Displaying publications 81 - 93 of 93 in total

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  1. Fulltext Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)
    Lee YQ, Ahmad Kamar A, Velayuthan RD, Chong CW, Teh CSJ
    Pediatr Neonatol, 2021 03;62(2):129-137.
    PMID: 33218933 DOI: 10.1016/j.pedneo.2020.10.002
    BACKGROUND: Gastrointestinal carriage of multidrug resistant (MDR) Gram-negative bacilli, especially Klebsiella pneumoniae and Escherichia coli, was highly associated with severe nosocomial infections. The main objectives of this study were to determine the clonal relatedness of intestinal carriage and transmission risk factors of MDR E. coli and K. pneumoniae amongst preterm infants admitted to the neonatal intensive care unit (NICU).

    METHODS: A prospective cohort study of preterm infants with gestational age 

    Matched MeSH terms: Intensive Care Units, Neonatal
  2. Fulltext Early outcome of congenital diaphragmatic hernia in a Malaysian tertiary centre
    Rohana J, Boo NY, Thambidorai CR
    Singapore Med J, 2008 Feb;49(2):142-4.
    PMID: 18301842
    This prospective observational study was conducted to determine the outcome of newborns with congenital diaphragmatic hernia (CDH). They were managed with a protocol of gentle ventilation to avoid barotraumas, and inhaled nitric oxide (iNO) or intravenous magnesium sulphate for treatment of persistent pulmonary hypertension of newborns (PPHN).
    Matched MeSH terms: Intensive Care Units, Neonatal
  3. Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial
    Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.
    Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.
    PMID: 27671836 DOI: 10.1136/archdischild-2015-310246
    OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.

    DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.

    SETTING: Two regional tertiary neonatal intensive care units.

    PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.

    INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.

    MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.

    RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.

    CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.

    TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.

