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CLINICAL AND LABORATORY PROFILE IN PAEDIATRIC PATIENTS WITH BICYTOPENIA OR PANCYTOPENIA IN A TERTIARY CARE CENTRE IN KOLAR - A CROSS SECTIONAL STUDY

2024-07-01T00:00:00Z

Title: CLINICAL AND LABORATORY PROFILE IN PAEDIATRIC PATIENTS WITH BICYTOPENIA OR PANCYTOPENIA IN A TERTIARY CARE CENTRE IN KOLAR - A CROSS SECTIONAL STUDY Authors: RAM SWAROOP REDDY Abstract: Background: Bicytopenia and pancytopenia are frequently seen in clinical settings with varied etiology , yet determining the optimal diagnostic approach needs to be addressed . These conditions have diverse causes influenced by genetic factors, geographic locations and nutritional deficiencies within the community. Objectives: This study aims to investigate bicytopenia/pancytopenia prevalence, clinical and laboratory profiles, and their potential correlation with fluoride exposure in children aged 1 to 18 years. Methodology: This cross-sectional study examined children aged 1-18 years diagnosed with bicytopenia / pancytopenia at a tertiary care centre in Kolar between September 2022 and December 2023. The collected data underwent statistical analysis. Results: In our study, the predominant presenting symptom was fever, noted in 90.4% of patients, followed by abdominal pain (60.7%) and easy fatigability (38.1%). Physical examination findings indicated hepatomegaly in 48.8% of patients, pallor in 32.1%, and splenomegaly in 19.1%. Peripheral smear analysis revealed normocytic normochromic anemia as the most prevalent type, observed in 70.2% of patients. Conclusion: Higher incidence of bicytopenia compared to pancytopenia with higher occurrence in school-aged male children. Normocytic normochromic anemia was the predominant peripheral smear. Our study observed majority of pediatric age group urine xxi fluoride values were under <2 ppm , highlighting the necessity for further exploration of fluoride on hematological parameters and transplacental passage of fluoride.

CORRELATION OF THOMPSON SCORE AND MODIFIED SARNAT STAGING IN PREDICTING EARLY NEONATAL OUTCOME IN POST ASPHYXIATED NEONATES - A PROSPECTIVE OBSERVATIONAL STUDY

2024-07-01T00:00:00Z

Title: CORRELATION OF THOMPSON SCORE AND MODIFIED SARNAT STAGING IN PREDICTING EARLY NEONATAL OUTCOME IN POST ASPHYXIATED NEONATES - A PROSPECTIVE OBSERVATIONAL STUDY Authors: KALAVAKURU MOUNA Abstract: Background: Birth asphyxia, a major cause of neonatal mortality and morbidity, is a significant global challenge, particularly in developing nations. Hypoxic-ischemic encephalopathy (HIE), a neurological syndrome resulting from perinatal asphyxia, can cause neonatal mortality or manifest later as cerebral palsy or cognitive impairment. Both the Modified Sarnat Staging and Thompson Scoring systems offer simple, non-invasive methods for early diagnosis and prognosis, which are crucial for guiding clinical decisions and parental counselling. However, the general propensity to use either technique depending on circumstances may lead to inconsistent outcomes. The aim of this study is to determine the correlation between Thompson Score and Modified Sarnat Staging in assessing the outcome in early neonatal period in post asphyxiated neonates. Material and Methods: A Prospective observational clinical study study was conducted in R. L.Jalappa hospital affiliated to Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research. Neonates within the sample size and inclusion criteria were assessed by the same person based on Thompson and Modified Sarnat scoring and were each given a score based on both Thompson and Sarnat modified scoring. Both scores done for each neonate were correlated in assessing for early neonatal outcome in the post asphyxiated neonates. Results: Among 50 neonates, overall mortality was observed in 16% of neonates, with deaths of (4%) occurring within 24 hours, (4%) between 24-72 hours and (8%) beyond 72 hours. A significant association was found between both Thompson and Modified Sarnat scores with mortality and other outcomes such as seizures, persistent pulmonary xviii hypertension(PPHN), hypotension, deranged coagulation, thrombocytopenia, anaemia, feeding intolerance, and acute kidney injury. A fair agreement of (74%) was observed between Thompson and Modified Sarnat scores, with both scores showing significant associations with various complications and outcomes .The Receiver Operating Characteristic (ROC) curve analysis demonstrated that the Thompson score's Area under the curve (AUC) was 0.859, indicating strong predictive capability for mortality. Conclusion: The Thompson Score and Modified Sarnat Staging are effective tools for assessing hypoxic-ischemic encephalopathy severity and predicting neonatal outcomes. The Thompson Score is more accurate and reliable, especially for identifying neonates at risk for adverse outcomes. It is preferred for early assessment and management of post-asphyxiated neonates, leading to better-targeted interventions and improved neonatal care.

