ABSTRACT
Background: Acute bacterial meningitis among children may result in hearing deficit
Objective: To determine the frequency of hearing deficit in hospitalized children with bacterial meningitis
Methodology: Study Design: Cross sectional study
Setting: Department of Pediatric Medicine, Services Institute of Medical Sciences / Services Hospital, Lahore
Duration: From 1[st] February to 30[th] July 2010. Patients diagnosed as bacterial meningitis were admitted in Paediatric Medicine Department of Services Hospital Lahore and included in the study. After informed consent, auditory brain stem evoked response [BERA] test was performed on all patients by a single audiologist. In this test patients were sedated and electrodes placed on patient's vertex, ear lobes and forehead. The wave forms of impulses generated at the level of brain stem [cochlear nerves, cochlear nucleus, superior olivary complex, nuclei of lateral leminiscus, inferior colliculus] were recorded and numbered in Roman numerals respectively. The outcome whether patient is deaf or not was noted and entered in pre-designed proforma. All patients received standard care for bacterial meningitis
Results: Two hundred and ten consecutively admitted cases of bacterial meningitis were enrolled in the study, 134[63.8%] cases were male and 76 [36.2%] were female. Out of 76 cases of hearing loss, 45 [59.3%] cases has bilateral hearing deficit and 31 [40.7%] has unilateral hearing loss
Conclusion: Hearing deficit developed in one third of cases. It is worth performing BERA in all patients with acute bacterial meningitis since there is a significant risk of developing sensorineural hearing loss
ABSTRACT
Objective: to assess the frequency of complications in neonates with the diagnosis of meconium aspiration syndrome [MAS]
Methods: a Neonate presented with respiratory distress along with meconium staining of vocal cords and body on 1st day of life was admitted in Neonatology Ward of Services Hospital. Neonates with dysmorphic features, congenital abnormalities of heart and lungs and those having risk factors for sepsis were excluded from the study. A predesigned proforma was used to record clinical data on presentation. This included necessary information like gestational age, weight, gender, signs of post term baby and mode of delivery. The proforma was updated on daily basis to make note of any complications arising during the course of hospital stay till outcome [discharge, leave against medical advice or death].Arterial blood gases [ABGs] were done daily to look for persistent hypoxia and Echocardiography was performed when ABGs and clinical examination suggested development of persistent pulmonary hypertension of newborn [PPHN]. Chest x-ray was done at the time of admission and repeated if clinical findings were suggestive of pneumothorax. Other investigations like blood culture were sent when there was clinical suspicion of sepsis. The data was subsequently computed and analyzed using SPSS [Statistical Package for the Social Sciences] version 10 by the authors
Results: 175 babies with meconium aspiration were included in the study. Complications like pneumothorax was observed in 28babies [16%], persistent pulmonary hypertension of newborn [PPHN] in 35[20%], respiratory failure in 21 [12%] and sepsis in 27 patients [15.4%]. 45 patients died [25.7%], 90 were discharged home [51 .4%] and 40 were referred to other hospitals [22.8%]. It was observed that commonest risk factor for MAS was post-maturity, found in 40% with poor APGAR score in 35.4%.There was no significant difference in morbidity between males and females
Conclusion: it was observed that meconium aspiration syndrome [MAS] is a leading cause of neonatal morbidity and it can be prevented by giving appropriate peri-natal care to high risk pregnancies, vigilance and timely intervention in delivery room
ABSTRACT
Objective: to assess the frequency of early morbidity in neonates with meconium aspiration syndrome
Material and Methods: neonates presented with respiratory distress along with meconium staining of vocal cords and body on 1st day of life were admitted in Neonatology Ward of Services Hospital. Neonates with dysmorphic features, congenital abnormalities of heart and lungs and risk factors for sepsis were excluded from the study. A predesigned proforma was used to record clinical data on presentation. This included necessary information like gestational age, weight, gender and mode of delivery. The proforma was updated on daily basis to make note of any complications arising during the course of hospital stay till outcome [discharge, leave against medical advice or death].Arterial blood gases [ABGs] were done daily to look for persistent hypoxia and Echocardiography was performed when ABGs and clinical examination suggested development of persistent pulmonary hypertension of newborn [PPHN]. Chest x-ray was done at the time of admission and repeated if clinical findings were suggestive of pneumothorax. Other investigations like blood culture were sent when there was clinical suspicion of sepsis. The data was analyzed using SPSS [Statistical Package for the Social Sciences] version 20.0
Results: 175 babies with meconium aspiration were included in the study. Complications like pneumothorax was observed in 28babies [16%], persistent pulmonary hypertension of newborn [PPHN] in 35[20%], respiratory failure in 21 [12%] and sepsis in 27 patients [15.4%]. 45 patients died [25.7%], 90 were discharged home [51.4%] and 40 were referred to other hospitals [22.8%]. It was observed that commonest risk factor for MAS was post-maturity, found in 40% with poor APGAR score in 35.4·%. About 60% patients were born at term while 40% were post mature. There was no significant difference in morbidity between males and females
Conclusion: it was observed that MAS is a leading cause of neonatal morbidity. It can be prevented by giving appropriate peri-natal care to high risk pregnancies, vigilance and timely intervention in delivery room