Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevalence of neonatal respiratory distress in our area. It was conducted for a period of two years from 1st August 2014 to 31st July 2016.Results: maximum admissions on day 1 of life i.e. 309 (77.25%) followed by on day 2 i.e. 90 (22.50%) 231 (57.75%) were males and 169 (42.25%) were females. Male to female ratio was 1.36:1 Out of 400 children 11 were less than 1000 gms, followed by 77 (19.25%) had birth weight between 1000 g - 1499 g, 193 (48.25%) neonates had weight between 1500 g - 2499 gms and 118 (29.5%) neonates had weight between 2500 - 3499 gms and remaining 1 neonate had birth weight > 3500 grams. Out of 400 Neonates with respiratory distress, 281 (70.25%) had low birth weight and remaining 119 (29.75%) neonates had normal birth weight.Conclusions: Respiratory distress was the major cause of admission in our NICU. Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of RD. The most common causes of respiratory distress were TTN, RDS, MAS, and perinatal asphyxia. The common cause of death was HMD. The outcome of neonatal respiratory distress was found as: a survival rate of 78.5%, mortality rate of 21.5%.
Background: World health organization (WHO) has defined perinatal asphyxia as a failure to initiate and sustain breathing at birth. HIE is one of the most common complication in an asphyxiated neonate because of its serious long term neuromotor sequalae among the survivors. Nucleated red blood cells (NRBC) count in umbilical cord of newborns is been suggested as a sign of birth asphyxia. As the present markers are not accurate in diagnosis and assessing the severity of fetal asphyxia, this study was undertaken to find the values of NRBCs in normal and asphyxiated neonates and the correlation of NRBCs with birth asphyxia.Methods: Eighty neonates with asphyxia along with eight healthy newborns were undertaken for two years study period. Maternal and neonatal information was recorded follow by clinical and laboratory evaluation. NRBC levels was determined per 100 white blood cells (WBC). After discharge, immediate follow-up of asphyxiated infants was performed. Neonates were divided into two groups, with favorable and unfavorable outcome based on discharge or death.Results: We observed that NRBC count with more than 10 per 100 WBC/mm3, had sensitivity of 88.75% and specificity of 100% in predicting complications of asphyxia, while in NRBC count with more than 10, the sensitivity and specificity were 88.75% and of 100%, respectively. Conclusions: We demonstrate that NRBC/100 WBC can be used as prognostic marker for neonatal asphyxia, which in combination with the severity of asphyxia could indicate high infant mortality, immediate outcome and complications of asphyxia
Sickle cell disease is a very common inherited disorder of the hemoglobin. It is inherited in an autosomal recessive manner. Most affected are the people of African, Indian and Arabian origin. It occurs due to change in the single base pair gene wherein thymine replaces adenine in the 6th codon of the beta-globin gene. This result in the sickling shape of the red blood cells. Sickle cell disease includes a variety of phenotypes like the SS, AS, Sickle-thal, SC patterns, etc. Sickle cell- SS pattern also termed as sickle cell anemia is the most common of form of the disorder and is also responsible for the morbidity and mortality caused by the disorder. The sickling pattern of the red blood cells occludes the blood vessels and leads to a wide range of complication in the affected individuals. These complications can be seen in number of different systems of the body and also multiple systems at the same time. These complications are termed as crisis, which then include the vaso-occlusive crisis, acute chest syndrome, splenic sequestration crisis, etc. These crises can negatively affect the quality of life to a large effect, but are also largely controllable or rather delayed and effectively managed as far as possible with reduced effect in the normal well being. Hence the knowledge about these crisis and their treatment is an important aspect of medical practice, especially in the countries where this disorder is commonly seen. Here in this review article we aim to highlight the major crises seen in sickle cell disease and their treatment in brief.
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