Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.

Background: One in every seven pregnancies ends with meconium-stained amniotic fluid (MSAF). MSAF can be harmful to the newborn with short and long-term sequelae. This study was aimed to find out the incidence, predictors, onset and severity of respiratory distress among vigorous babies born through meconium stained amniotic fluid which may or may not be evident at birth.Methods: It is a prospective observational study. One hundred forty-one neonates were studied. Data was collected on perinatal risk factors, clinical course and development of respiratory distress. Significance of the perinatal risk factors were identified by fisher’s exact test (p-value) and score based on odds ratio was assigned for significant risk factors. Results: This study included one hundred and forty-one vigorous babies born through meconium stained amniotic fluid, of which 36.9% (52) babies developed respiratory distress. Of the 52 babies who developed respiratory distress 19.23%(10 babies) developed meconium aspiration syndrome (MAS). In our study, it was observed factors like caesarean section and thick meconium increased risk of respiratory distress in the neonates born through meconium stained amniotic fluid who were vigorous.Conclusions: The incidence of respiratory distress in vigorous babies born through meconium stained liquor in this study was observed to be 36.9% (52 babies). 98.07% (51 babies) developed respiratory distress at birth or within one hour of life. All the babies who developed MAS had mild or moderate form of MAS. None of the babies required assisted ventilation. Risk factors like thick meconium, caesarean section showed significant increase in the incidence of respiratory distress. Therefore intrapartum monitoring and timely intervention can prevent the complications of MAS.

Introduction Placental transfusion is additional volume of blood transferred to the baby during birth. A newborn who receives placental transfusion at birth obtains 30% more blood volume than the newborn whose cord is cut immediately. Receiving an adequate blood volume from placental transfusion at birth may be protective for the distressed neonates. It provides sufficient iron reserves for the first 3 to 6 months of life there by preventing or delaying iron deficiency anemia until the use of iron fortified food is implemented. There are 2 ways of placental transfusion, they are delayed cord clamping and umbilical cord milking. Delayed cord clamping (defined as clamping till cessation of pulsations or up to 60-180 s) leads to improvement in levels of hemoglobin and hematocrit at 6 weeks of age. However, universal application is limited due to concerns for the risk of hypothermia, and delay in initiation of resuscitation if required. Umbilical cord milking involves milking the entire contents of the umbilical cord towards the baby with in 20 s. Umbilical cord milking can be used in deliveries where delayed cord clamping is not feasible. Objective Comparison of hematological parameters (cord hemoglobin at birth, hemoglobin, hematocrit, and bilirubin levels in term neonates at 48 h with umbilical cord milking and delayed cord clamping). Methods and Analysis In this study all the term neonates delivered by vaginal delivery and lower segment caesarean section born to nonanemic mothers were considered eligible. All newborns with no risk factors underwent delayed cord clamping (n = 148) and those term neonates in whom delayed cord clamping was not feasible and/or currently WHO guidelines recommend for immediate cord clamping were allocated for umbilical cord milking (n = 121). Cord hemoglobin at birth, hemoglobin, hematocrit, and bilirubin (direct and indirect) were sent at 48 h. These parameters were compared between 2 groups. Results At birth cord hemoglobin was 15.36 and 15.46 (mean difference = 0.1) in DCC and UCM, respectively. At 48 hours, mean hemoglobin was 18.73 and 18.95 (mean difference = 0.22, P = .3591). Mean hematocrit was 52.22 and 53.28 (mean difference = 1.06, P = .0989), and mean total bilirubin levels was 11.24 and 10.56 (mean difference = 0.69, P = .466). Conclusion There were no statistically significant differences in the hematological parameters in full term neonates at 48 h, between delayed cord clamping and umbilical cord milking groups.