Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/57554.2372
Introduction: Neonatal candidiasis is one of the leading causes of sepsis amongst newborns admitted to newborn care unit, especially premature and Low Birth Weight (LBW) babies. It is one of the significant contributors to neonatal morbidity and mortality. Aim: To describe the spectrum and epidemiology of fungal sepsis in Neonatal Intensive Care Unit (NICU) at a tertiary care level. Materials and Methods: A longitudinal study was conducted from January 2018- December 2019 in NICU of Chirayu Medical College and Hospital, a tertiary level hospital in Bhopal, Central India. All neonates, who had positive fungal blood culture were included in the study, their demographic data was analysed (age, birth weight, predisposing factors etc.,), maternal history, their response to the antifungal treatment documented and complications. Statistical analysis was done using the Chi- square test with the help of Statistical Package for Social Sciences (SPSS) software version 2.0. Results: A total of 409 neonates admitted in the NICU during the study period, were suspected clinically to have sepsis and their blood culture was done, of which 110 samples were culture positive. Amongst the 110 neonates, 41(37.2%) were positive for fungal infection {29 showed Candida albicans, 12 Non Albicans Candida (NAC)}. Total 25 neonates were preterm (60.97%). The mean age of admission was 3.02 days, 51.2% (21/41) of the neonates had a history of respiratory distress and related symptoms at birth. There was no significant maternal history. Amongst the risk factors, lower birth weight (<2.5 kg), preterm (<34 weeks), and presence of invasive central lines were statistically associated with morbidity. Urine for candidial hyphae was positive in 12 out of 41 cases (29.27%). Incidence of candidal meningitis was seen in four neonates (13.33%). Thrombocytopenia was the most common laboratory finding amongst these cases (32/41). Among the different regimens used the combination regimen of Lipid based amphotericin B and voriconazole was associated with a better survival. Conclusion: Candida sepsis was found to be the most common cause of septicaemia in the NICU. LBW and preterm babies are especially at greater risk of candida sepsis. Candida albicans still continues to be a dominant aetiology for fungal sepsis, as compared to non candida species.
{"title":"Neonatal Candidiasis: Clinical Spectrum and Epidemiology at a Tertiary Care Centre, Bhopal, India","authors":"","doi":"10.7860/ijnmr/2023/57554.2372","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/57554.2372","url":null,"abstract":"Introduction: Neonatal candidiasis is one of the leading causes of sepsis amongst newborns admitted to newborn care unit, especially premature and Low Birth Weight (LBW) babies. It is one of the significant contributors to neonatal morbidity and mortality. Aim: To describe the spectrum and epidemiology of fungal sepsis in Neonatal Intensive Care Unit (NICU) at a tertiary care level. Materials and Methods: A longitudinal study was conducted from January 2018- December 2019 in NICU of Chirayu Medical College and Hospital, a tertiary level hospital in Bhopal, Central India. All neonates, who had positive fungal blood culture were included in the study, their demographic data was analysed (age, birth weight, predisposing factors etc.,), maternal history, their response to the antifungal treatment documented and complications. Statistical analysis was done using the Chi- square test with the help of Statistical Package for Social Sciences (SPSS) software version 2.0. Results: A total of 409 neonates admitted in the NICU during the study period, were suspected clinically to have sepsis and their blood culture was done, of which 110 samples were culture positive. Amongst the 110 neonates, 41(37.2%) were positive for fungal infection {29 showed Candida albicans, 12 Non Albicans Candida (NAC)}. Total 25 neonates were preterm (60.97%). The mean age of admission was 3.02 days, 51.2% (21/41) of the neonates had a history of respiratory distress and related symptoms at birth. There was no significant maternal history. Amongst the risk factors, lower birth weight (<2.5 kg), preterm (<34 weeks), and presence of invasive central lines were statistically associated with morbidity. Urine for candidial hyphae was positive in 12 out of 41 cases (29.27%). Incidence of candidal meningitis was seen in four neonates (13.33%). Thrombocytopenia was the most common laboratory finding amongst these cases (32/41). Among the different regimens used the combination regimen of Lipid based amphotericin B and voriconazole was associated with a better survival. Conclusion: Candida sepsis was found to be the most common cause of septicaemia in the NICU. LBW and preterm babies are especially at greater risk of candida sepsis. Candida albicans still continues to be a dominant aetiology for fungal sepsis, as compared to non candida species.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267477","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}
Introduction: High neonatal mortality rates may be attributed to the lack of early recognition of severe illness, early and safe referral, and proper care. Therefore, there is a need to develop a simple, cost-effective scoring system that can be quickly applied to newborns referred from peripheral to tertiary care settings in resource-constrained areas. The Extended Sick Neonate Score (ESNS) is one such scoring system used to assess the severity of illness in critically ill neonates and predict their outcomes. Aim: To evaluate the effectiveness of the Extended Sick Newborn Score in predicting outcomes for neonates admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care centre. Materials and Methods: This prospective cohort study included 122 outborn neonates admitted to the NICU of SDM College of Medical Sciences and Hospital in Dharwad, Karnataka, India, from June 2021 to June 2022. All the required parameters for scoring, such as respiratory effort, heart rate, mean blood pressure, axillary temperature, capillary filling time, random blood sugar, SpO2, Moro reflex, and modified Downe’s score, were assessed and documented in a predesigned proforma. The ESNS was calculated upon admission to predict the outcomes. Statistical analysis included ANOVA test and independent t-test, using SPSS version 17.0 and MS Excel. Results: The study evaluated a total of 122 neonates, including 78 males and 44 females. Of these, 99 were term neonates and 23 were preterm neonates. The mean age for term neonates was 8.5 days ±8.6, and for preterm neonates, it was 4.1 days ±4.3. Term neonates with an ESNS Score ≤11 exhibited higher mortality, while preterm neonates with an ESNS score ≤12 showed higher mortality. The sensitivity and specificity of the ESNS score in predicting death were 78.57% and 99.07%, respectively. The ESNS score at admission was significantly lower in non-survivors compared to survivors, and it demonstrated a positive correlation with the outcome. Conclusion: This study found a significant correlation between the ESNS score at admission and in-hospital mortality. The use of the ESNS score is an acceptable method for risk stratification and prognosis of newborns in the NICU.
