Indian Journal of Neonatal Medicine and Research最新文献

{"title":"Organophosphorus Poisoning with Homicidal Intention in a Neonate","authors":"Laxman Basany, Roja Aepalapala","doi":"10.7860/ijnmr/2022/58467.2358","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/58467.2358","url":null,"abstract":"Organophosphorus Compounds (OPC) are widely used as pesticides, and poisoning due to OPC is very rare in neonates. A 12-day- old female neonate was admitted with gasping respiration, excessive oral secretions and cold extremities. She had frothing from mouth and nose with an offensive odour, was hypothermic, hypotonic, cyanosed and was in mild stupor. Pupils were pin pointed, capillary refill time was 4-5 sec and had bilateral crepitations of lungs on auscultation. The baby was intubated, given 0.1 mg of atropine followed by 0.9% saline bolus and gastric lavage. She was treated with empirical antibiotics, atropine, Pralidoxime (PAM) and respiratory support. The baby responded well to treatment and was discharged on 10th day of admission. This could be the second case of Organophosphorus (OP) poisoning with homicidal intention reported in neonates.","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":"71266579","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}

{"title":"Achromobacter xylosoxidans Causing Late-onset Sepsis with Pneumonia in a Term Neonate","authors":"Basany Laxman, Aepala Roja","doi":"10.7860/ijnmr/2022/58884.2355","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/58884.2355","url":null,"abstract":"Achromobacter xylosoxidans (A. xylosoxidans), is an aerobic gram negative motile bacillus that rarely causes infection in healthy adults and is exceptionally rare in neonates. A. xylosoxidans is ubiquitous in nature, causing nosocomial infections especially in debilitated and immunocompromised patients. Few outbreaks caused by this organism were reported in Neonatal Intensive Care Units (NICU) along with sporadic cases in neonates. A 3-week-old term neonate presented with late-onset sepsis and pneumonia caused by A. xylosoxidans that was successfully treated with antibiotics and supportive care. Awareness regarding this uncommon pathogen and initiation of appropriate antibiotic therapy would improve the outcome and prevent mortality.","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":"71266676","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}

{"title":"Central Line Associated Blood Stream Infections and Effectiveness of Care Bundle Approach: A Prospective Cohort Study","authors":"G. Sridhar, Sn Kumar, K. Nagendra, G. Gopal, S. Rudrappa","doi":"10.7860/ijnmr/2022/52245.2344","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/52245.2344","url":null,"abstract":"Introduction: Insertion and maintenance of Central Venous Catheters (CVC) are integral components for the supportive care of critically ill neonates. Their use is often associated with the unavoidable risk of acquiring Healthcare Associated Infections (HAI) like Central Line Associated Blood Stream Infections (CLABSI) especially in resource limited public sector Neonatal Intensive Care Units (NICU). Adopting a care bundle approach to decrease CLABSI rates in such NICUs still remains a challenge. Aim: To determine the baseline CLABSI rate, identify the risk factors associated with it and also to determine the effectiveness of care bundle approach in decreasing CLABSI. Materials and Methods: An analytical prospective cohort study was conducted in Cheluvamba Hospital, attached to Mysore Medical College and Research Institute, Mysuru, Karnataka, India, from June 2018 to June 2020. In the preintervention phase (June 2018 to May 2019), the data of 307 neonates in whom Central Line (CL) was inserted were analysed to determine the baseline CLABSI rate and risk factors. CLABSI bundle involves a group of evidence-based practices which when implemented reliably and consistently have shown to significantly reduce CLABSI rates. CLABSI bundle was implemented in June 2019 and in the postintervention phase (July 2019 to June 2020), the data of 283 neonates were analysed and compared to those in the preintervention group in order to assess the effectiveness of the care bundle approach. Chi-square test was used to compare categorical variables whereas a two sample t-test was used to compare continuous variables. Results: A total of 41 CLABSI episodes were documented in the preintervention phase (Group 1) as compared to 12 in the postintervention phase (Group 2). Mean birth weight and gestational age was significantly lower in neonates with CLABSI as compared to neonates without CLABSI in both the groups. The incidence of CLABSI was significantly higher in neonates with a catheter dwell time of more than eight days and in those who received Total Parenteral Nutrition (TPN). Implementation of the CLABSI bundle resulted in the reduction of the baseline CLABSI rate from 16.25 to 8.3/1000 CL days; a significant reduction in the catheter dwell time and duration of NICU stay was also noted in group 2. Duration of NICU stay and death rate among neonates who developed CLABSI did not differ significantly between both the groups. Conclusion: Despite incorporating the care bundle approach, CLABSI rate remained to be high. Very preterm neonates with birth weight of <1500 grams and NICU stay of more than 25 days were more likely to develop CLABSI. Significant reduction in CLABSI rates can be achieved with widespread implementation of the CLABSI bundle in resource limited NICUs across India.","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":"71266219","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}

