scholarly journals Audit of neonatal congenital anomalies required surgical intervention at tertiary care centre

2019 ◽  
Vol 6 (6) ◽  
pp. 2406
Author(s):  
Vinod Uplonkar ◽  
Nandkishor Shinde ◽  
Vikas Kumar
Keyword(s):  
Congenital Anomalies ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Hypertrophic Pyloric Stenosis ◽  
Posterior Urethral Valve ◽  
Duodenal Atresia ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
Urethral Valve ◽  
Lobar Emphysema

Background: Nearly 10% of neonatal deaths are due to congenital malformations requiring surgical intervention. Hence our aim is to study spectrum and outcome of the different neonatal congenital anomalies requiring surgical intervention.Methods: This prospective study was conducted over a period of 2 years. 130 cases which required surgical intervention in neonatal period were included in the study. Plain x-ray abdomen was done in all the cases of our study. Ultrasound scan was done in all the cases to rule out renal and other anomalies. Contrast radiography was also performed in selected cases. All cases underwent their respective operations depending upon the diagnoses. Complication and mortalities during hospital stay were noted.Results: During the study period total 130 neonates underwent surgical intervention. Out of 130 cases 5(3.84%) neonates had trachea-esophageal fistula, 2(1.53%) had pure esophageal atresia, 5(3.84%) had duodenal atresia, 9(6.92%) had jejunal atresia, 14(10.76%) had ileal atresia, 3 had meconium ileus(2.30%), 9(6.92%) had malrotation, 15(11.5%) had HD and 5(3.84%) had Meckel's diverticulum, 10(7.69%) had Hypertrophic Pyloric Stenosis, 2(1.53%) had gastroschisis, 3(2.30%) had omphalocele, 16(12.30%) had anorectal malformation, 4(3.07%) had Patent Vitello Intestinal Duct, 3(2.30%) had persistent patent urachus, 4(3.07%) had congenital diaphragmatic hernia, 1(0.76%) had Congenital Lobar Emphysema, 4(3.07%) had Neural Tube Defects, 8(6.15%) had Inguinal Hernia, 6(4.61%) had Posterior Urethral Valve and 2(1.53%) had Pelvi-ureteric Junction Obstruction. There were 85 males and 45 females (M: F-2:1). Septicaemia (40%) was most common complication, 21 (16.15%) cases had mortality.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

scholarly journals Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU

2019 ◽  
pp. 1-9
Author(s):  
K. G. Sachin ◽  
K. R. Sachin ◽  
H. Ramesh ◽  
Guru Prasad ◽  
Harsha Bullapur
Keyword(s):  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Population Control ◽  
Tertiary Care ◽  
Relevant Information ◽  
The United States ◽  
Physical Structure ◽  
Neonatal Deaths ◽  
Medical College

Background: A congenital anomaly may be defined in terms of physical structure as a malformation, an abnormality of physical structure or form usually found at birth or during the first few weeks of life. Congenital anomalies affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. Congenital anomalies or birth defects are relatively common, affecting 3% to 5% of live births in the United States (US) and 2.1% in Europe. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. Objectives: To provide an insight on the burden and types of surgical problems encountered in our NICU of Bapuji Child Health Institute & Research Center, JJM Medical College, Davangere, Karnataka, India and to study the incidence, clinical profile and outcome of surgical condition. Methodology: A total of 3820 babies were examined over a period of 2 years. The relevant information was documented on a semi-structured proforma and analysed. Results: Overall incidence of congenital malformations at birth was 24.8 per 1000 births. The GIT system (51.58%) was most commonly involved followed by respiratory system (26.32%). The incidence of congenital malformation was more in male babies than female babies. Increased frequency was seen in babies born to mothers between 26–30 years & primigravida. The factors which significantly increased the rate of congenital malformations were consanguinity in parents & bad obstetric history. Out of 95 cases, 72% got discharged normally, 18% died in NICU and 10% got discharged against medical advise. Conclusion: With emphasis on “small family” norms and population control it is necessary to identify malformations so that interventional programmes can be planned. Systematic clinical examination of newborns for early detection of anomalies that may warrant medical or surgical intervention. Accurate antenatal anomaly scan need to be done to identify major malformations and terminate the pregnancy.

