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  Citation statistics : Table of Contents
   2014| July-September  | Volume 3 | Issue 3  
    Online since September 8, 2014

 
 
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CASE REPORTS
Massive liver mass and parenteral nutrition extravasation secondary to umbilical venous catheter complications
Joanna Yeh, Jorge H Vargas, Laura J Wozniak, Jeffrey B Smith, M Ines Boechat, Marlin Touma
July-September 2014, 3(3):158-160
DOI:10.4103/2249-4847.140404  
Umbilical vein catheters (UVC) are widely used in neonatal medicine. Serious complications from UVC placement are uncommon but do exist, including infection, thrombosis, arrhythmias, and hemorrhage. Although rare, hepatic complications, in particular, have been associated with significant morbidity and mortality. Correct positioning of the catheter prior to starting infusion of hyperosmolar solutions and early recognition of UVC-related complications are crucial in minimizing iatrogenic injury. We report the case of a neonate who was found at 10 days of age to have large pleural and peritoneal effusions and a massive fluid collection in the liver due to malposition of a UVC.
  4 3,801 413
ORIGINAL ARTICLES
Cost and effectiveness analysis of Kangaroo mother care and conventional care method in low birth weight neonates in Tabriz 2010-2011
Reza Gholi Vahidi, Kamal Gholipour, Ali Jannati, Mohammad Bagher Hosseini, Javad Ghoddoosi-Nejad, Hajieh Bayan
July-September 2014, 3(3):148-152
DOI:10.4103/2249-4847.140401  
Objective: This study aimed to compare the cost and effectiveness of Kangaroo mother care (KMC) and conventional methods of care in low birth weight (LBW) neonates. Materials and Methods: A retrospective economic evaluation conducted in Al-Zahra Teaching Maternity Hospital of Tabriz, Iran by participating 45 LBW and preterm neonate in each therapeutic groups (90 neonates). Convenience sampling used to select participants from KMC and conventional care method (CCM) (incubator) groups in 2010-2011. Baseline characteristics, therapeutic interventions, resources utilization data and clinical events during the initial hospitalization and at 2-month follow-up were collected according a detailed case report forms. Data are described as mean (standard deviation) and no (percentage) and were compared with Student's t-test, χ2 and Fisher exact test between groups. P ≤ 0.05 were considered to be statistically significant. Data were analyzed using the SPSS-16 statistical package. Result: The mean birth weight (BW) of the patients in KMC group was 1240.89 (5.98) g and in CCM was 1133.78 (139.06) g, hence differences in BW was statistically significant ( P < 0.001). Greatest cause of problem in groups was icter and after that preterm birth and House Dust Mite (HDM) with icter were the most frequent problem between neonates. In 2 months follow-up period, 3.7% of infants cared with KMC and conventional methods died respectively ( P = 0.078). Daily weight gain was 12.28 g in KMC group and 9.65 g in conventional group ( P = 0.011). The mean cost of hospitalization per individual infant for KMC was 3539.47$, whereas for Conventional group was 2907.27$. Conclusion: KMC promoted weight gain in LBW infants better than conventional care. Although KMC's unit cost is a little higher than Conventional method, but comparing its positive outcomes on breastfeeding's and mortality it can be considered as cost effective method.
  4 5,207 524
Complications due to breastfeeding associated hypernatremic dehydration
Asif Ahmed, Javeed Iqbal, Ikhlas Ahmad, Bashir A Charoo, Qazi Iqbal Ahmad, Sheikh Mushtaq Ahmad
July-September 2014, 3(3):153-157
DOI:10.4103/2249-4847.140402  
Objective: The aim was to assess the incidence, presenting features, and complications of breastfeeding associated hypernatremic dehydration among hospitalized neonates. Materials and Methods: A retrospective study over a period of 18 months to identify term and near term (≥35 weeks of gestation) breastfed neonates, who were admitted with serum sodium concentration of ≥150 mEq/l and no apparent explanation for their hypernatremia other than inadequate breastmilk intake. Results: The incidence of breastfeeding associated hypernatremic dehydration among 2100 term and near term neonates was 1.38%. The median serum sodium at presentation was 164 mEq/l (range: 151-191 mEq/l). The mean weight loss in these patients was 10.16% ±6.6%. The reasons for seeking medical attention were refusal of feeds (72.41%), lethargy (68.96%), decreased urine output (44.82%), jaundice (27.58%) and fever (24.13%). Five patients (17.24%) had seizures and three (10.34%) had coagulopathy. Other complications included hypoglycemia, hypocalcemia, acute kidney injury (AKI) (37.93%) and intraventricular hemorrhage. The mean serum creatinine was 1.82 ± 2.5 mg/dl (range: 0.19-9.6). A statistically significant association was seen between serum sodium concentration at presentation and AKI. It was also found that those patients who had AKI had a higher weight loss and had presented later to the hospital than those without AKI. One patient died within 12 h of admission. This child had disseminated intravascular coagulopathy, AKI, and hypoglycemia. Conclusions: Breastfeeding associated hypernatremic dehydration is a serious condition with many serious complications and even results in death if detected late. Health care providers have increasing responsibilities of promoting proper breastfeeding techniques and taking measures for early diagnosis and treatment of this problem.
