Thrombocytopenia is the commonest hematological abnormality encountered in the neonatal intensive care unit (NICU). This prospective, observational study was conducted among 78 consecutive at-risk ...neonates admitted in NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2016 to August 2017. Platelet count was measured in all at risk neonates at enrollment and less than 1,50,000/cmm was consiered as the cut off point for determining thrombocytopenia. Platelet count was measured every alternate day till discharge or normalisation of platelet count if the initial platelet count was low. If initial platelet count revealed normal, then the babies were followed up clinically if they develop any further risk condition for developing thrombocytopenia. During the period from enrollment to discharge, if any baby develops thrombocytopenia at any time then baby was defined as thrombocytopenic. Overall 39.7%patients found to be thrombocytopenic among 78 at-risk neonates. Pregnancy induced hypertension (PIH), neonatal sepsis and small for gestational age (SGA), intra uterine growth restriction(IUGR), prematurity, necrotizing enterocolitis (NEC) were significantly associated with thrombocytopenia. Sepsis and NEC were found to be independent risk factor for thrombocytopenia. Regarding outcome, length of hospital stay was significantly more in thrombocytopenic patients than non-thrombocytopenic patients. Death rate was also higher in thrombocytopenic patients in comparison to non-thrombocytopenic patients. BSMMU J 2022; 15(2): 115-120
•Approximately one-third of the neonates with clinically observed seizures die in the hospital.•More than half of those discharged develop neurodevelopmental disorder (NDD) within nine months.•Global ...developmental delay is the most common neurodevelopmental disorder.•More than one-fourth have concomitant cerebral palsy, epilepsy, and global developmental delay.•Recurrent seizures, antiepileptics needed, and abnormal EEG findings are key predictors of NDD.
Neonatal seizures can lead to long-term neurodevelopmental problems. This study aims to identify predictors of poor developmental outcomes in neonates with seizures to aid in early intervention and referral for follow-up and rehabilitation.
This observational study was conducted in the Department of Neonatology and Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University. Among 75 study cases of neonatal seizure, 23 died, and 46 were followed-up at 6 and 9 months after discharge. EEGs were performed on every patient. A comprehensive neurological examination and developmental evaluation were performed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III).
Three-fourths of neonates were born at term (76.1 %), and over half were male (56.5 %). The majority were appropriate for gestational age (79.7 %) and had an average birth weight of 2607 ± 696 g (±SD). Over half of the neonates (52.2 %) had adverse neurodevelopmental outcomes, with global developmental delay being the most common. Recurrent seizures, the number of anticonvulsants needed to control seizures, and abnormal Electroencephalograms were identified as independent predictors of adverse neurodevelopmental outcomes.
The study highlights the need for early referral for follow-up and rehabilitation of neonates with seizures having abnormal electroencephalograms, recurrent seizures and requiring more anticonvulsants to control seizures.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The COVID-19 pandemic had substantial effects on education. As a result, online education has gained popularity among postgraduate medical students. The aim of this study was to explore postgraduate ...learners’ experiences regarding online classes. This study was carried out in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from March 2020 to September 2020. A questionnaire was sent to neonatology and pediatrics allied residents and students of FCPS paediatrics. Qualitative data were collected and using likert scales to assess satisfaction regarding online learning experience. The study included 79 participants. Of them, 71 (89.9%) responded, 12 (16.9%) attended online classes before the COVID-19 situation. Thirty-four (47.9%) residents opined that online classes provided the right amount of theory. Eighteen (25.4%) disagreed that high-quality learning can be accomplished without face-to-face contact. Twenty-four respondents (33.8%) disagreed that studying online was more motivating than attending a regular classes. Fortytwo (59.2%) concluded that online class was really beneficial, and 50 (70.4%) were satisfied with online education. More than half of them (57.7%) preferred online theoretical classes compelling situation. Though students prefer online education as an alternative to classroom education, both face-to -face and online teachings are necessary. BSMMU J 2022; 15(3): 151-156
Background: Birth defect is one of the most important causes of neonatal mortality worldwide. In a developing country like Bangladesh many possible factors for birth defects are present which should ...be identified. This study was performed to determine those risk factors of birth defect and complications associated with it.
Materials and Methods: A hospital based matched case-control study was conducted from August 2015 to July 2016 in department of Neonatology along with Obstetrics and Gynecology at BSMMU. A total of 98 mother-infant pair (49 babies with birth defect as cases and 49 healthy babies without any birth defects as controls) was included in the study. For each case, a gestational age, sex and post-natal age matched control was taken. Data was collected by face to face interview. Univariate and multivariate conditional logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 23.0. Variables with p-value <0.05 were considered statistically significant.
