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Friday, November 1, 2019

Neonatal Hypoglycemia

<40mg/dl and symptomatic (give IV glucose)

Asymptomatic:
Birth to 4 hours of age:
Initial Screen: 25 mg/dl (Feed and check again in 1 hr)
< 25mg/dl (give iv glucose)
25-40 mg/dl ( refeed , i/v glucose as needed)
4 to 24 hours of age:
Continue feeds q2-3 hrly, screen glucose prior to each feed, e Target of >45mg/dl
<35mg/dl (feed and check in  1 hr)
<35 again ? (iv glucose)
35-45 mg/dl (refeed / iv glucose)

TREATMENT: target 40 to 50 mg/dl200mg/kg ( 10%DW 2ml/kg) Stat followed by+/-  5to8mg/kg/min(80-100 ml/kg/day)



Transient Neonatal Hypoglycemia is the most common cause.
It resolves by 48 hrs of life.
Risk factors for transient hypoglycemia are:
*PT
*SGA
*LGA
*IDM
*Septic neonates
*Polycythemic neonates
*Cardiopulmonary instability



If GIR > 10, consider hyperinsulinism.

Wednesday, October 30, 2019

Believing men and women : An Nur (The Light)

"Tell the believing men that they must lower their gazes and guard their private parts; it is more decent for them. Surely Allah is All-Aware of what they do."

"And tell the believing women that they must lower their gazes and guard their private parts, and must not expose their adornment, except that which appears thereof, and must wrap their bosoms with their shawls, and must not expose their adornment, except to their husbands or their fathers or the fathers of their husbands, or to their sons or the sons of their husbands, or to their brothers or the sons of their brothers or the sons of their sisters, or to their women, or to those owned by their right hands, or male attendants having no (sexual) urge, or to the children who are not yet conscious of the shames of women. And let them not stamp their feet in a way that the adornment they conceal is known. And repent to Allah O believers, all of you, so that you may achieve success "