Delayed development in newborns with hypoxic ischemic encephalopathy stage-2.

2021 ◽  
Vol 28 (03) ◽  
pp. 333-337
Author(s):  
Amna Wajdan ◽  
Maria Saleem ◽  
Asim Khurshid
Keyword(s):  
Normal Development ◽  
Case Series ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Demographic Information ◽  
Telephone Number ◽  
Female Ratio ◽  
Delayed Development ◽  
Male To Female ◽  
Ischemic Encephalopathy

Objective: To determine the frequency of delayed development in newborns with hypoxic ischemic encephalopathy (HIE) stage 2 presenting to Nishtar Hospital Multan. Study Design: Descriptive Case Series. Setting: Department of Pediatrics, The Children’s Hospital and The Institute of Child Health, Multan. Period: August 2019 to February 2020. Material & Methods: Children with birth asphyxia (HIE stage 2) admitted in NICU were registered. The basic demographic information including name, age, sex, address and telephone number was recorded in a specifically designed proforma. Children were followed up at 3 months and developmental milestones were recorded in the proforma. Results: Mean age of newborns was 17.15±15.95 hours and mean weight was 2.88±0.28 kg. There were 55 male newborns (67.9%) and 26 female newborn babies (32.1%). Male to female ratio was 2.1:1. Frequency of delayed development of the beabies in our study was 34.6% while 53 babies (65.4%) had normal development assessed through milestones achieved at 3 months. Milestones achieved at 3 months were; head control in 54 newborns (66.7%), lifts head and chest above couch in prone position in 50 newborns (61.7%), head above line of body on ventral suspension in 55 newborns (67.9%), follows light through an arc of 180 degrees/defensive blink in 21 newborns (25.9%), turns to nearby voice in 38 newborns (46.9%), happy response to mother’s face when feeding in 63 newborns (77.8%). Conclusion: Frequency of delayed development of the newborns with stage-2 HIE in our study was high.

Hypoxic Ischemic Encephalopathy in Neonates with Birth Asphyxia - A Hospital Based Study

2021 ◽  
Vol 18 (2) ◽  
pp. 22-26
Author(s):  
Jyoti Adhikari ◽  
Deepak Paudel
Keyword(s):  
Birth Asphyxia ◽  
College Teaching ◽  
Hypoxic Ischemic Encephalopathy ◽  
Obstructed Labor ◽  
Female Ratio ◽  
Live Births ◽  
Normal Birth ◽  
Risk Pregnancy ◽  
Clinical Presentations ◽  
Ischemic Encephalopathy

Introduction: Each year approximately 4 million babies are born asphyxiated, which results in 1 million deaths and an equal number of serious neurological sequelae. One of the commonest organs involved in birth asphyxia is brain which may lead to a syndrome of clinical manifestation called Hypoxic Ischemic Encephalopathy (HIE). Aims: To find out possible maternal and neonatal risk factors for Hypoxic Ischemic Encephalopathy, to analyze clinical presentations and outcome of HIE in asphyxiated newborns. Methods: Hospital based observational study was carried out among fifty newborns with Apgar score less than 7 at 1 minute of life admitted in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke. Results: The incidence of birth asphyxia and birth asphyxia with HIE were 37.2 per 1000 live births and 14 per 1000 live births with male: female ratio of 1.27:1. Most of the neonates 22(44%) were in HIE stage II. Meconium stained amniotic fluid 18 (36%) was the most common intrapartum risk factor followed by maternal use of intrapartum medications 14 (28%), Premature Rupture of Membrane (PROM) 8 (16%), prolonged labor 5 (10%) and obstructed labor 6 (12%). Four (8%) asphyxiated neonates with HIE had cord prolapse and 7 (14%) had cord around the neck. The most common resuscitation done was bag and mask ventilation (56%) (P<0.05). Majority of the studied neonates were of normal birth weight (76%) and head circumference (84%) (P<0.05) with clinical presentations of respiratory distress (88%), seizures (44%), apnea (22%), bradycardia (8%), tachycardia (6%) and bulged anterior fontanel (6%). The overall mortality of neonates with HIE was 20% of which most were of HIE stage III. Conclusion: Certain measures could be taken to prevent birth asphyxia: early detection and intervention of high risk pregnancy, prompt and effective resuscitation of asphyxiates newborns.

