bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparision of efficacy of visual inspection of cervix with acetic acid, Pap smear and colposcopy for prevention of cervical cancer
Authors: Rajkumar  , Kumawat Himantika , Sharma Mamta , Vijay Aushima
Published: May 2023

Background: Cervical cancer is second most common cancer in women globally. Overall 80% cases occurs in developing countries.  An important reason for the high incidence of cervical cancer in developing countries is the lack of effective screening programs to detect precancerous conditions and treat before it progresses to invasive cancer due to severe restrictions on the availability of infrastructure, resources and funding. Aim of this study was to compare the sensitivity, specificity, PPV, and NPV of VIA, Pap smear and colposcopy with colposcopic directed biopsy (as a gold standard).
Methods: This prospective analytical study was conducted on 200 women’s (age>19 years) with abnormal cervix in the Department Of Obstetrics and Gynaecology, Government Medical College Kota from 1 august 2020 to 31 July 2022 who fulfil the Inclusion criteria. All the Symptomatic patients with symptoms like vaginal discharge postcoital bleeding, itching, and other gynaecological problems along with asymptomatic patients with accidental finding of bad cervix (cervical erosion).
Results: Maximum cases had common complaint of discharge per vaginum (60.55%), followed by post coital bleeding (11.5%). VIA when compared with HPR, had sensitivity 94.85% and specificity 74.76% and corresponding PPV 78% and NPV 94%. Paps smear when compared with HPR, the sensitivity was 62.89% and specificity was 89.32% and corresponding PPV 84.72% and NPV 71.88%. Colposcopy when compared with Histopathological report, the sensitivity was 70% and specificity was 91.26% and corresponding PPV 88.3% and NPV 76.4%.
Conclusions: Best result for early detection of pre-invasive lesions could be with combined use of Pap smear, VIA, colposcopy and colposcopy guided biopsy rather than any individual diagnostic procedure. It will immensely reduce the morbidity and mortality.
A study on primary caesarean section in multigravida patients at a tertiary care center
Authors: Mendapara Sneha A. , Goswami Kamal
Published: May 2023

Background: Historically, most caesarean delivery took place because of or in association with obstetric complications or medical illness. However, rates of elective primary caesarean deliveries with no clear medical or obstetrical indication are rising dramatically. The most common indication for primary c-section include in order of frequency labor dystocia, abnormal or indeterminate fetal heartrate tracing, fetal malpresentation, multiple gestation, fetal macrosomia. Many other factors that have contributed to the increasing rate of caesarean include improved surgical technique and patient demand and pressure on caregivers to practice “defensive medicine”. The increasing rate of caesarean section is a matter of international public health concern as it increases the caesarean related maternal morbidity and fetal complications as well as the cost of health care as compared to normal delivery.
Methods: This study was carried out in the Department of Obstetrics and Gynecology at PDU Medical College and Hospital Rajkot, Gujarat from January 2021 to June 2022.
Results: The study was conducted on 234 cases, the percentage of primary caesarean section in the study population of PDU Medical College Rajkot was found to be 2.96%. In this study, 38.46% of patients belonged to 26-30 year age group. In this study, 78.63% of multigravida patients were 2nd and 3rd para. There were 41.45% of cases underwent LSCS for foetal distress, 12.39% for antepartum haemorrhage, 12.82% for malpresentation and rest for various other indications. 33.33% of the study population in this study belonged to Robson’s group 3, 26.92% were included in category 4a, 15.81% belonged to category 4b. Among all deliveries 94.87% were live births whereas 5.98% were still births.
Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.
Maternal near miss: a surrogate indicator of obstetrics care
Authors: Thakur Anita , Jain Madhu , Anuranjani Lavanya , Srivastava Yashi , Ambat Gopika , Priya Prerna
Published: May 2023

