ABSTRACT
Background: Just about three decades ago (1976) congenital malformations comprised 8% of perinatal deaths, from available data and ranked fifth as a cause of perinatal mortality. But the trend is rapidly changing over the years. perinatal death was due to congenital malformation, is the second commonest cause. This changing trend over years warns us that with the control of nutritional and infectious diseases, congenital malformations will come to the forefront as it is in India. To find out the incidence of congenital anomalies in stillbirth. And the probable etiology of congenital anomalies.Methods: The study was conducted at Government Mohan Kumaramangalam Medical College Hospital, Salem in the year 2017 August- September 2018. Totally 5000 babies born of consecutive deliveries were taken for the study, over the period of one year. All mothers were interrogated within 48 Hours of delivery as per the proforma prepared, which contains the following particulars like, maternal and paternal age, consanguinity, detailed antenatal history with reference to exposure to teratogens, especially during 1st Trimester.Results: Of the five thousand consecutive deliveries 48 deliveries were multiple delivers and a number of stillbirths were 108. The incidence of congenital anomalies was 30.4 per 1000 live birth (152 cases). Major malformations were present in 20.8 per 1000 (104 cases) while minor malformations were 9.6 per 1000 (48 cases).Conclusions: Incidence of malformation were higher in preterm babies 6.31%. Incidence of malformations were higher in male babies, especially genitourinary system anomalies. Antenatal events in the 1st trimester like fever, drug intake could be implicated in the etiology of malformations especially neural tube defects in our study.
ABSTRACT
Background: Children born to Human immunodeficiency virus (HIV) positive parents who are not infected with tuberculosis (TB) themselves, are also at higher risk of acquiring TB because of exposure. The source of transmission of TB to a child is usually an adult with sputum-smear positive PTB. To evaluate the clinical, bacteriological and radiological pattern of TB in HIV seropositive children in correlation with CD4 count.Methods: This study was conducted over a period of 12 months from May 2008- April 2009 at GMKMCH Salem. 100 children screened positive for HIV at voluntary counselling and testing centers (VCTC) in Antiretroviral therapy (ART) center and diagnosed to have TB infection as per Revised national tuberculosis control programme (RNTCP) guidelines.Results: Out of the 100 children with HIV and TB infection 62 were males and 38 were females. The ratio was 1.63:1. The sputum positivity in our study shows that only 9% of the children are sputum positive. Sputum culture for M. Tuberculosis remains the gold standard for the diagnosis of Pulmonary TB. In resource-poor countries, the diagnosis is heavily dependent on the sputum AFB smear. In our study CD4 cell count, less than 300 was observed in 33 children. In these children the predominant X-ray lesions were Hilar adenopathy, lower lobe infiltrations, diffuse infiltrates and miliary mottling. Upper lobe infiltrates was common with higher CD4 count mean 350.Conclusions: With the conventional sputum positivity and Tuberculin test not providing an adequate diagnostic help, familiarity with clinical radiological spectrum of TB and HIV co-infection will help in early diagnosis and improve survival among HIV seropositive children.