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 Frequency of Patients Passing an Impacted Esophageal Meat Bolus by Conservative Method Alone

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Ghulam Murtaza ◽  
sarwat Hassan Syed ◽  
Mohammad Qamar Nasir ◽  
Damish Arsalan ◽  
Muhammad Awais Amin ◽  
...  
Keyword(s):  
Conservative Management ◽  
High Frequency ◽  
Clinical Suspicion ◽  
Barium Swallow ◽  
Single Intravenous Dose ◽  
Demographic Information ◽  
Food Bolus ◽  
Female Ratio ◽  
Age Range ◽  
Male To Female

Objectives: To determine the frequency of patients passing the impacted esophageal meat bolus by conservative management Methods: After obtaining permission from ethical committee of Hospital,a total of 62 patients meeting the study criteria were recruited in the study which was conducted in Department of Otorhinolaryn-gology, Services Hospital, Lahore. Demographic information (name, age, gender, contact) was also obtained. Patients with clinical suspicion of impacted esophageal food bolus of age 20-50 years of either gender were included. Patients with known esophageal abnormalities like stricture, web or growth on either barium swallow or esophagogastroduodenoscopy, peptic ulcer and GERD were excluded. After taking informed written consent from each patient, single intravenous dose of buscopan 20mg was given to each patient. Each patient was followed by the researcher himself for 24 hours to assess the passage of food bolus. Results: 20-50 years was the age range in our study, with mean age being 34.10± .63 years. Majority of the patients 32 (51.61%) were between 20 to 35 years of age. Out of 62 subjects, 37 (59.68%) were male, 25 (40.32%) were females with male to female ratio 1.5:1. In our study, Frequency of patients passing the impacted esophageal meat bolus by conservative management was found in 51 (82.26%) patients. Conclusion: This study concluded that there is a high frequency of patients passing the impacted esophageal meat bolus by conservative management. Keywords: Esophagus, foreign body, conservative management.

scholarly journals CARCINOMA OF URINARY BLADDER;

2017 ◽  
Vol 24 (11) ◽  
pp. 1691-1696
Author(s):  
Khalid Hussain ◽  
Manzoor Ahmad Khan ◽  
Attiq ur Rahman Khan ◽  
Imran Amin ◽  
Muhammad Khalid Butt
Keyword(s):  
Bladder Tumor ◽  
Tnm Classification ◽  
Case Series ◽  
Female Ratio ◽  
Voiding Symptoms ◽  
Case Series Study ◽  
And Gender ◽  
Muscle Invasive ◽  
Male To Female ◽  
Gross Haematuria

Introduction: The most common presentation of carcinoma of urinarybladder is haematuria. Almost 80-90% of patients with carcinoma of bladder present eitherwith microscopic or gross haematuria and it is mostly intermittent rather than constant. Somepatients also complain of irritative voiding symptoms such as frequency, urgency and dysuria.Study Design: Descriptive, case series study. Setting: Department of Urology, DHQ Hospital,Gujranwala, Pakistan. Period: July 2015 to June 2016. Materials & Methods: Total 30 patientsirrespective of age and gender with diagnosis of bladder tumor based on clinical symptomsand supported by laboratory tools like Urine cytology, Ultrasound and IVU were included. Thealready diagnosed patients of bladder tumor that have been treated with different modalitieswere excluded. All the tumors were staged according to TNM classification after TURBT andgraded on the basis of histopathology. Results: Mean age was 53.17+16.07SD years. Maleswere 25(83.3%) and females were 5(16.7%). Male to female ratio is 5:1. Twenty eight (93.3%)patients out of 30 presented with painless haematuria. 23(73.33%) patients out of 30 patientswere smokers. 09 (30%) patients had Ta, in which G1 was found in 2 patients and G2 in 7patients. T1 was found in 10 (33.3%) patients, in which G2 was 5(17.3%) and G3 was 5(17.3%)cases. Muscle invasive T2a was diagnosed in 04 patients amongst them G2 and G3 wasdetected in 2(6.6%) patients each respectively. T2b was present in 3 patients, which had G1 in1(3.3%) and G3 in 2(10%) patients. T3b G2 was found 01 patient and T3b G3 was detected in1(3.3%) patient, T4M1 G3 was present in 2(6.6%) patients. Conclusion: This study concludedthat the bladder tumor is quite common with muscle invasive TCC is more common. Painlesshematuria is the commonest presentation and also smoking has a definite association with CAbladder.

scholarly journals Current Controversies in Newer Therapies to Treat Birth Asphyxia

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Pia Wintermark
Keyword(s):  
Brain Injury ◽  
Neurological Outcome ◽  
Mild Hypothermia ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Monitoring Technology ◽  
The Past ◽  
Neuroprotective Strategy ◽  
Ischemic Encephalopathy

