The aim of this paper was to study hand washing practices in the Neonatal Intensive Care Unit (NICU), Hospital Universiti Sains Malaysia. All medical personnel handling babies in the NICU were observed without their knowledge for a total of three times before and after an educational intervention between November 1, 1993 and December 31, 1993. Hand washing techniques with both Hibisol Spray and Chlorhexidine were scored from 1-4. The results of the study are shown as follows: the number of personnel observed were: before educational intervention -paediatric doctors (PD) 14, non-paediatric doctors (ND) 13 and nurses (N) 48; after educational intervention - PD 10 , ND 12 and N 42. PD and N washed hands significantly more often than ND (p < 0.001), before and after intervention. PD but not ND or N improved their rate of hand washing after educational intervention PD (p= 0.02). The Hibisol handwashing technique was poor in all groups (77.1% of all observations). The Chlorhexidine hand washing technique was better than Hibisol (p<0.0001). However only 15% of observed washes with Chlorhexidine were well done and almost one third were done poorly. Both Hibisol and Chlorhexidine techniques did not improve after educational intervention. Hand washing was performed more often in the Level III than Level II nursery [85% of all observations in Level III and 73% of all observations in Level II, p=0.002]. In conclusion, the present educational program is not sufficient and more direct means should be taken to improve the frequency of hand washing among all medical personnel. All medical personnel in the NICU should be educated in the use of the Hibisol, otherwise Hibisol should be removed from the nursery.
Keywords: Handwashing, doctors, neonatal intensive care unit, nurses
Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Congenital varicella syndrome is a rare outcome of early primary maternal varicella zoster infection. The neuromuscular anomalies, skeletal defects and skin lesions of such a case are described in our case report. The diagnosis of congenital varicella syndrome, the prenatal risk and management of primary maternal varicella infection in pregnancy are also discussed.
Domiciliary deliveries have always been the responsibility of traditional birth attendants. Since Independence, acquired in 1957, educated young women have been trained as auxiliary midwives and sent to serve in rural communities where they usually are met with resistance by the established traditional birth attendants. To counter this and to incorporate the traditional birth attendants into the health team, new roles were developed for each so that the two would be able to cooperate and support each other rather than rival and antagonise each other. A specific experience in one area of Malaysia is examined as an example.
We report a rare case of a newborn baby girl who was delivered at 36 weeks of gestation with birth weight of 2680 grams and has ankyloblepharon filiforme adnatum with cleft lip and palate diagnosed at birth. The baby was managed with simple procedures of eyelid bands separation. We also reviewed the embryology of eyelid and its relation with ankyloblepharon formation and discussed the various syndromes and abnormality which may be associated with this eyelid abnormality. The four types of ankyloblepharon which was described by Rosenman and colleague is presented.
This research describes a comparative study using convenience sampling on management of intravenous lines in Maternity Neonatal Intensive Care Unit (MNICU), HKL. Questionnaires were answered by nurses and the techniques of anchoring, splinting and maintaining of intravenous lines by nurses in MNICU were observed by the researchers. The study showed that nurses with less than two years experience working in MNICU had significantly less knowledge and skills in the management of intravenous lines and are likely to encounter more difficulties and complications, compared to nurses with more experience.
Oral health problem among pregnant woman has been shown to have possible
association with preterm birth and low birth weight. Several studies found that pregnant women
have limited knowledge of these adverse outcome .The aims of this study were to evaluate the
knowledge, attitude and practices of pregnant women and to examine their practices in relation
with their intraoral health status. (Copied from article).
Haemolytic Disease of Foetus and Newborn (HDFN) and Haemolytic Transfusion Reaction (HTR) may occur due to antibodies against Kidd antigen. In Malaysia, the prevalence of RBC alloimmunization due to Kidd antibody for cases of HDFN and HTR have been reported [1-2] however there is insufficient data in Hospital Umum Sarawak (HUS).The aim of this study is to determine whether Kidd alloimmunization causes HDFN and HTR. Indirectly categorize Kidd phenotype blood in regular blood donors.
Despite the proven benefit of cryotherapy in the management of
threshold retinopathy of prematurity (ROP), it was shown
leading to ocular adverse effects. A male infant was born at 28
week of gestation with a birth weight of 1200 g. Serial
examinations revealed worsening ROP in both eyes until he
reached a high risk pre-threshold ROP in his right eye and
threshold ROP in his left eye. Cryotherapy was performed for
the threshold ROP in the left eye while the right eye was
subjected to further observation. Subsequently, ROP in both
eyes regressed without cicatrisation. The patient was followedup
over 8 years and refractions showed that the treated eye
developed steadily increasing myopia while the untreated eye
remained emmetropic. This case demonstrated the detrimental
effect of cryotherapy to the treated eye leading to the progressive
myopia as the child grew.
Objectives: This is a retrospective study in which all neonates with confirmed dengue fever mother admitted to our special care nursery from March 2014 to March 2015 were recruited. This is to determine the percentage of positive dengue serology in the neonates of mother with confirmed dengue fever and to investigate the correlation between the duration of maternal illness with these neonatal seropositivity of dengue antibody and their presenting symptoms.
Method: A total of 22 neonates whose mother with confirmed dengue fever were recruited out of which 14 (63.6%) neonates of confirmed dengue fever mothers had positive dengue serology.
Results: Eight out of fourteen neonates were dengue seropositive when mother dengue illness was between day 1 to 5 of illness (acute phase) at the time of delivery. Thirteen out of twenty-two neonates (59%) were symptomatic, out of which 61.5% (8 out of 13) were delivered during maternal acute phase of illness.
Conclusion: From this study, we concluded that neonates were more likely to be dengue seropositive and symptomatic when mother presented in acute phase of illness during delivery. However, our sample size was small, only 22 neonates were recruited from a single centre, therefore a larger sample size from multicentre is required in future.
Adrenal hemorrhage (AH) is a relatively uncommon condition (0.55-1.9%) during the neonatal period [1]. The adrenal gland is vulnerable to haemorrhage because of its large size and high vascularity. Clinical features of AH are variable and nonspecific. AH in a newborn can present as anemia, hyperbilirubinemia, abdominal mass, painful swelling or hematoma of the scrotum, acute adrenal crisis or shock [2]. We report such a case of adrenal haemorrhage in a newborn.(Copied from article)