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Relationship between antibiotic consumption pattern and antibiotic resistance in neonatal sepsis. Med Pharm Rep 2023; 96:35-40. [PMID: 36818325 PMCID: PMC9924814 DOI: 10.15386/mpr-2409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/26/2022] [Accepted: 06/09/2022] [Indexed: 01/20/2023] Open
Abstract
Background and aim Inappropriate use of antibiotics may increase antimicrobial resistance (AMR) among different microorganisms and may lead to treatment failure in neonatal septicemia. The aim of this study was to recognize the most common microorganisms responsible for neonatal sepsis and to evaluate the trend of change of resistance pattern among microorganisms. Methods This study was done retrospectively on 344 cases diagnosed with neonatal sepsis, including both early and late onset cases, admitted to the tertiary care teaching hospital of southern India from January 2012 to July 2017. Accordingly, 231 culture positive neonatal sepsis cases were collected from hospital data base and analyzed. Culture positive cases within 72 hours of life were termed as early onset while after 72 hours were late onset. Antibiotics utilization during the period was calculated using WHO AMC tool and reported as (DDD)/100 bed days. Results Klebsiella pneumoniae with 56 (21.8%) and Coagulase negative Staphylococcus with 52 (20.2%) cases were the most frequent isolated organisms which were responsible for 55.8% and 14.6% of deaths among the study subjects respectively. Amikacin (86.7%), vancomycin (52.3%) and ampicillin (40.6%) were the most used antibiotics in terms of DDD/100 bed days. Conclusion The results obtained from our study have brought substantial information on the antibiotic resistance pattern among microorganisms causing neonatal sepsis. Moreover, results obtained from this study can be used for designing antibiotic stewardship policies to prevent the emergence of resistance and to improve the treatment outcome.
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Role of Neutrophil CD64 in the Diagnosis of Neonatal Sepsis. JOURNAL OF NEPAL PAEDIATRIC SOCIETY 2022. [DOI: 10.3126/jnps.v42i2.39821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Introduction: Neutrophil surface CD64 (Cluster of differentiation 64), the highaffinity Fc receptor, is quantitatively up-regulated during infection and sepsis. The diagnostic utility of NCD64 as a reliable marker of neonatal sepsis has not been explored so far. Hence this study has been conducted to compare NCD64 with other currently used infection markers including total leucocyte count, platelet count, absolute neutrophil count (ANC), band:neutrophil ratio and highly sensitive C reactive protein (hs-CRP).
Methods: Consecutively born neonates between March 2014 to November 2014 were enrolled with documented sepsis (n = 81), clinical sepsis (n = 35), and no sepsis (n = 87). NCD64 was analyzed by flow cytometry.
Results: Sepsis episodes had a higher median CD64 index of 10.35 (Range: 15.88, 6.87) as against 2.97 (Range: 5.53, 1.64) in the control group (p < 0.001). The percentage of NCD64 positive cells was also significantly higher in the sepsis group compared to the control group (63.90 ± 2.67 vs 15.07 ± 1.95; p = 0.001). In the ROC curve analysis NCD64, percentage of NCD64 positive cells had the highest AUC (AUC-0.914) using a cutoff of 28.01%, followed by CD64 mean fluorescence intensity (MFI) with an AUC of 0.850 using a cutoff of 5.54. NCD64 was significantly elevated in the groups with documented and clinical sepsis (p < 0.001).
Conclusions: NCD64 is a highly sensitive marker for neonatal sepsis. Prospective studies incorporating NCD64 into a sepsis scoring system are warranted.
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Identification of potential risk factors for the poor prognosis of neonatal sepsis. Med Pharm Rep 2022; 95:282-289. [PMID: 36060509 PMCID: PMC9387580 DOI: 10.15386/mpr-2331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 04/07/2022] [Accepted: 04/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background and aim. Risk factor-based approach is one of the best approaches employed by middle income countries which are not well facility driven for any disease management. Thus, through this approach, we aim to identify the potential risk factors responsible for the poor outcome in neonatal sepsis.