{"title":"Assessment of Neonates with Extended Sick Neonate Score (ESNS) for Predicting Mortality in a Tertiary Care Center in Dharwad, Karnataka, India: A Prospective Cohort Study","authors":"Yeruva Ramani Maria, Kavita Shantmalappa Konded, Kulkarni Poornima Prakash, Jasmine Kandagal","doi":"10.7860/ijnmr/2023/65335.2393","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/65335.2393","url":null,"abstract":"Introduction: High neonatal mortality rates may be attributed to the lack of early recognition of severe illness, early and safe referral, and proper care. Therefore, there is a need to develop a simple, cost-effective scoring system that can be quickly applied to newborns referred from peripheral to tertiary care settings in resource-constrained areas. The Extended Sick Neonate Score (ESNS) is one such scoring system used to assess the severity of illness in critically ill neonates and predict their outcomes. Aim: To evaluate the effectiveness of the Extended Sick Newborn Score in predicting outcomes for neonates admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care centre. Materials and Methods: This prospective cohort study included 122 outborn neonates admitted to the NICU of SDM College of Medical Sciences and Hospital in Dharwad, Karnataka, India, from June 2021 to June 2022. All the required parameters for scoring, such as respiratory effort, heart rate, mean blood pressure, axillary temperature, capillary filling time, random blood sugar, SpO2, Moro reflex, and modified Downe’s score, were assessed and documented in a predesigned proforma. The ESNS was calculated upon admission to predict the outcomes. Statistical analysis included ANOVA test and independent t-test, using SPSS version 17.0 and MS Excel. Results: The study evaluated a total of 122 neonates, including 78 males and 44 females. Of these, 99 were term neonates and 23 were preterm neonates. The mean age for term neonates was 8.5 days ±8.6, and for preterm neonates, it was 4.1 days ±4.3. Term neonates with an ESNS Score ≤11 exhibited higher mortality, while preterm neonates with an ESNS score ≤12 showed higher mortality. The sensitivity and specificity of the ESNS score in predicting death were 78.57% and 99.07%, respectively. The ESNS score at admission was significantly lower in non-survivors compared to survivors, and it demonstrated a positive correlation with the outcome. Conclusion: This study found a significant correlation between the ESNS score at admission and in-hospital mortality. The use of the ESNS score is an acceptable method for risk stratification and prognosis of newborns in the NICU.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"2010 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207629","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}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/59711.2392
Leena Dhande, Prerana Ganaboor, Rasika Hattewar, Chetan Jaiswal
Introduction: Hearing impairment and deafness are global issues that affect 5% of the world’s population, with nearly 34 million children requiring rehabilitation to address their hearing loss (HL). An approximately 10-20 fold higher incidence of audiological risk factors has been noted in Neonatal Intensive Care Units (NICUs), which translates that 2-5% of all newborns in NICUs may be affected. Early diagnosis of HL and intervention can be advantageous from the timely fitting of hearing aids or cochlear implants. Aim: The aim of this study was to evaluate the risk factors for HL in NICUs and Special Neonatal Care Units (SNCUs) at a tertiary care hospital in Central India. Materials and Methods: This prospective, observational, single-centre study was conducted from October 2019 to September 2021 in the Department of Paediatrics at Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India. A total of 319 neonates at high risk for HL, discharged from NICUs and SNCUs, were included in the study. The association between risk factors like prematurity, low birth weight (LBW), Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex (TORCH) infections, neonatal asphyxia, neonatal sepsis, meningitis, exchange transfusion, assisted ventilation, and HL were studied. The chi-square test was used to assess the association between SNHL and risk factors. Results: The incidence of Sensorineural Hearing Loss (SNHL) was 3.76%. Neonatal asphyxia (p-value <0.01), exchange transfusion (p-value <0.001), TORCH infections (p-value < 0.001), meningitis (p-value <0.001), and assisted ventilation (p-value <0.001) were found to be significant risk factors associated with SNHL. Conclusion: Based on the assessment of risk factors, it was concluded that neonates should undergo hearing screening tests within the first month of life, and a diagnosis should be made by three months of age. This allows specialists to initiate treatment and intervention by six months of age, helping children with impaired hearing avoid the harmful consequences of semantic deprivation.
{"title":"Risk Factors for Hearing Loss in High-Risk Neonates at a Tertiary Care Centre in Central India: A Prospective Observational Study","authors":"Leena Dhande, Prerana Ganaboor, Rasika Hattewar, Chetan Jaiswal","doi":"10.7860/ijnmr/2023/59711.2392","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/59711.2392","url":null,"abstract":"Introduction: Hearing impairment and deafness are global issues that affect 5% of the world’s population, with nearly 34 million children requiring rehabilitation to address their hearing loss (HL). An approximately 10-20 fold higher incidence of audiological risk factors has been noted in Neonatal Intensive Care Units (NICUs), which translates that 2-5% of all newborns in NICUs may be affected. Early diagnosis of HL and intervention can be advantageous from the timely fitting of hearing aids or cochlear implants. Aim: The aim of this study was to evaluate the risk factors for HL in NICUs and Special Neonatal Care Units (SNCUs) at a tertiary care hospital in Central India. Materials and Methods: This prospective, observational, single-centre study was conducted from October 2019 to September 2021 in the Department of Paediatrics at Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India. A total of 319 neonates at high risk for HL, discharged from NICUs and SNCUs, were included in the study. The association between risk factors like prematurity, low birth weight (LBW), Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex (TORCH) infections, neonatal asphyxia, neonatal sepsis, meningitis, exchange transfusion, assisted ventilation, and HL were studied. The chi-square test was used to assess the association between SNHL and risk factors. Results: The incidence of Sensorineural Hearing Loss (SNHL) was 3.76%. Neonatal asphyxia (p-value <0.01), exchange transfusion (p-value <0.001), TORCH infections (p-value < 0.001), meningitis (p-value <0.001), and assisted ventilation (p-value <0.001) were found to be significant risk factors associated with SNHL. Conclusion: Based on the assessment of risk factors, it was concluded that neonates should undergo hearing screening tests within the first month of life, and a diagnosis should be made by three months of age. This allows specialists to initiate treatment and intervention by six months of age, helping children with impaired hearing avoid the harmful consequences of semantic deprivation.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136209292","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}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/58192.2381
Jayesh R Solanki, Janakiram .
