Clinico-Etiological Profile and Outcome of Neonatal Respiratory Distress in Tertiary Care Hospital, Guntur

Introduction: Respiratory distress (RD) is a common causeof admission in the neonatal unit. Early recognition of RDand initiation of appropriate treatment is important to ensureoptimal outcomes. RD is one of the most common causes ofmorbidity in newborn. Aim of the present research was tostudy clinical profile of neonatal respiratory distress (RD),to find out most common etiology of respiratory distress innewborn and to assess the immediate clinical outcome of RDin our neonatal intensive care unit (NICU).Material and Methods: A prospective study was conductedat Tertiary Care Hospital, Guntur from May 2019 to October2019 and study includes 200 cases. Term, pre-term and postterm babies both in-born and out-born cases were included inthe study.Results: The study showed among the 720 newborns admittedin NICU, 200 (28 %) cases were admitted with Respiratorydistress. Of them, 116 babies (58%) were delivered vaginallyand 84 (42%) by lower segment caesarean section. There were122 (61%) pre-term babies, 68 (34%) term and 10 (5%) postterm neonates who were admitted with respiratory distress. Themajority of cases were clinically presented with tachypnea,flaring of alae nasi, and chest indrawing. The respiratorydistress resolved on the 4th day in majority of cases.Conclusion: Respiratory Distress is one of the commonestcause of NICU admissions. Transient tachypnea of thenewborn is the most common cause of respiratory distress interm babies whereas Hyaline membrane disease is common inpreterm babies. The survival rate was 90% among RD casesadmitted to NICU.

Quality of Sleep in Association with Relapse in Patients with Bipolar Affective Disorder

Introduction: Bipolar Affective Disorders is an episodic mooddisorder with significant global morbidity. Sleep deprivationin addition to being a core symptom and early warning sign ofimpending mood episodes can also trigger relapse. Individualswith Bipolar Affective Disorder in specific, differ in theirtendency for sleep loss to trigger relapse depending on theirsociodemographic and clinical factors.Current study objective was to evaluate the frequency andquality of sleep as a trigger for relapse of mood episode inpatients with bipolar affective disorders and to correlate itwith socio-demographic profile and clinical variables.Material and methods: This observational cross sectionalclinical study was conducted on 62 patients with ICD10diagnosis of bipolar affective disorders presenting with relapseof mood episode. Presence of acute sleep deprivation andchronic sleep insufficiency according to American academy ofsleep medicine criteria was considered. Young Mania RatingScale (YMRS) and Hamilton Depression Rating Scale (HAMD) were administered. Pittsburgh Sleep Quality Index (PSQI)Scale was used to assess quality of sleep. Written Informedconsents were taken from all the subjects. The data wasanalyzed with appropriate statistical methods.Results: Of the 62 patients assessed with diagnosis of bipolaraffective disorders presenting with mood episode, 58.1% havepoor quality of sleep and 41.9% have good quality of sleep.No statistically significant association noted in any domains ofsocio demographic profile. Statistically significant associationis noted with triggers in the present episode of relapse with94.4% of individual were noted to have sleep deprivation(p<0.001). 52.8% individuals with current episode manic,16.7% with depression, 27.8% with hypomania and 2.8% withcurrent episode mixed is noted to have poor quality of sleepand statistically significant association is noted with polarityof current episode. No statistically significant associationnoted between quality of sleep with other clinical variables.Conclusion:Poor quality of sleep may trigger relapse ofmood episode in patients with bipolar affective disorders.Our finding substantiates the need for careful assessment andmanagement of sleep disturbances during maintenance phasefor bipolar disorders

Etiological Evaluation of Convulsions in Children between 1 Month to 5 Years of Age in Tertiary Care Hospital, Guntur.

Introduction: Seizure is a common problem evaluated inpediatric emergency department. The different causes ofseizures are febrile seizures, CNS infections, metabolic,developmental defects, traumatic brain injury, vascularaccidents, brain tumors and idiopathic or epilepsy. Currentresearch aimed to study the etiology of convulsions in childrenbetween 1 month to 5 years of age admitted in pediatricward, Government General Hospital, Guntur. To assess thecommon incidence of convulsions in children of age 1 to 5years admitted to pediatric ward, Department of Pediatrics,Government General Hospital, Guntur.Material and methods: Our study was retrospective,descriptive study. 100 cases admitted to pediatric ward,Government General Hospital, Guntur with convulsions in theage group of 1 month to 5 years during the period of July 2018and April 2019. Study was done by detailed history, throughphysical examination and relevant investigations includingcomplete blood counts, serum electrolytes, serum glucose,serum calcium, CSF analysis, EEG and neuroimaging (CT/MRI brain) studies. Variables recorded were demographics,clinical presentation, laboratory investigations, EEG andneuroimaging.Results: The most common cause of seizures in our study wasfebrile seizures (32%). About 24% cases were due to epilepsy(idiopathic or unprovoked) and 33% cases were symptomaticseizures of various causes like CNS infection, metabolic,traumatic, vascular etc.Remaining 11% were due to othermiscellaneous causes.Conclusion: This was the hospital based retrospective,descriptive study to know the etiology of convulsions inchildren between 1 month to 5 years. Convulsions in childrencan be due to various underlying pathology. In our study mostcommon cause of convulsions was febrile seizures, followedby epilepsy and symptomatic seizures of infective etiology ofCNS, viral encephalitis being the most common.

Knowledge, attitudes and practices of adolescent school girls regarding prevention of iron deficiency anaemia

Background: Anaemia is very prevalent in adolescent girls, especially in developing countries like India. Treatment of anaemia based on the cause during adolescence decreases morbidity and mortality during early pregnancy. Despite weekly iron and folic acid supplementation programmes, the prevalence of anaemia among women and adolescent girls is still high. The objective of the study was to assess the proportion of anaemia and its determinants among adolescent school girls.Methods: An observational study was conducted in adolescent school girls of Chandragiri from January to March, 2018. Demographic data, knowledge and practices of personal hygiene were collected. Nutritional status was assessed by collecting anthropometric, body composition measurements, dietary habits and haemoglobin was estimated.Results: Of the 111 girls studied, 55.9% were found to be anaemic. Knowledge and practices of personal hygiene was lower in anaemic girls compared to non-anaemic girls. The extent of deficit of iron rich food consumption was low in both anaemic and non-anaemic girls.Conclusions: Prevalence of mild anaemia was high and iron rich foods intake was low in our study subjects. Assessment of burden of anaemia among adolescent girls is essential to address gaps in implementation of public health programs and effective intervention programs can be designed to reduce the burden of anaemia.

Neuropsychiatric manifestations in patient with normal pressure hydrocephalus improved with therapeutic lumbar tapping

Normal pressure hydrocephalus is a communicating hydrocephalus without evident obstruction of the normal pathway of CSF flow. Normal-pressure hydrocephalus is a common cause of reversible dementia and it can also present with various psychiatric symptoms. A 76-year old man was brought to psychiatry OPD with history suggestive of decreased need for sleep for 8 days, disinhibited behaviour, increased libido, increased activity and increased talk for 4 days. On examination patient was noticed to be having increased psychomotor activity with increased talk, mood reported to be happy with elated affect, no content or perceptual disturbances were elicited. Cognitive functions were within normal limits. Personal and social judgement was impaired with grade 0 insight. General physical and systematic examinations were within normal limits. MRI reports showed ventricular enlargement suggestive of normal pressure hydrocephalus. Patient underwent diagnostic and therapeutic lumbar tapping. There was significant improvement in patient’s behavioural symptoms following therapeutic lumbar tapping. Therapeutic lumbar tapping in this case of normal pressure hydrocephalus was effective in the management of manic symptoms. Early identification of organic cause in late onset psychiatric disorders is necessary. Prompt intervention of the organic cause was effective in the management of manic symptoms.

Evaluation of postoperative complications of open reduction and internal fixation in the management of mandibular fractures: A retrospective study

Background: Mandible is one of the most prominent bones of the facial skeleton leading to high prevalence of fracture during facial trauma. The management of mandibular fractures has evolved from intermaxillary fixation (IMF) to a combination of IMF and wire osteosynthesis, lag screw, and plate fixation. Despite the evolution in techniques, no technique including open reduction and internal fixation (ORIF) has proven to be completely devoid of complications. However, ORIF has many advantages and has resulted in better outcome when compared with the closed reduction methods. Aim: The aim of this retrospective study is to assess the incidence of postoperative complications in 98 patients treated with ORIF for mandibular fractures. Materials and Methods: A sample size of 98 patients with mandibular fractures reporting to Saveetha Dental College and Hospital, Chennai, from January 2014 to November 2016, treated by ORIF was included in the study and was split into three groups. The patient's records were analyzed for deriving the number and type of complications that occurred during the postoperative period of ORIF. Results: Patients with fractures in the condyle region reported with the highest number of complications when compared to the angle and parasymphysis regions. The most common complications that the patients reported were infection that led to plate removal and paresthesia. Others were wound dehiscence, occlusal disturbances, and facial nerve paralysis which were less common. Conclusion: The most common postoperative complication of the procedure in this retrospective study was found to be infection of the plates that are preventable with better aseptic techniques.

Penicillin induced toxic epidermal necrolysis with secondary impetiginization: a rare case.

Drug induced allergic reactions can be categorized into IgE-mediated and non-IgE mediated hypersensitivity reactions. Symptoms of IgE-mediated reactions are angioedema, bronchospasm, anaphylaxis, and urticaria that appears within 72 hours and those which are Non-IgE mediated hypersensitivity reactions include morbilliform eruptions, interstitial nephritis, hemolytic anemia, serum sickness, thrombocytopenia, and erythema multiforme, after 72 hours. TEN is defined as an extensive detachment of full-thickness epidermis most often related to an adverse drug reaction. We report a rare case of penicillin induced toxic epidermal necrolysis with Secondary Impetigination in a 38-year-old male patient with complaints of rashes all over the body, chest pain and dry tongue since seven days. Based on history and clinical examination patient was diagnosed as of penicillin induced toxic epidermal necrolysis with secondary impetigination and was successfully treated with antihistamines, parenteral antibiotics and corticosteroids.