Background: Over the past few decades, the burdens of very low birth weight (VLBW) preterm infants are increasing due to advances in obstetrics and perinatal services. Objectives of the study were to assess predictors of mortality of extramural VLBW neonates.Methods: Prospective one year cohort study was undertaken on VLBW neonates fulfilling the inclusion criteria at a tertiary institute. Maternal and neonatal demographic data were analyzed.Results: Male to female ratio was 1.26:1. One hundred and thirty seven (74.9%) neonates had birth weights from 1000-1499 g while 46 (25.1%) had birth weights <1000 g (ELBW) and 90% were preterm. One hundred and sixty five (90.2%) neonates were admitted in early neonatal period. Anaemia was the commonest maternal illness and preeclampsia/eclampsia was the most common obstetric complication. Respiratory distress, temperature instability and lethargy were common clinical presentations. Respiratory distress, sepsis and perinatal asphyxia were common diagnoses on admission. Mortality rate in VLBW neonates was 59.6% and respiratory distress was the commonest cause of death. Male gender (p=0.01), home delivery (p=0.04), vaginal delivery (p=0.05) and positive septic screen (p=0.003) had significantly higher mortality while mode of delivery (aOR 0.27 CI 0.086-0.83 p=0.02) and positive septic screen (aOR 4.0 CI 1.67-9.84 p=0.002) were independent risk factors for mortality.Conclusions: In extramural VLBW neonates, male gender, home delivery, vaginal delivery and positive septic screen had significantly higher mortality whilst mode of delivery and positive septic screen were independent risk factors for mortality.
Congenital arhinia is a seldom defect and may be associated with other facial and systemic defects. It is described as complete absence of nose. Case Report: Neonates are obligate nasal breathers but our neonate with complete absence of nose adjusted well to breathing through mouth without any need of urgent ventilator support or tracheostomy. Conclusion: Neonates may adapt breathing through mouth and bypass major respiratory support that is oral intubation or tracheostomy.
Background: The objective of the study was to determine the prevalence of pulmonary hypertension in pediatric patients with beta thalassemia major in a tertiary care centre in Central India.Methods: A cross sectional study was conducted in department of pediatrics, Government Medical College and Hospital, Nagpur, India over a period of 2 years. Total 100 subjects of thalassemia major diagnosed by high performance liquid chromatography (HPLC) attending day care in this department were enrolled for study. Measurement of pulmonary pressure was done by using 2D echocardiography with Doppler studies and tricuspid regurgitant jet velocity was measured. This was done by experienced cardiologist. Variables predictive of pulmonary hypertension studied were age, sex, serum ferritin levels, age of onset of chelation therapy, compliance to chelation therapy and number of blood transfusion per year.Results: Out of 100 subjects, 18 subjects had pulmonary hypertension. Univariate analysis proved that age, serum ferritin levels, age of onset of chelation therapy, compliance to chelation therapy and number of blood transfusion per year were significant predictors of pulmonary hypertension. While, multiple logistic regression analysis revealed that only 3 variables that is age of onset of chelation therapy, number of blood transfusion per year and compliance to chelation therapy retained their significance in this patient population.Conclusions: Prevalence of pulmonary hypertension was found out to be 18%. 2 subjects in the pulmonary hypertension group died. High morbidity and mortality of pulmonary hypertension clearly indicates that much work is needed in disease detection and development of more effective therapies. For thalassemic children, early detection and prevention of pulmonary hypertension in childhood would improve survival, reduce morbidity and mortality.
Background: Over the past few decades, the burden of extramural very low birth weight (VLBW) neonates is increasing due to advances in obstetrics services. Objective of present study was to know variables affecting mortality in these neonates. Methods: A prospective observational study was conducted at department of paediatrics, government medical college and hospital, Nagpur, India over a period of 2 years. Out-born neonates admitted in this tertiary care centre with birth weight between 1000-1499 gm were included in the study. Proper antenatal, natal history were taken and data was collected using data collection sheet. All subjects were followed up till discharge or death whichever was earlier. Results: Significant demographic factors associated with neonatal mortality were found out to be place of birth, birth attendant, distance travelled and transport time. Neonatal factors which significantly associated with mortality were found out to be hypothermia and SpO2 less than 90%.Conclusions: Univariate analysis concluded that age at presentation (>24 hours), place of birth, birth attendant, distance travelled, mode of transport, transport time, hypothermia, SpO2<90% were found to be significant factors for predicting risk of mortality in VLBW neonates. However, multivariate analysis concluded only 4 predictors that is age more than 24 hours, transportation time, SpO2 on admission and hypothermia were found to retain their significance. VLBW babies are vulnerable, but with small improvements in infrastructure and personnel training, significance difference in prevention of morbidity and mortality can be seen.
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.