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Objective: To compare the continuous real time blood glucose (CG) measurement with venous laboratory blood glucose (LG) level in neonates during perioperative period. Methods: Glucose levels were measured simultaneously by CG, glucometer glucose (GG) and LG at 40 time points in ten neonates during perioperative period. Intraclass correlation coefficient (ICC) and Bland Altman analysis were used for comparison. Result: Correlation between CG and LG was excellent (ICC= 0.953; P<0.001), and average difference was 23.8 (95%CI 52.9 to -5.3) mg/dL, showed better reliability than at hyperglycemic state (ICC=0.653; P=0.006). The GG-LG showed excellent reliability with ICC = 0.985; P<0.001 and average difference of 15.4 (95% CI 30.7 to 0.1) mg/dL. CG at euglycemic state (ICC= 0.880; P<0.001). Conclusion: CG measurement is reliable for blood sugar estimation in neonates; but has lower reliability for hyperglycemia. The continuous trend of glucose measurement by CG is helpful for timely diagnosis of hyperglycemia during perioperative period in neonates.
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Objectives: To compare breast milk volume between manual method and breast pump expression in mothers of preterm infants at different time point of first week. Design: Randomized controlled trial. Setting: Postpartum ward of Obstetrics department and tertiary level neonatal intensive care unit (NICU) in a single institution in Orissa between October, 2020 and May, 2021. Participants: Mothers who delivered before 34 completed weeks of gestation. Interventions: Manual breastmilk expression (ME) group using Marmet technique and breast pump milk expression (PE) group using pigeon manual breast pump, initiated milk expression within one hour of delivery. Outcome measures: Expressed breast milk (EBM) volume in mothers of preterm infants at different time point of first week, and cumulative milk volume. Results: Out of 170 mothers (83 PE and 87 ME group), 7-days milk volume data was available for 137 (71 ME and 66 PE) mothers. In per protocol analysis for 126 mothers (63 in each group), the median (IQR) EBM volume on day 2 and day 7 of ME and PE groups were similar [10 (5,20) vs 12 (5,28), P=0.10] and [280 (220-356) vs 280 (220-360), P=0.66]. The median (IQR) cumulative EBM volume over first 7 days in ME group was not significantly different from PE group [733 (593-995) vs 848.5 (571-1009)] P=0.55). A similar number of mothers in the PE and ME group [56 (88.9%) vs 58 (92%); P=0.14] provided exclusive breast milk for their neonates during the first week. Similar results were found on intention to treat analysis. Conclusion: EBM volume expressed was comparable between mothers expressing manually or with breast pump.
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Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.
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Road traffic noise assessed in 13 different squares of major intersection points in Bhadrak city during four different specified times i.e. 7-10 a.m., 11a.m.-2 p.m., 3-6 p.m. and 7-10 p.m.. Road traffic was found to be the most important source of community noise at the studied sites. The noise levels of all the 13 squares were found to be beyond the permissible limit [70 dB (A)] during day time. Leq (equivalent noise level) values ranged from 93.4 to 100.5; 91.5 to 100.6; 95.1 to 107.3 and 97.3 to 106.3 dB during 7-10 a.m., 11a.m.-2 p.m., 3-6 p.m. and 7-10 p.m. respectively. LNP values range from 115.7 to 127.7; 114.2 to 129.8; 118.2 to 138.2 and 120.7 to 135 dB, while TNI values range from 134.3 to 154.7; 130.7 to 157.9; 136.7 to 168.2 and 137.2 to 165 dB during 7-10 a.m., 11a.m.-2 p.m., 3-6 p.m. and 7-10 p.m. respectively. Reprehensibly, even minimum LNP and TNI values are more than 114 and 130 dB respectively. Analysis of variance also computed for investigated squares at the peak hour i.e. 7-10 p.m. to infer the level of significance. The observed value of F (0.47) was less than the tabulated values and was not significant at both 5 and 1% levels of significance. Thus, the noise levels of different squares did not differ significantly at their peak hours. A preliminary public health survey carried out based on questionnaire method amongst 202 local inhabitants reveal the degree of annoyance due to road traffic noise.