Introducton: Perinatal asphyxia is one of the most important causes of mortality and morbidity in full-term neonates, where due to the hypoxic insult, mortality and various morbidities happens. So, it is important to predict both the outcomes to aid in patient management, as well as to counsel the caregivers regarding the outcome of the patient, especially the neurological outcome. Aim: To determine the usefulness of abnormal Resistive Index (RI) values on transcranial USG doppler and its association with clinical outcomes in term neonates with perinatal asphyxia. Materials and Methods: This prospective longitudinal study was conducted in the extramural Neonatal Intensive Care Unit (NICU) and Rukmani Chainani NICU of Sir Sayaji General (SSG) Hospital, Vadodara, Gujarat, India, from June 2020 to November 2021. Study was conducted among a cohort of 174 term newborns with perinatal asphyxia admitted in both intramural and extramural NICU of SSG Hospital Vadodara. Neurodevelopmental assessment was done by Amiel-tison scoring system, done at birth, at the time of discharge, at three and six months of age with simultaneous RI value monitoring by a trained radiology resident. The clinical association was done in terms of mortality at birth, morbidities encountered during the NICU stay and neurological outcome at six months of age. Development assessment was done by history taking and clinical examination, patients with delay in two or more domains were classified as global developmental delay, patients with delay in less than two domains were classified as mild developmental delay. Continuable variables were analysed using one-way Analysis of Variance (ANOVA). Categorical data were analysed with Pearson’s Chi-square test. Significance was defined by p-values less than 0.05 using a two-tailed test. Results: Out of 174 newborns enrolled, 97 patients had normal RI values at birth, and 77 patients had abnormal RI values. Forty-eight patients expired after birth, with 27% mortality, and among which 43 patients had abnormal RI values at birth, which was statistically significant (p-value <0.0001). The majority of the newborns with abnormal RI required invasive mechanical ventilation (n=62) and had persistent pulmonary hypertension of newborn (n=40), ventricular dysfunction (n=33), feed intolerance (n=17), acute kidney injury (n=19) and sepsis (n=27). Conclusion: Transcranial Ultrasonography (USG) doppler in the calculation of RI at birth is a useful non invasive point of care method to determine immediate short-term outcomes in the form of mortality and short-term morbidities encountered during NICU stay.
简介:围产期窒息是导致足月新生儿死亡和发病的重要原因之一，由于缺氧损伤，围产期窒息可导致死亡和各种疾病的发生。因此，重要的是预测结果，以帮助患者管理，以及咨询护理人员关于患者的结果，特别是神经系统的结果。目的:探讨经颅USG多普勒电阻指数(RI)异常值与围产期窒息足月新生儿临床预后的关系。材料和方法:本前瞻性纵向研究于2020年6月至2021年11月在印度古吉拉特邦瓦多达拉市Sir Sayaji General (SSG)医院的新生儿重症监护室(NICU)和Rukmani Chainani NICU进行。研究对象为174名在瓦多达拉SSG医院内、外NICU住院的围产期窒息足月新生儿。神经发育评估采用Amiel-tison评分系统，在出生时、出院时、3个月和6个月时进行，同时由训练有素的放射科住院医师进行RI值监测。临床关联是根据出生时的死亡率，在新生儿重症监护病房逗留期间遇到的发病率和6个月大时的神经预后来进行的。通过病史记录和临床检查进行发育评估，两项及两项以上发育迟缓者为全面发育迟缓，两项以下发育迟缓者为轻度发育迟缓。可持续性变量采用单因素方差分析(ANOVA)进行分析。分类资料采用Pearson卡方检验进行分析。采用双尾检验，p值小于0.05定义显著性。结果:入组的174例新生儿中，97例新生儿出生时RI值正常，77例新生儿出生时RI值异常。48例患者出生后死亡，死亡率27%，其中43例患者出生时RI值异常，差异有统计学意义(p值<0.0001)。大多数RI异常新生儿需要有创机械通气(n=62)，并伴有新生儿持续性肺动脉高压(n=40)、心室功能障碍(n=33)、饲料不耐受(n=17)、急性肾损伤(n=19)和脓毒症(n=27)。结论:经颅超声(USG)多普勒计算出生时的RI是一种有用的无创护理点方法，可以确定新生儿在新生儿重症监护病房期间的短期死亡率和短期发病率。
{"title":"Transcranial Ultrasonography Doppler in Detecting Clinical Outcome of Term Neonates with Perinatal Asphyxia: A Longitudinal Study","authors":"Jayesh R Solanki, Janakiram .","doi":"10.7860/ijnmr/2023/58192.2381","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/58192.2381","url":null,"abstract":"Introducton: Perinatal asphyxia is one of the most important causes of mortality and morbidity in full-term neonates, where due to the hypoxic insult, mortality and various morbidities happens. So, it is important to predict both the outcomes to aid in patient management, as well as to counsel the caregivers regarding the outcome of the patient, especially the neurological outcome. Aim: To determine the usefulness of abnormal Resistive Index (RI) values on transcranial USG doppler and its association with clinical outcomes in term neonates with perinatal asphyxia. Materials and Methods: This prospective longitudinal study was conducted in the extramural Neonatal Intensive Care Unit (NICU) and Rukmani Chainani NICU of Sir Sayaji General (SSG) Hospital, Vadodara, Gujarat, India, from June 2020 to November 2021. Study was conducted among a cohort of 174 term newborns with perinatal asphyxia admitted in both intramural and extramural NICU of SSG Hospital Vadodara. Neurodevelopmental assessment was done by Amiel-tison scoring system, done at birth, at the time of discharge, at three and six months of age with simultaneous RI value monitoring by a trained radiology resident. The clinical association was done in terms of mortality at birth, morbidities encountered during the NICU stay and neurological outcome at six months of age. Development assessment was done by history taking and clinical examination, patients with delay in two or more domains were classified as global developmental delay, patients with delay in less than two domains were classified as mild developmental delay. Continuable variables were analysed using one-way Analysis of Variance (ANOVA). Categorical data were analysed with Pearson’s Chi-square test. Significance was defined by p-values less than 0.05 using a two-tailed test. Results: Out of 174 newborns enrolled, 97 patients had normal RI values at birth, and 77 patients had abnormal RI values. Forty-eight patients expired after birth, with 27% mortality, and among which 43 patients had abnormal RI values at birth, which was statistically significant (p-value <0.0001). The majority of the newborns with abnormal RI required invasive mechanical ventilation (n=62) and had persistent pulmonary hypertension of newborn (n=40), ventricular dysfunction (n=33), feed intolerance (n=17), acute kidney injury (n=19) and sepsis (n=27). Conclusion: Transcranial Ultrasonography (USG) doppler in the calculation of RI at birth is a useful non invasive point of care method to determine immediate short-term outcomes in the form of mortality and short-term morbidities encountered during NICU stay.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267039","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}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/59294.2377
L. Jha, Vasanth Kumar, Subho Sankar Banerjee, Chandreyi Bandhopadhyay
Introduction: Procedural pain remedies in neonates is an area of active research due to better understanding of short and long-term outcomes of neonatal painful exposures. Non pharmacological interventions are especially attractive as it avoids unnecessary drug exposure. While dextrose is known to be effective, results with small volumes (2 mL) of Expressed Breast Milk (EBM) are equivocal. There is recent theoretical evidence to show that larger doses of EBM may be more efficacious. Aim: To compare the efficacy of a larger volume of EBM 5 mL and 2 mL of 25% Dextrose (25D) in relief of procedural pain from venipuncture in term and preterm neonates. Materials and Methods: A single center randomised placebo- controlled study was conducted at Bokaro General Hospital, Bokaro Steel City, Jharkhand, India, between March 2014 and February 2016. Neonates ≥34 week gestation, requiring venipuncture in a neonatal care unit were randomly allocated into 3 equal groups using a random number table- Sterile Water (SW), 2mL 25D, 5 mL EBM was given two minutes prior to venipuncture. Video of facial response, cry times, Maximal Heart Rate (MHR), and minimum Oxygen Saturation (SpO2) were recorded till five minutes after venipuncture. The Premature Infant Pain Profile (PIPP) score was used to assess the effect of the interventions on procedural pain. Subgroup analysis was done in term and preterm neonates. Continuous variables were presented as mean±SD or median. Categorical variables were expressed as frequencies and percentages. The comparison of normally distributed continuous variables between the groups was performed using Analysis of Variance (ANOVA). Results: The PIPP score in the 25D group (2.94±1.41) was significantly lower than the EBM (7.42±1.69) and SW (10.56±1.69) groups (p-value<0.001). MHR was significantly lower in the 25D group, but no difference was found between the EBM and SW groups (p-value=0.23). SpO2 was significantly higher in the 25D group but for the initial 2.5 minutes only. Cry times were significantly lower in the intervention groups. There was no difference in outcomes in term vs. preterm infants. Conclusion: The use of 2 mL 25D was more effective in reducing procedural pain from venipuncture compared to 5 mL EBM. The return of physiological markers (MHR and SpO2) to baseline were faster and more complete in the 25D group.
