Insufficiency in mesenteric flow is a risk factor for the development of necrotizing enterocolitis (NEC). Recurrent episodes of supraventricular tachycardia (SVT) can lead to gut ischemia, with subsequent reperfusion injury. We present a term infant who developed NEC at 37 days of life after refractory SVT and reverted to sinus rhythm on day 23 and 25 of life. Resected stenotic ileum and transverse colon demonstrated inflammation with ischemia. This is the first case of NEC following SVT in a term infant without a congenital morphologic abnormality. In view of the temporal sequence of events, and in the absence of other risk factors for NEC, the SVT and NEC were likely causally related.

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Background Significant Neonatal Hypoglycaemia (NH) is considered as a major risk for neuro-developmental problems. Over the years, several guidelines have been issued in an attempt to minimise these potentially harmful sequelae1,2,3,4. This is the first audit/survey of the screening of neonatal hypoglycaemia in our region. Aims To determine the adherence to guidelines on the screening of NH on the Postnatal Ward. Furthermore, this aimed at establishing the optimum frequency and number of Blood Glucose (BG) recordings that are required to detect hypoglycaemia at the pre-set high risk group of babies. Method The records of all babies born at our hospital from 1 August 2011 till the end of February 2012 were retrospectively reviewed. Babies who qualify for NH screening are the Infants of Diabetic Mothers (IDMs), babies with Low Birth weight < 2500 g, babies who were > 4000 g at birth and late preterm babies (35 –37 completed weeks of gestation). Babies at risk of hypoglycaemia are offered the first feed within 30–60 min after birth. BG was checked before the 2nd, 3rd and 4th feeds. When three consecutive blood glucose levels were ≥ 2.6 mmol/l, the BG is checked before alternate feeds for further 3 readings. Results 1099 babies were born over the study period. As an example the total number of IDMs was 59 babies (5.3%). 113 babies were late preterms (10.2%). None of the babies at risk of hypoglycaemia has missed monitoring. In these high risk babies, the lowest BG was detected during the first 12 h of monitoring. It was 1.3 mmol/l. During the 6 hly pre feed BG checks (after three consecutive 3 hly readings), the lowest BG was 2.4 mmol/l. These recordings were managed successfully by feeding and re-checking pre next feed. Conclusions The procedure for screening for NH on postnatal ward was followed. Low BS was mainly detected in the first 12 h of monitoring. The subsequent monitoring did not show significantly low BS irrespective of the category. Based on these results, one may safely consider shortening the period required for screening. Larger scale studies will still be required to resolve this issue5.

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illness and healthcare provision. The positive examples of individual leaders who had observed shortfalls and designed solutions to respond to the health needs of their local population inspired us to adopt similarly proactive approaches in our own clinical practice. Living and working in Sierra Leone developed our personal resilience and was emotionally impactful. Overall, a short-term program like GH-QEP not only benefits trainees personally and professionally, it might help increase specialty trainee application and retention. Furthermore, it could be expanded to incorporate a binational exchange program.