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Introduction: Neonatal seizure is defined as paroxysmal electrical discharge from the brain. The immature brain seems more prone to seizures. The incidence was found to increase with decreasing gestation and birth weight- preterm neonates (20.8 vs. 8.4 per 1000 live-births) while very low birth weight neonates had more than 4-fold higher incidence (36.1 per 1000 live-births). Objective: The study was conducted to estimate the incidence, etiological factor, time of onset, clinical types, and biochemical abnormalities among the different types of neonatal seizures. Methods: This is a hospital based prospective observational study conducted in NICU, Department of Pediatrics, SMIMER during the period of January 2020 to March 2021. Results: Total patients with neonatal seizures were 90 in our study. Incidence of neonatal seizures in our study was 1.1%. Incidence was higher in pre-term neonates (4.8%) and more in males (56.67%). Incidence of neonatal seizures was higher in LBW babies (4.3%) and more common in SGA babies (51.11%). Incidence among vaginal delivered babies was 0.9%, LSCS was 1.7% and forceps was 1.1%. Birth asphyxia (41.1%) was the most common cause of all neonatal seizures followed by hypoglycemia (17.8%), neonatal meningitis/septicemia (14.5%), hypocalcemia (12.2%), ICH (7.8%). Subtle seizures (44.4%) were the most common type of seizure followed by tonic (38.9%), focal clonic (11.1%), multifocal clonic (5.6%). 33.3% of neonatal seizures occurred in < 24hrs & 40% in 24-72 hrs. The most common biochemical abnormality was hypoglycemia (17.8%) followed by hypocalcemia (12.2%). Conclusion: Incidence of neonatal seizures was 11.1/1000 live births (1.1%) & more common in preterm, LBW & LSCS deliveries. Birth asphyxia was the most common cause and subtle seizures were the most common type of seizure. Subtle seizures were more common in 24-72 hours of life. Most common biochemical abnormality was hypoglycemia followed by hypocalcemia
ABSTRACT
Background: In clinical settings, wasting in childhood has primarily been assessed with the use of a weight-for-height z score (WHZ), and in community settings, it has been assessed via the mid upper arm circumference (MUAC) with a cutoff <115mm for severe wasting and 115-125mm for moderate wasting. Our recent experience indicates that many wasted children were not identified when these cutoffs for MUAC were used.Methods: Authors determined the cutoffs for MUAC to detect wasting in Indian children aged 6-60 mo. A secondary analysis was carried out on data from 1446 children aged 6-59 mo. The area under the receiver operating curve was used to indicate the most appropriate choice for cutoffs that related MUAC with WHZ. The MUAC measurement of each subject was taken using standard technique. Following the World Health Organization (WHO) age and sex-specific cut-off points, nutritional status of children was determined.Results: The mean'SD age for the entire group was 19.8'13.6 mo, MUAC was 132'13mm, and 45% of subjects were girls. Age-stratified analyses revealed that, for ages 6-24 mo, MUAC cutoffs were <120mm for a WHZ <-3 and <125mm for a WHZ <-2 with a sensitivity of 68.3% and 64.7%, respectively, and a specificity of 82.6% and 83.4%, respectively; for ages 25-60 mo, MUAC cutoffs were <135mm for a WHZ <-3 and <140mm for a WHZ <-2 with a sensitivity of 63.7% and 65.4%, respectively, and a specificity of 81.6% and 78.3%, respectively.Conclusions: The respective cutoffs for MUAC to better capture the vulnerability and risk of severe (WHZ <-3) and moderate (WHZ <-2) wasting would be <120 and <125mm for ages 6-24 mo, <135 and <140mm for ages 37-60 mo.
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Background: The objective of the study to compare the predictive ability of predischarge serum total bilirubin (STB) and clinical factors for significant hyperbilirubinemia (SHB) in newborn to observe the prediction of the hyperbilirubinemia.Methods: In the prospective study, enlist of healthy newborn infants with >35 weeks gestation, in a tertiary hospital in western India. The serum bilirubin between 36-48 hours of age and risk factors for SHB were identified before discharge. SHB was distinct as a bilirubin level that exceed or was within 1mg/dL (17'mol/L) of the hour-specific phototherapy conduct threshold recommended by American Academy of Pediatrics (AAP) guideline on the management of neonatal hyperbilirubinemia.Results: Of 505 infants, 380 infants were included in final analysis, among which 70 babies (22.5%) developed SHB. On univariate analysis STB, gestational age (GA) and percentage of weight loss were found to be predictive of SHB. On multiple logistic regressions, the prognostic ability of predischarge STB is higher than that of percentage of weight loss and GA. The predictive accurateness of predischarge (<48 hours) STB level was comparable to that of percentage of weight loss (AUC=0.88, 95% CI 0.84-0.93). However, the prediction model that combined multiple risk factors such as predischarge STB, GA and percentage of weight loss have the best accuracy for predicting SHB.Conclusions: Combination of specific clinical factors (gestational age and percentage of weight loss) with predischarge serum total bilirubin described best predicts development of considerable hyperbilirubinemia.
ABSTRACT
Introduction : Fungal sinusitis was once considered a rare disorder but is now reported with increasing frequency throughout the world. Fungal chest infection is relatively considered common. The classification of fungal sinusitis has evolved in the past two decades, and this entity is now thought to comprise five subtypes. Acute invasive fungal sinusitis, chronic invasive fungal sinusitis and chronic granulomatous invasive fungal sinusitis made the invasive group, whereas non-invasive fungal infection is composed of allergic fungal sinusitis and fungus ball (fungal mycetoma). Objective : The five subtypes of sinusitis described above are distinct entities with different clinical and radiologic features. The treatment strategies for the subtypes are also different, as are their prognosis. We aim to clearly delineate the radiologic features of culturally proven fungal cases so as to direct the clinician towards expeditious diagnosis and necessary treatment. Methodology : 40 culturally positive patients with the spectrums of different manifestations were studied and recorded. They were followed up for one month. Conclusion : An understanding of the different types of fungal sinusitis and knowledge of their particular radiologic features allowed the radiologist to play a crucial role in alerting the clinician to use appropriate diagnostic techniques for confirmation. Prompt diagnosis and initiation of appropriate therapy avoided a protracted or fatal outcome.