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Biomedical subjects

N K Anand

Publications and source records attributed to N K Anand.

At least 37 records · Page 2Linked to original sources
PubMed1991

Role of bacteriological monitoring of the hospital environment and medical equipment in a neonatal intensive care unit.

The aim of this study was to evaluate the usefulness of performing routine monthly bacteriological surveillance of the nursery environment, resuscitation equipment, baby placement sites, medications, formula feeds, cleansing solutions and miscellaneous medical items such as intravenous cannulae in relation to development of hospital-acquired bacteraemia in a Neonatal Intensive Care Unit (NICU) over a period of 19 months. The study is based on a retrospective review of records from the neonatal division and the microbiology laboratory. On discriminant analysis, only three NICU sites, namely baby placements, resuscitation equipment and various cleansing solutions were found to be significantly associated with hospital-acquired infections (HAI) (P less than 0.001). The probability that a batch of newly admitted babies would develop HAI if all three sites were colonized was 0.602. Similarly, the probability if none of these sites was colonized was 0.10. On multiple logistic regression analysis, however, the relative risk of infection was greatest if baby placement sites were colonized (Odds ratio = 7.48; P less than 0.01). In contrast, pathogens present in the inanimate NICU environment, e.g. floors, walls, sink-drains or furniture were not associated with HAI. Routine bacteriological surveillance of the inanimate nursery environment, is not therefore justified. However, our results suggest that routine bacteriological monitoring of medical equipment and cleansing solutions may have a role in the prevention of HAI.

Bacterial Infections↗
PubMed1991

Hearing assessment by brainstem auditory evoked responses (BAER) in neonates at risk.

In the present study, brainstorm auditory evoked responses (BAER) were recorded in 68 at risk neonates discharged from the neonatal ICU of Safdarjung Hospital. The high risk group of 35 neonates included 13 neonates with multiple (3-4) risk factors and 22 neonates with single risk factors, viz., prematurity (less than 32 weeks) low birth weight (LBW) (less than 1500 g), hyperbilirubinemia requiring exchange transfusion, severe birth asphyxia, craniofacial malformations and sepsis with meningitis treated with amikacin for 3 weeks. The remaining 33 neonates were grouped in the low risk category who had only one of the following factors: prematurity (33-36 weeks)/LBW (1500-2000 g), hyperbilirubinemia requiring phototherapy, mild/moderate birth asphyxia, or sepsis treated with amikacin for 2 weeks. The test was performed at the mean conceptional age of 40.2 weeks (range 34-44 weeks) and involved determination of threshold of hearing as per presence of wave V. A normal response had wave V at 30 dB hearing level click stimulus at 50/sec from both ears or to 30 dB hearing level from one ear and 45 dB hearing level from the other ear. Thirteen neonates of the high risk group failed to produce a normal response (5 failed at 30 dB, 6 failed at 45 dB, and 2 failed at 75 dB hearing level). Forty six per cent of them had multiple high risk factors. All the low risk group neonates had normal threshold of 30 dB hearing level in the initial screening.(ABSTRACT TRUNCATED AT 250 WORDS)

Auditory Threshold↗
PubMed1991

Coagulase negative staphylococcal septicemia in newborns.

The case records of 2177 newborn infants admitted in the Neonatal Intensive Care Unit (NICU) from January, 1989, through July, 1990, with positive blood cultures for coagulase-negative staphylococci (C-NS) were evaluated. Seventy four (3.4%) neonates yielded C-NS in blood cultures during the study period. Of these, 58 (2.7%) infants had clinical and hematological features compatible with the diagnosis of septicemia. Remaining 16 babies with positive cultures had no evidence of sepsis, and were designated as "C-NS bacteremia". The age at which positive cultures were obtained differed between the bacteremic and septicemic groups. In bacteremic group, the onset occurred between one to four days of age. In contrast, in septicemic group the range was 6-20 days, with a mean of 10.22 (+/- 3.53) days. More than two third of total cases of C-NS sepsis were premature and low birth weight (LBW). Prominent clinical features included lethargy, poor feeding and fever. Besides this apneic spells were seen predominantly in babies weighing less than 1500 g. Further, before the diagnosis of C-NS sepsis, more than half of neonates had received prolonged intravenous fluid therapy, a quarter had undergone umbilical catheterization and a further quarter needed a ventilator support. Overall mortality in C-NS sepsis was 17.24%, distinctly higher in neonates with RDS and those requiring mechanical ventilation (p less than 0.05). Only 1.34% C-NS isolates were resistant to all routinely used antibiotics and sensitivity was maximum with newer cephalosporins, ciproflox and amikacin.

Bacteremia↗
PubMed1991

Auditory brainstem response in neonates with hypoxic-ischemic-encephalopathy following perinatal asphyxia.