{"title":"Prevalence of Haemoglobin Variants and Haemoglobinopathies in a Single Paediatric Centre in Southern India: A Retrospective Cross-sectional Study","authors":"B. V. Kumar, Pramila Kadiyala, Menaka Kandasamy, P. P. Malar, Papathi Sadagopan, C. Ravichandran","doi":"10.7860/ijnmr/2022/53469.2329","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/53469.2329","url":null,"abstract":"Introduction: Haemoglobinopathies are qualitative disorders of Haemoglobin (Hb) resulting from structural defects in the amino acid sequence of one of the globin chains, whereas, thalassaemia results from quantitative defects in the synthesis of one or more of the globin chain subunits of the Hb tetramer. Cation Exchange- High Performance Liquid Chromatography (CE-HPLC) is one of the methods for initial screening of Hb variants like HbS, HbD, HbE etc and for quantification of HbF, HbA and HbA2 levels. Aim: To find out the prevalence of haemoglobinopathies in patients of a Government paediatric tertiary care hospital in south India. Materials and Methods: In this retrospective, cross-sectional study, all laboratory requests, in the period from August 2019 to July 2021, for Hb variant analysis by HPLC were collected, irrespective of provisional diagnosis. The Hb variant analysis was carried out by CE-HPLC on the Bio-Rad D-10 analyser. This study was conducted in a Government Paediatric tertiary care hospital in Southern India for patients who had any clinical or familial suspicion of haemoglobinopathies. The Statistical analysis was performed using Microsoft Excel 2010. Results: Total data of 704 laboratory requests for Hb Variant analysis were obtained. Out of 704 laboratory request, 585 were from children younger than 12 years of age and 119 were parental screening. There were 164 abnormal chromatograms. Out of 164 patients, 91 were female patients and 73 were male patients. Out of 164 abnormal chromatograms, 97 (59.15%) were beta- thalassaemia trait, 18 (10.98%) were beta-thalassaemia major, 13 (7.93%) were sickle cell trait, 2 (1.22%) were sickle cell disease, 21 (12.80%) were HbE trait, 2 (1.22%) were homozygous HbE, 2 (1.22%) were HbD trait, 3 (1.83%) were Hereditary Persistence of Foetal Hb (HPFH)/delta beta-thalassaemia, 2 (1.22%) were HbJ trait, 1 (0.61%) was HbE beta-thalassaemia, 1 (0.61%) was sickle- beta-thalassaemia and 2 (1.22%) were alpha thalassaemia. Conclusion: From this study, beta-thalassaemia trait and beta- thalassaemia major were found to be the first and second most prevalent haemoglobinopathies in children below 12 years of age. This data suggests the importance of premarital and antenatal screening procedures that can help in reducing the possibility of such haemoglobinopathies in the future generation, suffering and burden of disease to the family and society.","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":"71266404","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}

