scholarly journals Clinico-bacteriological profile of neonatal sepsis in rural tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1259
Author(s):  
K. Venkataramana Reddy ◽  
K. Sailaja ◽  
A. Ashok ◽  
K. Poojitha
Keyword(s):  
Developing Countries ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Group B Streptococci ◽  
Mortality And Morbidity ◽  
Group B

Background: Neonatal sepsis one of the most common cause for neonatal mortality and morbidity in developing countries. Group B Streptococci being the most common organism in developed countries, whereas CONS and Gram negative bacteria frequently encountered organisms in developing countries. It is advisable to have an individualised institutional protocol based on their own culture reports to reduce the antibiotic resistance.Methods:A prospective observational study was conducted from September 2016- February 2017, at the Department of Paediatrics, S.V.S. Medical College and Hospital, Mahabubnagar, Telangana, India. The study included 65 neonates admitted in our NICU. A questionnaire was filled by mothers after taking consent. Data was Collected data was analysed.Results: In present study, we found that CONS were the most commonly isolated organisms followed by Klebsiella.Conclusions:Neonatal sepsis creates a significant burden due to its impact on neonatal mortality and long-term morbidity. Following proper hand washing techniques with minimal handling in intensive care units will reduce neonatal sepsis from opportunistic infections. 

scholarly journals Prevalence and outcome of anaemia among pregnant women attending tertiary care hospital in Visakhapatnam

2017 ◽  
Vol 5 (1) ◽  
pp. 203
Author(s):  
Radha Kumari Paladugu ◽  
Srinivas Jagath Pentakota ◽  
Sushma N.
Keyword(s):  
Socioeconomic Status ◽  
Developing Countries ◽  
Pregnant Women ◽  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Developed Countries ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Study Population

Background: Anaemia in pregnancy is now considered as a major public health problem, caused by iron deficiency. WHO has estimated that prevalence of anaemia in developed and developing countries in pregnant women is 14% in developed countries and 51 percent in developing countries and 65-75% in India. Various programmes regarding anaemia prophylaxis and maternal health have been implemented but still the prevalence of anaemia related complications among pregnant women continues to be high. Hence the present study was conducted to study the prevalence and pregnancy outcome as a result of anaemia in a tertiary care center in Visakhapatnam. Methods: A cross sectional descriptive study was carried out from June 2016 to August 2016 in the Department of Obstetrics and Gynecology among postnatal women in King George hospital, Visakhapatnam. A semi-structured questionnaire was prepared and information regarding age, socioeconomic status, parity, gestational age interval between pregnancies and outcome and complication of pregnancy were collected. Results: Mean age of study population is 22.4 years. Out of 100 women involved in the study 65 are from urban areas 29 from rural areas and 6 from tribal areas. Majority of the study population 66% were having HB% between 8-11% i.e. mild anaemia. When Outcome of pregnancy was seen in relation to anaemia majority of the women had live births (90%) followed by 7% IUDs and 2% still births. Conclusions: Majority of the women are in the age group of 20-24 years. Socioeconomic status is directly related to anaemic status of the women. Majority of the women had complication of puerperal sepsis. 

scholarly journals Mean platelet volume (MPV) as a diagnostic marker in neonatal sepsis

2019 ◽  
Vol 6 (3) ◽  
pp. 1036
Author(s):  
Prathyusha . ◽  
Shreekrishna G. N. ◽  
Sinchana Bhat ◽  
Sahana P.
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Diagnostic Marker ◽  
Tertiary Care ◽  
Study Groups ◽  
Care Hospital ◽  
Neonatal Deaths ◽  
Significant Difference ◽  
Group B

Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8±1.52, 10.82±1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals Burden of congenital heart diseases in a tertiary cardiac care institute of high altitude area

2019 ◽  
Vol 7 (5) ◽  
pp. 1441
Author(s):  
Zubair Mushtaq Tramboo ◽  
Aamir Rashid Patigaroo ◽  
Nazir Ahmad
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Indian Subcontinent ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Mortality And Morbidity

Background: Congenital heart disease is one of the major causes of mortality and morbidity in the paediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors.  The objective of the study was to find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (Jammu and Kashmir).Methods: All children admitted at territary care hospital with age 0-15 years were screened for congenital heart disease. The study was conducted for period of one year to ascertain the prevalence and spectrum of CHDs.Results: A total of 232 patients out of 23000, were found having CHDs measuring a prevalence of 10.5/1000. About 170 (73%) were the acyanotics, and 62 (27%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 54 (23%), followed by patent ductus arteriosus in 50 (22%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 15 (6.4%) patients.Conclusions: Authors observed high prevalence of CHD in our population. The pattern and spectrum of CHD were comparable to national and international data.

scholarly journals Diagnostic accuracy of clinical tool ‘STOPS’ and Serum Procalcitonin for optimizing antibiotic therapy in Neonatal Sepsis

2021 ◽  
Vol 13 (1) ◽  
pp. e2021019
Author(s):  
Vishal Vishnu Tewari
Keyword(s):  
Antibiotic Therapy ◽  
Diagnostic Accuracy ◽  
Neonatal Sepsis ◽  
Skin Color ◽  
Late Onset ◽  
Tertiary Care ◽  
Negative Likelihood Ratio ◽  
Care Hospital ◽  
Clinical Tool ◽  
Mortality And Morbidity

Background:  Antibiotic therapy is initiated in neonates on suspicion of sepsis. Optimizing therapy is a felt need of clinicians as injudicious prolonged use increases mortality and morbidity risk. Objective: To evaluate the diagnostic accuracy of clinical tool ‘STOPS’ and serum procalcitonin (PCT) for identifying neonates with early onset neonatal sepsis (EONS) or late onset neonatal sepsis (LONS) and early discontinuation in those with no sepsis. Methods: The study had a prospective analytical design conducted at a tertiary care hospital. All neonates with suspected EONS or LONS were enrolled. The ‘STOPS’ tool comprising of sensorium, temperature, oxygenation, perfusion, skin color and blood sugar was applied at 6 and 12 hr of enrollment. Serum PCT was sent at 12 hr. The sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (PLR and NLR) were estimated. Results:  The study enrolled 380 neonates of which 330 were given antibiotics for EONS and 50 for LONS. Temperature recording in the EONS group at 12 hr showed a PPV of 100% and a PLR of 9.1 (7.7 – 18). Perfusion assessment at 12 hr had a PPV of 77% and PLR of 8.25 (2.3 – 29). Skin color assessment at 12 hr it had a PPV of 100% and PLR of 13.5 (9.7 – 27). The diagnostic accuracy of PCT in the EONS group was unremarkable. In the LONS group, skin color at 12 hr had a PPV of 100% and PLR of 11.2 (8.6 – 19.5). The diagnostic accuracy of PCT in the LONS group showed a PPV of 82% and PLR of 7 (1.7 – 29). Conclusion: Identifying abnormal STOPS parameters was superior to PCT alone in EONS and as good as PCT in LONS. The ‘STOPS’ tool allows early identification of neonates with no sepsis thereby optimizing antibiotic use.

scholarly journals A STUDY ONCYTOPENIAS AND THE FACTORS ASSOCIATED WITH CYTOPENIAS AMONG HIV INFECTED PATIENTS ADMITTED AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 9 (08) ◽  
pp. 172-179
Author(s):  
Manju Rose Sebastian ◽  
Seena Sankar ◽  
Mary George
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Prevalence Ratio ◽  
Developed Countries ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Hiv Patients ◽  
Factors Associated

