factors within that particular home and dynamic. However, due to the small numbers of cases of SIDS in the time frame reviewed it was impossible to determine whether the inclusion of social care involvement to the SBS would improve the statistical model overall.
Congenital protein C deficiency presenting as purpura fulminans is a rare condition in neonates. It is a disorder with autosomal recessive inheritance and is caused by homozygous or compound heterozygous mutations in PROC gene. The authors report a case of autosomal homozygous PROC gene transversion mutation in a newborn baby born to third degree consanguineous parents who presented as purpura fulminans at birth. She had almost undetectable protein C levels. As protein C concentrate was not readily available, she was managed with low molecular weight heparin along with fresh frozen plasma. Despite our best efforts, baby succumbed to her illness on day 21 of life. Autosomal recessive protein C deficiency should always be sought as an explanation for thrombotic disorders in the newborn with manifestations of disseminated intravascular coagulation.
Background: We evaluated the usefulness of RDW (red cell distribution width) as a diagnostic tool in newborn sepsis. Several biomarkers for sepsis have been studied including CRP (C-reactive protein), procalcitonin, interleukins, total WBC count (TC) absolute neutrophil count (ANC), ratio of immature neutrophils to total neutrophils (I/T ratio). An ideal biomarker for sepsis is still elusive. Hence we evaluated RDW as a sepsis marker as it was cheap and available. The objective of the study was to evaluate the role of RDW as a prognostic marker in newborn sepsis compared to healthy newborns.Methods: The study sample comprised of two groups (cases and control group) each with 40 neonates. Group 1 (cases group) comprised 40 newborns with suspected/probable sepsis based on clinical or laboratory parameters. In group 1 (suspected/probable sepsis) RDW was done at the time of suspicion of sepsis along with other relevant investigations. According to the clinical course these parameters were repeated 24-48 hrs after first value. Group 2 (control group) comprised 40 normal newborns in the postnatal ward. For the control group blood sampling for CBC and RDW was done simultaneously along with blood sampling for newborn screening.Results: On comparing the baseline variables there is no significant difference among cases and control group with respect to gender distribution, age in days, gestational age in weeks and birth weight. The mean RDW among the cases group was significantly higher than among the control group. In ROC analysis we obtained a cut off value of RDW of 17.25 is helpful to diagnose sepsis with reasonable sensitivity (70%) and specificity (60%).Conclusions: This study revealed that RDW may also be included in the diagnosis of sepsis in newborns as it is a simple, inexpensive, available and easily repeated test as it is routinely done with a complete blood count.
Background Preterm infants may be more vulnerable to fractures due to physiological, metabolic and environmental factors, but an increased risk of fractures up to the age of 2 is unproven. The diagnosis of child abuse is one of exclusion and otherwise unexplained fractures in infants and young children may be erroneously attributed to premature birth despite the lack of evidence. The dilemma is complicated by reports that preterm children are more likely to be subjected to abuse as compared to term children. Epidemiological and clinical data comparing fractures in both preterm and term children could help experts form an opinion on the possibility of child abuse. Objectives To ascertain the rate of fractures, any differences in clinical presentation between preterm and term populations in the first 3 years of life and describe any differences in fracture patterns with an emphasis on fractures specific for abuse (rib and metaphyseal). Methods A retrospective study was conducted of children (term or preterm) born in the neonatal department of [screened] and subsequently attending the Emergency Department at [screened] with a suspected fracture within a 10-year period. We excluded any child who returned with the same injury, with known metabolic bone disease, with any disease or condition known to reduce bone density, who received any medication known to affect Vitamin D metabolism within 3 months of enrolment or who had fractures post-surgery/resuscitation. Variables such as the number of fractures sustained each year, age of presentation to the Emergency Department and mechanism of injury were compared between the preterm and term groups using statistical analysis (c2 and Fisher exact test for categorical variables and Student's t-test for continuous variables). Simple linear regression was performed on the total number of fractures sustained by age 3. Results 3,737 children were born and 2,533 attended ED during the study period, of which 79 attended with fractures. 44 children were included. Of these, none were born extremely preterm, 24 (55%) were preterm, and 20 (45%) were born at term. Mean gestational ages of the preterm and term groups were 32 weeks 3 days and 39 weeks 6 days, respectively. There were no extremely low birth weight or very low birth weight children. There was no significant difference in the number of fractures sustained yearly, the age of presentation to the Emergency Department or the site of fracture between preterm and term groups. Linear regression showed that the total number of fractures sustained by age 3 years was unrelated to prematurity status, gender or birth weight category. Conclusions Our data failed to show any association between prematurity and risk of childhood fractures up to the age of 3 years. Clinical presentation, site and types of fractures sustained by premature infants were not different from the term cohort. There were no fractures typical of abuse presenting over the 10-year study period, which suggests they are an uncommon finding in preterm children up to the ...
Background: The objective was to evaluate the proportion of ophthalmia neonatorum among 425 hospital born newborns who had received antibiotic eye prophylaxis within one hour of birth at a tertiary care centre in Central Kerala and to detect their causative organisms.Methods: The study design was an observational study done for a period of 10 months. A total of 425 term well newborn babies were included in the study. At delivery after the normal routine newborn care, babies were received azithromycin 1% eye ointment as prophylaxis for neonatal conjunctivitis in both eyes within one hour of birth. Babies were observed routinely during every vital monitoring for developing signs of neonatal conjunctivitis for the first 72 hours of life at hospital. During outpatient follow ups, 7 to 14 days and 14 to 28 days, these babies were examined for the presence of neonatal conjunctivitis. Babies having neonatal conjunctivitis were treated empirically with the same topical 1% azithromycin eye ointment after taking eye swab for culture and sensitivity in both eyes. The treatment has been modified based on the culture reports. Proportions were compared using Chi-square test with significance at p<0.05.Results: A total 15 (3.5%) of the 425 babies developed ophthalmia neonatorum. The most common isolate was Staphylococcus aureus which was 4 (26.7%) of all positive cultures followed by Escherichia coli 13.3%, Klebsiella pneumoniae 6.7%, Serracia marcescens 6.7%. None of the risk factors were found to be having association with conjunctivitis.Conclusions: This study concludes that a high proportion of neonatal conjunctivitis present despite eye antibiotic prophylaxis, though a greater reduction in cases has been shown when compared with no prophylaxis at our centre during the previous year. S. aureus was the most common causative organism isolated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.