Background: A maternal near miss (MNM) is an event in which a pregnant woman is on the verge of dying but doesn't die. Despite the fact that most maternal deaths can be avoided, efforts to reduce maternal mortality have not always been successful. This study aimed to identify and analyze the frequency of maternal near-misses (MNMs) cases and causes of maternal near miss due to severe obstetric complications.
Methods: A retrospective observational study was carried out at Department of Obstetrics and Gynecology, Heritage Institute of Medical Sciences, Varanasi. The study duration was from January 2021-June 2022. Purposive sampling was used to collect the total of 2053 samples.
Results: The study involved in total of 56 maternal near miss cases which includes total of ten maternal deaths. The majority of the respondents have more than 20 years of the age (82.1%) where near miss cases were higher in multiparous women (73.2%). First delays (delay in women seeking help) were almost a third in numbers to affect the maternal mortality and morbidity. Hypertension (32%). hemorrhage (20%) and anemia (14%) were the major leading cause of obstetrical complications. About 66% of the maternal near miss cases needed the interventional management that was ICU admission, mechanical ventilation (41.1%) and blood transfusion (32.1%).
Conclusions: Pregnancy hypertension, postpartum hemorrhage, and severe anemia continue to be important determinants of maternal morbidity. First-referral unit facilities and training should be improved so that they can better respond to basic obstetric emergencies such as hypertension, anemia and hemorrhage.
Effect of timing of cord clamping (early vs delayed) on hemoglobin level among newborns: an Indian study
Authors: S. Jafra Bikramjit , Mehendiratta Sunil K. , R. Jafra Pooja , Jafra Anudeep
Published: May 2023

Background: Aim of the current study was to evaluate effect of delayed cord clamping on hemoglobin level among newborns and look for any adverse effects following delayed cord clamping.
Methods: Total 60 newborns were enrolled in the study and were randomly allocated to either control (early cord clamping 15 secs) and cases (delayed cord clamping 3 mins). Samples were collected in labor room, during birth to check the hemoglobin, billirubin and hematocrit levels in two groups. Follow up data were collected in postnatal ward, 24 hours after birth to estimate hemoglobin, hematocrit and billirubin levels and infants were assessed for the presence of respiratory distress.
Results: Hb levels among cases were significantly higher compared to controls at birth. The mean Hb at birth among controls was 14.90±1.28 g/dl and among cases was 16.06±2.37 g/dl (p value 0.023). Hb levels among cases were significantly higher compared to controls at 24 hours. The mean Hb at 24 hours among controls was 16.16±1.70 g/dl and among cases was 19.28±2.16 g/dl (p value <0.001).
Conclusions: Hemoglobin and hematocrit levels were significantly increased at birth as well as at 24 hours of age in delayed compared to early clamping group with no significant adverse effects seen in the group with delayed clamping.
Fetomaternal outcome in pregnant women with derranged thyroid function
Authors: Popli Sangeeta , Shreshta Jandrasupalli , Dath S. Suman , Sharma Manisha
Published: May 2023

Background: Thyroid dysfunction is the second most common endocrine disorder observed during pregnancy after diabetes. Universal screening of thyroid disorders is recommended in the first trimester of pregnancy. The present study aims to determine the fetomaternal outcome in women with thyroid dysfunction.
Methods: The study was a prospective observational study conducted at Department of Obstetrics and Gynaecology, Hindu Rao Hospital and North DMC Medical College, Delhi from January 2019 to June 2022. It was approved by Institutional Ethics Committee. Pregnant women aged 18 to 40 years up to 20 weeks of gestational age with singleton pregnancy were included in this study. All the data was entered in pre designed proforma. The data analysis was done by statistical package for Social Sciences (SPSS) version 21.0.
Results: A total of 110 pregnant women were included in the study. 55 pregnant women with thyroid dysfunction were taken as study group and 55 euthyroid pregnant women were taken as controls. With respect to   maternal complications, neonatal birth weight and Apgar score in the study group are significant.
Conclusions: Timely screening for thyroid dysfunction during pregnancy will reduce fetomaternal complications.
Maternal near miss and maternal death among women with hypertensive disorders in pregnancy: an observational study in a selected hospital in West Bengal
Authors: Maity Sima , Chaudhuri Snehamay , Ghosh Pramit
Published: May 2023

