114 days left before my exam..

already entered paediatric posting..one of the 'malignant' posting..not all part of the posting..

this time, we're divided into four subgroup : Neonatal Posting, Paediatric Clinic Posting and two groups on General Paediatric..

For me, i'm prefered to be in NICU (Neonatal ICU)..and tomorrow, i have my oncall there..

hope got some procedure to learn..

In NICU, most of the babies got problems with respiration such as respiration distress syndrome due to premature and some complication during antenatal period such as maternal hypertension, maternal diabetes, fetal distress ..or intrapartum problem eg: prolonged 2nd stage of labour etc..

can you imagine..dealing with small, red pitiful face babies who are in respiratory distress..as light as 800gm..kesian woooo..some are due to unexplained premature delivery..

Failure to Thrive in Premature Infants

one baby..at birth with the weight of 1.0kg born at 25 weeks of gestation..but still didn't gain weight after 1 month in NICU..still dunno the causes of the failure to thrive...

Heart Disease

One term infants diagnosed to have Double Outlet Right Ventricle..this baby always in cyanosed condition..(blue-spell)..especially during cying..means that, he always in chronic hypoxia state..which was not good for his developement..and the brain..to help him..oxygen supplementation was given via nasal prong (not comfortable at all to wear this..wanna try??)

Hypoxic-Ischemic Encephalopathy (HIE)

This condition was due to prolonged hypoxia or anoxia during intrapartum..usually the baby did not cry just after birth..and always need intubation..there's one case the baby's head stuck for more than 10 minutes in breech delivery.. try to imagine, did not get oxygen for 10 minutes..

nak tahan nafas seminit pun dah penat..

HIE got 3 grade : Grade I-III.

Grade III had the worst prognosis for later development..and characterised by seizures during neonatal period..and many more criteria using Sarnat-Sarnat Criteria of Grading..

for further information..boleh carik kat internet or jurnal..

Birth Injury

1. The trauma occurs during antenatal, intrapartum period..

maybe due to lacking of amniotic fluid (oligohydramnios),

eg: limbs fracture

2. assisted delivery (Ventouse or Vacuum delivery, Forceps delivery),

eg: bruises over the scalp or hematoma ranging from non-life threathening to life threathening.

3. big baby who had difficulty to deliver the shoulder (shoulder dystocia) where the shoulder stuck at the maternal pelvis

eg: paralysis of the shoulder and upper limb..can be transiet or permanent.

banyak lagi causes of admission kat NICU ni..xhabih nk cerita..sebab nk study jap yer..hehe..