Methods. A case control was conducted retrospectively with neonates admitted to Neonatal Intensive Care Unit during January 2012 to December 2016. Cases were identified using ICD-10 Code from inpatient medical records and demographic, maternal and neonatal details were collected from the medical files. Logistic regression was performed to identify the risk factors associated with mortality in neonatal sepsis. Results. A total of 613 neonates were found to have culture positive sepsis from the 4690 neonates admitted in the Neonatal Intensive Care Unit (NICU). There was a total of 831 episodes in the 613 neonates. The mortality rate in neonates with sepsis was found to be 25.4%. Extremely low birth weight (OR 6.171, CI 3.475-10.957), extreme preterm (OR 5.761, CI 2.612-12.708), very preterm (OR 2.548, CI 1.607-4.042), preeclampsia (OR 1.671, CI 1.091-2.562), acute renal failure (OR 4.939, CI-2.588-9.426), coagulopathy (OR 2.211, CI-1.486-3.289), septic shock (OR 173.522, CI-23.642-1273.59), thrombocytopenia (OR 5.231, CI-3.310-8.268), leukopenia (OR 2.422, CI- 1.473-3.984), CRP > 24 (OR 2.099, CI-1.263-3.487) and abnormal absolute neutrophil count (OR 2.108, CI-1.451-3.062) were some of the significant predictors, identified through risk-based approach, in assessing mortality in neonatal sepsis.
Conclusion. Risk-based approach applied was successful in determining plausible important predictors such like extreme low birth weight, extreme preterm, resistance against gram negative infections, preeclampsia, septic shock, hypotension, leukopenia, neutropenia, thrombocytopenia in predicting mortality in neonatal sepsis. These potential risk factors, identified through risk- based approach, can play a pivotal role in assisting clinician to make appropriate and judicious decision.
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Pharmacometric approach to assist dosage regimen design in neonates undergoing therapeutic hypothermia. Pediatr Res 2022; 92:249-254. [PMID: 34493833 PMCID: PMC9411058 DOI: 10.1038/s41390-021-01714-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/09/2021] [Accepted: 08/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Therapeutic hypothermia (TH) is the treatment of choice for neonates diagnosed with perinatal asphyxia (PA). Dosing recommendations of various therapeutic agents including antimicrobials were not specifically available for the neonates undergoing TH. METHODS A systematic search methodology was used to identify pharmacokinetic (PK) studies of antimicrobials during TH. Antimicrobials with multiple PK studies were identified to create a generalizable PK model. Pharmacometric simulations were performed using the PUMAS software platform to reproduce the results of published studies. A suitable model that could reproduce the results of all other published studies was identified. With the help of a generalizable model, an optimal dosage regimen was designed considering the important covariates of the identified model. RESULTS With the systematic search, only gentamicin had multiple PK reports during TH. A generalizable model was identified and the model predictions could match the reported/observed concentrations of publications. Birth weight and serum creatinine were the significant covariates influencing the PK of gentamicin in neonates. A dosage nomogram was designed using pharmacometric simulations to maintain gentamicin concentrations below 10 μg/mL at peak and below 2 μg/mL at trough. CONCLUSIONS A generalizable PK model for gentamicin during TH in neonates was identified. Using the model, a dosing nomogram for gentamicin was designed. IMPACT Dosing guidelines for antimicrobials during TH in neonates is lacking. This is the first study to identify the generalizable model for gentamicin during TH in neonates. Nomogram, proposed in the study, will aid the clinicians to individualize gentamicin dosing regimen for neonates considering the birth weight and serum creatinine.
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Novel urinary markers: taurine, dopamine and L-fucose levels in predicting neonatal seizures. Biomedicine (Taipei) 2021. [DOI: 10.51248/.v41i4.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Neonatal seizure is an age specific neurological emergency. Their unique pathophysiological mechanism has become subject of interest for many research studies. The recurrence risk for seizures is high during neonatal period and currently used treatment strategies have limited efficacy in preventing it. From past decades although the treatment has not changed, there is a gradual progress in various mechanisms that are involved in generation of seizures and their response to anti-epileptics. With the emergence of new biochemical parameters for risk assessment in patients with seizures, there is a strong need for their comparative evaluation in order to evaluate their potential clinical application. So, this study was carried out to compare the urine levels of taurine, dopamine and fucose in assessing their role in mechanism of seizure.
Materials and Methods: After obtaining ethical approval and consent from parents total 43 neonates, urine taurine, dopamine and fucose were measured in 24 cases of seizures and 19 apparently healthy normal controls. Dopamine and Taurine were measured using ELISA and L-fucose by Dische and Shettles method.
