ABSTRACT
Introduction: Birth asphyxia is a leading cause of neonatal deaths across the globe. Clinical examination, Apgar score, pH, EEG/aEEG, Lactate are being used as markers for prediction of outcome. Serum Lactate is a better reflector of metabolic mechanism. We intend to study cord blood lactate and serial lactate levels in term birth asphyxia babies. Aim: To determine correlation between cord blood lactate, serial lactate levels and short term outcome in term new-born babies with perinatal asphyxia. Materials and Methods: It was a prospective, observational study. Thirty term babies with birth asphyxia were selected. Their Cord blood lactate, serum lactate at 6, 12, 24 hours of life were correlated to short term outcomes (NICU stay, shock, Acute kidney injury, mortality). Results: Eighteen babies with moderate asphyxia and 12 with severe asphyxia had mean cord blood lactate of 10.4mmol/L and 13.47mmol/L respectively. There was difference in mean lactate levels at 6, 12, 24 hours of life between the babies who survived and expired; also survivors had significant reduction in mean lactate levels at various time points. Babies with moderate asphyxia had no shock and AKI. Babies with severe asphyxia and shock had mean lactate levels of 12mmol/L in survivors and 13.8mmol/L in who expired. Babies with severe asphyxia and AKI had mean lactate of 14mmol/L in survivors and 14.6mmol/L in who expired. Babies with moderate asphyxia had no mortality. In babies with severe asphyxia, survivors had mean lactate of 12.74mmol/L and 14mmol/L in babies who expired. There was no correlation between the lactate levels and the length of the NICU stay. Conclusion: Serial lactate levels can be used to predictor the short term prognosis in term babies with perinatal asphyxia. There was significant difference in mean lactate levels between the babies who survived and expired. Serial lactate levels showed significant reduction in babies who survived.
ABSTRACT
Background: Cutaneous Adverse Drug Reaction (CADR) is considered as one of the reasons for discontinuation of drug as well as medication non-adherence. This study analyses the common drugs causing CADR, clinical spectrum of different types of CADR, causality and drugs causing severe CADR.Methods: This was a retrospective cross-sectional observational study conducted by the Department of Pharmacology, Coimbatore Medical College, Coimbatore, Tamil Nadu, India. The study was conducted using data collected in CDSCO’s ADR reporting forms with CADR from June 2015 to July 2017. Patient’s information, details related to adverse drug reaction, suspected medication details, concomitant medication history, causality and seriousness were recorded.Results: A total of 102 CADR were evaluated in this study. The mean age of sample was 37.21±20.33 years. Maximum number of cases was in the age group of 40-49 years. Male to female ratio was 0.96:1. The commonly incriminated drugs causing CADR were antimicrobial agents. Ciprofloxacin (21.57%), phenytoin (9.8%), diclofenac sodium (6.86%), anti-snake venom (6.86%) and vancomycin (3.92%) were the common drugs implicated in CADR. Maculopapular rash and itching were the most common CADR. Anticonvulsants especially phenytoin was commonly associated with severe CADR.Conclusions: The present study has made an impact on all departments of this institution and awareness has been created about spontaneous reporting of all adverse drug reactions in CDSCO ADR reporting forms to the pharmacovigilance centres. Thus, sound knowledge about the adverse drug reactions may decrease the occurrence of drug induced morbidity and mortality.