4-D ultrasonography may have an important role in prenatal assessment of fetal neurobehavior and prediction of adverse neurological outcome. However, further large studies are recommended before the test could be recommended for wider clinical practice.

Urinary infections are an important cause of prolonged jaundice. But there is conflict about the role of the urinary infections on the pathological jaundice in the first 14 days of the life. This study aims to determine the frequency of urinary tract infections in neonates presenting with jaundice in the first 2weeks of life with bilirubin levels that require phototherapy. This study was done with neonates 2-14 days old they have indirect bilirubin levels above the phototherapy limit but were not found to have any condition that would lead to elevated bilirubin levels, e.g. systemic infection, isoimmunization, erythrocyte enzyme defect, erythrocyte structural defect, hypothyroidism, sequestrated blood, polycythemia, or metabolic disease. Urine samples for urinalysis and culture were obtained using catheterization. During the study, 482 neonates presented with jaundice and 262 of these fulfilled our criteria. UTI rate was 12%. Mean bilirubin level was 20.9+6.1mg/dl. Thirtyfive(13%) of these patients underwent to blood exchange, the rest were treated with phototherapy only. Weight loss in terms of percentage of birth weight was higher on uninfected patients and rebound bilirubin levels was higher on UTI group. UTIs may present with isolated jaundice and may cause urosepsis, renal scarring, hypertension and chronic renal failure if they are not treated. In the neonatal period, infections lead to hyperbilirubinemia via hemolysis, inadequate conjugation, decreased excretion and oxidant stres. The findings of this study show the benefits of obtaining urine cultures for the diagnosis of UTI in neonatal patients with hyperibilirubinemia requiring phototherapy who have unexplained hyperbilirubinemia.

Background: Preterm and growth-restricted babies are at high risk of milk intolerance and necrotising enterocolitis, as well as post-natal growth failure. Objective: To evaluate the effects of an "early" enteral feeding regimen, starting on day 2 after birth compared to late enteral feeding, starting on day 6 after birth in preterm growth restricted babies with abnormal antenatal Doppler studies regarding the incidence of NEC and feeding intolerance. Patients and Methods: Babies with gestational age below 37 weeks, and with birth weight below 10th centile for gestational age, will be randomly allocated to an "early" or "late" enteral feeding regimen. Results: Hundred-thirty three infants enrolled in the study: 66 received early feeding and 67 received delayed feeding. The incidence of NEC and feeding intolerance was not significantly different between the two groups. Conclusion: Early minimal enteral feeding (MEF) of preterm infants with IUGR and abnormal antenatal Doppler results may not have a significant effect on the incidence of NEC or feeding intolerance.

BACKGROUND: Respiratory support in the form of mechanical ventilation is a crucial intervention in premature neonates, with respiratory problems. However, prolonged mechanical ventilation and endotracheal intubation may be associated with major adverse effects. The ideal time for extubation is based on clinical and laboratory parameters assessed at the time of planned extubation. However, such parameters are not very objective, which makes extubation in NICUs a trial-and-error approach. OBJECTIVE: This work was done to assess the use of extubation bundle including modified spontaneous breathing trial (SBT) (10 minutes) to reduce the rate of reintubation, among preterm neonates≤30 weeks who were mechanically ventilated and extubated to non-invasive ventilation in the NICU, Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, Qatar. METHODS: A prospective study based on the collection of data regarding preterm neonates≤30 weeks gestation admitted to the NICU, Women’s Wellness and Research Center (WWRC), from January, 2015 to December, 2017, who were subjected to mechanical ventilation (MV) and extubation. When the clinical team decides a newborn is ready for extubation based on the extubation bundle, a modified SBT (10 min) is used. RESULTS: This study included 465 premature babies from 24-≤30 weeks recruited in the NICU, Women’s Wellness and Research Center (WWRC). Extubation bundle with modified SBT was able to predict success of extubation with 95% sensitivity and 90.4% Positive Predictive Value (PPV) in the gestational age (GA) group 24 -≤27 weeks (245) and 95.3% sensitivity and 90% PPV in the GA group > 27 -≤30 weeks (220). As expected, successfully extubated babies had a higher GA and weighed more at extubation, compared to babies who required re-intubation. CONCLUSION: We recommend the extubation bundle with modified SBT prior to elective extubation to be used in predicting successful extubation in premature babies. Guidelines for extubation among premature babies are needed in order to reduce unnecessary exposure to adverse effects of mechanical ventilation.

A full-term male baby born with severe complete median cleft lip and palate and multiple facial cutaneous polyps on the right nostril, left and right ears and angle of the mouth. Eye fundus examination revealed hypopigmented fundi, pigmented rings around both discs and hypopigmented maculae. Neurological, Cardiovascular and abdominal examination was unremarkable, with normal echocardiography and abdominal ultrasound. CT and MRI of the brain revealed hypogenesis of the corpus callosum and midline paracallosal lipomas and calcifications. Chromosomal study showed normal male 46, XY karyotype. This is the first reported case in Qatar and the second case in a patient of Arabian descent. BACKGROUND