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Background: Several sick neonates require transfer to tertiary level care neonatal unit for treatment. The facilities of neonatal transport in India are not optimal and the newborn thus transported can become hypothermic, hypoxic and/or hypoglycemic which can affect the neonatal outcome. These parameters can be maintained during transport by adopting simple measures. The aim and objective of this study is to study impact of acute physiological parameters during transfer of neonates on their immediate outcome by using TOPS score. TOPS score - Temperature, Oxygenation, Perfusion (Assessed by capillary refill time), Blood sugar.Methods: This prospective observational study was conducted at the special newborn care unit, Civil Hospital, Ahmedabad enrolling 460 transported neonates. TOPS scoring for each neonate was done at admission, and then the parameters of the TOPS score were correlated with the outcome at 48 h of admission.Results: A total of 460 transported newborns were assessed, 47.8% newborns were hypothermic, 33.9% had poor perfusion, 27.8% were hypoxemic, and 22% were hypoglycemic. On correlating with the outcome, Hypoxemia and hypo perfusion had the highest sensitivity (92.2% and 57.3%, respectively) while hypoglycemia had the highest specificity (88%), for an adverse outcome.Conclusions: TOPS score is a useful and easy to use the method to assess the physiological status and predict early mortality in transported neonates.
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Introduction: Recent developments in mechanotherapy andchanges in concepts have reduced the need for extraction inseveral types of discrepancies.Case report: This case report explains a non-extractiontreatment in a patient with severe anterior crowding with theuse of a modified Hilger’s Pendulum appliance. The patientshowed unilateral half unit Class II molar relation on theleft. The appliance was modified to cater to the treatmentneeds and activation was done unilaterally to achieve thedesired results. Post distalization, fixed orthodontic treatmentwas initiated and crowding was relieved with levelling andaligning.Conclusion: An ideal overjet and overbite along withmaintenance of the pleasing profile was achieved at the endof the treatment