Background: 0.8% of India's health care spending is for universalization of SNCU. The working status of a nonmedical college SNCU is still far from satisfaction in relation to manpower, availability, maintenance and utilization of equipment's. There are very few studies on outcome of morbities in non-teaching hospital SNCU and no studies analysing on morbities of LBW neonates in such SNCU with multiple deficiencies. LBW comprises 30% of SNCU admissions, half of perinatal and 1/3 rd of neonatal deaths. Methods: A retrospective study analyzing morbities and survival outcome of admitted LBW neonates in SNCU of district hospital Madikeri, Kodagu District, Karnataka, India from October 2014 to October 2015. 224 LBW neonates were grouped as per birth weight (<1 kg, 1-1.499 kg, 1.5-1.99 kg, 2-2.499 kg and maturity at birth (<28 weeks, 28-34 weeks, 34-37 weeks, Term). Intrauterine growth charts used to note birth weight for period of gestation and further classified into preterm, and term IUGR. Morbidities and survival outcomes followed until discharge were analyzed by descriptive and analytic statistics with respect to maturity, birth weight and IUGR. Results: 28.61% of SNCU admissions were LBW. 79.46% of LBW babies were preterm. 8.93%, 37.1%, 33.48% and 20.54% babies were <28 weeks, 28-34 weeks, 34-37 weeks and term neonates. 1.7%, 24.6%, 43.75%, and 29.99% weighed <1 kg, 1-1.499 kg, 1.5-1.99 kg and 2-2.499 kg. Incidence of RDS was 20.09%, Meconium aspiration syndrome was 4.46%, Neonatal sepsis 16.1%, Birth asphyxia 11.61%, Neonatal jaundice 7.59%, Apnoea 2.71%, hypoglyceamia 1.34%, hypothermia 1.79%, Refusal to feed 2.71%, congenital anomalies 1.34%. Discharge, deaths, referrals and LAMA for <1 kg (25%, 25%, 25%, 25%), for 1-1.499 kg (47.27%, 25.45%, 14.54%, 12.73%), for 1.5-1.99 kg (80.61%, 5.1%, 11.22%, 3.06%), for 2-2.499 kg (76.12%, 1.49%, 13.43%, 8.9%). Prevalence of IUGR in admitted LBW neonates was 43.75%. Early preterm <34 weeks were LBW AGA babies and late preterm 34-37 weeks were LBW SGA babies (P value-<0.001). Correlation between ELBW, VLBW and LBW neonates and its relation to deaths and discharge were highly significant (P value -<0.001), LAMA was significant (P value -<0.05). 70.08% cases were successfully discharged, 12.59% referred to tertiary care, 7.59% LAMA. 9.38% babies died. LBW constituted 47.72% of total SNCU deaths. Conclusions: Morbidity and survival outcome of LBW neonates is directly proportional to birth weight and gestational age. Though a low resource non-teaching hospital unit with deficiencies in manpower and functioning equipment's 70.08% of LBW babies were successfully discharged. FBNC units are contributing enormously to bring down neonatal death rates.
Foreign body aspiration in pediatrics is a potentially fatal accident which will continue until children explore their surroundings with their hand and mouth. Pediatric aspirations will persist until mankind exists. Not all foreign body aspirations are witnessed hence chances of delay in diagnosing an aspiration are high. Delay in diagnosis depends on site and character of foreign body aspirated. The chest x-ray findings and type of foreign body extracted vary depending on the duration the foreign body remains in airway. OBJECTIVE: To study the X-ray finding in pediatric airway aspiration and its relation to time lapse, the type and site of lodgment of foreign body extracted via bronchoscopy. The type of foreign body in relation to time lapse in aspiration. MATERIAL AND METHODS: This was a prospective study done in Bapuji child health institute and research center, JJM Medical College, Davangere. History and pre bronchoscopy x-Ray finding were noted for 65 children who were posted for suspicious bronchoscopy from August 2011 to September 2013. 11 children were excluded from study as they showed no foreign body on bronchoscopy. Time lapse in aspiration and seeking medical care was noted. The bronchoscopic findings regarding site of foreign body lodgment and type of foreign body were recorded. The type of foreign body and variation of xray picture in relation to time lapse in aspiration were noted. Data collected was analyzed using descriptive statistics. RESULT: It was observed that mean age was 28 months. About 80% of the cases were between 1 to 3 years age. 82% (n=53/54) were radio lucent foreign body, only 1.5% (n=1/54) were radio opaque. Site of lodgment of foreign body was right main bronchus in 48% (n=26/54), left main bronchus 46% (n=25/54), tracheal 1.85% (n=1/54), subglottic 1.85% (n=1/54), carinal 1.85% (n=1/54), multiple site i.e. left bronchus +right bronchus+ carinal 1.85% (n=1/54). Groundnut was most common foreign body 40.74% (n= 22/54), Arecanut in 24.07% (n=13/54), tamarind seed in 11.11% (n=6/54), Bengal gram 9.2% (n=5/54), corn seed in 5.5% (n=3/54), rest other organic foreign bodies accounting to 5.5% (n=3/54). Inorganic foreign body like pen cap and safety pin accounting for 3.7% (n=2/54). Chest X-ray taken prior to bronchoscopy showed U/L Obstructive emphysema in 53.7% cases (n=29/54), U/L Collapse 20.37% cases (n=11/54) Consolidation in 18.54% cases (n=10/54), collapse + consolidation 3.7% cases (2/54), Chest X-Ray was normal in 3.7% cases % (n=2/54). When analyzing time lapse in aspiration it was seen 81.81%cases (n=18/54) of aspirated ground nut presented within 1-7 days.72.92% cases (n=10/13), 66.66% cases (n=4/6) of arecanut and tamarind seed aspirations presented >30days post aspiration. Radio opaque foreign body like safety pin, large foreign body a pen cap, and other nuts and pulses presented either <1day or between 1-7 day post aspiration. When analyzing chest X ray in relation to time lapse in aspiration, 65.51%cases(n=19/29
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