ABSTRACT
BACKGROUND: Malaria is the most prevalent infectious diseases in the world. This study aims to assess the correlation of hepatorenal dysfunction in malaria patients in pediatric age group. MATERIALS AND METHODOLOGY: This study was conducted on patients of malaria admitted in the Department of Paediatrics, PBM hospital, Bikaner (Rajasthan), during resurgence of various outbreaks of malaria in the year 2011 and 2012. The diagnosis of malaria was confirmed by examination of thick and thin smear/optimal test; malarial hepatic and renal patients were included in the study. RESULTS: The mean age of patients with hepatic and/or renal dysfunction in malaria was 5-10 years and preponderance of males. Association between hepatic and renal dysfunction was significant as 9 (40.9%) in 22 patients with serum bilirubin >3 mg/dl had renal failure in Plasmodium falciparum (PF) and 5 (71.43%) out of 7 patients in mixed (Plasmodium vivax [PV] and PF) patients. This association was not significant in PV as 6 (10.52%) out of 57 patient with serum bilirubin >3 mg/dl had renal failure. CONCLUSION: The specific reason for presenting our observation is to develop awareness regarding the early complications of malaria and to prevent them prompt action can be taken.
ABSTRACT
BACKGROUND: Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically. METHODOLOGY: An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done. RESULTS: On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst. CONCLUSIONS: Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.
ABSTRACT
BACKGROUND: To screen the newborn by Transient evoked Otoacoustic emission and to assess the incidence of hearing damage and associated risk factors. METHOD: This longitudinal prospective observational study was conducted at a tertiary care hospital in India. A total of 415 babies were included in the study. All the newborns were evaluated with Transient evoked Otoacoustic emission (TEOAE) which was done by age of 1-3 days. Auditory brain stem response audiometry (AABR) was performed at the age of three months for confirming the hearing loss in the neonates those who failed the TEOAE screening. For infants proven to have significant hearing loss in one or both ears, were denoted to an ear, nose, and throat specialist for further evaluation & rehabilitation. RESULTS: Out of total 415 babies included in the study, 22 neonates showed abnormal TEOAE examination. Out of these 22 neonates, hearing loss was confirmed in 18 (82 %) subjects. by AABR. The following antenatal and post-natal risk factors were associated with hearing loss: ante-partum bleeding, history of maternal blood transfusion, fetal distress, prematurity, severe birth asphyxia, NICU admission for more than 24 h and Apgar score less than five at 5 min. CONCLUSION: Late identification of hearing loss presents a substantial public health burden. Early recognition and intervention prior to 6 months of age has a significant positive impact on development. A high incidence of hearing impairment seen in our study neonatal population warrants the urgent implementation of universal hearing screening of all the newborn infants in India. NICU infants admitted for more than 24 h are to have an auditory brainstem response (AABR) included as part of their screening so that neural hearing loss will not be missed.
