A Comparative Study of Clinicomicrobiological Profile of Late-Onset Neonatal Sepsis between Family Nursing Care and Hospital Care Groups of Extramural Neonates

2016 ◽  
Vol 10 (04) ◽  
pp. 108-112
Author(s):  
Tamoghna Biswas ◽  
Archan Sil ◽  
Rakesh Mondal ◽  
Somosri Ray ◽  
Tapas Sabui ◽  
...  
Author(s):  
Pramod P. Singhavi

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.


2014 ◽  
Vol 3 (6) ◽  
Author(s):  
Nur Fadhilah
Keyword(s):  
P Value ◽  

Tuberkulosisi (TB) masih masalah utama kesehatan masyarakat di Indonesia. Karena pengobatan memerlukan waktu yang lama maka penderita TB Paru sangat memungkinkan mengalami stress yang cukup berat sehingga selain diperlukan pengobatan secara medis juga diperlukan dukungan sosial dari orang di sekitarnya maupun keluarga. Program pengendalian penyakit TB di Puskkesmas Gadingrejo hanya berfokus kepada pasien saja tanpa melibatkan secara maksimal anggota keluarga yang ada, sehingga hal ini semakin memperparah keadaan pasien. Tujuan penelitian ini adalah mengetahui efektifitas pelaksanaan Askep Keluarga terhadap kemandirian keluarga dengan anggota keluarga penderita TB di wilayah kerja puskesmas Gadingrejo tahun 2014. Metode penelitian adalah kwantitatif dengan rancangan Pra Experimen pendekatan One Group Pretest Postest, alat ukur yang digunakan adalah lembar observasi untuk mengetahui tingkat kemandirian keluarga, analisis data dengan menggunakan uji Wilcoxon. . Hasil penelitian menunjukkan bahwa terdapat pengaruh antara pelaksanaan Askep Keluarga terhadap kemandirian keluarga dengan anggota keluarga penderita the patient's condition. The purpose of this study was to determine the effectiveness of family nursing care to family independence TB dengan nilai Z hitung -3,450 dengan Z table (α=0.05) yaitu -1.96 sehingga Z hitung > Z table. Dengan demikian Ho ditolak dan Ha diterima. Hasil ini juga dapat dijelaskan dari nilai Asymp.sig yaitu 0.000, artinya p value < α (0.000 <0.05). Diharapkan perawat puskesmas dapat menjalankan program Perkesmas sebagai program wajib terutama dalam melakukan pengobatan pasien TB sehingga keluarga akan secara mandiri dapat melakukan perawatan pada anggota keluarga yang terkena TB.


Author(s):  
Adel Hagag ◽  
Mohamed S Elfarargy ◽  
Reham Lyonis ◽  
Ghada M Al-Ashmawy

Background: Neonatal sepsis is a clinical syndrome characterized by symptoms and signs of infection in the first twenty eight days of life. Serum thyroid, cortisol and hepcidin are affected by neonatal sepsis. Aim of the work: The aim of this study was to assess the predictive value of serum thyroid hormones including free triiodothyronine (free TT3) and free tetraiodothyronine (free TT4), serum cortisol and hepcidin levels through comparison of their concentrations between normal neonates and neonates with high probable late onset sepsis. Patients and Methods: This case control study was carried out on 40 neonates with suspected high probable late onset neonatal sepsis based on clinical and laboratory finding who were admitted to NICU of Pediatric Department, Tanta University, Egypt in the period from April 2017 to May 2019 (group I) and 40 healthy neonates matched in age and sex as a control group (group II). For patients and controls; blood culture, highly sensitive C‑reactive protein (H-s CRP), serum hepcidin, serum cortisol and thyroid hormones levels including free TT3 and free TT4 were assessed. Results: There were no significant differences between studied groups as regard weight, gestational age, sex and mode of delivery. H-s CRP, serum cortisol and hepcidin were significantly higher in group I than group II while serum free TT3 and free TT4 were significantly lower in group I compared with controls. There was significantly lower H-s CRP, serum hepcidin and cortisol and significantly higher serum free TT3 and free TT4 in group I after antibiotic therapy compared to the same group before treatment while there were no significant differences between group I after antibiotic therapy and control group as regard the same parameters. There were significant positive correlation between H-s CRP and serum hepcidin and cortisol in group I while there was significant negative correlation between H-s CRP and free TT3 and free TT4. ROC curve of specificity and sensitivity of H-s CRP, serum hepcidin, cortisol, free TT3 and free TT4 in prediction of neonatal sepsis shows that serum hepcidin had the highest sensitivity and specificity with 95% and 90% respectively followed by serum cortisol, H-s CRP, free TT3 and lastly free TT4. Conclusion and recommendations: Neonates with high probable sepsis had significantly higher serum cortisol and hepcidin and significantly lower free TT3 and free TT4 compared with healthy neonates. These findings may arouse our attention about the use of these markers in diagnosis of in neonatal sepsis which can lead to early treatment and subsequently better prognosis.


