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Background: The neonatal period is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra- uterine survival. If the neonate has a coexisting pathology which needs surgery, this challenge is magnified. Neonatal surgical conditions are unique in their type because some require early diagnosis, prompt surgery and postoperative care to improve the survival and outcome. Objective: The aim of this study was to know the clinical profile of congenital surgical conditions and to estimate the burden and outcome in special new born care unit. Method: The study population include 138 surgical neonate admitted in special new born care unit, department of paediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior (M.P.) from April 2017 to April 2018 including six month follow up period. Results: Total admission in special new born care unit were 5378 out of which 138 (2.5%) neonates of surgical condition were admitted in the study period. Incidence of neonatal surgical condition was found to be 8.48%. Surgery was performed in 57 (41.30%) neonates. The Commonest neonatal surgical condition was constituted by gastrointestinal system (39.13%). Among gastrointestinal system anomalies, tracheoesophageal fistula were 28.6% of total gastrointestinal system cases. The most common surgical condition encountered was meningomyelocele, 23.36% of total cases. The survival of neonatal surgical condition in hospital was 52.89% and after six month follow up was 26.08%. The overall mortality with neonatal surgical condition in this study was 73.91%. Maternal age, antenatal care, history of congenital malformation, socioeconomic status, mode of delivery, prematurity, type of admission, single or multiple surgical condition, inotropic and ventilation support, post operative complication were significantly associated with final outcome of neonatal surgical condition. Conclusion: High mortality was found in neonates suffering from surgical conditions. Commonest anomaly includes conditions of gastrointestinal tract. Maternal age more than 35 year, poor antenatal care, prematurity, vaginal delivery, extra mural neonate, multiple surgical condition, inotropic and ventilation support and post operative complications were associated with increased mortality.
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Background: Aim of the study was to evaluate the role of endoscopy and ultrasonography in pediatric patients suffering from portal hypertension .subjects: children under 12 years of age hospitalized with any symptom or sign suggestive of portal hypertension.Methods: The study was conducted in 30 children with portal hypertension. They were divided into two groups on the basis of site of lesion: extrahepatic (extra hepatic portal vein obstruction) and intrahepatic (chronic liver diseases).Results: Mean age of children with EHPVO (extra hepatic portal vein obstruction) was 4 years and 4 months while that of children with CLD (chronic liver diseases) mean age was 8 years and 4 months. Endoscopic findings in patients with EHPVO have severe grade of varices as compared to those with CLD. In patients with EHPVO, the most common USG finding was nonvisualisation of the main portal vein or either branch (75-85%). Portal vein cavernoma was seen in 75% of these patients. Portosystemic collaterals were visualized in 23 patients' in which the left gastric collateral (60%) was the most common followed by short gastric collaterals in 11 children (55%).Conclusions: Endoscopy and ultrasonography are new and better modalities to assess the diagnosis and severity of portal hypertension. Extra hepatic portal vein obstruction is the commonest cause followed by intrahepatic obstruction (Chronic liver diseases).
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Malnutrition is a silent emergency. The prevalence of malnourished children in India is 43% which is nearly 2 fold higher than that of Sub-Saharan Africa. Malnutrition results from imbalance between the body’s needs and the intake of nutrients. Objective: To assess the nutritional status of pre-school children (3-5 yrs) residing in the catchment area of Ram Nagar Urban Health Center.This study was undertaken in the urban slum area of Ramnagar UHC. Using formula n= 4pq/d2the calculated sample size was 275. The sample was selected by Simple Random Sampling. A pre-designed and pilot tested questionnaire was developed. Ethical clearance and informed consent was obtained. It was seen that nearly one third of the children were under weight, wasted and stunted. One third was also categorized as malnourished by MUAC criteria. The mean ±SD age of pre-school children was 47.63 10.42 months, the mean ±SD weight of pre-school children was 12.98 1.14 kg and the mean ±SD height of pre-school children was 98.49 2.86 cm. There was an immediate need for nutritional intervention by the government sectors to improve the nutritional status of the children. The running of ICDS program must be evaluated to know its effectiveness and efficiency.
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Among the neural tube defects incidence of spinabifida and myelomeningocele is less in twins compared to singletons. This article reports a case of dizygotic twins with myelomeningocele, a rare occurrence. Possible association of twining and neural tube defects and its impact on genetic counseling in such cases has been discussed.