MBBS (MEDICAL COLLEGE KOLKATA) JUNIOR RESIDENT, DEPARTMENT OF PEDIATRICS , MIDNAPORE MEDICAL COLLEGE SENIOR RESIDENT, DEPARTMENT OF PEDIATRICS, MIDNAPORE MEDICAL COLLEGE. Address: VILL- RAIPUR, P.O - CHAMPAHATI, P.S - SONARPUR, DIST -24 PARGANAS(SOUTH), WEST BENGAL, INDIA, PIN -743330
Introduction: Neonatal seizures are common but can be manifestations of serious underlying disord... more Introduction: Neonatal seizures are common but can be manifestations of serious underlying disorders and sometimes have a grave prognosis. Predictors for adverse outcomes are important for early referral and advanced interventions. Aim: To study the incidence and factors associated with neonatal seizure and to determine the predictors of adverse outcomes. Materials and Methods: This was a longitudinal study, conducted from April 2020 to March 2021 at a Rural Medical College (Midnapore Medical College and Hospital, West Bengal) in Eastern India. All the admitted newborns (N=143) in the Special Newborn Care Unit (SNCU), who had clinically evident seizures, were included in the study. Data were collected regarding the perinatal history, gestational age, type of delivery, birth weight, APGAR score at 1 and 5 minutes, and need for resuscitation at birth. The onset of the seizure, seizure type, investigation findings, possible aetiological diagnosis, and final outcome was noted. The manag...
International Journal of Pediatrics and Neonatology
Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in... more Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in developing countries like India. Methods: A cross-sectional hospital based study was done among paediatric population admitted to the hospital with history of snakebite. Results: Deaths due to snakebite were 2.8% of total death. Most of the cases were during monsoon (55%) and from rural area (93%). Only 13.6% patients came to hospital within 6 hours. Prothrombin time and activated partial thromboplastin time were prolonged in 36.67% and 33.33% cases respectively. The 20-minute Whole Blood Clotting Test (WBCT20) was positive in 47.6% of poisonous snakebites and in 63.6% of vasculotoxic snakebites. 62% cases recovered with 10 vials of ASV, however some needed >20 vials. Conclusion: Epidemiological data are vital for evaluation of exact scenario of snakebite cases. Poor health care seeking behaviour of community increases mortality.
International Journal of Pediatrics and Neonatology , Jan 2020
Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in... more Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in developing countries like India. Methods: A cross-sectional hospital based study was done among paediatric population admitted to the hospital with history of snakebite. Results: Deaths due to snakebite were 2.8% of total death. Most of the cases were during monsoon (55%) and from rural area (93%). Only 13.6% patients came to hospital within 6 hours. Prothrombin time and activated partial thromboplastin time were prolonged in 36.67% and 33.33% cases respectively. The 20-minute Whole Blood Clotting Test (WBCT20) was positive in 47.6% of poisonous snakebites and in 63.6% of vasculotoxic snakebites. 62% cases recovered with 10 vials of ASV, however some needed >20 vials. Conclusion: Epidemiological data are vital for evaluation of exact scenario of snakebite cases. Poor health care seeking behaviour of community increases mortality.
International Journal of Science and Research (IJSR) , 2020
Abstract: Aim : To find out the efficacy and safety of low dose oral erythromycin (... more Abstract: Aim : To find out the efficacy and safety of low dose oral erythromycin (6mg/kg/day) in gastro intestinal dysmotility of premature infants. Methods : A prospective double blind randomised placebo controlled study was done on 82 preterm infants admitted to the neonatal unit. The infants were randomly allocated to receive oral erythromycin or equivalent volume of normal saline as placebo. The time taken to establish quarter, half, three quarter and full enteral feed after drug treatment were compared in between two groups. Potential adverse effects of oral erythromycin were assessed. Results : Infants with < 30 weeks , 30- 34 weeks and 34- 38 weeks gestational age achieved full enteral feeding (FEF) at the of 19.44 days, 12.81 days and 9.36 days respectively in erythromycin group whereas in control group it took 34.33days, 21.50 days and 18.65 days. None of the infant developed cholestasis, pyloric stenosis or QT prolongation in both groups. Only 1 infant from erythromycin group and 8 from control group had developed necrotising entero-colitis. Keywords: erythromycin, preterm infants, gastro-intestinal dysmotility, necrotising entero-colitis
Sri Lanka Journal of Child Health, 2021; 50(1): 12-16 , 2021