2021 ◽  
pp. 097321792110075
Author(s):  
Rameshwor Yengkhom ◽  
Pradeep Suryawanshi ◽  
Rahul Murugkar ◽  
Bhavya Gupta ◽  
Sujata Deshpande ◽  
...  

Background and Objectives: Point of care neonatal ultrasound is a useful tool in evaluation of heart, brain, lungs, and abdomen in neonatal sepsis. The objective of our study was to perform bedside ultrasound screening of heart, brain, lungs, and abdomen in neonates with late onset culture positive sepsis and study the patterns of abnormalities and also their role in change of patient management. Methods: This prospective observational study was conducted at a tertiary level neonatal care unit from March 2017 to May 2018. All neonates with suspected late onset sepsis on the basis of clinical and laboratory findings underwent point of care neonatal ultrasound of heart, brain, lungs, and abdomen. Results: Of 153 suspected and eligible late-onset neonatal sepsis (LONS) cases, 67 (44%) had positive blood culture and were analyzed. Of this 67 neonates, 30 (45%) had abnormal neurosonography, 38 (57%) had abnormal cardiac output, 14 (20%) had abnormal cardiac contractility, 17 (25%) had abnormal pulmonary pressure, 18 (27%) had pulmonary arterial hypertension, 19 (28%) had pneumonia, and 7 (10%) had free fluid in abdomen. Clinical management was changed in 26 (39%) neonates. Conclusion: Bedside point of care neonatal ultrasound is a useful tool in assessment of heart, brain, lungs, and abdomen in a LONS. It could help in making appropriate decisions in the management, and therefore potentially reduce morbidity and mortality.


Author(s):  
Sujata Deshpande ◽  
Pradeep Suryawanshi ◽  
Shrikant Holkar ◽  
Yogen Singh ◽  
Rameshwor Yengkhom ◽  
...  

2021 ◽  
Vol 8 (06) ◽  
pp. 337-341
Author(s):  
Rajesh Khanna Pulmamidi ◽  
Ramya Madhuri Yendamuri

BACKGROUND Neonatal thrombocytopenia is one of the most common haematological abnormalities in neonates occurring in 1 to 2 % of healthy term neonates. Various risk factors like sepsis, prematurity, and birth asphyxia are known to be associated with this condition. Maternal factors also predispose to this condition. Early detection and appropriate management is of utmost importance to prevent complications. The aim of the study is to evaluate the predisposing factors for neonatal thrombocytopenia in a teaching hospital. METHODS This was a cross sectional observational study done in the Department of Peadiatrics, MediCiti Institute of Medical Sciences, Medchal, Telangana, for a duration of one year i.e., from January 2019 to December 2019. A total of 60 neonates with thrombocytopenia were studied for onset of thrombocytopenia, severity based on platelet counts, aetiology and for contributing maternal factors. RESULTS Early onset thrombocytopenia (< 3 days of age) was seen in 46.6 % (28 / 60) and late onset thrombocytopenia (3 - 28 days) in 53.3 % (32 / 60). The most common cause for neonatal thrombocytopenia was neonatal sepsis 30 % (10 / 60), followed by birth asphyxia. Common maternal predisposing factors were pregnancyinduced hypertension and pregnancy-induced diabetes mellitus. CONCLUSIONS Neonatal thrombocytopenia is one of the most common clinical problems in neonates. It can be of early or late onset type and has fetal and maternal predisposing factors. Neonatal sepsis is one of the most common cause for neonatal thrombocytopenia followed by birth asphyxia which is a preventable cause. Early diagnosis and thorough evaluation are needed to prevent complications. KEYWORDS Neonatal Thrombocytopenia, Neonatal Sepsis


2018 ◽  
Vol 24 (4) ◽  
pp. 508-537 ◽  
Author(s):  
Susanne Broekema ◽  
Marie Louise A. Luttik ◽  
Gabriëlle E. Steggerda ◽  
Wolter Paans ◽  
Petrie F. Roodbol

This study describes nurses’ perspectives about their experience of being involved in a 6-day educational intervention which focused on the development of competency in family nursing practice with a particular emphasis on family nursing conversations. The foundational knowledge of the educational intervention was based on the Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM). A research design incorporating quantitative and qualitative measurement was used. Before and after the family nursing educational intervention, nurse participants ( n = 18) completed the Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) instrument. The outcomes were analyzed using paired-samples t tests. FINC-NA scores increased by 6.94 points ( SD = 5.66, p < .001). To complement the quantitative findings, in-depth interviews were conducted with all of the participants. Participants reported increased awareness of the importance of families in nursing care. In addition to an increase in positive attitudes about families, participants perceived that their knowledge and skills regarding family nursing conversations were more comprehensive. A 6-day educational intervention with a focus on reflection appears useful in helping nurses to “think family” and encouraging perceptions of increased competence in family nursing conversations.


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