scholarly journals Maternal factors and feeding pattern in neonates admitted with dehydration

2018 ◽  
Vol 5 (4) ◽  
pp. 1561
Author(s):  
Suresh Goyal ◽  
Sunny Malvia ◽  
Lakhan Poswal ◽  
Bhupesh Jain

Background: Some healthy breast-fed infants do not establish an adequate milk intake, continue to lose weight and may develop dehydration. The aim of the study is to find out the maternal factors and feeding pattern of neonates admitted with dehydration.Methods: Hospital based prospective study on neonates (>34 week gestation and >2kg birth weight) with signs/symptoms of dehydration and >10% weight loss after birth admitted in the NICU, MBGH, RNT Medical college, Udaipur, Rajasthan, India for period of 12 months from July 2015-June 2016. Sick neonates with sepsis, birth asphyxia and congenital anomalies were excluded. One apparently healthy neonate and mother selected randomly for each study group dehydrated neonate. Ethical clearance and informed consent for the study was taken.Results: 384 neonates with dehydration were enrolled. Most neonates (96.6%) with dehydration were admitted between Day 3-14 of birth. Dehydration was found in 2.5% caesarean section and 0.8% normal vaginal delivered neonates (p value<0.00001). Dehydrated neonates groups (n=384) was compared with non dehydrated healthy control group (n=384) neonates. Primiparous mothers (p value <0.00001), Pregnancy related complications (p value=0.02), delayed initiation of breast feeding (>1 hour) after birth (p value<0.00001), poor attachment during breast feeding (p value <0.00001), absent let down reflex (p value<0.00001), decreased (<8/day) breast feeding frequency (p value<0.00001), presence of nipple problems (p value<0.001) were more significantly present in dehydrated group as compared to control group. Socioeconomic status, education status and position of mother during breast feeding among mothers in dehydrated group were not significant. 379 neonates were discharged successfully, and 5 neonates expired.Conclusions: Dehydration is a serious problem in breastfed neonates, and early initiation of breast feeding, with proper counselling of breast feeding practices with breast examination in antenatal as well as postnatal period can help in its prevention. 

Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.


2021 ◽  
pp. 53-54
Author(s):  
B Revanth Reddy ◽  
Gauri Chauhan ◽  
Anand Kumar Bhardwaj ◽  
Sasanka Chakrabarti

Introduction: Perinatal asphyxia is one of the leading causes of perinatal morbidity and mortality. Feasible and early biochemical markers to diagnose and predict the neurologic outcome is a great need of time as APGAR score alone is inuenced by various factors. The present study was performed to determine the urinary uric acid to creatinine ratio in perinatal asphyxia and its correlation with APGAR score and compare urinary uric acid to creatinine ratio with Sarnat and Sarnat staging. Materials and Methods: This study was carried out on 100 term neonates with an equal number of cases and control 50 each, control group being the neonates with Apgar score ≥ 7 at 1 minute of life and cases being the neonates who suffered from perinatal asphyxia with Apgar < 7 at 1 minute of life. The spot urine sample was collected within 24 hours of birth and their uric acid and creatinine levels were measured and the ratio calculated. Asphyxiated neonates were classied according to Sarnat and Sarnat staging. We Compare UA/Cr ratio with Apgar score and HIE staging using Sarnat and Sarnat staging.Results: On comparison of UUA/Cr among cases and controls we found that ratio was signicantly higher in asphyxiated neonates as compared to non asphyxiate neonates. (Control vs. Cases Group: 2.4 ± 1 vs. 3.6 ± 1.5; p –value < 0.0001). On comparison of UUA/Cr among cases with Sarnat and Sarnat staging of HIE, there is a signicant difference observed in mean UA/Cr ratio across Sarnat and Sarnat staging of HIE (F – Value = 68.760; p – value = 0.0001). Conclusion: Urinary uric acid and creatinine ratio can be used as markers for perinatal asphyxia for screening in centers where other markers for assessing perinatal asphyxia are not available. Urinary uric acid and creatinine ratio is a non-invasive, cheap and easily available marker for assessing the severity perinatal asphyxia.