{"title":"Efficacy of Enhanced Dose of Expressed Breast Milk in Neonatal Procedural Pain Relief: A Randomised Placebo-controlled Study","authors":"L. Jha, Vasanth Kumar, Subho Sankar Banerjee, Chandreyi Bandhopadhyay","doi":"10.7860/ijnmr/2023/59294.2377","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/59294.2377","url":null,"abstract":"Introduction: Procedural pain remedies in neonates is an area of active research due to better understanding of short and long-term outcomes of neonatal painful exposures. Non pharmacological interventions are especially attractive as it avoids unnecessary drug exposure. While dextrose is known to be effective, results with small volumes (2 mL) of Expressed Breast Milk (EBM) are equivocal. There is recent theoretical evidence to show that larger doses of EBM may be more efficacious. Aim: To compare the efficacy of a larger volume of EBM 5 mL and 2 mL of 25% Dextrose (25D) in relief of procedural pain from venipuncture in term and preterm neonates. Materials and Methods: A single center randomised placebo- controlled study was conducted at Bokaro General Hospital, Bokaro Steel City, Jharkhand, India, between March 2014 and February 2016. Neonates ≥34 week gestation, requiring venipuncture in a neonatal care unit were randomly allocated into 3 equal groups using a random number table- Sterile Water (SW), 2mL 25D, 5 mL EBM was given two minutes prior to venipuncture. Video of facial response, cry times, Maximal Heart Rate (MHR), and minimum Oxygen Saturation (SpO2) were recorded till five minutes after venipuncture. The Premature Infant Pain Profile (PIPP) score was used to assess the effect of the interventions on procedural pain. Subgroup analysis was done in term and preterm neonates. Continuous variables were presented as mean±SD or median. Categorical variables were expressed as frequencies and percentages. The comparison of normally distributed continuous variables between the groups was performed using Analysis of Variance (ANOVA). Results: The PIPP score in the 25D group (2.94±1.41) was significantly lower than the EBM (7.42±1.69) and SW (10.56±1.69) groups (p-value<0.001). MHR was significantly lower in the 25D group, but no difference was found between the EBM and SW groups (p-value=0.23). SpO2 was significantly higher in the 25D group but for the initial 2.5 minutes only. Cry times were significantly lower in the intervention groups. There was no difference in outcomes in term vs. preterm infants. Conclusion: The use of 2 mL 25D was more effective in reducing procedural pain from venipuncture compared to 5 mL EBM. The return of physiological markers (MHR and SpO2) to baseline were faster and more complete in the 25D group.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267239","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}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/60764.2373
S. Agrawal, .. Ravanagomagan, Sethi Rohith Shamsher, Chaurasiya Rachna
Introduction: Perinatal Asphyxia (PA) causes impaired exchange of ventilatory gases, or ischemia that leads to persistent decrease in oxygen levels (hypoxemia) and increase in carbon dioxide levels (hypercarbia). It occurs during the peripartum period can contribute to early neonatal mortality and morbidity. Aim: To assess the role of early changes in cranial ultrasound a predictor of outcome in babes with PA. Materials and Methods: This prospective cohort study was conducted in a tertiary care neonatal unit in Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India, from July 2018 to October 2019. A total of 50 neonates with PA were studied. Cranial ultrasound was performed at or after seven days of life. Neurodevelopment assessment of the subjects were done at 3, 6, 9 and 12 months of life using Development Quotient (DQ). Variables were analysed by student’s t-test and categorical variables were analysed by Fisher’s-exact probability test using graph pad software. Results: Out of 50 infants of PA, 29 had an abnormal ultrasound scan and 21 had normal ultrasound scan. A 16/29 patients had abnormal outcome along with abnormal ultrasound scan while rest of the 13 had normal outcome. The mean DQ of the neonates having abnormal ultra sonographic examination was significantly lower as compared to those with normal examination. A 6 out of 21 neonates had abnormal outcome inspite of having normal ultrasound scan. Cranial ultrasound has a specificity=55%, sensitivity=73%, Positive Predictive Value (PPV)=58% and Negative Predictive Value (NPV)=71% in predicting neurodevelopment outcome of patients with birth asphyxia. Conclusion: Cranial Utrasonography (USG) findings in PA babies reveal a strong association with the development severity.
{"title":"Early Cranial Ultrasound Changes as Predictors of Outcome during First Year of Life in Infants with Perinatal Asphyxia- A Prospective Cohort Study","authors":"S. Agrawal, .. Ravanagomagan, Sethi Rohith Shamsher, Chaurasiya Rachna","doi":"10.7860/ijnmr/2023/60764.2373","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/60764.2373","url":null,"abstract":"Introduction: Perinatal Asphyxia (PA) causes impaired exchange of ventilatory gases, or ischemia that leads to persistent decrease in oxygen levels (hypoxemia) and increase in carbon dioxide levels (hypercarbia). It occurs during the peripartum period can contribute to early neonatal mortality and morbidity. Aim: To assess the role of early changes in cranial ultrasound a predictor of outcome in babes with PA. Materials and Methods: This prospective cohort study was conducted in a tertiary care neonatal unit in Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India, from July 2018 to October 2019. A total of 50 neonates with PA were studied. Cranial ultrasound was performed at or after seven days of life. Neurodevelopment assessment of the subjects were done at 3, 6, 9 and 12 months of life using Development Quotient (DQ). Variables were analysed by student’s t-test and categorical variables were analysed by Fisher’s-exact probability test using graph pad software. Results: Out of 50 infants of PA, 29 had an abnormal ultrasound scan and 21 had normal ultrasound scan. A 16/29 patients had abnormal outcome along with abnormal ultrasound scan while rest of the 13 had normal outcome. The mean DQ of the neonates having abnormal ultra sonographic examination was significantly lower as compared to those with normal examination. A 6 out of 21 neonates had abnormal outcome inspite of having normal ultrasound scan. Cranial ultrasound has a specificity=55%, sensitivity=73%, Positive Predictive Value (PPV)=58% and Negative Predictive Value (NPV)=71% in predicting neurodevelopment outcome of patients with birth asphyxia. Conclusion: Cranial Utrasonography (USG) findings in PA babies reveal a strong association with the development severity.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"843 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267438","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}
Pub Date : 2023-01-01DOI: 10.7860/ijnmr/2023/58137.2367
S. Panda, Simanta Das, D. Behera, Sanaga Meghna, Suchismit Mahapatra, Nibedita Pradhan
