CORRELATION OF MRI BRAINS WITH NEUROLOGICAL OUTCOME AT 12 MONTHS OF AGE IN NEWBORNS WITH HYPOXIC ISCHAEMIC ENCEPHALPATHY AT A TERTIARY REFERRAL HOSPITAL OF KOLKATA: A PROSPECTIVE LONGITUDINAL STUDY

2021 ◽  
pp. 39-41
Author(s):  
Adrita Bose ◽  
Gobinda Chandra Das ◽  
Debasish Dey ◽  
Dipak Singh
Keyword(s):  
Neurological Outcome ◽  
Longitudinal Design ◽  
Large Population ◽  
Newborn Care ◽  
Hypoxic Ischemic Encephalopathy ◽  
Published Data ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
Ischemic Encephalopathy

Introduction:In spite of an improved understanding of its pathogenesis , perinatal asphyxia and resulting hypoxic ischemic encephalopathy (HIE) is one of the most dreaded neurological disease of the newborn. Published data show that 25-60% of the babies who survive, suffer from permanent neuro developmental handicaps including cerebral palsy, seizures, mental retardation, and learning disabilities. Aims & Objectives: To correlate Magnetic Resonance Imaging (MRI) Brain with neurological outcome at 12 months in term (more than or equal to 37 weeks gestational age) neonates with Hypoxic Ischemic Encephalopathy. Materials And Methods: Sick Newborn Care Unit (SNCU) and Neonatal Intensive Care Unit (NICU) of R G Kar Medical College & Hospital, Kolkata(2) Department of Radiology of R.G.Kar Medical College & Hospital, Kolkata. From February 1st, 2019 to July 31st 2020. Aprospective observational study in longitudinal design. Results:All the babies with fetal bradycardia(N=19) had abnormal cardiotocographical ndings, out of them 16 babies had suspicious suspicious ndings and 3 had pathological cardiotocographical ndings. Most of the cases with abnormal CTS (N=19) i.e. Suspicious(N1=16)+ Pathological(N2=3) were delivered by LSCS(18) followed by breech vaginal (1). About 45.5 % of the study population had MSL (meconium stained liquor), followed by clear liquor(27.3%), blood stained (21.21%). Only 6.1% showed features of chorioamionitis with foul smelling liquor. Summary & Conclusion:Though normal MRI babies can later be normal or may have minor disabilities in future. But MRIs showing moderate to severe grade of injuries always resulted in severe neuromotor disabilities like cerebral palsies. Further large population studies in other regions of India are to be conducted to emphasize the role of a validated MRI Scoring system to determine the possible clinical outcomes. This will help to initiate early interventions and thus can improve outcomes.

scholarly journals Endemicity of malaria in rural areas: A prospective longitudinal study in India

2013 ◽  
Vol 2 (2) ◽  
pp. 28-33
Author(s):  
Mohammad Athar Ansari ◽  
Iqbal Mohd Khan
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Public Health Problem ◽  
Integrated Approach ◽  
Presumptive Treatment ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Paramedical Staff ◽  
Increasing Trend ◽  
Prospective Longitudinal

The aim of the study is to assess the magnitude of the problem and certain epidemiological factors associated with malaria and examine the changing pattern of malaria through its parameters of measurement during 2009-2011. The study was carried out at the Rural Health Training Center (RHTC), under the J. N. Medical College, Aligarh Mus-lim University, Aligarh, (India) for three years from 1st January 2009 to 31st December 2011. Teams of doctors and paramedical staff regularly visited the villages. If any person was found to be suffering from fever, his/her blood was examined for the malaria parasite. Patients were given presumptive treatment and radical treatment if slides were positive. The findings of the study demonstrated that the number of malaria cases increased during the study period, but in the year 2010, a sudden upsurge was noticed. Out of 5594 patients, most of the patients seen were in the age group of 11-20 years (34.3%). P. vivax (96.2%) was the most common malaria infection in these areas. An increasing trend of malaria was seen from July to October. Most of the parameters of malaria measurement in-creased many folds in 2010 and showed a declining trend in 2011. The overall findings of the study indicated the high endemicity of malaria in the study area and demonstrated a changing pattern of malaria in the registered vil-lages as most of the parameters of malaria measurement increased. An integrated approach is needed which in-cludes mass survey or active surveillance, and appropriate drug therapy to tackle this public health problem. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15940 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 28-33

