Online ISSN: 2515-8260

Keywords : Neonates


Feasibility of long saphenous vein cut down at sapheno-femoral junction for central venous access in neonates: A single centre experience of 3 years

Dr. Pramod S, Dr. Tejashwini K, Dr. Shanthi M, Dr. Dilip Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1785-1790

Background: Neonates pose a challenge in Neonatal intensive care unit (NICU) for central vascular access, which represents a daily practice. We have reported our experience with Central venous cut down through long saphenous vein (LSV) at sapheno-femoral junction (SF), its indications, feasibility and complications.
Objective: To assess the feasibility of insertion of central line by Sapheno-femoral (SF) cut down.
Methods: This is a retrospective study carried out in a Tertiary care hospital in a Metropolitan city of India. All the neonates who required Central venous access were included in the study.
Results: In our setting 176 neonates required LSV cut down for vascular access over a period of 3 years (2019-2022). The mean weight of the neonates was 1980 grams (range 680-4.1kg). The mean day at which the catheter was inserted was 7.1 days. Out of 176 neonates 8 neonates required vascular access for surgical condition and remaining 168 for medical condition. In 10 neonates the central line was inserted in operation theatre under general anesthesia. In the remaining 166 neonates the catheter was inserted in NICU under local anaesthesia. The mean time required for insertion of catheter was 14.2 minutes. The most common indications for Central line insertion included Sepsis, Respiratory distress syndrome, prematurity. The complications of CVL in our setting were central line induced sepsis followed by limb oedema.
Conclusion: Open surgical cut down of long Saphenous vein is feasible and a safe procedure, It can be performed as a bedside procedure without the need for General anaesthesia.

Cord blood albumin as a predictor of significant neonatal hyperbilirubinemia in normal term healthy newborn

Dr. Dharmagadda Sai Krishna, Dr. Hemant Gupta, Dr. Neelam Grover, Dr. Bharti Kawatra, Dr. Kiranjeet Kaur

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 18-24

Introduction: Hyperbilirubinemia is the most common morbidity in normal term healthy
newborn. There is evidence that cord blood albumin (CBA) level can act as a potential marker
for the prediction of hyperbilirubinemia in neonates. The present study was therefore designed
to establish a correlation between the level of cord blood albumin (CBA) and total serum
bilirubin (TSB) so that albumin level could be standardized as a prediction marker for the
neonatal hyperbilirubinemia.
Methods: CBA and TSB levels were analysed in 500 normal term healthy newborns with birth
weight ≥2500 grams and APGAR score ≥ 7/10 at 1 min and 5 mins, after obtaining consent
from their parents. Albumin levels were analysed from the cord blood at the time of birth and
TSB levels were analysed from venous blood. Pearson’s correlation coefficient was used to
analyse the correlation between CBA and TSB levels.
Results: The mean CBA was 2.94 ± 0.34 g/dl and mean TSB was 11.17 ± 2.52 mg/dl. The
relationship between CBA and TSB values was statistically significant on further analysis of
CBA with the modality of treatment, the results were again statistically significant. The
correlation between CBA and TSB was also observed with negative correlation of r = - 0.43
with p value of <0.0001 which was highly significant.
Conclusion: Newborns with high CBA levels have low risk of developing neonatal
hyperbilirubinemia and can be discharged early from hospital. Whereas low CBA is an
indicator for developing neonatal hyperbilirubinemia in the first week of life.

Early Detection of Inborn Errors of Metabolism among Neonates Admitted to Neonatal Intensive Care Unit

MervatAbdallahHesham, Shams Sami Abdo,Wesam A. Mokhtar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2789-2798

Background:Early diagnosis and treatment are very important to reduce the rates
of morbidity and mortality related to Inborn errors of metabolism .The present
study aimedto detect the inborn errors of metabolism early among neonates.This
was a cross sectional study was carried out at neonatal intensive care unit in
pediatric department at Zagazig university children hospital. This study involved
114 neonates who were subjected to full medical history, thorough clinical
examination and laboratory investigations which included Complete blood count,
Coagulation profile ,C-reactive protein ,procalcitonin, Liver and renal function
tests , Serum levels of electrolytes, Plasma ammonia and lactate, Urine organic acid
analysis, Extended metabolic screening, Blood gas and serum anion gab and Blood
glucose level. Results:About 53.5% of the studied groups were males and 46.5%
were females. As regards mode of delivery 74.6% were by CS and 25.4% by NVD.
Also, 30.7% had positive consanguinity, 12.3% had sibling death, and 3.5% have
similar condition. History of abortion was found in 22.8% and genetic disease was
in 2.6% of the studied group. The main clinical presentations among the studied
group were RD, Encephalopathy and hypotonia. Only 6.1% of the studied group
had positive culture metabolic acidosis was detected only in 9.6% of the studied
group. About 90.4% of the studied group was alive and 9.6% were died.
Conclusion: IEM disorders are not rare disease in high-risk neonates with
attentions to consanguinity which is a common tradition in our country. The
manifestations of metabolic disorders are common, and many physicians
misdiagnose them as they are unaware about these disorders.

