Global journal of pediatrics & neonatal care最新文献

{"title":"Clinical Profile and Outcome of Meconium-Stained Babies Managed in a Tertiary Care Hospital","authors":"R. Rashid","doi":"10.33552/GJPNC.2021.03.000566","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000566","url":null,"abstract":"Objectives: This study evaluates clinicopathological features and the outcome of meconium-stained babies managed in the special care baby unit of Dhaka Medical College Hospital (DMCH), a tertiary care hospital in Bangladesh. Methods: This observational study was performed in DMCH from 1st March to 31st October 2011. One hundred two neonates with meconiumstained amniotic fluid (MSAF) at birth were selected purposively. Information about the duration of labour, mode of delivery, maternal illness, and maternal medication during pregnancy were recorded. Any other complications like obstructed labour, history of premature rupture of membrane (PROM), history of less fetal movement, history of birth asphyxia were taken from parents and available medical records. Babies’ clinical conditions were assessed with APGAR score, birth weight, gestational age, signs of asphyxia, respiratory difficulties, convulsion, reflex activity and requirement of resuscitation, percentage of oxygen saturation, capillary blood glucose (CBG). Other related investigations were also recorded. The outcome of these babies was observed and recorded. Statistical analysis (Chi-square tests) was performed on the recorded data using SPSS (version 24) to identify the association between meconium staining and different clinical features of the newborn. Results: Among the 102 neonates, we found 39 (38.2%) cases of only meconium staining, 56 (54.9%) cases of staining with ingestion, and 7 (6.9%) cases of staining with aspiration. Only meconium-stained cases were relatively well alert with normal vital parameters. Other cases of ingestion and aspiration developed complications, such as birth asphyxia, aspiration pneumonia, meconium aspiration syndrome and hypoxicischemic encephalopathy, septicemia. 7.84% of the studied 102 cases died, who were mainly from the aspiration group. Conclusion: This study found that meconium-stained babies’ prominent clinical features are breathing difficulties, hypoxic-ischemic encephalopathy, features of sepsis, features of pneumonia, and meconium gastritis. Hospitalization was needed in 97.06% of cases, and 7.8% of cases died due to associated complications.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43177409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspergillus Calidoustus Endocarditis in a Child after Cardiac Surgery: Case Report","authors":"L. Broughton","doi":"10.33552/GJPNC.2021.03.000565","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000565","url":null,"abstract":"We report a case of a 14-year-old male with Aspergillus calidoustus endocarditis occurring in an expanded polytetrafluoroethylene conduit for Tetralogy of Fallot. Aspergillus calidoustus is a concerning newly described species that is often resistant to voriconazole. Our patient was optimally treated by using antifungal therapy active against the fungus and surgical resection of the infected tissue.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42932078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Abdominal Pain Caused by Sorbitol Malabsorption","authors":"Cátia Granja","doi":"10.33552/GJPNC.2021.03.000564","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000564","url":null,"abstract":"Sorbitol is a carbohydrate, a monosaccharide polyalcohol, naturally present in fruits and juices. It is also widely used as a “sugar-free” substitute sweetener in the food industry, especially in sweets, chewing gum and diet products [1,2]. The incidence of sorbitol intolerance in the general population is estimated at 8 to 12% and are frequently combined with adverse food reactions, food allergies, and irritable bowel syndrome (IBS). Sorbitol undergoes only slight intestinal resorption by passive diffusion and absorption is dose and concentration related. Sorbitol can be transformed into fructose within the intestine, blocking GLUT-5 transporter, so the symptoms are the same as those of fructose malabsorption [2,3]. This results in the typical cardinal symptoms of postprandial flatulence, nausea, meteorism, diarrhea, and nonspecific abdominal pain [4]. Sorbitol H2 breath test is effective in detecting small bowel damage with a relevant reduction of absorption surface. In carbohydrate malabsorption false positive tests for small intestinal bacterial overgrowth may occur due to colonic fermentation and production of gas. In gastrointestinal motor disorders, delayed gastric emptying may cause false negative tests, and rapid transit through small bowel may result in false positive breath tests, false positive results may also occur if the subject does not adhere to a low fiber diet the day before the test [5].","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47184247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Audit of Specialized Newborn Care Unit’s (SNCU) Performance at a Taluk Hospital in India","authors":"D. Hegde","doi":"10.33552/GJPNC.2021.03.000563","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000563","url":null,"abstract":"Objective: To report the performance of specialized newborn care unit (SNCU) at a Taluk hospital and its impact on the trends in neonatal mortality rate (NMR) over one calendar year. Existing publications on NMR are from tertiary centers that may not reflect ground realities at semi-rural and district hospitals. Design: Retrospective comparative clinical