Results: The median level of urine fucose was significantly higher in male neonates, taurine was significantly decreased in cases compared to that of controls. Males had higher preponderance to develop seizures. The median levels of urine dopamine were high in cases compared to controls but has not showed any significance.
Conclusion: Amino acid like taurine, carbohydrate moiety like fucose and a neuromodulator like dopamine may have a mechanistic role in development of seizures in neonatal period.
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Designing a mobile health intervention for preterm home care: Application of conceptual framework. Public Health Nurs 2021; 39:296-302. [PMID: 34889469 DOI: 10.1111/phn.13020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022]
Abstract
Mobile health (mHealth) solutions are being widely explored in low- and middle-income countries (LMICs) due to its scope in reducing the healthcare access gap and improving health outcomes. The fit of mHealth solutions to specific users and their viability in a particular setting plays a significant role in the successful adoption and sustainable implementation. This article describes the process of designing a sustainable mHealth application for delivering preterm home care to babies discharged from the neonatal intensive care unit (NICU) in India. Intended end-users are the parents, who are primary caregivers at home, especially mothers of preterm babies and healthcare providers who cared for them at the hospital. This mHealth application is designed to facilitate continuity of care for these preterm babies transitioning from an intensive healthcare setting to home with unique and complex health care needs. It is equipped to remotely monitor the growth and development for early detection of growth impairment and developmental delay often seen in preterm babies in their early years. Therefore, a mHealth application was designed applying a relevant conceptual framework for successful adoption and an ecological model for sustainability in the Indian setting.
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Factors Associated With Neonatal Pneumonia and its Mortality in India: A Systematic Review and Meta-Analysis. Indian Pediatr 2021. [PMID: 34837367 PMCID: PMC8639407 DOI: 10.1007/s13312-021-2374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Neonatal pneumonia remains a significant contributor to infant mortality in India and responsible for increased prevalence of infant deaths globally. Objective To identify risk factors associated with neonatal pneumonia and its mortality in India. Study design A systematic review was conducted including both analytic study designs and descriptive study designs, which reported a quantitative analysis of factors associated with all the three types of pneumonia among neonates. The search was conducted from August to December, 2016 on the following databases; CINAHL, EMBASE, Ovid MEDLINE, PubMed, ProQuest, SCOPUS, Web of Science, WHO IMSEAR and IndMED. The search was restricted to Indian setting. Participants The population of interest was neonates. Outcomes The outcome measures included risk factors for incidences and mortality predictors of neonatal pneumonia. These could be related to neonate, maternal and pregnancy, caregiver, family, environment, healthcare system, iatrogenic and others. Results A total of three studies were included. For risk factors, two studies on ventilator-associated pneumonia were included with 194 neonates; whereas for mortality predictors, only one study with 150 neonates diagnosed with pneumonia was included. 11 risk factors were identified from two studies: duration of mechanical ventilation, postnatal age, birth weight, prematurity, sex of the neonate, length of stay in NICU, primary diagnosis, gestational age, number of re-intubation, birth asphyxia, and use of nasogastric tube. Metaanalysis with random-effects model was possible only for prematurity (<37 week) and very low birth weight (<1500 g) and very low birth weight was found to be significant (OR 5.61; 95% CI 1.76, 17.90). A single study was included on predictors of mortality. Mean alveolar arterial oxygen gradient (AaDO2) >250 mm Hg was found to be the single most significant predictor of mortality due to pneumonia in neonates. Conclusion The study found scant evidence from India on risk factors of neonatal pneumonia other than ventilator-associated pneumonia. Electronic Supplementary Material Supplementary material is available in the online version of this article at 10.1007/s13312-021-2374-4
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Vitamin D Levels in Neonates With and Without Seizures: A Single Center Cross-Sectional Study. Indian Pediatr 2021; 58:839-841. [PMID: 34016803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the serum vitamin D levels in neonatal seizures and vitamin D status of the mothers whose babies had vitamin D deficiency. METHODS For this cross-sectional study, vitamin D levels were studied in term and late preterm neonates admitted to NICU with seizures at our tertiary care center. Controls were term and late preterm healthy neonates admitted in the postnatal ward with the mothers in the same center. RESULTS 30 cases and 30 controls were enrolled. The mean (SD) serum vitamin D was 19.33 (7.76) ng/mL among cases and 16.83 (6.74) ng/mL among controls (P=0.18). We tested maternal vitamin D levels in babies with seizures and low vitamin D levels. The mean (SD) serum vitamin D level among these mothers (n=11) was 13.25 (6.17) ng/mL. CONCLUSIONS There was no statistically significant association between serum vitamin D levels and seizures among neonates in our study.
