Spectrum of Congenital Heart Disease in a Tertiary Care Center

Background: Congenital heart disease (CHD) is not an uncommon entity in our country. The prevalence of CHD is 9.3 Per 1000life birth in Asia which is found to be highest globally. Not much of Indian data is available particularly from south part of thecountry. So we conduct a retrospective study to know the spectrum of congenital heart disease in our set up.Methods: This is a retrospective hospital based study carried out over a period of 12 months (2018 January – 2019 January)where all suspected children (< 12 years) of CHD were subjected to echocardiographic study. The age, sex, clinical presentationand echo findings were well documented.Results: The total number CHD diagnosed were 124 and were more common among males (54.5%) with male to female ratiois 1.2:1.Congenital heart diseases were diagnosed more commonly between 1 month to 1 Year (45.9%). The commonest typeof acyanotic CHD in our study was ventricular septal defect (VSD) (32.3%) and cyanotic CHD is tetralogy of Fallot (8.06%). Themajor clinical finding was a detection of a murmur (84.4%) followed by tachycardia (41.5%) and tachypnea (36.3%).Conclusions: In this era of most accurate diagnostic modalities, any clinical suspicion of congenital heart disease should beconfirmed by echocardiography to hasten the diagnosis, timely management and prevention of complications.

​Nucleated Red Blood Cell Count as Earliest Prognostic Marker for Adverse Neonatal Outcome in Neonatal Sepsis

Introduction: The most common cause of neonatal mortality is neonatal sepsis, the diagnosis of which depends on bloodculture, which has low sensitivity and takes time. We hypothesize that demonstration of elevated NRBC levels in neonatalsepsis might help in predicting an adverse neonatal outcome.Aim of the Study: To analyse elevated NRBC it can serve as a prognostic marker for neonatal sepsis and an increased riskfor adverse neonatal outcome.Materials and Methods: This is a hospital based prospective study done in neonates who are admitted in NICU of MaduraiMedical College with risk factors or clinical features of sepsis. After getting informed consent, the maternal details and examinationfindings were recorded and blood sample taken for sepsis screen, blood culture and peripheral smear for NRBC.Results: The sensitivity of NRBC in identifying sepsis was 81.5%, its specificity was 61.76%, positive predictive value was 70.4%and negative predictive value was 75%. In the neonates who expired, serial NRBC counts (mean – 22.4) were significantlyincreased from baseline value (mean 17.3).Conclusion: NRBC is significantly elevated in the neonatal sepsis and is a predictor of adverse neonatal outcome.