Hypernatremia and excessive weight loss in exclusively breastfed term infants in early neonatal period

Introduction: Newborn infants lose weight in the first week of life. There is an increasing recognition of hypernatremia and it’s complications in exclusively breastfed newborns. Early recognition of critical weight loss, signs, and symptoms of dehydration and hypernatremia are keys to prevent morbidity and mortality in these neonates. Objectives: To identify term neonates with excessive weight loss >10% of birth weight and to compare their serum sodium levels with levels in babies with weight loss <10% of birth weight. Materials and Methods: A prospective observational study was conducted on healthy full-term exclusively breastfed newborns delivered in a rural tertiary hospital. The primary outcome was the proportion of newborn infants with loss >10% of birth weight at day 5 and serum sodium levels in these babies. Results: Weight loss >10% of the birth weight was seen in 6.22% of term babies. The mean weight loss in this group was 360.14±81.82 g in comparison to 141.32±67.78 g in rest of the babies. Serum sodium >149 meq/L was seen in three neonates in excess weight loss group, i.e., 1.33% of neonates in the study. The mean serum sodium was higher in babies with excess weight loss (141.71±4.39 vs. 139.74±2.32 mEq/L, p=0.0045). Conclusion: About 6.22% of exclusively breastfed term neonates had excessive weight loss and serum sodium levels were higher in these babies with than those with weight loss <10% of birth weight. Neonates with excessive weight loss need more cautious follow-up for early recognition of potential hypernatremia and its complications

Decentralized shape formation and force-based interactive formation control in robot swarms

Swarm robotic systems utilize collective behaviour to achieve goals that might be too complex for a lone entity, but become attainable with localized communication and collective decision making. In this paper, a behaviour-based distributed approach to shape formation is proposed. Flocking into strategic formations is observed in migratory birds and fish to avoid predators and also for energy conservation. The formation is maintained throughout long periods without collapsing and is advantageous for communicating within the flock. Similar behaviour can be deployed in multi-agent systems to enhance coordination within the swarm. Existing methods for formation control are either dependent on the size and geometry of the formation or rely on maintaining the formation with a single reference in the swarm (the leader). These methods are not resilient to failure and involve a high degree of deformation upon obstacle encounter before the shape is recovered again. To improve the performance, artificial force-based interaction amongst the entities of the swarm to maintain shape integrity while encountering obstacles is elucidated.Comment: 6 pages, 10 figure

VOLTAGE FLICKER MITIGATION USING FUZZY LOGIC BY THE ANALYSIS OF DVR PERFORMANCE

The issue of voltage lists and its serious effect on delicate burdens is surely understood. To tackle this issue, The DVR is an advanced and critical custom force gadget for pay voltage droops in force dissemination frameworks. The Dynamic Voltage Restorer (DVR) is quick, adaptable and proficient answer for voltage droop issue. The DVR is an arrangement compensator used to alleviate voltage lists and to restore load voltage to its evaluated esteem. In this paper, a diagram of the DVR, its capacities, setups, segments, working modes, voltage infusion strategies and shut - circle control of the DVR yield voltage are surveyed alongside the gadget abilities and constraints

Clinical features and bacteriological profile of late onset sepsis

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is associated with community environment or postnatal exposure to hospital environment. It's incidence is rising due to greater survival of preterm neonates and very low birth weight babies. The bacterial isolates of neonatal sepsis especially that in LOS are changing. An understanding of the changing epidemiology of neonatal LOS will help to reduce the associated mortality and morbidity. The objective was to study the clinical symptoms and signs of late onset sepsis, to study the bacteriological profile of LOS.Methods: A prospective observational study. All neonates presenting with signs and symptoms of sepsis after 72 hours of life up to day 28 were included. Babies with birth asphyxia and congenital anomalies were excluded from the study.Results: A total of 120 newborns with LOS were included in the study. Of this 42.5% had blood culture positive sepsis. Lethargy, refusal of feeds and apnoea were seen in 61.66%, 55.0% and 34.17% of babies respectively. Klebsiella (25.49%), Staphylococcus aureus (23.53%) and coagulase negative Staphylococcus (21.57%) were the predominant organisms isolated in LOS.Conclusions: Prompt diagnosis of neonatal sepsis is a challenge. The incidence of LOS in neonates is rising. Klebsiella is the most common gram negative organism; Staphylococcus aureus and CONS are the predominant gram positive organisms. CONS is emerging as an important causative organism in LOS.</jats:p

