Background: With advancements of perinatal, neonatal care congenital defects were the most common cause of morbidity and mortality in developed world. It is one of the common causes of morbidity and mortality in India. Its incidence also influenced by many preventable risk factors. Hence, we are carried out this study to know the changing pattern of congenital anomalies and to know the effect of environmental risk factors on congenital anomalies.Methods: Prospective observational study conducted at Niloufer hospital Hyderabad during period from November 2017 to 2018. We included intramural and extramural babies. Analysed data by appropriate statistical methods.Results: Most common system involved was Central nervous system (CNS) with 25 cases out of 112 cases followed by Gastrointestinal system (GIT)and Cardiovascular system (CVS). Meningomyelocele, anorectal malformations and acyanotic heart diseases were most common type of congenital anomalies. Thirty seven to forty weeks gestational age group babies were most commonly have congenital anomalies than other gestational age group babies. Low birth weight babies had higher percentage of congenital anomalies (2.64%). Congenital anomalies were more in the male sex (2.53%) as compared to female babies (1.73%). Maternal obesity, consanguineous marriage and previous family history of congenital anomalies associated with increased risk of congenital anomalies with significant p values.Conclusions: Incidence of congenital anomalies was 2.15%. Most of congenital anomalies were involved in CNS. Birth weight, Gestational age, Male sex, consanguineous marriage, maternal Obesity and previous family history of congenital anomalies were significantly associated with increased risk of congenital anomalies.
Background: Respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm newborns. Continuous positive airway pressure (CPAP) acts by preventing atelectasis and improves functional residual capacity and arterial oxygenation. Aims: This study aims to evaluate the effectiveness of early nasal bubble CPAP in treating preterm neonates with mild-to-moderate RDS in the rural setting. Materials and Methods: It is a prospective analytic observational study done at a tertiary hospital in the rural area of southern India from December 2018 to December 2019. All babies between 28 and 34 weeks of gestation with mild and moderate RDS were included in the study. Babies with severe RDS requiring surfactant were excluded from the study. Results: Incidence of RDS among babies born between 28 and 34 weeks of gestation was 3.2%. Out of total 50 babies who were managed with early nasal CPAP, it proved effective in 43 babies (86%), while remaining 7 babies (14%) had to be intubated and required ventilation. Babies were studied based on radiological appearance and we found a success rate of 93.1% in moderate grade hyaline membrane disease (HMD) (p<0.005). Conclusion: Bubble CPAP is effective in treating mild and moderate cases of RDS at peripheral center and help decrease the burden at tertiary care center.
Infestation is a state of being invaded or overrun by parasites. Myiasis is an infestation caused by dipterous fly. Even though human myiasis is a rare infestation particularly in newborn period unlike animal myiasis as neonate is just newly introduced to the environment and during this period neonate usually more protected and taken care by us. In rural areas of tropical countries where good hygiene conditions will not be there, authors are still identifying these cases. Risk factors for myiasis usually poor socioeconomic conditions and unhygienic environment. Finding cases of umbilical myiasis usually indicates poor environmental sanitary measures at that particular place. Here authors are presenting a case of neonatal umbilical myiasis caused by Chrysomya megacephala. These flies usually lay their eggs over the wounds or moisture dead necrotic tissues unlike other species of flies where they usually lay eggs over the animal fecus. But some other free-living flies(saprophagous) also cause myiasis due to accidental laying of eggs over dead necrotic tissues due to open defecation. In present case authors identified myiasis as early as third completed day of life, means infestation occurred at the time of delivery as incubation period for hatching eggs to larvae usually 4-8 days. These larvae able to survive inside deep tissue by breathing through a small hole. Even though myiasis usually have good prognosis it will become a focus for secondary infections. If deep-seated causes severe morbidity and even in extreme cases causes death also. Diagnosis is mainly clinical, authors can identify the species by microscopic examination of third stage larvae and finding age of the larvae also useful in identifying time of infestation. Treatments usually direct removal of larvae from the site by manipulation, irrigation, suffocation by ether and surgery if deep-seated. As they usually create nadir for infection by bacteria ruling out secondary infection and treatment is necessary. It is better to take preventive strategies like birthplace cleanliness and environmental sanitation. Tracking the case helpful in finding the places where authors need to improve sanitary measures it is better to give feedback to appropriate administrative officers to prevent home deliveries.
Fibrinogen disorders are rare bleeding disorders. Fibrinogen is also called factor I which is involved in last step of coagulation cascade. Congenital hypofibrinogenemia is usually caused by mutation of FIB (fibrinogen-binding protein) gene. These disorders should be suspected when Thrombin time is prolonged in well look child with history of bleeding manifestations. We are describing a female child who is having pallor with history of recurrent ecchymosis and minor post traumatic bleeding. Based on coagulation screening profile, we made the diagnosis of hypofibrinogenemia.
Floppy baby is a non-specific and potentially serious multisystem disorder in the neonatal period. Diagnosing hypotonia in a newborn is very difficult as many disorders could manifest with diminished tone. In most cases, medical history and laboratory tests are useful for diagnosis, but they still require advanced research such as whole exome sequencing. The objective of this study was to know the presentation and how we evaluated hypotonia by using basic investigations to comprehensive molecular genetics tests which provides the advantage of the rapidity and diagnostic specificity as a part of the workup. Methods: This study was conducted on infants hospitalised in NICU at a tertiary care centre (Niloufer hospital), Hyderabad, Telangana, India. Clinical presentations, clinical examinations, laboratory tests, imaging, and genetic studies were reviewed. Clinical assessment includes evaluation of muscle tone, primitive reflexes, deep tendon reflexes, resting postures, and maneuvers. We used images and molecular genetic tests in the required cases. Results: Ten babies with hypotonia were studied. The male to female ratio was 6:4. The most common complaint was poor feeding, and other presentations were seizures, tachypnea, and icterus. On examination, all cases had hypotonia with absent DTR, and a few cases had dysmorphism.
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