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Biomedical subjects

O N Bhakoo

Publications and source records attributed to O N Bhakoo.

At least 37 records · Page 2Linked to original sources
PubMed1992

Routine hematological values in term newborns.

Routine hematological parameters were investigated in 240 term normal neonates, 40 neonates in the first week of life and 49 infants between 3 and 6 months of age. Term normal neonates were selected on the basis of well defined criteria. Cord blood Hb values of 16.2 +/- 1.5 g/dl compared well with some of the recent Indian studies and Caucasian figures. Cord blood hemoglobin was lower in the presence of low maternal hemoglobin and in newborns delivered by Cesarean section. A wide variation existed in the total and differential leucocyte counts, thus limiting the clinical utility of white cell counts in the newborn period. Platelet counts were within the adult normal range.

Blood Cell Count↗
PubMed1991

Clinical & bacteriological profile of neonatal pneumonia.

In a prospective study of 44 neonates (33 outborn and 11 inborn) with pneumonia, the bacteriology of pneumonia was determined by blood culture and serum counterimmunoelectrophoresis (CIEP). Twenty-nine babies also underwent lung aspiration. The lung aspirate was subjected to bacterial culture and CIEP. CIEP was done to detect the bacterial antigens of Streptococcus pneumoniae and Haemophilus influenzae. Absence of tachypnoea, found more commonly in low birth weight babies, was a poor prognostic sign. Low birth weight babies had a significantly higher mortality than babies with normal birth weight. Altogether, a bacterial etiology of neonatal pneumonia could be established in 25 cases (56.7%). In 10 babies, Strep. pneumoniae antigen was detected in serum and/or lung aspirate. Micro-organisms were cultured from blood and/or lung aspirate from 17 babies. Eleven babies (25%) grew Gram negative bacteria. The common bacteria identified in decreasing order of frequency were Strep. pneumoniae, Klebsiella pneumoniae, Staphylococcus epidermidis, Acinatobacter lowfii, Staph. aureus, Pseudoamonas aeruginosa etc. All the Gram negative bacteria as well as staphylococci were sensitive to amikacin while only 23.5 per cent was sensitive to gentamicin. All staphylococci isolated were sensitive to methicillin.

Bacteremia↗
PubMed1991

Prevention of neonatal hypothermia in Himalayan villages. Role of the domiciliary caretaker.

Given severe winters at high altitudes, prevention of environmental neonatal hypothermia is of particular importance in Himalayan villages. This is a retrospective study of traditional concepts and practices for the prevention of neonatal hypothermia. 202 babies were studied from a population of 16,425 in three districts of a Himalayan state of North India. The community was found to believe that newborns, especially if underweight are vulnerable to cold induced disease for the first few months of life. A warm heated room for delivery and lying-in, early rooming in, oil massage and layers of warm clothing are traditional means for thermo-regulation as practiced by mothers, birth attendants and relatives. The ritual practice of bathing immediately after birth and then upto three times each day even in winter is not perceived by them to provoke hypothermia. For upto one month postpartum mothers are believed to be at risk for cold induced disease.

Altitude↗
PubMed1991

Clinical profile and management of symptomatic patent ductus arteriosus in premature infants.

Twenty cases of symptomatic patent ductus arteriosus (PDA) in preterm inborn infants were studied retrospectively. The diagnostic criteria were a systolic or a systolodiastolic murmur, tachycardia (greater than 160 per minute), hyperdynamic precordium, collapsing arterial pulses, cardiomegaly or a need for intermittent positive pressure ventilation or continuous distending airway pressure. The incidence was found to be 2.48/1000 live births and 1.5% of SCBU admission. All babies were less than 35 weeks gestation and 18/20 weighed less than 1750 g at birth. Ten babies were treated with indomethacin (0.2 mg/kg) and two of these babies died before the course of treatment was completed. Ten babies were treated with conservative therapy. They could not be administered indomethacin because two died of fulminant sepsis soon after the diagnosis was made; two babies had sepsis and DIC but recovered from it, three had thrombocytopenia, one had azotemia, two babies had hyperbilirubinemia requiring exchange transfusion. The two groups of babies matched in respect to gestational age, sex, age at presentation, birth weight and associated illnesses. Two babies in each group died soon after diagnosis. Of the eight babies in each group, six babies closed the ductus on indomethacin therapy as against two on conservative therapy. This difference was significant (p less than 0.05). The babies who responded to indomethacin were all treated within two weeks of age. None of them showed any complication of drug therapy or recurrence of PDA. We conclude that intragastric indomethacin given early in the management of symptomatic PDA in term infants is a safe and effective modality.

Ductus Arteriosus, Patent↗
PubMed1990

Polycythemia in the newborn.

