Arvind Nilkanthrao Chavan, Saleem H. Tambe, Mangesh Karemore, Ismail A Inamdar, Pratiksha Dhurve
Abstract Background: Thrombocytopenia is a frequent problem in neonatal sepsis and is among the most predictive, independent risk factors for sepsis-associated mortality. The present study was undertaken to correlate neonatal sepsis and thrombocytopenia in terms of severity, clinical course, organism specificity and outcome. Method: Total 384 neonates age <28 days with sepsis and thrombocytopenia were studied and analyzed with their clinical profile, symptoms, lab findings and outcomes. Results: Male babies (55.86%), age <72 hrs (80.35%), preterm (68.70%) and LBW babies (85.58%) were more prone to sepsis. Maternal fever (67.44%), foul smelling liquor (53.79%) and PROM >18 hrs (66.74%) make babies more prone to neonatal sepsis. The Commonest clinical features were not accepting feed (69.95%), lethargy (67.85%) and breathing difficulty (79.04%). Early onset sepsis (82.54%) and probable sepsis (40.26%) were more common and associated with preterm and LBW babies. Leucocytosis was seen in 64.57%, thrombocytopenia moderate degree 45.67% and severe degree 34.65%, MPV >12 69.11%, ANC <1800 47.50%, micro ESR >15 mm 72.16% and CRP positivity 28.60%. Severe degree thrombocytopenia (<50000) was more common with PROM >18 hrs (83.02%), maternal fever (83.09%) and gram-negative organism(61.29%). Leucopenia (<4000) was more common with maternal fever (75.79%), proven sepsis (43.16%) and gram-negative organism (70.31%). Severe degree thrombocytopenia (61.29%), leucopenia (70.31%) and mortality (64.51%) were more commonly associated with gram-negative organism. Outcome was bad with severe degree of thrombocytopenia (62.32%), leucopenia (73.91%), and gram-negative organism (64.51%). Conclusion: Proper antenatal mother care, hygiene and early evaluation for illness can prevent early onset of sepsis in neonates. Severity of degree of thrombocytopenia directly proportional to the worst outcome.
背景:血小板减少症是新生儿脓毒症的常见问题,也是脓毒症相关死亡率最具预测性的独立危险因素之一。本研究旨在探讨新生儿脓毒症和血小板减少症在严重程度、临床病程、机体特异性和预后方面的相关性。方法:384例18小时新生儿(66.74%)易发生新生儿败血症。最常见的临床特征为不进食(69.95%)、嗜睡(67.85%)和呼吸困难(79.04%)。早发性脓毒症(82.54%)和可能的脓毒症(40.26%)更为常见,并与早产和低体重儿相关。白细胞减少64.57%,中度血小板减少45.67%,重度血小板减少34.65%,MPV bbb12 69.11%, ANC 15 mm 72.16%, CRP阳性28.60%。重度血小板减少(18小时)(83.02%),产妇发热(83.09%)和革兰氏阴性菌(61.29%)。白细胞减少(<4000)在产妇发热(75.79%)、确诊败血症(43.16%)和革兰氏阴性菌(70.31%)中更为常见。重度血小板减少症(61.29%)、白细胞减少症(70.31%)和死亡率(64.51%)与革兰氏阴性菌相关。结果较差,重度血小板减少(62.32%)、白细胞减少(73.91%)和革兰氏阴性菌(64.51%)。结论:正确的母婴护理、卫生及疾病早期评估可预防新生儿早发性败血症。血小板减少的严重程度与最坏的结果成正比。