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Promoting developmental supportive care in preterm infants and families in a level III neonatal intensive care unit (NICU) setting in India. Nurse Educ Pract 2019; 40:102612. [PMID: 31518893 DOI: 10.1016/j.nepr.2019.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 08/08/2019] [Accepted: 08/18/2019] [Indexed: 11/19/2022]
Abstract
Despite evidence of short- and long-term benefits of developmental care, several studies have documented nurses' lack of knowledge and skills related to developmental care concepts. This study aims to enhance neonatal nurses' abilities to acquire care practices (knowledge and skills) regarding Developmental Supportive Care (DSC). A nonrandomized before and after intervention design was adopted to improve the knowledge and skills of staff nurses in DSC practices for preterm infants in Level III B NICU. The study included 50 level III B NICU nurses (25 in interventional group, 25 in control group) located within a tertiary care hospital in India. A significant increase in the mean knowledge score was seen among participants in the intervention group (pre-test: 16.6 ± 3.1, post-test: 29.9 ± 4.1, p = 0.01) but not in the control group (pre: 16.4 ± 2.2, post: 18.6 ± 3.6, p = 0.98). The improvement in the skills of providing DSC among neonatal nurses was also higher in the intervention group (106.4 ± 7.4) relative to the control group (65.8 ± 3.6), p < 0.01, at 0.05 level of significance. The Developmental Supportive Care Program (DSCP) had a significant impact in improving the knowledge and skills of nurses in providing care and preventing complications in preterm infants.
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Randomized controlled trial on effectiveness of mHealth (mobile/smartphone) based Preterm Home Care Program on developmental outcomes of preterms: Study protocol. J Adv Nurs 2018; 75:452-460. [PMID: 30375032 DOI: 10.1111/jan.13879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/16/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
AIM To describe a randomized controlled trial protocol designed to evaluate the effectiveness of mobile health based Preterm Home Care Program (mHealthPHCP) known as "NeoRaksha" mobile health application in improving parent-infant-interaction, growth and development of preterms. DESIGN A prospective, randomized controlled clinical trial. The protocol is approved and funded by Department of Biotechnology, Government of India on 2 August 2016. METHODS A total of 300 preterm-mother dyads admitted to neonatal intensive care unit of a tertiary care hospital will be recruited and randomized to intervention and control group. The intervention group would receive mobile health based Preterm Home Care Program and the control group would receive standard preterm care. Intervention group will be followed up at home by community health workers known as Accredited Social Health Activist who will be trained in using the NeoRaksha mobile health application. Preterms outcomes will be assessed during follow-up at hospital. DISCUSSION Supporting continuity of preterm care is vital as parents and preterms experience transition from Neonatal Intensive Care unit to their home. Empowering mothers and community health workers by integrating mobile technology into health care can help promote healthy preterms, enhance development outcomes and follow-up, which in turn can reduce the mortalities, morbidities, and disabilities associated with prematurity. IMPACT The results of this study could open up new horizons in integrating hospital and home based preterm care through technology, which paves way to scale up the model across the countries.
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Abstract
INTRODUCTION India accounts for more neonatal deaths than any other country. There is a lack of consolidated evidence from India regarding the determining factors of pneumonia in neonates. This systematic review is aimed to consolidate and appraise the evidence on risk factors and determinants of pneumonia among neonates in India. METHODS AND ANALYSIS This protocol is part of a project consisting of three reviews (two systematic reviews and one scoping review) and a qualitative study on neonatal pneumonia in India. English language observational studies which report risk factors and determinants of neonatal pneumonia in India will be eligible for inclusion. Electronic searching of nine databases, and hand searching will be done. Two authors will independently conduct screening (title, abstract and full-text stages), extract data and assess risk of bias. A meta-analysis is planned to be performed with random-effects model. A narrative synthesis will be used to summarise the characteristics and findings of the review, if a meta-analysis cannot be performed. If there are more than 10 studies, publication bias will be assessed. Sensitivity and subgroup analysis will performed based on data availability. The quality of our review will be assessed by using 'Assessing the Methodological quality of Systematic Reviews' and 'Grades of Recommendation, Assessment, Development and Evaluation'. ETHICS AND DISSEMINATION The protocol of the entire project has been approved by the host institution's ethics body (Institutional Ethics Committee, Manipal University, Manipal, India), and the 'Health Ministry Screening Committee' under the Ministry of Health and Family Welfare, Government of India. The study findings will be disseminated among relevant stakeholders using knowledge dissemination workshops, policy briefs, publications, etc. PROSPERO REGISTRATION NUMBER CRD42016044019.