Introduction: Neonatal polycythaemia is a commonly encountered morbidity and mortality among neonates admitted to neonatal care units and sick newborn care units. Most affected infants have no clinical symptoms and signs, but neonates may present with lethargy, poor feeding, plethora, cyanosis and jaundice within 12-72 hrs. Aim: To find out the incidence and clinical manifestations of neonatal polycythaemia along with detection of disease by laboratory abnormalities. Materials and Methods: This was a hospital-based, prospective, observational study conducted in the Neonatal Care Unit of Sriram Chandra Bhanja Medical College, Eastern Odisha, India, in 1760 neonates, from October 2018 to September 2020. All neonates admitted through Outdoor and Emergency were included in this study irrespective of gestation, birth weight, maturity and mode of delivery with haematocrit >65% at 12 hours of life. These polycythaemic babies were further categorised on the basis of maturity, gestational age, birth weight, gender and the clinical features, laboratory abnormalities were noted, Partial Exchange Transfusion (PET) when required was done through central route, the umbilical venous catheter was used for withdrawing blood while same amount of normal saline was replaced through a peripheral vein, and in asymptomatic cases additional fluid of 20 mL/kg was added to the daily fluid requirements either through enteral or parenteral route and outcomes were noted. Short-term outcome at 48 hours was measured by decreasing haematocrit with improvement of signs and symptoms. Chi-square test was employed to analyse the collected data using Statistical Package for the Social Sciences (SPSS) software version 20.0. The p-value <0.05 was considered statistically significant. Results: Out of 1760 newborns enrolled, (n=75) were polycythaemic. The Incidence of polycythaemia was 4.26%), which was significantly higher among Small for Gestational Age (SGA) compared to Large for Gestational Age (LGA) neonates (p-value=0.0214). Clinical features in decreasing order were lethargy (66.6%), poor feeding (66.6%), Plethora (53.3%), cyanosis (40%) and jaundice (33.3%). Main laboratory abnormalities were hypoglycaemia (36%), hyperbilirubinaemia (28%), thrombocytopenia (22.66%) and hypocalcaemia (13.3%). Out of 75 polycythemic neonates, n=17 (22.67%) underwent PET and rest 58 (77.33%) neonates were treated with extra fluid of 20 mL/kg/day. Conclusion: Study showed that lethargy and poor feeding were the main presentation and hypoglycaemia as the major laboratory abnormality. The incidence of polycythaemia was high among SGA neonates and the response to partial exchange transfusion as well as extra fluid was good which was characterised by decreasing haematocrit values with improvement of signs and symptoms.
{"title":"A Study on Incidence, Pattern of Clinical Features, Laboratory Abnormalities and Outcome of Neonatal Polycythaemia in a Tertiary Care Hospital, Odisha, India","authors":"S. Panda, Simanta Das, D. Behera, Sanaga Meghna, Suchismit Mahapatra, Nibedita Pradhan","doi":"10.7860/ijnmr/2023/58137.2367","DOIUrl":"https://doi.org/10.7860/ijnmr/2023/58137.2367","url":null,"abstract":"Introduction: Neonatal polycythaemia is a commonly encountered morbidity and mortality among neonates admitted to neonatal care units and sick newborn care units. Most affected infants have no clinical symptoms and signs, but neonates may present with lethargy, poor feeding, plethora, cyanosis and jaundice within 12-72 hrs. Aim: To find out the incidence and clinical manifestations of neonatal polycythaemia along with detection of disease by laboratory abnormalities. Materials and Methods: This was a hospital-based, prospective, observational study conducted in the Neonatal Care Unit of Sriram Chandra Bhanja Medical College, Eastern Odisha, India, in 1760 neonates, from October 2018 to September 2020. All neonates admitted through Outdoor and Emergency were included in this study irrespective of gestation, birth weight, maturity and mode of delivery with haematocrit >65% at 12 hours of life. These polycythaemic babies were further categorised on the basis of maturity, gestational age, birth weight, gender and the clinical features, laboratory abnormalities were noted, Partial Exchange Transfusion (PET) when required was done through central route, the umbilical venous catheter was used for withdrawing blood while same amount of normal saline was replaced through a peripheral vein, and in asymptomatic cases additional fluid of 20 mL/kg was added to the daily fluid requirements either through enteral or parenteral route and outcomes were noted. Short-term outcome at 48 hours was measured by decreasing haematocrit with improvement of signs and symptoms. Chi-square test was employed to analyse the collected data using Statistical Package for the Social Sciences (SPSS) software version 20.0. The p-value <0.05 was considered statistically significant. Results: Out of 1760 newborns enrolled, (n=75) were polycythaemic. The Incidence of polycythaemia was 4.26%), which was significantly higher among Small for Gestational Age (SGA) compared to Large for Gestational Age (LGA) neonates (p-value=0.0214). Clinical features in decreasing order were lethargy (66.6%), poor feeding (66.6%), Plethora (53.3%), cyanosis (40%) and jaundice (33.3%). Main laboratory abnormalities were hypoglycaemia (36%), hyperbilirubinaemia (28%), thrombocytopenia (22.66%) and hypocalcaemia (13.3%). Out of 75 polycythemic neonates, n=17 (22.67%) underwent PET and rest 58 (77.33%) neonates were treated with extra fluid of 20 mL/kg/day. Conclusion: Study showed that lethargy and poor feeding were the main presentation and hypoglycaemia as the major laboratory abnormality. The incidence of polycythaemia was high among SGA neonates and the response to partial exchange transfusion as well as extra fluid was good which was characterised by decreasing haematocrit values with improvement of signs and symptoms.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71267421","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}
Pub Date : 2022-01-01DOI: 10.7860/ijnmr/2022/57853.2360
Hemachitra Jagannathan, Arunkumar Ramachandran, V. Subramanian, Aravind Shanmugam, K. Rajendran
Introduction: Iron deficiency (ID) anaemia in pregnant mothers can affect the iron reserves of their newborns and lead to anaemia later. The haematological indices and iron status of pregnant women and its correlation with their neonates is still unclear. Aim: To assess the correlation between maternal and cord blood Hb and iron status. Materials and Methods: The present cross-sectional study included 134 antenatal mothers, at term gestation without any significant antenatal complications. Complete haemogram, serum iron, ferritin, and iron binding capacity were assessed for these mothers before delivery and also from the cord blood samples of their newborns at birth. Statistical difference and correlation were observed using Chi-square test and Pearson’s correlation coefficient. Results: Maternal anaemia Hb <11 gm/dL) was observed in 62 (46.3%). The mean Hb and ferritin of the mothers were 11.06±1.02 gm/dL and 113.3±7.1 μg/L, respectively. The mean Hb and ferritin levels of the cord blood samples were 12.24±0.17 gm/dL and 214.3±20.1 μg/L, respectively. In univariate analysis, maternal Hb showed a significant correlation with cord blood Hb with Odds Ratio (OR) 0.508 and 95% Confidence Interval (CI): 0.428-0.603. The Pearson’s correlation showed a moderate correlation between mother and cord blood Packed Cell Volume (PCV) (r=0.344, p<0.001) and weak correlation between other maternal and cord blood iron indices and serum ferritin (r=0.191, p=0.027 and r=0.203, p=0.019). Conclusion: There is a significant correlation between maternal and cord blood Hb in term neonates. The study indicates that the haematological indices of pregnant women determine the neonatal Hb in term babies.