{"title":"Study of Clinical and Outcome Profile of Neonatal Sepsis with Thrombocytopenia Patients Admitted at Tertiary health care Centre Nanded","authors":"Arvind Nilkanthrao Chavan, Saleem H. Tambe, Mangesh Karemore, Ismail A Inamdar, Pratiksha Dhurve","doi":"10.47799/pimr.1003.17","DOIUrl":"https://doi.org/10.47799/pimr.1003.17","url":null,"abstract":"Abstract\u0000 \u0000 Background: Thrombocytopenia is a frequent problem in neonatal sepsis and is among the most predictive, independent risk factors for sepsis-associated mortality. The present study was undertaken to correlate neonatal sepsis and thrombocytopenia in terms of severity, clinical course, organism specificity and outcome. Method:\u0000 Total 384 neonates age <28 days with sepsis and thrombocytopenia were studied and analyzed with their clinical profile, symptoms, lab findings and outcomes. Results: Male babies (55.86%), age <72 hrs (80.35%), preterm (68.70%) and LBW babies (85.58%) were more prone to sepsis. Maternal fever (67.44%), foul smelling liquor (53.79%) and PROM >18 hrs (66.74%) make babies more prone to neonatal sepsis. The Commonest clinical features were not accepting feed (69.95%), lethargy (67.85%) and breathing difficulty (79.04%). Early onset sepsis (82.54%) and probable sepsis (40.26%) were more common and associated with preterm and LBW babies. Leucocytosis was seen in 64.57%, thrombocytopenia moderate degree 45.67% and severe degree 34.65%, MPV >12 69.11%, ANC <1800 47.50%, micro ESR >15 mm 72.16% and CRP positivity 28.60%. Severe degree thrombocytopenia (<50000) was more common with PROM >18 hrs (83.02%), maternal fever (83.09%) and gram-negative organism(61.29%). Leucopenia (<4000) was more common with maternal fever (75.79%), proven sepsis (43.16%) and gram-negative organism (70.31%). Severe degree thrombocytopenia (61.29%), leucopenia (70.31%) and mortality (64.51%) were more commonly associated with gram-negative organism. Outcome was bad with severe degree of thrombocytopenia (62.32%), leucopenia (73.91%), and gram-negative organism (64.51%). Conclusion: Proper antenatal mother care, hygiene and early evaluation for illness can prevent early onset of sepsis in neonates. Severity of degree of thrombocytopenia directly proportional to the worst outcome.","PeriodicalId":30624,"journal":{"name":"Perspectives In Medical Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46857185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haseeb ul Haq, S. Raghunath, Channamaneni Amithkumar
Abstract Introduction: Predictive markers enabling Pediatricians to identify which neonates will develop jaundice have mandatory for prevention of severe hyperbilirubinemia. We aim to determine the critical cord bilirubin and albumin levels and bilirubin/albumin ratio. Design: This prospective study included131full-termnewborns. Hyperbilirubinemia can be predicted by Measuring cord bilirubin , albumin and bilirubin/albumin ratio. Results: Neonatal hyperbilirubinemia (67.8%) had cord albumin level less than or equal to 2.7gm/dl. CordBilirubin/albumin ratio cutoff value greater than 0.62 had a good predictive value with a sensitivity of 100% and specificity of 88.36%, Conclusion: neonatal hyperbilirubinemia predictors are Cord BILIRUBIN/ALBUMIN ratio , serum bilirubin and albumin.
