scholarly journals Profile of hypoxic ischemic encephalopathy in newborns in a tertiary care centre of Bhilai, Chhattisgarh, India

2018 ◽  
Vol 5 (6) ◽  
pp. 2032
Author(s):  
C. Sudhakar ◽  
Pallavi Jindal
Keyword(s):  
Tertiary Care ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Obstetrics And Gynecology ◽  
Long Term Outcome ◽  
Study Population ◽  
One Year ◽  
Prospective Longitudinal ◽  
Ischemic Encephalopathy

Background: Birth asphyxia is an important cause of static development and neurological handicap in both term and preterm infants. Birth asphyxia is found to be responsible for 28.7% deaths in hospital settings and 20% deaths in rural/tribal areas. Approximately the same number develops serious sequelae which cripples these children both physically and mentally. Children who have suffered moderate encephalopathy had varying rates of infant death and morbidity. Precise determination of the prognosis in the term new born, who sustains a hypoxic ischemic insult is hindered by difficulty in determining the severity of insult.Methods: This was a prospective longitudinal, observational study was conducted in the Department of Paediatrics, CMC Bhilai with close association with the Department of Obstetrics and Gynecology, Department of Radio diagnosis and Department of Neurology. All deliveries taking place in the Department of Obstetrics and Gynecology of CMC Bhilai were enrolled for the study. Each enrolled infant underwent a detailed neurologic examination within the first 12 hours after birth. During the period of data collection 180 babies with birth asphyxia were admitted to NICU. Out of which 126 babies had fulfilled the inclusion criteria and completed one year follow up, hence as cases. Babies who lost follow up were not included in study. The neurological examination was performed 14 days after discharge, then at 1 month, 3-month, 6-month, 9 month and 12 months. Long term outcome in this study is defined as outcome at one year of age in terms of morbidity and mortality.Results: The female and male ratio is 0.4:1. Most of the asphyxiated newborn, 81 (64%) were in 2500-3000gm. Among the study population, maximum number of cases 76 (60%) were suffering from HIE-I. Majority of study population, 87 (69%) were born by LSCS. Normal CUS in 93 babies and abnormal in 33 babies; with normal CUS, there were no death in study population and out of 33 abnormal CUS, 12 deaths occurred. Out of the different complications enlisted in the table convulsions (66.7%) is most common followed by Apnea (65.08%). Recurrent infections (45.24%) is the most common complication followed by seizure disorders (22.63%) and failure to thrive (20.63%).Conclusions: Hypoxic ischemic encephalopathy is one of the major consequences of perinatal asphyxia. Despite of best care, some babies are likely to develop it.

MRI IN HYPOXIC ISCHEMIC ENCEPHALOPATHY WITH CLINICAL FOLLOW UP

2021 ◽  
pp. 43-48
Author(s):  
M R Shashikumar ◽  
Narasipur Lingaiah Rajendrakumar ◽  
Sanjay P ◽  
Nanjaraj Chakenalli Puttaraj ◽  
Shruti Shruti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Mr Imaging ◽  
Developmental Disorders ◽  
Brain Mri ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Preterm Neonates ◽  
Diffusion Restriction ◽  
Ischemic Encephalopathy

Introduction: HIE is often clinically suspected in the setting of a known perinatal stress event arising from a complicated or difcult delivery. The most sensitive and specic imaging technique for examining infants with suspected hypoxicischemic brain injury is MR imaging. It also gives information about the timing and specic patterns of injury and also suggest diagnoses other than HIE such as metabolic disorders and developmental disorders of the brain. MRI is also a useful tool in the determination of prognosis and also follow-up of HIE. Aim: This study was undertaken to evaluate the various MRI appearances of hypoxic ischemic encephalopathy in term and preterm neonates and to correlate the MRI appearances with clinical outcome. Materials and Methods: All neonates with history of birth asphyxia, referred for MRI examination to the Department of Radio-Diagnosis, K. R. Hospital attached to Mysore Medical College and Research Institute, during January 2018 to January 2019. All MRI scans were performed on GE optima MR360 1.5 Tesla. Sequences used were T1W axial, T1 FLAIR axial, T2W axial, T2 FLAIR axial, T1W sag, T2W coronal, T2W GRE axial, DWI axial and ADC maps. Results: 30 babies with clinically suspicion of HIE and positive ndings on MR imaging were evaluated in our study. Out of 30 babies, 18 were term and 12 babies were preterm. Periventricular luecomalacia is most common MRI pattern in preterm and central pattern in term neonates. 16 babies had abnormal developmental outcome at 6 months follow up study. 16 babies with diffusion restriction in corpus callosum, 12 had abnormal outcome. 7 out of 10 babies with loss of normal signal in internal capsule had abnormal outcome. Babies with diffusion restriction in basal ganglia had gross developmental delay. Conclusion: MRI is the modality of choice for evaluation of HIE because of excellent gray – white matter resolution, well-depiction of myelination pattern and multi-planar imaging capabilities. There is a strong relation between the MRI appearances of birth asphyxia and the clinical outcome. Therefore MRI has a strong role in prognosticating lesions.

