BACKGROUND Hyperbilirubinemia is the most common ailment requiring medical attention in newborns. Neonatal hyperbilirubinemia nearly affects 60% of term & 80% of preterm neonates during the first week of life. Neonatal jaundice has much higher incidence in premature babies and often requires therapeutic intervention. Neonatal physiological jaundice could result either due to increased breakdown of foetal erythrocytes or low concentrations of hepatic glucuronyl transferase. Hypocalcaemia is one of the known adverse effects of phototherapy. 90% of the preterm and 75% of the full-term neonates develop hypocalcaemia post phototherapy. We intended to study the effects of photo therapy on serum electrolytes (Na + , K + , Ca ++). METHODS It is a prospective interventional study. Neonates who were born or admitted to 'Sardar Vallabhbhai Patel Postgraduate Institute of Pediatrics (SVP PG IP), Sriram Chandra Bhanja (SCB) Medical College and Hospital, Cuttack, Odisha, from October 1 st , 2016 to September 30 th , 2018 receiving phototherapy for unconjugated hyperbilirubinemia after 24 hrs. of life without any co-morbidities were studied. RESULTS Serum calcium and serum sodium levels decrease with increasing duration of phototherapy. The comparative correlation between the preterm and term neonates considering the change in calcium level before and after phototherapy shows more change in values in term neonates. CONCLUSIONS Electrolyte changes are seen more commonly in pre-term neonates. The incidence of hypocalcemia was 22%, it was 51.6% at >48 hrs. duration of phototherapy (PT) and 52.9% in preterm neonates. The incidence of hyponatremia was 10%, it was 19.3% at >48 hrs. duration of PT and 29.4% in preterm neonates. The mean serum calcium levels before and after PT were 1.08±0.135 mmol/L and 1.008±0.161 mmol/L respectively.

No abstract

Introduction: Incidence of Hypoxic Ischemic Encephalopathy (HIE) is 2-4 per 1000 live birth in USA, 1.8 per 1000 live births in Sweden, 3.8 per 1000 term live births in Australia. In India the incidence of HIE is 10-15 per 1000 live birth. The survivors from severe HIE develop cerebral palsy and mental handicaps as high as 50%. Concurrent use of cranial ultra sound and clinical staging systems are evolving to predict the prognosis. Objective: To study the cranial ultrasonogrphic finding in HIE Infants and its clinical correlation and prediction of outcome. Method: it is a prospective clinical study of 120 baby suffering from hypoxic ischemic encephalopathy. Result: Co-relation of initial cranial ultra sonography grading with mortality and sequel showed an increasing trend as the ultrasonography grading increases, with 51.4% mortality in grade –III, 18.5% in grade-II and 15.4% in grade –I. Seqele 48.6% was observed only in grade-III sonographic abnormality. Conclusion: Sonographic grading is more accurate than the clinical staging in predicting recovery, mortality and sequel.

Background: Retinopathy of prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with decreasing gestational age. India shares 20% of the world childhood blindness. Besides congenital cataract, congenital glaucoma and ocular injuries, ROP is emerging as one of the important causes of childhood blindness in India.Methods: This hospital based prospective study was undertaken during October 2016 to September 2018 in the Department of Ophthalmology, SCB Medical College. Authors included (a) all preterm infants weighing less than 1750gm or gestational age less than 34 weeks at birth, (b) infants with birth weight between 1750gm to 2000gm and gestational age more than 34 weeks (late preterm and term infants) those were considered as high risk.Results: Among the 328 babies included in our study, the incidence of ROP was 29.57%. Bilateral ROP was found in 76.29% with nearly equal stages in both eyes and only 23 neonates showed unilateral involvement.Conclusions: Low birth weight, lower gestational age, blood transfusion, Respiratory Distress Syndrome (RDS), apnoea, supplemental oxygen therapy, maternal anaemia and gestational diabetes mellitus (GDM) were strongly associated with development of ROP.

Introduction: There is a high incidence of acute kidney injury (AKI) among asphyxiated term. AKI manifests by changes in urine output and blood chemistries & can have serious clinical consequences. Oliguria has been reported in higher number of neonates affecting nearly 25%-70% babies. Methodology: This study was undertaken to study renal failure in asphyxiated neonates. This is a prospective case controlled study done over a period of two years. Various clinical, biochemical and radiographic parameters pertaining to renal injury among asphyxiated neonates were studied. Results: About 64 asphyxiated newborns were studied. Majority (53.12%) was term weighing between 2.5-3 kg & most of them were in HIE-2 grade (43.75%). Oliguria was mostly noted among HIE-3 (31.57%). Birth asphyxia and subsequent acute renal failure was more in babies delivered vaginally. Biochemical parameters also showed correlation with the severity of asphyxia. Premature babies were more prone to develop renal failure secondary to asphyxia. Mortality was directly related to severity of perinatal asphyxia and presence of oliguria. Conclusion: The incidence of acute renal failure due to perinatal asphyxia was high. Incidence with oliguria was high in severe asphyxia. Prevention of asphyxia & prompt management of morbidities like ARF can improve the outcome of perinatal asphyxia.

No abstract

Introduction: Poisoning in children is a common and preventable cause of morbidity and mortality. Our environment is still not child-safe and the medications are not dispensed in a child-safe manner. The incidence of childhood poisoning in India varies from 0.3 to 7.6 percent. Poisoning accounts for 0.03% of mortality in infants, 0.16% in preschool age group and 0.37% of in five to fourteen year's age group as per the statistics projected by Government of India. The poisoning in paediatric age group includes obsolescent traditional poisons, the in fashion intoxications with recreational drugs as well as chronic exposure to industrial chemicals. The peak incidence of accidental overdoses is in the second year of life and 85% of accidental poisoning affect children under five years of age. Methodology: This is a prospective case controlled study done over a period of two years. The study was conducted in S C B Medical College, Cuttack, Odisha. Results: The poisoning constitutes 1.15% of total paediatric admissions. The commonest type of poisoning was due to Non-Medicaments (56 cases-78.87%), out of which the commonest poisoning was due to hydrocarbons. Conclusion: Non medicament ingestions particularly kerosene still one of the very common toxic ingestion in children used in accidental poisoning cases.

Introduction: Chronic liver diseases (CLD) account for 1 to 5% of paediatric ward admissions and upto 20% of ward mortality in our country. Now a day Indian childhood cirrhosis is a rarity, whereas diseases likechronic hepatitis, Wilsons disease and biliary atresia are diagnosed with increasing frequency and therefore became relatively important forms of paediatric liver disease. Methodology: The study was done to determine the clinico-etiological profile of chronic liver disease in children 1 year to 14 years. This is a prospective case-controlled study done over a period of two years. Various clinical, biochemical and radiographic parameters pertaining to chronic liver disease were studied. Results: About40 cases were studied. CLD was found to be prevalent in 5-10 years of age group. Male were more affected than female. Jaundice was the most common presenting feature. Hepatomegaly, Ascitis, Splenomegaly were thecommonest presenting signs.Conclusion: CLD is not uncommon condition in children. It constitutes 18.34% of the patients of the with liver disease in our region. Wilson's disease was the most common aetiology apart from idiopathic which constitute 52.5% of the cause.