ABSTRACT
Background: The objective of the study was to know the maternal clinical profile and short term outcome of term large-for-gestational-age (LGA) neonates.Methods: The study was a prospective observational study conducted in the tertiary neonatal unit, Odisha, during the study period February to November 2018. All inborn term neonates with birth weight above 90th percentile for gestational age excluding neonates with major congenital anomalies were included. Maternal clinical profile data from the antenatal records, neonatal demographic profile and co-morbidities over time were recorded using a checklist. The analysis of data was done using SPSS 21.0. Univariate summary statistics and bivariate Fischer’s exact test were used to analyse the data.Results: The prevalence of delivery of LGA and macrosomic neonate in our institution was 2.5%, and 1.1% respectively. Ninety one percent of LGA neonates were born before 39weeks and 80% babies delivered by cesarean section. Majority 39 (86.7%) of LGA babies were born to non-diabetic mother, four (8.9%) neonates born to GDM mother, two (4.4%) were born to mother with pre pregnancy diabetes mellitus. Sixteen (35.5%) neonates were admitted to NICU for different comorbidities like neonatal jaundice (37.8%), polycythemia (24.4%), transient tachypnea of new-born (20%), hypoglycemia (15.6%), hypocalcaemia (15.6%), and seizure (4.4%). The comorbidities like hypoglycaemia, hypocalcemia, respiratory distress were more in LGA babies with diabetic mother compared to non-diabetic mother.Conclusions: About nine in ten LGA neonates were born to non-diabetic mothers, however, LGA infants of diabetic mothers are at higher risk of metabolic complications like hypoglycemia, hypocalcemia compared to non-diabetic mother
ABSTRACT
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.
ABSTRACT
Background: The objective is to study the various social and demographic determinants of severe acute malnutrition in children aged 6 months to 59 months in a tertiary care centre of Odisha, India.Methods: This is a hospital based prospective observational study done in a tertiary care centre of Odisha during the period of Nov 2015 to Oct 2017 in which all children with severe acute malnutrition as per WHO criteria in the age group 6 months to 59 months were enrolled and their socioeconomic and demographic details were evaluated.Results: Present study revealed a prevalence of severe acute malnutrition as 2.8%. Males (54.2%) were more affected than females (45.8%). Most common age group affected was 6-12 months (37.4%). Most of the children were from low socioeconomic status (96.4%) and from rural areas (84.8%).63.7% of the study population were unimmunised. Only 12.6% of the participants were exclusively' breast fed.100% of the children in the study population received top feeding with cow's milk.Conclusions: The prevalence of malnutrition is high in Odisha but most of the causative factors are preventable. Adequate education regarding exclusive breastfeeding, complementary feeding, immunisation, promotion of proper referral and health care services can help to improve nutritional status in the state of Odisha.