study with a closed audit loop (i.e. level of evidence [LoE] III) comparing the NMR before inception of SNCU (Group I) vs. since establishing SNCU (Group II) was undertaken. Setting: Review of all live births and neonatal deaths at SNCU of a Taluk hospital of Uttara Kannada district in Karnataka state, India. Patients: The parturition and death registers of all deliveries over two calendar years immediately preceding the establishment of SNCU (Group I) and since its inception and regular functioning (Group II) were reviewed and details pertaining to the sex of the neonate, mode of delivery, birth weight, pre-term vs. full-term, reason for admission to SNCU, cause of death (where applicable) were collected against a standardized proforma which formed the study cohort. Interventions: The clinical services provided to neonates by SNCU and its impact on neonatal mortality rate (NMR) was studied. Outcomes: NMR was the key outcome studied in reporting SNCU’s performance. Results: There was a two-fold reduction in NMR in Group II and SNCU was instrumental in reducing the NMR from 6.4/1000 live births (Group I) to 3.03 (Group II). There was also a significant reduction in NMR of babies born out of caesarean sections (p=0.04). Conclusion: The SNCU was pivotal in providing round the clock clinical care that was associated with reduction in NMR and timely referrals to tertiary centers in realizing the national rural health mission’s(NRHM) millennium developmental goals (MDG) towards improving maternal and child health.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42697294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Kaiser Model-Based Disaster Vulnerability Analysis in Pediatric Clinics of Tertiary General Hospitals","authors":"Yu-lian Zhang","doi":"10.33552/GJPNC.2021.03.000562","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000562","url":null,"abstract":"Objective: To find out the risk events of pediatric outpatients by carrying out disaster vulnerability analysis, improve the emergency management and disposal capabilities of pediatric outpatients, and effectively avoid and deal with disaster risk events. Methods: The Delphi method was used to screen for risk events, and the Kaiser model was used to design a personalized questionnaire to analyze the vulnerability of pediatric outpatient services. Results: Through analysis, sorted out the top ten types of risk events, drug safety hazards (42.57%), patient identification error events (40.43%), patient falls / falls (39.93%), and violent medical disputes (38.84%), fire (38.37%), emergency life support system failure (38.08%), information system failure (35.14%), infectious disease epidemic (33.72%), medical gas failure (32.33%), air-conditioning failure (29.36%). Conclusion: Disaster vulnerability analysis can more realistically reflect the key and difficult issues of emergency management of pediatric outpatients, provide objective evidence for pediatric outpatient emergency management planning, and improve the risk management of departments.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49108677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Surgical Smoke in COVID Pandemic. Known and Unknown Facts","authors":"Pradyumna Pan","doi":"10.33552/GJPNC.2021.03.000561","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000561","url":null,"abstract":"In a short period, the corona crisis has reached gigantic proportions. There is an orchestrated interruption in the normal operation of the hospital to redirect the resources available for crisis management. COVID-19, the 2020 pandemic of the novel coronavirus, has raised questions about the possibility of transmission of viruses to operating room workers. This refers not only to the intubation and extubating of the airway during anesthesia, but also to the release into the smoke or plume of possible infectious particles. Owing to the uncertain prevalence of asymptomatic COVID-19 carriers, conducting surgeries during this pandemic poses risks to the surgical team in the absence of widespread monitoring. Aerosol development during the activity of these tissues, given the highly contagious transmissibility.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47618703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation Training: An Original Pedagogical Tool to Reduce Maternal and Neonatal Mortality in Africa","authors":"Ndour Daouda","doi":"10.33552/GJPNC.2021.03.000560","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000560","url":null,"abstract":"The proportion of neonatal deaths among children under age 5 is still relatively low in sub-Saharan Africa (36%), which remains the region with the highest under-five mortality rate in the world. In Europe and North America, where under-five mortality rates are among the lowest of the regions targeted in the sustainable development goals, 54% of all under-five deaths occur in the neonatal period. An exception is South Asia, where the proportion of neonatal deaths is among the highest (62 percent) despite a relatively high under-five mortality rate [1].","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41756197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crigler - Najjar Syndrome Type 2: A Usual Presentation of a Rare Disease","authors":"H. Pathan","doi":"10.33552/GJPNC.2021.03.000559","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000559","url":null,"abstract":"Crigler - Najjar syndrome (CN) type 2 is caused by a partial defect in uridine diphosphate glucoronosyl transferase-1 (UGT1A1) activity. It is characterized by isolated clinical jaundice. A clinical diagnosis may be confirmed by a