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Biomedical subjects

A Narang

Publications and source records attributed to A Narang.

At least 91 records · Page 5Linked to original sources
PubMed1994

Cortisol response in acute foetal distress.

Thirty neonates born after having acute intrapartum distress (study group) and 30 neonates matched for gestation, born without any clinical evidence of acute foetal distress (control group) were studied. Neonates with congenital malformation were excluded. Samples for cortisol estimation were taken from cord artery, cord vein at birth and from peripheral vein at 6 h of age. At birth maternal venous blood was also taken for cortisol estimation. Cortisol level was estimated by radioimmunoassay. Cord blood pH was measured immediately at birth in all neonates whereas base deficits were estimated in 20 neonates in the study group and 23 neonates in control group. Cortisol levels did not differ significantly in the groups with or without foetal distress. There was no significant correlation between cord blood pH and cord arterial cortisol levels. Significant positive correlation was found between cord arterial cortisol and maternal cortisol levels. We failed to find any significant cortisol response in acute foetal distress.

Acute Disease↗
PubMed1993

Mode of delivery in deep transverse arrest.

OBJECTIVES: To determine the trends in the mode of delivery in deep transverse arrest (DTA) over two decades and their impact on maternal morbidity and neonatal outcome. METHODS: Obstetric and neonatal records of women with DTA who delivered at Nehru Hospital, PGIMER, Chandigarh in the years 1970, 1980 and 1990 were analyzed. RESULTS: Although Kielland's forceps was used very frequently in 1970 (44.4%) it had disappeared by 1990 because of increased morbidity associated with it. Instead, use of vacuum extractor and cesarean section has increased over the years. Manual rotation forceps extraction was the most commonly used vaginal method of delivery over two decades (49.5%). Perinatal outcome was better with manual rotation forceps extraction or vacuum extraction as compared to Kielland's forceps. Cesarean section was associated with a high incidence of birth asphyxia (30%). CONCLUSIONS: Manual rotation forceps extraction and vacuum extraction are safe methods of delivery in DTA. Cesarean section as an alternative does not improve the perinatal outcome.

Cesarean Section↗
PubMed1993

Neonatal necrotizing enterocolitis an epidemiological study.

Necrotizing enterocolitis (NEC) was diagnosed in 77 infants among 2200 admissions to the NICU during the period January 1986 to September 1990. The incidence was 0.5% of all live births and 3.5% of NICU admissions. Majority (57.1%) had Stage I of the disease while 23.4% had Stage II and 19.5% had Stage III of the disease. The average birth weight of the babies was 1650 +/- 577 g and gestational age 33.3 +/- 2.6 weeks. Majority (53.2%) were very low birth weight (VLBW) babies. Incidence was significantly more (5.7% vs 0.25%, p < 0.001) in VLBW infants and in preterm infants of gestational age less than 32 weeks (5.2% vs 0.09%, p < 0.001). Multiple risk factors were present in these babies while 8 babies did not have any risk factor. Risk of developing NEC was significantly more if infants had any of these risk factor (p < 0.001). Incidence of severe birth asphyxia was more in Stage I cases (35.7% vs 10.3%, p < 0.05). The age at presentation was 4.9 +/- 4.8 days and majority (96%) presented during the first 14 days. The overall survival was 61% and was 70.5, 77.8 and 13.3% in Stages I, II and III, respectively. VLBW and preterm infants had a higher mortality.

Age Factors↗
PubMed1993

Cerebral palsy.

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Cerebral Palsy↗
PubMed1993

Neonatal necrotizing enterocolitis: a clinical study.

Necrotizing enterocolitis was found in 77 infants over a 5 year period. Diagnosis of NEC was established on 4.9 + 4.8 days in babies with birth weight of 1667 + 577 grams and the gestational age of 33.3 + 2.6 weeks. Definite disease occurred in 33 (42.9%) babies while there was strong suspicion in another 44 (57.1%) babies. Prefeed gastric residue (98.7%), abdominal distension (97.3%), lethargy (78.7%), hypotonia (60%) and jaundice (48%) were the main presenting features. However, blood in stools and abdominal wall erythema were found in 38.7% babies. About one third of infants had a positive blood culture. Pneumatosis intestinalis was present in 83.9% of babies and pneumoperitoneum was seen in 35.5% of neonates with NEC. Ileo-ceco-colic region was the commonest site of involvement. Overall survival was 61% and survival with Stage III was only 13%. Birth weight less than 1500 g, gestational age less than 32 weeks, erythema of the abdominal wall, intra-abdominal mass, portal venous gas in abdominal X-ray and Gram negative septicemia were associated with higher mortality.

Age of Onset↗
PubMed1993

Pendred's syndrome.

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Audiometry, Evoked Response↗
PubMed1993

Renal function in SFD and AFD preterm babies.

Maturation of neonatal glomerular function as evidenced by serum creatinine and creatinine clearance was assessed in 15 preterm small for dates infants (Group I) and compared with values obtained in 15 preterm appropriate for date babies (Group II), on 3rd, 7th and 14th postnatal days. The mean gestational ages were 34.2 and 32.5 weeks and birth weights 1436 +/- 302g and 1752 +/- 422 g, respectively. The mean serum creatinine values in Group I were 1.40 +/- 0.28, 1.18 +/- 0.22 and 0.92 +/- 0.11 mg/dl and for Group II, 1.22 +/- 0.22, 1.01 +/- 0.24 and 0.82 +/- 0.17 mg/dl on days 3, 7 and 14, respectively. Glomerular filtration rates as evidenced by creatinine clearance were 16.08 +/- 3.53, 21.25 +/- 4.79 and 36.96 +/- 6.44 ml/min/1.73 m2 for Group I as compared to 21.38 +/- 6.65, 35.96 +/- 11.47 and 57.61 +/- 21.61 ml/min/1.73 m2 for Group II on these days, showing statistically significant (p < 0.001) increase in renal function in both the groups from days 3 to 14. Even though the serum creatinine values in the two groups were comparable at identical postnatal ages, creatinine clearance was shown to be statistically less (p < 0.05 on day 3, p < 0.001 on day 7 and p < 0.01 on day 14, respectively) in Group I as compared to Group II, thereby implying slower renal maturation in small for dates preterm babies.

Creatinine↗
PubMed1993

Management of meconium stained amniotic fluid: a team approach.

Passage of meconium in utero is a serious neonatal disorder carrying high morbidity and mortality. Role of planned team approach with aggressive intrapartum suctioning and intensive neonatal management was studied to evaluate its impact on neonatal morbidity and mortality. Meconium Stained Amniotic Fluid (MSAF) was found amongst 7.4% of all deliveries and among these 238 (10.5%) babies developed meconium aspiration syndrome (MAS). Ninety five per cent babies with MSAF were born at > 36 weeks of gestation and 76% were more than 2.5 kg. Passage of thick and thin meconium was seen in 44 and 56% respectively. Passage of thick meconium was significantly associated with severe asphyxia and carried a bad prognosis with increased risk of development of meconium aspiration syndrome, hypoxic schemic encephalopathy, seizures and pulmonary air leak syndrome. Aggressive team approach was responsible for lowering the mortality to 7.7%.

Birth Weight↗