Omar Abu-Sa'da - Academia.edu (original) (raw)

Papers by Omar Abu-Sa'da

Research paper thumbnail of Pediatric Patients and the Current COVID-19 Pandemic

Similar to pediatric cases infected with severe acute respiratory syndrome (SARS) and Middle East... more Similar to pediatric cases infected with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), children who acquired SARS-CoV-2 virus (Coronavirus Disease, COVID-19) were less likely to be infected, and showed milder symptoms than adults [1]. However, they are still vulnerable as the virus is very contagious. In addition, demographic data seem to be different from one country to the other as the virus continues to spread through the world.

Research paper thumbnail of Microbiology of Neonatal Gram-Negative Sepsis in A Level III Neonatal Intensive Care Unit (NICU). A Single Center Experience

Global Journal of Pediatrics & Neonatal Care, 2019

Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when c... more Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when caused by Gram-negative bacteria. The causative organisms and their susceptibility to antibiotics vary among units. Empiric antibiotic therapy is based on the likely pathogens and their susceptibility pattern in a NICU. This study aims to identify, in a cohort of neonates diagnosed with Gram-negative sepsis, the bacteriological profile and the antibiotic susceptibilities as well as to evaluate the appropriateness of the empirical antibiotic coverage. Material and methods: In this retrospective observational study, all Gram-negative pathogens isolated in the blood culture of neonates admitted to the neonatal unit in a tertiary referral hospital between January 2011and December 2015 were analyzed. Demographic data, causative organisms, antibiotic susceptibility, empiric therapy and outcomes were collected and analyzed. Results: Of the 2732 neonates admitted to NICU, 80 infants (2.9%) had a blood culture-proven sepsis with a Gram-negative pathogen. Klebsiella pneumonia was the commonest causative organism. Sensitivity to gentamicin and meropenem were 95% and 99% respectively. Mortality, necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity was more prevalent in affected infants. Conclusion: In our unit, neonatal sepsis caused by gram-negative organisms was highly sensitive to aminoglycosides. Almost all cases Gramnegative sepsis were adequately covered by carbapenem.

Research paper thumbnail of The Effect of Caffeine on the Developing Brain

Paediatrics and Child Health, 2010

conclusions: Diagnosis of clients via Telemedicine was found to be cost effective, and demonstrat... more conclusions: Diagnosis of clients via Telemedicine was found to be cost effective, and demonstrated a higher level of satisfaction when compared to diagnosis at a Toronto clinic. Findings support increasing diagnostic capacity by using Telemedicine in other Northern Communities. 24 tHe effect of caffeiNe oN tHe deVeloPiNG BraiN *os abu-sa'da, e armstrong, K shen, PY cheung, G Baker, JJ Yager University of alberta, edmonton, alberta Background: Caffeine is a commonly used medication for the treatment of apnea of prematurity. Despite studies indicating a benefit of caffeine for the premature infant, controversy remains about the long term and subtle effects of caffeine on the immature and still evolving brain of the newborn. oBjective: To determine the long term behavioral and neuropathological effects of clinically relevant doses of caffeine, as used for apnea of prematurity, on the immature rat brain. design/Methods: Rat pups at P3 (equivalent to 26-28 weeks gestation) were injected subcutaneously (sc) with 20mg/Kg caffeine citrate, as a load, and subsequently on days P4-P7 with 15mg/Kg. Control pups received identical volumes of sc normal saline. On P4 through P21, rat pups underwent a battery of early behavioral reflexes. Long term behavior was determined using Object Recognition on P63, and the Morris Water Maze on P160. Separate Groups of rat pups were euthanized on P4, P8, P21, and P160 to examine the neuropathology for evidence of neuroglial cell death. results: There was no mortality during the course of the study. Analysis of behavior shows no difference between the caffeine and the control groups for any of the early or long term behavioral tests. Analysis of FloroJade-B stain at P4 shows that caffeine caused statistically significant neuronal cell death in the: nucleus accumbens, globus pallidus, substantia nigra, thalamus, hypothalamus, CA1. At P8, the analysis shows no statistical difference between the 2 groups in any of the previous brain regions. Anti-NeuN at P21 shows a statistically significant neuronal cell loss in CA1 and Hypothalamus regions in the caffeine group, while at P160, the analysis shows no statistical difference between the 2 groups. Analysis of Anti-Neurofilament-M at P8, P21 and P160 shows no statistical difference between the 2 groups. conclusions: Our results indicate that the use of caffeine, in a manner similar to that utilized for the treatment of apnea of prematurity, has no significant effect on functional outcome in our newborn rat pups. While analysis of the neuropathology shows that caffeine caused neuronal cell death at P4, and neuronal cell loss at CA1/ Hypoth. regions at P21, there is no long-lasting effect on neuropathological outcome. These findings are consistent with current clinical studies, and indicate that caffeine may be a safe medication for use in preterm infants.

