Determinants of survival in very low birth weight neonates in a public sector hospital in Johannesburg

<p>Abstract</p> <p>Background</p> <p>Audit of disease and mortality patterns provides essential information for health budgeting and planning, as well as a benchmark for comparison. Neonatal mortality accounts for about 1/3 of deaths < 5 years of age and very low birth weight (VLBW) mortality for approximately 1/3 of neonatal mortality. Intervention programs must be based on reliable statistics applicable to the local setting; First World data cannot be used in a Third World setting. Many neonatal units participate in the Vermont Oxford Network (VON); limited resources prevent a significant number of large neonatal units from developing countries taking part, hence data from such units is lacking. The purpose of this study was to provide reliable, recent statistics relevant to a developing African country, useful for guiding neonatal interventions in that setting.</p> <p>Methods</p> <p>This was a retrospective chart review of 474 VLBW infants admitted within 24 hours of birth, between 1 July 2006 and 30 June 2007, to the neonatal unit of Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg, South Africa. Binary outcome logistic regression on individual variables and multiple logistic regression was done to identify those factors determining survival.</p> <p>Results</p> <p>Overall survival was 70.5%. Survival of infants below 1001 grams birth weight was 34.9% compared to 85.8% for those between 1001 and 1500 grams at birth. The main determinant of survival was birth weight with an adjusted survival odds ratio of 23.44 (95% CI: 11.22 - 49.00) for babies weighing between 1001 and 1500 grams compared to those weighing below 1001 grams. Other predictors of survival were gender (OR 3. 21; 95% CI 1.6 - 6.3), birth before arrival at the hospital (BBA) (OR 0.23; 95% CI: 0.08 - 0.69), necrotising enterocolitis (NEC) (OR 0.06; 95% CI: 0.02 - 0.20), hypotension (OR 0.05; 95% CI 0.01 - 0.21) and nasal continuous positive airways pressure (NCPAP) (OR 4.58; 95% CI 1.58 - 13.31).</p> <p>Conclusions</p> <p>Survival rates compare favourably with other developing countries, but can be improved; especially in infants < 1001 grams birth weight. Resources need to be allocated to preventing the birth of VLBW babies outside hospital, early neonatal resuscitation, provision of NCPAP and prevention of NEC.</p

Becoming Australian: a review of southern Sudanese students’ educational experiences

This research presents a review of the literature around meeting students’ learning needs in Australian schools. It is referenced to one group of students with refugee experience who have been in Australian schools for over 15 years; students with a background of oracy from Southern Sudan. The development of psychological health and literacy competencies are two of the most critical and complex responsibilities undertaken by education, and, in the case of these students two of the most significant when considered in relation to successful settlement, acculturation and assimilation. In presenting this literature, the bigger picture of how schools can fail, not only these students, but for any number of students from diverse backgrounds, becomes startlingly obvious, as do the ways in which the current political agenda inherent in the public education system in Australia privileges students of specific class and culture. Finally, recommendations are made regarding the development of policy and the concentration on pedagogical practices which acknowledge and respect the strengths and capabilities of this group of students

Galactosialidosis in a newborn with a novel mutation in the CTSA gene presenting with transient hyperparathyroidism

Galactosialidosis is a lysosomal storage disease caused by deficiency of protective protein that is encoded by the cathepsin A (CTSA) gene localized on chromosome 20q13.1. Mutations of this gene are the cause of galactosialidosis that result in loss of function of protective protein. Galactosialidosis is an autosomal recessive inherited disease and has been divided into three subtypes based on age of onset and the severity of clinical manifestations. We report an early infantile form of galactosialidosis in a newborn with a novel mutation on the CTSA gene

Reference values and cultivar-induced differences in the evaluation of apple flower analysis

WOS:000638991800001This study was conducted to investigate the possible use of flower analyses in assessing the nutritional status of apple orchards at the initiation of vegetation. In successive years, samples were taken from 150 orchards at the initiation of bloom for flowers and at seven different time points covering the timeframe between 14 and 98 days after full-bloom for leaves. When the flower nutrient contents were ordered from lowest to highest, the lower and upper percentage quartile was accepted as the reference value for each nutrient and as the cutoff for nutrient deficiency or excess. Reference values were 3.33–3.98% N, 0.46–0.54% P, 2.10–2.47% K, 0.39–0.51% Ca, 0.25–0.31% Mg, 67–110 ppm Fe, 35–65 ppm Cu, 20–31 ppm Mn, 37–50 ppm Zn and 55–79 ppm B. Correlations between nutrient contents of the flowers and leaves sampled at all time points were also investigated. The presence of significant correlations showed that flower analysis can be used to determine the nutritional status of apples. Positive outcomes were observed for P, Mg, Mn and B. In addition, cultivar-induced differences were also observed in flower for Ca, Mg, Fe, Mn, Zn and B. © 2020 Taylor & Francis Group, LLC

An update on patent ductus arteriosus and what is coming next

Patent ductus arteriosus is the most common cardiovascular condition in preterm infants. There is a significant uncertainty about when and how to close ductus arteriosus in preterm infants due to a high spontaneous closure rate even in very immature preterm infants. Diagnosis and management of patent ductus arteriosus remain a challenge for both neonatologists and pediatric cardiologists. Researchers have tried to define a balance between an expectant approach and active treatment in selected infants. This review aimed to focus on the pathophysiology and management of patent ductus arteriosus and to make suggestions about approaches that might eliminate the association of morbidities with patent ductus arteriosus

Taking advantage of catastrophes: education privatization reforms in contexts of emergency

Episodes of disaster are powerful triggers of education reform. The sense of urgency and bewilderment associated with catastrophic situations (including natural disaster or armed conflicts) prove a seizable opportunity for education reform advocates, rendering other stakeholders more receptive to drastic interventions. In particular, catastrophic situations are distinctive enablers of privatization and pro-market education reforms in that they allow for a particularly accelerated and drastic advancement of such types of reforms