Background: Prematurity is a major cause of neonatal mortality and morbidity. Most of the studies are focused on outcomes among preterm neonates less than 34 weeks gestation which has the highest mortality and morbidity. The main objective was to study the morbidity and mortality pattern of late preterm neonates as compared to term neonates. Methods: Neonates delivered at Cheluvamba hospital Mysore, India from March 2014 to September 2014 were subjected to gestation assessment. Gold standard for gestational assessment was early obstetric ultrasound (6-12 weeks). In the absence of which, the gestation was calculated from the clinical assessment of gestation by expanded new Ballard score. The enrolled babies were divided into two groups: Study group: Gestational age 34 0/7 to 36 6/7 weeks (Late Preterm) and Comparison group: Equal number of term (above 36 weeks 6 days of gestation and below 42 weeks of gestation) neonates born in our hospital during the study period. After including cases, details were entered in predesigned proforma which included detailed maternal history for risk factors and detailed natal and postnatal history for complications and late preterm were compared with term neonates. Results: A total of 110 late preterm neonates were compared with 110 term neonates. As compared to term neonates, late preterm neonates were more at risk for need of resuscitation (p=0.013), need for nutritional and supportive care (p=0.000), respiratory distress (p=0.000), birth asphyxia (p=0.032), early onset sepsis (p=0.001), neonatal jaundice (p=0.001), hypothermia (p=0.000) and feeding difficulties (p=0.000). They also had prolonged duration of stay in hospital (p=0.000) and also mortality was more in late preterm neonates as compared to term neonates (p=0.002). Conclusions: Late preterm neonates have a higher risk for morbidity and mortality as compared to term neonates and hence, need special attention.
BACKGROUNDHospital readmission due to neonatal hyperbilirubinaemia is a cause for concern among parents as well as clinicians. Early discharge carries the risk of delayed recognition of hyperbilirubinaemia and the possibility of bilirubin-induced brain damage.The aim of the study is to correlate the umbilical cord bilirubin level as a predictor of subsequent neonatal hyperbilirubinaemia in term healthy newborns.
Background: Neonatal sepsis accounts for early-half of all neonatal death in India. Although the gold standard for the diagnosis of neonatal sepsis is by blood culture, there is a need for a test that is cheap, accurate, easily performed with quick availability of reports so that prompt and appropriate treatment is ensured. In this study we try to analyse the diagnostic value of I/T2ratio in comparison to I/T ratio and absolute neutrophil count (ANC) independently to correctly predict neonatal sepsis. Subjects and Methods: A time bound, prospective comparative study was done on neonates with suspected neonatal sepsis for a 2 year period. Neonates were then analysed in three groups depending on their blood culture results as no sepsis, probable sepsis and proven sepsis. I/T2was calculated for all the babies and an optimum cut off was found for the same. The diagnostic accuracy of I/T2 ratio with septic screen positivity and blood cultures were assessed. Results: 245 neonates included in the study were divided into three groups depending on whether they were blood culture positive sepsis, probable or clinical sepsis. The means of septic screen parameters including I/T2 were highly significant when compared between the three groups (p value <0.001). ROC curve created showed the AUC for I/T, I/T2 and ANC was 0.822, 0.809, 0.610 (p value <0.001) and a higher specificity. Conclusion: I/T2 shows promise as a parameter to screen for sepsis in neonates. Calculating the I/T2 ratio in conjunction with established septic screen parameters could enhance prediction of sepsis in newborns.
Background: Cerebral Palsy is the most common chronic motor disorder of childhood. Clinical spectrum is different in developing and developed countries. Aim of the study was to evaluate the clinical profile, co-morbidities and the imaging correlate of children with CP.Methods: Data was collected retrospectively from individual case records from March 2016 to October 2018. All children aged 2 years and above with clinical signs of cerebral palsy were included in the study.Results: A total of 78 children had the diagnosis of cerebral palsy, out of which 63 cases were included which satisfied the inclusion criteria. Most of the children were born out of singleton pregnancy (90.4%). The mean gestational age was 36.94±1.48 weeks. Most common type of cerebral palsy noted in present study was spastic quadriplegic type (n=34) followed by diplegic type (n=14). Epilepsy was associated in 36.5% (n=23) of children, and most commonly associated with spastic quadriplegic type of cerebral palsy(n=16). Other associated abnormalities included mental retardation, speech, hearing, cognitive, and behavioral abnormalities. Magnetic resonance imaging was normal in 60.3% (n=38) of children and abnormal in 39.68% (n=25) of children. Diffuse cerebral atrophy was the most common abnormal finding (n=9). Other abnormal findings included periventricular leucomalacia, basal ganglia lesions, cortical/subcortical lesion, focal infarcts and miscellaneous lesions.Conclusions: MRI helps in knowing the pathological basis of the disease, but clinical findings carry utmost importance. MRI positivity was seen in only 39.68% of cases. Hearing abnormalities being the most common association, proper screening tests and regular follow up is very essential.
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