Assessment of gestational age using anthropometric parameters in newborns

Background: Estimation of gestational age was needed for the measurement of intrauterine growth and associated conditions, such as whether infants with a low birth weight are preterm or growth-retarded, and identifying high-risk status for developmental delay. Menstrual history was unreliable in most of the cases and ultrasound was not feasible in low resource area, so in this study we were used anthropometric measurements as a simple tool for assessment of gestational age.Methods: This study was a cross sectional observational study conducted in 380 babies born in January 2020-December 2022 in department of pediatrics, Rajah Muthiah Medical College and Hospital. The data were collected using semi-structured questionnaire and anthropometric assessment. The Epi info 7 software was used to analyse the data.Results: The mean gestational age among neonates studied was 37.06±2.32 weeks, the mean head circumference was 33.48±1.01 cm and majority of them 141 babies had head circumference 33 cm, the mean chest circumference was 30.69±1.08 cm. and majority of the babies, had chest circumference of 30 cm, the mean foot length was 7.64±0.24 cm, the mean length of the babies was 47.9±1.26 cm.Conclusions: Our study conclude that anthropometeric parameters in combination (head, chest circumference, length, foot length, birth weight) and as single parameters (foot length) was a simple and easy tool for assessing gestational age in low resource setting where we can make quick referral.

Electrolyte abnormalities and type of feeding in acute diarrhoea in children upto five years

Background: Children in infancy are protected against diarrhoea by breastfeeding as suggested by many studies. Failure to exclusively breastfeed and early introduction of complementary feeds in children predispose to several diseases especially diarrhoea. This study was mainly aimed at analysing electrolyte abnormalities in children with diarrhoea in relation to their type of feeding.Methods: Around 100 children under five years of age with acute diarrhoea presenting to paediatrics department were enrolled in the study after meeting the inclusion criteria. The electrolyte abnormalities, glucose level, renal parameters, severity of dehydration and type of feeding of the children were recorded. The incidence of electrolyte abnormalities in diarrhoea in the children and their type of feeding were analysed.Results: Participants had hyperkalaemia which was 30%, followed by 19% had hyponatremia, 13% had hypokalaemia, 12% had hypernatremia and 1% had hyperchloremia. 38% had no dehydration, 8% had severe dehydration and 54% had some dehydration. 49% of the children followed breast feeding, 16% followed formula feeding, 14% were taken cow’s milk and 21% were followed mixed feeding. There was no statistically significant relationship between electrolyte abnormalities and type of feeding except for hypokalemia.Conclusions: Except with hypokalaemia, our study did not find a statistically significant relationship between electrolyte abnormalities in diarrhoea in children with type of feeding. But still, need for exclusive breastfeeding, continuation breast feeding more than two years remains protective against acute diarrhoea in children.

Serum zinc levels in children aged two months to five years in hospitalized children with pneumonia

Background: Pneumonia is the infection of the lung parenchyma which is one the leading cause of morbidity and mortality among under five age group. The prime aim of this study is to identify the severity and to supplement the children with factors that reduce the mortality caused by pneumonia, zinc being one of the major factors in the immune defense mechanism in reducing the severity and mortality. Our study estimates the amount of zinc in severe pneumonia child thereby to arrive at a rationale to supplement zinc among Pneumonia children to reduce the course of illness. The core objective of this study is to compare serum zinc level in children with severe pneumonia among different age and sex.Methods: A prospective case-control study was carried out with 50 cases and 50 controls in age group of 2 months to 5 years admitted in Government Cuddalore Medical College, Chidambaram. The study period ranges from December 2020 to December 2022. The cases are identified as per history thorough clinical examination and radiological evidence based on IMNCI criteria. All the children in both case and control group were subjected to serum-zinc level analysis after obtaining informed consent from the Parents. Zinc level in both groups were compared and analyzed. Statistical package for the social sciences (SPSS) version-16 was used as a statistical tool. Ethical clearance has been obtained.Results: The mean serum zinc level in children admitted with pneumonia is 55.126 and the mean serum zinc level in controlled growth is 78.803. Zinc level is significantly lower in children with pneumonia.Conclusions: The estimated mean serum zinc levels in pneumonia group children confirms that there is a relative zinc deficiency in children with pneumonia and may play a role in the severity progression. Our study supports the need for zinc supplementation in pneumonia children to boost their immune defense mechanism which in turn reduces the severity and the progression of pneumonia. It tends to curtail the case fatality rate of pneumonia.

