AIM:To study the determinant of mortality on extramural arrival of sick newborns and mode of neonatal transport at tertiary care Centre. BACKGROUND: Neonatal transport system in our country is major gap in holistic newborn care and acute neonatal physiology is deranged during transport which adversely affects the mortality and morbidity of sick newborns. MATERIAL & METHODS: This is prospective observational cohort study carried out in out born neonatal intensive care unit over a period of one year. Inclusion criteria were age up to 28 days, delivered at home or private nursing home or any health centre; and exclusion criteria were age more than 28 days, abandoned newborns and those delivered in the institution of study. A predesigned and tested proforma was used to record information by the pediatric resident on duty at time of neonatal admission. Data were analysed and tabulated, for analysis of data software STATISTIX was used, chisquare test for dichotomous variables and multiple logistic regression for predictors of mortality. RESULT: Out of 200 newborns 146 were male and 54 were female, 140 were term and 59 were preterm, 39 newborns expired and common mode of transport was taxi 47%, bus 16%, auto 16% and ambulance 2.5%. The common factors determining the outcome were low admission weight, prematurity, longer duration of transport and deranged physiological factors e.g. hypothermia, respiratory distress, prolonged CRT and central cyanosis. CONCLUSION: This study concludes that neonatal transport in our country is self-supported; the ideal element of neonatal transport is major gap in holistic neonatal care. Thus we suggest RUSH-IN FACILITY for neonatal transport.
Severe acute malnutrition (SAM) may affect cardiac structure and function. Cardiac changes in sick children with SAM have received little attention in the literature. Children aged 6–60 months with SAM were cases, and age and sex matched children were controls. Cardiac biomarker levels were measured by the quantitative the Enzyme- linked immunosorbent assay (ELISA) method, and echocardiography was used to assess cardiac changes in all children. The study included 76 children in each group. Children with SAM had less left ventricular mass and increased myocardial performance index as compared with controls (
p
< 0.0001). Cardiac biomarker levels were increased in children with SAM (
p
< 0.0001). Cardiac changes and biomarker levels were comparable in children with edema and children without edema except creatine kinase-MB (
p
= 0.01).
To evaluate the fracture toughness of cement-retained implant-supported metal-ceramic molar crown with that of all-ceramic crowns, fabricated using IPS Empress 2 and yttria-stabilized zirconia copings. An dental implant and abutment was embedded in a clear polymethyl methacrylate model. A wax pattern reproducing the anatomy and dimension of a mandibular molar was made using inlay wax. Copings were made from the manufacturers guidelines for zirconia, metal ceramic and empress crown, in total of 21 copings, which were built for the crowns with metal layering ceramics specified by the manufacturers. The polymethylmethacrylate block-implant abutment complex was mounted on universal testing machine, and a static continuos vertical compressive load with a crosshead speed of 0.5 mm/min was applied. The breaking load and the peak load (in kilo Newtons) were recorded. The fractures for group I (zirconia-ceramic) and group II (metal-ceramic) occurred on the mesio-buccal aspect of the crowns involving the veneered ceramic layer while the catastrophic/bulk fracture was not observed. The mean value of breaking load for zirconia-ceramic, metal-ceramic and IPS-empress 2 was 3.4335, 3.071 and 1.0673 kN respectively. The mean value of peak load for zirconia-ceramic, metal-ceramic and IPS-empress 2 was 4.7365, 3.2757 and 1.566 kN respectively. It can be concluded that the zirconia-ceramic crown with the fracture toughness of 4.7365 ± 2.2676 kN has sufficient strength to allow clinical testing of these crowns as an alternative for metal-ceramic crowns (3.2757 ± 0.4681 kN).
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