Hypoglycemia incidence and risk factors assessment in hospitalized neonates

Background: Hypoglycemia is a major metabolic problem among neonates. Neonates are usually asymptomatic and hypoglycaemia can cause brain damage if not detected and treated early. This study was conducted to identify incidence as well as risk factors of hypoglycemia in neonates admitted to the NICU.Methods: Blood sample for glucose testing was collected in neonates who were less than 72 hours old, at the time of admission to our NICU (Kempegowda institute of medical sciences, Bangalore, India).Results: Total 250 neonates were admitted to the NICU for various reasons and all were screened for hypoglycaemia. Of the 250 babies 112 were hypoglycemic. 147 babies were males and 103 babies were females. 178 of the 250 babies enrolled were preterm and 72 babies were term. 44% babies were detected to have sepsis and 17.6% were detected to have respiratory distress syndrome. Only 7% (8 no. of) babies displayed symptoms like hypoglycemic convulsions, jitteriness.Conclusions: Neonates with premature birth, low birth weight and perinatal asphyxia were susceptible to hypoglycemia. Active and continuous monitoring of blood glucose level should be performed in the early newborns, especially in high-risk children, and attention should be paid to timely feeding for the early diagnosis and treatment of neonatal hypoglycemia to reduce its impact on the newborns.

A randomised controlled trial on effect of splinting a joint on the lifespan of intravenous cannula in pediatric patients

Background: Children admitted to hospital and ICUs for various reasons like sepsis, respiratory distress, dehydration, shock etc. require an intravenous line for medications and IV fluids. Properly securing an intravenous line is very important. It is equally important to maintain the patency of the intravenous line for longer periods of time. But there is no adequate data regarding factors affecting the duration of patency of an IV line. This study was done to compare effect of limb splinting versus non-splinting with the functional duration of peripheral IV cannula.Methods: This study was done over 3 months between October - December 2018 in pediatric patients (age 6 months to 5 years) admitted to Kempegowda Hospital. Patients were randomised into splint group and non-splint group. In the splint group a firm splint was applied to the joint that was cannulated. No such intervention was done in the non-splint group. Time from IV line placement to removal was measured.Results: Total 438 patients were taken into study. After exclusion 200 patients were given a splint and 200 were not splinted. The median survival time was more in splint group when compared to non-splint group.Conclusions: This study shows that splinting helps to maintain patency of IV line for a more longer duration than non splinting of the joint.

Usefulness of serum albumin as a prognostic factor in dengue

Background: Dengue is a major public health problem throughout subtropical and tropical regions. In more severe or complicated dengue, patients present with a severe febrile illness characterized by abnormalities of hemostasis and increased vascular permeability, which in some instances results in a hypovolemic shock. Dengue is endemic in more than 100 countries in tropical and subtropical regions with an estimated 390 million infections occurring worldwide, among which 96 million infections are clinically apparent. The objective of this study is to assess the usefulness of serum albumin as a prognostic factor in dengue.Method: This observational study enrolled 100 patients who were admitted in KIMS Hospital from June 2017 to June 2018 without any co morbidities as mentioned in the exclusion criteria. On day 4 of illness hemoglobin, packed cell volume, platelet and serum albumin were done, and the participants were classified into 3 groups based on clinical manifestationResults: In this study, hemoglobin was elevated on day 4 in group 3 when compared to other groups and it was statistically significant. Hemoconcentration and low platelet values were also seen in group 3 when compared to other groups showing statistical significance.Serum albumin was also low in group 3 when compared to other groups, which was strongly significant.Conclusion: Hence serum albumin can be used as a prognostic factor in dengue.