Introduction: Newer light emitting diodes (LED) phototherapy units have become indigenous part in the management of neonatal hyperbilirubinemia almost replacing the conventional compact fluorescent light (CFL) units. Only few studies from India available compare the efficacies of two, so a randomised control study was undertaken. Methods: 60 healthy neonates ≥ 35 weeks gestational age were randomised into CFL and LED groups using computerised random number sequence. The rate of fall of bilirubin levels at 6 hours and at completion along with total duration of phototherapy in both groups was measured. Results analysed by standard statistical methods. Results: LED phototherapy units showed higher rate of fall bilirubin at 6hrs (LED 0.41± 0.10mg/dl/hr VS CFL 0.23± 0.17 mg/dl/hr, C.I=95%, p<0.05) and after completion of therapy (LED 0.29± 0.08 mg/dl/hr VS CFL 0.19± 0.06 mg/dl/hr with p<0.05 C.I 95%) compared to CFL group. There was no statistically significant difference in total duration of therapy in both the groups (LED 18.8±8hrs VS CFL 20±6 hrs C.I=95% p=0.56). 2 among CFL group had failure of phototherapy whereas 1 was lost to follow up in LED group. Both groups didn't show any side effects. Conclusion: The LED phototherapy units are more efficacious in terms of higher rate of fall of bilirubin levels in similar time duration compared to CFL units. But the total duration of phototherapy was equal; it can be because there was significant difference between both the groups in terms of bilirubin levels at start and at end of therapy which couldn't be prevented even after effective randomisation.
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: Septicemia is characterized by positive blood culture, thrombocytopenia & elevated C-reactive protein. Objective: To compare platelet indices and CRP among gram-positive, gram negative and fungal sepsis in newborns. Methods: This is a retrospective case analysis of 52 blood culture positive patients 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, baseline CRP, change in CRP, (baseline CRP-change in CRP)/ baseline CRP, CRP peak, incidence & duration of raised crp. Statistical analysis: All data were collected in validated preformatted proforma sheet & analysed using appropriate statistical methods. Results: Majority (61.53%) had gram negative sepsis. Klebsiella was the commonest organism & was isolated in 21.15% of babies. Weight of the baby (p= 0.014), CRP Peak (p= 0.034), incidence of high CRP (p = 0.003), duration of high CRP (p= 0.004) & duration of thrombocytopenia (p = 0.001) differed significantly among gram-positive, gram negative & fungal sepsis. Conclusion: We noted higher rise in CRP with prolonged duration following Gram negative sepsis. However the incidence of both raised CRP and thrombocytopenia were more among fungal sepsis. Though the onset was delayed, lower platelet nadir, more severe thrombocytopenia with prolonged duration was noted among fungal sepsis.
Background: Preterm birth is one of the major clinical problems in Obstetrics and Neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. Very low birth weight (VLBW) neonates comprise between 4-8% of live-births but about one-third of deaths during the neonatal period occur in this group of newborns. Data on the probability of survival of infant in high risk pregnancies can be of great value in guiding management. The objective is to study the survival at discharge of VLBW neonates admitted in a tertiary care hospital.Methods: Retrospective observational study of all VLBW infants admitted in Aditya Hospital NICU over 3 years between 1-7-2011 to 30-6-2014. Descriptive and inferential statistical analysis has been carried out in the present study.Results: In the present study maternal PROM was seen in 32.9% of cases, Preeclampsia in 31.7% of cases which constituted the most important antenatal risk factor for VLBW followed by multiple gestations in 25.2%. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Survival improved with increasing gestational age and weight.Conclusions: Birth weight and gestational age specifically predicts survival of preterm VLBW babies, facilitating decision making for obstetricians, neonatologists and parents. In the present study total survival rate was 86.6% with a mortality of 13.4%.
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