Friday, February 8, 2013

Ahmad Adam Syukri

Salam...

Al Fatihah to Ahmad Adam Syukri who had passed away about 2 hours ago at Institute Pediatric, HKL. I started to know about Ahmad Adam since I saw him in MHI. He was about 7 months old at that time and having Hypoxic Ischaemic Encephalopathy(HIE). First time I saw him, he was very thin with muscle wasting and depend on ventilation and suction machine.  Then I tried to followed his condition through his facebook fanpage. Recently, he looked more stable and having muscle bulk already.

I think this is Adam after few days of life.
He was on endotracheal tube and nasogastric tube already.


Differ with above picture right??
There was muscle wasting and the eyes looked cloudy.
Nasal prong to deliver oxygen.


Tembam suda Adam masa ni, comel and cute!!!!
Had undergone eye surgery at this time and looked like he was respond to surrounding already, and want to smile actually!!! 

Allah loves him more, he had passed away this afternoon. Takziah to his family.
Another special about Adam was he had a good support from his parents. I am proud with his parents!!!

 I believed that family support is a part of therapy in treating medical illness anyway. So, give support if you have any family member, relative or friends who are ill. I am sure they will appreciate you and help in recovery.


Hypoxic Ischaemic Encephalopathy
- Is a clinical manifestation of brain injury less than 48 hours after hypoxia event
- it occurs as reduce of oxygen and glucose delivery to the brain that cause cell death by
   inflammation reaction and apoptosis
- the causes can be due to antenatal, perinatal and postnatal condition

- Causes :
1. Fetal - Twin to twin transfusion
             - cord prolapse
             - preterm
2.  Maternal - placenta abruptio
                    - placenta previa
                    - pre-eclampsia
                    - uterine rupture

- Many HIE case are referred to newborn infant but can apply to many other brain injury as well like drug overdose, blood loss, smoke inhalation and choking.  
- the prevalence is about 1-6% per 100 live term births
      25% die or have multiple disabilities, 4% have mild to moderate cerebral palsy and 10% have 
      developmental delay

- Classification of HIE:
  • Stage 1: hyperalert (eyes wide open, ↓ blinking, excessive response to stimulation), impaired feeding 2° to weak suck but normal tone
  • Stage 2: lethargic, mild hypotonia, reduced spontaneous movement, seizures
  • Stage 3: no spontaneous movements, withdrawal or decerebrate posturing only to pain, variable abnormal tone (hypotonia/​hypertonia), suppression of primitive (Moro, tonic neck, sucking) and brainstem (corneal, gag) reflexes. Prolonged seizures refractory to treatment.
- Essential criteria for diagnosis HIE
   1. Metabolic acidosis
   2. Early onset encephalopathy
   3. Multisystem organ dysfucntion

- Complications of HIE
   1. Acute renal failure
   2. Myocardial dysfunction and hypotension
   3. Coagulation impairment
   4. Necrotising enterocolitis
   5. Hypoglycemia

- Basically, the treatment is to prevent secondary central nervous system insult like seizure control, correct hypoglycemia, hypotension, hyponatremia, hypocalcemia, hypomagnesemia, control brain edema, prevent fluid overload, appropriate oxygenation and treat affected organs.
- Therapeutic cooling or treat hypothermia is important to reduce mortality and major neurodevelopmental disbility

Okaayyyyy... all that I wrote here was based on I saw him from MHI and red from his FB fanpage and other blogs. So, if got any mistake, I felt sorry for it.

I hope I will remembered Ahmad Adam Syukri when I was asked about HIE  or facing with HIE patient when I worked later!!!!!!

Al Fatihah again for `bakal ahli syurga Ahmad Adam Syukri`.

Tq...

References :
1. Hypoxic Ischaemic Encephalopathy slide by The University of Chicago Medical Centre. Reviewed on 7th February 2013.
2. Helen AB and Ram N. Peadiatric & Child Health. 2nd edition. Wiley-Blackwell 2010.



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