Background: Snake bite can result in local as well as systemic manifestations. Major ... more Background: Snake bite can result in local as well as systemic manifestations. Major systemic complications include acute renal failure, neurological symptoms requiring ventilator support and coagulation disorders. The coagulation disorders lead to various serious systemic complications like haemorrhage, infarction and even death if the diagnosis and treatment are delayed. Objectives: To describe the clinical profile of the snake bitten patients who developed coagulopathy and the role of coagulation markers to evaluate the morbidity and mortality of the victims. Method: A cross-sectional hospital based study was done on patients aged 12 years or less having local or systemic signs of envenomation and no history of bleeding or coagulation disorders. The coagulation profile was assessed by peripheral blood sampling and urine analysis. Results: In the present study haemorrhagic manifestations seen included bleeding from injection site (46.7%), haematemesis (5%), haematuria (33.3%), bleeding gums (11.7%), epistaxis (1.7%), and haemoptysis (3.3%). Haemoglobin estimation revealed anaemia in 53.3% cases. The 20 minute whole blood clotting time (WBCT20) was positive in 86.4% of vasculotoxic snakebites and negative in all neuro-paralytic bites. Leucocytosis was observed in 60% cases with relative neutrophilia in 63.3%, thrombocytopenia was observed in 8.3%, bleeding time was prolonged in 13.3% and clotting time was prolonged in 56.7%. Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites
Aim: Neonatal seizures are less likely to be idiopathic. Proper diagnosis of etiology can help in... more Aim: Neonatal seizures are less likely to be idiopathic. Proper diagnosis of etiology can help in prompt management. The study was done to diagnose the preventable causes early and develop strategies for the prevention of neonatal seizures. Materials and Methods: This prospective observational study was done among neonates who developed seizures before or during the stay in the Neonatal Intensive Care Unit (NICU), irrespective of gestational age and birth weight from June 2018 to May 2019. Results: In the study, 4.95% of the total admitted babies were with seizure out of which 66.2% were term. Most of the seizures were detected within 24 hours of birth (53.6%) in neonates of primigravida (62%) and who are delivered normally (74.7%). Present study showed subtle seizures-45.1%, multifocal clonic seizures -39.4%, focal clonic seizures-8.5% and tonic seizure-7% of cases (n =71). Birth asphyxia (49.5%) being the most common cause followed by sepsis (29.5%) and metabolic abnormalities (25.4%). Most of the patients required only phenobarbitone (80.28%), a few patients required more than one anticonvulsant. Conclusion: Neonatal seizures have an impact on cognitive, behavioural or epileptic complications later in life. The commonest cause of neonatal seizures is perinatal asphyxia.
Introduction: Neonatal seizures are common but can be manifestations of serious underlying disord... more Introduction: Neonatal seizures are common but can be manifestations of serious underlying disorders and sometimes have a grave prognosis. Predictors for adverse outcomes are important for early referral and advanced interventions. Aim: To study the incidence and factors associated with neonatal seizure and to determine the predictors of adverse outcomes. Materials and Methods: This was a longitudinal study, conducted from April 2020 to March 2021 at a Rural Medical College (Midnapore Medical College and Hospital, West Bengal) in Eastern India. All the admitted newborns (N=143) in the Special Newborn Care Unit (SNCU), who had clinically evident seizures, were included in the study. Data were collected regarding the perinatal history, gestational age, type of delivery, birth weight, APGAR score at 1 and 5 minutes, and need for resuscitation at birth. The onset of the seizure, seizure type, investigation findings, possible aetiological diagnosis, and final outcome was noted. The manag...
International Journal of Pediatrics and Neonatology
Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in... more Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in developing countries like India. Methods: A cross-sectional hospital based study was done among paediatric population admitted to the hospital with history of snakebite. Results: Deaths due to snakebite were 2.8% of total death. Most of the cases were during monsoon (55%) and from rural area (93%). Only 13.6% patients came to hospital within 6 hours. Prothrombin time and activated partial thromboplastin time were prolonged in 36.67% and 33.33% cases respectively. The 20-minute Whole Blood Clotting Test (WBCT20) was positive in 47.6% of poisonous snakebites and in 63.6% of vasculotoxic snakebites. 62% cases recovered with 10 vials of ASV, however some needed &gt;20 vials. Conclusion: Epidemiological data are vital for evaluation of exact scenario of snakebite cases. Poor health care seeking behaviour of community increases mortality.
