Background: The imapct of Kangaroo Mother Care (KMC) in neonates is positively reported in the literature. However, several challenges hindered the wide-scale application of this practice. Objectives: To assess the levels of knowledge and competency of kangaroo mother care (KMC) among nurses and to identify the potential barriers to practice. Methodology: Structured web-based questionnaires were submitted to nurses working at neonatal intensive care units (NICUs) located in Riyadh, Saudi Arabia. The participants were asked to answer 23 questions distributed in four main domains, namely, demographic data, knowledge about KMC, practice levels, and barriers to KMC practice. For answers to the knowledge and barriers to practice domains, the mean scores (standard deviations) were calculated to present participants' perceptions and beliefs from 1 (strongly disagree) to 5 (strongly agree). Results: Two hundred nine NICU nurses responded (95.2% females, 89.5% working in a government hospital, 69.9% obtained a Bachelor's degree). The majority of respondents perceived KMC as promoting maternal-infant bonding (4.47 ± 1.3) and enhancing successful breastfeeding (4.44 ± 0.9), while there were considerable uncertainties about KMC application in infants weighing < 1000 g (2.21 ± 1.2). Most of the nurses encouraged parents to perform KMC (92.8%) and provided sufficient information to optimize practice (90%). However, several barriers were apparent, including fear of accidental extubation, lack of time due to workload, familial reluctance to initiate KMC, and lack of privacy during KMC practice. Conclusion: There is reasonable knowledge among NICU nurses, and most of them are actively engaged in practice. There is an urgent need to address the reported barriers through the implementation of clear practice guidelines, provision of suitable educational programs, optimization of staff numbers, and financial support for the development of areas conducive to KMC.

The prevalence of anabolic androgenic steroid use amongst athletes in Riyadh (Saudi Arabia)

Purpose: To analyze trends of conditions originating in the perinatal period (COPP) in England and Wales between 1999 and 2020. Patients and methods: An ecological study of COPP was conducted using hospital admission data from April 1999 to March 2020 from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Results: The overall hospital admission rates increased by 41.6%, from 1913 per 100,000 persons (95% CI: 1905– 1922) in 1999 to 2709 (95% CI: 2700– 2719) in 2020 (trend test p< 0.001). The most common causes for neonatal admissions were disorders related to the length of gestation and fetal growth, respiratory and cardiovascular disorders specific to the perinatal period, and hemorrhagic and hematological disorders of newborns (28.8%, 27.3%, and 15.2%, respectively). Although the admission rates increased for both males and females (by 33.1% and 35.1%, respectively), hospital admission rates for all causes were higher among males compared to females (p< 0.05). Conclusion: COPP-related hospital admissions rate in England and Wales increased significantly over the past 21 years. Notably, the proportion of COPP-related hospital admissions of males was higher than females. Further studies are warranted to explore the role of gender in hospital admissions and health care for COPP.

Purpose: To assess mothers’ approaches to infant sleep practices. Patients and Methods: A cross-sectional survey study was conducted on mothers with babies aged below five months who were attending paediatric clinics between November 1st, 2020, and January 5th, 2021, in Riyadh, Saudi Arabia. Results: A total of 522 mothers participated in this study. A total of 38.9% practised exclusive formula feeding. A total of 61.9% of the participants practised the supine position. The majority (93.3%) of the mothers shared a room with their babies, while 34.7% shared a bed. Only 6.9% did not use any soft bedding. Age was a significant predictor associated with participant practices regarding sleeping and feeding positions (p < 0.05). Having two or more children was associated with improper sleeping practices (p < 0.05). Being non-Saudi and having a university degree or higher were associated with having a higher risk of unsafe practices regarding bed-sharing (p < 0.05). On the other hand, being contacted by a doctor, nurse, or other healthcare worker about safe sleep practices were an important factor that influenced safe practices regarding feeding (p < 0.05). Receiving care at a private hospital was associated with safer practices regarding sleeping position and bed-sharing (p < 0.05). Conclusion: We observed high-risk sleeping practices among Saudi mothers. This includes using soft bedding and unsafe sleeping positions. The importance of this study lies in the future implementation of this result through public health measures aimed at at-risk populations.

Objectives To compare complications in neonates who had umbilical venous catheter (UVC) versus peripherally inserted central catheter (PICC), percentage of non-elective removal of central catheters, and to compare complications of PICC in the upper limb compared with the lower limb. Design A prospective cross-sectional cohort study. Setting Neonatal intensive care unit (NICU) in Prince Sultan Military Medical City in Riyadh, Saudi Arabia. Participants All infants who are admitted to the unit requiring central catheter insertion were included in the study. Primary outcome measure Complications of central catheters in infants admitted to the NICU. Results A total of 415 central catheters were involved in this study (206 UVCs and 209 PICCs (85 in the lower limb, 99 in the upper limb and 25 in the head and neck). The median birth weight of the neonates was 1470 grams (1000–2215). Low birth weight was the most common reason for central catheter insertion, which accounted for 59.8%. Neonatologists were the main insertor for the majority of the cases. The median dwell days for the study sample were 11.00 (7.00–16.50) days. Complications were more common across PICC cases compared with UVC cases (p=0.001). There was non-elective removal of PICC (32.1%) compared with UVC (22.8%) (p=0.035). Phlebitis, occlusion, local infiltrate and leakage were more common in PICC compared with UVC (p<0.05). However, malposition was more commonly associated with the use of UVC (mainly to the liver) (p0.05). Conclusion Close monitoring during extended dwell times is crucial. Our findings underscore the importance of raising awareness of CLABSI risk factors and adhering to best practices for central catheter maintenance. Healthcare professionals should be vigilant about the differences in complication rates between PICC and UVC, tailoring their approach accordingly.

Objective: The aim of this study was to look into the rates of perinatal admissions for respiratory, cardiac, and cardiovascular diseases in England. Methods: This ecological study was conducted in England. The Hospital Episode Statistics (HES) database in England provided the study with the publicly accessible data. The data set for this study was considered between April 01, 2012 and April 01, 2020. The HES database contains information on patients’ admissions to hospitals, notably for those hospitalised with perinatal cardiovascular and respiratory diseases. We used the chi-squared test to assess the difference between the hospital admission rates between 2012 and 2020. Results: An increase of 15.6% was observed in hospital admissions rate during the study period [from 10,940.37 (95% CI 10,865.99– 11,014.75) in 2012 to 12,649.00 (95% CI 12,565.03– 12,732.98) in 2020 per 100,000 people, p< 0.05]. Intrauterine hypoxia, chest congestion and breathing-related respiratory distress of newborns, and other perinatal respiratory disorders accounted for 35.5%, 29.8%, and 21.3%, respectively. Males contributed for more than half of them (56.7%). The rate of hospital admission among males increased by 15.1% [from 12,227.79 (95% CI 12,118.83– 12,336.74) in 2012 to 14,074.77 (95% CI 13,952.11– 14,197.43) in 2020 per 100,000 persons, p< 0.05]. The rate of hospital admission among females increased by 17.4% [from 9,646.15 (95% CI 9,545.31– 9,747.00) in 2012 to 11,324.20 (95% CI 11,209.47– 11,438.92) in 2020 per 100,000 persons, p< 0.05]. Conclusion: The study’s findings show that the most common causes of hospital admissions for respiratory and cardiovascular disorders were intrauterine hypoxia, neonatal respiratory distress, and other perinatal respiratory issues, which were detected particularly during the perinatal period. Further research is warranted to identify risk factors of hospital admissions for respiratory and cardiovascular disorders during the perinatal period.