Impact of medical and spiritual counselling on the mental health of parent during their child’s illness

During the child’s illness, family members need someone who gives them time, listens to them, educates them, guides them about the state of health, and reminds them of a proper Islamic approach during the scourge. This mentoring role is required in any case, especially for severe or chronic diseases that need further research to confirm the diagnosis. Furthermore, the understanding and competence of this guidance can lead to assurance and moderation of parent’s mental health. The assessment on the impact of medical and spiritual counselling among the medical team during the child’s illness and its impact on the parent’s mental health and the comparison with individual medical guidance. The purpose of the study is to compare the combined medical and spiritual counselling with individual medical counselling during a child’s illness and its impact on the mental health of the parent. A comparative study between the first two groups used a questionnaire that only included elements of medical guidance. The second group will be presented with a questionnaire containing the elements of medical and spiritual guidance performed by the team of doctors, nurses, or medical students while dealing with the patient in the Department of Paediatrics, International Islamic University Malaysia. A standard questionnaire for the medical team on medical and spiritual guidance elements and the degree of conveyance to the parent. Another questionnaire is used to determine the degree of assimilation, details of the condition, and the parent’s rate of anxiety, fear, or mental illness. Department of Paediatrics, Kulliyyah of Medicine, International Islamic University Malaysia. This study used 200 cases involving all types of acute or chronic cases, whether they can be healed or required treatment. The number will be divided into two double-digit study groups, with 100 cases in each group. We will compare once in and once out for acute situations. In chronic cases, we will add follow-up after three months of patient discharge. First, this study will perform an advanced census to determine the performance of the medical team and its impact on the parent in the study groups. Then, the results will be compared in the two groups and their impact on the parent’s mental health. Does the addition of spiritual guidance to medical counselling reduce the rate of mental disorders towards the parent

Atypical presentation of a rare cardiac anomaly in an infant of diabetic mother

Introduction: Screening for heart defects in babies is widely required. Here we present a case of neonatal asphyxia and pneumothorax. Early cardiac ECHO on the first day of life can reveal a rare congenital heart defect. Presentation: This reports an infant of a diabetic mother with oligohydramnios presented with, symmetrical IUGR at 37 weeks of gestation. She presented due to foetal distress, went for instrumental delivery, and the baby was born to find with one cord coil around the neck. Upon delivery, the baby was limp and required active resuscitation and intubation. The APGAR score was 6 and 7 at one and five minutes respectively, and the cord blood gas showed a pH of 7.27 and a BE of -7.2. Ventilator settings were on minimal sittings where the baby had stable vital signs and normalized ABG, warranting extubation to high nasal flow cannula, the baby covered by first-line antibiotics awaiting the results of septic workup. The baby tolerated HFNC for a short time before experiencing respiratory distress. CXR showed right-sided pneumothorax with normal cardiac shadow, baby was reintubated. Clinical examination did not reveal any murmurs, but bedside ECHO screening was unable to pick the tributaries of the MPA. Urgent formal ECHO showed absent right pulmonary artery. CT thorax with contrast showed an oligemic right lung compared to the left lung. With ASD, RPA anomalies, Patent left PDA from aortic isthmus to the main pulmonary. Cardiac catheterization confirmed closing PDA, a blind pouch of RPA from brachiocephalic, abnormal RPA connections, disconnected RPA, and supply of PDA. Conclusion: Even in the absence of signs of CHD on physical examination and CXR, the early cardiac screen in neonates is important. Either by cardiac screen via oxygen saturation and perfusion index or real-time ECHO can accomplish early detection, intervention, and improved prognosis. Keywords: (5 words) Cardiac screening, Neonates, Congenital Heart Disease, ECHO, Infant of Diabetic Mother. Introduction: Screening for heart defects in babies is widely required. Here we present a case of neonatal asphyxia and pneumothorax. Early cardiac ECHO on the first day of life can reveal a rare congenital heart defect. Presentation: This reports an infant of a diabetic mother with oligohydramnios presented with, symmetrical IUGR at 37 weeks of gestation. She presented due to foetal distress, went for instrumental delivery, and the baby was born to find with one cord coil around the neck. Upon delivery, the baby was limp and required active resuscitation and intubation. The APGAR score was 6 and 7 at one and five minutes respectively, and the cord blood gas showed a pH of 7.27 and a BE of -7.2. Ventilator settings were on minimal sittings where the baby had stable vital signs and normalized ABG, warranting extubation to high nasal flow cannula, the baby covered by first-line antibiotics awaiting the results of septic workup. The baby tolerated HFNC for a short time before experiencing respiratory distress. CXR showed right-sided pneumothorax with normal cardiac shadow, baby was reintubated. Clinical examination did not reveal any murmurs, but bedside ECHO screening was unable to pick the tributaries of the MPA. Urgent formal ECHO showed absent right pulmonary artery. CT thorax with contrast showed an oligemic right lung compared to the left lung. With ASD, RPA anomalies, Patent left PDA from aortic isthmus to the main pulmonary. Cardiac catheterization confirmed closing PDA, a blind pouch of RPA from brachiocephalic, abnormal RPA connections, disconnected RPA, and supply of PDA. Conclusion: Even in the absence of signs of CHD on physical examination and CXR, the early cardiac screen in neonates is important. Either by cardiac screen via oxygen saturation and perfusion index or real-time ECHO can accomplish early detection, intervention, and improved prognosis. Keywords: (5 words) Cardiac screening, Neonates, Congenital Heart Disease, ECHO, Infant of Diabetic Mother. References 1-Maryam M, Furqan M, Muhammad A, et al. HEART BIRTH DEFECTS IN INFANTS OF DIABETIC MOTHER. Zenedo. Org, December 31, 2019 2-Roy V, Jai G, Jeeva N, et al. Anomalous origin of right pulmonary artery from innominate artery: Repair using pulmonary artery pedicled flap plasty. Ann Pediatr Cardiol. 2017 Sep-Dec; 10(3): 278–280. PMCID: PMC5594939, PMID: 28928614 3-Carolyn A, David R. Identifying newborns with critical congenital heart disease. UpToDate. Literature review current through: Oct 2020. 4-Abouk R, Grosse SD, Ailes EC, et al. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths. JAMA. 2017; 318(21): 2111-2118. 5-Lisa A. Wandler and Gerard R. Critical Congenital Heart Disease Screening Using Pulse Oximetry: Achieving a National Approach to Screening, Education and Implementation in the United States Martin Children’s National Heart Institute, International Journal of Neonatal Screening. 19 October 2017 CT pulmonary angio showing absent right pulmonary artery

