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Biomedical subjects

A Saili

Publications and source records attributed to A Saili.

At least 19 recordsLinked to original sources

Free oxygen radicals and immune profile in newborns with lung diseases.

Respiratory difficulties constitute the commonest cause of morbidity in new born infants and pulmonary pathology is the most frequent autopsy finding. Various components, such as free oxygen radicals, immunoglobulins, and compliment systems, play an important role in immunopathology and immune defence. The aim of the present study was to assess free oxygen radical markers in neonatal lung diseases, studying their relationship with immune profile and ascertaining their relevance as predictors of clinical outcome. Full term newborns with respiratory distress and X-ray proven lung disease formed the study group. Blood samples were assessed for lipid peroxide (LPO), superoxide dismutase (SOD), glutathione peroxidase (GPx), immunoglobulins IgM and G, CD4 and CD8 subpopulations of T-lymphocytes. Levels of free radical markers were significantly higher in the study group. The humoral immune response was seen in terms of raised IgM levels in the study group which were still within the normal range. The cellular immune response was demonstrated by a raised percentage of CD4 T-lymphocytes which in turn accentuated the CD4:CD8 ratio. Higher levels of reactive oxygen species (ROS) were associated with a prolonged duration of respiratory distress and oxygen dependence. Since the free radicals have emerged as the major final common pathway of tissue injury, free radical ablation offers substantial potential for treatment; but whether antioxidants, scavengers and other modalities would have a significant impact on clinical outcome, remains to be investigated.

Biomarkers↗

Immune status of full-term small-for-gestational age neonates in India.

The immune status of 25 full-term small-for-gestational age neonates was studied and compared with another 25 term appropriate-for-gestational age neonates, who served as controls. It was observed that the term SGA's had an altered immunological profile. The lymphocyte percentage was low. Cellular immunity as assessed by CD4 and CD8 subset of T-cells, and their ratio was deranged. IgG levels were lower in SGA neonates and showed a linear relation with birth weight. IgM and IgA levels were not affected in SGAs. Complement C3 levels were significantly lower in the SGA neonates. The SGAs are allegedly more prone to infections and this deranged immune status could be the underlying explanation for the predisposition.

CD4-CD8 Ratio↗

Phototherapy induced hypocalcemia.

Sixty neonates with hyperbilirubinemia were included in the study. There were 20 preterm (Group A) and 20 full term (Group B) neonates. Ten neonates from each group formed the control group. The study group neonates were managed with phototherapy while the control group neonates were not subjected to phototherapy. Serum calcium levels of the two groups were studied. Ninety per cent preterm neonates and seventy-five per cent full term neonates developed hypocalcemia after being subjected to phototherapy. There was a highly significant fall in the total as well as ionized calcium levels in the study group in contrast to the control group. It is recommended that neonates under phototherapy should be given supplemental calcium to prevent hypocalcemia.

Calcium↗

Reliability of capillary blood gas estimation in neonates.

In order to compare the reliability of capillary blood gases to the arterial blood gases, we studied fifty one neonates with moderate birth asphyxia. A significant difference (p less than 0.05) was found between the capillary and the arterial blood gas values with respect to blood pH, PCO2 PO2 and oxygen saturation. However, the levels of blood bicarbonate as assessed by the 2 samples were comparable. Capillary blood gas values are unsatisfactory indicators of the arterial blood gas values and may result in inappropriate management.

Asphyxia Neonatorum↗

Neonatal mortality patterns in an urban hospital.

Neonatal mortality rate is perhaps the most reliable indicator of the perinatal outcome. An assessment of perinatal outcome can be made through knowledge of causes of death. This study was carried out to evaluate the neonatal deaths in our hospital. Live births (n = 7309) and deaths (n = 328) during a 6 months period were retrospectively analyzed. These were grouped into non-preventable and potentially preventable causes of death. The single most important factor contributing to the mortality was respiratory distress (29.3%) followed by sepsis (24.4%) and birth asphyxia (16.2%). The non-preventable causes of mortality (e.g., lethal congenital malformations, extremely low birth weight) accounted for 10.4% of the total mortality. The idealized neonatal mortality rate was 4.6/1000 live births, while the salvageable death rate was 40.2/1000 live births. The mortality increased significantly if the birth weight fell below 2 kg. The salvageable deaths could perhaps be prevented through better antenatal and intranatal care, ventilatory support and prevention of sepsis.

