Will outlining neonatal near miss events make a change? A hospital based case control study

Background: In paediatrics and neonatology, the term ‘‘near miss’’ is mostly used in the situation of adverse events during patient care. Another common use of the term is in the perspective of Sudden infant death syndrome (SIDS). No accepted definition of NNM in this setting currently exists. The definition of Neonatal near miss (NNM) used differently, can aid in assessing and improving obstetric and paediatrics practice in different settings. By identifying those neonates that escaped being apprehended as a death statistic, deficiencies in the services rendered to pregnant women may be addressed and this may lead to further improvement in care.1Methods: The unmatched case control study was conceded in Neonatal intensive care unit (NICU) at Rukamani Chainani Hospital Vadodara. Newborns admitted in NICU, having any one of criteria like birth weight less than 1500, gestational age less than 30 weeks and Apgar score less than 7 at 5 minutes, were defined as Near miss in this study.Results: Neonatal mortality rate was 22 per 1000 live births during study period, whereas neonatal near-miss rate was 87.6 per 1000 live births. In study groups average duration of stay in NICU was 10 days for neonates.Conclusions: There must be a scoring system or calculation of infant mortality index events into the system to identify near miss events which help for the restructuring and improvement of care for pregnant women and newborns.

Variation in superior articular facets of atlas vertebrae in terms of its morphology.

Background: Hypermobility of Atlanto-Occipital joints give rise to symptoms related to vascular compromise viz syncope, vertigo, transient impairment of visual field, altered consciousness. Surgical management of congenital anomalies of craniovertebral junction requires a precise identification of underlying pathophysiological condition. For this reason variation in superior articular facets of atlas vertebrae in terms of its morphology should be known. Method: The morphology of 100 atlas vertebrae had been studied and observations of total 200 facets were noted. Measurements were taken with a vernier callipers and a compass. Result :In the present study, typical oval, elongated or kidney shaped outline was found in 74.5% facets. Constrictions or notches were present on 48% facets. Complete separation (4.5%) is suggestive of tendency towards possible restriction of movement at atlanto-occipital joint as part of evolutionary changes. Roughly circular pressure facets had been observed in 78% of vertebrae indicating possibly greater pressure at this site during movement at atlanto-occipital joint.Conclusion: Knowledge of this variation in craniovertebral junction is of significant importance for Neurosurgeons and Orthopaedic surgeons doing various surgeries in this region.

prevalence of intestinal parasitic infections in the urban slums of a city in Western India

There is scant information available on the prevalence of parasitic infections in Gujarat, a state in Western India. The present community-based study was undertaken in the urban slums of a city in Gujarat to determine the following parameters: [a] the prevalence and type of pathogenic intestinal parasites and [b] the availability of sanitary facilities in the study population. This cross-sectional study was conducted in 2008, and the study participants were urban slum dwellers. Considering an expected infection prevalence of 30% among slum dwellers, an allowable error of 10% and an anticipated design effect of two, the sample size for the cluster design was set to 1800 participants from 30 clusters and 360 households [HHs]. Stool samples were examined using both direct wet mount and the formalin-ether sedimentation concentration technique, followed by trichrome staining for protozoan cysts. Toilet facilities were utilized by 56% of the HHs, while 44% of the HHs resorted to open air defecation. The overall prevalence rate of intestinal parasitic infections was 15.19%. Parasitic infections due to protozoa were observed in 70.71% of the study participants. Helminth infections were detected in 25.71% of the participants, and multiple parasitic infections were detected in 3.57%. Diarrhea was the most common complaint [9.56%] in the study population. This study demonstrates that poor sanitation and inadequate environmental conditions are the main determining factors that predispose the population to intestinal parasites. Mass deworming programs are recommended for school children, as this population is easily accessible