Contents Chapter Topic Page Neonatology Respiratory Cardiology

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Duration of Anticonvulsant Therapy- Guidelines (JJ Volpe: Neurology of the Newborn: pg 207) Optimal duration of therapy relates to the probability of recurrence of seizures if the drugs are discontinue and the risk of subsequent epilepsy. This can be determined by considering the neonatal neurological examination, cause of the seizure and the EEG. Neonatal Period If neonatal neurological examination becomes normal, discontinue therapy If neonatal neurological examination is persistently abnormal consider etiology and obtain electroencephalogram(EEG) In most cases – continue phenobarbitone discontinue phenytoin reevaluate in a month One Month after Discharge If neurological examination has become normal, discontinue phenobarbitone over 2 weeks If neurological examination is persistently abnormal, obtain EEG If no seizure activity or not overtly paroxysmal on EEG, discontinue phenobarbitone over 2 weeks If seizure activity is overtly paroxysmal continue phenobarbitone until 3 months of age and reassess in the same manner. PROGNOSIS OF NEONATAL SEIZURES Most important determinant of neurological prognosis is the underlying nature of the neuropathological process. Neurological Disease Normal Development (%)^ Hypoxic Ischemic Encephalopathy 50 Severe Intraventricular Hemorrhage with PVH infarction 10 Primary Subarachnoid Hemorrhage Hypocalcaemia Early onset (depends on the prognosis of complicating illness, if no 50 neurological illness present prognosis approaches later onset ) Later onset ( nutritional type) Hypoglycemia 50 Bacterial Meningitis 50 Developmental defect 0 ^ - Prognosis is based on those cases with the stated neurological disease when seizures are a manifestation. This will differ from overall prognosis of the disease. (based on JJ Volpe: Neurology in the Newborn:4 th edition. <strong>Page</strong> 202) References: 1. JJ Volpe: Neurology in the Newborn: Fourth Edition 100
2. Klauss & Fanaroff: Care of The High Risk Neonate: Fifth Edition 3. McDermott CA, Kowalczyk AL, Schnitzler ER et al: Pharmacokinetics of lorazepam in critically ill neonates with seizures. J Pediar 120: 479- 483,1992 4. Deshmukh a, Wittert W, Schnitzler ER et al: Lorazepam in the treatment of refractory neonatal seizures: a pilot study.Am J Dis Child140:1042-1044. 1986. 5. MaytalJ, Novak GP, King KC: Lorazepam in the treatment of refractory neonatal seizures:J Child Neuro6;319-323,1991 6. Hu KC, Chiu NC, Ho CS, Lee ST, Shen EY Continuous midazolam infusion in the treatment of uncontrollable neonatal seizures. Acta Paediatr Taiwan. 2003 Sep-Oct;44(5):279-81. 7. Ng E, Klinger G, Shah V, Taddio A.Safety of benzodiazepines in Newborns. Ann Pharmacother. 2002 Jul-Aug;36(7-8):1150-5. 8. Gamstorp I, SedinG; Neonatal convulsions treated with continuous intravenous infusion of diazepam:Ups J Med Sci87: 143-149, 1982.
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Contents Chapter Topic Page 1 Norma
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Dermatology 67 Atopic Dermatitis…
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Dato’ Dr. Lim Nyok Ling Consultan
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ISSN 1823-3856 Printed by: Perniaga
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Foreword One of the maxims of scien
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B. Anthropometric Measurements a) H
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Immunisation 1. Immunisation schedu
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2 General Notes 2.1 Many vaccines (
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3.5.6 Rubella - Contraindicated in
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4.8 Rubella May have rash, fever,
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5.5 Close contacts of immuno-defici
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Developmental Assessment Developmen
Page 25 and 26:
Hearing Assessment Warning signs fo
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Global Developmental Delay History
Page 29 and 30:
Developmental Milestones Table AGE
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AGE Gross Motor Vision & Fine Motor
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Principles of Transport of the Sick
Page 35 and 36: 3.1 Airway Management Establish a p
Page 37 and 38: 3.7 Environment Neutral Thermal Env
Page 39 and 40: 7. Special Surgical Conditions 7.1
Page 41 and 42: • Ventilation - Most of the babie
Page 43 and 44: Neonatal Resuscitation High Risk De
Page 45 and 46: • Drugs are available (and prepar
Page 47 and 48: Meconium stained liquor: Meconium i
Page 49 and 50: Summary: Use of medications during
Page 51 and 52: Definition Premature infant: < 37 w
Page 53 and 54: 8. Supplements: a. At birth : Vitam
Page 55 and 56: Enteral Feeding in Neonates 1. Intr
Page 57 and 58: 32 weeks Well babies Start milk imm
Page 59 and 60: Total Parenteral Nutrition for Neon
Page 61 and 62: Clearance is usually monitored by m
Page 63 and 64: Daily weight Meticulous care of th
Page 65 and 66: Monitor BUSE and correct any imbala
Page 67 and 68: C. UAC and UVC care UAC position Le
Page 69 and 70: HIGH FREQUENCY OSCILLATORY VENTILAT
Page 71 and 72: 6. Infants must be monitored closel
Page 73 and 74: pH , PaCO2, PaO2, HCO3 - , Bases Ex
Page 75 and 76: Q. Name a likely diagnosis A. RDS 3
Page 77 and 78: A. Definition Birth Asphyxia There
Page 79 and 80: E. Management I. Good intrapartum c
Page 81 and 82: c. All doctors managing such infant
Page 83 and 84: Etiology Determination of etiology
Page 85: FLOW CHART: MANAGEMENT OF NEONATAL
Page 89 and 90: D. Asymptomatic Hypoglycaemia Feed
Page 91 and 92: NEONATAL JAUNDICE What is jaundice?
Page 93 and 94: Physical examination • General co
Page 95 and 96: Once the baby is on phototherapy, v
Page 97 and 98: Reference: extracted from MOH publi
Page 99 and 100: - 1ml of 4.2% NaHCO3 given for ever
Page 101 and 102: a. If unconjugated hyperbilirubinae
Page 103 and 104: APNOEA IN THE NEWBORN Definition :
Page 105 and 106: History NEONATAL SEPSIS Septic Neon
Page 107: Antibiotic choice will depend on pr
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Contents Chapter Topic Page Neonatology Respiratory Cardiology

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