ABSTRACT
Background: Congenital hypothyroidism is one of the most common causes of mental retardation in pediatric age group. Screening for congenital hypothyroidism is one of most cost effective tools to prevent mental retardation among the general population. Umblical cord TSH estimation remains an easily available option for screening of congenital hypothyroidism. Aims and objectives was to estimate correlation between TSH obtained from cord blood TSH and heel prick TSH at 3rd day of life using blood spot. To estimate the predictability to rule out congenital hypothyroidism using cord blood spot TSH and to determine whether cord blood TSH can be advocated to screen congenital hypothyroidism.Methods: Prospective study conducted in department of Neonatology, IOG, Egmore after obtaining consent from parents. The study was carried out in two phases. First phase, to establish correlation between cord blood spot TSH and heel prick TSH and to establish median cutoff point of TSH .Second phase, to establish cord blood spot TSH as screening method.Results: The birth weights ranged between 2.5 to 4.3 kg. TSH values ranged from 2.0-33.3mlU/L. The mean value was 16.45mlU/L. A cutoff value of 20mlU/L was used for recall testing of complete thyroid profile (T3, T4 and TSH). Thirty six infants were recalled for repeating complete thyroid profile.Conclusions: Congenital hypothyroidism (CH) is the one of the most common preventable causes of mental retardation which can be detected by measuring cord blood TSH .Cord blood TSH can be advocated in national public health program as a routine so that all babies can be tested before discharge thereby minimising interventions for the baby.
ABSTRACT
Background: Human milk bank plays an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The aims and Objectives is to study the morbidity and mortality outcome' profile of babies fed with PDHM (pasteurized donor human milk) comparing data between Pre Human Milk Breast bank (2015) and Post Human Milk Breast bank (2016, 2017 and 2018).Methods: Milk bank collect, screen, store, process, and distribute human milk. Retrospective observational study was done in Department of Neonatology, Institute of Obstetrics and Gynaecology and Women and Children Hospital, Chennai. Data obtained retrospectively comparing data Pre HMB (2015) and Post HMB (2016, 2017 and 2018).Results: In this study authors collected the data comparing Pre human milk bank (Pre HMB) and Post human milk bank (Post HMB).' After starting human milk bank, around 1799 babies were benefitted and 14.45 lakh ml milk was collected from 16000 donor mothers in last 3 years. Bacterial contamination rate of PDHM has reduced to 4.39% (2018) compared to 7.73% (2016) with P Value 0.0042 (statistically significant). CONS and Staphylococcus aureus were the most common Organisms isolated. There was reduction in morbidity profile like sepsis rate, NEC/ Feed intolerance and ROP profile. Mortality profile also reduced to (7.73-9.31%). Duration of hospital and Duration to attain full feeds were improved all GA group babies.Conclusions: In this study, after starting human milk bank there was reduction in mortality, morbidity outcome, sepsis. Duration to attain full feeds' and duration of hospital stay reduced. We concluded that establishment of breast milk bank will be more useful and beneficial for all GA group babies for better outcome.