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Risk factors and barriers to case management of neonatal pneumonia: protocol for a pan-India qualitative study of stakeholder perceptions. BMJ Open 2017; 7:e017403. [PMID: 28965099 PMCID: PMC5640148 DOI: 10.1136/bmjopen-2017-017403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/05/2017] [Accepted: 07/18/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION India accounted for more neonatal deaths (estimated at 696 000) than any other country, as of 2015. Of these , most neonatal deaths due to infections can be attributed to pneumonia which accounts for 16% of all neonatal mortalities (2010). Despite simple, inexpensive case management strategies being available, pneumonia continues to cause significant mortality and morbidity among neonates. Understanding the perceptions and experiences of stakeholders of neonatal care can help find solutions to barriers to care and design tailored strategies for controlling neonatal pneumonia. METHODS AND ANALYSIS A pan-India qualitative study will be conducted. Participants include healthcare providers, programme officers, academicians, representatives of non-governmental organisations/bilateral agencies and policy makers. They will be recruited purposively from rural and urban, public and private, and facility and community healthcare settings across six Indian regions. Within each region, a minimum of one state will be selected. Districts will be based on neonatal mortality indicators, and will be subject to feasibility at the time of conducting the study. We plan to conduct in-depth interviews (IDI) and focus group discussions focusing on (a) burden, (b) risk factors, (c) case management, (d) treatment guidelines, (e) barriers to case management, (f) recommendations. The number of interviews will depend on the information saturation. Interviews will be audio-recorded with prior written consent and transcribed verbatim. Principles of thematic analysis will be applied for qualitative data analysis using R package for Qualitative Data Analysis (RQDA). ETHICS AND DISSEMINATION The protocol has been approved by the Health Ministry Screening Committee, Government of India and the Institutional Ethics Committee at the host institution. Confidentiality and privacy of the participants will be maintained. The findings of the study will be shared with all stakeholders of this research including the participants. Knowledge dissemination workshops will be conducted to ultimately transfer the evidence tailored to the stakeholders' need.
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Abstract
INTRODUCTION India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. METHODS AND ANALYSIS This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. ETHICS AND DISSEMINATION As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449.
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Abstract
INTRODUCTION India contributes to the highest number of neonatal deaths globally. It also has the greatest number of pneumonia-related neonatal deaths in the developing world. We aim to systematically review the evidence for the factors associated with mortality due to neonatal pneumonia in the Indian context, to address the lack of consolidated evidence on this important issue. METHODS AND ANALYSIS This protocol is part of a series of three reviews on neonatal pneumonia in India. Observational studies reporting on outcome of neonatal pneumonia in the Indian context, and published in English in peer-reviewed and indexed journals will be eligible for inclusion. Outcomes of this review will be the factors determining mortality due to neonatal pneumonia. A total of nine databases will be searched. Electronic and hand searching of published and grey literature will be performed. Selection of studies will be done in title, abstract and full text screening stages. Risk of bias, independently assessed by two authors, will be evaluated. Meta-analysis will be performed and heterogeneity assessed. Pooled effect estimates will be stated with 95% confidence intervals. Narrative synthesis will be done where meta-analysis cannot be performed. Publication bias will be evaluated and sensitivity analysis performed according to study quality. Quality of this review will be evaluated using AMSTAR (Assessing the Methodological quality of Systematic Reviews) and GRADE (Grades of Recommendation, Assessment, Development & Evaluation). A summary of findings table will be reported using GRADEPro. ETHICS AND DISSEMINATION Since this is a review involving analysis of secondary data which is available in the public domain, and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to transfer the evidence, tailored to the stakeholder (eg, policy briefs, publications, information booklets, etc).