Background: Aim of the this study was to assess the prevalence of hypertensive disorder in pregnancy and the  incidence of maternal death and maternal near miss from the hypertensive disorders of pregnancy and utilization of maternal health care services by them.
Methods: An observational study was performed at Purba Medinipur District Hospital, West Bengal from 1st April 2018 to 31st December 2020. The main outcome measures included incidence of potentially life threatening conditions, life threatening conditions maternal near miss cases and mortality developed due to PIH/preeclampsia/eclampsia and utilization of maternal health care services by them.
Results: Present study reflected that the prevalence of hypertensive disorder in pregnancy was 9.01% (3543/39310) of total admission. The incidence of maternal mortality due to complication of hypertensive disorder was 7 out of total maternal mortality 30 during that period i.e. 23.3% of total mortality and incidence of MNM was 82 out of total 249 MNM cases during the same period i.e. 32.9% of total MNM cases. Utilization of maternal health care services revealed that there is a scope to increase the service delivery.
Conclusions: Health care programmes need to enhance the existing efforts to improve timely health seeking behavior of women. There is a need of better quality antenatal care and extra resources are needed for identification and transportation of the women to reach hospital when the women develops complications. There is also a need of improvement of critical care in women who are suffering from life threatening condition.
A study on fetomaternal outcome in prelabour rupture of membrane conducted at tertiary health care centre at Rajkot, Gujarat, India
Authors: Dudhrajia Kavita , Chauhan Tinjal
Published: May 2023

Background: Prelabour rupture of membrane is defined as a rupture of membrane before onset of labour and in the absence of uterine contraction. When it occurs before 37weeks it defined as a preterm PROM. One of the most common complication is preterm delivery approximately 7-10% and account for 1-2% of foetal death. Most commonly associated with subclinical UTI.
Methods: A prospective study was conducted from (June 2021-June 2022) at a tertiary health care hospital. All female with spontaneous rupture of membrane after 28weeks of gestation.
Results: In present study total 200 cases taken and incidence of department was 6.76%,varies between 2% to18%  commonly involved age groups belongs to 20-24 years, at 35 -36 weeks (52%) and  with high vaginal delivery rate (approximately) with average baby weight between 2.1-2.5 kg with more than 7 APGAR score, more in multigravida.
Conclusions: Incidence of prelabour rupture of membrane can be reduced by early diagnosis of subclinical UTI in antenatal visits.
Knowledge on respectful maternity care among staff nurses: a descriptive survey
Authors: Devassy Dhanya , X. Sangeetha
Published: May 2023

Background: Pregnancy is an especial, rousing and often blissful period in a woman’s life. Women may undergo various physiological changes during antepartum, intrapartum and postpartum period. The birthing room environment and health care provider’s attitude are important to minimize the pain and offer a positive childbirth experience. Across the world, women endure disrespect and abuse (D&A) during childbirth. Dearth of Respectful Maternity Care (RMC) from medical professionals like doctors and midwives may cause patients to feel unsatisfied with the healthcare system and lessen their obligation to seek antenatal (ANC), delivery, and postnatal care services. Objective of the study was to assess the existing knowledge on RMC among staff nurses working in the labour room.
Methods: A non-experimental descriptive survey design was used to assess the knowledge on Respectful Maternity Care among staff nurses working in the labour room. Non-probability convenient technique was used to select 69 staff nurses from Ramaiah Medical College Hospital, Ramaiah Memorial Hospital, Motherhood Hospital, Lakshmi Maternity and Surgical Center and Aveksha Hospital, Bengaluru from April 2022 to May 2022. Structured knowledge questionnaire was used to assess the knowledge on respectful maternity care.
Results: The overall knowledge score shows that 65.5% had moderately adequate knowledge on Respectful Maternity Care. The overall knowledge score mean was 16.72 with mean percentage of 64.30 and SD of ±3.438.
Conclusions: Assessment and improvement in nurses’ knowledge will improve the quality of care as a means of enhancing safety during childbirth and positive childbirth experience.
Clinical safety and efficacy of atosiban brief duration 14-hour treatment regimen in delaying preterm labor
Authors: Dewan Bhupesh , Shinde Siddheshwar
Published: May 2023