scholarly journals Neuro developmental outcome of preterm babies with hypoxic ischemic encephalopathy

2019 ◽  
Vol 6 (3) ◽  
pp. 1315
Author(s):  
Ramya H. S. ◽  
Rajendra Prasad T. C. ◽  
Nisar Ahamed A. R. ◽  
Muragesh Awati ◽  
Maria George
Keyword(s):  
Preterm Infants ◽  
Stage I ◽  
Stage Ii ◽  
Hypoxic Ischemic Encephalopathy ◽  
Stage Iii ◽  
Research Centre ◽  
Long Term Outcome ◽  
Preterm Babies ◽  
Ischemic Encephalopathy

Background: Neonatal encephalopathy, following severe birth asphyxia or perinatal hypoxia is referred to as hypoxic ischemic encephalopathy (HIE). Cerebral ischemia occurs as a consequence of cerebral oedema and reduced cerebral perfusion due to myocardial dysfunction as a result of hypoxic cardiomyopathy. Sarnat stage I -100% recovery, HIE stage II - 80% normal and 20% mortality and HIE stage III - 50% mortality and 50% morbidity. Relatively few studies have been made on outcome in HIE affected preterm infants. The aims and objectives of this study was to find out the neurodevelopmental outcome in preterm infants with HIE.Methods: This study is an observational clinical study, undertaken in Kempegowda Institute of Medical sciences and research centre, Bangalore, India. Study was performed between November 2016 to September 2018. 31 preterm infants with HIE were included in the study. Regular follow-up was done at 3, 6, 9, 12.15, 18 months by using Trivandrum development screening chart (TDSC) to stage II HIE infants.Results: The incidence of abnormal neurological outcome was 12.9%. Out of 31 preterm babies, stage I were 24, stage II was 4 (100% morbidity) and stage III were 3 (100% mortality).Conclusions: In present study, stage II HIE had 100% morbidity and moderate disability, stage III 100% mortality. Thus at 3-5 months of age during follow-up, when authors identify developmental delay, it is an ideal time to start interventional therapy to improve long term outcome.

To Study the Complications of Meconium Aspiration Syndrome & their Outcome In Relation to Gestational Age & Birth Weight In Tertiary Health Care Centre

2020 ◽  
Vol 7 (2) ◽  
pp. 47-49
Author(s):  
Dr. Kajalkumari Jain ◽  
Dr. Ramesh B. Kothari ◽  
Dr. Sunil Natha Mhaske ◽  
Dr. Ganesh B. Misal ◽  
Dr. Ujjwala Shirsath
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Aspiration ◽  
Ischemic Encephalopathy

Neonates born through meconium stained amniotic fluid,2-3% of them develop Meconium Aspiration Syndrome. Out of them,5-10% of them develop complications. Meconium Aspiration is typically seen in post-mature, small for date infants or a term infant with intrauterine hypoxia and in babies born with birth weight more than 2500gm.The objective is to study the complications of Meconium Aspiration Syndrome and their outcome in relation to gestational age and birth weight. Methodology: It is an prospective observational study was carried out in NICU of tertiary care centre and included 32 cases of Meconium aspiration syndrome. Study was done in a period of 14 months in and around Ahmednagar district. Result: The complications are Hypoxic Ischemic Encephalopathy (HIE), Seizures, Septicaemia, Pneumonia, Persistent Pulmonary Hypertension(PPHN), Airleak. Outcome of meconium aspiration syndrome in relation to gestational age is maximum death of 56.25% occurred in term babies which were 18.Outcome of meconium aspiration syndrome in relation to birth weight is maximum death of 53.12% occurred in neonates weighing between 2.5 to 3.5 kg which were 17. Conclusion: Meconium aspiration syndrome is seen in the new born period and contributes significantly to the neonatal morbidity and mortality. Severe Hypoxic ischemic encephalopathy being most common complication and birth asphyxia being most common cause of death.

scholarly journals An update of the long-term outcome of patients with nonspecific pleurisy at medical thoracoscopy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan-Xia Yu ◽  
Yuan Yang ◽  
Yan-Bing Wu ◽  
Xiao-Juan Wang ◽  
Li-Li Xu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Disease ◽  
Long Term Outcomes ◽  
Benign Diseases ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medical Thoracoscopy ◽  
One Year

Abstract Background Medical thoracoscopy (MT) is recommended in patients with undiagnosed exudative pleural effusion and offers a degree of diagnostic sensitivity for pleural malignancy. However, not all patients who undergo MT receive an exact diagnosis. Our previous investigation from 2014 summarized the long-term outcomes of these patients with nonspecific pleurisy (NSP); now, we offer updated data with the goal of refining our conclusions. Methods Between July 2005 and August 2018, MT with pleural biopsies were performed in a total of 1,254 patients with undiagnosed pleural effusions. One hundred fifty-four patients diagnosed with NSP with available follow-up data were included in the present study, and their medical records were reviewed. Results A total of 154 patients were included in this study with a mean follow-up duration of 61.5 ± 43.7 months (range: 1–180 months). No specific diagnosis was established in 67 (43.5%) of the patients. Nineteen patients (12.3%) were subsequently diagnosed with pleural malignancies. Sixty-eight patients (44.2%) were diagnosed with benign diseases. Findings of pleural nodules or plaques during MT and the recurrence of pleural effusion were associated with malignant disease. Conclusions Although most NSP patients received a diagnosis of a benign disease, malignant disease was still a possibility, especially in those patients with nodules or plaques as noted on the MT and a recurrence of pleural effusion. One year of clinical follow-up for NSP patients is likely sufficient. These updated results further confirm our previous study’s conclusions.

