Informatics Publishing Limited

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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Ravindra Sonawane ¹, Suhas Patil ², Tushar Godbole ², Sanket Pande ², M. K. Tolani ²

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

Abstract

Objective: To study the effect of Synbiotics on weight gain and feed tolerance of newborns.

Methods: This prospective interventional trial included 50 newborns treated with a dietary supplement containing Synbiotics in addition to the routine treatment and 48 newborns served as control without Synbiotics supplement. The primary outcome was weight gain and feed tolerance. Results: Newborns in the Synbiotics group reached the full feeds earlier as compared to those in Control group (7.5 ± 4.26 days Vs 14.02 ± 7.88 days p=0.532) along with better weight gain(14.61 ± 9.6 grams per day Vs 2.97 ± 3.81 grams per day p=0.0000001).

Conclusions: Newborns receiving Synbiotics are more likely to reach full feeds earlier and show better weight gain.

Keywords

Newborns, Probiotics, Prebiotics, Synbiotics, Feed Tolerance, Weight Gain

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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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Vaishali Mishra ¹, Suhas Patil ², Ashutosh Mishra ¹

Affiliations
1 Vishwakarma Institute of Information Technology, Pune, IN
2 Bharati Vidyapeeth University COE, Pune, IN

Abstract

The introduction of personal computing and wireless communication technology provides an option for on site device software updating and data retrieving. This is especially true for any devices sitting in a remote site where computing network is not accessible. In many advanced computing systems, frequent software updating and configuration profiles refreshing are required. This is clumsy and error prone procedures when users are not familiar with the operating systems. Suppose all the necessary files and programs are predefined in a mobile phone. All necessary files and software can be transferred to the corresponding computing devices and PCs at remote sites through wireless communication links such as Bluetooth/infrared. This idea helps to solve the initial installation cost of a communication network to a remote site. Index Terms - Bluetooth, mobile communication.

Keywords

Cell Phone, Portable Storage Device.

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Deepa Dinesh Joshi ¹, Sanjita Ram Chaddha ², Suhas Patil ³, Nilesh Vitthalrao Ahire ³

Affiliations
1 Assistant Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, IN
2 Former PG Resident, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, IN
3 Associate Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422203, Maharashtra, IN

Abstract

Background: Electrolyte imbalance is one of the serious complications in hospitalized children with severe pneumonia. Monitoring of changes in electrolytes is very essential to prevent the complications leading to increased morbidity and mortality. Aims and objectives: To study serum electrolytes and calcium disturbances in patients with severe pneumonia. To identify relation of serum electrolytes with outcome of severe pneumonia. Material and Methods: After taking approval of ethics committee of our institute, we studied a total of hundred cases over a span of 24 months- August 2018 to December 2020. Study is carried out among cases of severe pneumonia and community acquired pneumonia (CAP) in age group of 2 months to 5 years admitted in pediatrics department of tertiary care centre in Maharashtra. Laboratory investigations of serum sodium, potassium, chloride and calcium levels were noted at admission and 24 hours after hospitalization. Results: This is observational cross study carried out in 100 children of severe pneumonia admitted in paediatric intensive care unit at Dr. Vasantrao Pawar Medical College, Nashik to observe and study electrolyte changes in them. Most children were in age group of 2 months to 12 months (i.e., 72%) followed by 28% in age group of 13 months to 60 months. At admission most common abnormality was hypocalcemia 49% followed by hyponatremia 27%, hyperchloremia 7%, hyperkalemia 6%, hypernatremia 6%, hypokalemia 4%, hypochloremia 1%. After 24 hours of stabilization hyponatremia was most common 40%, followed by hapocalcemia 43%, hypokalemia 9%, hypernatremia 8%, hyperkalemia 4%, hyperchloremia 4%. Conclusion: Mortality was significantly higher in cases with chloride level abnormality than with normal chloride level. Cases with disturbances in electrolytes showed higher mortality than those without electrolyte disturbances. Hyponatremia and hypokalaemia were associated with adverse outcomes in pneumonia cases. Electrolyte disturbances are commonly seen in pneumonia cases, so we should monitor them properly while treating them to avoid complications. Hyponatremia in pneumonia occurs due to Syndrome of Inappropriate Anti Diuretic Hormone secretion (SIADH). Hyponatremia at admission significantly affect outcome in terms of prolonged duration of hospitalization and two fold increase in mortality.

Keywords

CAP - Community Acquired Pneumonia, SIADH - Syndrome of Inappropriate Anti-Diuretic Hormone Secretion Serum Electrolytes, Hapocalcemia, Hypokalemia, Hypernatremia, Hyperkalemia, Hyperchloremia

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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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