Results: The mean (± SD) birth weight for cases and controls were 2718.37 (±756.9) grams, and 2617.14 (±978.8) grams respectively. Cardiovascular system was the predominant system (21%) involved in birth defects. Maternal age between 20-29 years (AOR: 4.69; 95% CI 1.078, 20.448), less than four antenatal care visits (AOR: 10.07; 95% CI 2.816, 36.0), no multivitamin intake (AOR: 7.38; 95% CI 1.791, 30.365) and presence of maternal diabetes (AOR: 0.194; 95% CI 0.047, 0.799) were significantly associated with birth defects among newborns. Sepsis, asphyxia, hypoglycemia and dyselectrolytemia were the most prevalent problems among these babies. The need of intravenous fluid, thermal care, antibiotics and mechanical ventilation was also high among the cases.
Conclusion: Birth defect is an upcoming issue in current newborn health situation which need to be prioritized. Significant risk factors should be addressed timely for early diagnosis and proper management of these babies can help in reduction of mortality.
Bangladesh Journal of Medical Science Vol.19(1) 2020 p.133-140
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight ...(LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness. The Vayu bCPAP, a simple and portable alternative, offers a constant flow of oxygen-enriched, filtered, humidified, and pressurized air. Our study, conducted in five health facilities, explores the useability, acceptability, and perceived treatment outcome of Vayu bCPAP in the local context of Bangladesh.
A qualitative approach was employed in special care newborn units (SCANUs) of selected facilities from January to March 2023. Purposive sampling identified nine key informants, 40 in-depth interviews with service providers, and 10 focus group discussions. Data collection and analysis utilized a thematic framework approach led by trained anthropologists and medical officers.
Service providers acknowledged Vayu bCPAP as a lightweight, easily movable, and cost-effective device requiring minimal training. Despite challenges such as consumable shortages and maintenance issues, providers perceived the device as user-friendly, operable with oxygen cylinders, and beneficial during referral transportation. Treatment outcomes indicated effective RDS management, reduced hospital stays, and decreased referrals. Though challenges existed, healthcare providers and facility managers expressed enthusiasm for Vayu bCPAP due to its potential to simplify advanced neonatal care delivery.
The Vayu bCPAP device demonstrated useability, acceptability, and favorable treatment outcomes in the care of neonates with RDS. However, sustained quality service necessitates continuous monitoring, mentoring and retention of knowledge and skills. Despite challenges, the enthusiasm among healthcare providers underscores the potential of Vayu bCPAP to save lives and simplify neonatal care delivery. Development of Standard Operating procedure on Vayu bCPAP is required for systematic implementation. Further research is needed to determine how the utilization of Vayu bCPAP devices enhances accessibility to efficient bCPAP therapy for neonates experiencing RDS.
Background: Expectant reduction of neonatal mortality and formulation of preventive strategies can only be achieved by analysis of risk factors in a particular setting. This study aimed to document ...incidence of neonatal death and to analyze the risk factors associated with neonatal death.
Methods: This retrospective study was carried out in department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) over a 12-month period from January to December 2015. The newborns that died within 28 d of life were defined as "Cases" and "Control" were the surviving newborn discharged to home as healthy. Two birth weight and gestational age matched controls were taken for each case. Maternal, obstetric, and newborn characteristics were analyzed between both the groups. Data analysis was performed using SPSS version 20.0 (SPSS Inc., Chicago, IL). A probability of < .05 was considered statistically significant. The strength of association was determined by calculating odds ratio and their 95% confidence intervals (CIs).
Results: During the study period, the proportion of death was 9.6% (64/612). Both in Chi-square analysis and in logistic regression analysis, less than four antenatal visits (odds ratio (OR) 2.78; 95% CI: 1.23-6.28, p = .014) and sepsis (OR 2.37; 95% CI: 1.07-5.26, p = .034) were found to be independent risk factors for deaths, whereas LUCS found to be protective for deaths (OR 0.40; 95% CI: 0.19-0.83, p = .015).
Conclusion: In conclusion, less than four antenatal visits and presence of sepsis were found to be independent risk factors whereas LUCS protective of newborn death.