A RARE CASE OF ACHONDROPLASIA- SHORT LIMB

BACKGROUND A 6-year-old boy was presented to the paediatric department with shortening of all the limbs and delay in growth. Clinical examinations revealed height less than third percentile along with other abnormalities like frontal bossing, midfacial hypoplasia, flattened nasal bridge, short neck and rhizomelic type of shortening of all the limbs. These clinical features raised the diagnosis towards achondroplasia, which was further supported by radiologic evidence. Achondroplasia is a disorder involving growth of bone. The conversion of cartilage to bone is hampered. The affection is particularly seen in the long bones of arms and legs. The characterising features of this disorder are dwarfism, limitation in range of motion at the elbows, enlarged size of head, small fingers, but with normal intelligence. Other complications like apnoea, obesity, recurrent ear infections and lordosis of the spine are often associated with achondroplasia. The basic defect in achondroplasia lies in mutations of the FGFR3 gene. It is an autosomal dominant disorder

EFFECT OF DOUBLE SURFACE PHOTOTHERAPY ON SERUM MAGNESIUM LEVELS IN TERM AND LATE PRETERM NEONATES

BACKGROUND Hyperbilirubinaemia is one of the most common sign encountered in newborns. Untreated, severe unconjugated hyperbilirubinaemia is potentially neurotoxic. Phototherapy is the first line of treatment in neonatal hyperbilirubinaemia. Phototherapy has potential complications like dehydration, electrolyte and haematological changes, etc. Limited studies on magnesium changes after giving phototherapy. Hence, present study to find out magnesium level changes after double surface phototherapy. MATERIALS AND METHODS It is a hospital-based prospective comparative study in the Department of Paediatrics in MVJ MC and RH. The study included admitted 30 term and 30 late preterm neonates who are subjected to phototherapy for neonatal hyperbilirubinaemia. Parameters were checked at 0 hours (before starting phototherapy) and after 48 hours of phototherapy. Sample at 0 hours was taken as control group and sample at 48 hours was taken as study group. Comparative study was done between the 2 groups to determine the changes. Results correlated according to duration of phototherapy, weight changes and changes in serum magnesium level. RESULTS In term neonates, mean total bilirubin was 15.52 ± 1.081 mg/dL before phototherapy and 9.893 ± 1.042 mg/dL after phototherapy. In late preterm neonates, mean total bilirubin was 15.08 ± 1.128 mg/dL before phototherapy and 9.5 ± 0.841 mg/dL after phototherapy. In term neonates, mean total magnesium was 2.317 ± 0.197 mg/dL before phototherapy and 1.917 ± 0.204 mg/dL after phototherapy. In late preterm neonates, mean total magnesium was 2.513 ± 0.206 mg/dL before phototherapy and 1.923 ± 0.198 mg/dL after phototherapy. The differences were statistically significant. With phototherapy, there was decrease in the bilirubin level as well as magnesium level in both term and preterm neonates. CONCLUSION Hyperbilirubinaemia can result in damage to brain and other tissues due to increased bilirubin levels. Phototherapy decreases bilirubin level with simultaneous decrease in magnesium level. Positive correlation present between bilirubin and magnesium level. Neonatologists need to be aware of this situation and consider magnesium supplements, if it is too low