Abstract 18649: Long-term Outcome and the Mechanisms of Pulmonary Antrum Radial-linear Ablation in Patients With Paroxysmal Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Xue Zhao ◽  
Jianqiang Hu ◽  
Yan Huang ◽  
Yawei Xu ◽  
Yanzhou Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Holter Monitoring ◽  
Pericardial Tamponade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
One Year

Objectives: The aim of this study was to determine the mechanisms and effectiveness of pulmonary antrum radial-linear (PAR) ablation in comparison with pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (AF) after a long-term follow-up. Background: The one-year follow up data suggested that PAR ablation appeared to have a better outcome over the conventional PVI for paroxysmal AF. Methods: The enrollment occurred between March, 2011, and August, 2011, with the last follow-up in May, 2014. A total of 133 patients with documented paroxysmal AF were enrolled from 5 centers and randomized to PAR group or PVI group. Event ECG recorder and Holter monitoring were conductedduring the follow-up for all patients. Results: The average procedure time was 151±23 min in PAR group and 178±43 min in PVI group ( P <0.001). The average fluoroscopy time was 21±7 min in PAR group and 27±11 min in PVI group ( P= 0.002). AF triggering foci were eliminated in 59 patients (89.4%) in PAR group, whereas, only 4 patients (6.0%) in PVI group (P<0.001).At median 36 (37-35) months of follow-up after single ablation procedure, 43 of 66 patients in PAR group (65%) and 28 of 67 patients in PVI group (42%) had no recurrence of AF off antiarrhythmic drug (AAD) (P=0.007); and 47 of 66 patients in PAR group (71%) and 32 of 67 patients in PVI group (48%) had no recurrence of AF with AAD (P=0.006). At the last follow-up, the burden of AF was significantly lower in PAR group than in PVI group (0.9% ± 2.3% vs 4.9% ± 9.9%;90th percentile, 5.5% vs 19.6%; P=0.008). No major adverse event (death, stroke, PV stenosis) was observed in all the patients except one case of pericardial tamponade. Conclusions: PAR ablation is a simple, safe, and effective strategy for the treatment of paroxysmal AF with better long-term outcome than PVI. PAR ablation might exhibit the beneficial effect on AF management through multiple mechanisms. Registration: ChiCTR-TRC-11001191

scholarly journals Neurodevelopmental outcome of babies with hypoxic ischemic encephalopathy

2017 ◽  
Vol 5 (7) ◽  
pp. 3197
Author(s):  
Sirajuddin Nazeer ◽  
Senthilkumar K. ◽  
Thangavel A. ◽  
Uma Maheswari M.
Keyword(s):  
Neurological Outcome ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mri Brain ◽  
Early Markers ◽  
Cdc Grading ◽  
Ischemic Encephalopathy

Background: The aim of the study was to find out the neurodevelopmental outcome of babies with hypoxic ischemic encephalopathy at 6 months of age and to predict early markers of abnormal neurological outcome in those babies.Methods: 50 babies admitted with hypoxic ischemic encephalopathy were enrolled in this prospective study and followed up at 3 and 6 months of age at Mahatma Gandhi Memorial Government Hospital, Trichy. The neurological outcome of the babies was assessed by CDC grading of motor milestones, Trivandrum development screening chart, Amiel Tison angles head circumference and weight measured. USG cranium was done for all the babies and MRI brain was done in babies with abnormal neuro sonogram and abnormal outcome. Vision and hearing were tested clinically.Results: The incidence of abnormal neurological outcome was 14%. The early markers predicting abnormal neurological sequele are identified.Conclusions: Early identification of abnormal neuro behaviour helps in starting early intervention to improve the long term outcome.

scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY OF CLINICAL PROFILE IN ETIOLOGY OF ANEMIA IN ELDERLY-A HOSPITAL BASED STUDY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

2021 ◽  
Vol 9 (09) ◽  
pp. 961-972
Author(s):  
K. Shivaraju ◽  
◽  
Karanam Sai Arun ◽  
Mandhala Saikrishna ◽  
◽  
...  
Keyword(s):  
Tertiary Care ◽  
The Elderly ◽  
Moderate Degree ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Total Study Population ◽  
Study Population ◽  
Poor Outcomes ◽  
One Year ◽  
Severe Degree

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.

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