Introduction: India has the third highest burden of HIV in the world. Haematological complications are common in HIV patients, of which cytopenias are the most frequently encountered. The cytopenias have been found to adversely affect the outcome of HIV patients with greater mortality and decreased quality of life. Aims and Objective: To assess the prevalence of cytopenias among patients admitted in a tertiary care hospital and to assess the factors associated with the cytopenias. Materials and Methods: The present study was conducted in the department of general medicine at a tertiary care hospital and 191 patients admitted in the hospital during the study period were taken for the study. The baseline investigations at the time of admission were taken into consideration. Patients were interviewed and charts reviewed to collect the data. The data collected was analysed with SPSS-2018. Continuous variables were expressed as mean +/- standard deviation and as median and interquartile ranges as appropriate. Categorical variables were expressed as percentages and frequencies. Comparisons between data was done by student’s t test and chi square. The factors associated with various cytopenias was assessed using log binomial regression. A p value of < 0.05 was taken as significant. Results: The overall prevalence of any cytopenia was found to be 85.9%. The most common cytopenia was anaemia with a prevalence of 78.5% followed by thrombocytopenia and leucopenia with prevalences of 28.8% and 24.1% respectively. Anaemia was found to be more prevalent among females with a prevalence ratio of 3.05 (95% CI: 1.39- 10.16, p value 0.009) when compared to males. The most common cause of anaemia was found to be B12 deficiency. There was significant association between leucopenia and CDC staging with the prevalence of leucopenia being higher among patient with CDC stage 3. [Prevalence ratio:1.46 (95% CI 0.67-3.17, p 0.024)]. No significant association was found with gender, duration of HIV, ART regimen, CDC stage or presence of opportunistic infections and thrombocytopenia. Conclusion: The prevalence of cytopenias among HIV patients was found to high – 85.9% especially compared to other developed countries. The most common cytopenia among the patients was found to be anaemia with a prevalence of 78%. The next most common cytopenia was thrombocytopenia, followed by leucopenia. The factors associated with these cytopenias can help to screen for patients at higher risk of developing these cytopenias and hence establish preventive strategies against them.

scholarly journals Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan

2014 ◽  
Vol 8 (01) ◽  
pp. 067-073 ◽  
Author(s):  
Muhammad Matloob Alam ◽  
Ali Faisal Saleem ◽  
Abdul Sattar Shaikh ◽  
Owais Munir ◽  
Maqbool Qadir
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Cost Effective ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Local Data ◽  
Group B

Introduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical records of all neonates born at Aga Khan University, Karachi over a period of five years (2007-2011) with PROM (> 18 hours) were reviewed. Data about maternal and neonatal risk factors for EONS was collected and adjusted logistic regression (AOR) analysis was applied. Results:Incidence of PROM in this neonatal birth cohort was 27/1,000 live births. A total of 17 (4%) cases with blood-culture proven bacterial sepsis were identified within 72 hours of birth. Klebsiella pneumonia (n = 5; 29%) and Pseudomonas aeruginosa (n = 4; 24%) were the commonest isolates followed by group B Streptococcus (n = 3; 18%) and Escherichia coli (n = 2; 12%). Maternal fever (p = <0.001; AOR, 36.6), chorioamnionitis (p < 0.001; AOR, 4.1), PROM > 48 hr. (p < 0.001; AOR, 8.2), neonatal prematurity < 34 weeks (p < 0.001; AOR, 4.1) and low birth weight < 1,500 grams (p 0.001; AOR, 9.8) along with neonatal thrombocytopenia and raised CRP were found to be independent risk factors associated with culture-proven EONS in PROM. Conclusions: Preventive measures should focus on recognition of these high-risk infants with prompt laboratory screening for sepsis and early institution of empirical antibiotic based on local data. Such approaches would be a safe and cost-effective strategy, especially in developing countries.

scholarly journals Prevalence of teenage pregnancy and its obstetric and perinatal outcomes in a rural tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 3989
Author(s):  
Venkata Ramya Krishna Madala ◽  
Keshav Gangadharan ◽  
Pradeep Shivaraju ◽  
Devivaraprasad Mateti
Keyword(s):  
Developing Countries ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Teenage Pregnancy ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Maternal Complications ◽  
Hypertensive Disorders

