Displaying publications 1 - 20 of 93 in total

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  1. Fulltext Priority in special care nurseries in Malaysia
    Lam KL
    Med J Malaysia, 1983 Mar;38(1):1-3.
    PMID: 6633326
    Matched MeSH terms: Intensive Care Units, Neonatal/manpower*
  2. Fulltext Outcome of neonates admitted to special care nursery, University Hospital, Kuala Lumpur: a comparison of two periods
    Toh CK, Tan PC, Chan YK
    Med J Malaysia, 1984 Mar;39(1):21-7.
    PMID: 6513836
    The overall mortality rate of babies delivered in the University Hospital, Kuala Lumpur has improved significantly from 18.5 in 1969-1971 to 9.9 per thousand live births in 1979-1981. This drop in mortality is also seen in those infants weighing 1001 - 2000 g at birth. Indian babies in the weight group 1001 - 1500 g at birth appear to have a significantly lower mortality than the other races. Babies referred from outside have a much higher mortality rate compared to babies delivered in University Hospital, Kuala Lumpur.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  3. Fulltext The stethoscope and the transfer of bacteria in the neonatal nursery
    Boo NY, Wong YH, Khoo AK
    Med J Malaysia, 1989 Mar;44(1):87-8.
    PMID: 2696869
    Matched MeSH terms: Intensive Care Units, Neonatal*
  4. Biosocial variances and infant survival: a path analysis approach
    Frisch AS, Kallen DJ, Griffore RJ, Dolanski EA
    J Biosoc Sci, 1992 Apr;24(2):175-83.
    PMID: 1583032
    This study used path analysis to assess the chances of survival of babies in a neonatal intensive care unit in Lansing, Michigan, USA. Two paths to neonatal survival were identified and the variables accounted for 20% of the variance in gestational age. The first path showed that prior infant losses were negatively correlated with gestational age while in the second path, gestational age showed negative relationships with pre-pregnancy weight and household job worries.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  5. An outbreak of methicillin resistant Staphylococcus aureus in the neonatal intensive care unit - Seremban Hospital
    Musa Mohd Nordin, Wong, Swee Lan
    Malaysian Journal of Child Health, 1993;5(1):26-30.
    MyJurnal
    An outbreak of Methicillin Resistant Staphylococcus aureus (MRSA) in the Neonatal Intensive Care Unit (NICU), Seremban Hospital is reported. The pattern of colonisation and infection with the MRSA was studied for the 1 year period between May 1987 till April 1988. There were few serious MRSA infections. The majority of patients were either colonised or superficially infected. The organism was resistant to all Penicillins, Gentamicin and most Cephalosporins. Netilmicin and Amikacin have shown good activity against MRSA.
    Matched MeSH terms: Intensive Care Units, Neonatal
  6. Fulltext Prelabour rupture of membranes and neonatal morbidity in level II nursery in Kelantan
    Malik AS
    Med J Malaysia, 1994 Mar;49(1):12-6.
    PMID: 8057984
    In view of controversial reports about the role of prelabour rupture of foetal membranes (PROM) in neonatal morbidity and to study the association of PROM with infections and meconium aspiration syndrome (MAS), a prospective case control study was conducted in a level II nursery of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan. Of the 111 neonates with PROM studied, 18 developed clinical problems (septicaemia and other specific problems such as pneumonia, omphalitis, skin infection and MAS) while 5/56 of the control group developed similar problems. The difference between the two groups was not significant (p < 0.30). There was no neonatal death. It is concluded that PROM is not associated with neonatal morbidity. Neonates with this problem alone do not need to be admitted to the neonatal nursery.
    Matched MeSH terms: Intensive Care Units, Neonatal
  7. Fulltext Early onset neonatal septicaemia in a level II nursery
    Malik AS, Pennie RA
    Med J Malaysia, 1994 Mar;49(1):17-23.
