Background: Infections in early neonatal period are one of the important factors responsible for high perinatal mortality and neonatal morbidity in developing countries. This study aims to know the role of Gastric aspirates cytology in predicting the early septicemia in newborn babies.Methods: The study will be conducted on 100 neonates with suspected septicemia and 50 normal neonates admitted to neonatology section. Gastric aspirate sample was collected for sepsis screening of neonates. All the collected data was tabulated and statistically analysed by using SPSS 2.0 software.Results: The sensitivity of gastric aspirate cytology is 50%, specificity 65.62%, positive predictive accuracy 47.6%, negative predictive accuracy of 67. 7%. The relationship between gastric aspirate cytology and maternal risk factors was found to be statistically not significant except PIH and PROM in which association is significant. The relationship of prolonged rupture of membranes with gastric aspirate cytology was found to be highly statistically significant.Conclusions: The chances of positivity of gastric aspirate increase as the duration of rupture of membranes increased. Gastric aspirate had high percentage of specificity and negative predictive accuracy. No specific and significant correlation between positive gastric aspirate cytology and rural/urban area, birth weight, sex, gestation, prolong labour, meconium stained amniotic fluid, mode of delivery was found.
Background: Congenital heart disease is defined as a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance. This study aims to know the prevalence of occurrence of extra cardiac malformations in patients with CHD, based on clinical features and necessary investigations when required and to study whether these extracardiac malformations occur as a part of a known syndrome or they occur in isolation.Methods: This study is a cross sectional hospital based observational study, carried out in the Department of Paediatrics, Dr. B. C. Roy Postgraduate Institute of Paediatric Sciences, Kolkata over two years from July 2014 to June 2016. A thorough general physical examination, vitals, anthropometry was undertaken. Systemic examination was done in all cases according to the study proforma. CHD was confirmed by X-ray chest, Electrocardiography, Echocardiography.Results: Twenty-three percentages (23%) of the patients were found to have an associated major ECM. Down syndrome was the most commonly identified syndrome in the present study accounting for 50% of the patients of CHD with an associated syndrome. The most common CHD among patients with Down syndrome were multiple CHD and VSD.Conclusions: Whenever more than 1 minor anomalies are found, a careful search for an underling major malformation such as CHD should be made. In all cases of congenital heart diseases with associated extracardiac malformations, effort should be made by the treating pediatrician to rule out an associated syndrome; so that parents can be counselled about prognosis, recurrence in the subsequent pregnancies.
Background: Sepsis is an important cause of neonatal morbidity and mortality. The magnitude of problem may be reduced by early detection of amniotic fluid infections and appropriate treatment of the neonate. Objective: The objective of this study was to know the role of gastric aspirates cytology and micro-erythrocyte sedimentation rate (m-ESR) in predicting the early-onset septicemia in newborn babies. Materials and Methods: The study was conducted on 100 neonates with suspected septicemia and 50 normal neonates admitted to neonatology section of a tertiary care hospital. Blood sample and gastric aspirate sample were collected for sepsis screening of the neonates. All the collected data were tabulated and statistically analyzed using SPSS 2.0 software. Results: About 55% of neonates had positive cytology and m-ESR and 22.2% had subsequent sepsis. Combined sensitivity was 50%, specificity was 81.25%, positive predictive value (PPV) was 62.5%, and negative predictive value (NPV) was 72.2%. Of the 45% of cases with positive cytology and micro-ESR, 13.3% had septicemia, 6.6% had pneumonia, and 2.2% had meningitis. The other 55% of cases had negative cytology and m-ESR, and out of them, 9.09% had septicemia, 7.2% had pneumonia, and 1.8% had meningitis. The sensitivity of m-ESR was 60%, specificity was 62.5%, PPV was 50%, and NPV was 71.5%. The combined sensitivity was 50%, specificity was 81.25%, PPV was 62.5%, and NPV was 72.2%. Conclusion: Combined gastric aspirate and m-ESR had high percentage of specificity and NPV. No specific and significant correlation between positive gastric aspirate cytology and rural/urban area, birth weight, sex, gestation, prolong labor, meconium-stained amniotic fluid, and mode of delivery was found.
Background: Neonatal hyperbilirubinemia in many of the cases is only in physiological range, but quite often it requires phototherapy and even exchange transfusion for proper management. Although hypocalcemia is often proposed to be associated with phototherapy in term and preterm newborns, its exact incidence and clinical significance still remains to be elucidated.Methods: Current study was carried out in a tertiary care center in North India with 29 term neonates in test group receiving single surface phototherapy and 29 age, sex and gestational age matched neonates in control group, who did not receive phototherapy. Serum calcium levels at 0 and 48 hours of starting phototherapy were determined in both the groups and compared.Results: Mean difference of Serum ionized calcium between two groups was statistically significant at 48 hours with mean for test group was 4.58 mg/dl compared to 4.94 mg/dl for control group (p <0.001). 10 newborns (47%) in test group had hypocalcemia according to standard definitions and 3 out of them (30%) had were clinically symptomatic with jitteriness and poor feeding, which resolved after calcium supplementationConclusions: Term neonates undergoing phototherapy are at increased risk for hypocalcemia. A universal recommendation regarding calcium supplementation in neonates undergoing photherapy is yet to be established but seems like a reasonable intervention.
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