Study of sociodemographic factors affecting outcome of babies admitted in neonatal care unit

Background: A country needs sound epidemiological information to prioritize, plan and implement the public health care system effectively. Outcome data from hospitalized patients reflect the causes of major illnesses and care seeking behaviour of the community. Thus, we felt the need to conduct this study at our hospital to assess the socio-demographic factors affecting outcome of babies admitted in neonatal intensive care unit.Methods: The present study was a hospital based observational descriptive study. The study was undertaken in neonatal intensive care unit (NICU) of department of paediatrics of tertiary care centre. The study period was from January 2013 to December 2013 i.e. total period of one year.Results: Among 1050 total neonatal admissions 601 (57.29%), were from rural area and 449 (42.70%) were from urban area. Multinomial regression analysis reveals that socio-demographic factors like age of mother, parental intake of tobacco alcohol in any form, socioeconomic class IV, in born place of delivery, occupation and education of father, low birth weight and male sex of baby affects the outcome of babies.Conclusions: Cure rate in NICU admissions was 69% which may be due to available speciality staff and logistics. Taking this into account, 40 bedded NICU in tertiary care hospital seemed to be essential and sufficient.

Takotsubo cardiomyopathy complicating a twin pregnancy at partum

Takotsubo cardiomyopathy is a rare syndrome characterized by acute left ventricular dysfunction with regional left ventricular ballooning, mimicking myocardial infarction. This condition is often described in post-menopausal women. Authors present a case in an elderly primi with twin gestation immediately after Cesarean surgery. We discussed her presentation, investigations, diagnosis, management and outcome. 35 year female, a primi with twin pregnancy developed chest pain and shortness of breath immediately after Cesarean surgery. Her Electrocardiograph was abnormal, and Echocardiogram demonstrated abnormal apical ballooning of the left ventricle and severe dysfunction. Cardiac enzymes were elevated and chest skiagram showed pulmonary edema. She was managed in the intensive care unit with oxygen supplementation, diuretics and inotropes. She made an excellent recovery with normalization of left ventricular ejection fraction within 8 days. During the six months follow up, she was asymptomatic and left ventricular function remained normal.