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Ravindra Sonawane ¹, Suhas Patil ¹, Nilesh Ahire ¹, Nimish Kulkarni ¹

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

Abstract

Background&Objective: More than 20 million infants worldwide, representing 15.5 per cent of all births are born with low birth weight. More than 95 percent of them are born in developing countries. The incidence of low birth weight in developing countries (16.5 per cent) is more than double the incidence in developed regions (7 per cent). In India, nearly 8 million babies are born with a Low Birth Weight every year. In India, we are still struggling to get minimum care facilities for our neonates. The neonatal mortality rate in India is still 5 to 6 times higher compared to that in developed countries. Because of their susceptibility to complications, low birth weight neonates require specialized and expert care during the neonatal period. This study was undertaken to study the role of various morbidities in the mortality of LBW neonates admitted in the N.I.C.U.

Material and Methods: The study was conducted in the N.I.C.U. of a Tertiary Health Care Centre, in Department of Pediatrics. 106 neonates with birth weight less than 2500 grams from among the neonates admitted in the NICU were included in the study. Results: There were 48 deaths out of 106 cases studied thus making the mortality rate of 45.28% and the survival rate of 54.72% (58/106 cases). Respiratory distress contributed maximum to mortality, followed by Septicemia/Sepsis. Neonatal Hyperbilirubinemia followed septicemia in prevalence. Among the spectrum of Respiratory distress, Hyaline Membrane Disease (HMD) contributed maximum to mortality.

Keywords

LBW, Low Birth Weight, Mortality, Neonatal Mortality

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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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Ravindra Sonawane ¹, Nilesh Ahire ¹, Suhas Patil ¹, Abhijit Korde ²

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422203, Maharashtra, IN
2 Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422203, Maharashtra, IN

Abstract

Introduction: Allergic rhinitis and asthma are two very common allergic diseases of respiratory tract in pediatric patients. In this geographical area, where the prevalence of allergens exists, the role of allergens as the etiological factor is higher in allergic respiratory disorders. Confirmation of allergen as etiologic agent is cumbersome in a small setup, where IgE estimation and allergy tests are not accessible. In this study, the simple test of peripheral smear and nasal smear eosinophil count as a reliable diagnosis to solve the above problem and establishing allergy as etiological agent has been tried. Material and Methods: For the present study which was conducted over 2 years in children between 2 to 12 years who visited tertiary health care center, Nashik. The allergic respiratory cases based on typical history and clinical features were included in the study and investigated for nasal and blood eosinophilia. Children with TB, recurrent and chronic pneumonia, malnutrition, malignancy, collagen vascular disorders and those who are on steroid therapy were excluded from the study. The clinical profile of allergic rhinitis with or without asthma and nasal and blood eosinophils are studied. Result: Out of 100 patients, there was male predominance and incidence was increasing as age increases. Dust is the most common risk factor for allergic rhinitis followed by weather changes, whereas in allergic rhinitis with bronchial asthma, weather change is common risk factor followed by dust and family history. In children with allergic rhinitis with or without bronchial asthma, there is positive relation between nasal and peripheral smear eosinophil count. Conclusion: So, nasal eosinophil count which is simple, non-invasive, economical and reliable can be used as an alternative to invasive peripheral smear eosinophil count as both are equally efficacious in diagnosing allergic respiratory diseases.

Keywords

Allergic Rhinitis, Bronchial Asthma, Eosinophilia.

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Nilesh Ahire ¹, Ravindra Sonawane ¹, Rajendra Gaikwad ¹, Suhas Patil ¹, Tushar Sonawane

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422203, Maharashtra, IN

Abstract

Introduction: Neonatal Hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. Insignificant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH. Methods: Study was performed at the Department of Pediatrics in a Medical College Hospital and Research Centre. Intramurally delivered, 113 Healthy full-term newborns during 1-year period were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 48 hours and 5 day of age and later if required. Results: Significant NH in our study is 3.5%. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post natal day was 10.81 mg/dl. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17%, positive predictive value of 66.67% and negative predictive value of 100%. Conclusion: A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

Keywords

Cord Bilirubin, Hyperbilirubinemia, Newborns, Neonate.

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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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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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