August 2008
36 posts
Another Health Insurance Scheme to be launched... →
It is probably a bit too early to start celebrating the proposed launching of another health insurance scheme in the Maldives. The last time this happened, the scheme did not survive long enough….
Apologies
Several times over the past one month I have had to take unscheduled time off from work, both at IGMH and Heartline Medicals. I apologise to my patients and their relatives for cancelled appointments over this period of time.
This past month has seen my kids, both of them, fall ill more frequently than they have before. Being there for your own kid is as important as giving them medications. As...
A social security scheme being launched in...
It is probably a bit too early to start celebrating the proposed launching of another health insurance scheme in the Maldives. The last time this happened, the scheme did not survive long enough. Nevertheless, in these times of desperation, as the proverbial saying goes, we are indeed willing to make an effort to clutch at even a straw.
Some information on the new NSPA (National Social Protection...
[Original articles] Currently recommended... →
Introduction: Constipation is a common complaint in children and early intervention with oral laxatives may improve complete resolution of functional constipation. However, most treatment…
[Original articles] Spray bacteriotherapy... →
Objective: Secretory otitis media (SOM) is characterized by persistent fluid in the middle ear cavity, but the cause is unknown. We investigated clinical, bacteriological and immunological…
[Original articles] Spinal subdural hematomas in... →
Background and purpose: To examine the incidence of spinal pathology in infants with non accidental head injury.
Methods: 18 infants with non-accidental injury (NAI) were investigated in our…
[Review] The management of cystic adenomatoid... →
Congenital cystic adenomatous malformation of the lung (CCAM) is a rare lung lesion easily diagnosed on prenatal scan. The pathology of fetal lesions differs from postnatal lesion, hence the need…
[Original articles] No Change in Developmental... →
Objective: Randomized controlled trial investigating effect of basic elements of developmental care (DC) (incubator covers and positioning aids) on growth and neurodevelopment in infants born <32…
[Original articles] Oxygen saturation and heart... →
Following concerns about harmful effects of 100% oxygen on newly born infants, we started resuscitation in the delivery room (DR) with air.
Objective: To describe preductal oxygen saturation…
[Original articles] The Apgar Cycle: A New View of... →
Apgar scores are universally recorded, but they should no longer be used to guide resuscitation; thus, some authorities have suggested that the scores should be abandoned. However, the…
[Original articles] Chronic Autoimmune Thyroiditis... →
Objective: To investigate the clinical manifestations of autoimmune thyroiditis (AIT) leading to referral in children and adolescents, in addition to disease course and long-term outcome.
…
[Review] Evidence-based Child Health - SIGN and... →
Clinical medicine is a holistic attempt to provide the best care for patients. What are the relevance of Evidence-based Child Health (EBCH) and of guidelines in informing clinical practice? In…
[Original articles] Parent-based language... →
Objective: The aim of this randomised controlled trial was to evaluate the effectiveness of a short, highly structured parent-based language intervention group programme for two-year-old children…
[Original articles] Environmental Exposures and... →
Introduction: Preterm infants have a substantially increased risk of developing respiratory illnesses. The goal of this study was to consider the impact of modifiable postnatal exposures on…
[Original articles] Volume Guarantee Ventilation:... →
We report two unexpected observations during ventilation with the Dräger Babylog 8000+ in volume guarantee mode. Firstly, during complete obstruction to gas flow down the endotracheal tube the…
[Review] Prevention and treatment of renal disease... →
Objective: To determine the benefits and harms of therapies used to prevent or treat renal involvement in Henoch-Schönlein Purpura.
Design: Systematic review of randomised controlled trials.
…
[Original articles] Prescribing trends in asthma:... →
Background: Inhaled corticosteroids (ICS) are effective treatment for childhood asthma. Cross sectional studies indicate that some asthmatic children are treated with excessively high dose ICS…
Traveling to Raa Atoll
I am in Raa Atoll to conduct WHO Essential Newborn Care training for healthcare providers of the atoll. I am scheduled to return to Male’ on the 15th of August.
I will also be seeing patients at Ungoofaaru Regional Hospital during my time in Ungoofaaru.