Early Detection of Hearing Impairment in Neonates with Dual/Multiple TORC (Toxoplasma, Rubella, Cytomegalovirus) Infections

Risa Etika, Iin Fatimah, Nyilo Purnami, GadisMeinar Sari, Puspa Wardhani

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3238-3253

Background and objective:Hearing impairment is often associated with pregnancy
infections such as Toxoplasma, Rubella, Cytomegalovirus (TORC). The aimswere to
determine the prevalence of hearing impairment using Otoacoustic Emissions (OAE) and
analyze the associated risk factors in neonates with dual/multiple TORC infections.
Materials and Methods:This cross-sectionalstudy was conducted from
SeptemberuntilNovember 2019. Infants admitted in the intermediate room during the
period were included in the study and underwent OAE to evaluate the presence of hearing
impairment.Infants with OAE refer tested with TORC examination. Prevalence of hearing
impairment with dual/multiple TORC infections was calculated and the Odds Ratio for
specific risk factors was measured using Fisher’s exact test.
Results: Over the period, 50 babies were screened. Forty-three babies (86%) presented
normal hearing at OAE. Seven babies (14%) response OAE refer. Out of 7 infants, one
infant classified OAE refer had early discharged, the six of them undergo TORC
examination. Out of 6 infants, 5 of them represented dual/multiple TORC infections. By
univariant analysis,the most higher risk factor for hearing impairment and dual/multiple
TORC infection was the premature rupture of membrane OR 41; 95% CI 3,65 – 46,03.
Correlation between dual/multiple TORC infection and hearing impairment was
significant statistically, p=0.001, R = 0.826.

Evaluation of Inborn Errors of Metabolism in Neonates and Children

Mohamed R. Beshir; Ahmed Emam; Wesam A. Mokhtar; Esraa H. Elsayyad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2181-2188

Background: Inborn errors of metabolism (IEMs) make up a large group of rare
disorders caused by an inherited deficiency or absence of proteins that have
enzymatic, carrier, receptor, or structural roles. This study is aimed to early
detection, diagnosis, and intervention to improve outcome.
Patients and methods: This cross-sectional study was done in Pediatrics
Department, Zagazig University Hospitals. It included 65 cases with suspected
inborn errors of metabolism. All the studied cases were subjected to full history
taking, clinical examination and Laboratory investigations.
Results: The age of neonates, infant and children were 35 (54.6%), 22 (34.37%), 8
(10.93%) cases respectively, 34 cases were females and 30 males. The most common
complaint was poor suckling in 14 cases (21.8%) then lethargy as well as fever in 6
cases (9.37%). Disturbed consciousness and hepatosplenomegaly were present in 11
cases (17.18%). Metabolic disorders including metabolic acidosis (25%),
hypoglycemia (3.12%), raise lactate level (4.68%), hyperammonemia (14) and
presence of ketonuria in (4.68%) of cases, respectively. The different disease types
of the studied cases after routine and specific laboratory finding, our results showed
that, 18 cases Suspected IEM (not diagnosed), 11 cases Diagnosed metabolic (non
PKU), 36 cases Diagnosed Phenylketonuria (PKU).
Conclusion: Early diagnosis of inborn errors of metabolism (IEMs) during
neonatal period or infancy for starting its proper treatment will improve outcomes,
control complications of metabolic diseases and decrease the mortality rates.

Evaluation of Pneumothorax in Neonates in Al Immamian Alkadhomain Medical City

Abbas Jaafar Khaleel Al-Anbari; Dr. Jawad Kkadhum Abid

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 214-219

Introduction: Pneumothorax occur most during neonatal age than other age of life in
human being, this more related to high morbidity and death rate. It started form damage
to alveoli that more distended. The air seepages lengthways of the perivascular sheath of
connective tissue inside to the pleural space, The aim of our study is to assessment of
prevalence, recognize the danger factors and to define the clinical features, treatment and
consequence of neonates that have pneumothorax and determine the fate of neonates
after treatments.
Method: Prospectively collected data from newborn infants with pneumothorax observed
and treated at the Neonatal Intensive Care Unit (NICU) in al immamian alkadhomain
medical city, Sociodemographic data of neonates, clinical features of pneumothorax and
treatment of pneumothorax. Finally, assessment the fate of neonate assessed.
Results: A cross section descriptive study on 41 neonates mean age (34.6 ± 3) weeks
most age group 31 – 40 weeks 85% and weight (2 ± 0.7) kg most neonates (49%) with
2.1 – 3 kg, 34% females and 66% males, 61% of neonates are single parity, 71% of
neonates not need to antenatal steroid, while 56% of neonates delivered by CS, 71% of
neonates with Apgar score less than 7 in first 1 min., Significant association between
sociodemographic variables and clinical features as show in table 4; 52% of right
pneumothorax occur in male, 88% of left pneumothorax occur in male and 100% of
bilateral pneumothorax occur in male. 57% of RDS occur females while 43% of RDS in
male. 100% of TTN occur in single parity. 67% of pneumonia occur at age group 21- 30
week. Significant association between sociodemographic variables and treatment and fate
as show in table 5; 56% of neonate’s need C-pap were females and 44% were males.
56% of neonates need O2 therapy with weight 2.1-3kg, 26% of them that need O2 therapy
with weight 1-2 kg. 55% of alive neonates are males and 45% are females, 72% of single
parity neonates still alive.
Conclusion: Pneumothorax is moderately common in the NICU. The fate of neonates are
71% still alive and 29% dead. Pneumothorax itself was not a factor of death, probably due
to the sufficient and rapid therapy used in the NICU.

Neonatal Danger Signs: Knowledge Inmothers Of Children Aged Less Than 1 Year In Uae.

Raagapriya Madhan Kumar; Dr. Koushik. M; Dr.B. Charumathi; Dr.Timsi Jain

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 3451-3459

Introduction:The neonatal period comprising the first 4 weeks (28 days) of a child's life after birth is critical and dangerous events might occur. Structural, functional changes occur rapidly in this period. It is very important for mothers to be aware of the danger signs in neonates during this period. This study was done to find the prevalence of knowledge and awareness of danger signs among mothers of children aged less than 1 year.
Methods: A Community based cross-sectional study was carried out in United Arab Emirates from June 2020 to August 2020. Simple random sampling method was used and the sample size was calculated as 150. Mothers of children aged below 1 year were included in the study. A semi-structured pre-tested questionnaire was used in this study for interview purposes. Informed oral consent in common languages- English, Hindi, Tamil, Telugu, and Malayalam was obtained.
Results: The prevalence of good knowledge of danger signs among mothers of children aged less than 1 year in this study was found out to be 28.6%. 91.2% of the mothers have reported having sought medical care when any of the mentioned Danger signs occurred whereas 8.7% of them had opted to treat at home.
Conclusion:In spite of extensive coverage of maternal and child health services, the knowledge and awareness of the danger signs in neonates are fairly low in the mothers. Therefore more awareness and health education campaigns need to be implemented.

Prevalence and Risk Factors of Congenital Anomalies among the sick neonates of the Ladakh region of India

Mohd Murtaza; MdNiamat Ali; MahrukhHameed Zargar; Oliyath Ali

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1083-1092

Congenital anomalies are the structural and functional irregularities at birth. In this progressive study, all the neonates who are admitted to the Neonatal Intensive Care Unit during the three year period from 1st June 2017 to 31 May 2020.
Aim: The study aims to examine the prevalence, type, and epidemiological factors of congenital anomalies among the population of Ladakh India.
Subject and methods: All the neonates during the study period were examined by pediatrics and questionnaire filled by the consent of the family. A total of 936 parents of neonates was agreed to participate in this study and among them, 524 are male neonate and 412 was female.
Results: Four and a half percent were diagnosed as being congenital malformed and the common system affected by congenital anomalies in the digestive system followed by the mucso-skeletal system. In this study, based on the logistic regression consanguineous marriage with OR of 9.862 (4.221; 23.041), P= <0.001, familial congenital anomalies in the family with OR of 17.008 (4.343; 66.606), P=0.001, an anaemic mother with OR of .124 (.029; .538). P = .005, Apgar score with .033 (.016: .067), P-value of <0.001 and paternal smoking with OR of 13.305 (5.558: 31.854) with P value of <0.001 had shown a very good significant correlation with the congenital anomalies.
Conclusion: The occurrence and distribution of congenital anomalies in Ladakh were reported. More active prenatal screening and the possible role of genomics study are major importance to uncovering the susceptibilities.