scholarly journals Lower Genital Tract Trauma in a Tertiary Care Centre in Mid-Western Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das
Keyword(s):  
Genital Tract ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Genital Tract ◽  
Clinical Presentations ◽  
Fall From Height

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.

scholarly journals Congenital anomalies and associated risk factors in a Saudi population: a cohort study from pregnancy to age 2 years

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026351 ◽  
Author(s):  
Ahmed M Kurdi ◽  
Muhammad Ali Majeed-Saidan ◽  
Maha S Al Rakaf ◽  
Amal M AlHashem ◽  
Lorenzo D Botto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Risk Factor ◽  
Neural Tube ◽  
Congenital Anomalies ◽  
Tertiary Care ◽  
Chromosomal Anomalies ◽  
Saudi Population ◽  
Tertiary Care Centre ◽  
Renal Malformations

ObjectiveTo assess the three key issues for congenital anomalies (CAs) prevention and care, namely, CA prevalence, risk factor prevalence and survival, in a longitudinal cohort in Riyadh, Saudi Arabia.SettingTertiary care centre, Riyadh, Saudi Arabia.ParticipantsSaudi women enrolled during pregnancy over 3 years and their 28 646 eligible pregnancy outcomes (births, stillbirths and elective terminations of pregnancy for foetal anomalies). The nested case-control study evaluated the CA risk factor profile of the underlying cohort. All CA cases (1179) and unaffected controls (1262) were followed through age 2 years. Referred mothers because of foetal anomaly and mothers who delivered outside the study centre and their pregnancy outcome were excluded.Primary outcome measuresPrevalence and pattern of major CAs, frequency of CA-related risk factors and survival through age 2 years.ResultsThe birth prevalence of CAs was 412/10 000 births (95% CI 388.6 to 434.9), driven mainly by congenital heart disease (148 per 10 000) (95% CI 134 to 162), renal malformations (113, 95% CI 110 to 125), neural tube defects (19, 95% CI 25.3 to 38.3) and chromosomal anomalies (27, 95% CI 21 to 33). In this study, the burden of potentially modifiable risk factors included high rates of diabetes (7.3%, OR 1.98, 95% CI 1.04 to 2.12), maternal age >40 years (7.0%, OR 2.1, 95% CI 1.35 to 3.3), consanguinity (54.5%, OR 1.5, 95% CI 1.28 to 1.81). The mortality for live births with CAs at 2 years of age was 15.8%.ConclusionsThis study documented specific opportunities to improve primary prevention and care. Specifically, folic acid fortification (the neural tube defect prevalence was >3 times that theoretically achievable by optimal fortification), preconception diabetes screening and consanguinity-related counselling could have significant and broad health benefits in this cohort and arguably in the larger Saudi population.

scholarly journals Perinatal Characteristics and Outcome of Neonates at NICU of a Tertiary Level Hospital in Bangladesh

2017 ◽  
Vol 41 (1) ◽  
pp. 34-39
Author(s):  
Mohammod Shahidullah ◽  
M Zahidul Hasan ◽  
Ismat Jahan ◽  
Firoz Ahmed ◽  
Arjun Chandra Dey ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Birth Asphyxia ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
Development Goals ◽  
Medical University ◽  
Mdg 4 ◽  
Level Hospital