{"title":"Early Neurodevelopmental Outcome of Asphyxiated Newborns Treated with Therapeutic Hypothermia: A Non Randomised Cohort Study","authors":"J. Prajapati, D. Singh, Pramila Ramawat, Nilesh Jain","doi":"10.7860/ijnmr/2022/55116.2363","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/55116.2363","url":null,"abstract":"Introduction: Therapeutic Hypothermia (TH) is now a proven model of treatment to prevent complications in asphyxiated newborns. Perinatal asphyxia is the leading cause of mortality and disability in India and developing countries. The TH is still not the standard treatment protocol in developing India, and data regarding early neurological outcomes after TH is lacking. Aim: To evaluate the early neurological outcome at 3, 6, and 9 months of asphyxiated newborns who received TH compared to non recipients. Materials and Methods: This was a non randomised cohort study conducted at the tertiary care teaching hospital. A total of 190 asphyxiated newborns admitted to Neonatal Intensive Care Unit (NICU) within 24 hours of life, meeting the laboratory and/ or clinical criteria of perinatal asphyxia were enrolled. Eligible newborns admitted within 6 hours of birth receiving TH were labelled as recipients, and those who received standard care were labelled as non-recipients. Neonates were assessed at 3, 6, and 9 months and compared for neurodevelopment using the Hammersmith Infant Neurological Examination (HINE) optimality score and Denver Developmental Screening Test II. Both groups were compared using t-test and chi-square test. Results: Out of the total 190 enrolled participants, 14 were excluded and 176 newborns were further divided into recipients and non recipients groups. Baseline demographic characters were similar in both groups. Seventy-five recipients were followed up till three months, 72 at six months, and 69 at nine months vs 62, 60, and 56 non recipients, respectively. Lesser number of recipients scored suboptimal scores (HINE score <67) at 3 months vs non recipients (20% vs 35.4%, mean/ SD 63 [3.43] vs 57 [4.55], [p<0.001]). At six months (HINE score<70), the incidence was 18% vs 21% (p=0.02), mean score 67 vs 61 (p<0.0001); and at 9 months (HINE score<73) the incidence was 14.4% vs 30.3% (p=0.048), mean score 72 vs 65 among recipient vs non recipients (p<0.0001). Recipients also had less incidence of severe disability (HINE score< 40) at 6 (8.3%vs 21.6% p<0.02), and 9 months (8.3% vs. 19.6%, p<0.04) as compared to non recipients. More recipients had a normal developmental screening at 3,6, and 9 months on the DDST scale. Recipients required fewer anti-epileptics at 3 and 6 months (3 vs 11) as compared to non recipients (p<0.05). Mortality was also less in recipients (7.8% vs 20.9%, p<0.05) as compared to non recipients. Conclusion: There was a significant developmental and neurological improvement with decreased mortality, less episode of seizures, reduction in the need for antiepileptic among recipients of TH compared to non recipients at 3, 6, and 9 months of age.","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":"71266528","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}

{"title":"Suspected Cystic Fibrosis in Infantile Onset Pneumonias: A Case Series and Review of Literature","authors":"Hema B. Gupta, Parasdeep Kaur, Rajesh Bethu, P. Priya, Anju Yadav","doi":"10.7860/ijnmr/2022/57469.2361","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/57469.2361","url":null,"abstract":"Pneumonias are common in infancy and infections remain the most common aetiology especially in developing countries. A case- series of 14 children (9 males and 5 females) with cystic fibrosis is presented who came with persistent/recurrent pneumonia. Most children had infantile onset of symptoms (mean age 4.6±4.2 months). Despite multiple medical consultations in infancy a severe delay in diagnosis (mean age of diagnosis 75.5±65.1 months) and presentation was observed. The youngest child in this series was diagnosed at 2 months of age. Most common manifestations were respiratory, gastrointestinal, and failure to thrive (100%). Sweat chloride test was done in 12/14 children and was elevated in 100%. Genetic mutation was reported in 5 children only. Complications included computed tomography diagnosed bronchiectasis in (7/14;50%), pseudomonas infections (6/14,42.9%; other infections (7/14%, 50%), pulmonary hypertension (3/14,21.4%), gastroesophageal reflux (2/14; 14%). There was a high (5/14,35.7%) mortality in this series, as most of them presented late. Lack of awareness and meager diagnostic facilities are major limitations in early diagnosis of cystic fibrosis and may lead to increased morbidity and mortality among these children.","PeriodicalId":31116,"journal":{"name":"Indian Journal of Neonatal Medicine and Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71266648","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}