Cranial ultrasound findings in asphyxiated term neonates and their correlation clinically with hypoxic ischemic encephalopathy staging

Background: The survival of asphyxiated neonates has significantly increased in recent years because of numerous advancements in contemporary neonatal intensive care. The most popular and easily repeatable imaging method for the neonatal brain, the neurosonogram can demonstrate the most common types of cerebral injury in preterms and term infants. This study aims to analyse the value of cranial ultrasonography as an investigative tool for birth asphyxia babies (>34 weeks) will be evaluated to learn the morphology of various cerebral lesions and to compare clinical findings with neurosonogram results.Methods: An observational study was conducted in 75 neonates (>34 weeks) admitted in Government Cuddalore medical college with birth asphyxia. A detailed history and clinical examination was carried out according to the designed proforma. All the babies in the study group were subjected to cranial ultrasound and the morphology of findings studied. CUS findings were correlated clinically.Results: Among babies with HIE stage I, 89.7% had normal Cranial Ultrasound Findings, and 10.3% had abnormal findings. 43.3% babies had abnormal Cranial ultrasound findings in HIE stage II, and 70% had abnormal findings in HIE stage 3.Conclusions: Cerebral oedema was the commonest neurosonogram finding in Asphyxiated babies and HIE 3 had the maximum abnormal findings in our study. Since there is a positive correlation between the severity of hypoxic ischemic encephalopathy and cranial ultrasound findings, USG cranium can be performed as a screening tool in all neonates with birth asphyxia in whom additional investigations could not be performed.

A STUDY OF EXECUTIVE FUNCTIONS IN RIGHT HEMISPHERIC STROKES

Introduction: Stroke is a leading cause of disability worldwide. Cognitive functions and, in particular, executive function is commonly affected after stroke, leading to impairment in daily activities. Previous studies have shown confiicting evidence regarding the incidence of executive dysfunction in patients with right or left hemispheric strokes. Few studies have shown that executive dysfunction is more prevalent in right hemispheric strokes. Aims and Objectives: 1. To study the executive dysfunction in patients with Right Hemispheric strokes. 2. To compare the impairment of executive functions with the Vascular territory involved Methods: This was a prospective observational study which included 100 patients admitted to a tertiary care center from January 2021 to August 2021. After Institutional EC clearance, patients with Right-Hemispheric ischemic stroke on neuro-imaging (CT or MRI) were included in the study. Demographic data, clinical history, neurological examination and etiological workup like echocardigraphy, carotid and vertebral artery doppler, CT/MR angiography were performed. Executive function was tested clinically using go-no-go test, digit-span test, trail making test, N-back test, Rey-osterreith complex ?gure test and clock drawing test. Data was entered to a pre-formatted data sheet and analysed. Results: The mean age of the included patients was 58.76years, 54 patients were male, Sixty-nine patients had anterior circulation stroke, 31 had posterior circulation stroke. Forty three patients had executive dysfunction as evidenced by abnormal go-no-go test (n=22), digit-span test(n=35), trail making test(n=10), N-back test(n=23), Rey-osterreith complex figure test(n=38) and clock drawing test(n=29). Executive dysfunction was more prevalent in anterior circulation strokes (n=37) as compared to posterior circulation strokes (n=6) (p=0.001) Executive dysfunction Conclusion: was a common finding in patients with right hemispheric stroke and was significantly higher in patients with anterior circulation strokes

​Efficacy Of Early N-Acetylcysteine In Rat Killer Paste Poisoning

Introduction: Rat killer paste (yellow phosphorous) is one of the most common forms of poisoning in South India. It causeshepatotoxicity. No specific antidote has been found. Recently, N-acetylcysteine is used as supportive therapy in many casesof acute liver failure.Aim: This study aims to evaluate the effectiveness of early N-acetylcysteine in preventing the rat killer paste poisoning.Methods: Patients who ingested rat killer paste poison and age >12 years were included in the study. Patients having jaundice,liver disease, and age <12 years were excluded from the study.Results: Among 30 patients studied, five patients died, seven patients developed hepatitis, one patient developed acute kidneyinjury with hepatitis, and one patient developed hyponatremia.Conclusion: Early initiation of N-acetylcysteine had a significant impact in reducing mortality.