Comparison of Pain Response to Venepuncture Versus Heel Lance Blood Sampling in Term Neonates.

Introduction: Pain in neonates is largely underestimated and neglected. Pain experience can alter clinical outcome, brain development and subsequent behavior in newborns. Numerous newborns undergo blood sampling routinely in nurseries/NICUs and these procedures are often done without pain relieving measures. Heel lancing and venepuncture are two common procedures for blood sampling in neonates. The objective of this study was to compare pain response to venepuncture versus heel lance in full term neonates. Materials and Methods: A comparative observational study was conducted among 200 term neonates who were undergoing blood sampling for bilirubin or glucose estimation. Neonates were randomly assigned to heel lance (HL) and venepuncture (VP) groups with 100 babies in each group. During the procedure, pain was assessed by Neonatal/Infant pain Scale (NIPS). Heart rate (HR) and oxygen saturation (SpO2) were continuously monitored 5 minutes prior to procedure and upto 5 minutes after the procedure. Results: The median NIPS score in HL and VP were 7 and 3.5 respectively which showed statistically significant (p= 0.0001) higher level of pain experience in HL than in VP. During the procedure, both the groups (HL and VP) showed significant changes in heart rate and oxygen saturation i.e., increase in HR (p= 0.0001) and decrease in SpO2 (p= 0.0001), however the increase in heart rate and decrease in oxygen saturation were significantly more in HL than in VP (p= 0.0001). Conclusion: Neonates perceive pain as demonstrated by Neonatal Pain Scale and venepuncture is the less painful procedure than heel lancing for blood sampling in neonates.

Prospective evaluation of contracted sockets.

AIMS: To establish a correct method of evaluation and management of contracted sockets RESULTS: Anopthalmic socket were frequently seen in orbit and Oculoplasty clinic of Aravind Eye Hospital, Madurai, South India. Prospective evaluation of Anophthalmic Sockets was done in this study. Anophthalmic Socket which can not support prosthetic eye is called contracted socket.4,5,14. These sockets were graded as congenital and acquired, which were managed using single, combined and multiple procedures. Surgical outcome of each case were analyzed.

Analysis of corneal injuries in King Mahendra Memorial Eye Hospital Bharatpur, Chitwan.

OBJECTIVE: To determine the corneal injuries pattern. MATERIAL AND METHOD: It is a retrospective hospital based analysis of 5504 corneal injuries among the 111781 patients attending King Mahendra Memorial Eye Hospital over a period of 4 years in order to know the lesions pattern for planning purpose. RESULTS: Among the corneal lesions, 59.7% were traumatic and 40.3% were non traumatic lesions, wood stick was the commonest traumatic agent (28.7%), 24.1% cases reported in hospital within 7 days of injury. Corneal ulcer was the most commonest traumatic lesions (48.2%). Clinically 69.2% cases were of bacterial lesions. 71.4% cases underwent medical treatment. 54.24% had good vision after treatment 1,2,3,5. CONCLUSION: Early treatment with antibiotic drops in a case of corneal injuries restores good vision. Protective glasses while working are the preventive measure against traumatic lesions.

Comparative bacterial study of oral rehydration solution (ORS) prepared in plain unboiled and boiled drinking water of Kathmandu valley.

Result of bacterial study on Oral Rehydration Solution (ORS) prepared in plain unboiled and boiled drinking water of Kathmandu valley is reported. Of the total 100 water samples collected from different sources and area all the samples, as a base line study, were subjected for the examination of bacterial presence. Eighty eight percent of the water samples studied were found to be unsatisfactory for drinking. Thirty five percent of the ORS prepared in unboiled water and kept for 24 hours at room temperature showed increased bacterial count whereas none of the ORS prepared in 5 minute boiled water and kept for 24 hour at room temperature showed any bacterial growth. Decreased bacterial count was not found in any of the ORS prepared in unboiled water. Typical coliform bacilli were found grown in 57.0% of the ORS prepared in unboiled water samples.