The study defines the normal SpO(2) in healthy term newborns of NVD and CS delivered newborns and also concludes that there is no significant difference in SpO(2) among NVD and CS.

Background: Early prediction and identification of severe hyperbilirubinemia for that age and appropriate treatment are must to prevent kernicterus. Objective: The objective is to study the predictive value of bilirubin albumin ratio (BAR) and to compare it with cord bilirubin alone for early identification of significant neonatal hyperbilirubinemia in healthy term neonates. Materials and Methods: This prospective cross-sectional study was done in a tertiary care center located in Central India on 543 healthy term neonates. Cord blood of 2 ml was collected during the delivery from the placental end and sent for BAR and cord bilirubin analysis. All the neonates had undergone total serum bilirubin estimation and neonates with serum bilirubin ≥17 mg/dl at ≥72 h of age were defined to have significant hyperbilirubinemia. Results: Among the study population, 44 neonates developed significant hyperbilirubinemia. Sensitivity and specificity of cord BAR were 95.45% and 89.78%. Sensitivity and specificity of cord blood bilirubin were 95.65% and 95.57%. Positive predictive value (PPV) and negative predictive value (NPV) of cord BAR were 45.16% and 99.55%. PPV and NPV of cord blood bilirubin were 64.70% and 99.58%. Considering mean as the cutoff value, cutoff value for cord BAR was 0.89 and it was 2.95 for cord blood bilirubin. Diagnostic accuracy of cord BAR and cord blood bilirubin in predicting the hyperbilirubinemia was 90.79% and 96.31%, respectively. Conclusion: Both cord BAR and cord blood bilirubin are the early predictors of neonatal significant hyperbilirubinemia, but cord blood bilirubin is the better diagnostic tool than the former in early detection of neonatal jaundice.

Background: Clinical spectrum of cerebral palsy (CP) is different in developing and developed countries. We evaluated the clinical profile, etiological factors and co-morbidities of children with CP in central India. Methods: 50 children with CP came to the hospital in our rehabilitation center were compared with our previous study done in India and western countries. Results: Spastic quadriplegia is the commonest type of CP (90%). Birth asphyxia remains the main (48%) etiological factor. Prematurity was second most common (22%), Pre-eclamsia (10%), convulsions (10%), infection (8%) and pathological jaundice (8%) other important etiological factors. due to bilirubin-encephalopathy remained same (∼30%). Microcephaly (56%), Speech problems (34%), seizures (36%), auditory defect (8%) and visual defect (4%) are common co-morbidities. Common neuroimaging findings include cortical atrophy (50%), periventricular leukomalacia (12.5%) and developmental defect (12.5%). Conclusion: The spectrum of CP is evolving in the developing countries. Lack of proper antenatal and perinatal care, malnutrition and infections appeared to be the major factors for development of CP.

No abstract

No abstract

Idiopathic Juvenile osteoporosis (IJO) is a rare primary bone demineralization disorder that presents in childhood. Because of the difficulty in diagnosis, it is unfamiliar to most pediatricians and there is a long list of differential diagnosis. We report a five year old boy who presented with generalized osteoporosis. Diagnosis of IJO was made by excluding other common causes of childhood osteoporosis.

Background: Perinatal asphyxia is one of the most common medical emergencies of newborn and important cause of neonatal morbidity and mortality. In India, about 1 million babies suffer from birth asphyxia every year, and it is responsible for nearly 28.8% of the neonatal deaths and the subsequent major sequelae. Objectives: The objective of the study was to evaluate the clinico-etiological and electrophysiological profile of neonates with birth asphyxia and its correlation with the neurodevelopment outcome at 6 months of age. Methods: In this prospective observational follow-up study, 50 neonates of >35 weeks of gestation with a history of birth asphyxia were included. Electroencephalographic (EEG) was performed within the first 72 h of life or as soon as neonate was stable. Follow-up visits were scheduled as per NNF guidelines at 6, 10, and 14 weeks, 3 and 6 months of age. Detailed neurological examination, neurodevelopment and tone were assessed by Denver II and Amiel–Tison method, respectively, on every visit. Results: All neonates were on hypoxic-ischemic encephalopathy (HIE) Stage I had normal EEG recording; 36.7% with HIE Stage II had abnormal EEG recording while 100% the neonates of HIE Stage III showed abnormal EEG. All neonates, who had normal EEG recording, survived, and 96.5% (n=28) of them show normal neurodevelopment outcome. 3.7% (n=1) showed developmental delay. All the neonates who had abnormal background on EEG showed adverse outcome. 50% of them expired and rest 50% had abnormal neurodevelopment outcome on follow-up. Conclusion: The severity of encephalopathy in asphyxiated neonates correlates well with the abnormalities on EEG records.

Background: The rate of preterm births ranges from 5% to 18% across 184 countries. Almost 12% births are preterm in low-income countries compared with 9% in high-income countries. Almost 1 million children die each year due to complications of preterm birth. Of those who survive, suffer from face developmental disabilities and undernourishment. Aims and Objectives: To assess the physical growth and its relation with the development of babies taken into study. Materials and Methods: A prospective study was conducted on 159 preterm babies of gestational age 32 to 36 weeks. All the treatments given during hospitalization, course of stay, and special procedures done were recorded. Baby’s weight, length, and head circumference were again noted at the time of discharge. Anthropometric measurements were done at every follow-up visit. Neurodevelopmental screening was performed at each follow-up. At the end of 12 months the risk factors contributing to the delayed development were analyzed. Results: 95.5% infants born as preterm had a length of more than 58 cm (– 3SD) and weight 5.6 kg at 1 year and 50% infants had a head circumference of more than 39 cm (– 3SD). Conclusion: Preterm babies when followed-up for 1 year of age did attain appropriate weight and length of their corrected age. Microcephaly was observed in 30% of babies at 1 year of age, of which 15.7% were found with developmental delay.