Background: For preventing preterm labor, the recommended duration of atosiban infusion is 48 hours and the patient has to be hospitalized during the course of treatment. The treatment consists of administering one vial of 0.9 ml as a bolus and then an infusion at a rate of 300 mcg/min for 3 hours followed by 100 mcg/min for the next 45 hours, utilizing nine vials of 5 ml. The objective of the study was to evaluate an alternative brief duration (14-hour) of atosiban treatment involving a bolus dose of 0.9 ml followed by an infusion of 300 mcg/min for 2 hours and 100 mcg/min for the next 12 hours utilizing 3 vials of 5 ml. The advantage being that the treatment could be completed in an outpatient setup and be convenient for the patient as well as for the healthcare staff. This would also reduce the overall cost of the treatment. This prospective single-center study was conducted to evaluate the efficacy and safety of an atosiban brief duration (14-hour) treatment regimen to prevent preterm labor.
Methods: A total of 50 patients with symptoms of preterm labor were enrolled in the study. The efficacy of tocolysis was determined by the percentage of patients who remained undelivered up to 48 hours after atosiban therapy initiation and the follow-up of the patients was done up to delivery. Safety was assessed in terms of the number of maternal and fetal adverse events reported.
Results: The mean gestational age at the enrolment was 32.1±2.6 weeks and the delivery were delayed by a mean of 18.13±17.97 days (range 1-62 days). Thirty-five (70%) patients remained undelivered at 48 hours and 29 (58%) at 7 days. No maternal or fetal adverse events were reported during the study.
Conclusions: A favourable safety and efficacy profile of a brief duration atosiban regimen was observed resulting in ease of administration and a shorter stay in the healthcare facility providing convenience to both patient and hospital staff. The overall cost of the therapy was also reduced. Further clinical trials with larger sample size are required to confirm the findings.
Placental polyp after normal vaginal delivery: a rare diagnostic dilemma
Authors: Agarwal Himanshi D. , Desai Archish I. , Gheewala Amisha S. , Parikh Sonam K. , Shukla Ashwini A. , Dudhwala Princy R.
Published: May 2023

Placental polyp is retained placental tissue within the endometrial cavity, which forms a nidus for inflammation and bleeding. Placental polyp is a rare entity with an incidence of less than 0.25% of all pregnancies as reported. Here, we report a case of 23-year-old P2L2 woman with complaints of intermittent vaginal bleeding since her recent normal vaginal delivery, 1.5 months back. A polypoid mass (51×41 mm) with abundant vascularity was detected as retained products of placenta (RPOC) within the endometrial cavity by imaging studies. A combination of polypoidal mass within the endometrial cavity with normal beta human chorionic gonadotropin (hCG) of <2.0 mIU/ml raising the suspicion of retained products of placenta or trophoblastic neoplasms. After yielding an unsatisfactory biopsy containing only fibrin deposition, total hysterectomy was performed due to profuse bleeding during biopsy. The uterus specimen showed slight globular enlargement with presence of a red-coloured polypoid mass within the endometrial cavity with rough outer surface and fragile consistency. The histological specimen of the protruding lesion, from the exaggerated placental implantation site, showed intermediate trophoblastic cells infiltrated into the myometrium, which might lead to the diagnosis of placental polyp. However, since placental polyp and uterine arteriovenous malformation have similar clinical characteristics, it is important to accurately identify and differentiate between them to ensure optimal treatment therapy. Definite diagnosis is ultimately made by histopathological examination. We report here a case that is suggestive of either a placental polyp or uterine arteriovenous malformation and will discuss the differential diagnoses and treatments for both diseases, based on a literature review.
Role of imaging modalities in diagnosis of silent caesarean scar ectopic pregnancy after ovulation induction: a case report
Authors: Priya Prerna , Pandey Yashaswi , Jain Madhu , Anuranjani Lavanya , Mahaske Vanita , Srivastava Yashi , Thakur Anita , Ambat Gopika
Published: May 2023

