Meconium aspiration syndrome and neonatal outcome: a hospital based study

Background: The incidence of meconium stained amniotic fluid is 8-20% among all deliveries. The Aspiration of meconium into the airway results in various short term and long term morbidities and mortality. Timely management of these neonates with meconium in amniotic fluid may prevent Meconium aspiration syndrome.Methods: This prospective cohort study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. All live Term neonates born between December 2016 and July 2018 with meconium in amniotic fluid were enrolled in the study. Details of the neonate was entered in the pre-designed Proforma. The objective of this study the outcome of MAS neonates and find factors associated with Meconium aspiration syndrome when compared with Meconium stained amniotic fluid neonates as a whole. These associated factors were presented as Odds Ratio (OR) and 95% Confidence Interval. Chi-square test was done where applicable and a p-value <0.05 was taken as significant.Results: Meconium aspiration syndrome was seen in 79 out of the 188 neonates born with meconium stained amniotic fluid.Conclusions: The morbidity and mortality in a neonate with Meconium stained amniotic fluid (MSAF) to develop meconium aspiration syndrome (MAS) can be avoided with timely antenatal care. Meconium-stained babies should be aggressively managed to prevent complications like perinatal asphyxia and respiratory failure which may lead to the mortality. Those neonates with risk for adverse outcome should be managed with special focus on respiratory care with use of assisted ventilation and inhaled nitric oxide and extracorporeal membrane oxygenation, where available.

Hypomagnesemia as a predictor of mortality in critically ill pediatric patients in picu using prism score

Background: Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation after potassium. A potential relationship between low magnesium levels and increased mortality has been suggested in the literature. The objectives were to detect prevalence of hypomagnesemia in critically ill children, its association with sepsis and to correlate this with mortality.Methods: This study was an observational study done on 100 children who met the inclusion criteria, admitted to the PICU of Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India. Patients under the study were managed and treated according to their clinical status and supportive traditional treatment.Results: Prevalence of hypomagnesemia in critically ill pediatric patients was 53%. In this study, majority of the cases admitted to PICU were dengue (19%) and bronchopneumonia (15%) which were significantly associated with hypomagnesemia as p value was less than 0.05. As regard prognosis, Mg had an AUC of 0.576 for prediction of mortality whereas the AUC for PRISM score was 0.811. Logistic regression analysis showed that hypomagnesemia is a significant predictor for mortality among critically ill children (p value=0.028) and OR=3.180 (0.854-7.965).Conclusions: Present study has found high prevalence of hypomagnesemia in critically ill patients. Hypomagnesemia was associated with a higher mortality rate in critically ill patients and commonly associated with infections and respiratory diseases. Hypomagnesemia indicated poor outcome and higher mortality rates in critically ill patients.