The impact of covid-19 lockdown on glycemic control and lifestyle changes in children and adolescent with type 1 diabetes mellitus: a systematic review

Background: The World Health Organization has declared the SARS-CoV-2 outbreak as a pandemic on 11th March 2020. As a measure to prevent the spread of COVID-19, many countries have implemented a lockdown order. The restriction led to lifestyle changes and further affected glycaemic control in children and adolescents with type 1 diabetes mellitus. Thus, this systematic review aims to evaluate the impact of COVID-19 lockdown on glycaemic control and lifestyle changes in children and adolescents with type 1 diabetes mellitus. Method: We systematically identified studies by searching Scopus, Pubmed Central, Oxford Academy, Google Scholar, JSTOR and included 17 studies. Levels of HbA1c, blood glucose readings, time in range (TIR), time below range (TBR), time above range (TAR) and glucose standard deviation (SD) were our primary outcomes. Result: A total of 17 studies are included in our research. Regarding the glycaemic control, n=7 (41 %) studies showed significant improvement in glycaemic outcomes. However, n=3 (18 %) research noticed a deterioration of glycaemic control during the lockdown. Furthermore, there were some studies, n=7 (41%) showed no significant changes. Most of the children and adolescents with type 1 diabetes mellitus had lifestyle changes during this lockdown. It was observed that different countries demonstrate different findings in which studies from Italy and the UK show improvement while studies from KSA, Japan and Egypt show deterioration of glycaemic outcomes. Conclusion: The number of studies that showed children and adolescents with improved glycaemic control is similar to the number of studies that showed no significant changes. Thus, further research on a broader scale is recommended

Memorex in the Neonatal Resuscitation Program (NRP). hottest recommendations from NRP 8th edition 2021

