Therapeutic Hypothermia in Asphyxiated Neonates: Experience from Neonatal Intensive Care Unit of University Hospital of Marrakech

Introduction. Therapeutic hypothermia (TH) is now recommended for the treatment neonates with hypoxic-ischemic encephalopathy (HIE). This treatment protocol is applied in our department since June 2012. The aim of this study is to report the first experience with head cooling in asphyxiated neonates in Morocco. Patients and Methods. Prospective study of newborns admitted for HIE from July 18, 2012, to May 15, 2014, in Neonatal Intensive Care Unit (NICU) of Mohamed VI University Hospital. The results were studied by comparing a newborn group who received hypothermia to a control group. Results. Seventy-two cases of neonates with perinatal asphyxia were admitted in the unit. According to inclusion criteria thirty-eight cases were eligible for the study. Only 19 cases have received the hypothermia protocol for different reason; the arrival beyond six hours of life was the main cause accounting for 41%. Complications of asphyxia were comparable in both groups with greater pulmonary hypertension recorded in the control group. The long-term follow-up of protocol group was normal in almost half of cases. Conclusion. Our first experience with the controlled TH supports its beneficial effect in newborns with HIE. This treatment must be available in all the centers involved in the neonatal care in Morocco

Lipoprotein Lipase (LPL) Gene Mutation: A First Report in Children

Genetic hyperchylomicronemia is a rare autosomal recessive disorder of lipoprotein metabolism estimated to affect approximately one per million individuals. We report a case with a rare mutation identified. It’s a genetic chylomicronemia in a Moroccan newborn baby, with massive hypertriglyceridemia and clinical signs of acute pancreatitis. She was a newborn female, first-degree of consanguineous parents. She was hospitalized for hypertriglyceridemia, complicated by acute pancreatitis; serum was noted to be milky. The genetic study found a mutation of the Lipoprotein Lipase (LPL) gene: homozygous pathogenic variant c.1019-3C > A. She enjoyed good health, developed well and the triglyceride was maintained at a concentration o

Study of Bacterial Contamination of Mobile Phones and Stethoscopes in Neonatal Intensive Care Unit

Mobile phones and stethoscopes used in neonatology units could be colonized by potentiel bacteria pathogens. It can be a vector of severe nosocomial infections and multi-drug-resistant pathogens. The aim of this study is to evaluate the microbial contamination of mobile phones and stethoscopes, used by medical and paramedical staff. The study was conducted in neonatal intensive care unit (NICU) of Mohamed VI University Hospital, Marrakech (Morocco) in April 2016. The bacteriological study was made on 17 mobile phones and 13 stethoscopes. Samples were taken from all surfaces of mobile phones and stethoscopes, with a sterile swab. Bacterial contamination rate of all mobile phones and stethoscopes was 100%. The cultures of bacteria isolated were polymorphic. Among the bacteria isolated, six multi-resistant bacterial strains were isolated at the mobile phones (35%), corresponding to 4 Klebsiella pneumoniae and 2 strains of E. coli. A strain of Klebsiella pneumoniae multidrug-resistant (7.7%) was found on a stethoscope. This study shows that mobile phones and stethoscopes could be involoved in the transmission of severe nosocomial infections, with multidrug-resistance. As part of the prevention of such risks, we must educate the medical staff, users of mobile phones on the importance of hand washing and use of hydro-alcoholic solutions after each use of mobile phones and stethoscopes

Management of Severe COVID-19 in Pregnancy

The scarcity of data concerning pregnant patients gravely infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) makes their management difficult, as most of the reported cases in the literature present mild pneumonia symptoms. The core problem is laying out evidence on coronavirus’s implications on pregnancy and delivery, as well as vertical transmission and neonatal mortality. A healthy 30-year-old pregnant woman, gravida 6, para 4, at 31 weeks of gestation, presented severe pneumonia symptoms promptly complicated with premature rupture of membranes (PROM). A nasopharyngeal swab returned positive for SARS-CoV-2 using reverse transcription polymerase chain reactions (RT-PCR). The parturient underwent a cesarean delivery. This paper is an attempt to outline management of the critical condition of COVID-19 during pregnancy