2018 ◽  
Vol 6 (2) ◽  
pp. 65-68 ◽  
Author(s):  
Meera Bista ◽  
Toran KC

Background: Otoscopic procedure like tympanoplasty is one of the magic wands that an ear nose throat surgeon possesses to alleviate the suffering of a hearing impaired patient. Endoscopic trans-tympanic pop in technique is an alternative method where tympanic fascial graft is placed medial to tympanic membrane remnant through the perforation without elevation of tympanomeatal flap and angled endoscope is used to assess the ossicular chain.Objective: The study was done to compare the results of endoscope assisted trans-tympanic pop-in tympanoplasty with permeatal underlay tympanoplasty.Methods: The study is a prospective, longitudinal and experimental study conducted in Kathmandu Medical College Teaching Hospital from January 2016 to June 2016. A total of sixty-two patients, thirty-one in study and thirty-one in control group were present. The comparison was made in terms of success rate, decrease in taste sensation and time taken for the procedure. Data analysis was done by SPSS version 20. Categorical data were tested by Fisher Exact test and p-value of <0.005 was considered statistically significant.Result: Among 62 patients, 55 had successful graft uptake (88.7% success rate). Hearing improvement was seen in 51 patients (88.25%). Regarding taste sensation 5 out of 62 had decrease in taste sensation after surgery (8%). Time taken was approximately 30 to 45 minutes (mean =44.1min) in endoscopic transtympanic pop-in type and 60 to 90 minutes (mean =73.8 min) in permeatal underlay type.Conclusion: We can conclude that endoscopic trans-tympanic pop-in tympanoplasty gives similar hearing and graft uptake result but with less time and greater ease as compared to permeatal underlay technique.


2017 ◽  
Vol 25 (2) ◽  
pp. 82-86
Author(s):  
Afrina Begum ◽  
Tabassum Ghani ◽  
Subinoy Krishna Paul ◽  
Taufiqua Hussain ◽  
Noorjahan ◽  
...  

Introduction: Premature rupture of membrane or PROM means when membrane ruptures before the onset of labour at a gestational age less than 37 completed weeks. In Bangladesh, every year, around 28,000 women die due to complications of pregnancy and childbirth. Nonscientific intervention in PROM made at various levels intensify the pregnancy complications several times, thereby leading many more deaths of foetus and newborn. Aetiology of PROM is largely unknown. The possible causes are either reduction of membrane strength or an increase in intrauterine pressure or both. Proper diagnostic facilities, proper monitoring and standard protocol in the management can improve the maternal and fetal outcome.Aim and objective: The aim of the study was to observe the incidence, type and maternal and fetal outcome of PROM.Materials and Method: A prospective case control analytical study was carried out at Dhaka Medical College Hospital, Dhaka from May ‘2000 to December‘2000. Total 120 patients were selected for this study among them 60 patients as case (Group A) and 60 patients were taken as control (Group B). Both primi and multigravida with Pregnancy more than 28 weeks with intact membrane as control and spontaneous rupture of membrane taken as case. High- risk patients such as hypertensive disorder of pregnancy, APH, cardiac disease, previous H/O caesarean section were excluded from the study. After taking proper history, speculum examination, some diagnostic investigations were carried out. Findings were recorded in predesigned questionnaire and statistical analysis were done using computerized software SPSS for Windows. A P value < 0.05 was taken as significant.Results: In our study maternal complications were significantly higher in Group A patients (Chi-square test: X2 = 6.263, df= 1, P< 0.05). Number of premature babies in PROM patients (25%) was significantly higher than control group. Perinatal morbidity was found higher in PROM (36.66%) compared to control group (31.66%). Most common morbidity was neonatal jaundice in PROM patients (13.33%) compared to babies of control group (8.33%).Conclusion: This study focused on certain risk factors in relation to PROM which can be preventable and reduce incidence and improvement of maternal and fetal outcome.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 82-86


Author(s):  
Dr. Pradeep Kumar Jena ◽  
◽  
Dr. Himansu Parida ◽  
Dr. Banashree Swain ◽  
Dr. Mangal Charan Murmu ◽  
...  