Polycythemia (venous PCV greater than 65%) in neonates is not an infrequent occurrence. Over the last 2 years out of approximately 1500 admissions to the Neonatal Unit, polycythemia was detected in 46 babies (3.06%). Seventeen (36%) of these babies were preterm and 29 (63%) were term. Approximately one third were small for dates while 2 babies (4%) were large for dates. Four of them had been born to mothers with gestational diabetes and 7 were twin deliveries. Severe perinatal asphyxia (5 minute Apgar score less than or equal to 5) was present in 12 cases (26%). Symptoms suggestive of polycythemia included lethargy in 15%, refusal to feed in 13%, respiratory distress in 10%, vomiting in 8% and abdominal distension in 6%. Associated hypoglycemia was seen in 5 cases (10.8%) while twelve babies (26%) had significant jaundice (bilirubin greater than or equal to 12 mg/dl). Twenty eight babies (60.8%) were given a partial plasma exchange transfusion through the umbilical route. There was 6.5% mortality in these 46 babies with polycythemia. Blood letting through a peripheral vein along with a plasma infusion may be a safer alternative to partial plasma exchange transfusion through umbilical route in babies with polycythemia.

Bloodletting↗
PubMed1990

Outbreak of Salmonella worthington meningitis & septicaemia in a hospital at Chandigarh (north India).

During August 1988 an outbreak of hospital acquired infection due to S. worthington has been reported at the Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh. A total of seven neonates presented with the clinical features of meningitis and septicaemia during this outbreak and six babies died. S. worthington was isolated from blood and cerebrospinal fluid respectively. The same strains were isolated from the baby warmer mattress, baby cot, suction machine bottle and wall of the fridge. Samples from doctors, nurses and apparently healthy babies born during this period did not grow the above organism. This appears to be the first report on S. worthington in human beings from India. The outbreak was controlled by thorough cleaning and fumigation. The organisms were also mostly sensitive to antibiotics used, in contrast to the multiple drug resistant pattern reported from elsewhere.

Cross Infection↗
PubMed1989

Survey of cutaneous lesions in Indian newborns.

A total of 900 consecutive newborns delivered at the Nehru Hospital, Chandigarh, India, over a period of 7 months were examined for presence of skin lesions within 48 hours of birth. Commonly observed skin lesions were Epstein pearls (88.7%), mongolian spots (62.2%), milia (34.9%), sebaceous hyperplasia (31.8%), salmon patches (28.4%), and erythema toxicum neonatorum (20.6%). These figures are comparable with earlier reports. Impetigo neonatorum occurred in 11.3% of infants, and was frequent in our hot and humid climate from May to August. Traumatic skin lesions were most often present in babies who had forceps deliveries. Three hundred ten (34%) babies were available for follow-up up to six weeks. Additional skin lesions observed were omphalitis (16 babies), oral thrush (9) and postinflammatory hypomelanosis (8). Three infants had atopic dermatitis, two each had seborrheic dermatitis, diaper dermatitis, pityriasis versicolor, and nevus achromicus. One each had vitiligo, ichthyosis vulgaris, urticaria, and strawberry hemangioma. These observations highlight the importance of repeat examination for the appearance of skin lesions during the neonatal period.

Female↗
PubMed1989

Fetal hydantoin syndrome: a case report.

An infant with features of fetal hydantoin syndrome, born to an epileptic mother, was followed from birth to 20 months of age. Physical findings included gum hypertrophy, digitalization of the thumbs, hypoplasia of the distal phalanges and nails, epicanthal folds, pseudohypertelorism, epidermoid cyst, and geographic tongue. Available literature about the disorder is reviewed.

Abnormalities, Drug-Induced↗
PubMed1989

Evaluation of Minolta jaundicemeter and icterometer for assessment of neonatal jaundice.

Neonatal jaundice is an important disorder, because of its potential complication of kernicterus. Biochemical estimation of bilirubin can be unreliable with lots of interpersonal and interlaboratory variability. Minolta jaundicemeter and perspex icterometer were evaluated for their usefulness in assessment of neonatal jaundice. Thirty premature babies with hyperbilirubinemia were simultaneously studied with jaundicemeter, icterometer and their plasma bilirubin were estimated by AO Bilirubinometer. Babies were subdivided into three groups, viz., Group I upto 1500 g birth weight, Group II 1501-2500 g with gestation 33-34 weeks and Group III 1501-2500 g with gestation 35-36 weeks. There was a good correlation between minolta Jaundicemeter and plasma bilirubin with 'r' values of 0.84, 0.89 and 0.72 in Groups I, II and III, respectively. Except for Group III (r = 0.67), good correlation was found between icterometer and plasma bilirubin with 'r' value of 0.84 and 0.82 in Groups I and II, respectively.

Bilirubin↗
PubMed1989

Lessons from improved neonatal survival at Chandigarh.

We observed a significant fall in neonatal mortality in babies weighing less than 2 kg during 1986 as compared to 1973 (7.94% vs 12.88%; p less than 0.005), and in preterm babies the mortality fell from 26.88 to 11.5% (p less than 0.001) during 1986. This was achieved despite 2-3 fold increase in the high risk babies and without any increase in the number of neonatal special care beds or nurses. Effective utilisation of the facilities was made possible through: (a) reduction in admissions to neonatal special care unit of babies with birth weight more than 1500 g; (b) early discharge of babies to home from NSCU; (c) involvement of the mothers in the care of their high risk babies: and (d) care of babies with sucking difficulties and asymptomatic birth asphyxia outside NSCU. All babies discharged home at less than 2 kg weight, and living in Chandigarh were followed for 3 months and 98.2% were doing well. This observation highlights the judicious use of neonatal special care facilities and mothers for the care of high risk neonates.

Asphyxia Neonatorum↗