3 research outputs found
Single dose surfactant early rescue therapy in respiratory distress syndrome-experience and outcome at a tertiary care centre
Background: Neonatal respiratory distress syndrome (RDS) is a progressive respiratory failure that is caused primarily by a deficiency of pulmonary surfactants (PS). We undertook a prospective study to evaluate outcomes of neonatal respiratory distress syndrome (RDS) patients treated with early rescue pulmonary surfactant.Methods: This was a prospective cross sectional study conducted at level III NICU. A total of 47 eligible patients out of 142 diagnosed RDS on chest x-ray or FiO2 ≥40 was needed to reach SpO2 between 85 and 93% received early recue surfactant therapy (within 2hrs of life) and maternal ,neonatal and clinical data was analysed using SPSS software.Results: In this study prevalence of RDS amongst neonates admitted in NICU was 16.4%, early rescue surfactant therapy could be given only to 47 cases. There was male predominance (2.62:1). Mean age of administration of surfactant was 1.30±0.8 hr and Antenatal steroid was given in only 21.3% of mothers. Fraction of inspired oxygen concentration (Fio2) requirement also significantly decreases before and after therapy (p value˂0.0001) at 6,12, and 24 hrs. PEEP also shows decreasing trend at 24 hrs (p value ˂0.05). Sepsis was the commonest complication leading to mortality.Conclusion: Implementation of early rescue administration of surfactant in infants at high risk for developing RDS in neonatal ICU is a safe and effective modality of respiratory support which decreases ventilatory requirements, improves respiratory status, and causes early extubation.
Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants
Background: Kangaroo Mother Care (KMC) is dened
as skin-to-skin contact between a mother and her
newborn baby derived from practical similarities to
marsupial care giving, proximately exclusive
breastfeeding and early discharge from hospital. This
concept was proposed as an alternative to conventional
methods of care for low birth weight (LBW) infants,
and in replication to quandaries of earnest
overcrowding in Neonatal Intensive Care Units
(NICUs). KMC essentially utilizes the mother as a
natural incubator Aim and Objectives: The aim was to
assess the feasibility, acceptability and the
effectiveness of KMC in LBW infants. It avoids
agitation routinely experienced in busy ward. Material
and Methods: A pilot open-labeled quasi-randomised
clinical trial was conducted in Level III NICU of a
teaching institution. 60 newborn infants <2500 g,
meeting inclusion criteria were alternatively
randomised into two groups: Kangaroo Mother Care
(KMC) and Conventional Methods of Care (CMC).
Kangaroo mother care was practiced with minimum
total period of eight hours a day intermittently for the
intervention group while the controls remained in
incubators or cots. Weight, head circumference,
length, morbidity episodes, hospital stay, feeding
patterns were monitored for all infants till postmenstrual
age of 42 weeks in preterm babies or till a
weight of 2500 g is achieved in term SGA babies.
Results: The pilot study conrmed that trial processes
were efcient, the intervention was acceptable (to
mothers and nurses) and that the outcome measures
were appropriate; KMC babies achieved signicantly
better growth at the end of the study (For preterm
babies, weight, length and head circumference gain
were signicantly higher in the KMC group (weight
19.28±2.9g/day, length 0.99±0.56cm/week and head
circumference 0.72±0.07 cm/week) than in the CMC
group (P <0.001). A signicantly higher number of
babies in the CMC group suffered from hypothermia,
hypoglycemia, and sepsis. Conclusion: Kangaroo
mother care improves growth and reduces morbidities
in low birth weight infants. It is simple, acceptable to
mothers and can be continued at home
Bacterial meningitis or cobalamin deficiency: A diagnostic conundrum
Studies show nearly half to two-thirds of the children in India to be deficient in vitamin B12. Meningitis is a major disease in Indian children with studies attributing up to 22% of under-five deaths to meningitis and pneumonia. India is one of the countries with the highest mortality in absolute numbers due to meningitis. Usually, the diagnosis of each of these entities is straightforward. The presence of meningeal signs, papilledema, seizures, and altered sensorium often suggests meningitis. And vitamin B12 deficiency has a myriad of clinical presentations. At times, encephalopathy secondary to cobalamin deficiency may be confused with infection. Here, we present a case that presented with signs and symptoms suggestive of central nervous system infection but turned out to be cobalamin deficiency eventually. To our knowledge, this is the first presentation of cobalamin deficiency presented with features suggestive of meningitis