Informatics Publishing Limited

Sagar Sonawane ¹, Milind Suryawanshi ¹, Priyanka Patil ¹, Ravidra Sonawane ¹, M. K. Tolani ¹

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik, IN

Abstract

Objective: To study the clinical profile of Neonatal Sepsis & the sensitivity of various markers of sepsis screen. Material & Methods: This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture & Sensitivity was done with conventional non–automated method using Herley’s Broth. Result: Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) & Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).

Keywords

Neonatal Sepsis, Clinical Profile, C–reactive Protein

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Ravindra Sonawane ¹, Suhas Patil ¹, Lalit Gulati ¹, Sagar Sonawane ¹

Affiliations
1 Dr. Vasantrao Pawar Medical College Hospital and Research Center, Nashik, IN

Abstract

This was a randomized controlled trial undertaken to study the role of zinc supplementation on growth of low birth weight infants (b.wt≤2500 gm). Out of 120 LBW infants, 23 were excluded due to loss of follow up. The remaining 97 LBW eligible neonates were randomized in to 2 group (zinc & control group), zinc group were given zinc supplementation at a dose of 2 mg/kg/day for 8 weeks from enrollment. They were then followed up every 4 weeks up to 8 weeks. At each visit, detail anthropometry including e weight, length, and head circumference were recorded at each visit. The infants in the zinc group had significantly higher weight gain (p<0.000), length gain (p<0.000), linear growth velocity and head circumference at 8 weeks. We concluded that zinc supplementation at 2 mg/kg/day for 8 weeks in LBW infants improves their growth during infancy.

Keywords

LBW (Low Birth Weight Babies), Zinc, Supplements to Infants, Growth of Infants

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Sagar Sonawane ¹, M. K. Tolani ¹, Milind Suryawanshi ¹, Priyanka Patil ¹

Affiliations
1 Department of Paediatrics, Dr. V. N. Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik-422011, IN

Abstract

Objective: To study the bacteriological profile and sensitivity pattern in cases of Neonatal sepsis at 12 bedded Neonatal Intensive Care Unit (NICU). Methods: This was a prospective study of neonates admitted to our NICU from Jan 2010 to Oct 2011 with diagnosis of neonatal sepsis or those who developed sepsis later during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture&Sensitivity was done with conventional non-automated method using Herley's Broth. Results: Out of 55 cases blood culture was positive in 27 (49.09%) cases. Klebsiella Pneumoniae 15 (55.55%) was the most common organism isolated in both early and late onset sepsis showed sensitivity to collistin in 86.6% of cases followed by sensitivity to imipenam-cilastin in 46.67% cases. Only 20% Klebsiella isolates were sensitive to drugs like Ampicillin-sulbactum, Amikacin, Tazobactum, cefpime and for other antibiotics like Meropenam, Piperacillin-tazobactum, Vancomycin it was less than 20%. Other organisms isolated were Staph. aureus, E. Coli, Pseudomonas, Enterobactor, Acinetobactor and candida species. Conclusion: Gram negative organisms are most common cause of early as well as late onset sepsis and there is alarming degree of antibiotic resistance to commonly used antibiotics.

Keywords

Antibiotic Sensitivity, Bacteriological Profile, Gram Negative Organisms, Neonatal Sepsis.

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Sagar Sonawane ¹, M. K. Tolani ¹, Ravindra Sonawane ¹, Nilesh Ahire ², Suhas Patil ², Sandip Patil ²

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Adgaon, Nashik, IN
2 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Adgaon, Nashik, IN

Abstract

Congenital Diaphragmatic Hernia of Morgagni occurs through the foramen of Morgagni, is rare in children. It is usually asymptomatic and detected accidentally. If symptomatic, then symptoms are variable and nonspecific making diagnosis difficult . Our patient presented with signs and symptoms suggestive of congenital heart disease, gastroesophageal reflux disease and recurrent pneumonia.

Keywords

Foramen of Morgagni, Hernia of Morgagni.

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Abhishek Janjale ¹, Sanket Pande ², Ravindra Sonawane ¹, Nilesh Ahire ¹, Sagar Sonawane ¹

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, IN
2 Department of Paediatrics, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati - 444603, IN

Abstract

Introduction: The present study was to emphasize the chief causative factors, clinical manifestations, various hematological and morphological types in children with severe anemia, admitted to the pediatric wards of a tertiary care hospital. Objectives: The primary objective was to study clinical profile of severe anemia in children with various risk factor and hematological parameters among children with severe anemia. Methods: This was an observational study conducted in a tertiary health care institute. Children with severe anemia satisfying eligibility criteria with Hb less than or equal to 7gm/dl in age group 6 Month to 59 months. Less than or equal to 8gm/dl in age group 5 years to 14 years were included. Associated complaints and Clinical features were studied. Complete blood cell count with RBC indices- MCV, MCH and MCHC peripheral smear examination, reticulocyte count, stool examination, urine examination and Mantoux test were done in all patients. Serum ferritin, Hb electrophoresis, bone marrow examination, liver function test and renal function test, and x ray, U.S.G. abdomen, CT scan in relevant cases were done. Result: In this series 59 patients were included. Incidence of severe anemia was more in < 3.5 years age group (50.85%). Male to female ratio was 1.45:1. Out of 59 cases studied, 47(79.66%) had varying degrees of malnutrition. Pallor is the most prominent and characteristic sign noted in 59 cases (100%). Nutritional anemia was most common in 32 cases (55.93%) out of which 28 were microcytic and 4 were dimorphic. Associated infections were noted in 35 cases (59.32%). Conclusion: Nutritional deficiency is the most common cause of severe anemia especially iron deficiency anemia. Most of the children were malnourished and had infection indicating that severe anemia is directly related to malnutrition and infection. Pallor is the most consistent clinical sign of severe anemia. Severe anemia is more common in children aged < 3.5 years.