The technique of auditory brainstem evoked responses testing (ABR) was applied to twenty four new born infants with asphyxia complicated by hypoxic-ischemic-encephalopathy (HIE) in an attempt to study potential influence of HIE on hearing impairment. Twenty normal term neonates with no apparent neurological disorder, were also examined for comparison. Twenty two per cent (n = 5) of the patients with HIE showed some abnormality in the ABR pattern, the major one being a transient elevation in threshold of wave V (n = 4; 16.6%). ABR abnormalities, however, were found with greater frequency in neonates with Stage II HIE (75% vs 10%, p less than 0.001). Further ABR abnormalities were found in Stage II HIE only when duration of neurological abnormalities was greater than 5 days. There was no difference, however, between the ABR latencies of the asphyxiated and non-asphyxiated newborn infants (p greater than 0.05). One neonate (4%) with severe HIE, however, had persistent ABR abnormality in the form of bilateral absence of all waves in the later part of the ABR with preservation of wave I. This implied only cochlear functions and absence of any brainstem conduction. These results indicate that birth asphyxia complicated by HIE is a significant high risk factor for hearing impairment in the affected neonates. This justifies ABR testing of neonates with HIE (particularly Stage III), at the time of their discharge, as a screening procedure for early detection of permanent hearing loss.

Asphyxia Neonatorum↗
PubMed1991

Congenital syphilitic hepatitis.

Hepatitis is a known manifestation of congenital syphilis, however hepatitis developing during penicillin therapy is unknown. Ten patients of congenital syphilis were studied and serial liver enzymes were done before and after starting penicillin therapy. Eight of the ten patients developed hepatitis after initiating penicillin therapy. Whether hepatitis in these cases was secondary to toxic reaction to the products of treponemal lysis or an autoimmune reaction needs to be investigated.

Alanine Transaminase↗
PubMed1990

Low serum immunoglobulin G--a predictor of frequent relapses in idiopathic nephrotic syndrome.

Serum immunoglobulins were measured in 25 children at the onset of nephrotic syndrome, in 20 during remission and in 19 during relapse. On follow up, 10 of them were frequent relapsers (FR). As compared to children who were infrequent relapsers (IFR), frequent relapsers had significantly lower levels of IgG at onset (p less than 0.001) which persisted during remission. IgG in FR at onset and at remission were 27.2 and 42.5% of normal mean as compared to 70.0 and 74.4% of normal mean observed at onset and remission, respectively in IFR. Very low levels of IgG may help predict onset of a tendency towards frequent relapses in children with minimal change nephrotic syndrome.

Child↗
PubMed1990

Ultrasonic intrauterine growth curves.

Intrauterine growth was studied by serial ultrasonic measurements of biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC) in 241 normal low risk obstetric patients. These measurements were used to construct normal ultrasonic fetal weight and length curve. The data correlate well with the already established, postnatal weight and length curves after 28 weeks of gestation. The fetal ponderal index curve was compared with postnatal ponderal index curves available. Antenatal recognition of fetal weight, length and ponderal index can be used to evaluate pregnancies at risk for altered fetal growth.

Birth Weight↗
PubMed1990

Fetal ponderal index in predicting growth retardation.

Fetal ponderal indices were calculated by ultrasound examination and compared with the neonatal ponderal indices in 154 pregnancies. No significant difference was found between the prenatal and postnatal values of weight, length and ponderal indices of the entire sample as well as in babies with intrauterine growth retardation (IUGR). The fetal ponderal index had a sensitivity and specificity of 56.7 and 84.6 per cent respectively. These data suggest that fetal ponderal index could be used to rule out IUGR with reasonable accuracy (negative predictive value: 86%).

Birth Weight↗
PubMed1990

Ceftriaxone.

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Ceftriaxone↗
PubMed1990

Campomelic syndrome.

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Abnormalities, Multiple↗
PubMed1990

Evaluation of beneficial effects of nonnutritive sucking in preterm infants.

The effects of nonnutritive sucking (NNS) were studied in 40 preterm infants weighing less than or equal to 1800 g and of less than or equal to 35 weeks gestation by using a pacifier. The provision of NNS accelerated the maturation of sucking resulting in a faster transition from gavage to oral feedings. Treated infants (20) were ready for bottle feeds 1.54 days earlier, took their bottle feeds 1.5 min/30 ml faster and were transferred out of the nursery on an average .5 days earlier than the control infants. No adverse effects due to NNS were observed throughout the period of study. This resulted in an earlier union with their mother, less maternal deprivation and decreased work load on the nursery staff. Used judiciously this simple and safe modality of providing a pacifier for NNS during tube feeding may be useful in the management of preterm infants.

Body Weight↗
PubMed1990

Salmonella senftenberg outbreak in a neonatal unit.

Salmonella senftenberg was isolated from the stools of 35 newborns between June, 1987 and September, 1988. Twenty nine (82.8%) babies were preterms and twenty six (74%) babies were less than 2,000 grams in weight. All of them were symptomatic within 6 days of life, 74.3% (26) within 4 days. All of them had loose stools and weight loss. Other features were sclerema, jaundice and paralytic ileus. The organism was sensitive to nalidixic acid (100%), amikacin (94.6%), gentamicin (72.9%), cephaloridine (56.7%), and chloramphenicol (29.8%) and resistant to benzyl penicillin and ampicillin. Babies showed good response to a combination of cephaloridine and amikacin along with supportive care. Five babies died, 4 of septicemic shock and one of pulmonary hemorrhage.

Cross Infection↗