Laparoscopy has many advantages over open surgery including less post-operative pain, earlier return of normal bowel function, shorter hospital stay, and earlier recovery. Bowel injury is a serious complication of gynecological laparoscopy. The most common site of bowel injury is the small bowel, followed by the large bowel and stomach. This is in agreement with a recent systematic review which has shown that the incidence of bowel injury in gynecologic laparoscopy is 1 in 769.3. Air saline test performed to check bowel integrity by inserting the rectal probe and filling the cavity with normal saline. After performing total laparoscopic hysterectomy with bilateral salphingoopherectomy with retroperitoneal lymphnode dissection done initially after pushing air from rectal probe into the bowel, no bubble was noted but after pushing sigmoid into the pool of saline, escape of air was seen. After suction, a 2×2 cm incidental sigmoidal injury was detected. Bowel injury is a serious complication in laparoscopic surgeries and routine intraoperative checking of bowel integrity by air saline test with the help of rectal probe is a useful modality of intraoperative bowel repair.
Chronic non-puerperal incomplete uterine inversion
Authors: Sofat Agam , Dubey Sunita , Tandon Rimpy , Sehgal Alka , Aggarwal Purnima
Published: May 2023

Chronic non-puerperal uterine inversion is an extremely rare diagnosis especially in younger women. The diagnosis commands high level of clinical suspicion supplemented with imaging. An emergency admission of a 35-year-old para 1 with submucosal fundal fibroid presenting with excessive menstrual flow with hemodynamic instability requiring multiple blood transfusions is presented. On abdominal examination slight suprapubic tenderness was made out with no palpable mass. Bimanual examination revealed a non-pediculated mass in upper vagina with a circular constriction around it. On ultrasound, cupping of fundus suggested uterine inversion. Pelvic MRI reaffirmed the findings of a highly vascularized intracavitary leiomyoma protruding through the cervix. After optimization patient underwent myomectomy and Haultain’s procedure followed by total abdominal hysterectomy with bilateral salpingectomy. Post-operative period was uneventful. Inversion is generally associated with fundal fibroid polyp but can rarely follow submucosal leiomyoma. Imaging helps preoperative planning of management.
Sad fetus syndrome: a rare case report
Authors: K. Mamatha , Gawda Lekha Prakash
Published: May 2023

Gestational trophoblastic disease (GTD) is a condition that develops from abnormal proliferation of placental trophoblasts. A rare division of GTD is a partial mole with a co-existing live fetus-a condition also referred to as “sad fetus syndrome” We report a rare case of a 24-year-old, primigravida with 26 weeks of gestational age with single live intrauterine gestation coexisting with partial molar pregnancy who had a spontaneous preterm delivery at 27 weeks. The post-natal period was uneventful and patient was followed up till βhcg normalised. The diagnostic challenges and dilemma associated with the management of molar pregnancies with an apparently normal fetus, especially in the second trimester, remains challenging.
Headache and seizure on postpartum day 7: late postpartum eclampsia: a case report
Authors: Raj Aman Deep , Dixit Abhinav
Published: May 2023

