Apert syndrome or Acrocephalosyndactyly is a rare congenital disorder that affects the craniofacial structures and the limbs and is characterized by bicoronal synostosis, midface hypoplasia and complex syndactyly of the hands and feet. We report a neonate who had clinical and radiological features consistent with Apert syndrome.
Background: Neonatal hyperbillirubinemia is a common condition encountered in newborn. Phototherapy is a non invasive, cheap and safe modality for treatment of neonatal jaundice. Halogen spot light, fluorescent lamp devices, fiberoptic pads, compact fluorescent tubes and light emitting diodes are the various light sources used in phototherapy devices. This study was conducted to compare the efficacyof LED phototherapy with compact fluorescent light (CFL) phototherapy in management of healthy term and late preterm neonates with non-haemolytic jaundice. Methods: A randomized control study was conducted on 276 neonates of gestational age > 35 weeks with significant hyperbilirubinemia. Patients were randomly allocated to CFL phototherapy group (n = 147) and LED phototherapy group (n=129). Total serum bilirubin level at 12 & 24 hours, rate of fall of serum bilirubin, side effect profile, rebound hyperbilirubinemia and phototherapy failure was assessed. Result: Mean total bilirubin at 12 hours for LED and CFL phototherapy groups was comparable (p>0.05). Mean total serum bilirubin at 24 hours for LED phototherapy group was significantly lower as compared to CFL phototherapy group (p < 0.05). Mean rate of fall of serum bilirubin was significantly higher in LED group as compared to CFL phototherapy group (p<0.05) but the mean duration of hospital stay was similar between two groups (p>0.05). Side effect profile was comparable between two groups. Conclusion: LED phototherapy is superior to CFL phototherapy for management of neonatal hyperbilirubinemia. LED phototherapy has advantage of greater reduction in total serum bilirubin level and higher rate of fall of serum bilirubin as compared to CFL phototherapy. Both LED and CFL phototherapy has good safety profile.
Background: In India, an estimated four million deaths occur each year in the neonatal period. Effective intervention at primary care level can prevent a large proportion of these deaths. Objective: To assess the impact of training on knowledge and skill regarding newborn care among Auxiliary Nurse Midwife (ANM). Methods: A total of 180 ANMs who attended skilled birth attendant training program under RCH were included in the study. The study was conducted over a period of 2 years from May 2013 to June 2015. A 14 training sessions each lasting for 15 days were conducted in 2 years and each session had a batch of 12-15 ANMs. They were assessed for the impact of training at the end of training on semi-structured and pretested schedule. Results: The knowledge of health workers related to the care of a newborn at birth was not adequate. An average of 94.8 ANMs responded correctly to pre-test questions whereas after training there was a significant improvement in the post-test score. After training an average of 160.5 ANMs (p=0.001) responded correctly. A mean of 84 ANMs had adequate knowledge related to danger signs in the neonatal period before training. Aftertraining significant number of ANMs (mean=156, p=0.002) responded correctly. Baseline knowledge related to feeding of the newborn was also inadequate (mean=120), but after training there was a significant improvement, 164 ANMs respond correctly (p=0.02). Conclusion: Knowledge of ANMs in the rural area regarding essential newborn care is inadequate. The training of health workers need to be remodeled and updated to improve neonatal outcome.
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