Cause of Death↗

Stress associated gastric bleeding in newborn--role of ranitidine.

Stress associated gastric bleeding in sick neonates is an ominous sign and frequently heralds mortality. This study was aimed at evaluating the H2 receptor antagonist drug-ranitidine in the treatment of this bleeding. Thirty eight neonates with gastric hemorrhage were included in the study. Twenty neonates were given ranitidine while 18 acted as controls. Both groups were well matched with respect to various parameters. Gastric bleeding was controlled earlier in the ranitidine group in contrast to the control group. No untoward side effects were observed with the use of ranitidine. The use of this drug in stress associated gastric bleeding in neonates is recommended.

Humans↗

Acute renal failure in asphyxiated newborns.

The study was undertaken to evaluate the occurrence of renal failure following perinatal asphyxia in the newborns. Thirty newborns with severe birth asphyxia were included in the study along with 30 normal newborns who comprised the control group. Any neonate presenting with oliguria or blood urea more than 40 mg/dl or creatinine more than 1 mg/dl was subjected to a fluid and diuretic challenge. If oliguria or renal dysfunction persisted then the child was labelled as renal failure and these subjects were further investigated. It was observed that 43% of asphyxiated babies developed acute renal failure (ARF); 69.2% babies had oliguric renal failure. While no significant correlation could be seen between Apgar scores at 5 and 10 min and development of ARF, a significant relationship was seen between hypoxic-ischemic encephalopathy and ARF. Patients with oliguric ARF carried a poorer prognosis as compared to non-oliguric ARF.

Acute Kidney Injury↗

Renal dysfunction in septicemic newborns.

The study was undertaken to assess the association and incidence of acute renal failure (ARF) in septicemic neonates. Thirty neonates with septicemia formed the subject matter. Neonates with renal dysfunction were labelled as ARF patients after non responsiveness to a fluid and a diuretic challenge. Renal function tests were also evaluated. Nearly 15% neonates with septicemia developed ARF which was predominantly oliguric in type. The mortality rate in the septicemic neonates with ARF was significantly high. Further the mortality in neonates with oliguric ARF was significantly higher than those with non-oliguric ARF.

Acute Kidney Injury↗

Liver dysfunction in severe birth asphyxia.

A total of 46 full term, appropriate for gestational age neonates were included in this study. Out of this, 31 infants had suffered severe birth asphyxia, while 15 normal babies formed the control group. The liver function tests of the asphyxiated group was deranged in 64.52% babies. There was 60% mortality in asphyxiated babies with deranged liver function. The serum levels of transaminases (SGOT, SGPT) and alkaline phosphatase in non-survivors were significantly higher than those of survivors.

Asphyxia Neonatorum↗

Delayed cesarean section: neonatal outcome.

One hundred and twenty one consecutive cesarean sections producing single term, appropriate for gestational age neonates, out of which 85% were emergency cesareans, were included in this study. Fetal distress, nonprogress of labour, and cephalopelvic disproportion were major indications for surgery. The waiting period varied from less than 30 minutes to greater than 4 hours. More than 50% of neonates studied suffered from some problem. The morbidity increased significantly if cesarean section was delayed for more than two hours.

Cesarean Section↗

Role of cimetidine in prevention and treatment of stress induced gastric bleeding in neonates.

Gastric bleeding from stress ulcers in acutely sick infants frequently signals impending mortality. This study was carried out to evaluate the efficacy of cimetidine in preventing and treating stress ulcers in such neonates. One hundred babies were included in this study. Out of this, 32 babies were given prophylactic cimetidine and 68 neonates acted as controls. It was observed that the babies on prophylactic cimetidine fared better than controls. In the second part of study, 77 neonates with clinical evidence of hemorrhage were included, 43 were put on cimetidine and 34 acted as controls. It was observed that babies on cimetidine therapy showed a better response. The gastric bleeding stopped earlier, and more babies responded favourably to this therapy. Use of cimetidine in stress induced bleeding in high risk neonates is recommended.

Cimetidine↗