Screening of Hearing in Infants at Risk in a Tertiary Care Centre: A Descriptive Cross- sectional Study

2020 ◽  
Vol 3 (2) ◽  
pp. 3-7
Author(s):  
Bijaya Kharel ◽  
Yogesh Neupane ◽  
Prashant Tripathi ◽  
Pabina Rayamajhi ◽  
Sureshwor Lal Karna ◽  
...  

Background: Screening of hearing impairment in children facilitates earlier identification, management and prevention of disability. The objective of this study was to perform a screening of hearing in infants at risk in Tribhuvan University Teaching Hospital. Methods: A descriptive cross-sectional study was done among 228 infants who were at risk of hearing loss. All ‘at risk’ infants born to mothers in Tribhuvan University Teaching Hospital and ‘at risk’ children below one year of age admitted in the pediatric ward and intensive care unit were screened for hearing loss by automated otoacoustic emission (OAE) and automated auditory brainstem reflex (ABR). The results were categorized as pass or refer (fail). The association between hearing loss and the potential risk factors was analyzed. Results: Out of 228 infants screened, 117 (51%) were male and 111 (49%) were female. Seventy (30.7%) failed OAE and 44 (19.3%) failed ABR. Univariate analysis (Pearson Chi-square test) showed that the failure rate for ABR was significantly associated with preterm babies (p = 0.009), low birth weight (p = 0.009), usage of ototoxic drugs (p = 0.03), and intensive care unit stay of more than five days (p = 0.03). Only preterm birth was significantly associated with failed OAE test (p = 0.03). Conclusion: Premature birth (gestational age < 34 weeks) was associated with failure of the ABR and OAE tests. The infants with low birth weight, history of ototoxic drugs, ICU stay more than 5 days were only associated with ABR test failure.

2020 ◽  
Vol 7 (12) ◽  
pp. 2369
Author(s):  
Farogh Hassan ◽  
Vasanth N. Kumar ◽  
Imran Asghar ◽  
Lata Jha ◽  
Indranil Choudhury

Background: The objective of the study was to study the prevalence and various risk factors of dysnatremia in sick newborns admitted in neonatal intensive care unit (NICU).Methods: Cross sectional study conducted in Paediatric Department of tertiary care hospital from February 2016 to October 2016 which includes 384 neonates admitted to NICU during the study period. After informed consent, detailed history was taken and clinical examination carried out in both cases and controls. Blood investigations were done to diagnose sodium levels in sick neonates. Based on the corrected sodium values, the subjects were classified as having hyponatremia (serum sodium <135 meq/l), hypernatremia (serum sodium >145 meq/l) or normonatremia (serum sodium 135 to 145 meq/l).Results: The mean (SD) (range) serum sodium in sick newborns measured was 136.72 (6.7) (115-165) meq/l at a median (range) age of 56.97 (1-545) hours. Out of 384 sodium values obtained, 285 (74.2%) were sent on ≤3 days, 64 (16.7%) between 4th to the 6th day and 35 (9.1%) were sent on ≥7 days. The overall frequency of dysnatremia in 384 sodium values from 384 patients was 142 (37%). Hyponatremia was observed in 117 (30.5%) and hypernatremia in 25 (6.5%) of sodium values. Hyponatremia observed in term, low birth weight, very low birth weight and extremely low birth weight neonates were 16.4%, 25.2%, 67.2% and 100% respectively whereas hypernatremia were 10.1%, 4.6%, 3.4% and 0% respectively. Various risk factors for hyponatremia namely; prematurity, necrotizing enterocolitis, renal failure, birth asphyxia, sepsis, meningitis, vomiting/ nasogastric drainage.Conclusions: Hyponatremia are common in sick newborns in NICU.


2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104


2021 ◽  
Vol 21 (2) ◽  
pp. 547-552
Author(s):  
Henrique Yuji Watanabe Silva ◽  
Felipe Teixeira de Mello Freitas

Abstract Objectives: to describe the epidemiology of invasive candidiasis in a neonatal intensive care unit. Methods: cross-sectional study that included all neonates with invasive candidiasis confirmed by blood culture from April 2015 to June 2018. Demographic, clinical and microbiological data were analyzed, comparing neonates with extreme low birth weight (ELBW) with neonates ≥ 1000g birth weight, considering a p <0.05 as statistically significant. Results: there were 38 cases of invasive candidiasis, resulting in an overall incidence of 2.5%. Twelve (32%) were ELBW neonates and 26 (68%) neonates ≥ 1000g birth weight, an incidence of 4.4% and 2.0%, respectively. Abdominal surgery was more frequent among neonates with birth weight ≥ 1000g compared to ELBW neonates (85% vs. 17%; p <0.01), as well as the median in days of antibiotics use (18 vs. 10.5; p = 0.04). The median in days of mechanical ventilation was more frequent among ELBW neonates (10 vs. 5.5; p = 0.04). The majority of Candida species were non-albicans (64%). Fatality rate was 32%. Conclusions: the incidence of invasive candidiasis among neonates with birth weight ≥ 1000g was higher than that found in the literature. This group has a higher proportion of gastrointestinal malformations that require surgery. Thus, fluconazole prophylaxis may be necessary for a broader group of neonates.


2021 ◽  
Vol 7 (4) ◽  
pp. 318-319
Author(s):  
Laura Herranz ◽  
Juliana Gurgel da Silveira ◽  
Luis Filipe Lannes Trocado ◽  
Anna Luiza Alvaraes ◽  
Juliana Fittipaldi

Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.


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