{"title":"Early Predictors of Hyperbilirubinemia in Full Term Newborn","authors":"Haseeb ul Haq, S. Raghunath, Channamaneni Amithkumar","doi":"10.47799/pimr.1003.18","DOIUrl":"https://doi.org/10.47799/pimr.1003.18","url":null,"abstract":"Abstract\u0000 \u0000 Introduction: Predictive markers enabling Pediatricians to identify which neonates will develop jaundice have mandatory for prevention of severe hyperbilirubinemia. We aim to determine the critical cord bilirubin and albumin levels and bilirubin/albumin ratio.\u0000 \u0000 Design: This prospective study included131full-termnewborns. Hyperbilirubinemia can be predicted by Measuring cord bilirubin , albumin and bilirubin/albumin ratio.\u0000 \u0000 Results: Neonatal hyperbilirubinemia (67.8%) had cord albumin level less than or equal to 2.7gm/dl. CordBilirubin/albumin ratio cutoff value greater than 0.62 had a good predictive value with a sensitivity of 100% and specificity of 88.36%,\u0000 \u0000 Conclusion: neonatal hyperbilirubinemia predictors are Cord BILIRUBIN/ALBUMIN ratio , serum bilirubin and albumin.","PeriodicalId":30624,"journal":{"name":"Perspectives In Medical Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41942054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: Untreated acute pancreatitis can have high morbidity and mortality. It is a serious gastrointestinal emergency. Its incidence is approximately 51.0 % and it can cause both local and systemic problems. The diagnosis usually involves laboratory tests like amylase and lipase as well as an ultrasound exam. The ideal imaging test is a contrast-enhanced CT scan. This study used scoring systems based on laboratory and radiological investigations to determine the clinical progression and outcome. Methods : Patients who were diagnosed with acute pancreatitis and in whom computed tomography was done were included. From the imaging findings, the category and subcategory of acute pancreatitis and types of fluid collections were described in these patients using the revised Atlanta classification. BISAP score was calculated in all these patients. The clinical outcome assessed in these patients is the duration of stay in the hospital, mortality, presence of persistent organ failure, the occurrence of infection and need for intervention. Finally, the correlation between the Revised Atlanta classification and BISAP score was analyzed and compared with clinical outcomes. Results: The analysis of the correlation between Revised Atlanta classification severity grade and BISAP score, among the n=57 patients with mild acute pancreatitis n=56, had BISAP score less than 3 and only one had BISAP score greater or equal to three. Among the n=25 patients graded as moderately severe acute pancreatitis, n=20 cases had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Among the n=08 patients graded as severe acute pancreatitis, n=3 had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Conclusion: Standardizing nomenclature and facilitating proper documentation of a variety of imaging abnormalities in acute pancreatitis is made possible by incorporating the new Atlanta categorization system into daily practice. We can triage, predict, and treat patients with acute pancreatitis with greater precision by integrating the new Atlanta classification with BISAP clinical grading, significantly improving medical care.
{"title":"Assessment of Severity of Pancreatitis by Computerized Tomography Using Revised Atlanta Classification and Comparison with BISAP Clinical Scoring System","authors":"Srikanth Sagi, Keerthi Bharati","doi":"10.47799/pimr.1003.03","DOIUrl":"https://doi.org/10.47799/pimr.1003.03","url":null,"abstract":"Abstract\u0000 \u0000 Background: Untreated acute pancreatitis can have high morbidity and mortality. It is a serious gastrointestinal emergency. Its incidence is approximately 51.0 % and it can cause both local and systemic problems. The diagnosis usually involves laboratory tests like amylase and lipase as well as an ultrasound exam. The ideal imaging test is a contrast-enhanced CT scan. This study used scoring systems based on laboratory and radiological investigations to determine the clinical progression and outcome.\u0000 \u0000 Methods\u0000 : Patients who were diagnosed with acute pancreatitis and in whom computed tomography was done were included. From the imaging findings, the category and subcategory of acute pancreatitis and types of fluid collections were described in these patients using the revised Atlanta classification. BISAP score was calculated in all these patients. The clinical outcome assessed in these patients is the duration of stay in the hospital, mortality, presence of persistent organ failure, the occurrence of infection and need for intervention. Finally, the correlation between the Revised Atlanta classification and BISAP score was analyzed and compared with clinical outcomes.\u0000 \u0000 Results: The analysis of the correlation between Revised Atlanta classification severity grade and BISAP score, among the n=57 patients with mild acute pancreatitis n=56, had BISAP score less than 3 and only one had BISAP score greater or equal to three. Among the n=25 patients graded as moderately severe acute pancreatitis, n=20 cases had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Among the n=08 patients graded as severe acute pancreatitis, n=3 had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three.\u0000 \u0000 Conclusion: Standardizing nomenclature and facilitating proper documentation of a variety of imaging abnormalities in acute pancreatitis is made possible by incorporating the new Atlanta categorization system into daily practice. We can triage, predict, and treat patients with acute pancreatitis with greater precision by integrating the new Atlanta classification with BISAP clinical grading, significantly improving medical care.","PeriodicalId":30624,"journal":{"name":"Perspectives In Medical Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43200537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ishrath Fatima Fatima, Swati N. Nagapurkar, Amreen Khan
Abstract Background: Grand multiparous pregnancies have been considered to be at higher risk of developing antenatal and perinatal complications like pre-eclampsia, gestational diabetes mellitus, anemia, antepartum hemorrhages, preterm labor, mal-presentation, mal-position and feto-pelvic disproportion This study was done to know the magnitude of grand multipara attending the tertiary care center with possible complications related to high parity. Objectives:To study the prevalence possible feto-maternal complications associated with grand multipara at rural setup. Methodology:Descriptive cross-sectional study conducted in medical college of rural area for 12 months. Grand multipara with 5 or more deliveries before current pregnancy coming for antenatal checkup and delivery were enrolled. Antenatal history was recorded till delivery and feto-maternal outcomes were noted. Results:Out of 1500 deliveries conducted during study period, 110 (7.5%) cases were grand multipara. Majority of them (79.5%) were Muslim and 80% were anaemic. 60% delivered with FTND, and 25.4% had emergency LSCS with one intrauterine death and a single breach delivery. Predominantly preeclampsia (23.6%) and malpresentation (14.5%) were diagnosed as antepartum complications. Almost one fifth of them had postpartum hemorrhage which was controlled with no mortality. 13 (11.8%) grand multipara women had still birth or early neonatal death, though fetal distress was observed in 37 cases. Conclusion: Grand multiparty is still a high-risk pregnancy associated with adverse maternal and fetal outcomes in our facility with multiple interrelated but mostly preventable causes.
{"title":"Study of magnitude of grand multiparty and its perinatal outcome in a tertiary hospital \u0000 of rural area in \u0000 Maharashtra","authors":"Ishrath Fatima Fatima, Swati N. Nagapurkar, Amreen Khan","doi":"10.47799/pimr.1003.15","DOIUrl":"https://doi.org/10.47799/pimr.1003.15","url":null,"abstract":"Abstract Background: Grand multiparous pregnancies have been considered to be at higher risk of developing antenatal and perinatal complications like pre-eclampsia, gestational diabetes mellitus, anemia, antepartum hemorrhages, preterm labor, mal-presentation, mal-position and feto-pelvic disproportion This study was done to know the magnitude of grand multipara attending the tertiary care center with possible complications related to high parity. Objectives:To study the prevalence possible feto-maternal complications associated with grand multipara at rural setup. Methodology:Descriptive cross-sectional study conducted in medical college of rural area for 12 months. Grand multipara with 5 or more deliveries before current pregnancy coming for antenatal checkup and delivery were enrolled. Antenatal history was recorded till delivery and feto-maternal outcomes were noted. Results:Out of 1500 deliveries conducted during study period, 110 (7.5%) cases were grand multipara. Majority of them (79.5%) were Muslim and 80% were anaemic. 60% delivered with FTND, and 25.4% had emergency LSCS with one intrauterine death and a single breach delivery. Predominantly preeclampsia (23.6%) and malpresentation (14.5%) were diagnosed as antepartum complications. Almost one fifth of them had postpartum hemorrhage which was controlled with no mortality. 13 (11.8%) grand multipara women had still birth or early neonatal death, though fetal distress was observed in 37 cases. Conclusion: Grand multiparty is still a high-risk pregnancy associated with adverse maternal and fetal outcomes in our facility with multiple interrelated but mostly preventable causes.","PeriodicalId":30624,"journal":{"name":"Perspectives In Medical Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43985709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}