitted to the neonatal intensive care unit of Xiamen Maternal and Child Health Hospital from January 1, 2019 to June 30, 2020. The infants underwent HFOV as the preferred treatment. The infants were randomly divided into an observation group (50 infants with direct weaning from HFOV) and a control group (51 infants with weaning after HFOV was switched to conventional mechanical ventilation). The two groups were compared in terms of failure rate of ventilator weaning within 72 hours, changes in blood gas parameters at 2 hours before weaning and at 2 and 24 hours after weaning, respiratory support therapy, incidence rates of complications, and outcome at discharge. Results There was no significant difference in the failure rate of ventilator weaning within 72 hours (8% vs 14%, P > 0.05). The observation group had a significantly shorter duration of mechanical ventilation than the control group [(64±39) hours vs (88±69) hours, P 0.05). Conclusions For preterm infants with NRDS, the strategy of weaning directly from HFOV is safe and reliable and can reduce the duration of invasive mechanical ventilation, and therefore, it holds promise for clinical application.

Neonatal abstinence syndrome in neonates born of mothers in drug-assisted rehabilitation.

In recent years, the use of opioid maintenance treatment (OMT) during pregnancy has been a topic of much debate among clinicians. A frequent consequence of such therapy is neonatal abstinence syndrome in the newborn infant. This study aimed to investigate whether follow-up of these neonates was in line with national recommendations. All maternity units in Norway were asked whether they treated neonates born to mothers in opioid maintenance treatment (OMT). 14 out of 42maternity units treated these patients in collaboration with neonatal units, while 28 units referred the patients onward. Altogether 13 of the 14 treatment units answered a questionnaire on the nature of the care received by neonates. None of the hospitals treated more than ten neonates at risk of neonatal abstinence syndrome each year. All neonatal units used a standardised scoring form to assess the development of abstinence. When there was a need for pharmacological treatment, morphine was the first-line choice for all the units. All of them used non-pharmacological interventions. Observation time, procedures for dose reduction of pharmacological treatment and use of supplementary medication varied considerably between the units. Key aspects of the management of neonates born to mothers in opioid maintenance treatment (OMT) were practised in the same manner and in line with national recommendations. However, our study revealed differences between the hospitals, which overall represent a potential for improvement in the treatment of a vulnerable patient group.

Burden, epidemiological pattern, and surveillance gap of rubella in Nigeria: A call for routine vaccination policy

Rubella is an epidemic-prone disease with endemic transmission in Nigeria. It is a vaccine-preventable disease caused by the rubella virus whose devastating teratogenic effect makes it a disease of major public health importance when it occurs in pregnancy leading to congenital rubella syndrome (CRS) in infants. This article seeks to do a review of the burden, epidemiology, and examine the rubella surveillance gap in Nigeria. This is a review of literatures and the use of available World Health Organization secondary surveillance data to establish the burden, epidemiological pattern, and surveillance gap of rubella in Nigeria. Data were analyzed and presented with appropriate tables and charts. Epidemiologically, rubella occurs worldwide with seasonal variation. Available data from two geo-political zones (North-central and Southwest) of Nigeria showed that the peak incidence of rubella occur in the first 4 months of the year with most of the cases occurring in those

Antenatal Betamethasone Induces Increased Surfactant Proteins and Decreased Foxm1 Expressions in Fetal Rabbit Pups.

Introduction: Antenatal steroid improves respiratory distress syndrome in preterm infants. The molecular mechanism of the process is not well established. The aim of this study is to investigate the possible association between antenatal steroid and fetal Forkhead box M1(Foxm1) expression.Materials and methods: An animal study using mated pregnant New Zealand white rabbits and their fetuses was designed. Fourteen mother rabbits were assigned to four groups to undergo a cesarean section. In groups 1, 2, and 3, preterm pups were harvested on day 27 of gestation. In group 4, term pups were harvested on day 31. Antenatal maternal intramuscular injection was performed in groups 2 (normal saline) and 3 (betamethasone). Using qRT-PCR and Western blot, mRNA transcription and protein expression of surfactant protein (SP) A, B, C, and Foxm1 were compared between the pups of those four groups.Results: Sixty two fetal rabbits were harvested. One-way ANOVA test showed higher mRNA transcription of SPs in groups 3 and 4 than groups 1 and 2. Significantly lower Foxm1 mRNA transcription and protein expression were observed in group 3 or 4 compared with group 1 or 2.Conclusion: Decreased Foxm1 expression was associated in an antenatal betamethasone animal model.