Background: Teenage pregnancy has been reported as one of the leading causes of death in adolescent girls in both developed and developing countries. In developed countries teenage pregnancies are most common in unmarried girls whereas in developing countries like India where early marriages are more common, teenage pregnancies are seen mostly in married women.Methods: In this retrospective observational study, data between January 2018 and December 2019 was studied; data was evaluated using MS excel for statistical purpose. In the present study, only pregnant women less than 20 years were included.Results: Out of 6,028 pregnant women delivered during this period, 686 i.e. 11.3% age of women were less than 20 years, 609 (88.7%) had delivery at term and the remaining 77 (11.2%) women had preterm delivery. As per this study, incidence of hypertensive disorders were 12.24%, 5.5% were associated with anemia and most of them had vaginal delivery (65.01%) including induced and instrumental; cesarean section was 35.5%. In present study, 24.1% babies were of low birth weight and 3.49% of babies were intrauterine growth restricted (IUGR) babies.Conclusions: This study showed hypertensive disorders were the most common maternal complication and the incidence of vaginal delivery was higher compared to that of cesarean section, incidence of anaemia was less compared with other studies. Proper antenatal care, institutional delivery and postnatal care can reduce fetal and maternal complications in childbearing women in teenage age group. 

scholarly journals OUTCOME OF PRETERM INFANTS AFTER DELIVERY ROOM CARDIOPULMONARY RESUSCITATION. A RETROSPECTIVE OBSERVATIONAL STUDY

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e19-e19
Author(s):  
Bishal Gautam ◽  
Sarah McKnight ◽  
Michael Miller ◽  
Bryan Richardson ◽  
Abrar Ahmed ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Chest Compression ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Delivery Room ◽  
Bivariate Analysis ◽  
Care Hospital ◽  
Mortality And Morbidity

Abstract BACKGROUND Chest compression in the delivery room (CPR-DR) during neonatal resuscitation is considered as an extreme measure. When respiratory support alone is unable to establish circulatory transition, chest compression with or without epinephrine is necessary. The results of earlier studies have shown varied results in mortality and morbidity of preterm infants who received CPR-DR. OBJECTIVES To examine the relationship between need of CPR-DR in infants born between 23 and 32 weeks gestation and neonatal mortality and morbidity. DESIGN/METHODS This was a population-based cohort study of 23 0/7 to 32 6/7 weeks gestational age infants born at a Canadian tertiary care hospital between January 1, 2007 and December 31, 2016. Data were retrieved from the Neonatal-Perinatal database. Neonatal mortality and morbidities were examined between infants who did and did not need CPR-DR. RESULTS Of 1443 newborns meeting study criteria, 55 (3.8%) received CPR-DR. On bivariate analysis, outcome of infants requiring CPR-DR was associated with higher mortality (40% vs. 5.8%, p <0.001), intraventricular hemorrhage grade 3 or 4 (21.8% vs. 6.1%, p <0.001), patent ductus arteriosus (54.5% vs. 27.7%, p<0.001), bronchopulmonary dysplasia (35.4% vs. 19.6%, p=0.007), need of mechanical ventilation (90.9% vs. 61.1%, p<0.001) and sepsis (23.6% vs. 13.5%, p=0.034). However, in a multivariable logistic regression analysis controlling for predictor variables, CPR-DR was only associated with increased neonatal mortality (aOR=4.41 p<0.001, 95%CI [2.18, 8.92]). CONCLUSION While CPR-DR is associated with a high mortality rate in infants less than 32 weeks gestation, associated morbidities are largely predicted by other risk factors.

scholarly journals A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

2021 ◽  
Vol 64 ◽  
pp. 298-302
Author(s):  
Ritika Singla ◽  
Neetu Sharma
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Care Hospital ◽  
Immunodeficiency Virus ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

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