BACKGROUND Congenital heart diseases are the most common congenital malformations and account for 6-10% of all infant deaths. Congenital heart defects affect 8 to 10 out of every 1000 live births. Pulse oximetry in newborn screening can detect mild hypoxemia that may not be recognised by clinical examination. Thus, pulse oximetry can help to identify babies that may be affected with critical congenital heart disease before they leave the newborn nursery. There are many studies carried out on pulse oximetry with different sensitivity and specificity for detection of congenital heart disease. The objectives of the present study were to screen all newborns admitted in NICU to rule out congenital heart disease before discharge and to find out the utility of pulse oximetry to detect congenital heart disease. METHODS This prospective study was conducted in Neonatal Intensive Care unit, Gauhati Medical College and Hospital in 1720 neonates over a period of 12 months (February 2015 to January 2016). Both pulse oximetry and clinical examination were done. Persistent pulse oximetry (SPO2) reading below 95% or more than 3% difference between right hand and one foot, it was considered as positive pulse oximetry. Newborns with positive pulse oximetry and abnormal clinical examination findings were subjected to echocardiography. RESULTS Positive pulse oximetry cases were 47(2.73%), out of which 39 cases had only positive pulse oximetry (with negative clinical examination). Positive clinical examination cases were 58(3.37%), out of which 50 cases had only positive clinical examination findings (with negative pulse oximetry). Eight (8) cases had both positive pulse oximetry and positive clinical examination. Total congenital heart disease cases detected in our study was 34(1.98%) out of 1720. VSD was the most common CHD followed by PDA, TOF, TGA in this study. The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry were 41.18%, 98.04%, 29.79%, 98.80% respectively. CONCLUSION Pulse oximetry is a useful tool to detect congenital heart disease. Its accuracy in detecting congenital heart disease increases if combined with positive clinical examination.
Introduction: Urinary Tract Infection (UTI) is a common problem in children. It is a very common cause of fever in children after gastrointestinal and respiratory diseases. Uropathogens causing community acquired UTI is increasing due to changing antibiotic sensitivity pattern over time. Appropriate choice of antibiotic is crucial to prevent complications related to UTI. Aim: To study the clinical profile, risk factors, associated pathogen spectrum and their antibiotic sensitivity pattern in community acquired UTI. Materials and Methods: A cross-sectional observational study with 150 sample size was conducted in the Department of Paediatrics, Gauhati Medical College and Hospital, Guwahati, Assam, India and was carried out among children (1 month to 12 years of age) with community acquired UTI, over a period of one year in the state of Assam. Fresh urine samples were collected by clean catch mid-stream method for toilet trained children and by transurethral catheterisation for infants and young children. It was followed by routine urine examination and culture and sensitivity testing to diagnose UTI. Descriptive statistics was used to describe the results. Proportion test was used for statistical evaluation. Results: Majority of UTI cases were in the age group 1 to 5 years (57.3%) and there was female preponderance (59.3%). Fever was the most common presentation (55.3% cases) in the present study. This was followed by poor feeding (12.6%), lower abdominal pain (10.6%), failure to gain weight (10.6%). In urinalysis, 87 cases (58%) showed pyuria, 6 cases (4%) showed significant haematuria. Most prevalent uropathogens in the present study was Escherichia coli (E.coli) (66%cases), followed by Enterococcus sp. (16.7%), Klebsiella sp. (14%). E.coli had maximum sensitivity for nitrofurantoin (90.9%). It was followed by amikacin (80%), co-trimoxazole in 64.6% and gentamycin in 62.6% cases. Conclusion: All fever cases in children should be screened to rule out UTI. All UTI cases should undergo culture and sensitivity testing to determine the sensitivity pattern.
Background: Diabetes mellitus is one of the most common metabolic disorder with its increasing incidence world wide. Thyroid dysfunction is another common endocrine disorder frequently encountered in clinical practice(1). The association between diabetes mellitus and thyroid disorder is widely known. Under this backdrop, the present study was undertaken with the following aims and objectives. 1) To know the prevalence of thyroid dysfunction in Type 2 diabetes mellitus. 2)To know the spectrum of thyroid dysfunction in Type 2 diabetes mellitus. Methods: This hospital based prospective study was conducted in the department of Medicine, FAA Medical College & hospital, Barpeta, Assam, India over a period of one year from May 2015 to April 2016. A total number of 120 patients with Type 2 diabetes mellitus were included in the study. Data collection was done by history taking, clinical examination and essential laboratory tests. Results: Out of 120 patients , 27 (22.5%) had thyroid dysfunction and remaining 93 patients had normal thyroid function. In this study, out of 27 thyroid dysfunction patients, 8 (6.6%) had clinical hypothyroidism , 17 (14.1%) had subclinical hypothyroidism and 2 (1.6%) diabetics had hyperthyroidism. Thyroid dysfunction was seen more in female 18 (15%) cases than in male 9 (7.5%) cases. Thyroid dysfunction was more common in diabetic patients above 60 years of age. Further, diabetics with microvascular complications had more thyroid dysfunctions. Conclusion: In conclusion, the present study showed a high prevalence of thyroid dysfunction (22.5%) among the diabetic patients studied. Subclinical hypothyroidism was more common than clinical hypothyroidism. It is known that undiagnosed thyroid dysfunction in diabetics increases the cardiovascular risk in these patients. Hence, screening for thyroid dysfunction among diabetic patients should be routinely performed to reduce the morbidity and mortality.
BACKGROUNDJaundice is the most common problem in the first week of life. About 25-50% of all term neonates and higher percentage of preterm neonates develop clinical jaundice during neonatal period. Jaundice in newborn is a medical emergency, because unconjugated hyperbilirubinemia may cause bilirubin encephalopathy and needs urgent treatment. The objective of the study was to know the aetiology of hyperbilirubinemia in neonate admitted in neonatal intensive care unit of Gauhati Medical College and Hospital.
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