{"title":"Effect of Haemoglobin and Iron Status of the Antenatal Mothers on their Newborns at Birth: A Cross-sectional Study","authors":"Hemachitra Jagannathan, Arunkumar Ramachandran, V. Subramanian, Aravind Shanmugam, K. Rajendran","doi":"10.7860/ijnmr/2022/57853.2360","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/57853.2360","url":null,"abstract":"Introduction: Iron deficiency (ID) anaemia in pregnant mothers can affect the iron reserves of their newborns and lead to anaemia later. The haematological indices and iron status of pregnant women and its correlation with their neonates is still unclear. Aim: To assess the correlation between maternal and cord blood Hb and iron status. Materials and Methods: The present cross-sectional study included 134 antenatal mothers, at term gestation without any significant antenatal complications. Complete haemogram, serum iron, ferritin, and iron binding capacity were assessed for these mothers before delivery and also from the cord blood samples of their newborns at birth. Statistical difference and correlation were observed using Chi-square test and Pearson’s correlation coefficient. Results: Maternal anaemia Hb <11 gm/dL) was observed in 62 (46.3%). The mean Hb and ferritin of the mothers were 11.06±1.02 gm/dL and 113.3±7.1 μg/L, respectively. The mean Hb and ferritin levels of the cord blood samples were 12.24±0.17 gm/dL and 214.3±20.1 μg/L, respectively. In univariate analysis, maternal Hb showed a significant correlation with cord blood Hb with Odds Ratio (OR) 0.508 and 95% Confidence Interval (CI): 0.428-0.603. The Pearson’s correlation showed a moderate correlation between mother and cord blood Packed Cell Volume (PCV) (r=0.344, p<0.001) and weak correlation between other maternal and cord blood iron indices and serum ferritin (r=0.191, p=0.027 and r=0.203, p=0.019). Conclusion: There is a significant correlation between maternal and cord blood Hb in term neonates. The study indicates that the haematological indices of pregnant women determine the neonatal Hb in term babies.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71266846","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}
Pub Date : 2022-01-01DOI: 10.7860/ijnmr/2022/56379.2343
Tarapada. Ghosh, Sumanta Das, M. P. Mohanta, B. K. Khuntdar
Introduction: Congenital malformations are important contributors for neonatal and infant mortality after prematurity, intrapartum complications and infections. Aim: To find out the prevalence and pattern of congenital malformations among the live born neonates in study area as well as to identify the associated risk factors. Materials and Methods: This descriptive hospital based cross- sectional study was carried out in 305 cases at Midnapore Medical College, Medinipur, West Bengal, from July 2016 to June 2017. All live inborn neonates were assessed for the presence of any malformation(s). The still born or out born babies were excluded. Congenital malformations were diagnosed by clinical examination as well as imaging studies. Data regarding risk factors were collected from the history and the case records. Chi-square test was done to find out the significance of the risk factors. Results: During the study period, there were 14240 live births, out of which 305 cases of congenital malformations were noted. Prevalence of congenital malformations was 214.1 per 10,000 live births or 2.14%. Out of 305 cases, 165 (54.10%) were males, 137 (44.92%) were females, and 3 (0.98%) had ambiguous genitalia. Prevalence of malformations was not significantly different between primi and multipara mothers, and for the different socio-economic backgrounds. A higher prevalence of congenital malformations in mothers above 30 years, consanguinity, low birth weight and prematurity were observed. History of abortion and still birth were associated with higher prevalence. Polyhydramnios, pregnancy induced hypertension and previous abortion and still birth were also associated with higher prevalence of malformations. Musculoskeletal system was majorly involved in 92 (30.16%) cases, followed by central nervous system 48 (15.74%). Conclusion: Prevalence of congenital malformations was found to be 214.1 per 10,000 live births or 2.14%. Maternal age >30, consanguinity, prematurity and low birth weight were associated with increased prevalence of congenital malformations. Musculoskeletal system was the most commonly involved system.