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Feasibility and Safety of Therapeutic Hypothermia and Short Term Outcome in Neonates with Hypoxic Ischemic Encephalopathy. Indian J Pediatr 2016; 83:175-7. [PMID: 26141549 DOI: 10.1007/s12098-015-1829-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/18/2015] [Indexed: 02/05/2023]
Abstract
Therapeutic hypothermia is well known for neuroprotection in asphyxiated neonates with hypoxic ischemic encephalopathy. The authors aimed to study the feasibility and safety of therapeutic hypothermia and short term outcome in neonates with hypoxic ischemic encephalopathy (HIE). Total 31 neonates with moderate to severe HIE were enrolled in the study. Continuous temperature recording was noted in 31 neonates; 17 neonates were studied prospectively while 14 neonates were studied retrospectively. Rectal temperature was monitored in 31 neonates and maintained between 33 and 34 °C by switching off the warmer and using ice packs. Reusable ice packs were used which were inexpensive. Therapeutic hypothermia was maintained for 72 h and babies were then rewarmed 0.5 °C every hour. Therapeutic hypothermia was feasible and inexpensive. There was no major complication during the study. MRI was done in 17 neonates; 52 % were found to have normal MRI at the end of first week. Among the study neonates (n = 31) 64.5 % were neurologically normal at the time of discharge. To conclude, therapeutic hypothermia is feasible in a low resource setting and is a safe way of neuroprotection. Short term outcome was also favourable in these neonates.
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Abstract
Burkholderia cepacia is a rare cause of sepsis in newborns and its transmission involves human contact with heavily contaminated medical devices and disinfectants. The authors aimed to determine epidemiology, clinical features, antibiotic sensitivity pattern, complications and outcome of blood culture proven B. cepacia infections in 12 neonates. All neonates were outborn, 5 preterm and 7 term. B. cepacia was isolated from blood in all and concurrently from CSF in three neonates. Lethargy and respiratory distress (41.7 %) were major presenting features. Five newborns (41.7 %) required mechanical ventilation for 3-7 d. Highest bacterial susceptibility was observed for meropenem (100 %), followed by cefoperazone-sulbactam, piperacillin-tazobactam, sulfamethoxazole-trimethoprim (all 83 %), ceftazidime (75 %) and ciprofloxacin (42 %). Piperacillin-tazobactam, ciprofloxacin and cotrimoxazole either singly or in combination led to complete recovery of 11 (91.7 %) newborns; one developed hydrocephalus. Eight of nine infants who completed 6 mo follow up were normal. Prompt recognition and appropriate antibiotic therapy for B. cepacia infection results in complete recovery in majority.
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Towards continuous monitoring of pulse rate in neonatal intensive care unit with a webcam. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2014; 2014:3817-20. [PMID: 25570823 DOI: 10.1109/embc.2014.6944455] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We describe a novel method to monitor pulse rate (PR) on a continuous basis of patients in a neonatal intensive care unit (NICU) using videos taken from a high definition (HD) webcam. We describe algorithms that determine PR from videoplethysmographic (VPG) signals extracted from multiple regions of interest (ROI) simultaneously available within the field of view of the camera where cardiac signal is registered. We detect motion from video images and compensate for motion artifacts from each ROI. Preliminary clinical results are presented on 8 neonates each with 30 minutes of uninterrupted video. Comparisons to hospital equipment indicate that the proposed technology can meet medical industry standards and give improved patient comfort and ease of use for practitioners when instrumented with proper hardware.
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Maternal anxiety and family support among mothers of neonates admitted in Neonatal Intensive Care Unit. ACTA ACUST UNITED AC 2014. [DOI: 10.9790/1959-03514043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Suppurative sialadenitis in a neonate by methicillin-resistant Staphylococcus aureus: do we need search and kill superbug strategy? Indian J Med Microbiol 2012; 30:113. [PMID: 22361778 DOI: 10.4103/0255-0857.93087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Relationship between stress, coping and nursing support of parents of preterm infants admitted to tertiary level neonatal intensive care units of Karnataka, India: A cross-sectional survey. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.jnn.2009.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Phenylethanolamine-N-methyltransferase activity in various areas of human brain, tissues and fluids. Brain Res 1976; 115:357-9. [PMID: 974753 DOI: 10.1016/0006-8993(76)90523-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Preliminary studies of some biochemical properties of enteric and genital isolates of Salmonella dublin and a possible correlation with reduced virulence. Vet Rec 1971; 89:112-3. [PMID: 5105168 DOI: 10.1136/vr.89.4.112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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25
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Baylor's 1967 Dental Health Mission. Central America revisited. DENTAL STUDENT 1967; 46:220-1. [PMID: 5236531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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