Background: One of the Millennium Development Goals (MDG-4) is to reduce child mortality up to two-thirds by 2015. In most developing countries, a higher proportion of neonatal deaths are observed. It has been recognized that without a substantial reduction in neonatal deaths, MDG-4 will not be met.Objective: To assess the perinatal characteristics, pattern of admissions and outcome of neonates in a tertiary care centre in Bangladesh.Methods: A retrospective review of consecutive neonatal admissions to Bangabandhu Sheikh Mujib Medical University, between January and December 2013, was conducted. Data were collected from the neonatal admission, discharge and death registers. Standard definitions of the conditions were used to diagnose the clinical conditions.Results: Total 683 neonates were admitted to the NICU. Among them 56.1% were inborn and males were 56.8%. Total 61.3% neonates were low birth weight and 60.3 % were preterm. The overall cesarean section rate was 61.9%. Total 35.3% neonates had sepsis and perinatal asphyxia was present in 16.8% neonates. Congenital anomaly was present in 17.6% neonates. The mean duration of hospital stay was 11.1 days and overall mortality rate was 14.9%.Conclusion: Prematurity, neonatal infections, birth asphyxia and congenital anomalies were the main causes of neonatal hospital admission and neonatal deaths in this study.Bangladesh J Child Health 2017; VOL 41 (1) :34-39

scholarly journals Radiological Assessment of the Indian Children with Congenital Sensorineural Hearing Loss

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Sangeet Kumar Agarwal ◽  
Satinder Singh ◽  
Samarjit Singh Ghuman ◽  
Shalabh Sharma ◽  
Asish Kr. Lahiri
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Temporal Bone ◽  
Congenital Anomalies ◽  
Tertiary Care ◽  
Sensorineural Hearing ◽  
Tertiary Care Centre ◽  
Indian Children ◽  
3D Scan

Introduction. Congenital sensorineural hearing loss is one of the most common birth defects with incidence of approximately 1 : 1000 live births. Imaging of cases of congenital sensorineural hearing loss is frequently performed in an attempt to determine the underlying pathology. There is a paucity of literature from India and for this reason we decided to conduct this study in Indian context to evaluate the various cochleovestibular bony and nerve anomalies by HRCT scan of temporal bone and MRI with 3D scan of inner ear in a tertiary care centre.Material and Methods. A total of 280 children with congenital deafness (158 males and 122 females), between January 2002 to June 2013 were included in the study and they were assessed radiologically by HRCT scan of temporal bone and MRI with 3D scan of inner ear.Results. In the present study we found various congenital anomalies of bony labyrinth and vestibulocochlear nerve. Out of 560 inner ears we found 78 anomalous inner ears. Out of these 78 inner ears 57 (73%) had cochlear anomaly, 68 (87.1%) had anomalous vestibule, 44 (56.4%) had abnormal vestibular aqueduct, 24 (30.7%) had anomalous IAC, and 23 (29.4%) had abnormal cochleovestibular nerves.Conclusion. In present study, we found lower incidences of congenital anomalies comparative to existing literature.

scholarly journals Diverse spectrum of facial dog bite presentation and their management

2018 ◽  
Vol 5 (9) ◽  
pp. 3017
Author(s):  
Rakesh Kumar Jain ◽  
Gautam Prakash ◽  
Manojit Midya ◽  
Pankaj Sharma
Keyword(s):  
Surgical Intervention ◽  
Primary Repair ◽  
Tertiary Care ◽  
Psychological Trauma ◽  
Wound Management ◽  
Dog Bite ◽  
Tertiary Care Centre ◽  
Basic Principles ◽  
Dog Bites ◽  
Head Neck