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 Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025395
Author(s):  
Vipin Gupta ◽  
Ruchi Saxena ◽  
Gagandeep Kaur Walia ◽  
Tripti Agarwal ◽  
Harsh Vats ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Ethics Committees ◽  
First Trimester ◽  
High Rate ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Start Date ◽  
Gestational Weight ◽  
Quantitative Changes ◽  
Prospective Longitudinal

IntroductionPregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth.Methods and analysisA prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring’s weight and body composition at birth will be investigated using regression modelling.Ethics and disseminationThe study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.

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.

scholarly journals Seizure Scores Predict Compromised Neurological Outcome after Hypoxic-ischemic Encephalopathy 1272

1998 ◽  
Vol 43 ◽  
pp. 218-218
Author(s):  
S N Jacobson ◽  
V Booth ◽  
F Allen ◽  
D Puri ◽  
B Latal-Hajnal ◽  
...  
Keyword(s):  
Neurological Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Ischemic Encephalopathy

scholarly journals Correlation of Thompson Score in Predicting Early Outcome of Newborn with Birth Asphyxia

2020 ◽  
Vol 18 (3) ◽  
pp. 406-410
Author(s):  
Sabina Shrestha ◽  
Sangita Puree Dhungana ◽  
Sujit Shrestha ◽  
Gentle Sunder Shrestha
Keyword(s):  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Clinical Score ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Outcome ◽  
Medical College ◽  
A Prospective Study ◽  
Ischemic Encephalopathy

Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

scholarly journals Experience of Continuous Ambulatory Peritoneal Dialysis in Children with Chronic Kidney Disease Stage” V

2017 ◽  
Vol 25 (1) ◽  
pp. 32-38
Author(s):  
Shireen Afroz ◽  
Tahmina Ferdaus ◽  
Rokeya Khanam ◽  
Maliha Alam Simi ◽  
Sanjida Sharmim ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Chronic Kidney Disease Stage ◽  
Pediatric Nephrology ◽  
Disease Stage ◽  
Uncontrolled Hypertension ◽  
College Hospital ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal

The lifespan and outcome of End Stage Kidney Failure (ESKF) children have dramatically improved since the development of continuous ambulatory peritoneal dialysis (CAPD), it offers several advantages over hemodialysis. This study was done to evaluate the efficacy, outcome and to find out the complication profile of CAPD. This prospective longitudinal study was carried out in the department of Pediatric Nephrology, Dhaka Medical College Hospital (DMCH), Bangladesh, over a period of 3 year. A total of 8 children with ESKF were included. (Age 5-14 year, M:F=1:1), All underwent CAPD. Average duration of CAPD 40.6 months with a total of 185 patient months of CAPD. The rate of complications was recorded. Common complications being observed were peritonitis 1 episode per 13.9 patient months, catheter obstruction by omental capture was in 4. Catheter tip dislocation was found in 3 children and all needed laparotomy and omentectomy. Satisfactory level of improvement of mean weight, mean serum albumin and declining of serum creatinine has been found after CAPD in all 8 study children. At the end of the study, 3 out of 8 are still on CAPD, 2 transferred to haemodialysis and 3 expired due to uncontrolled hypertension with congestive heart failure and sepsis. So, CAPD is an effective modality of renal replacement therapy for children. Early detection of complications and prompt therapy is essential for a favourable outcome. Placement of catheter by surgical method with elective omentectomy will reduce catheter related complications.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 32-38

scholarly journals Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10164
Author(s):  
Ilango Saraswathi ◽  
Jayakumar Saikarthik ◽  
K. Senthil Kumar ◽  
Kumar Madhan Srinivasan ◽  
M. Ardhanaari ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Sleep Quality ◽  
Undergraduate Medical Students ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Self Administered Questionnaire

Background The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.

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