{"title":"Spectrum of Congenital Malformations and Associated Factors: A Cross-sectional Study from Eastern India","authors":"Tarapada. Ghosh, Sumanta Das, M. P. Mohanta, B. K. Khuntdar","doi":"10.7860/ijnmr/2022/56379.2343","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/56379.2343","url":null,"abstract":"Introduction: Congenital malformations are important contributors for neonatal and infant mortality after prematurity, intrapartum complications and infections. Aim: To find out the prevalence and pattern of congenital malformations among the live born neonates in study area as well as to identify the associated risk factors. Materials and Methods: This descriptive hospital based cross- sectional study was carried out in 305 cases at Midnapore Medical College, Medinipur, West Bengal, from July 2016 to June 2017. All live inborn neonates were assessed for the presence of any malformation(s). The still born or out born babies were excluded. Congenital malformations were diagnosed by clinical examination as well as imaging studies. Data regarding risk factors were collected from the history and the case records. Chi-square test was done to find out the significance of the risk factors. Results: During the study period, there were 14240 live births, out of which 305 cases of congenital malformations were noted. Prevalence of congenital malformations was 214.1 per 10,000 live births or 2.14%. Out of 305 cases, 165 (54.10%) were males, 137 (44.92%) were females, and 3 (0.98%) had ambiguous genitalia. Prevalence of malformations was not significantly different between primi and multipara mothers, and for the different socio-economic backgrounds. A higher prevalence of congenital malformations in mothers above 30 years, consanguinity, low birth weight and prematurity were observed. History of abortion and still birth were associated with higher prevalence. Polyhydramnios, pregnancy induced hypertension and previous abortion and still birth were also associated with higher prevalence of malformations. Musculoskeletal system was majorly involved in 92 (30.16%) cases, followed by central nervous system 48 (15.74%). Conclusion: Prevalence of congenital malformations was found to be 214.1 per 10,000 live births or 2.14%. Maternal age >30, consanguinity, prematurity and low birth weight were associated with increased prevalence of congenital malformations. Musculoskeletal system was the most commonly involved system.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71266938","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}
Pub Date : 2022-01-01DOI: 10.7860/ijnmr/2022/53542.2341
Daasara Gururaju, Navya N. Parameshwarappa, A. H. Rao, Manjunath Rangappa
Introduction: Diagnosis of sepsis in neonates is challenging due to overlapping of signs and symptoms. Currently blood culture and sepsis screen are used for diagnosis. Blood culture is the gold standard but its usefulness is limited due to low positivity, delay in reporting. Sepsis screen has variable sensitivity and specificity. To overcome these limitations, platelet indices can be used in diagnosis. Aim: To assess platelet indices as a marker to diagnose neonatal sepsis and to calculate sensitivity and specificity of platelet indices in comparison to clinical symptoms, sepsis screen and blood culture. Materials and Methods: This case-control study was conducted from June 2021 to November 2021 in Neonatal Intensive Care Unit (NICU) of tertiary care centre, Karnataka, India. Total of 198 neonates with signs and symptoms of sepsis and/or risk factors of sepsis were included. Weight and gestational age matched 198 healthy neonates served as control. Investigations include blood culture, sepsis screen and platelet indices were sent. Platelet indices were compared between cases and controls. Sensitivity and specificity of platelet indices were calculated in culture positive, screen positive and both negative groups. Data of both the groups were compared using Independent t-test and Chi-square test. Results: Demographic profile was homogenous between both study groups. Out of 198 cases, 145 (73.2%) had platelet count <1.5 lakhs, 132 (66.7%) had Mean Platelet Volume (MPV) >10.8 fl and 109 (55.05%) had Platelet Distribution Width (PDW) >19.1 fl. These values were statistically significant (p-value<0.001) when compared with controls. Statistically significant (p-value <0.001) difference was seen in mean of platelet count (1.3±0.7 lakhs/ cumm), MPV (10.7±0.8 fl), PDW (19.1±2.3 fl) and Plateletcrit (PCT) (0.1±0.1) between cases and controls. Platelet count was more sensitive (73.2%) and specific (81.3%) marker when compared between cases and controls. Conclusion: Platelet indices are cheaper and widely available markers in diagnosing neonatal sepsis. Thrombocytopenia, high MPV and high PDW were associated with neonatal sepsis.
{"title":"Diagnostic Accuracy of Platelet Indices as a Marker for Sepsis in Neonates: A Case-control Study","authors":"Daasara Gururaju, Navya N. Parameshwarappa, A. H. Rao, Manjunath Rangappa","doi":"10.7860/ijnmr/2022/53542.2341","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/53542.2341","url":null,"abstract":"Introduction: Diagnosis of sepsis in neonates is challenging due to overlapping of signs and symptoms. Currently blood culture and sepsis screen are used for diagnosis. Blood culture is the gold standard but its usefulness is limited due to low positivity, delay in reporting. Sepsis screen has variable sensitivity and specificity. To overcome these limitations, platelet indices can be used in diagnosis. Aim: To assess platelet indices as a marker to diagnose neonatal sepsis and to calculate sensitivity and specificity of platelet indices in comparison to clinical symptoms, sepsis screen and blood culture. Materials and Methods: This case-control study was conducted from June 2021 to November 2021 in Neonatal Intensive Care Unit (NICU) of tertiary care centre, Karnataka, India. Total of 198 neonates with signs and symptoms of sepsis and/or risk factors of sepsis were included. Weight and gestational age matched 198 healthy neonates served as control. Investigations include blood culture, sepsis screen and platelet indices were sent. Platelet indices were compared between cases and controls. Sensitivity and specificity of platelet indices were calculated in culture positive, screen positive and both negative groups. Data of both the groups were compared using Independent t-test and Chi-square test. Results: Demographic profile was homogenous between both study groups. Out of 198 cases, 145 (73.2%) had platelet count <1.5 lakhs, 132 (66.7%) had Mean Platelet Volume (MPV) >10.8 fl and 109 (55.05%) had Platelet Distribution Width (PDW) >19.1 fl. These values were statistically significant (p-value<0.001) when compared with controls. Statistically significant (p-value <0.001) difference was seen in mean of platelet count (1.3±0.7 lakhs/ cumm), MPV (10.7±0.8 fl), PDW (19.1±2.3 fl) and Plateletcrit (PCT) (0.1±0.1) between cases and controls. Platelet count was more sensitive (73.2%) and specific (81.3%) marker when compared between cases and controls. Conclusion: Platelet indices are cheaper and widely available markers in diagnosing neonatal sepsis. Thrombocytopenia, high MPV and high PDW were associated with neonatal sepsis.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71266065","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：