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.
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