Indian Journal of Neonatal Medicine & Research

Message from the Mermaid-Do not Miss the Anomaly Scan

Charu Sharma, Abhishek Bhardwaj, Siddesh RC, Anita Yadav, Senthil kumar

Sirenomelia, also known as Mermaid syndrome is a rare congenital structural anomaly, caused by a vascular insult during the embryonic life. It is characterized by varying degrees of fusion of the lower extremities along with urogenital and gastrointestinal malformations. Diagnosis of sirenomelia can be made as early as 11-13 weeks and hence the birth of this syndromic baby can be prevented. We report a case of Sirenomelia- Mermaid Syndrome along with the clinical autopsy findings and review its literature.

Type II Colonic Atresia and High Anorectal Malformation: A Rare Coexistence and Literature Review

Prasanta Kumar Tripathy, Pradeep Kumar Jena

Colonic atresia and anorectal malformation are congenital anomalies affecting distal gastrointestinal tract. Individually, both the anomalies need urgent surgical and medical care for survival of the newborn. However, the association between them is reported only in a handful of cases and very little information is available regarding the management of the combined anomaly. We came across a three-day-old male neonate having Type II colonic atresia along with high anorectal malformation. Because of the rarity and unique challenges needed for management of both the anomalies, this case is being reported with review of relevant literature.

Acute Neonatal Suppurative Parotitis with Facial Palsy and Pneumonia

RAHUL MANSING KADAM, VSV PRASAD, SUDHA BODA

Acute Neonatal Suppurative Parotitis (NSP) is a rare infection in neonates. To our knowledge, only few cases are reported in English literature with hardly any case from India. The most common causative organism is Staphylococcus aureus. Here, we report a rare case of acute NSP with late onset sepsis and complications such as facial palsy and pneumonia due to Pseudomonas aeruginosa infection in a term neonate.

Coils in Umbilical Cord and their Perinatal Significance in North Indian Population: A Cross-sectional Studynormocoiled

Shilpa Singh, Richa Sharma, Gita Radhakr ishnan, Shuchi Lakhanpal, Vikas Lakha

Introduction: Umbilical Coiling Index (UCI) is defined as number of coils present per centimeter of cord. Abnormal coiling index (hypocoiled/hypercoiled) has been studied previously and found to be associated with adverse perinatal outcome. There is limited literature available on Indian population Aim: To analyze association between UCI and maternal and fetal risk factors and to evaluate how hypocoiling, normocoiling and hypercoiling are linked to materno-fetal outcome in a North Indian population. Materials and Methods: A cross-sectional study was conducted on 500 antenatal women who were enrolled in their active phase of labour and UCI calculated after delivery. UCI was determined by formula- number of coils/length of cord in centimeters (cm). Normocoiling, hypocoiling and hypercoiling were determined and its association with various maternal risk factors and perinatal outcome was noted. Results: On an average 0.2±0.09 coils were found per cm of coil. Hypocoiling was found to be significantly associated with anaemia, abruption, prematurity, Premature Rupture of Membranes (PROM), meconium stained liquor, instrumental delivery and APGAR at 5 minutes <7. Hypercoiling was found to be associated with diabetes and post datism. Conclusion: Post delivery umbilical coiling index serves as a significant indicator of perinatal outcome and therefore antenatal determination of UCI can help identify high risk pregnancies.

Drug Utilization Pattern of Antimicrobials in Neonatal Sepsis in a Tertiary Care Teaching Hospital, Indiaand

Narendra Behera, Jayanti Prava Behera

Introduction: Neonatal sepsis is a major cause of neonatal mortality and treated with antibiotics. The antibiotic susceptibility pattern varies from place to place at any point of time. Antimicrobial resistance, a burning problem globally, is due to irrational use of antibiotics. Drug utilization study is a strong tool for evaluating rational use of antibiotics. Aim: To evaluate the antimicrobial use pattern, to identify problems associated with rational drug utilization and to know the clinical outcomes of neonates under treatment with various antimicrobial regimens in neonatal sepsis. Also to suggest any steps can be taken for possible improvement in rational antimicrobials use in this condition. Materials and Methods: This was a descriptive observational study conducted from June, 2015 to September, 2016 in a Tertiary Care Teaching Hospital, Odisha, India. The consecutive neonatal sepsis cases, admitted to SNCU, Paediatrics Department, were included. The protocol was approved by IEC and written informed consents were obtained from the parents/guardians prior to the study. Total 204 diagnosed, screen positive neonatal sepsis cases of 0 -28 weeks old and both the sexes were enrolled. Demographic data like age, sex, place of delivery, gestational age and birth weight and antibiotic use data as per WHO guide line for drug utilization study were recorded in a case record form. The categorical data were expressed in percentage and mortality data was analyzed using GraphPad Prism ver.0.7 by Chi square test and p<0.05 was considered as significant. Results: EONS (Early Onset of Neonatal Sepsis) was more than LONS (Late Onset of Neonatal Sepsis). Neonatal sepsis predominantly affected male babies. Preterm, LBW (Low Birth Weight), home delivery and NVD (Normal Vaginal Delivery) cases were more associated this condition. All of them received empirical antibiotics such as ampicillin/cefotaxime combined with amikacin/gentamicin from EDL (Essential Drug List) and prescribed almost rationally. Though cure rate was good, the death percentage was quite alarming. Conclusion: The empirical antibiotics were given to all cases of neonatal sepsis, selected from EDL. Though, in this study group the antibiotic use pattern found rational, death rate was still high. So further study regarding risk factors associated and awareness about preventive measures will be required.