detailed history and a thorough clinical evaluation. It needs to be differentiated from Gilbert syndrome. The hallmark of this benign condition is abnormally high unconjugated hyperbilirubinemia and its prompt response to oral phenobarbital therapy with excellent prognosis. Needless investigations should be avoided. Enzyme and gene testing could increase financial constraints in benign disease. We report one such case. Background: Non-hemolytic unconjugated hyperbilirubinemia is a disorder of bilirubin conjugation, characterized by a nearly complete lack of UGT1A1 enzyme activity resulting in severe, even life-threatening symptoms (Crigler - Najjar syndrome type 1, CN type 1); or by partial enzyme activity and milder symptoms (Crigler - Najjar type 2,CN type 2 or Gilbert’s syndrome, GS). It is caused by mutation in the gene UGT1A1 located on the long arm (q) of chromosome 2 (2q37) [1,2]. Crigler - Najjar syndrome is a rare disease with only few 100 cases described in the literature. Its incidence is estimated to be 1 in 1,000,000 births. The more common inherited unconjugated hyperbilirubinemia, GS, affects approximately 3–7% of adult population [1,2]. Disorders that causes unconjugated hyperbilirubinemia can be either result of excessive bilirubin production (hemolysis), or decreased clearance of bilirubin (hepatic or intestinal), or may be combinations of both [1,2]. Unconjugated bilirubin (bond to albumin, water-insoluble), is rapidly and selectively taken up by hepatocytes, converted, to bilirubin glucuronide, conjugates (water-soluble) and ultimately secreted into bile. In affected individuals, bilirubin conjugation is inhibited, resulting in abnormally high levels of unconjugated bilirubin in the blood (hyperbilirubinemia) [1-3]. Case presentation: In this report, we present a girl with recurrent episodes of non-hemolytic hyperbilirubinemia with high unconjugated bilirubin levels that decreased after phenobarbital treatment.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46158476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"https://irispublishers.com/gjpnc/fulltext/creation-of-a-neonatal-thrombosis-center-and-its-use-to-successfully-treat-infants-with-severe-thromboses.ID.000557.php","authors":"N. V. Varghese","doi":"10.33552/gjpnc.2021.03.000558","DOIUrl":"https://doi.org/10.33552/gjpnc.2021.03.000558","url":null,"abstract":"","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41897648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creation of a Neonatal Thrombosis Center and its Use to Successfully Treat Infants with Severe Thromboses","authors":"Ashley Hinson","doi":"10.33552/GJPNC.2021.03.000557","DOIUrl":"https://doi.org/10.33552/GJPNC.2021.03.000557","url":null,"abstract":"Background: Clinically significant thrombosis, which can be life threatening, is a common problem in the neonatal period, affecting up to 6.8 per 1,000 neonatal intensive care admissions. These infants have increased risk for bleeding complications from anticoagulant therapy due to immature coagulation systems, concomitant infections, inflammation and coagulopathies, and CNS hemorrhage risk due to prematurity. Thus, care for these infants requires a specialized multidisciplinary team, composed of neonatologists and hematologists, along with pharmacy support. Objectives: We aim to describe the development of a neonatal thrombosis center at our institution, co-run by a neonatologist with expertise in neonatal hematology, and a pediatric hematologist. The utility of the center will be explored through the case review of four neonates with large, life threatening thromboses, successfully treated with systemic tissue plasminogen activator (TPA). We will also describe the development of a neonatal thrombosis database for studying risk factors and treatments for neonatal thrombosis. Methods: Protocols for evaluation and treatment of neonatal thromboses were prepared, based on literature review and best practices, and presented and approved by the institution’s pharmacy and therapeutics committee. Anticoagulation protocols including heparin, low molecular weight heparin, and systemic TPA were created electronically within our computerized order entry system. A protocol for consulting the neonatal thrombosis team was created and presented during grand rounds. All neonates with thromboses are followed by the neonatal thrombosis team as outpatients, with thrombophilia evaluations completed as necessary. Information regarding age, risk factors, diagnoses, treatments and outcomes are then compiled in a neonatal thrombosis database. Results: Four infants with life-threatening thromboses were successfully treated with systemic TPA using our neonatal thrombosis treatment center. These include a full-term infant with an occlusive thrombus in the main pulmonary artery, a full term infant with a mural thrombus in the heart, a full term infant with an occlusive thrombus in the aortic arch, and a 26-week premature infant with a large right atrial thrombus. Conclusion: Neonates, especially those in intensive care, are at increased risk for thromboses, which can be life-threatening. Treatment of neonates with significant thromboses requires a multidisciplinary approach. Creation of a neonatal-thrombosis team and treatment center can be used to effectively treat these patients and gather data about their care and outcomes. To our knowledge, this is one of the first dedicated neonatal thrombosis teams.","PeriodicalId":87261,"journal":{"name":"Global journal of pediatrics & neonatal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42923235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}