Introduction: Perinatal asphyxia is a serious problem globally and is one of the common causes ofneonatal mortality. Worldwide each year four million infants suffer from birth asphyxia. Of these onemillion die and an equal number develop serious sequelae. Perinatal asphyxia ranks as the secondmost important cause of neonatal death after infections accounting for about 23% of mortalityworldwide. Aim & objective: To establish the level of nucleated red blood cells as an indicator ofpoor immediate outcome in perinatal asphyxia. Method: It was a case-control study done in thedepartment of pediatrics, S C B Medical College & S V P PG I P, Cuttack. Observation: The NRBCcount was significantly higher in neonates with adverse outcomes than in those with favourableoutcomes (p-value <0.001). NRBC count cut-off of >27/100 WBC had a sensitivity of 75% andspecificity of 95.2% in predicting adverse outcome defined as death, hemiplegia, hypertonia orsignificant hypotonia, unreliable sucking and seizures resistant to Phenobarbital. Conclusion:Nucleated red blood cell count can be used as a surrogate marker for birth asphyxia. It has asignificant negative correlation with Apgar score at one minute and Apgar score at 5minutes &significant positive correlation with severity of hypoxic ischemic-encephalopathy, time is taken forrecovery of neurological impairment following birth asphyxia and duration of NICU stay.


2022 ◽  
Vol 71 (6) ◽  
pp. 2189-93
Author(s):  
Noaman Ishaq ◽  
Shabana Ali ◽  
Muhammad Waqar Aslam Khan ◽  
Kulsoom Farhat ◽  
Nausheen Ata ◽  
...  

Objective: To evaluate the chondroprotective effects of hyaluronic acid in a rat model of osteoarthritis. Study Design: Laboratory based experimental study. Place and Duration of Study: Department of Pharmacology, Army Medical College, Rawalpindi, in alliance with National Institute of health, Islamabad and Department of Pathology, Army Medical College Rawalpindi, from Apr to Jun 2019. Methodology: Sixteen (16) rats of Sprague Dawley breed were procured in this study. Osteoarthritis was induced in right knee joint of rats by surgical resection of medial meniscus and anterior cruciate ligament. They were allocated into two (02) groups with eight (08) rats in both groups. Group-I was control group that was treated with 0.2 ml intra articular saline once weekly for four weeks. While group-II was treatment group that was intra particularly administered with 0.2ml hyaluronic acid once weekly for four weeks. One week after the last dosage, gait pattern of the animals was scored. Then animals were sacrificed and a part of proximal tibia was obtained for histopathologic analysis. Results: Mean gait score of control group and treatment group was 3.25 ± 0.707 and 1.00 ± 0.756 respectively with a statistically significant p-value of <0.001, while mean histopathological Modified Mankin score of control and treatment group was 11.5 ± 1.195 and 5.50 ± 1.195 respectively with a significant p-value of <0.001. Conclusion: Intra articular viscosupplementation of hyaluronic acid in rat model of osteoarthritis resulted in improved gait pattern and histopathology.


2018 ◽  
Vol 6 (1) ◽  
pp. 191
Author(s):  
Sagar Potharajula ◽  
Shreedhara Avabratha Kadke

Background: Wheezing is the most common chronic health problem in childhood. Many studies have found protective effect of breastfeeding on wheezing, while few others have not. Hence this study was taken up to find out the correlation between breastfeeding and wheezing in children.Methods: Case control study done in a Medical College Hospital. Cases were children of 2-5yrs age with history of wheezing or who had received nebulisation. Controls were children without history of wheezing or nebulisation. Mothers were interviewed with a predesigned proforma. Results were analysed by Chi square test and Odd’s ratio and p value <0.05 was considered significant.Results: There were 92 cases and 184 controls. Sixteen (53.4%), 48 and 27 cases were breastfed less than 1year, till 2yrs and beyond 2yrs respectively. 14 (46.6%), 128, and 40 were the numbers in control group. Breast feeding duration till 1 year of age is statistically correlated with wheezing with p value of 0.02, higher proportion of children who were breastfed for less than 1 year had wheezing when compared to controls. 26 cases out of 69 were not exclusively breast fed till 6 months and 66 cases out of 207 were exclusively breastfed. Higher proportion of cases who were not exclusively breastfed had developed wheeze although it was not significant statistically. 45 cases (36.8%) were initiated on cow’s milk before 1yr of age, 47 cases (30.5%) were initiated after 1year. Higher proportion of children who were initiated on cow’s milk early had developed wheeze but was not significant statistically. 34 cases and 24 controls had family history of asthma. With family history wheezing episodes were 3.72 times more likely irrespective of breast-feeding duration.Conclusions: Breast feeding gives protection against wheezing in children. Mothers should be encouraged to breast feed their children.