Keywords

Nutritional Deficiency Anemia, Pallor, Severe Anemia.

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Ravindra Sonawane ¹, Akshay Patil ¹, Sagar Sonawane ¹

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Introduction: Pulmonary disorders represent one of the most common diagnoses in infants admitted to neonatal units. The clinical presentation of respiratory distress in the new born includes apnea, cyanosis, grunting, inspiratory stridor, nasal flaring, poor feeding, and tachypnea. Most cases are caused by transient tachypnea of the newborn, respiratory distress syndrome, or meconium aspiration syndrome, but various other causes are possible. Objectives: Study was performed to analyze clinical profile, risk factors and outcome in terms of mortality. Methods: Data was collected for 78 newborns included in the study with respiratory distress. General information, socioeconomic status, history and clinical examination were documented. Newborn with respiratory distress were shifted to NICU for further management. Time of onset of distress was documented and the severity of the distress was documented and the severity was assessed by using Silverman and Anderson clinical scoring. Duration of O₂ therapy, intervention done in the form of surgical/ventilator/ surfactant therapy/treatment and mortality was documented to assess the clinical outcome against the final diagnosis. Results: It was seen that in 97.4% of the cases of newborn respiratory distress the cause was respiratory in origin. Majority of the newborns had severe respiratory distress (47.43%) and moderate respiratory distress (46.15%) compared to mild distress (6.4%). 100% of newborns with RDS was diagnosed with severe respiratory distress (5 out of 5) and 73.9% was with diagnosis of MAS (17 out of 23) had developed severe respiratory distress as compared to 29.8% of the neonates with respiratory distress with diagnosis of TTNB (14 out of 47). 55.5% of the newborns (30 out of 54) male babies developed severe respiratory distress compared to 33.3% (8 out of 24) female babies. Interpretation and Conclusions: Transient tachypnea of the newborn is the most common cause of respiratory distress in newborn. Almost 50% of newborn with respiratory distress develop severe respiratory distress which require intensive monitoring. Risk factors like high maternal age, primigravida mothers, Small for gestation age, birth weight less than 2.5Kg associated with severe respiratory distress in newborns.

Keywords

Neonate, Respiratory Distress.

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Ravindra S. Sonawane ¹, Ripal Dipak Shah ², Sagar Sonawane ³, Rajendra Gaikwad ⁴

Affiliations
1 Professor and Head, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra

Abstract

Background: Early diagnosis of congenital heart disease is important for a good clinical outcome. Unrecognized or delayed diagnosis of some severe congenital heart diseases can lead to cardiac failure, cardiovascular collapse, and even death. Pulse oximetry screening (POS) in newborns has been shown to enhance the detection of critical congenital heart disease (CCHD). Clinical evaluation is likely to miss the diagnosis in first few hours of hospital stay after birth due to absence of signs and symptoms of CCHD. In the absence of clinical findings during early neonatal period, the best parameter that can be assessed, is the detection of hypoxemia by pulse oximetry screening. Aims and Objectives: Usefulness of pulse oximetry in newborn for early detection of Critical Congenital Heart Disease (CCHD). Material and Methods: This Prospective Observational Study was conducted on 125 newborn babies in postnatal ward at tertiary care centre for a period of 2 years satisfying the inclusion and exclusion criteria. Evaluation was done between 24 to 48 hours of birth with pulse oximeter. Institutional ethics committee permission was taken prior to study. Results and Conclusion: Total 125 neonates were screened by pulse oximeter, 2 were detected to have positive screen for Congenital Heart Disease (CHD) of which 1 had CCHD confirmed by echocardiography. Study revealed that Pulse Oximetry screening can be an important screening tool in routine neonatal care for early detection of CCHD.

Keywords

Critical Congenital Heart Disease, Pulse Oximetry

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Nilesh Ahire ¹, Shripad Dakhane ², Ravindra Sonawane ³, Suhas Patil ⁴, Sagar Sonawane ⁵

Affiliations
1 Associate Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India ., IN
2 Former PG Resident, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India., IN
3 Professor and Head, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India ., IN
4 Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India, IN
5 Associate Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, India ., IN

Abstract

Objective: Acute lower respiratory tract infections are leading cause of morbidity and mortality in under five children in developing countries. Hence presence study was undertaken to study various modifiable risk factor for acute lower respiratory tract infection in under five children. Study Design: Data collected from a observational study of eighty Acute Lower Respiratory Tract Infection (ALRTI) cases of age group from 2 month to 5 year fulfilling WHO criteria of pneumonia to study various modifiable risk factor. Eighty healthy control of same age group also interrogated. Result: The significant modifiable risk factor were parental illiteracy, low socioeconomic status, overcrowding, partial immunization, pre lacteal feed, early weaning, malnutrition, parental smoking, history of respiratory infection in family and rickets. Conclusion: The present study has identified various modifiable risk factors for acute lower respiratory tract infection which can be tackled by effective education of community .

Keywords

Acute Lower Respiratory Tract Infection, Children, Risk Factors, Socio Demography

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