Despite major advances in monitoring technology and knowledge of fetal and neonatal pathophysiology, neonatal hypoxic-ischemic encephalopathy (HIE) remains one of the main causes of severe adverse neurological outcome in children. Until recently, there were no therapies other than supportive measures. Over the past several years, mild hypothermia has been proven to be safe to treat HIE. Unfortunately, this neuroprotective strategy seems efficient in preventing brain injury in some asphyxiated newborns, but not in all of them. Thus, there is increasing interest to rapidly understand how to refine hypothermia therapy and add neuroprotective or neurorestorative strategies. Several promising newer treatments to treat birth asphyxia and prevent its devastating neurological consequences are currently being tested. In this paper, the physiopathology behind HIE, the currently available treatment, the potential alternatives, and the next steps before implementation of these other treatments are reviewed.

Controlled hypothermia in complex therapy for hypoxic ischemic encephalopathy in infants with birth asphyxia

2020 ◽  
Vol 5_2020 ◽  
pp. 90-97
Author(s):  
Savelyeva G.М. Savelyeva ◽  
Shalina R.I. Shalina ◽  
Аnаnkina А.А. Аnаnkina ◽  
Kunyakh Zh.Yu Kunyakh ◽  
Sichinava L.G. Sichinava ◽  
...  
Keyword(s):  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Complex Therapy ◽  
Controlled Hypothermia ◽  
Ischemic Encephalopathy

Operative management of external auditory canal cholesteatoma: case series and literature review

2013 ◽  
Vol 127 (9) ◽  
pp. 859-866 ◽  
Author(s):  
M Sayles ◽  
H A Kamel ◽  
F F Fahmy
Keyword(s):  
External Auditory Canal ◽  
Case Series ◽  
Operative Management ◽  
External Ear ◽  
Ear Canal ◽  
Female Ratio ◽  
External Ear Canal ◽  
Temporal Bones ◽  
External Auditory Canal Cholesteatoma ◽  
Male To Female

AbstractObjectives:To describe the clinical features of external auditory canal cholesteatoma, and to assess the outcome following bony meatoplasty with tragal cartilage and perichondrium graft repair.Methods:A retrospective review was carried out, comprising all patients with external auditory canal cholesteatoma who presented between January 2007 and December 2011. Patients underwent pre-operative audiometry and computed tomography imaging of the temporal bones, before undergoing bony meatoplasty via a postauricular incision. Pre- and post-operative comparisons were made of patients' otological symptoms and the otoscopic appearance of the external ear canal.Results and conclusion:Eight patients were included in the analyses. The median age of patients was 46.5 years (range 14–68 years), with a male to female ratio of 1:1. The median length of follow up was 16 months. The most common presenting features were unilateral otalgia and purulent otorrhoea. All patients had relatively advanced disease at presentation, with erosion of the temporal bone. All patients underwent bony meatoplasty via a postauricular approach to eradicate the disease. Bony meatoplasty was successful in the definitive management of external ear canal cholesteatoma.

scholarly journals Association of high BNP level with heart failure in patients presenting with STEMI.

2021 ◽  
Vol 28 (04) ◽  
pp. 491-496
Author(s):  
Muhammad Waqas ◽  
Hafiz Muhammad Faiq Ilyas ◽  
Irfan Majeed ◽  
Muhammad Nouman Ahmad ◽  
Muhammad Nazim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Informed Consent ◽  
Study Design ◽  
Inclusion Criteria ◽  
Demographic Information ◽  
Female Ratio ◽  
The Mean ◽  
Male To Female ◽  
Study Setting

Objective: The objective of this study is to to determine the association of high BNP level with heart failure in patients presenting with STEMI. Study Design: Cohort Study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 01 January 2017 to 30 June 2017. Material & Methods: After meeting the inclusion criteria 150 patients were enrolled. Informed consent and demographic information was taken. Then patients divided in two groups, high and normal BNP groups. Then patients were admitted in cardiology wards and were followed-up there for 5 days. Patients evaluated for symptoms of heart failure and underwent echocardiography for confirmation of presence or absence of heart failure. All the collected data was entered and analyzed on SPSS version 21. Results: In this study the mean age high BNP group was 48.87± 10.18 years while the mean age in normal BNP group was 48.99±12.15 years. Male to female ratio of the patients was 2:1. The heart failure occurred in 19(12.67%) patients. There is 1.58 times higher risk of heart failure in high BNP than normal BNP i.e. RR=1.58[1.14-2.19]. Conclusion: This present study concluded that high BNP level is strongly associated with heart failure in patients presenting with STEMI.

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