Congenital ocular malformations at birth.
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Biomedical subjects
Publications and source records attributed to B V Bhat.
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Three thousand seven hundred and two deliveries between January and December, 1990 were the study subjects. The perinatal mortality rate (PNMR), stillbirth rate (SBR) and early neonatal death rates (ENDR) were found to be 57/1000, 35.1/1000 and 22.7/1000, respectively. The preterms had much higher PNMR, SBR and ENDR as compared to term babies. Term babies weighing > or = 2500 g had a PNMR of 18/1000. In preterm and term babies the mortality was reduced considerably with increase in birth weight (BW). The unbooked deliveries had significantly higher PNMR, SBR and ENDR compared to booked deliveries. The fall in PNMR compared to observations of a decade ago was due to a fall primarily in ENDR, with SBR remaining unchanged signifying failure of existing MCH set up. Nearly, 92% of ENDR were in first 72 hours which signifies the need for developing and strengthening the intensive care facilities along with timely referral of high risk mothers.
Sixty final year MBBS students were trained in the art of neonatal resuscitation based on the 'NALS' course material. The students scored 11.6 +/- 3.02 in the pretest and 17.85 +/- 4.42 (out of 20) in the post-test. The trainees felt that the programme was extremely useful. Majority of them said that the course content was optimum with appropriate use of teaching-learning media. It is recommended that this training may be imparted to all the undergraduate students at the entry of final year MBBS course before their labor room posting so that they can have effective reinforcement of the training.
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A rare case of birth injury having intrauterine complete perineal tear is presented. Defunctioning sigmoid colostomy was undertaken because of bad perineal condition. The baby died of Pseudomonas septicemia on the 15th day before definitive surgical procedure could be undertaken.
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During a two-year period, the various factors associated with loose stools in the early neonatal period were studied among hospital born babies. Low birth weight babies had a lower incidence of non-infective loose stools when compared to neonates with a birth weight of more than 2500 g (p < 0.001). Newborns delivered by Cesarean section (p < 0.001) and those born to women with more than two children (p < 0.02) had a greater frequency of loose stools. Initiation of supplementary feeding and administration of antibiotics were important factors in causing loose stools. Bacterial etiology could be found only in 9.3% of newborns having loose stools. A later onset of loose stools was noted in those, whose stool culture grew bacterial organisms. Only nine newborns with loose stools required antibiotic therapy. Although loose stools were less common among low birth weight babies, they often required treatment with antimicrobials. None of them developed any complications. Since majority of them are non-bacterial and non-infective, great caution must be exercised before administering antibiotics to newborns with loose stools.
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Clinical profile of pyogenic meningitis was studied in 256 cases over a period of 8 years. The male to female ratio was 1.46: 1 and 83.6% of the patients were less than 3 years of age. Fever, altered sensorium, refusal to feed, convulsions and vomiting were the common presenting symptoms. Six (2.3%) of them had subnormal temperature and the sensorium was normal in 12.5% of cases. Cerebrospinal fluid was clear in 9.4%, cell count was less than 100/cmm in 8.2%, sugar was more than 40 mg% in 24.2% and protein was less than 50 mg% in 12.5% of cases. Diplococcus pneumoniae was the commonest causative agent. The overall mortality was 30.5%. It is concluded that young children suffering from this disease may not have the typical features and one should have the highest suspicion to make an early diagnosis so that the morbidity and mortality from this condition can be reduced.
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