Background: Optimal neonatal resuscitation in the first few minutes of life (the Golden minutes) can save critically ill neonates. Presentation: additional new steps include the Resuscitation Quality Improvement Program (RQI) focusing on the skill of positive pressure ventilation. The four pre-birth questions are Gestational age, clear Amniotic fluid, Additional risk factors, and Umbilical cord management plan. Initial steps fulfil Warm, dry, stimulate, position airway and, suction if needed. When an alternative airway becomes necessary, a cardiac monitor is essential. The initial IV or IO dose of epinephrine is 0.02 mg/kg (equal to 0.2 mL/kg). The endotracheal epinephrine dose equal to 0.1 mg/kg (1 mL/kg). Flush IV/IO epinephrine with 3 mL normal saline for all babies. Support skin-to-skin care for bonding, breastfeeding and normothermia. If the confirmed absence of HR after all appropriate steps are performed, consider cessation of resuscitation efforts around 20 minutes after birth (Initiate discussion with the family). Unchanging steps, a qualified person or resuscitation team should attend every delivery. Establish briefing, delegate workload, and check equipment. Key behavioural skills, including the call for help. Upon delivery, a rapid assessment is the baby term, muscle tone and breathing or crying, then commencing the initial steps. Use plastic wrap for less than 32 weeks. Lung Ventilation and Ventilation Corrective Steps (MRSOPA) is the critical steps. Adjust suction pressure from 60-100 and the flowmeter to 10 L/min, oxygen with 21%, increased judiciously guided by preductal saturation. If the heart rate is less than 60 despite adequate 30-second ventilation intubate, start chest compression for 60 seconds by two thumbs technique. If still bradycardic, give the medications. Delayed cord clamping of stable babies and avoid cord milking in preterm. Conclusion: NRP regulations changed according to evidence-based medicine. The latest NRP edition will help all institution

Breathing at birth: neonatal resuscitation in the golden minute of life

At the time of delivery, the process of transition of the baby from the mother’s womb to the extra uterine environment is among the most complex adaptations that a human faces in different phases of life. This transition involves both physiological and anatomical changes in the baby that occurs in a relatively short span of time. While most babies can smoothly undergo this transition without much difficulty, there are indeed many who face difficulties in this complex phase resulting in perinatal asphyxia evident by delayed or absent crying, cyanosis, generalized hypotonia, and so on. An astute assessment is needed to identify these babies at birth who are at risk of death or severe complications in the future. After identification, prompt management and resuscitation should be started immediately after birth to ensure the survival of these babies. The first moments after birth are vital, and the first 60 seconds after delivery is known as the golden minute of life. In case a baby does need resuscitation, it is imperative that the baby gets identified and effective resuscitation starts in the golden minute of life. The longer resuscitation is delayed, the more the chance of death or future complications. This paper attempts to describe the steps of neonatal resuscitation of newborn babies suffering from perinatal asphyxia to help them establish effective breathing after birth

أثر الإرشاد الطب ي والروحي عل ي الصحة النفسیة للأم والأب اثناء مرض الطفل

الملخص المقدمة: يحتاج الأهل أثناء مرض الطفل إلى من يعطيهم من وقته, يستمع اليهم ,بحنو عليهم، يثقفهم، يرشدهم تجاه الحالة الصحية, ثم يذكرهم بمنهج الإسلام القويم في التعامل مع البلاء. وهذا الدور الارشادي مطلوب في كل الأحوال خاصة عند وقوع الأمراض الشديدة أو المزمنة أو التي تحتاج إلى مزيد من الأبحاث لتأكيد التشخيص. إن اتقان وحرفية هذا الإرشاد يدعو إلى الاطمئنا ن وإلى اعتدال الصحة النفسية للأم والأب. موضوع البحث: تقييم أثر الارشاد الطبي والروحي للفريق الطبي أثناء مرض الطفل ومردوده على الصحة النفسية للأم والأب ومقارنته ﺑﺎلإرشاد الطبي منفردا. الهدف من الدراسة هو مقارنة الارشاد الطبي والروحي مجتمعين وبين الارشاد الطبي منفردا أثناء مرض الطفل ومردوده على الصحة النفسية للأم والأب. منهج الدراسة: دراسة مقارنة بين مجموعتين الأولى تقوم بعمل استبيان يشتمل علي عناصر الإرشاد الطبي فقط. أما اﻟﻤﺠموعة الثانية فستقوم بعمل استبيان يشتمل على عناصر الإرشاد الطبي والروحي التي يقوم ﺑﻬا الفريق المعالج من طبيب أو ممرض أو طالب الطب أثناء التعامل مع المريض في قسم الأطفال ﺑﺎلجامعة الإسلامية الكيفية: استبيان قياسي للفريق الطبي عن عناصر الارشاد الطبي أو الطبي والروحي ودرجة توصيلها للأهل .واستبيان اخر لتحديد درجة الاستيعاب للحالة وتفاصيلها ومعدل القلق أوالخوف أو اعتلال الصحة النفسية لدي الأم والأب. القسم: قسم الأطفال ﺑﺎلجامعة الإسلامية كلية الطب.حجم العينة: العدد 200 حالة تشتمل علي جميع انواع الحالات من حادة او مزمنة وهل يمكن شفاءها اوتحتاج علاجا تريحيا. ستقسم العدد الي مجموعتين دراسة مزدوجة اعمي 100 حالة في كل مجموعة . سنقوم ﺑﺎلمقارنة مرة عند الدخول واخرى عند الخروج في الحالات الحادة . أما في الحالات المزمنة فسنقوم ﺑﺈضافة متابعة بعد الخروج خلال ثلاثة أشهر. الاحصاء والبيا ن سنقوم بعمل احصاء متقدم لتحديد درجة الاداء للفريق الطبي واثر ذلك علي الاهل في مجموعتي الدراسة وفي النهاية نستطيع مقارنة النتائج في اﻟﻤﺠموعتين وأثر ذلك علي الصحة النفسية للأم والأب. سؤال البحث: هل اضافة الارشاد الروحي الي الارشاد الطبي يقلل من معدل الاضطرﺑﺎت النفسية لدي الأم والأب

