Oral Sucrose for Pain in Neonates During Echocardiography: A Randomized Controlled Trial.

Objectives: To test the efficacy of oral sucrose in reducing pain/ stress during echocardiography as estimated by Premature Infant Pain Profile score. Design: Double-blind, parallel-group, randomized control trial. Setting: Tertiary-care neonatal care unit located in Western India. Participants: Neonates with established enteral feeding, not on any respiratory support and with gestational age between 32 and 42 weeks requiring echocardiography. Interventions: Neonates in intervention group received oral sucrose prior to echocardiography. Main outcome measures: Assessment was done using Premature Infant Pain Profile score. Results: There were 104 examinations; 52 in each group. Baseline characteristics like mean gestational age (37.6 vs. 37.1), birth weight (2.20 vs. 2.08), and feeding status (Breastfeeding- 59.6% vs. 44.2%, paladai feeding- 13.5% vs. 13.5%, and gavage feeding- 26.9% vs. 42.3%) were comparable. The mean (SD) premature infant pain profile score was significantly higher in control group [(7.4 (3.78) vs. 5.2 (1.92), P <0.001]. Conclusion: Oral sucrose significantly reduces pain, and is safe to administer to neonates.

Arterial Blood Pressure is Inversely Associated with Vascular Sympathetic Reactivity l(sometric Handgrip Exercise) in Gujarati Indian Adolescents.

Studies conducted earlier have found that vascular sympathetic reactivity to isometric handgrip exercise is either low or high in adolescents with higher blood pressure (Hypertensives) as compared to adolescents with relatively lower blood pressure (Normotensive). The current study was conducted to determine the correlation of vascular sympathetic reactivity to isometric handgrip exercise with blood pressure in Gujarati Indian adolescents so as to understand the pathogenesis and/consequences of Hypertension in this population. A cross-sectional study was conducted on 651 Gujarati Indian adolescents (285 girls, 366 boys) of age group 13-19 years. Blood pressure was measured by oscillometry and vascular sympathetic reactivity (Percentage rise in Diastolic Blood Pressure, %RDBP) was assessed using isometric handgrip test. Pearson’s correlation coefficient was determined to study the correlation between %RDBP and blood pressure. In both girls and boys, %RDBP showed significant negative correlation with resting SBP, DBP and MAP. The study thus indicates that an inverse association exist between arterial blood pressure and vascular sympathetic reactivity to isometric handgrip exercise in Gujarati Indian adolescents.

Newborn Care Practices and Health Seeking Behavior in Urban Slums and Villages of Anand, Gujarat.

Health status of neonates in urban slums has not been studied in smaller towns. A questionnaire was administered to 154 families of 10 urban slums of Anand (population - 197351) and 160 families from 6 villages of Anand district. The socioeconomic and education status of the slum dwellers versus rural participants were significantly lower (P<0.001). Antenatal care (79.9 vs 94.4%, P<0.001), hospital delivery (82.5 vs 93.8%, P=0.002), neonatal follow-up (27.9 vs 78.8%, P<0.001), health seeking (56.5 vs 91.3%, P<0.001), essential newborn care and exclusive breastfeeding (6.5 vs 85.6%, P<0.001) were also lower in urban slums, as compared to villages, Care seeking was low in urban slums, Hindus and illiterate mothers. Health care and socioeconomic status of neonates in slums of smaller cities is poorer than in surrounding villages.