  4 5,373 614
IMAGES IN NEONATOLOGY
Rare neonatal dermatological emergency: Staphylococcal scalded skin syndrome (Ritter disease)
Mitul B Kalathia, Yogesh N Parikh, Dhara A Patel
July-September 2014, 3(3):174-175
DOI:10.4103/2249-4847.140413  
A sixteen days old newborn was admitted with exfoliating erythematous lesions over the trunk, face, back and extremities for two days. A diagnosis of Staphylococcal Scalded Skin Syndrome (SSSS) also known as Ritter disease was made clinically. The child responded to Injection amoxycillin-clavulinic acid (Augmentin) and topical fusidic acid. Lesions gradually resolved over 72 hours and child was discharged after ten days of hospitalization. SSSS represents a rare dermatology emergency in neonate which if untreated can be life threatening.
  2 4,325 353
LETTERS TO EDITOR
Neonatal septicemia caused by Salmonella paratyphi a in two nonbreast fed babies: Report from a rural teaching hospital in India
Baljeet Maini, Radhika Bansal, Gautam Madaan
July-September 2014, 3(3):180-180
DOI:10.4103/2249-4847.140422  
  2 1,743 173
CASE REPORTS
Transient severe isolated right ventricular hypertrophy in neonates
Hayrullah Alp, Zehra Karataş, Tamer Baysal
July-September 2014, 3(3):161-163
DOI:10.4103/2249-4847.140405  
Isolated right ventricular hypertrophy (RVH) is a rare form of hypertrophic cardiomyopathy and premature closure of the patent ductus arteriosus in utero is a probable etiologic factor. We reported transient isolated RVH in three neonates and ventricular hypertrophy resolved within 8-10 weeks period without any specific therapy in all cases.
  1 8,674 440
Rare location of mesenteric cystic lymphangioma in an infant
Minakshi Sham, Jyoti Kudrimoti
July-September 2014, 3(3):164-166
DOI:10.4103/2249-4847.140406  
A 2-month-old female infant presented with subacute intestinal obstruction of 1½ month duration. Investigations revealed a cystic intra-abdominal lesion. On exploration, a large multicystic mass was noted in the ileal mesentery with induration and inflammatory interbowel adhesions. It had resulted in bowel volvulus. It was completely excised along with the involved bowel. Histopathologic examination diagnosed the tumor to be a cystic lymphangioma. It is the youngest patient with mesenteric cystic lymphangioma ever reported in the literature.
  1 2,505 197
EBN SYNOPSIS - EVIDENCE-BASED NEONATOLOGY SYNOPSIS
Caffeine reduces intermittent hypoxia in preterm infants
Mohammed Jabr, Fahad Al Hazzani
July-September 2014, 3(3):140-142
DOI:10.4103/2249-4847.140394  
  1 2,064 316
ORIGINAL ARTICLES
Effect of gestational age, prematurity and birth asphyxia on platelet indices in neonates
Vidyavathi Kannar, A Deepthi, Malligere Lingaiah Harendra Kumar, Krishnappa Junjegowda, Narayanaswamy Mariyappa
July-September 2014, 3(3):144-147
DOI:10.4103/2249-4847.140399  
Context: Platelet indices are useful markers of platelet maturity and function and can be used for the early diagnosis of thromboembolic disorders. Prematurity, birth asphyxia (BA) and small for gestational age (SGA) babies have been associated with increased risk of hemostatic abnormalities. Aims: The aim was to study the platelet indices in prematuriy, SGA, and BA newborns. Settings and Design: The type of this study is Prospective study. Materials and Methods: Blood samples from 253 newborns were collected in K2EDTA (Becton Dickenson, USA) tubes within 24 h of birth. The following parameters were studied - platelet count, mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW). Data regarding the neonatal physiological status with respect to prematurity, gestational age and BA were collected. Statistical Analysis Used: The statistical analysis was performed on the entire sample used was mean, standard deviation and one-way ANOVA. P <0.05 was considered as significant. Results: The average platelet count in preterm, SGA, and BA newborn was significantly lower than the average platelet count in controls. MPV averaged 8.29 fL, 8.16 fL, and 8.35 fL in preterm, SGA and BA neonate, respectively and was significantly increased. PCT was 0.18% in preterm, SGA and in BA. Though, the difference was not statistically significant. PDW was significantly increased in preterm, SGA, and BA newborns when compared with controls. Conclusions: MPV, PDW was significantly increased in SGA, premature and BA newborns, which may be due to platelet activation. Platelet indices may provide to be a useful marker of thromboembolic status in newborns.