Historically, convulsions beginning more than 48 hours, but less than 4 weeks, after delivery, known as late postpartum eclampsia, was thought to be uncommon; however, recent evidence suggests that its incidence is increasing. In addition, the presentation of late postpartum preeclampsia-eclampsia may differ from that occurring during the pregnancy. About 40% of late eclampsia has no premonitory symptoms. This contributes to difficulty in diagnosing late postpartum preeclampsia-eclampsia in an emergency department setting. Greater awareness and knowledge of this disorder by ED physicians should improve outcomes in these potentially life-threatening cases. The authors present a case of new-onset seizures occurring 07 days postpartum. The patient presented with headache, hypertension, and generalized tonic-clonic seizures to the emergency department. Postpartum eclampsia was diagnosed and IV magnesium sulphate was administered. The patient had no further seizures and did not require long-term anticonvulsants.
Incidental finding of unilateral partial agenesis of fallopian tube with complete agenesis of ipsilateral ovary during caesarean section with neonatal outcome
Authors: Prajapati Pooja
Published: May 2023

Congenital unilateral absence of fallopian tube with ipsilateral ovarian agenesis is a rare occurrence with a suggested incidence of 1:11240.  Unilateral ovarian agenesis (UOA) and fallopian descent problems are other very rare congenital entity. We presented a case report, detailing one such patient where unilateral partial fallopian tube and ipsilateral ovarian agenesis was seen with neonatal outcome. Our case describes 28 years old G5P2L2A2 un booked case with an obstetric history of 2 spontaneous abortion and two previous full term institutional normal vaginal deliveries (both female child) presented at 37 weeks of gestation with borderline oligo hydramnios (USG suggestive of AFI- 9.1 cm), Posterior placenta, EFW- 2003 g, single loop of cord around fetal neck. On repeat scan USG suggestive of AFI-7.7cm, with discrepancy of >2 weeks between POG and LMP IUGR. Elective caesarean section done after patient and relatives counselling and informed consent done. During C- section unilateral partial agenesis of right fallopian tube and complete agenesis of right ovary found incidentally. The left fallopian tube and ovary was normal. A male baby with birth weight 2.2 kg, well cried was born. USG abdomen of baby was performed to rule out any congenital genitourinary abnormalities. USG revealed, a small aplastic left kidney, for which baby was referred to higher center for further renal function workup. This case was unique since the incidental diagnosis of right ovary and right fallopian tube agenesis occurred during C section instead of imaging.
A rare case report of amniotic band syndrome associated with gastroschisis and limb body wall complex
Authors: Rita D.  , Pushpalatha V. S.
Published: May 2023

The amniotic band syndrome can cause a wide range of anomalies and the most common associated anomalies include amputations, constriction bands, encephalocele, acrania, syndactyly, craniofacial defects, club feet and cleft lip. Vertebral and abdominal wall defects such as gastroschisis and scoliosis are extremely rare. A 19-year-old female, G1P0 (primi) presented to our outpatient department for her first antenatal visit at 14 weeks + 6 days’ period of gestation according to her LMP. Ultrasonography (USG) features suggestive of limb body wall complex/ amniotic band syndrome, undergone MTP after counselling. In amniotic band syndrome there is no known inheritance pattern. The prognosis in case of amniotic band syndrome is dependent on the specific anomalies present. Severe and complex malformations as seen in this case are incompatible with extra uterine life and are an indication for termination of pregnancy. This condition is diagnosable prenatally. It can also lead to lethal deformation of vital internal organs in rare cases. Because limb body wall complex is incompatible with life, early diagnosis is crucial for parental counseling.
A rare case report of Sertoli Leydig cell tumour of ovary
Authors: Rita D.  , Ravali G.
Published: May 2023

Sertoli-Leydig cell tumor (SLCTs) of the ovary, also known as androblastoma, is a rare neoplasm from the group of sex cord-stromal tumors of the ovary. They account for less than 0.5% of all ovarian tumors. They typically occur in young and reproductive women and the patients usually present with abdominal swelling or pain. A case of 35-year-old multiparous female presented with abdominal mass, ultrasonography revealed a large abdomino-pelvic complex solid cystic mass lesion arising from left ovary. She underwent staging laparotomy followed by total abdominal hysterectomy with left salpingo-ovariotomy and right salpingo-oopherectomy with partial omentectomy. Histopathological examination (HPE) revealed features suggestive of moderately differentiated SLCT of left ovary (with heterologous elements).
Administration colostrum in preventing mortality and morbidity in preterm infants
Authors: Mannan M. A. , Sihan M. Nazmus , Afreen Shazia , Rahman Tareq , Shahidullah M. , Moni Sadeka Choudhury , Shabuj Kamrul Hassan , Jahan Ismat
Published: May 2023

