Purpose: This study aimed to investigate whether non-invasive ventilation (NIV) in neonates admitted to the neonatal intensive care unit (NICU) is associated with an increased risk of hearing impairment. Materials and Methods: A retrospective cohort study was conducted including 798 neonates admitted to the NICU at Karab & uuml;k University Faculty of Medicine Training and Research Hospital between 1 January 2020 and 31 December 2023 who met the inclusion criteria. Infants were categorised into two groups: those who received non-invasive ventilation and those who received either supplemental oxygen or no ventilatory support. Hearing outcomes were assessed using auditory brainstem response (ABR) screening and brainstem evoked response audiometry (BERA). Results: There were no statistically significant differences between the groups in terms of birth weight or gestational age. Apgar (Appearance, Pulse, Grimace, Activity, Respiration) scores were significantly lower in infants who received NIV. A higher proportion of female infants received NIV. Although NIV was associated with an increased rate of failure in the initial ABR screening (ABR1), this association was not observed in subsequent ABR assessments (ABR2) or in BERA testing. Conclusion: NIV is associated with transient abnormalities in early auditory screening; however, this effect does not persist in confirmatory testing. These findings suggest that NIV does not confer a sustained risk of hearing impairment in neonates.
Background: Phototherapy is a promising treatment modality for neonatal jaundice; however, its utility is limited in low- and middle-income nations with a high burden of the disease. Objectives: To compare the efficacy and safety of a single-surface phototherapy unit covered with a white cotton curtain against a conventional single-surface phototherapy unit. Methods: An open-label, randomised controlled trial was conducted on 200 full-term neonates with significant hyperbilirubinemia at the Neonatal Intensive Care Unit of a tertiary care teaching institute in central India over a period of one year. A computergenerated randomisation technique was used to allocate 100 neonates each to the experimental and control groups. Experimental group neonates were exposed to a single-surface phototherapy unit covered by a white cotton curtain, whereas control group neonates were treated using a conventional singlesurface phototherapy unit. Demographic, maternal, and neonatal data were collected. Total serum bilirubin (TSB) was assessed at the initiation of phototherapy, at 6, 12, and 24 hours, and 24 hours postdiscontinuation of phototherapy. The rate of bilirubin decline, duration of phototherapy, and adverse side effects were observed. The independent 't'-test, Mann-Whitney U test, Chi-square test, and Fisher's exact test were used for intergroup comparisons. Results: Maternal/neonatal demographics, gestational age, birth weight, Apgar scores, and baseline TSB levels were comparable between the groups. The mean TSB in the experimental group at 6, 12, and 24 hours, as well as 24 hours post-discontinuation, was statistically significantly lower than that of the control group (p<0.0001). The mean duration of phototherapy was significantly shorter in the experimental group (13.69 +/- 5.35 hours) than in the control group (16.26 +/- 6.89 hours; p=0.003). The rate of bilirubin decline was significantly higher in the experimental group at all evaluated time points (p<0.001). No major adverse events were noted, except for mild hyperthermia in three neonates within the experimental group. Conclusion: Utilising a white cotton curtain around a phototherapy unit significantly increases its therapeutic efficacy among full-term neonates with hyperbilirubinaemia.
Aim: To investigate the neonatal and child maltreatment outcomes of babies born to mothers who took illicit drug during pregnancy. Methods: We retrospectively reviewed the babies with prenatal substance exposure under Comprehensive Child Development Service (CCDS) born from 2012 to 2019. Medical records were reviewed with information supplemented by territory-wide child protection registry. Results: One hundred and three babies born from mothers with active history of illicit drug were included for analysis. Overall, 20.4% of babies were premature and 44.7% had been neglected at birth with further 6.8% child maltreatment records by 5 years old. Prematurity (p-values <0.05) was higher in child maltreatment group. Child maltreatment was less identified in babies whose mother attended CCDS antenatal care (p<0.001). Conclusions: Prenatal substance exposure had high risk of prematurity and child maltreatment. Antenatal involvement of CCDS with multidisciplinary collaboration for pregnant illicit drug users may be a protective factor for child maltreatment.
Childhood primary central nervous system (CNS) vasculitis is a potentially reversible but serious inflammatory brain disease that manifests with acute or gradual onset neurological and psychiatric symptoms in children and adolescents. It can affect large or small blood vessels and can be categorised by size, location, aetiology or progression. Neurovascular imaging is crucial and mandatory to confirm the diagnosis of CNS vasculitis and may help to obviate the need for brain biopsy. We aimed to report a case of primary internal carotid artery vasculitis in a child, with presenting clinical and imaging findings.
We report a case of acute encephalopathy with biphasic seizures and restricted diffusion (AESD) in a two-year-old Chinese girl, who presented with biphasic seizures and characteristic imaging findings. She was started on anti-seizure medications and subsequently discharged with full neurological recovery. AESD is a rare clinico-radiological disease entity that should be considered in patients presenting with biphasic seizures; early imaging could guide the diagnosis.
