ABSTRACT
Background: Neonatal health remains a thrust area of public health, and an increased out-of-pocket expenditure (OOPE) may hamper efforts toward universal health coverage. Public spending on health remains low and insurance schemes few, thereby forcing impoverishment upon individuals already close to poverty line. Objective: To determine catastrophic health expenditure (CHE) in neonates admitted to the government neonatal intensive care unit (NICU) and factors associated with of out-of-pocket expenditure. Methods: This cross-sectional study was conducted in a governmental NICU at Agra from May 2017 to April 2018. A sample of 450 neonatal admissions was studied. Respondents were interviewed for required data. OOPE included costs at NICU, intervening health facilities, and transport as well. SPSS version (23.0 Trial) and Epi Info were used for analysis. Results: Of the 450 neonates analyzed, the median total OOPE was Rs. 3000. CHE was found among 55.8% of cases with 22% spending more than their household monthly income. On binary logistic regression, a higher total OOPE of Rs. 3000 or more was found to be significantly associated with higher odds of residing outside Agra (adjusted odds ratio [AOR] = 1.829), delay in first cry (AOR = 1.623), referral points ?3 (AOR = 3.449), private sector as first referral (AOR = 2.476), and when treatment was accorded during transport (AOR = 1.972). Conclusions: OOPE on neonates amounts to a substantial figure and is more than the country average. This needs to be addressed sufficiently and comprehensively through government schemes, private enterprises, and public杙rivate partnerships.
ABSTRACT
Background: As per the Child Mortality Report 2018 by UNICEF the current neonatal mortality rate in India stands at 24 per 1000 live births with it being more than the national average for Uttar Pradesh. The neonatal morbidity and outcome pattern in terms of discharge or otherwise shows considerable national, state, district and sub- district variations due to a multitude of diverse factors contributing to it at various levels. Aim & Objective: The aim of the study was to explore the mortality rate and outcome in NICU setting, and factors influencing the outcomes. Methods and Material: This government NICU based follow-up study comprised of data analysed from 450 neonates through a semi-structured questionnaire using face to face interview technique. Data was evaluated in SPSS and; independent t test and chi square test were applied. Statistical analysis used: Data was evaluated in SPSS and; independent t test and chi square test were applied. Results: For morbidity low birth weight (LBW) (14.4%) and for mortality LBW/prematurity (56%) were the most common causes. The discharge rate was 64.4%. Good outcome in the form of successful discharge was statistically significant with birth weight (p=0.000), gestational age (0.001), length of stay at NICU (p=0.003) male sex (p=0.003) and feeding of newborn (p=0.002) Conclusions: The study enunciates a high discharge rate in tertiary care government NICU with a mixed morbidity and mortality profile. The causes are mainly preventable and hence can be largely mitigated through dedicated ante natal, intra natal and post-natal care.
ABSTRACT
We report a young girl who presented to us with chest discomfort and had a paracardiac mass on chest radiograph. Computerised tomographic (CT) scan of the thorax was suggestive of pericardial cyst. Hydatid serology was negative. The cyst was excised.
Subject(s)
Adolescent , Diagnosis, Differential , Echinococcosis, Pulmonary/diagnosis , Female , Humans , Mediastinal Cyst/diagnosisABSTRACT
Drug induced acute parotitis is a very uncommon complication reported with a few drugs only. There is no case of acute bilateral parotitis reported previously with i.v. enalaprilat. We present here a female patient who developed acute bilateral parotitis within minutes of i.v. enalaprilat injection and recovered within 24 hours of stopping the drug and with symptomatic treatment.