    PMID: 8057985
    A prospective study of 486 high risk neonates admitted to a level II nursery in a relatively poor and rural area of Malaysia was carried out to determine the incidence, the spectrum of micro-organisms and predisposing factors in relation to early onset septicaemia. The incidence of proven or probable septicaemia was 57.61 per 1000 high risk newborns over 1.5 kg. The case fatality was 10.71 per cent. Coagulase negative staphylococci, Streptococcus Group B and Klebsiella species were the most commonly isolated organisms. Meconium staining of liquor was the most common risk factor for admission to the nursery, and prematurity was the most significant risk factor for early neonatal infection (P < 0.005) followed by small for gestational age (P < 0.04). Although the incidence of septicaemia was quite high in the level II nursery, the mortality rate was comparable to established figures.
    Matched MeSH terms: Intensive Care Units, Neonatal
  8. Fulltext The current practice of neonatology in Malaysia
    Boo NY
    Med J Malaysia, 1994 Mar;49(1):1-3.
    PMID: 8057980
    Matched MeSH terms: Intensive Care Units, Neonatal/trends; Intensive Care Units, Neonatal/statistics & numerical data
  9. Fulltext An outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit in Singapore: a 20-month study of clinical characteristics and control
    Tan KW, Tay L, Lim SH
    Singapore Med J, 1994 Jun;35(3):277-82.
    PMID: 7997904
    Methicillin resistant Staphylococcus aureus (MRSA) is a major infection control problem in many countries. There have been many reports of outbreaks in neonatal nurseries including, in our part of the world, Australia, Hong Kong and Malaysia. A recent outbreak of MRSA in the neonatal intensive care unit in the Kandang Kerbau Hospital, Singapore, presented us with the opportunity to study the clinical characteristics of the outbreak and the effects of infection control measures. Neonates admitted to the neonatal intensive care unit were studied over a 20-month period. They were all screened for nasal colonisation on admission and weekly thereafter. Infections were documented. Over this period there were altogether 2,576 admissions of which 85 infants had nasal colonisation with MRSA (3.3%) and 28 developed infections (1%). Although the majority of infants colonised by MRSA suffered no ill effects, 3 had septicaemia and 2 had septicaemia with osteomyelitis. There were no deaths. Standard infection control measures with barrier nursing and the use of mupirocin nasal ointment were ineffective, and control was achieved only after strict cohorting together with the use of mupirocin was instituted. This was done without additional costs to the department and without additional nurses or doctors.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  10. Effect of rooming in on length of hospital stay and weight gain of infants in a neonatal unit
    Deng, C.T., Lim, N.L., Sham Kasim, M., Weller, V.
    Malaysian Journal of Child Health, 1994;6(1):40-43.
    MyJurnal
    The neonatal Intensive Care Unit (NICU) in the Maternity Hospital Kuala Lumpur (MHKL) was frequently understaffed and overcrowded. A separate special care nursery (called K5) was set up in July 1991 for the purpose of providing non-intensive neonatal care for infants. Mothers were simultaneously admitted and they provided a major bulk of feeding and nursing care. Case records for 2 months prior to and 2 months after opening of the ward were studied. The average duration of hospital stay per neonate was shorter in the later period (9.18 days vs 11.05 days, p < 0.05). Also the very low birth weight infants (VLBW) gained weight faster (28 grams a day) compared to similar infants in the earlier period (22 grams a day, p < 0.05).
    Matched MeSH terms: Intensive Care Units, Neonatal
  11. Fulltext Bacteraemic infections in a neonatal intensive care unit--a nine-month survey
    Lim NL, Wong YH, Boo NY, Kasim MS, Chor CY
    Med J Malaysia, 1995 Mar;50(1):59-63.
