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Background: Sepsis in neonates is a syndrome which is characterized clinically by systemic symptoms or signs of infection and associated with bacteremia in the first 28 days of life. More than 40% of under-five deaths globally occur in the neonatal period, resulting in 3.1 million newborn deaths each year. Procalcitonin (PCT) is an early diagnostic tool for neonatal sepsis.Methods: Present prospective cross- sectional observational study was conducted at NICU of Base hospital, Delhi Cantonment from 1st Dec 2016 to Jan 31st, 2018. Universal sampling technique was followed. SPSS version 21 was used for statistical analysis. A p-value of less than 0.05 was taken as significant.Results: Out of the total 440 cases, 63% were males while rest 37% were females.' Mean gestation age and birth weight of the babies was 35.6 weeks and 2.13 Kg respectively. Raised/ decreased Total Leucocyte Count (TLC) and raised pro calcitonin levels were seen in 23% and 19.8% cases respectively.Conclusions: These results indicated that the sensitivity of procalcitonin was higher than TLC for the diagnosis of culture proven neonatal sepsis. Hence, PCT is a more sensitive and useful biomarker for the diagnosis of neonatal sepsis.
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Background: Neonatal seizure is defined as a paroxysmal alteration in neurological function. The diagnosis of neonatal seizures is difficult to establish because of varied etiologies involved. The incidences vary from 1.5-3.7/1000 live births in term babies.Methods: Hospital based observational study was conducted from December 1, 2016 till March 31, 2018. Universal sampling technique was followed. 93 neonates fulfilling the inclusion criteria were included in the study after consent from parents.Results: This study results showed that 60.2% were males. Pre-term delivery occurred in 12.9% neonates. Most common etiology of neonatal seizures was birth asphyxia with 47.3% followed by metabolic abnormalities 32.3%. Abnormal EEG pattern was seen in 29% cases of neonatal seizures.Conclusions: To conclude, the most common aetiology for neonatal seizures was birth asphyxia followed by metabolic abnormalities in which hypoglycaemia was the most common type. A significant association of seizures due to meningitis and metabolic abnormalities was observed with pre-term gestation while abnormal EEG pattern was observed with birth asphyxia and meningitis. EEG findings were found normal in majority of cases of neonatal seizure.
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Background: Neonatal seizure is defined as a paroxysmal alteration in neurological function. The diagnosis of neonatal seizures is difficult to establish because of varied etiologies involved. The incidences vary from 1.5-3.7/1000 live births in term babies.Methods: Hospital based observational Study was conducted from December 1, 2016 till March 31, 2018. Universal sampling technique was followed. 93 neonates fulfilling the inclusion criteria were included in the study after consent from parents.Results: Present study results showed that 60.2% were males. Pre-term delivery occurred in 12.9% neonates. Most common etiology of neonatal seizures was birth asphyxia with 47.3% followed by metabolic abnormalities 32.3%.Conclusions: The most common etiology for neonatal seizures was birth asphyxia followed by metabolic abnormalities in which hypoglycaemia was the most common type. A significant association of seizures due to meningitis and metabolic abnormalities was observed with pre-term gestation.
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Background: Recent reports indicated that the slope of the foveal depression influences the macular pigment (MP) spatial profile. MP has been shown to confer possible protection against age‑related macular degeneration (ARMD) because of its antioxidant properties. Aims: To study the configuration of foveal slope and the foveal thickness in fellow eyes of subjects with unilateral neovascular ARMD. Settings and design: Case‑control series. Materials and Methods: The study population consisted of 30 cases aged >50, who had unilateral choroidal neovascular membrane (CNVM) or disciform scar in the fellow eye and 29 controls aged >50, who had no sign of ARMD in the either eye. Using spectral‑domain optical coherence tomography, foveal thickness at different locations including the central subfield foveal thickness (CSFT) was noted. The foveal slopes were calculated in the six radial scans (between 0.25° and 1° retinal eccentricity) as well as the 3D scan. Results: Cases had a significantly higher CSFT when compared to controls (215.1 ± 36.19 μ vs. 193.0 ± 17.38 μ, P = 0.004). On the 3D scan, the cases had shallower superior (cases 1.32 ± 0.32 vs. controls 1.45 ± 0.13, P = 0.04) and temporal slopes (cases 1.27 ± 0.21 vs. controls 1.39 ± 0.12, P = 0.01) in comparison to the controls. Conclusions: We noted a shallower superior and temporal foveal slope and a higher CSFT in the fellow eyes of subjects with a unilateral neovascular ARMD. Prospective studies observing the development of CNVM in subjects with altered foveal slope might provide more information on this optical coherence tomography finding.
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Burn wound colonisation and infection is not only associated with delayed wound healing and scar formation; but may also lead to sepsisrelated mortality. A wide variety of microorganisms; like staphylococcus aureus; Pseudomonas aeruginosa; and Enterobacteriaceae-like Klebsiella pneumoniae and Escherichia coli; are involved. Resistance is generally increasing; with reports of multidrug-and pan-resistant isolates. This study was conducted to determine the common aerobic bacterial isolates in our setting and describe their antimicrobial susceptibility. This retrospective; descriptive study was carried out on 243 patients; from whom 312 burn wound specimens were received by the Nelson Mandela Academic Hospital microbiology laboratory of the National Health Laboratory Service; Mthatha. All samples were processed according to standard laboratory protocols; isolates were tabulated according to age and gender of the patients; and their percentage susceptibilities to relevant antibacterials were computed. A total of 229 patient specimens showed growth on culture. The total number of isolates was 629; out of which 269 were Gram-positive cocci and 360 were Gram-negative bacilli. The commonest organism was S. aureus (27.7); followed by K. pneumoniae (13.4); Proteus mirabilis (12.4); Group D streptococcus (9.4); P. aeruginosa (8.9) and E. coli (6.2). A generally high level of resistance was observed in many organisms. Methicillinresistant S. aureus accounted for 57.5 of the S. aureus. Resistance among the Gram-negative bacilli was; in general; least to imipenem; amikacin and ciprofloxacin. The common organisms causing burn wound infections in our setting include staphylococci; Klebsiella; Proteus and Pseudomonas and there is a high level of resistance against commonly used antimicrobials. Regular surveillance of burn wound organisms and their antimicrobial resistance patterns will help in determining empirical antibiotic therapy for subsequent related septic events
Subject(s)
Bacteria , Burns , Infections , Patients , Wound Healing/mortality , Wounds and InjuriesABSTRACT
An 11-year-old girl presented with acute onset of paraplegia with bowel and bladder incontinence. She had spinal tenderness and a sensory level at mid thoracic region. MRI spine revealed an intradural extramedullary arterio-venous malformation with hemorrhage into the intramedullary region. Hence a diagnosis of spinal arterio-venous malformation was entertained.