{"title":"Clinical and Haematological Profile of Dengue during 2021 Epidemic at a Tertiary Care Centre, Western Uttar Pradesh, India: A Cross-sectional Study","authors":"P. Mittal, S. Firoz, Neetipriya Pandey, Digvijay Ghangas, S. Bhatt","doi":"10.7860/ijnmr/2022/58951.2365","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/58951.2365","url":null,"abstract":"Introduction: Incidence of dengue fever has significantly increased in the last few years in developing countries. Its clinical presentation may be variable in paediatrics with high- risk of complications. Dengue fever causes high mortality and morbidity in the paediatric age group. Aim: To evaluate the clinical features and haematological parameters of dengue in paediatric cases in a tertiary care hospital. Materials and Methods: A cross-sectional observational study was conducted in the Department of Paediatrics, FH Medical College, Agra, Uttar Pradesh, India, on patients diagnosed with dengue fever from August 2021 to November 2021. All cases were subjected to detailed clinical history, examination and relevant investigations (laboratory parameters and clinical features). Data was collected in predesigned proforma, entered in Microsoft Excel sheet and analysed. Results: Out of 801 patients, 486 (60.67%) were males and 315 (39.33%) were females. The commonest symptoms were fever (n=779, 97.25%) followed by body pain/ arthralgia (n=700, 87.39%), flushing (n=622, 77.65%), abdominal pain (n=437, 54.55%), and vomiting (n=428, 53.43%). Highest number of cases (n=399, 49.82%), were from dengue with warning signs. Of total, 759 (94.75%) cases had thrombocytopaenia. Common complications were pleural effusion (26.8%) and ascites (11.88%). Of total, 611 (76.27%) cases got cured while 81 (10.11%) patients expired. Conclusion: Dengue fever is more common in paediatric age group with high rate of complications and disease severity, which has high mortality rate. High clinical suspicion and early fluid management are the only measures to reduce the mortality and morbidity.","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":"71266734","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}

{"title":"Perinatal Outcome with Isolated Oligohydramnios in Term Pregnancies: A Case-control Study from a District Hospital of Southern India","authors":"Cheruku Amani, S. Gopinath, S. Gururaja","doi":"10.7860/ijnmr/2022/57974.2349","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/57974.2349","url":null,"abstract":"Introduction: Oligohydramnios is an abnormality of amniotic fluid which is one of the common complications during pregnancy and a threat to foetal development. Often it is associated with maternal risk factors like uteroplacental insufficiency, hypertension and preeclampsia which by themselves can affect perinatal outcome. Aim: To determine the perinatal outcome in isolated oligohydramnios with Amniotic Fluid Index (AFI) ≤5cm at term pregnancies. Materials and Methods: This was a hospital-based prospective case-control study done in Department of Obstetrics and Gynaecology at District Hospital Tumakuru, Karnataka, India, from January 2019 to July 2020. The study included two groups i.e, case group included 150 pregnant females with Amniotic Fluid Index (AFI) ≤5 cm and control group included 150 pregnant females with AFI range between 6-24 cm. After interview of all participants, all the information was entered in the proforma. All newborn babies birth weight, APGAR scores (Appearance, Pulse, Grimace, Activity, and Respiration) at 1st and 5th minute was recorded. Categorical outcomes were compared between the groups using Chi-square test. A p-value <0.05 was considered statistically significant. Results: The mean age was 23.16±3.09 years in case group and it was 23.42±2.99 years in control group, the difference of age between study group was statistically not significant (p-value=0.460). Abnormal doppler in 19.33% of cases versus 6% of controls (p-value<0.001). Non reactive Non Stress Test (NST) was seen in 46.67% versus 10.67% in control group (p-value<0.001). The foetal distress as a cause for caesarean section was seen in 64.8% cases group in comparison with 23.9% of control group. Low birth weight was found in 58.67% of cases versus 30% in control groups (p-value<0.001). Low APGAR scores (<7) were seen in 24.67% of case group versus 5.33% in control groups. The difference in the proportion of APGAR score at 5 minutes between study group was statistically significant (p-value<0.001) Neonatal intensive care unit admissions were seen in 42.67% of cases versus 12.67% in controls (p-value<0.001). Perinatal deaths was in 5.33% in cases versus 0.67% in controls (p-value=0.017). Conclusion: Isolated oligohydramnios was a significant risk factor during term pregnancies. Incidence of operative deliveries (instrumental vaginal delivery and caesarean section) is significantly increased in these patients with significant increase in perinatal morbidity and mortality.","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":"71266891","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}