    PMID: 7752978
    A survey was conducted to determine the rate, outcome, and culture and sensitivity patterns of bacteraemic infections in a large Neonatal Intensive Care Unit (NICU). Over a nine-month period, 136 episodes of infection occurred in 132 (6.9%) out of 1926 admissions. Early onset infection accounted for 35 episodes (25.7%) and was associated with a higher mortality rate compared to late onset infection (45.7% vs 23.8%, p < 0.02). Very low birthweight (VLBW) infants had significantly higher rates of infection (19.4% vs 5.3%, p < 0.001) and mortality (45.2% vs 23.3%, p < 0.02) compared to bigger babies. Gram negative bacilli accounted for 25 early and 90 late isolates while gram positive organisms accounted for 10 early and 16 late isolates. The two main organisms (Acinetobacter and Klebsiella) showed a 69.0 to 85.3% resistance to aminoglycosides and 3rd generation cephalosporins. Ten of 13 isolates of Staphylococcus epidermidis and 3 of 4 Staphylococcus aureus were methicillin resistant. Multiply resistant infections were a major problem in this NICU and efforts to eradicate them needed to be intensified.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  12. A national study of risk factors associated with mortality in very low birthweight infants in the Malaysian neonatal intensive care units. Malaysian Very Low Birth Weight Study Group
    J Paediatr Child Health, 1997 Feb;33(1):18-25.
    PMID: 9069039
    OBJECTIVE: To determine the risk factors associated with mortality in very low birthweight (VLBW) infants admitted to the neonatal intensive care units (NIUC) in Malaysia.

    METHOD: A prospective observational study of outcome of all VLBW infants born between 1 January 1993 and 30 June 1993 and admitted to the NICU.

    RESULTS: Data of 868 VLBW neonates from 18 centres in Malaysia were collected. Their mean birthweight was 1223 g (95% confidence intervals: 1208-1238 g). Thirty-seven point four per cent (325/868) of these infants died before discharge. After exclusion of all infants with congenital anomalies (n = 66, and nine of them also had incomplete records) and incomplete records (n = 82), stepwise logistic regression analysis of the remaining 720 infants showed that the risk factors that were significantly associated with increased mortality before discharge were: delivery in district hospitals, Chinese race, lower birthweight, lower gestation age, persistent pulmonary hypertension of the newborn, pulmonary airleak, necrotizing enterocolitis of stage 2 or 3, confirmed sepsis, hypotension, hypothermia, acute renal failure, intermittent positive pressure ventilation, and umbilical arterial catheterization. Factors that were significantly associated with lower risk of mortality were: use of antenatal steroid, oxygen therapy, surfactant therapy and blood transfusion.

    CONCLUSION: The mortality of VLBW infants admitted to the Malaysian NICU was high and was also associated with a number of preventable risk factors.

    Matched MeSH terms: Intensive Care Units, Neonatal*
  13. The effect of providing expressed breast milk on infection rates, mortality and breast feeding of preterm babies
    Ram, S.P., Zabidi Azhar M Hussin
    Malaysian Journal of Child Health, 1997;9(1):83-87.
    MyJurnal
    Two active interventions were carried out in order to encourage breast feeding of low birth weight (LBW) neonates who were admitted to the neonatal intensive care unit (NICU), Universiti Sains Malaysia. These were the establishment of (a) an effective transport system for conveying expressed breast milk (EBM) from the motherk home to the neonatal intensive care unit and (b) providing rooming-infacilities in the neonatal ward. The EBM was transported by a male health assistant, by the parents themselves or by the local bus company. A total of 473 babies were admitted from April 1994 to September 1995. Thirty-three babies weighed between 540-1000g and 440 were between 1001-2000g. A total of 226 (47.8%) babies were given mixed formula (less than 20% of daily needs) and EBM feeds (Group A) and 247 (52.2%) were given only formula feeds (Group B). A total of 79 babies died of which 5 were in Group A and 74 were in group B. (P value is 0.00). In Group A, 45 babies had clinical sepsis, 9 of whom were blood culture positive. Four of these babies died. In group B, out of 108 babies with clinical sepsis 36 were blood culture positive. 29 died because of the sepsis This study shows that by providing an effective transport system for breast milk expressed at home and the availability of roomingfacilities in the neonatal ward a significant number of LBW babies admitted to the NICU continue to receive their mothers' milk. The incidence of nosocomial sepsis and the over all mortality due to sepsis was significantly higher in those on full formulafeeding compared to those given mixed formula and expressed breast milk.
    Matched MeSH terms: Intensive Care Units, Neonatal
  14. Fulltext Blood transfusion reactions in Malaysian newborn infants
    Boo NY, Chan BH
    Med J Malaysia, 1998 Dec;53(4):358-64.