Background: Early detection of critical congenital Heart diseases (CCHD) can improve clinical management with a good clinical outcome. Pulse oximetry is cost-effective instrument for detection of ...CCHD. It can be good an instrument for detection of CCHD. In this study we aimed to see the performance of pulse oximetry by meta-analysis of Meta-analytic studies. Methods: we included relevant citations by the search engine, Medline, Google Scholar and Cochrane Library. We selected meta-analytic studies that assessed the accuracy of pulse oximetry for the detection of CCHD in asymptomatic newborn. We calculated pooled sensitivity and specificity and corresponding 95% CIs for individual studies. Result: We screened 465 individual studies and identified 10 meta-analytic studies. Of the 10 meta-analytic studies 4 eligible studies with data for 1121912 newborn babies were analyzed. The Pooled Sensitivity of pulse oximetry for detection of critical congenital heart defects was 89 % (95% CI 87%-97%) and pooled specificity was 100% (95% CI 100%-100%). Diagnostic odd ratio of pulse oximetry was 2180.3 and symmetric summary area under curve (SAUC) was 99%. Conclusion: Our study concluded that Pulse oximetry is 100 % specific for detection on of critical congenital heart defects with moderate sensitivity. KEYWORDS Pulse-oximetry, Newborn, Congenital Heart disease, Meta-analysis.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
8.
An icteric newborn with bad obstetric history Shahidullah, Mohammod; Mannan, M. A.; Dey, Sanjoy Kumer ...
Bangabandhu Sheikh Mujib Medical University journal,
03/2018, Volume:
11, Issue:
1
Journal Article
Peer reviewed
Open access
This article has no abstract. The first 100 words appear below: A 34 week preterm baby was admitted with the complaints of respiratory distress soon after birth. The mother had bad obstetric history. ...She is having the fifth gravida with the first two alive and healthy who were born by the normal vaginal delivery at home. The third child was born with severe jaundice and was treated by exchange transfusion. Subsequently the baby developed bilirubin encephalopathy. Then the baby developed cerebral palsy and ultimately died due to aspiration pneumonia at the age of 2.5 years. Her first three pregnancies were not on any antenatal check-up by the health care provider due to poor socio-economic background and illiteracy.
Background: Patent ductus arteriosus (PDA) is a common cause of neonatal morbidity. We aimed to do this meta-analysis to compare the efficacy of oral paracetamol/acetaminophen and intravenous (IV) ...paracetamol for the closure of hemodynamically significant PDA (hsPDA) in preterm infants. Methodology: Medline, Embase, and Google Scholar databases were searched for citations. We included 14 studies with significant PDA and used either oral or IV paracetamol for PDA treatment. Pooled proportion of PDA closured was analyzed. Results: We included 14 studies with 454 premature infants having PDA. Pooled proportion of PDA closure with oral paracetamol was 77.79% (95% confidential interval CI 72.92-82.15) in fixed effect and 75.77% (95% 65.48-84.74) in random effect model. In case of IV paracetamol group, pooled portion of PDA closure was 81.52% (95% 74.00-87.64) and 81.52 (95% CI 74.62-87.55) in fixed and random model, respectively. The difference of proportion in the fixed effect model was 3.75% (95% CI, −5.08-11.64) (P = 0.37), and in the random effect model, it was 5.75 (95% CI, 3.14-13.74) (P = 0.181). Conclusion: Our study concluded that pooled proportion of PDA closure is comparable with oral versus IV route of paracetamol use.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aims: The aim of this study is to observe the postnatal weight gain as a predictor of retinopathy of prematurity (ROP) in preterm babies. Materials and Methods: A prospective cohort study was ...conducted from October 2018 to March 2020 in the Department of Neonatology and Ophthalmology, BSMMU Shahbag, Dhaka. Preterm neonates whose gestational age (GA) <35 weeks and birth weight (BW) <2000 g were included in the study. Results: The frequency of ROP was 35%. Most of them had Stage 1 ROP 17 (52%), and second most cause was aggressive posterior ROP 8 (24%). Severe form of ROP is more in "postnatal weight gain not achieved group." On bivariate analysis, postnatal weight gain, BW, gestation, sepsis, apnea, necrotizing enterocolitis, use of oxygen, continuous positive airway pressure, mechanical ventilation, and blood transfusion were significantly associated with ROP. Not achieving postnatal weight gain and low gestation were significantly associated with ROP on logistic regression analysis. Conclusion: Not achieving postnatal weight gain and low GA are a predictor of retinopathy of retinopathy.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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