ABSTRACT
Background: Hyperbilirubinemia in neonates is considered to be one of the common phenomena which generally occurs during the first week of life and usually leads to NICU admission in both term and preterm new-born babies. It is also regarded as one of the most common causes which leads to neonatal morbidity and mortality.Methods: A total of 100 neonates along with their mothers were enrolled in the study from time period between 2018 to March 2019. Newborns were assessed daily for the jaundice and serum bilirubin levels were done. Various fetal-maternal factors included in proforma were. analysed to find out the association of feto-maternal factors in the occurrence of significant neonatal hyperbilirubinemia. Two groups, group A <15.7 mg/dl and group B>=15.7 mg/dl were taken. For data analysis chi square test is applied and p-value is calculated.Results: Statistically significant association between total serum bilirubin with neonatal factors like birth weight (p<0.014), maturity (p<0.011), period of gestation (p<0.003), and heart rate abnormality (p<0.005) and maternal factors like age in years (p<0.05), oral contraceptive pills use (p<0.005), and anti-epileptics use (p<0.034) were found to be linked to neonatal hyperbilirubinemia.Conclusions: Neonatal jaundice should be considered as the main policy in all health care settings of the country. Therefore, identification of factors affecting the incidence of jaundice can be effective in preventing susceptible predisposing factors in new-borns and high-risk mothers.
ABSTRACT
Background: Prematurity is the most important cause of mortality in Under-5 children responsible for one million deaths/ year. Premature babies are not able to store enough nutrients for their optimal survival; it is essential to provide them total parenteral nutrition. Intravenous lipid infusion in neonates is linked with high risk of sepsis and thrombocytopenia. PN with amino acids and glucose can be imparted to achieve nutritional goal. This trial was intended to assess the effects of various components of amino acid PN on postnatal growth in VLBW and ELBW newborns.Methods: A prospective observational study was conducted from January 2018 - May 2019 in NICU of TMMC and RC which included preterm newborns with birth weight of less than 1500gms who received aminoven infusion. Anthropometric measurements, incidence of hypo/hypercalcaemia, hypo/hyperglycaemia, direct hyperbilirubinemia, incidence of sepsis were evaluated.Results: Out of 22 patients, 12 neonates received high dose aminoven therapy whereas 10 neonates received low dose aminoven therapy. It was seen that rapid rate of increment of amino acids had adequate weight on discharge, 72.72% have adequate growth among the rapid group compared to 36.36% among slower group. No significant changes in calcium metabolism or glucose metabolism were seen in both the groups.Conclusions: In resource limited settings, parenteral nutrition with intravenous amino acids have a better effect on the weight of preterm newborns at discharge when high doses of amino acids infusion started early with rapid increment in the dose.
ABSTRACT
Background: It is important to know an infant’s gestational age because its behaviour and anticipated problems can be predicted on this basis. It is also important for prediction of morbidity, mortality and further management. Methods: Study was done for two years.254 newborns delivered at MYH hospital and admitted in MYH and CNBC nursery were studied. Their gestational age ranged from 27 to 42 weeks. Results: Gestational age and foot length also showed a positive correlation with a correlation coefficient of 0.99. Both AGA and SGA babies showed positive correlation of gestational age with foot length with correlation coefficient of 0.99 and 0.99 respectively. Conclusions: Foot length of 73.7 mm can be used as a cut- off point for differentiating between term and preterm babies. Foot length measurements can be easily used by peripheral health workers to differentiate between term and preterm babies. They can be used at remote places by peripheral health workers.
ABSTRACT
Background: Typhoid fever is a systemic infection caused by Gram-negative bacterium Salmonella enterica serovar typhi (S. typhi). It is a major health problem in India. It carries significant morbidity and mortality. Antimicrobial therapy is critical for the management of typhoid fever. Emergence of multidrug-resistant (MDR) and nalidixic acid-resistant (NAR) strains of S. typhi has complicated therapy by limiting treatment options. Hence, this study was conducted to evaluate the efficacy and safety profile of ceftriaxone and azithromycin combination therapy in uncomplicated typhoid fever. Methods: Adults patients of blood culture proven uncomplicated typhoid fever admitted in the medicine ward of Teerthanker Mahaveer Medical College and Research Centre were treated with ceftriaxone intravenously (2 g daily for 14 days) and azithromycin orally (500 mg daily for 7 days). Patients were clinically and bacteriologically evaluated during the study period and follow-up. Results: 96% cure rate was observed. No relapse was recorded. Conclusion: Ceftriaxone-azithromycin combination may be considered as an empirical therapy for treatment of uncomplicated typhoid fever in view of the emergence of MDR and NAR strains of S. typhi.