    PMID: 10971978
    A prospective observational study was carried out over a seven month period in the neonatal intensive care unit (NICU) of a large Malaysian maternity hospital to determine the rate of blood transfusion and the incidence of transfusion reactions in newborn infants. During the study period, the rates of blood transfusion was 6.1% (n = 117) of NICU admission or 8.2 per 1,000 live births. The median birth weight of the infants who had received blood transfusion was 1,740 grams (range: 725-4,350), and their mean gestational age was 33.6 weeks (sd = 5.1, range = 24-41 weeks). The median age of infants when they first received blood transfusion was 4.0 days (range: 1-27 days). When compared with infants of birth weight between 3,000 and 3,499 grams, infants of birth weight less than 1,500 grams received significantly higher median number of transfusions per infant, (p < 0.001). The incidence of transfusion reaction was 2.7% (3/110) of all transfused infants or 1.3% (3/223) of all blood transfusions. Febrile nonhemolytic reaction was the only type of transfusion reaction detected during the study period. This study showed that transfusion reactions in newborn infants were not common.
    Matched MeSH terms: Intensive Care Units, Neonatal
  15. Hand washing practice in the neonatal intensive care unit
    Rasid, M.A., Quah, B.S., Pennie, R.A.
    Malaysian Journal of Paediatrics and Child Health, 1998;10(2):46-51.
    MyJurnal
    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
    Matched MeSH terms: Intensive Care Units, Neonatal
  16. Exchange transfusion for neonatal hyperbilirubinaemia: experience in an inborn neonatal intensive care unit
    Lim, N.L., Boo, N.Y., Nur Atiqah, N.A., Padma Soosai, A., Musa Mohd Nordin, M Sham. Kasim
    Malaysian Journal of Child Health, 1998;10(1):46-51.
    MyJurnal
    Severe jaundice (serum bilirubin level > 340 gmol/L) occurred in 81 infants admitted to the Neonatal Intensive Care Unit (NICU) of the Maternity Hospital Kuala Lumpur (MHKL) in 1993. Of these 46 (56.8%) underwent 53 exchange transfusions. In-patient case notes were available for study on 41 of them. Two infants had no cause identified while 12 were associated with prematurity, 13 ABO incompatibility, 8 G6PD deficiency, 6 sepsis 2 Rh isoimmunisation and 6 miscellaneous causes. In 14 infants it was felt that exchange transfusions might have been avoided if they were detected earlier and phototherapy instituted promptly. Twenty six (26) infants were deemed to have been given phototherapy at the appropriate time but jaundice increased to exchange transfusion levels, threshold values depending on the unit in charge. Use of higher intensity phototherapy might have been more effective in some of the cases. Available data showed similar outcomes in both groups.
    Matched MeSH terms: Intensive Care Units, Neonatal
  17. A comparative study on management of intravenous lines among nurses in a neonatal intensive care unit
    Faridah Ahmad Shiek, Alimatulsaadiah Abu Hassan, Zaiton Sudin, Zaitun Aris, Khoo A.S.B., Lim, N.L.
    Malaysian Journal of Child Health, 1998;10(1):34-39.
    MyJurnal
    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.
    Matched MeSH terms: Intensive Care Units, Neonatal
  18. Fulltext Nosocomial bacterial sepsis in babies weighing 1000-1499 g in Kelantan
    Halder D, Haque ME, Zabidi MH, Kamaruzzaman A
    Med J Malaysia, 1999 Mar;54(1):52-7.
    PMID: 10972005
    From January to December 1992, 92 babies weighing 1000-1499 gm here to referred as very low birth weight (VLBW) were admitted to NICU (Neonatal Intensive Care Unit), Hospital University Sains Malaysia (HUSM). Sixty babies were inborn giving a VLBW rate of 7.5 per 1000 live births. Incidence of nosocomial sepsis was 32.6% (30/92) of whom 43.3% (13/30) died. Eighty percent (24/30) of the septic babies had blood culture positive for gram negative organisms of which 40% (12/30) were sensitive only to imipenem. Ventilator support within 24 hours of life was required in 41.3% (38/94) babies of whom 42% (16/38) babies developed nosocomial sepsis. Delayed initiation of feeding was significantly associated with nosocomial sepsis. A strict asepsis policy and early feeding of the VLBW infant are essential components of any strategy to prevent of sepsis due to nosocomial infection.