Cardioprotective effects of gallic acid on an isoprenaline-induced myocardial infarction rat model

The use of antioxidants to protect against a wide range of human disease, including ischemic heart disease, has moved to the forefront in cardiovascular research. Gallic acid has shown promising effects against oxidative stress-induced disease; however, its effect in ischemic heart disease has not been well-studied. We designed the current work to investigate the potential protective effect of gallic acid against isoprenaline (ISO)-induced myocardial infarction (MI). Rats were injected subcutaneously with ISO, 100 mg/ kg for 2 days, to induce MI. Gallic acid treated rats received 15 mg/ kg gallic acid orally for 10 days prior to ISO injection. The histopathological examination of the Haematoxylin and Eosin-stained heart sections from the ISO treated rats shows karyopyknosis, hypereosinophilia, loss of striation, infiltration of macrophage in the interstitium, and thrombosis of the blood vessels, all of which indicate the induction of MI. In addition, ISO treatment significantly increased the plasma level of malondialdehyde and troponin-I, as well as the activity of alanine aminotransferase, lactate dehydrogenase, and creatine kinase, compared to untreated controls. Pre-treatment with gallic acid significantly attenuated the ISO-induced biochemical and histopathological changes, compared to untreated controls. Our results show that ISO induced oxidative stress-mediated MI, and that gallic acid protects the rat heart from MI, at least in part, through antioxidant mechanisms

Spores that crush the spine in infancy: a diagnostic dilemma for an infant with special tuberculosis

We are presenting a seven months old girl with spastic paraplegia. The case highlights the dilemma with the diagnosis we encountered until establish the final diagnosis which is spinal tuberculosis. We highlighted a lot of important lessons

Toxic sports: unscreened diseases are threatening wellbeing from conception to completion of neonatal screening program

Medical Screening is a basic test, which identifies rare and severe health problems. A newborn screening program (NSP) can detect disorders before they become symptomatic. Early treatment of these endocrine disorders can prevent intellectual disability and life-threatening crises. The hearing impairment will precipitate neurodevelopmental delay, mainly language and related skills among infants. Newborn screening for hearing loss can be done as a point-of-care screening. Universal screening for hearing loss by otoacoustic emissions or automated auditory brainstem response has a high sensitivity allowing early identification and intervention to improve the neurodevelopment among infants. Critical congenital heart disease (CCHD) can result in death, organ failure, or severe disabilities. The screening via pulse oximeter, perfusion index and echocardiography, prevent delayed diagnosis of CCHD. Developmental hip dislocation is screened clinically by Ortolani and Barlow's manoeuvres that have been the standard for detecting hip instability in newborns. Recently, ultrasound imaging of the hip in infants less than five months suggested as a possible extra tool for screening. Early screening of treatable and detectable diseases through newborn screening programs allows for timely intervention hence optimise outcomes. Keywords: Neonatal screening, Inborn error of metabolism, hearing screening, cardiac screening, Developmental Hip Dislocation screening

The consistency of Islamic and medical perspectives in the control of the COVID-19 pandemic

Controlling the current COVID-19 pandemic requires infection control at both the individual and global levels. There is insufficient information on the consistency between Islamic principles and medical guidelines regarding infection control measures. Therefore, this study aimed to explore the consistency between Islamic principles and evidence-based medical recommendations during the pandemic time. A comparison was made between the latest medical infection control recommendations and Islamic references (the Quran and its interpretation, and Sunnah and its explanation). Relevant materials such as books and research articles in Arabic or English were reviewed. The information was then classified into different levels of infection control strategies, which were individual, household, community and healthcare unit levels. This study demonstrated that both Islamic principles and medical guidelines are consistent in terms of infection control, which involves crisis supervision by the infection control authority and specialised agencies, hand and general hygiene, personal protection, seeking specialist consultation and treatment, comprehensive care, guidelines in the event of limited resources, home isolation, travel bans and quarantine. Moreover, it was observed that Islamic principles combine and optimise both the individual frame and societal cohesion