Introduction:Phenobarbitone is currently the drug of choice for neonatal seizures. In this study we analyzed the effect of Phenobarbitone in the management of neonatal seizures. Objectives: To review the cumulative dosage, efficacy of phenobarbitone and need for second and third anti-seizure medication in the treatment of neonatal seizures. Methods: This is a cross sectional retrospective observational study from January-2011 to December-2014. Based on clinical observation, anticonvulsant efficacy was assessed. Need for second Ant seizure drug and Cumulative loading dose were studied. All babies admitted with clinical seizures and those developing seizures during hospitalization who were treated with Phenobarbitone as the first drug were studied. Interventions: Management of neonatal seizures as per standard unit protocol. Study was approved by the Institutional Ethical Committee. Statistical Analysis: All the data were collected in validated preformatted proforma sheet and analysed using appropriate statistical methods. Results: 117 babies received phenobarbitone during the study period. Majority (49.57%) of seizures occurred during day 1 of life. HIE was the commonest cause noted in 42.73%. Seizure control with 20 mg/kg loading dose of phenobarbitone was noted in 40.17% of pateints & Seizure control with 30 mg/kg loading dose of phenobarbitone was in 19.65%. Seizure control with phenobarbitone as monotherapy was 59.82% and as combinant therapy with Levetiracetam was 32.47%. Conclusion: Phenobarbitone had significant seizure control both as monotherapy and along with levetiracetam as combinant therapy. ObjectivesWe have conducted this study to review the cumulative dosage, efficacy of phenobarbitone and need for second and third anti-seizure medication in the treatment of neonatal seizures.

Introduction: Very Low birth weight is associated with serious neonatal morbidity. Biologic factors are major determinants in their outcome. We analysed the effect of birth-weight, gestation, sex and intrauterine growth in the mortality and morbidity profile of VLBW babies during the neonatal period. Methodology: This is a cross sectional retrospective observational study from April-2012 to August-2014. Baseline demographics, disease features of 97 VLBW babies were analyzed. Results: Survival at discharge was 91.75%. There was significant difference in need of ventilation, surfactant, Apnea, ROP, IVH >/= Grade-II, Culture-negative Sepsis among all gestational subgroups. Survival increased as gestation advanced. Maximum decrease in mortality has occurred beyond 28 weeks. Maximum odds difference in need of ventilation, BPD was noted around 28 weeks. Major difference in HS-PDA, IVH, NEC were noted around 30 weeks. Significant difference in need of surfactant, apnea and anemia was observed around 32 weeks. Major decrease in HMD, Hyperbirubinemia and sepsis were identified around 34 weeks. Analysing intrauterine growth, Significant difference in Need of ventilation, surfactant use, IVH, NEC, Anemia and death was noted between AGA and SGA. Analysing birth weight wise, Survival improved as birth-weight increased. There was significant difference in HS-PDA and IVH in all birth-weight subgroups. Maximum decrease in death was noted in babies >1000g. Maximum odds difference in BPD, Apnea, Hyperbilirubinemia, IVH, Anemia, ROP and culture negative sepsis occured around 800g. Major difference in HMD, NEC, Culture positive sepsis was observed around 1000g. Significant odds difference in HS-PDA occurred around 1200g. Maximum decrease in need of surfactant and ventilation was noted around 1400g. Conclusion: There was no difference between male and female in survival or morbidities. Survival improved with advancing Gestation, Intrauterine growth and Birth-weight. Analysing intrauterine growth, Significant difference in Need of ventilation, surfactant, IVH, NEC, Anemia and death was noted between AGA and SGA. Significant variations in morbidity profile were noted among birth weight and gestational age subgroups.

Introduction: Platelet count & CRP are diagnostic markers of neonatal sepsis. Though the platelet count remains the same throughout the neonatal period, variations in platelet count have been noted based on gestational age, weight & sex of neonates. Beside other hematological findings, changes in platelet count induced by neonatal sepsis have been the focus of many studies. Objective: To analyze the variation in platelet count with gestational age, weight and sex in hospitalized newborns. Methods: This is a retrospective case analysis of 533 neonates between January-2012 to December-2014. The parameters examined were Baseline Platelet Count, Change In Platelet Count, (Baseline Platelet Count-Change In Platelet Count)/ Baseline Platelet Count, Platelet Nadir, Incidence, Duration & Severity of Thrombocytopenia. Statistical Analysis: All data were collected in validated preformatted proforma sheet & analysed sing appropriate statistical methods. Results: 533 babies were studied. About 21.2% had Culture negative sepsis, 9.75% had culture positive sepsis & 69.04% had no sepsis. No difference in any platelet parameter was noted between female & male babies. The prevalence of early onset sepsis in our study was 17.44% & late onset sepsis was 13.50%. Significant variations of all platelet indices were noted among lower gestational age babies. Significant variations in the Incidence, Prevalence & duration of thrombocytopenia were noted depending on the weight of the baby. Conclusion: The baseline platelet count of the neonates remains uniform irrespective of sex, weight or gestational age. There are quantitative differences in the platelet response based on weight and gestational age

Introduction: Neonatal Sepsis is commonly associated with thrombocytopenia. Objective: To assess the prevalence and course of thrombocytopenia in culture positive and culture negative neonatal sepsis in comparison to normal newborns. Methods: This is a retrospective case analysis of 533 neonates between January-2012 to December-2014. The parameters examined were Baseline Platelet Count, Change In Platelet Count, (Baseline Platelet Count-Change In Platelet Count)/ Baseline Platelet Count, Platelet Nadir, Incidence, Duration & Severity of Thrombocytopenia. Statistical Analysis: All data were collected in validated preformatted proforma sheet & analysed using appropriate statistical methods. Results: Among 533 neonates, 21.2% had Culture negative sepsis, 9.75% had culture positive sepsis & 69.04% had no sepsis. The prevalence of early onset sepsis was 17.44% & late onset sepsis was 13.50%. About 24.76% babies had thrombocytopenia; 9.56% had mild thrombocytopenia, 10.13% had moderate & 5.06% had severe thrombocytopenia. Late onset sepsis was associated with significant thrombocytopenia. Culture positive sepsis had significant drop in platelets with lower platelet nadir, higher incidence, more severe & prolonged thrombocytopenia compared to culture negative sepsis & normal neonates. Conclusion: There are quantitative differences in the platelet response to neonatal sepsis, particularly to culture positive sepsis. Hematological changes in platelet count induced by culture proven and culture negative neonatal sepsis can be used to make an early diagnosis and prompt management of neonatal sepsis.