Objective: To analyze the incidence of retinopathy of prematurity (ROP) among preterm neonates who were born small for gestational age (SGA) and appropriate for gestational age (AGA). Materials and ...Methods: A prospective cohort study among preterm neonates born <34 weeks of gestational age (GA) and <2000 grams birth weight (BW) was conducted. The neonates were divided into AGA and SGA group. Incidence of ROP and risk factors was compared among the groups. Result: 290 neonates were screened AGA: 240 (82.8%); SGA: 50 (17.2%). The mean birth-weight and gestational age were 1510.7 ± 390.64 grams and 31.4 ± 4.8 weeks, respectively. The incidence of ROP in AGA and SGA was 30.2% and 33%, respectively (P = 0.58), whereas the incidence of type 1 ROP in AGA and SGA was 14% and 19% (P = 0.41). Male sex, anemia, oxygen administration, surfactant administration, sepsis, and PIH were independent significant risk factors for ROP on multivariate analysis. Conclusion: This study showed that both AGA and SGA premature infants have similar incidence of ROP. SGA is not an independent risk factor for ROP.
Aims and Objectives: To determine the choroidal thickness (mainly subfoveal) using spectral domain optical coherence tomography (SD-OCT) in amblyopic eyes and to compare it with the choroidal ...thickness (CT) of healthy fellow eyes. Materials and Methods: In this prospective study, 140 eyes of 70 patients (aged 5-40 years) with strabismic and anisometropic amblyopia were examined using enhanced depth imaging (EDI) mode in SD-OCT. The CT was measured directly below the fovea and six other locations: 500 μ, 1000 μ, and 1500 μ from fovea in both nasal and temporal quadrants. Results: The mean age of the patients was 22.5 ± 11.2 years. The mean Best Corrected Visual Acuity (BCVA) in the amblyopic eyes was 0.87 ± 0.47 logMAR and 0 ± 0.02 logMAR in control eyes. The average subfoveal CT was 341.73 ± 60.39 μm in the amblyopic eyes and 314.77 ± 48.12 μm in the fellow eyes. Subgroup analysis showed that the patients with anisometropic amblyopia had a significantly thicker choroid as compared to the fellow healthy eyes (P = 0.00), whereas in strabismic amblyopic eyes, this difference was not significantly significant (P = 0.064). Conclusion: Significant choroidal thickening was observed in subjects with amblyopia, which may contribute to the amblyopia pathogenesis and this could be used as a diagnostic parameter for amblyopia. These changes were more pronounced in patients with anisometropic amblyopia than strabismic amblyopia.
Oligohydramnios is associated with increased maternal and foetal morbidities. However, some of the recent studies have shown no adverse effect of isolated oligohydramnios on perinatal outcome and ...recommends continuation of pregnancy. Pregnancies between 18-28 weeks with isolated Oligohydramnios were included. History and physical examination was recorded in a pre-designed proforma. All the cases received care as per the protocol. A total of seven patients were recruited of which one was a twin pregnancy with Oligohydramnios in both sacs. The mean age at presentation was 30 years. Three patients went into spontaneous explusion at an average gestational age of 22-24 weeks. One patient with twins delivered vaginally at 32 weeks. Rest were delivered by caesarean section between 34-35 weeks (indication in majority of the cases was foetal distress and cord compression). None of the babies suffered any complication and were discharged in good condition. Isolated oligohydramnios during second trimester does not increase adverse perinatal outcome significantly (but increases the caesarean section rate) and therefore, should not be an indication for termination of pregnancy.
Background: Asthma is the most common chronic childhood disease being increasingly diagnosed in recent years. A review estimating the prevalence of bronchial asthma in the Indian children concluded ...the burden to be high than previously understood. There is paucity of data from Punjab, and no study from Ludhiana has estimated the true prevalence of asthma in urban area. Objective: To determine the prevalence and risk factors for childhood asthma using questionnaires and pulmonary function tests. Material and Methods: This was a questionnaire based cross-sectional study over a period of 1.5 year in the age group of 5-15 years studying in three schools of urban Ludhiana. The data were analyzed b STATA Software (version 16, college station Tx, USA). P < 0.05 was considered as significant. Results: The retrieval of questionnaire I was possible in 80% of the 2500 distributed. The prevalence of asthma was calculated as 7.5% (95% confidence interval, 5.2-10.5). The mean age of the children with asthma was 8.67 2.62 years. The most common symptoms reported by the cases were wheezing and seasonal allergy. No predilection for sex, socioeconomic status, and pet at home was noted. The family history of asthma and allergy, family history of smoking were emerged as significant risk factors. Conclusions: The prevalence of asthma in the urban schools of Ludhiana was found to be 7.5% which was much higher than previously reported. Age groups 5-8 years were commonly affected. Family history of asthma or allergy, and smoking history were found to be significant risk factors for development of asthma.