    Matched MeSH terms: Intensive Care Units, Neonatal
  4. 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
  5. Reimagining the NICU: a human-centered design approach to healthcare innovation
    Mohammed S, Savage T, Smith J, Shepley MM, White RD
    J Perinatol, 2023 Dec;43(Suppl 1):40-44.
    PMID: 38086966 DOI: 10.1038/s41372-023-01794-2
    Design charettes have been utilized in architectural and design practice to generate innovative ideas. The Reimagining Workshop is a version that combines practical and blue-sky thinking to improve healthcare facility design. The workshop engages diverse stakeholders who follow a human-centered design framework. The Reimagining the Neonatal Intensive Care Unit workshop sought to generate ideas for the future, optimal NICU without specific site or client constraints. Key themes include family-centered care, technology-enabled care, neighborhood and village design and investing in the care team. Recommendations include a supportive physical environment, celebrating milestones, complementary and alternative medicine, enhancing the transition of care, aiding the transition period, and leveraging technology. The workshop showcased the potential for transformative change in NICU design and provided a roadmap for future advancements. These findings can inform regulatory standards for NICU design and drive improvements in family-centered care, patient experiences, and outcomes within the NICU environment.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  6. Risk factors associated with outcomes of very low birthweight infants in four Asian countries
    Wariki WM, Mori R, Boo NY, Cheah IG, Fujimura M, Lee J, et al.
    J Paediatr Child Health, 2013 Jan;49(1):E23-7.
    PMID: 23282105 DOI: 10.1111/jpc.12054
    The study aims to determine the risk factors associated with mortality and necrotising enterocolitis (NEC) among very low birthweight infants in 95 neonatal intensive care units in the Asian Network on Maternal and Newborn Health.
    Matched MeSH terms: Intensive Care Units, Neonatal/statistics & numerical data
  7. 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
  8. Fulltext Predictors of failed closure of patent ductus arteriosus with indomethacin
    Boo NY, Mohd-Amin I, Bilkis AA, Yong-Junina F
    Singapore Med J, 2006 Sep;47(9):763-8.
    PMID: 16924357
    Introduction: The aim of this study was to determine predictors of failed closure of patent ductus arteriosus (PDA) following a single course of indomethacin in symptomatic preterm infants.
    Methods: This prospective observational study was carried out on 60 preterm infants weighing less than 1,750 g with symptomatic PDA confirmed by echocardiography. At a median age of 7.0 days (interquartile range 4.0), they were given indomethacin of 0.1 mg/kg/day intravenously daily for six days. Closure of PDA was reassessed by echocardiography upon completion of therapy.
    Results: The PDA of 40 percent (n=24) of these infants remained patent. Forward logistic regression analysis showed that the only significant predictors of failed PDA closure in these infants were: PDA size (adjusted odds-ratio [OR] is 7.0; 95 percent confidence interval [CI] of OR is 2.0, 24.8; p-value is 0.002), birth weight (adjusted OR is 0.996; 95 percent CI of OR is 0.993, 1.000; p-value is 0.03) and platelet count (adjusted OR is 0.987; 95 percent CI is 0.975, 1.000; p-value is 0.045). Gestational age, maternal age and left atrium/aorta ratios were not significant predictors.
    Conclusion: Larger PDA, lower birth weight and lower platelet count were significant predictors of high failure in indomethacin therapy given late at one week of life.
    Matched MeSH terms: Intensive Care Units, Neonatal
  9. International comparison of care for very low birth weight infants: parents' perceptions of counseling and decision-making
    Partridge JC, Martinez AM, Nishida H, Boo NY, Tan KW, Yeung CY, et al.
    Pediatrics, 2005 Aug;116(2):e263-71.
    PMID: 16061579
    To characterize parent perceptions and satisfaction with physician counseling and delivery-room resuscitation of very low birth weight infants in countries with neonatal intensive care capacity.
    Matched MeSH terms: Intensive Care Units, Neonatal
  10. 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
  11. Fulltext A Prospective Cohort Study of Obstetric Immigrants in the Maternity Hospital Kuala Lumpur. A Pilot
    Noraihan Mohd. Nordin, Sharda, Priya, Zainab Shamsuddin
    International Medical Journal Malaysia, 2006;5(1):1-12.
    MyJurnal
    Objectives: The objectives of this study were to ascertain the prevalence of Indonesians obstetrics immigrant and to assess the fetal maternal outcome. Methodology: A prospective cohort study design was used to analyse 54 consecutive Indonesians obstetrics immigrant compared to 56 Malay women. Chi square and student t test were used where appropriate, p < 0.05 was considered to be of statistical significance. Results: There was a reducing trend in the incidence admission of Indonesians from 10.5 in 1999 to 6.5 % in 2002. The maternal mortality ratio showed an increasing trend from 1999 (40.0/100000) to 2001 (162.9/100000) but decreased to 5.8/100000 in 2002. The majority was between 20-40 years old, multiparous and booked, which was similar to the Malay population. Most Malays were in occupational class 1 to 3 and the husband has secondary and tertiary education compared to the Indonesians who were in class 4 and 5 and the husband has primary and no formal education. Significantly more immigrants were housewives compared to Malays who were working women. There was no significant difference in the antenatal complications. There were no significant difference in terms of delivery and most delivered vaginally. The perinatal outcome in terms of gestation, birth weight, Apgar score and admission to neonatal ICU were similar in both populations and there was no perinatal mortality. In conclusion, the incidence admission of Indonesian immigrant was on the decreasing trend. The outcome of these patients managed in MHKL was similar to the Malay population. Further studies with enrollment of a larger number of patients should be carried out to ascertain the significance of these findings.
    Matched MeSH terms: Intensive Care Units, Neonatal
  12. The performance of distortion product otoacoustic emissions and automated auditory brainstem response in the same ear of the babies in neonatal unit
    Abdul Wahid SN, Md Daud MK, Sidek D, Abd Rahman N, Mansor S, Zakaria MN
    Int J Pediatr Otorhinolaryngol, 2012 Sep;76(9):1366-9.
    PMID: 22770594 DOI: 10.1016/j.ijporl.2012.06.008
    OBJECTIVE: To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population.
    METHODS: A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge.
    RESULTS: There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy.
    CONCLUSION: AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.
    Matched MeSH terms: Intensive Care Units, Neonatal
  13. 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*
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