Clinical profile and outcome of respiratory distress in newborns admitted in rural tertiary health care centre of Maharashtra, India

Background: Respiratory distress is most common symptom complexes seen in newborn infants lead to high mortality. The objectives were to study various etiological factors, maternal and neonatal risk factors for development of respiratory distress along with need for CPAP, mechanical ventilation and surfactant to assess the immediate clinical outcome in newborns.Methods: The study was conducted at Krishna Hospital and Medical Research Centre, Karad in period of January to August 2018. A total of 100 neonates who were admitted in NICU within 72 hours of life were studied by clinical examination and relevant investigations. The severity of distress was assessed by Silverman-Anderson scoring, Downe's scoring and APGAR scoring respectively for neonates.Results: It was observed that max, 90% of the distress cases were of respiratory in origin and high severity of distress was observed among 27% newborns. The proportion of respiratory distress was higher, 51% in males and low APGAR score was reported in 14% cases. Among respiratory etiology of respiratory distress, high proportion was of TTNB 35.55%. The maternal and new born factors like maternal age >30 years (32%), gestational age 28-30 weeks (87.5%), gravid 2 and 3 mothers (35%), female gender (32.6%), low birth weight (70%) developed severe distress respectively. The recovery rate of respiratory distress due to respiratory etiology was of 88.8%.Conclusions: Transient tachypnoea of new-born is the most common cause among new-borns with respiratory distress. New-borns with low gestational age, low birth weight baby, low APGAR score is more prone to develop severe respiratory distress.

High-grade myxofibrosarcoma-presented as a large mass of right upper arm.

Myxofi brosarcoma is one of the rare soft tissue sarcomas. We present a case of a 65-year-old male having large soft tissue mass over right upper arm associated with surface ulceration. On histopathological study tumor was diagnosed as myxofi brosarcoma – high grade according to modifi ed FNCLCC grading system. Like many other tumors of connective tissue, soft tissue sarcoma exhibits high recurrence. In our case, tumor showed features of high grade with local recurrence, large size; however, no evidence of metastasis was noted. For this unpredictable clinical behavior, we are presenting this case.