Background: Dog bite patients are frequently encountered in our hospital seeking immediate as well as delayed reconstruction. More than two third of dog bite injuries involve head, neck and scalp region. Facial dog bites present a challenge for the surgeon, as they lead to cosmetic disfigurement and psychological trauma to the patient. Following thorough washout and debridement, we have used various reconstructive techniques for definitive management of wounds like- primary repair, V-Y advancement flap, nasolabial flap, SSG, FTG and Karapandzic flap. Purpose of the present study is to share our experiences in management of dog bite wounds on the face in both adult and paediatric patients with available reconstructive options to maximize the functional and cosmetic outcomes by using basic principles of surgery.Methods: Present study was a single centre retrospective study conducted in a tertiary care centre from February 2013 to January 2018. Total 497 patients of dog bite who presented in the emergency department were enrolled. Out of them 310 patients had involvement of head, neck and scalp requiring surgical intervention in any form.Results: In last five years, we have encountered mid face predilection in face, head and neck cases. Out of 310 cases, lip (25.16%) and cheek (24.51%) were involved in majority of the patients. Flap cover surgery is required in majority of the scalp and nose group of patients, as there is less mobility of tissue present in surrounding region, while cheek and lip were managed with primary closure in most of the patients.Conclusions: Although most of the dog bites are preventable, but cases of dog bite are increasing continuously. Child should never be left alone with dogs and, if they are fear of dogs, it’s better not to obtain dogs. As far now, it’s a major concern for treating physician or surgeon to provide optimal cosmetic as well as functional outcome. Early surgical intervention for wound management gives better results with the use of basic principles of plastic surgery.

scholarly journals Prevalence and associated factors of congenital anomalies in a tertiary care centre in Tamilnadu

2016 ◽  
Vol 2 (4) ◽  
pp. 55-63
Author(s):  
Dr. Prema N ◽  
◽  
Dr. Sudhakaran R ◽  
Dr. Divya B.V. ◽  
Dr. Meerabai V. ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Associated Factors ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Deciphering the Mutation Spectrum in South Indian Children With Congenital Anomalies of the Kidney and Urinary Tract

2021 ◽  
Author(s):  
Ambili Narikot ◽  
Varsha Chhotusing Pardeshi ◽  
Shubha AM ◽  
Arpana Iyengar ◽  
Anil Vasudevan
Keyword(s):  
Urinary Tract ◽  
Congenital Anomalies ◽  
Posterior Urethral Valve ◽  
Genetic Diagnostics ◽  
Genetic Profile ◽  
Fetal Life ◽  
Indian Children ◽  
South Indian ◽  
Dysplastic Kidney ◽  
Urethral Valve

Abstract Background: Congenital anomalies of the kidney and urinary tract (CAKUT) cover a spectrum of structural malformations that result from aberrant morphogenesis of kidney and urinary tract. It is the most prevalent cause of kidney failure in children. Hence, it is important from a clinical perspective to unravel the molecular etiology of kidney and urinary tract malformations. Causal variants in genes that direct various stages of development of kidney and urinary tract in fetal life have been identified in 5–20 % of CAKUT patients from Western countries. Recent advances in next generation sequencing technology and decreasing cost offer the opportunity to characterize the genetic burden of CAKUT in Indian population and facilitate integration of genetic diagnostics in care of children with CAKUT. Methods: Customized targeted panel sequencing was performed to identify mutations in 31 genes known to cause human CAKUT in 69 south Indian children with CAKUT. The NGS data was filtered using standardized pipeline and the variants were classified using ACMG criteria. Genotype and phenotype correlations were performed. Results: The cohort consisted of children mostly with posterior urethral valve (PUV) (39.1%), vesico-ureteric reflux (VUR) (33.3%) and multi-cystic dysplastic kidney (MCDK) (7.2%). Likely pathogenic variants were identified in two genes (TNXB and CHD1L) in 2 children (9 %) with CAKUT. One child diagnosed with posterior urethral valve (PUV) had mutation in two different genes [TNXB (p. Gln286fs), and CHD1L (p. Ser837fs)], while second child with left duplex system had a single gene mutation in TNXB gene (p. Gln286fs). Conclusions: The present study identified novel monogenic mutations in only a small proportion of patients with CAKUT using a targeted gene panel. The low prevalence of genetic cause may be due to higher proportion of children with abnormalities in lower urinary tract than hypodysplasia of kidneys. Clinical or whole exome sequencing may be a better method to characterize the genetic profile of Indians patients with CAKUT.

