Enteral feeding in neonates ≥34 weeks of gestation with moderate to severe birth asphyxia: A retrospective observational study.

There are no standard guidelines regarding time for initiation of feeds in moderate to severely asphyxiated neonates and data regarding the same in neonates are scanty. Case sheets of all neonates born ≥34 weeks of gestation who satisfied the definition were analysed. The early feeding group was defined as those in whomh feeds were started <24 h and the late feeding group as those started ≥24 h of life. The primary outcome of the study was time to achieve full enteral feeds. A total of 184 neonates were enrolled. Mean time to reach full enteral feeding was 53.7 ± 24.8 h in the early feeding group as compared to 95.0 ± 81.1 h in late enteral feeding group, with a mean difference of 41.3 (25.7-56.8) h. The incidence of adverse secondary outcomes was higher in the late feeding group.

Newborns with congenital complete heart block: Advice for perinatal care providers.

Congenital complete heart block (CCHB) is a rare, but a potentially life-threatening manifestation of autoimmune diseases in neonates. Bradycardia in CCHB can be misdiagnosed as foetal distress in utero and thus precipitating a Caesarean section. We report a case series of three neonates with bradycardia without any electrolyte abnormalities and structurally normal hearts with favourable outcomes.

Congenital pulmonary airway malformation manifesting with severe respiratory distress and pneumothorax in a neonate.

Congenital pulmonary airway malformation (CPAM) is congenital pulmonary anomaly characterized by multicystic areas, over-distension, and proliferation of terminal bronchioles with lack of normal alveoli. Clinical presentation may vary from mild respiratory symptoms to severe respiratory distress and frequent pneumothoraxes. We report a rare case of neonatal CPAM type I manifested with neonatal respiratory distress and pneumothorax, which was managed successfully with left lower lobectomy. Supplementary Information: The online version contains supplementary material available at 10.1007/s12055-023-01510-x.

Rapid vs. Slow Rewarming for Management of Moderate to Severe Hypothermia in Low-Birth-Weight Pre-term Neonates-An Open Label Randomized Controlled Trial.

BACKGROUND: Evidence is lacking regarding the optimal method of rewarming hypothermic low-birth-weight (LBW) pre-term neonates. We aim to evaluate the effect of rapid vs. slow rewarming in the management of moderate to severe hypothermia in LBW pre-term neonates. METHODS: In this open label, randomized controlled trial, 100 LBW (<2.5 kg), pre-term (<37 weeks) neonates with moderate to severe hypothermia (<36°C) was randomized to two groups of 50 each and received either rapid (at >0.5°C/h) or slow (at ≤0.5°C/h) rewarming rate till normothermia. The primary outcome was stabilization score [TOPS (temperature, oxygenation, perfusion and saturation) and MSNS (modified sick neonatal score)] at baseline, 6 and 24 h and mortality until discharge. Other neonatal morbidities were assessed as secondary outcomes. RESULTS: Mean TOPS score and MSNS score at baseline, 6 and 24 h of admission as well as change in score from baseline were similar between the two groups. The median rewarming rate [interquartile range (IQR)] was higher in rapid rewarming group than in the slow rewarming group [5.05°C/h (3.54-7.71) vs. 0.71°C/h (0.60-0.90); p < 0.001]. The median rewarming time taken in rapid rewarming group was lesser compared with that in the slow rewarming group [0.31 h (IQR 0.13-0.75) vs. 2.05 h (IQR 1.11-3.03); p < 0.001]. Mortality in rapid rewarming and slow rewarming group was similar [7/50 vs. 5/50; OR 1.46 (0.43-4.97), p = 0.538]. CONCLUSION: Rapid rewarming was as effective and safe as slow rewarming in the management of moderate to severe hypothermia in LBW pre-term neonates with similar short-term neonatal outcomes. CTRI NUMBER: CTRI/2018/01/011187.

Transient aplastic anemia in Down's syndrome - a rare association.

The association of Down's syndrome with aplastic anemia is extremely rare with only six such cases reported in world literature. Herein, we report a child of Down's syndrome with pancytopenia and hypocellular marrow. There was associated hypothyroidism and the pancytopenia resolved with thyroxine treatment. The child made uneventful recovery.