STUDY OF CLINICAL PROFILE AND OUTCOME OF SEPSIS IN NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL - A PROSPECTIVE OBSERVATIONAL STUDY

2024-07-01T00:00:00Z

Title: STUDY OF CLINICAL PROFILE AND OUTCOME OF SEPSIS IN NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL - A PROSPECTIVE OBSERVATIONAL STUDY Authors: GURRAM KAMALAKAR Abstract: BACKGROUND: Neonatal sepsis(NS) is defined as a clinical syndrome of bacteraemia with systemic signs and symptoms of infection in the first 4 weeks of life. Sepsis is the commonest cause of neonatal morbidity and mortality.1 Neonatologists managing NICUs constantly encounter the ongoing challenge of addressing newborn infections due to evolving microbial flora patterns. Understanding the microbiological profile and antimicrobial susceptibility patterns is crucial for paediatricians when selecting the most effective antibiotics for treating neonates with sepsis.2 OBJECTIVES: To determine the clinical profile of neonatal sepsis in neonates admitted to NICU and Sick Neonatal Intensive Care Unit(SNICU). METHODOLOGY: This prospective study was done in neonatal intensive care unit at R.L.JALAPPA HOSPITAL. All neonates who were admitted in NICU or SNICU fulfilling the inclusion criteria were included in the study and evaluated for clinical profile of sepsis and outcome. RESULTS: In the present study, among the 80 neonates, tachypnea was the most prevalent symptom, noted in 57.5% of cases. Blood culture results showed that 25 neonates (31.3%) were tested positive, while 55 neonates (68.8%) tested negative. The most frequently identified organism was Klebsiella species, found in 11 neonates (13.8%). Additionally, xviii Candida was detected in 5.0% of cases, E. coli in 3.8%, Acinetobacter in 2.5%, and Enterococci in 2.5%.It was observed that 31.25% of neonates had Culture Positive Sepsis (Definitive) while 68.75% had Probable (Clinical) Sepsis. CONCLUSION: This study focuses on the clinical profile and outcome of neonatal sepsis in a NICU setting, highlighting its substantial burden on neonatal health. Clinical manifestations varied widely, with tachypnea being the most common symptom. Blood culture results highlighted Klebsiella species as the most prevalent pathogen. Despite advances, the high mortality rate underscores the ongoing need for better early detection, prompt intervention, and overall care practices to improve outcomes for newborns affected by sepsis.

A PROSPECTIVE STUDY TO DETERMINE ASSOCIATION BETWEEN WEIGHT LOSS AND NEONATAL HYPERBILIRUBINEMIA IN NEONATES

2024-07-01T00:00:00Z

Title: A PROSPECTIVE STUDY TO DETERMINE ASSOCIATION BETWEEN WEIGHT LOSS AND NEONATAL HYPERBILIRUBINEMIA IN NEONATES Authors: JAHNAVI, ATLURI Abstract: BACKGROUND Neonatal hyperbilirubinemia is a frequently encountered issue during the early neonatal period, particularly within the first week of life. Significant levels of bilirubin in the blood are linked to increased weight loss after 72 hours post-birth. Inadequate caloric intake appears to play a significant role in the regulation of serum bilirubin levels.This study aimed to investigate the relationship between the maximum weight loss after birth and the occurrence of significant hyperbilirubinemia during the first week of life. METHODOLOGY This was a Prospective Observational study carried out in 85 newborn healthy term and post term babies delivered at RL Jalappa hospital during the period September 2022 to December 2023. Birth weight and weights at 24, 48, 72, 96 and 120 hours of life were assessed. Total serum bilirubin was assessed on day of significant weight loss. Weight loss and bilirubin values were compared. RESULTS 48 out of 85 babies had significant weight loss on day 4, followed by 28 babies on day 3, 5 babies on day 2 and 4 babies on day 5. Among subjects who had Significant Weight loss on day 3, 85.7% of them had significant hyperbilirubinemia. Among subjects who had significant weight loss on day 4, 70.8% of them had significant hyperbilirubinemia. CONCLUSION Significant weight loss after birth may be a predictor for neonatal hyperbilirubinemia, and serve as a helpful clinical indicator pointing towards necessary steps to be taken inorder Page 2 to prevent worsening of this treatable condition which may otherwise lead to devastating complications.