EFFECT OF DOUBLE SURFACE PHOTOTHERAPY ON SERUM MAGNESIUM LEVELS IN TERM AND LATE PRETERM NEONATES

BACKGROUND Hyperbilirubinaemia is one of the most common sign encountered in newborns. Untreated, severe unconjugated hyperbilirubinaemia is potentially neurotoxic. Phototherapy is the first line of treatment in neonatal hyperbilirubinaemia. Phototherapy has potential complications like dehydration, electrolyte and haematological changes, etc. Limited studies on magnesium changes after giving phototherapy. Hence, present study to find out magnesium level changes after double surface phototherapy. MATERIALS AND METHODS It is a hospital-based prospective comparative study in the Department of Paediatrics in MVJ MC and RH. The study included admitted 30 term and 30 late preterm neonates who are subjected to phototherapy for neonatal hyperbilirubinaemia. Parameters were checked at 0 hours (before starting phototherapy) and after 48 hours of phototherapy. Sample at 0 hours was taken as control group and sample at 48 hours was taken as study group. Comparative study was done between the 2 groups to determine the changes. Results correlated according to duration of phototherapy, weight changes and changes in serum magnesium level. RESULTS In term neonates, mean total bilirubin was 15.52 ± 1.081 mg/dL before phototherapy and 9.893 ± 1.042 mg/dL after phototherapy. In late preterm neonates, mean total bilirubin was 15.08 ± 1.128 mg/dL before phototherapy and 9.5 ± 0.841 mg/dL after phototherapy. In term neonates, mean total magnesium was 2.317 ± 0.197 mg/dL before phototherapy and 1.917 ± 0.204 mg/dL after phototherapy. In late preterm neonates, mean total magnesium was 2.513 ± 0.206 mg/dL before phototherapy and 1.923 ± 0.198 mg/dL after phototherapy. The differences were statistically significant. With phototherapy, there was decrease in the bilirubin level as well as magnesium level in both term and preterm neonates. CONCLUSION Hyperbilirubinaemia can result in damage to brain and other tissues due to increased bilirubin levels. Phototherapy decreases bilirubin level with simultaneous decrease in magnesium level. Positive correlation present between bilirubin and magnesium level. Neonatologists need to be aware of this situation and consider magnesium supplements, if it is too low

LATCH Score as a Tool to Predict Weight Gain in Term Babies at Six Weeks Post-discharge: A Prospective Cohort Study

Introduction: The LATCH score is an acronym representing L- LATCH, A- Audible swallowing, T- Type of nipple, C- Comfort, H- Hold. It is a comprehensive yet simple breastfeeding assessment tool used to evaluate breastfeeding practices. Babies with a poor LATCH score at discharge are at an increased risk of early breastfeeding cessation and inadequate weight gain. According to World Health Organisation (WHO), only about 44% of infants aged 0-6 months worldwide were exclusively breastfed from 2015-2020, with a goal of increasing this rate to atleast 50% by 2025. There have been very few studies conducted in developing countries regarding this matter. Aim: To determine the correlation between the LATCH score and weight gain at six weeks post-discharge in term babies. Materials and Methods: This prospective cohort study was conducted at MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India, from January 2023 to June 2023. The study included 355 healthy term and singleton babies. LATCH scores were assessed at the time of the first feed, 24 hours, 48 hours, 72 hours, and at the time of discharge. Mothers with a low LATCH score and the reasons for the low score were identified, corrected, and counselled until discharge. Weight gain velocity was analysed at the six-week follow-up. Analysis of Variance (ANOVA) was used to compare the mean values between variables, and Pearson’s correlation was used to analyse the correlation between the LATCH score and weight gain at six weeks post-discharge in term babies. Results: In the present study, the mean age of mothers was 26.21±5.40 years, and there were 200 males and 155 females babies. The mean LATCH score at the time of the first feed was found to be 3.91±1.09, which improved to 5.61±0.890, 7.03±0.742, 7.67±0.578, and 9.12±0.662 at 24 hours, 48 hours, 72 hours, and at the time of discharge, respectively. The reasons for a poor LATCH score were mainly attributed to primiparous mothers (42%) and incorrect positioning (35.5%). A significant positive correlation was found between the improvement of the LATCH score and weight gain at the six-week follow-up. Conclusion: The LATCH score was found to be a simple tool for identifying mothers and infants who require breastfeeding support and timely intervention to sustain breastfeeding. The LATCH score can serve as an effective predictor of weight gain at the six-week follow-up