ABSTRACT
Objective:To evaluate utility of a new Extended Sick Neonate Score (ESNS). to predict ‘in-hospital mortality’ and compare with Score for Neonatal Acute Physiology – PerinatalExtension II (SNAPPE II) and Sick Neonate Score (SNS). Design:Prospective observationalstudy. Methods:All extramural sick newborns transported to the neonatology unit of a tertiarycare teaching hospitalover a period of one year.Correlation between ESNS, SNAPPE-II andSNS scoring, and sensitivity/specificity of each score to predict mortality were determined.Results:961 newborns were enrolled in the study. ESNS, SNAPPE II and SNS were stronglycorrelated, even when stratified by gestation. ESNS of ≤11 had the best sensitivity (85.9%)and specificity (89.8%). For preterms, ESNS ≤12 had the best sensitivity (92.3%) andspecificity (76.7%). Conclusion:ESNS can predict ‘in-hospital mortality’ outcome withsatisfactory sensitivity and specificity
ABSTRACT
Objective: To establish the normative blood pressure (BP) values in healthy Indian neonates using oscillometric method, and to develop BP percentile charts. Design: Prospective observational study. Setting: Neonatal unit of a teaching hospital in Eastern India. Participants: 1617 hemodynamically stable inborn neonates without birth asphyxia, major congenital anomaly, maternal complications (e.g. preeclampsia, hypertension, diabetes) or critical neonatal illness. Procedure: Quite state measurements of systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) were recorded by oscillometric method on day 4, 7 and 14 of postnatal life. The averages of three readings at 2-minute intervals were used. Results: Percentile charts (providing 5th, 10th, 25th, 50th, 75th, 95th, and 99th percentile values) have been developed. SBP, DBP and MAP showed a steady rise from day 4 to day 14, and were comparable between males and females, but were significantly lower in preterms than in term neonates Conclusions: Normative neonatal BP data along with gestational age-wise percentile charts shall be of help for decision-making and planning for sick newborns.
ABSTRACT
Objective: To evaluate the growth pattern in children with juvenile idiopathic arthritis and its subtypes in comparison with age, sex and temporally matched controls. Study design: Prospective study. Setting: Pediatric rheumatology clinic of a tertiary care hospital in Eastern part of India. Participants: Seventy-five children (2-12 years) diagnosed as juvenile idiopathic erthritis by International League of Associations for Rheumatology criteria and 75 age- and sex- matched controls. Intervention: Weight, height and body mass index were recorded at six monthly interval in both groups over a period of 3 years. Main outcome measures: weight, height and body mass index. Results: Subtype distribution of juvenile idiopathic arthritis was: oligoarthritis (49%, n=37), rheumatoid factor negative polyarthritis (27%, n=20), rheumatoid factor positive polyarthritis (8%, n=6), systemic onset (15%, n=11) and enthesitis related arthritis (1.3%, n=1). Anthropometric parameters in children with juvenile idiopathic arthritis were not significant different from controls. Comparison between the subtypes showed significant differences in height (P=0.011), weight (P=0.005), and growth velocity (P=0.005), but not in body mass index. Systemic onset disease led to significant restriction in height (P=0.018; 95% CI 2.13-33.77) and weight (P=0.008; 95% CI 1.47-14.43) compared to controls. Growth velocity was significantly affected in rheumatoid factor positive polyarthritis (P=0.003; 95% CIO. 46-3.14). Conclusions: Children with juvenile idiopathic arthritis do not have significantly lower values of anthropometric parameters compared to controls. Significant restriction in height and weight is seen in systemic onset disease, and growth velocity is significantly reduced in rheumatoid factor positive subjects.