International Journal of Pediatrics and Neonatology , Jan 2020
Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in... more Background: Snakebite is a neglected tropical disease and one of the major causes of mortality in developing countries like India. Methods: A cross-sectional hospital based study was done among paediatric population admitted to the hospital with history of snakebite. Results: Deaths due to snakebite were 2.8% of total death. Most of the cases were during monsoon (55%) and from rural area (93%). Only 13.6% patients came to hospital within 6 hours. Prothrombin time and activated partial thromboplastin time were prolonged in 36.67% and 33.33% cases respectively. The 20-minute Whole Blood Clotting Test (WBCT20) was positive in 47.6% of poisonous snakebites and in 63.6% of vasculotoxic snakebites. 62% cases recovered with 10 vials of ASV, however some needed >20 vials. Conclusion: Epidemiological data are vital for evaluation of exact scenario of snakebite cases. Poor health care seeking behaviour of community increases mortality.
International Journal of Science and Research (IJSR) , 2020
Abstract: Aim : To find out the efficacy and safety of low dose oral erythromycin (... more Abstract: Aim : To find out the efficacy and safety of low dose oral erythromycin (6mg/kg/day) in gastro intestinal dysmotility of premature infants. Methods : A prospective double blind randomised placebo controlled study was done on 82 preterm infants admitted to the neonatal unit. The infants were randomly allocated to receive oral erythromycin or equivalent volume of normal saline as placebo. The time taken to establish quarter, half, three quarter and full enteral feed after drug treatment were compared in between two groups. Potential adverse effects of oral erythromycin were assessed. Results : Infants with < 30 weeks , 30- 34 weeks and 34- 38 weeks gestational age achieved full enteral feeding (FEF) at the of 19.44 days, 12.81 days and 9.36 days respectively in erythromycin group whereas in control group it took 34.33days, 21.50 days and 18.65 days. None of the infant developed cholestasis, pyloric stenosis or QT prolongation in both groups. Only 1 infant from erythromycin group and 8 from control group had developed necrotising entero-colitis. Keywords: erythromycin, preterm infants, gastro-intestinal dysmotility, necrotising entero-colitis
Sri Lanka Journal of Child Health, 2021; 50(1): 12-16 , 2021
Background: Snake bite can result in local as well as systemic manifestations. Major ... more Background: Snake bite can result in local as well as systemic manifestations. Major systemic complications include acute renal failure, neurological symptoms requiring ventilator support and coagulation disorders. The coagulation disorders lead to various serious systemic complications like haemorrhage, infarction and even death if the diagnosis and treatment are delayed. Objectives: To describe the clinical profile of the snake bitten patients who developed coagulopathy and the role of coagulation markers to evaluate the morbidity and mortality of the victims. Method: A cross-sectional hospital based study was done on patients aged 12 years or less having local or systemic signs of envenomation and no history of bleeding or coagulation disorders. The coagulation profile was assessed by peripheral blood sampling and urine analysis. Results: In the present study haemorrhagic manifestations seen included bleeding from injection site (46.7%), haematemesis (5%), haematuria (33.3%), bleeding gums (11.7%), epistaxis (1.7%), and haemoptysis (3.3%). Haemoglobin estimation revealed anaemia in 53.3% cases. The 20 minute whole blood clotting time (WBCT20) was positive in 86.4% of vasculotoxic snakebites and negative in all neuro-paralytic bites. Leucocytosis was observed in 60% cases with relative neutrophilia in 63.3%, thrombocytopenia was observed in 8.3%, bleeding time was prolonged in 13.3% and clotting time was prolonged in 56.7%. Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites
Aim: Neonatal seizures are less likely to be idiopathic. Proper diagnosis of etiology can help in... more Aim: Neonatal seizures are less likely to be idiopathic. Proper diagnosis of etiology can help in prompt management. The study was done to diagnose the preventable causes early and develop strategies for the prevention of neonatal seizures. Materials and Methods: This prospective observational study was done among neonates who developed seizures before or during the stay in the Neonatal Intensive Care Unit (NICU), irrespective of gestational age and birth weight from June 2018 to May 2019. Results: In the study, 4.95% of the total admitted babies were with seizure out of which 66.2% were term. Most of the seizures were detected within 24 hours of birth (53.6%) in neonates of primigravida (62%) and who are delivered normally (74.7%). Present study showed subtle seizures-45.1%, multifocal clonic seizures -39.4%, focal clonic seizures-8.5% and tonic seizure-7% of cases (n =71). Birth asphyxia (49.5%) being the most common cause followed by sepsis (29.5%) and metabolic abnormalities (25.4%). Most of the patients required only phenobarbitone (80.28%), a few patients required more than one anticonvulsant. Conclusion: Neonatal seizures have an impact on cognitive, behavioural or epileptic complications later in life. The commonest cause of neonatal seizures is perinatal asphyxia.
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Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites
Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites