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Biomedical subjects

A Narang

Publications and source records attributed to A Narang.

At least 55 records · Page 3Linked to original sources
PubMed1998

Respiratory rates of Indian infants under 2 months of age.

There are few data from developing countries, including India, on the normal range of the respiratory rate (RR) recorded by observation. To determine the normal range of RR in infants up to 8 weeks of age and to define tachypnoea, we studied 100 healthy infants, 50 of normal birthweight and 50 of low birthweight) at 1, 2, 4, 6 and 8 weeks of age. The RR was recorded by observation and auscultation simultaneously for 60 seconds on each visit when the baby was either asleep or awake and content. The median RRs ranged between 42 and 43 breaths/min in infants of normal birthweight and 40 and 44 breaths/min. in low birthweight infants. Inter-age variability up to 8 weeks of age was very slight and statistically insignificant. Only 2-10% of the infants at any given age had a RR > or = 60/min. At all ages, RR by observation was higher than that by auscultation (p < 0.001). Neither birthweight nor gender significantly influenced the RR. When awake, infants had significantly higher RRs than when asleep. The RR extrapolated from a 15-second breath count was significantly lower (p < 0.05-0.01), whereas results from 30-second counts were similar to 60-second counts. Our data endorse the use of a RR > or = 60 breaths/min. counted for 1 minute as a cut-off to define tachypnoea in infants < 2 months of age.

Auscultation↗
PubMed1998

Epidemiology of systemic candidiasis in a tertiary care neonatal unit.

143 neonates were diagnosed to have acquired systemic candidiasis out of a total 4530 admissions (3.2 per cent) to the neonatal intensive care unit (NICU) during a period of 6 1/2 years from January 1990 to June 1996. Mean age at onset was 10.4 days, mean birth weight 1454 g, and mean gestation was 31.7 weeks. Ninety-four per cent were premature, 95 per cent low birth weight (LBW), and all had undergone peripheral vein catheterization and had received broad spectrum antibiotics, except one, prior to the diagnosis. Fifty-eight per cent were ventilated and 15 per cent received parenteral nutrition. Persistent/recurrent pneumonia, apnoea, lethargy, high gastric aspirates, and abdominal distension were the common clinical manifestations. Candida tropicalis, C. albicans, and C. guillermondii were the most common isolates. Blood and urine were the predominant sites for isolation of Candida. Fluconazole was the most used antifungal agent, with 24 per cent resistance against it. Fifty per cent of babies died due to all causes. Of all the deaths, two-thirds were Candida related. Candida-attributable deaths occurred in 24 cases (17 per cent).

Age of Onset↗
PubMed1998

Effect of maternal low dose aspirin on neonatal platelet function.

OBJECTIVE: To evaluate the effect of maternal low dose aspirin ingestion in platelet function of newborn. DESIGN: Prospective randomized placebo controlled study. METHODS: 25 neonates born to mothers receiving low dose aspirin and 25 matched neonates with no maternal exposure to aspirin were studied. 2 ml of EDTA and 4.5 ml of citrate blood was collected from umbilical vein using double clamped umbilical stump for hemogram, coagulation profile and platelet functions. RESULTS: The platelet counts (10(9)/l) of study and control groups were 186.4 +/- 22.76 (116-225) and 205.28 +/- 17.34 (176-225), respectively. There was no significant difference in coagulation parameters. Prothrombin time index (PTI) was 86.24 +/- 6.623 and 87 +/- 6.43, respectively in the study and control group while PTTK (sec) was 55.88 +/- 20.54 and 52.12 +/- 11.82 in study and control subjects, respectively. The platelet aggregation studies (platelet function) with various platelet agonists in study and control group did not show any significant difference. Clinically, none of the babies had bleeding. CONCLUSIONS: Use of low dose aspirin in pregnant women was found to be safe and had no adverse effects on platelet functions of newborn.

Aspirin↗
PubMed1998

Role of early postnatal dexamethasone in respiratory distress syndrome.

OBJECTIVE: To study the effect of early postnatal dexamethasone therapy on severity of hyaline membrane disease. DESIGN: Prospective, randomized, controlled, unblinded study. SETTING: Neonatal Intensive Care Unit. METHODS: 19 babies who had hyaline membrane disease were included in this study. The inclusion criteria were clinical and radiographic diagnosis of RDS, requiring mechanical ventilation and FiO2 > 0.3. Ten babies received injection dexamethasone 0.5 mg/kg/dose 12 hourly for 3 days starting within 6 hours of birth. The control group did not receive any drug. Babies with active infection, bleeding tendency and congenital malformation were excluded. None of the babies received surfactant. The duration of ventilation and AaDO2 and FiO2 requirements from day one to five were calculated. RESULTS: The initial AaDO2 were similar in both the groups but on day 3, 4, 5 AaDO2 were low in study group (201, 85, 70) compared to control group (236, 209, 162). The initial FiO2 were 0.66 and 0.63 in dexamethasone and control groups, respectively and remained high till day 2 and came down in study group on days 3, 4 and 5 (0.41, 0.27, 0.27) compared to control group (0.53, 0.34, 0.42). The mean duration of ventilation was shorter in dexamethasone group (87 hours) vs control group (120 hours). CONCLUSION: Early use of postnatal dexamethasone reduces the disease severity and oxygen requirement in RDS and hence would be useful in the Indian context.

Anti-Inflammatory Agents↗
PubMed1997

Evolution of neonatal and pediatric critical care in India.

During the last decade, the disciplines of neonatal and pediatric critical care have rapidly progressed in India. The growth of Neonatal Intensive Care has paced the growth of Pediatric Critical Care. The substantial growth of discipline and the positive improvements in neonatal outcomes are the results of the concerted efforts of the National Neonatal Forum and commitment of expatriate physicians residing in the United States. This article provides the background information regarding perinatal, neonatal, and infant mortalities in India. It also describes the maternal child health care delivery system in the Indian subcontinent.

Child↗
PubMed1997

Simplified assessment of asphyxia at birth.

A simplified clinical method of assessment of the baby soon after birth was evaluated and compared with the cord blood pH and 1 min Apgar score. The assessment recorded cry, respiration, colour, activity, reflex response, and cord pulsation. Sixty-two neonates born at term by normal vaginal delivery with 1 min Apgar score of 0-6 (n = 31) and 7-10 (n = 31) were studied. Linear correlation coefficient (r) and Goodman's correlation coefficient (gamma) were used for statistical comparison. A combination of cry, colour and activity showed the best correlation with cord blood pH (r = 0.3842, P < 0.01: gamma = 0.7138) and 1 min Apgar score (r = 0.7768, P < 0.01, gamma = 0.9393) and was as useful as the combination of all the six clinical parameters. Illiterate traditional birth attendants can be safely taught to use cry, colour, and activity for assessing baby's condition at birth.

Apgar Score↗
PubMed1997

Anaerobes in neonatal septicaemia: a cause for concern.

The purpose of this study was to determine the prevalence and vertical transmission of anaerobic infection in early onset neonatal septicaemia in babies born to mothers with adverse perinatal factors. One-hundred neonates born to mothers with one or more adverse perinatal factors were prospectively studied. Aerobic and anaerobic blood cultures were drawn in addition to rapid diagnostic tests. High vaginal swabs were also taken from all mothers prior to delivery. Anaerobic Clostridium species infection was found in 5 per cent babies and all of them were symptomatic. Fifteen babies had aerobic infection. There was one baby with concomitant aerobic and anaerobic infection. There was no significant difference in sex distribution, birth weight, or gestational age between babies with aerobic and anaerobic infection. Similarly, there were no symptoms unique to anaerobic infection. None of the rapid diagnostic tests had a good sensitivity for anaerobic infection. Fifty-two per cent of the mothers had anaerobic growth in their vaginal swabs, but none had transmitted to their babies. All five babies recovered within 24-72 h of commencing therapy. This study shows that anaerobes have a role in early onset neonatal septicaemia. They cause serious morbidity, but carry a good prognosis. For identification of such infection blood culture is mandatory.

Bacteria, Anaerobic↗
PubMed1997

Photooxidant injury to glucose-6-phosphate dehydrogenase-deficient erythrocytes with bilirubin as the sensitizer--an in vitro study.

To evaluate the hypothesis that glucose-6-phosphate dehydrogenase (G6PD)-deficient erythrocytes are more prone to photooxidant injury with bilirubin as the sensitizer, we compared the malonyl dialdehyde (MDA) levels and haematocrit values in 11 G6PD-deficient samples with a bilirubin: albumin molar ratio of 1:2 (10 mg% bilirubin, 2.5 g % albumin) photoexposed at 6 microW cm-2 nm-2 (420-460 nm), with 11 of control samples. Twelve hours after photoexposure the incremental changes in MDA levels (OD units) were higher in G6PD-deficient samples [mean (SE) = 0.230 (0.171) vs 0.075 (0.043), p < 0.01]. Antioxidant drugs may have a protective role while G6PD-deficient neonates undergo phototherapy.

Bilirubin↗
PubMed1997

Etiology of sporadic acute and fulminant non-A, non-B viral hepatitis in north India.

BACKGROUND: Viral hepatitis is a major public health problem in India. AIM: To investigate the association of various hepatitis viruses in patients with acute liver diseases in north India. METHODS: One hundred and thirteen patients with acute viral hepatitis (AVH; n = 70) or fulminant hepatic failure (FHF; N = 43) were evaluated for the presence of hepatitis A, B, C and E virus infection. Hepatitis C virus (HCV) testing was done using second-generation anti-HCV ELISA test and reverse transcriptase polymerase chain reaction (PCR) for the detection of HCV RNA in the serum of patients with non-A, non-B (NANB) hepatitis. Detection of IgM anti-HEV antibody was done in patients found negative for the above viruses (n = 53). RESULTS: Hepatitis A and B viruses accounted for 3.5% and 42.5% of the 113 cases, respectively. HCV infection accounted for 12% of the NANB cases with AVH and 15.5% with FHF. PCR was more useful than serological tests for the detection of HCV infection. HEV infection accounted for 49% of the NANB, non-C cases with AVH and 25% with FHF; pregnant women with HEV infection had a fulminant course. No etiological agent could be established in 28.3% of cases. CONCLUSION: HEV is the most important cause of NANB hepatitis; hepatitis B virus is still a major concern, while HCV is not an important cause of acute viral liver disease in India.

Acute Disease↗
PubMed1997

Apnea in neonates.

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Aminophylline↗
PubMed1996

Kinetics of theophylline in apnea of prematurity in small for gestational age babies.

OBJECTIVES: To study the pharmacokinetics of theophylline and its correlations to pharmacodynamic effects in apnea of prematurity in small for gestational age babies. DESIGN: Prospective case control study. SETTING: Level III Neonatal Intensive Care Unit. SUBJECTS: Ten small for gestational age (SGA) babies and 10 gestation matched appropriate for gestational age (AGA) babies with recurrent apnea of prematurity. METHODS: All babies were investigated to exclude secondary causes of apnea. 5 mg/kg of aminophylline loading dose followed by 2 mg/kg as maintenance dose every 8 hourly intravenously was used. The trough and peak levels of theophylline were assessed on different days of therapy. Clinical monitoring was done for the efficacy and toxicity of the drug. Analysis was done using unpaired Student's 't' test and the correlation between plasma theophylline levels of different days was performed by using ANOVA. RESULTS: The therapeutic drug levels were achieved within 24 hours in all babies. The SGA babies showed 25% higher drug levels as compared to AGA babies. The mean trough plasma theophylline levels ranged from 8.15 +/- 1.59 to 12.37 +/- 1.54 micrograms/ml in SGA babies while in AGA babies they ranged from 6.26 +/- 1.93 to 9.96 +/- 1.96 micrograms/ml in first 8 days of therapy. The mean peak levels in SGA babies ranged from 11.91 +/- 1.84 to 17.13 +/- 1.63 micrograms/ml and in AGA babies ranged from 8.17 +/- 1.84 to 13.02 +/- 1.48 micrograms/ml. Twenty per cent SGA and AGA babies each developed clinical toxicity though toxic drug levels were found in 50% SGA and 30% AGA babies. CONCLUSION: There is a need to modify dosage schedule for these babies.

Aminophylline↗