ABSTRACT
Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.
ABSTRACT
Background: This study was undertaken to know about the clinical profile and outcome of patients admitted in paediatric ICU in a tertiary care teaching hospital.Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to paediatric ICU of Sri Venkateshwara Medical College Hospital and Research Centre Puducherry from Jan 2019 - Dec 2019 (12 months).Results: As about 424 patients were admitted paediatric ICU. 79 patients were excluded from the study. Remaining 345 PICU patients were analysed. According to the age distribution of patients, it showed that < 1year were (25.2%), 1-5 years were (44.3%), > 5years of age were (30.4%). There was a female preponderance (58.8%), males were (41.1%). Patients from rural area were 243 (70.4%) and 102 (29.5%) from urban area. Clinical profile showed that pneumonia was the most common diagnosis (8.4%) for admission in PICU. This was followed by bronchiolitis (6.9%), enteric fever in (6.6%), febrile seizures (6.3%), poisoning (6.0%), renal problems (5.7%), occult bacteremia (5.5%), unknown bite (5.2%), acute severe asthma (4.9%), sepsis (4.6%), severe gastritis (4.3%), clinical dengue (3.7%), seizure disorder (3.4%), croup (3.1%), traumatic head injury (2.8%), wheeze associated LRI (2.6%), acute otitis media (2.3%), migraine (2.0%), meningitis (1.7%), CHD with complications (1.7%), severe anaemia with CCF (1.4%), acute urticarial (1.4%), foreign body (1.1%), electric shock (1.1%), scorpion sting (0.8%), viral hepatitis (0.8%), clinical malaria (0.8%), nephrotic syndrome with complications (0.5%), scrub typhus (0.2%) and (0.2%) was angioedema. The outcome noted was, (87.8%) were discharged, (10.7%) patients went against medical advice, (1.4%) patients were referred at parent's request.Conclusions: Respiratory illness, infectious diseases, neurological problems and poisoning are the most common cause for PICU admissions. But seronegative dengue cases, electric shock, reemergence of scrub typhus, are being increasingly diagnosed. So, emphasis is therefore placed on high index of suspicion for this type of conditions. We also recommend better manpower and infrastructure to improve the outcome of patients admitted to PICU.
ABSTRACT
Background: Exclusive Breastfeeding (EBF) for 6 months is the optimal way of feeding infants. NFHS4 data shows 45.5% of children were exclusively breastfed at 6 months in Puducherry. The Global Nutrition Targets 2025 aims at increasing EBF rates in first 6 months up to at least 50%. The main objective is to find areas of needed intervention using LATCH scoring and to find factors responsible for fall in rates of EBF.Methods: A prospective study was conducted between November 2017 and April 2019 (1'years). Mothers were educated about breastfeeding. LATCH score assessed at 8 and 48 hours of life. At 48hours, score >8 indicates there is a high chance for EBF for next 6 months and score <8 indicates, mother is having difficulty in feeding and are intervened at this point. Data about EBF and reason for early weaning at 6 weeks and 6 months collected.Results: LATCH score at 8 hours was >8 in infants delivered via NVD: 50% as against 9.6% in babies delivered via LSCS. At 48 hours LATCH score improved in both groups: 60.8% in babies delivered via NVD, 38.3% in babies delivered via LSCS.' Compared to Primi-mothers, infants born to multigravida mothers had higher scores at 48 hours: 62.2% as against 31.1%. 84% were EBF at 6 weeks. 51% were EBF at 6 months. When mothers with LATCH score <8 at 48 hours were intervened, EBF rate at 6 weeks improved. Most common reason for early weaning at 6 weeks was maternal problems: 6.6% and at 6 months- due to influence of relatives: 27%.Conclusions: LATCH score helps in predicting breastfeeding duration as early as 48 hours of life. Low scores indicate, it requires intervention and identifies the areas of needed intervention. Counselling regarding EBF must include not only mothers but also relatives.