    Matched MeSH terms: Intensive Care Units, Neonatal/statistics & numerical data
  19. Comparison of the pattern of nosocomial infection between the neonatal intensive care units of hospitals kuala terengganu and universiti sains malaysia, kelantan
    Wan Hanifah W, Lee J, Quah B
    Malays J Med Sci, 2000 Jan;7(1):33-40.
    PMID: 22844213
    Nosocomial infection is a common problem in the Neonatal Intensive Care Unit (NICU) and a knowledge of the pattern of nosocomial infection will contribute greatly to the intensification of infection control measures and the development of antibiotic policies in the NICU. This study aims to compare the incidence and clinical characteristics of neonates with nosocomial infection in NICU of both Kuala Terengganu Hospital (HKT) and Universiti Sains Malaysia Hospital (HUSM). Neonates who had both clinical signs of sepsis and positive blood cultures, 48 hours after admission to NICU, from 1(st) January to 31(st) December 1998, in both hospitals were retrospectively studied. Among neonates admitted to NICU, 30 (5.4%) in HKT and 65 (3.6%) in HUSM had nosocomial infection (p = 0.07). The mean duration of hospitalisation was shorter (HUSM 37 days, HKT 49 days; p = 0.02), and the number of neonates with predisposing factors for infection is higher (HUSM 100%, HKT 73.3%; p < 0.001) in HUSM compared with HKT. There were no differences in gestation, mean age of onset of infection and mortality between both hospitals. The most common organism isolated from the blood in HKT was Klebsiella pneumoniae (33.3%), and in HUSM Klebsiella aerogenes (24.6%). Half of Klebsiella pneumoniae isolates were resistant to cephalosporins and aminoglycosides in HKT and a similar number of Klebsiella aerogenes isolates were resistant to piperacillin and aminoglycosides in HUSM. In conclusion nosocomial infection is a common problem in both hospitals. Except for more frequent predisposing factors for infection in HUSM, and a longer duration of hospital stay among neonates in HKT, the clinical characteristics of neonates with nosocomial infection in both hospitals were similar.
    Matched MeSH terms: Intensive Care Units, Neonatal
  20. Risk factors associated with feed intolerance in very low birthweight infants following initiation of enteral feeds during the first 72 hours of life
    Boo NY, Soon CC, Lye MS
    J Trop Pediatr, 2000 Oct;46(5):272-7.
    PMID: 11077935 DOI: 10.1093/tropej/46.5.272
    An observational study was carried out in the Kuala Lumpur Maternity Hospital to determine the risk factors associated with feed intolerance in very low birthweight (VLBW, <1501 g) infants given intermittent 3-hourly enteral feeds within 72h after birth. Feed intolerance developed in 85 (64.4 per cent) of 132 infants. Logistic regression analysis showed that the only significant risk factor associated with feed intolerance was the age when the first feed was commenced. For each hour delay in the age of the infants when the first feed was given, the adjusted odds ratios of feed intolerance was 1.03 (95 per cent confidence intervals: 1.01-1.05; p = 0.01). Other factors (modes of delivery, Apgar score at 1 min, sex, ethnicity, history of resuscitation at birth, birthweight, gestation, multiple pregnancy, perinatal asphyxia, types of milk, hypothermia before first feed, hypotension before first feed, respiratory distress syndrome, patent ductus arteriosus, septicaemia, theophylline therapy, indomethacin therapy, ventilatory support, continuous positive airway pressure, umbilical catheterization, and surfactant therapy) were not significantly associated with feed intolerance. Our study suggests that to promote tolerance of enteral feeds in VLBW infants, intermittent orogastric feeds should be commenced as soon as possible during the first 72 h of life.
    Matched MeSH terms: Intensive Care Units, Neonatal
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