Introduction: Perinatal asphyxia has become the leading cause of death for newborns. Since the parameters that are being routinely used as a predictor for perinatal asphyxia such as thick meconium stained liquor, non-reassuring fetal heart patterns, low Apgar scores, fetal or cord blood pH do not show consistent correlation with fetal acidosis but nucleated red blood cell counts in umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. The number of nucleated red blood cells (nRBCs)/100 white blood cells is variable but is rarely greater than 10 in normal neonates. The aim of this study was to study the using of nucleated red blood cells in umbilical cord blood of newborns as an indicator for perinatal asphyxia. Material and methods: The study comprised of intramural term neonates with and without asphyxia. It was a case control study conducted in the Department of Pediatrics in collaboration with Department of Obstetrics and Gynaecology, Rohilkhand Medical College and hospital, Bareilly from November 2017 to October 2018. There were 50 asphyxiated newborns and 50 healthy newborns in the study. The mean levels of nRBCs in cord blood were significantly higher (p value<0.001) in the asphyxial group (54.06+-22.42) as compared to control group (10.32+-5.86). Results: Nucleated red blood cells were found to be strongly associated with perinatal asphyxia. The mean values of cord blood nRBCs in cases were 54.06+-22.42 and in control group were 10.32+-5.86. The p value being <0.001 which was statistically significant indicating the correlation. Conclusions: Therefore it was concluded that nucleated red blood cells in umbilical cord blood of newborns can be used as an effective test for prediction of perinatal asphyxia.
Background: Feeding intolerance is a common problem in preterm infants delaying establishment of full enteral feeding (FEF). Sustained parenteral nutrition has many disadvantages. To promote feeding tolerance, glycerin suppository is being used. Aims: (a) To compare the efficacy of glycerin suppository versus no intervention in preterm, very low birth weight (VLBW) neonates in achieving FEFs, i.e., 180 ml/kg/day for at least 24 hrs both the groups. (b) Correlation of glycerin suppository with time to regain birth weight, necrotizing enterocolitis, and adverse effects following glycerin suppository. Materials and Methods: The present study is a prospective randomized control trial; study population - 50 VLBW (birth weight between 1000 and 1500 g) or preterm (gestational age between 28 and 32 weeks) neonates randomized to either glycerin suppository group or non-intervention group. Intervention group – glycerin suppository (1 g) once daily from day 2 to day 14 of life or non-intervention along with intermittent oral feeds and standardized care. Results: A total of 58 neonates were assessed for eligibility, 50 randomized to either glycerin suppository group or control group, 19 neonates in both the groups were analyzed for outcome. Mean time to achieve FEFs was 11.57±1.21 days in glycerin suppository group and 11.84±1.25 days in control group which was not statistically significant (p=0.441; RR=0.67; 95% confidence interval=?0.539, 1.079). There was no significant difference observed in secondary outcomes. Conclusion: Prophylactic glycerin suppositories did not reduce the time to achieve FEFs in preterm VLBW neonates in our setting.
Introduction: The umbilical cord of every newborn is clamped and cut at birth, yet the optimal timing for this intervention remains controversial. For at least over 200yrs, multiple controversies have arisen around the timing of umbilical cord clamping. Delayed cord clamping or placental transfusion could be a cost effective intervention to improve the iron status of infants by enhancing their red cell mass. Search in literature reveals that several controlled trials evaluating the short term and long term hematological outcomes of delayed cord clamping have been performed in the past but very few studies have investigated the risk of hyperbilirubinemia especially from this part of the world. Hence this crosssectional study was conceptualized. Material and Methods: It was a cross-sectional study conducted among 212 term infants born at Rohilkhand Medical College and Hospital, Bareilly, over a period of 1 year, who fulfilled the inclusion criteria were included in our study. Results: In the present study, hemoglobin, bilirubin, and hematocrit levels at birth and at 24 hours of birth in Immediate cord clamping and Delayed cord clamping was taken. Mean levels of hemoglobin, bilirubin and hematocrit was found higher in Delayed Cord Clamping group as compared to Immediate Cord Clamping group. Conclusion: The study was conclusive of the fact that in term infants delayed cord clamping increases hemoglobin, hematocrit and bilirubin levels at birth and at 24 hrs of birth as compared to immediate cord clamping. Moreover, there was no significant associated adverse effects.
Objective: The value of urinary uric acid and creatinine ratio in neonatal asphyxia. Method: This was a prospective observational study conducted over one year, on 45 newborns admitted in NICU with perinatal asphyxia. Cord blood from the umbilical artery was sent for pH analysis and urinary uric acid and creatinine levels were estimated in spot urine samples. Results: The urinary uric acid and creatinine ratio had a positive correlation with low APGAR scores at the 1st and 5th minute. Also, urinary uric acid to creatinine ratios was significantly higher in infants with severe HIE (3.18±0.61) when compared with infants of moderate HIE (2.19±0.32). It showed a significant negative correlation with pH of cord blood in neonates with perinatal asphyxia. Conclusion: The urinary uric acid and creatinine ratio can be used as a supportive diagnostic test for early diagnosis of perinatal asphyxia.
Introduction: Breastfeeding is a natural source of enormous value and is necessary for the life of babies. The influence of infants' eating patterns, on subsequent cholesterol levels is of interest. Breastfeeding has been found to be protective against atherosclerotic cardiac diseases and better lipid profile later in life compared to bovine milk. Hence, the study was carried out with aim to compare the lipid profiles of exclusively breastfed infants and cow milk fed babies. Material and Methods: It was a Prospective Observational Study conducted among fifty exclusively breastfed babies and fifty exclusively cow milk fed babies. Lipid profile were compared at three and six month of life over a span of one year in Rohilkhand Medical College and Hospital, Bareilly who fulfilled inclusion criteria of study. Results: In the present study, the exclusive breastfed babies showed lower levels of cholesterol and low density lipoprotein, rising levels of HDL/LDL ratio, high density lipoprotein in exclusive breastfed babies as compared to cow milk fed babies which showed declining concentrations of high density lipoprotein, HDL/LDL ratio, rising levels of low density lipoprotein. Conclusion: The study was conclusive of the fact that exclusive breastfeeding for initial six month of life shows an edge to the positive lipid profile (decreasing cholesterol, low density lipoprotein, triglycerides, and increasing high density lipoprotein and HDL/ LDL ratio) over six month as compared to exclusively cow milk fed babies.
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