  1 3,397 563
CASE REPORTS
Unilateral labial mass in a neonate: A rare clinical presentation of focal dermal hypoplasia
Suresh Chandran, Anitha Madayi, Haroon Manadath Pillay
July-September 2014, 3(3):167-169
DOI:10.4103/2249-4847.140408  
A full-term female baby presented at birth with a swollen left labia and atrophic lesions affecting the sacrum and left buttocks. A diagnosis of focal dermal hypoplasia was made from the histopathology of the labial lesion. Patient presented at the age of 2 years with urinary incontinence and constipation and imaging of the neuro-spinal axis showed lipomyelomeningocele with tethered cord.
  - 11,764 316
Neonatal sepsis with atypical presentations
Javeed Iqbal Bhat, Iqbal Qazi, Asif Ahmed, Gowhar Nazir Mufti, Bashir A Charoo
July-September 2014, 3(3):170-171
DOI:10.4103/2249-4847.140409  
Sepsis in neonatal intensive care units throws formidable challenges in homoeostasis, be in metabolic, nutritional or hematological. Newborn sepsis results in considerable morbidity and mortality among neonates. Due to inability on part of the neonate to develop adequate inflammatory response to localize the infection they commonly develop disseminated systemic infection, pneumonia and/or meningitis. We have described 4 cases of neonatal sepsis with localization at unusual sites. Our first case presented as a Fournier's gangrene, an infective necrotizing fasciitis of the perineal, genital or perianal regions. We also present a very rare entity of acute digital gangrene in a newborn baby as a sole manifestation of neonatal septicemia.
  - 9,350 429
EBN SYNOPSIS - EVIDENCE-BASED NEONATOLOGY SYNOPSIS
Field's massage with oil decreases bilirubin levels in healthy fullterm newborns
Sameer Y Al-Abdi
July-September 2014, 3(3):142-143
DOI:10.4103/2249-4847.140396  
  - 3,819 533
Heated humidified high-flow nasal cannulae: A good alternative to nasal continuous positive airway pressure
Lena Ignacio, Khalid AlFaleh
July-September 2014, 3(3):139-140
DOI:10.4103/2249-4847.140390  
  - 1,570 335
IMAGES IN NEONATOLOGY
Aplasia cutis congenita type 6: A rare entity
Romal Kumar, Chandra Madhur Sharma, Deepti Sharma
July-September 2014, 3(3):172-173
DOI:10.4103/2249-4847.140412  
Aplasia cutis congenita is defined as congenital localized absence of skin. This absence of skin most commonly affects the scalp, but any location of the body surface can be affected. Most patients with aplasia cutis congenita have no other anomalies. Aplasia cutis involving trunk and extremities in association with Epidermolysis bullosa is extremely rare. We describe a neonate with this rare disease having multiple other anomalies.
  - 5,469 342
Alobar holoprosencephaly with synopthalmia and proboscis
Anurag Singh, Prashant Babaji, Shamsher Singh, Seshadri Sekar, Anjani Kumar, Vidit Gupta
July-September 2014, 3(3):176-177
DOI:10.4103/2249-4847.140415  
Anomalies during growth and development do occur. Cyclopia is an unusual anomaly in which the anterior brain and the midline mesodermal structures develop anomalously. Cyclopia is seen in severe form of holopresencephaly with abnormal position of nose. This case report presents with a rare case of synopthalmia with proboscis.
  - 9,922 368
LETTERS TO EDITOR
Using sugar mixed boiled rice water for feeding children in slum, Surin province, Thailand
Pailin Umpai, Wasana Kaewla, Viroj Wiwanitkit
July-September 2014, 3(3):178-178
DOI:10.4103/2249-4847.140419  
  - 1,289 101
Stool calprotectin and necrotizing enterocolitis
Viroj Wiwanitkit
July-September 2014, 3(3):179-179
DOI:10.4103/2249-4847.140421  
  - 1,094 126
REVIEW ARTICLE
Updating the management of preterm infants in the 1st min after birth
Maximo Vento, Antonio Nuñez, Elena Cubells
July-September 2014, 3(3):133-138
DOI:10.4103/2249-4847.140384  
Prematurity comprises a series of disadvantages that render adaptation to extra-uterine life extremely difficult. Among these, establishing an adult type of cardiorespiratory circulation including closing of the fetal shunts, resorption of the fluid, which fills the lungs and achieving functional residual capacity, to change to oxygen enriched milieu, and keeping an adequate body temperature are altogether challenges that without the aid of heavily skilled caregivers in the delivery room (DR) are practically insurmountable for the very preterm infant. In recent years, there is an unequivocal tendency toward gentle management of preterm babies in the DR to avoid long-term consequences. Caregivers' aim should be to achieve a satisfactory stabilization of the patient without causing harm to his/her feeble organs during the so-called first golden minutes. The last International Liaison Committee on Resuscitation Guidelines were published in 2010. Since then, new information has rendered available. The aim of this review is to provide the reader with updated information regarding newly performed interventions in the DR hoping that it will be useful for their everyday clinical practice.
  - 3,282 631
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