Research paper thumbnail of Impacts of Hypoglycemia in At-Risk Infants on Admissions to Level-3 Neonatal Units in a Tertiary-Care Hospital

Research and Reports in Neonatology, 2021

Introduction: Hypoglycemia is frequent in level-1 postnatal units (PNU), which can result in many... more Introduction: Hypoglycemia is frequent in level-1 postnatal units (PNU), which can result in many transfers to the level-3 neonatal unit (NNU). Objectives: This study reports on hypoglycemia (capillary blood glucose <2.5 mmol/L in the first 24 h) in at-risk infants. Its main objective was to evaluate the impact of hypoglycemia in level-1 PNU on level-3 NNU admissions. Methods: The study was retrospective, conducted between January 01, 2018 and December 31, 2018. Inclusion criteria were infants in the PNU who were: 1) late-preterm (35≤ weeks' gestation <37), 2) infants-of-diabetic mothers (IDM), and/or 3) low (2.0-2.5 kg) or high (>4.0 kg) birthweight. Results: Of the 3192 deliveries, 983 (31%) were eligible for study enrollment; 77% were IDM and 19% late-preterm. A total of 192 (19.5%) newborns had hypoglycemia in the first 4 h and 42 (4.3%) within 4-24 h. Twenty-two (2.2%) newborns were transferred to NNU, 17 in first 4 h and five within 4-24 h. Overall, independent predictors of NNU transfer were late-preterm, cesarean delivery, and glucose measurement <1.5 h (P ≤ 0.019). Independent predictors of hypoglycemia in the first 4 h were late-preterm, cesarean delivery, glucose measurement before feeding, and glucose measurement <1.5 h (P ≤ 0.045). The independent predictor of hypoglycemia within 4-24 h was cesarean delivery (P = 0.017). Ten neonates had blood glucose ≤1.0 mmol/L; they all required NNU transfer for intravenous glucose. Conclusion: This study shows frequent low glucose readings in these infants (overall prevalence, 23.8%) and confirms the need for clinical observation and regular monitoring. It is prudent to initiate and maintain proper feeding and to adhere to evidence-based guidelines.

Research paper thumbnail of Assessment of initial vancomycin trough levels and risk factors of vancomycin-induced nephrotoxicity in neonates

European Journal of Hospital Pharmacy, 2020

Objectives Vancomycin is a glycopeptide antibiotic commonly used in neonatal intensive care units... more Objectives Vancomycin is a glycopeptide antibiotic commonly used in neonatal intensive care units (NICUs) to treat late onset sepsis. It is recommended that vancomycin trough levels at steady state following intermittent dosing regimen be maintained at 10–20 mg/L, which is largely dependent on the type of infection. Our objective is to assess the ability of initial vancomycin dosing regimens to obtain target trough levels and to assess the percentage and risk factors associated with the development of acute kidney injury (AKI) while on vancomycin. Methods This is a retrospective review of all NICU patients admitted between January 2016 and December 2017 who received vancomycin according to the NeoFax at either 10 mg/kg/dose (low-dose group, LDG) or 15 mg/kg/dose (high-dose group, HDG), with a frequency based on the postmenstrual age (PMA) and postnatal age (PNA). Both regimens were compared by their ability to attain target trough levels and the episodes of vancomycin-induced AKI. O...

Research paper thumbnail of The Effect of Caffeine on the Neurobehavioral and Neuropathological Outcome of the Newborn Rat

... the supervising committee and for many varied ways of demonstrating support and advice. My th... more ... the supervising committee and for many varied ways of demonstrating support and advice. My thanks go also to Arlene Figley for her excellent administrative help and to Dr. Richard Schulz for his chairing the examining committee. ... 1988; Koons, Mojica et al. 1993). ...

Research paper thumbnail of The Effect of Caffeine on the Neuropathological and Neurobehavioral Outcome in the Newborn Rat

Journal of Caffeine and Adenosine Research

Research paper thumbnail of Report of a case of Raine syndrome and literature review

American Journal of Medical Genetics Part A, 2015

We report on a case of Raine syndrome with a mutation in FAM20C and typical phenotypic features c... more We report on a case of Raine syndrome with a mutation in FAM20C and typical phenotypic features consisting of midface hypoplasia, hypoplastic nose, choanal atresia, wide fontanelle, exophthalmos, generalized osteosclerosis and intracranial calcification. New features in our patient are cerebellar hypoplasia and pachygyria. We review the literature and conclude that the triad of hypoplastic nose, exophthalmos and generalized osteosclerosis and/or intracranial calcification is consistent in all molecularly confirmed cases. © 2015 Wiley Periodicals, Inc.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.

Research paper thumbnail of Pediatric Patients and the Current COVID-19 Pandemic

Similar to pediatric cases infected with severe acute respiratory syndrome (SARS) and Middle East... more Similar to pediatric cases infected with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), children who acquired SARS-CoV-2 virus (Coronavirus Disease, COVID-19) were less likely to be infected, and showed milder symptoms than adults [1]. However, they are still vulnerable as the virus is very contagious. In addition, demographic data seem to be different from one country to the other as the virus continues to spread through the world.

Research paper thumbnail of Microbiology of Neonatal Gram-Negative Sepsis in A Level III Neonatal Intensive Care Unit (NICU). A Single Center Experience

Global Journal of Pediatrics & Neonatal Care, 2019

Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when c... more Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when caused by Gram-negative bacteria. The causative organisms and their susceptibility to antibiotics vary among units. Empiric antibiotic therapy is based on the likely pathogens and their susceptibility pattern in a NICU. This study aims to identify, in a cohort of neonates diagnosed with Gram-negative sepsis, the bacteriological profile and the antibiotic susceptibilities as well as to evaluate the appropriateness of the empirical antibiotic coverage. Material and methods: In this retrospective observational study, all Gram-negative pathogens isolated in the blood culture of neonates admitted to the neonatal unit in a tertiary referral hospital between January 2011and December 2015 were analyzed. Demographic data, causative organisms, antibiotic susceptibility, empiric therapy and outcomes were collected and analyzed. Results: Of the 2732 neonates admitted to NICU, 80 infants (2.9%) had a blood culture-proven sepsis with a Gram-negative pathogen. Klebsiella pneumonia was the commonest causative organism. Sensitivity to gentamicin and meropenem were 95% and 99% respectively. Mortality, necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity was more prevalent in affected infants. Conclusion: In our unit, neonatal sepsis caused by gram-negative organisms was highly sensitive to aminoglycosides. Almost all cases Gramnegative sepsis were adequately covered by carbapenem.

Research paper thumbnail of The Effect of Caffeine on the Developing Brain

Paediatrics and Child Health, 2010

conclusions: Diagnosis of clients via Telemedicine was found to be cost effective, and demonstrat... more conclusions: Diagnosis of clients via Telemedicine was found to be cost effective, and demonstrated a higher level of satisfaction when compared to diagnosis at a Toronto clinic. Findings support increasing diagnostic capacity by using Telemedicine in other Northern Communities. 24 tHe effect of caffeiNe oN tHe deVeloPiNG BraiN *os abu-sa'da, e armstrong, K shen, PY cheung, G Baker, JJ Yager University of alberta, edmonton, alberta Background: Caffeine is a commonly used medication for the treatment of apnea of prematurity. Despite studies indicating a benefit of caffeine for the premature infant, controversy remains about the long term and subtle effects of caffeine on the immature and still evolving brain of the newborn. oBjective: To determine the long term behavioral and neuropathological effects of clinically relevant doses of caffeine, as used for apnea of prematurity, on the immature rat brain. design/Methods: Rat pups at P3 (equivalent to 26-28 weeks gestation) were injected subcutaneously (sc) with 20mg/Kg caffeine citrate, as a load, and subsequently on days P4-P7 with 15mg/Kg. Control pups received identical volumes of sc normal saline. On P4 through P21, rat pups underwent a battery of early behavioral reflexes. Long term behavior was determined using Object Recognition on P63, and the Morris Water Maze on P160. Separate Groups of rat pups were euthanized on P4, P8, P21, and P160 to examine the neuropathology for evidence of neuroglial cell death. results: There was no mortality during the course of the study. Analysis of behavior shows no difference between the caffeine and the control groups for any of the early or long term behavioral tests. Analysis of FloroJade-B stain at P4 shows that caffeine caused statistically significant neuronal cell death in the: nucleus accumbens, globus pallidus, substantia nigra, thalamus, hypothalamus, CA1. At P8, the analysis shows no statistical difference between the 2 groups in any of the previous brain regions. Anti-NeuN at P21 shows a statistically significant neuronal cell loss in CA1 and Hypothalamus regions in the caffeine group, while at P160, the analysis shows no statistical difference between the 2 groups. Analysis of Anti-Neurofilament-M at P8, P21 and P160 shows no statistical difference between the 2 groups. conclusions: Our results indicate that the use of caffeine, in a manner similar to that utilized for the treatment of apnea of prematurity, has no significant effect on functional outcome in our newborn rat pups. While analysis of the neuropathology shows that caffeine caused neuronal cell death at P4, and neuronal cell loss at CA1/ Hypoth. regions at P21, there is no long-lasting effect on neuropathological outcome. These findings are consistent with current clinical studies, and indicate that caffeine may be a safe medication for use in preterm infants.

Research paper thumbnail of Impacts of Hypoglycemia in At-Risk Infants on Admissions to Level-3 Neonatal Units in a Tertiary-Care Hospital

Research and Reports in Neonatology, 2021

Introduction: Hypoglycemia is frequent in level-1 postnatal units (PNU), which can result in many... more Introduction: Hypoglycemia is frequent in level-1 postnatal units (PNU), which can result in many transfers to the level-3 neonatal unit (NNU). Objectives: This study reports on hypoglycemia (capillary blood glucose <2.5 mmol/L in the first 24 h) in at-risk infants. Its main objective was to evaluate the impact of hypoglycemia in level-1 PNU on level-3 NNU admissions. Methods: The study was retrospective, conducted between January 01, 2018 and December 31, 2018. Inclusion criteria were infants in the PNU who were: 1) late-preterm (35≤ weeks' gestation <37), 2) infants-of-diabetic mothers (IDM), and/or 3) low (2.0-2.5 kg) or high (>4.0 kg) birthweight. Results: Of the 3192 deliveries, 983 (31%) were eligible for study enrollment; 77% were IDM and 19% late-preterm. A total of 192 (19.5%) newborns had hypoglycemia in the first 4 h and 42 (4.3%) within 4-24 h. Twenty-two (2.2%) newborns were transferred to NNU, 17 in first 4 h and five within 4-24 h. Overall, independent predictors of NNU transfer were late-preterm, cesarean delivery, and glucose measurement <1.5 h (P ≤ 0.019). Independent predictors of hypoglycemia in the first 4 h were late-preterm, cesarean delivery, glucose measurement before feeding, and glucose measurement <1.5 h (P ≤ 0.045). The independent predictor of hypoglycemia within 4-24 h was cesarean delivery (P = 0.017). Ten neonates had blood glucose ≤1.0 mmol/L; they all required NNU transfer for intravenous glucose. Conclusion: This study shows frequent low glucose readings in these infants (overall prevalence, 23.8%) and confirms the need for clinical observation and regular monitoring. It is prudent to initiate and maintain proper feeding and to adhere to evidence-based guidelines.

Research paper thumbnail of Assessment of initial vancomycin trough levels and risk factors of vancomycin-induced nephrotoxicity in neonates

European Journal of Hospital Pharmacy, 2020

Objectives Vancomycin is a glycopeptide antibiotic commonly used in neonatal intensive care units... more Objectives Vancomycin is a glycopeptide antibiotic commonly used in neonatal intensive care units (NICUs) to treat late onset sepsis. It is recommended that vancomycin trough levels at steady state following intermittent dosing regimen be maintained at 10–20 mg/L, which is largely dependent on the type of infection. Our objective is to assess the ability of initial vancomycin dosing regimens to obtain target trough levels and to assess the percentage and risk factors associated with the development of acute kidney injury (AKI) while on vancomycin. Methods This is a retrospective review of all NICU patients admitted between January 2016 and December 2017 who received vancomycin according to the NeoFax at either 10 mg/kg/dose (low-dose group, LDG) or 15 mg/kg/dose (high-dose group, HDG), with a frequency based on the postmenstrual age (PMA) and postnatal age (PNA). Both regimens were compared by their ability to attain target trough levels and the episodes of vancomycin-induced AKI. O...

Research paper thumbnail of The Effect of Caffeine on the Neurobehavioral and Neuropathological Outcome of the Newborn Rat

... the supervising committee and for many varied ways of demonstrating support and advice. My th... more ... the supervising committee and for many varied ways of demonstrating support and advice. My thanks go also to Arlene Figley for her excellent administrative help and to Dr. Richard Schulz for his chairing the examining committee. ... 1988; Koons, Mojica et al. 1993). ...

Research paper thumbnail of The Effect of Caffeine on the Neuropathological and Neurobehavioral Outcome in the Newborn Rat

Journal of Caffeine and Adenosine Research

Research paper thumbnail of Report of a case of Raine syndrome and literature review

American Journal of Medical Genetics Part A, 2015

We report on a case of Raine syndrome with a mutation in FAM20C and typical phenotypic features c... more We report on a case of Raine syndrome with a mutation in FAM20C and typical phenotypic features consisting of midface hypoplasia, hypoplastic nose, choanal atresia, wide fontanelle, exophthalmos, generalized osteosclerosis and intracranial calcification. New features in our patient are cerebellar hypoplasia and pachygyria. We review the literature and conclude that the triad of hypoplastic nose, exophthalmos and generalized osteosclerosis and/or intracranial calcification is consistent in all molecularly confirmed cases. © 2015 Wiley Periodicals, Inc.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.

Research paper thumbnail of Arthrogryposis, renal tubular acidosis and cholestasis (ARC) syndrome: two new cases and review

Clinical Dysmorphology, 2005

ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a ... more ARC syndrome, the association of arthrogryposis, renal tubular dysfunction and cholestasis, is a rare genetic disorder. We report two Saudi infants from two different families with ARC syndrome. Magnetic resonance imaging of the brain of one of the infants showed lissencephaly, a previously unreported finding in this syndrome. We also review 39 ARC cases reported in the literature using the Medline database from January 1966 to September 2004.