2018 ◽  
Vol 5 (3) ◽  
pp. 1036
Author(s):  
Satheesh Kumar D. ◽  
Thenmozhi M. ◽  
Kumar .

Background: Perinatal asphyxia is the most common cause of neonatal morbidity and mortality in worldwide. It accounts for 23% of all neonatal deaths. Electrolyte abnormalities are more common in the immediate post asphyxiated period and influence neonatal the outcome effectively. Aim of this study was to measure the serum sodium, potassium and calcium levels in immediate postnatal period of asphyxiated newborns and assess the correlation with different degree of birth asphyxia.Methods: The serum sodium, potassium and calcium levels were measured in asphyxiated newborns in the early post-natal period. Both intramural and extramural newborns were included irrespective of their mode of delivery but according to the Apgar score. The measured electrolyte values were compared with the different severity of asphyxia. Results: Out of 100 newborns 53 had hyponatremia, 10 had hyperkalemia and 3 had hypocalcemia. The serum sodium and potassium levels showed significant P value (<0.00) with the different degree of both asphyxia but calcium levels were not significant (p valve = 0.06). There was a negative linear correlation with sodium and calcium levels and positive correlation with the serum potassium levels.Conclusions: Hyponatremia was significant in all stages of birth asphyxia, hyperkalemia was significant with increased severity of birth asphyxia and hypocalcemia was only weakly significant even in severe birth asphyxia.


2021 ◽  
Vol 71 (3) ◽  
pp. 976-79
Author(s):  
Qamar Zia ◽  
Nighat Arif ◽  
Tahira Sadiq

Objective: To determine the effect of paired formative assessment on students’ learning. Study Design: Quasi experimental study. Place and Duration of Study: Islamic International Medical College Rawalpindi, from Jan 2018 to Jun 2018. Methodology: A total of 160 students who attended otolaryngology module were included in the study. Randomized allocation was done by computerized software programme and students were divided into 2 groups i.e. experimental (group A) and control group (group B). Later on in group A, pairing of students was done by lottery method. Group A and B were dealt with paired and individual formative assessment respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in tests consisting of 20 MCQs from predefined and taught syllabus. A p-value were obtained by applying independent sample t-test and considered statistically significant at 0.05. Results: Out of 160 participants, 94 (58.7%) were females and 66 (41.3%) were males. In individual testing phase mean scores of group A was 13.36 ± 2.22 and mean scores of group B was 13.24 ± 2.5 (p 0.861). In paired formative assessment phase, mean scores of group A was 16.70 ± 1.94 (CI 95% 2.16-4.55) and mean of scores of group B was 13.40 ± 2.23 (CI 95% 2.16-4.55) p=0.001. Conclusion: The effectiveness of paired formative assessment. This method provides students a conducive environment to achieve learning objectives.


Author(s):  
Vikash K. Tiwari ◽  
Shashi Pandey ◽  
Ragini Mishra

Background: Medicine is a profession with high-stress prevalence. There are many stress markers but cortisol is one of the commonly used stress marker. Stress begins in the first year of medical carrier and increases with subsequent years of medical education. There is a decrease in overall academic performance and many health-related adverse effects due to stress. In this study, yoga was performed in the first year MBBS students of BRD Medical College, Gorakhpur and the impact of yoga in stress reduction was studied using serum cortisol as stress a marker.Methods: Study groups, yoga and control contained 26 and 27 subjects including male and female MBBS students. Yoga group practiced selected yogic asana, pranayama, and yoga nidra for 3 months. The control group as a stress marker had been kept in touch and allowed to go on their usual activity as before. Morning (8.00 AM to 9.00 AM) serum cortisol level was used as a stress marker in both group, pre and post-study.Results: There was a significant reduction in morning serum cortisol level (stress level) in yoga group (p-value = 0.0271) but there was no significant change in morning serum cortisol level of the control group (p-value = 0.8573).Conclusions: Yoga is an effective stress reduction technique for medical students. Yoga classes should be introduced in the first year of the medical carrier under the supervision of expert physiologists. This may lead to the implantation of a healthy lifestyle in our future healthcare providers. Yogic practice by health care providers may have long term positive impacts on our healthcare system.


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