[Original articles] How Common Are Rib Fractures... →
Background: This study was prompted by incidental finding of healing rib fractures on chest radiographs of ex-preterm born infants, who were admitted to hospital with acute respiratory illnesses…
[Review] Rare childhood diseases: how should we... →
Paradoxically, rare diseases are common, collectively affecting 6 to 10% of the population, and have a huge impact on patients and families, health services, clinicians and the wider community….
[Original articles] Growth and Growth Biomarker... →
Objective: To determine the effect of adenoidectomy and/or tonsillectomy (“adenotonsillectomy”) upon growth and growth biomarkers, in the context of sleep disordered breathing (SDB). SDB in…
[Original articles] What place do "saviour... →
Background: Not all children in need of a haematopoietic stem cell transplant have a suitable relative or unrelated donor available. Recently, in vitro fertilization (IVF) with pre-implantation…
[Papers] Pilot study of a novel education... →
Aims: To pilot an education programme (KICk-OFF) for children and adolescents with Type 1 diabetes mellitus (DM). Evaluation included i) independent assessment of curriculum quality, ii)…
[Original articles] A Simplified Gentamicin Dosing... →
Background: At least 5% of all paediatric admissions are complicated by a medication error. Nurses can prevent some errors by correctly verifying prescriptions before administering drugs. To do…
[Original articles] Detection of human bocavirus... →
Background: HBoV, a recently discovered parvovirus, is present in a substantial proportion of respiratory tract diseases of suspected infectious origin. The relative importance of HBoV in viral…
[Review] Emergency management of anaphylaxis in... →
The incidence of anaphylaxis is rising. Confusion can still occur about the diagnosis, treatment, investigation and follow up of children after an anaphylactic reaction. Recently, the…
[Papers] The variation in stool patterns from 1 to... →
Objective: To document normal stool patterns of young children.
Design: Prospective population based longitudinal study.
Setting: Avon Longitudinal Study of Parents and Children (ALSPAC).
…
[Review] When to use drugs to help sleep →
Paediatric sleep medicine is a relatively new, but important and rapidly growing field. It is increasingly recognised that many ‘adult’ sleep disorders begin in childhood where the consequences of…
[Original articles] Childhood leukaemias and... →
Background: Monitoring time trends in the incidence of childhood leukaemias and lymphomas requires a well functioning and continuously data collecting system. In countries missing official cancer…
[Leading articles] Mask Ventilation in the Early... →
Background: Children with congenital central hypoventilation syndrome (CCHS) require life long ventilatory support usually during sleep. Traditionally, they have received either intermittent…
[Leading articles] The extremely preterm births. ... →
With the advances in medical technology, the outcome for high-risk infants has greatly improved and the limit of human viability has shifted towards an increasingly lower gestational age. However,…
[Original articles] The Effect of Two Levels of... →
Objective: To study the effect of different levels of pressure support ventilation (PSV) on respiratory parameters in preterm infants during the weaning phase of mechanical ventilation.
…
[Review] Bronchopulmonary Dysplasia and... →
Bronchopulmonary dysplasia (BPD) is the most common, serious sequelae of premature birth. Inflammation is a major contributor to the pathogenesis of BPD. Often initiated by a pulmonary fetal…
[Original articles] Random safety audits in the... →
Background: Random safety audits have been shown to be effective in improving standards of practice in high risk industries. They are process audits rapidly performed during real time clinical…
[Original articles] Association of gastric fluid... →
Objective: Gastric fluid microbes were examined in preterm infants at birth to assess their influence on the postnatal outcome.
Study design: Prospective cohort study.
Setting: Level III…
July 2008
15 posts
Loss of Leave!
At the beginning of the year I had 76 days of accumulated annual leave. Recently, before the civil service law came into effect, I took 13 days from that to travel to the Atolls for unofficial work. Now, I have been told, under the new rules, I have only 17 days of my annual leave remaining!!!
My protests, as expected, fell on deaf ears. I was told that I’d be paid for the “cancelled...
MMA reaffirms its position on EECP →
Maldivian Medical Association stands firm against unethical and immoral marketing of EECP by private medical center.