ASSESSMENT OF NEONATAL OUTCOME IN BOOKED AND UNBOOKED PREGNANCY CASES IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 63-65
Author(s):  
Pranoy Dey ◽  
L. Lotha ◽  
Sawant Kumar Sahu ◽  
Rajlakshmi Borgohain
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
And Child Health

Majority of neonatal deaths occurs in low and middle income countries indicating poor quality of health services provided by the government of the respective countries.In a developing country like India , a high morbidity and mortality serves as an sensitive indicator reecting the poor maternal and child health care services of the country.Most of the neonatal deaths can be attributed to avoidable factors which can be minimized by the effective utilization of antenatal services , early detection of high risk pregnancy and timely referral of these cases.The current study was conducted to determine the neonatal outcomes in booked and unbooked pregnancy cases in the tertiary care centre ,Assam Medical College and Hospital, Dibrugarh. METHODS: Close ended structured questionnaires were used to collect information from the parents (150 booked and 150 unbooked).Neonatal outcomes were categorised under groups of term and preterm ,live birth and stillbirts, birthweight, Gestational age, iugr, large for gestational age APGAR score ,NICU admissions and clinical course during hospital stay,course during rst 28 days of life along with complications,if any are all taken into consideration. RESULTS: During the study period 28.67% had low birth weight in booked cases and 41.33% had low birth weight in unbooked cases.The incidence of stillbirth and early neonatal deaths were 2%,4% respectively in booked cases and 4.67% , 6% respectively in unbooked cases.Higher incidence of MSL,prematurity ,birth asphyxia ,respiratory problems ,birth injuries,congenital malformations,infections and hyperbilirubinemia were seen in unbooked cases. CONCLUSIONS: The inference derived from the study ,showed that availability of antenatal care is directly proportional to the neonatal outcome .Thus unavailbility or lack of proper medical attention during the pregnancy results in unfavourable neonatal outcomes which can be prevented by increasing the range of availability , utilization and effectiveness of maternal and child health services alongwith ensuring booking of all the pregnancy cases in our country.

scholarly journals A study on eclampsia and its maternal and perinatal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4990
Author(s):  
Devika J. Kamat ◽  
Guruprasad Pednecar
Keyword(s):  
Antenatal Care ◽  
Perinatal Outcome ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
Nicu Admission ◽  
A Prospective Study

Background: Eclampsia is one of the major causes of maternal and perinatal mortality in India. Here authors present a prospective study which was conducted in a tertiary health centre to study the cases of eclampsia, the mode of presentation and the maternal and perinatal outcomes.Methods: A total 95 women were diagnosed as eclampsia during the period of 2 years. Various parameters and their effects on maternal and perinatal morbidity and mortality were studied. Maternal outcomes were assessed based on parameters like antenatal care received, mode of delivery, complications associated with eclampsia. Perinatal outcomes were noted depending upon the period of gestation, NICU admission, stillbirths and neonatal deaths.Results: Authors found the incidence of eclampsia to be 0.9%. 52.7% women had irregular antenatal follow up at any nearby health centre. A total 76.8% women had antepartum eclampsia. 56.8% delivered by caesarean section while 7.4% required operative vaginal delivery. 61.1% women delivered within 10 hours of onset of convulsion. Authors had 02 deaths in the study group, one due to ARDS with DIC and the other attributed to pulmonary oedema. There were 51.6% preterm deliveries. 21 neonates required NICU admission with 5 neonatal deaths and 11 stillbirths.Conclusions: Due to inadequate antenatal care, most of the cases of pre-eclampsia go unnoticed increasing the referrals to tertiary care centre for intensive care. Thus, it is necessary to emphasise on timely interventions and availability of blood bank, ICU and NICU facilities at the closest referral centre for better maternal and perinatal outcome.

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