{"title":"Cardiac Involvement among HIV-positive Individuals less than 18 years of Age on Antiretroviral Therapy- An Observational Study from a Rural Tertiary Care Hospital, West Bengal, India","authors":"U. Sarkar, Indrajit Mandal, S. Ganguly, Akash Rai, Kaushik Ishore","doi":"10.7860/ijnmr/2022/60609.2366","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/60609.2366","url":null,"abstract":"Introduction: With advancement of medical science, individuals diagnosed with Human Immunodeficiency Virus (HIV) infections are getting treated earlier and a fewer of them develop Acquired Immunodeficiency Syndrome (AIDS)-related complications. But the downside is that there is an earlier onset and higher relative risks for different chronic diseases including cardiovascular diseases. Aim: To determine the proportion and pattern of cardiac involvements among children undergoing treatment for HIV infection and to correlate various cardiac findings with duration of Antiretroviral Therapy (ART) among them. Materials and Methods: An observational cross-sectional study was conducted among 136 HIV infected patients attending Paediatrics and General Medicine Outpatient Departments of North Bengal Medical College and Hospital (NBMCH) from October 2019 to March 2021. All patients were assessed clinically and underwent two dimensional (2D) echocardiography, Motion mode (M mode) and colour doppler for assessing cardiac involvement. Collected data were analysed using Statistical Package for the Social Sciences (SPSS) software version 22.0 and Pearson’s Correlation test was applied to test association between duration of ART and different echocardiographic parameters. Results: The mean age of the study participants was 10.14 years and the mean duration of ART was 49.18 months. Almost half (48.5%) of the HIV-positive individuals had cardiovascular findings. The most common echocardiographic change noted in patients was diastolic dysfunction 39 (28.7%) followed by Pericardial Effusion (PE) 29 (21.3%) and systolic dysfunction 28 (20.6%). Statistically significant positive correlation between changes in the values of Left Ventricular Internal Diameter in Diastole (LVIDD) (r=0.982), Left Atrium (LA) (r=0.634), mean Pulmonary Artery Pressure (mPAP) (r=0.200) with duration of ART was noted. Negative correlation was seen between duration of ART with ejection fraction (r=-0.984) and Tricuspid Annular Plain Systolic Excursion (TAPSE) (r=-0.438). This indicated that all these important cardiological parameters became worser with advancement of treatment. Conclusion: Cardiac involvements among HIV positive individuals undergoing ART were still high. There was definite correlation between cardiac involvement and duration of ART.","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":"71267293","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}

{"title":"Clinical Profile and Outcome of Children with Acute Central Nervous System (CNS) Infection from a Tertiary Care Centre in the Present Vaccination Era","authors":"B. Babu, P. Punitha, Adithya Vijayaraghavan, A. Prakash, J. Balaji","doi":"10.7860/ijnmr/2022/53552.2339","DOIUrl":"https://doi.org/10.7860/ijnmr/2022/53552.2339","url":null,"abstract":"Introduction: Meningitis is a common tropical infection which causes significant morbidity and mortality in children. Vaccination is available now-a-days for Haemophilus influenza and pneumococcus which are the common infection causing meningitis. Profile of acute Central Nervous System (CNS) infection in children varies with time to time as it depends on the organism, age, seasonal period, outbreaks, immunisation and place. Aim: To study the clinical, microbiological, radiological profile and outcome of children with acute CNS infection in a tertiary care centre in the present vaccination era. Materials and Methods: This prospective observational study was done in the Department of Paediatrics, Government Dharmapuri Medical College Hospital, Tamil Nadu, India, from December 2018 to June 2020. Total 50 children from one month to 12 years with features of acute CNS infection were included in the study. Clinical features, Cerebrospinal Fluid (CSF) and serology findings, Computed Tomography (CT) scan findings and outcome were taken for analysis. The data were entered in Microsoft Excel software and analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: During the study period, 50 children were diagnosed with acute CNS infection. A total of 37 (74%) children were less than 3 years and 31 (62%) male children were commonly affected. Fever 42 (84%), seizures 46 (92%) and altered sensorium 31 (62%) were the common symptoms. Status epilepticus 40 (87%), shock 18 (36%), respiratory distress 16 (32%) were common findings. In CSF, elevated cell count, reduced sugar, elevated protein were seen in 21 (42%), 14 (28%) and 27 (54%), respectively. Pneumococcus 3 (6%), Japanese Encephalitis (JE) 8 (16%), dengue 5 (10%), herpes 4 (8%), scrub typhus (aetiological agent Orientia tsutsugamushi) 2 (4%) were the common aetiological agents for CNS infection. CT brain was abnormal in 8 (16%) children. Nine children died (18%) and rest 41 (82%) recovered. Conclusion: In the present vaccination era, viruses and tropical fevers- JE, dengue, herpes and scrub typhus were common causes for acute CNS infection in children. Common clinical features were status epilepticus, fever, altered sensorium, respiratory distress and shock. Initial stabilisation of physiological status, specific management and JE vaccination are mandatory to improve the outcome in CNS infection.","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":"71266079","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}