AimChest X ray has been used in diagnosing RDS since long. Lung Ultrasound is an upcoming bedside, point of care modality with no radiation exposure to diagnose RDS. This study aims to compare lung ...ultrasound and traditional chest X ray for diagnosing respiratory distress syndrome.Material and MethodThis study was conducted in level III Neonatal Intensive Care Unit of a tertiary care Hospital. Preterm newborns (GA <34 weeks) with respiratory distress (Downe s greater than 4) within 2 hours of birth, and FiO2 >0.3% were included in this study. Chest X ray and Lung ultrasound were done within 2 hours of birth. Preterm Neonates with FiO2 requirement of >0.4% with RDS were given surfactant. Also neonates with septic shock, Chorioamnionitis, Meconium Aspiration Syndrome and antenatally diagnosed congenital lung disease were excluded from the study. Data was analysed using SPSS software. P Value of <0.5 was significant.ResultsOut of total 180 preterm newborns, We enrolled 70 cases. Mean gestational age was 30.17 + 2.90 weeks. Median Birth weight was 1387 grams (IQR 865 - 1850 grams). As per chest X Ray 72% cases were suggestive of Hyaline Membrane Disease. As per criteria (FiO2 > 40% and RDS) 45.7% (31 cases ) were given surfactant. Lung Ultrasound done within 2 hours of birth was suggestive of RDS in 53.7% cases. Area under Curve for Lung ultrasound was 0.89 and score of 8 was kept cut off.ConclusionsLung ultrasound along with FiO2 requirement has a predictive value to administer surfactant in preterm neonates.
Background: Acute kidney injury (AKI) is common in critically ill children and is associated with poor outcome.
Objective: To study the incidence, risk factors and outcome of AKI in children admitted ...to paediatric intensive care unit (PICU) of a developing country.
Materials and Methods: This prospective observational study was conducted in a tertiary care PICU over one-year period. Critically ill children aged from 2 months to 18 years were included. RIFLE criteria based on GFR, and urine output was used for categorisation.
Results: Of 380 children, 53 children (14%) had AKI (met any of the RIFLE criteria). The most common diagnoses underlying AKI were acute lower respiratory tract infection, CNS illness and severe dehydration. Subjects with AKI had a higher PRISM score (>10) at admission, longer duration of stay and high mortality. Significant risk factors for AKI following multivariate analysis were: age 1-5, PRISM score (>10) at admission, shock, infection, thrombocytopenia, hypo-albuminaemia and multi-organ dysfunction. Twenty-six of 53 subjects fulfilled the maximum RIFLE criteria within 72 h after admission and the mean (SD) time to first RIFLE attend was 1.6 (1.2) day. Subjects with AKI (RIFLE criteria) had 4.5 times higher mortality than those without AKI (36 vs 8%, P< etc).
Conclusion: A high incidence of AKI was noted in the PICU that was associated with high mortality. The RIFLE criterion is an effective tool which can be used not only for predicting the outcomes, but may help in the early identification of patients at risk for AKI.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
8.
Ocular manifestations of de-Morsiers syndrome Arora, Priyanka; Arora, Kamaldeep; Utaal, Shubhneek K. D. ...
International Journal of Contemporary Pediatrics,
11/2020, Letnik:
7, Številka:
12
Journal Article
A two-year old male child presented to the ophthalmology outpatient department (OPD) with parents complaining of child’s inability to make an eye contact. On examination, the patient had horizontal ...manifest nystagmus with no fixing and following. The pupillary reactions and the anterior segment examination were normal. Fundus examination in both eyes revealed small optic disc with 360 degree hyperpigmented ring in both the eyes (Figure 1 A and B). The macula was >2 disc diameter (DD) in distance from optic disc, suggestive of optic nerve hypoplasia. Magnetic resonance imaging (MRI) brain showed absent septum pellucidum (Figure 1 C and D). Serum growth hormone levels were significantly high. Based on the examination and investigations, diagnosis of de Morsier’s syndrome was made.
In neonatal intensive care units (NICUs), preterm infants lie down immobile for long hours in a particular position, which makes them susceptible to develop pressure ulcers (PUs). These are developed ...due to continuous constant contact pressure generated by the self-weight of the infants with bed surfaces on their sensitive skin, which is 60% less than the thickness of an adult and hampers blood flow from the subcutaneous areas. Therefore, it is necessary to change the posture in a periodic manner. Hospitals manage the position changes by nursing staff, which is of limited effect and puts additional loads on them. Hence, in this paper, an anti-pressure ulcer bed was designed and tested to prevent pressure ulcers and also help in reducing the effort of nurses. The contact pressure of both the neonatal phantom and neonatal baby with the silicone-made bed surface was automatically varied by fluid pressure in the multi-channels based on the actuation mechanism (which rises alternately in inflated regions and falls in deflated regions), and it was measured using the force sensors. The demonstrated work was carried out in finite element modeling (FEM) using Abaqus to validate the results. We anticipate that it'll reduce the risk of pressure ulcers, confirming the designed bed's performance.
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