Background: Oropharyngeal administration of colostrum has found to play a role in preventing the Necrotizing Enterocolitis (NEC), thus reducing mortality and morbidity in preterm infants. We aimed to determine whether early oropharyngeal administration of mother’s own colostrum can reduce the rates of NEC and/or mortality in preterm infants.
Methods: We conducted a randomized, placebo controlled, intervention study in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka from 2019 to 2021. Total 92 infants were enrolled, 52 were randomized to oropharyngeal administration of colostrum group and 40 to placebo group. Oropharyngeal administration of colostrum group received maternal colostrum (0.2 ml), after 24 hours of postnatal life and were given every 3 hour for the next 3 days. Serum IgA was measured at 24 hrs and 7th day of postnatal age. Clinical data during hospitalization were collected. SPSS version 21 was used for statistical analysis.
Results: Baseline characteristics were comparable and almost similar between the two groups. There was significant reduction in the incidence of NEC stage 2, 16 (30.7%) vs. 26, (65%); p = 0.001). There was significant reduction of age of achieving full enteral feeding (12.1±4.5 vs 19.5±7.5; p = 0.001), disseminated intravascular coagulation (DIC) 12 (23%) vs. 22 (55%); p=0.002, use of mechanical ventilators, 11 (21.1%) vs. 22 (55%); p = 0.001 and number of inotropes (1.2±0.3 vs. 1.61±0.4975; p = 0.002), duration of inotropes (19.7±14.2 vs. 36.5±17.5; p=0.002) in OAC group. However, there was no significant difference in probable sepsis, culture proven sepsis, survival rate and serum IgA level at 1st and 7th day in OAC group, compared to placebo.
Conclusions: There was a positive effect in decreasing the incidence of NEC, but no significant effect was observed on survival rate. This intervention facilitates faster achievement of full enteral feeding, reducing the risk of DIC in preterm infants.
Prevalence of hypocalcemia in term newborns requiring phototherapy
Authors: Pereira Rochelle A. , Avasthi Bhupendra , Saste Sonal , Bavdekar Sandeep B.
Published: May 2023

Background: Neonatal hyperbilirubinemia in the first week of life is one of the most prevalent clinical entity observed, affecting 60% of term-babies and 80% of preterm newborn babies, many requiring intervention in the form of phototherapy. The effect of phototherapy on serum calcium levels has not been studied much in Indian literature. The objectives of this study was to evaluate the prevalence of hypocalcemia in healthy, term newborn babies receiving phototherapy for unconjugated hyperbilirubinemia and to determine the association, if any between serum calcium and birth weight, postnatal age at start of phototherapy, weight at enrolment, gestational age at birth, maternal age and duration of phototherapy.
Methods: This was a prospective observational study conducted over a period of 10 months among 80 term neonates admitted to the inpatient department at a tertiary care centre in Mumbai. Total serum calcium and ionised calcium levels were measured at the start of phototherapy and on stopping phototherapy/discharge. Data were analysed using statistical package for social sciences (SPSS) version 21 software.
Results: Two (2.5%) out of the 80 neonates were found to have hypocalcemia after phototherapy with serum ionic calcium levels less than 1 mmol/l. Even though a larger proportion of neonates showed a decrease in the serum total calcium (56.25%) and serum ionic calcium (58.75%) levels after phototherapy, none of the neonates developed symptomatic hypocalcemia at those levels. A statistically significant association was found between maternal age in years with the serum total calcium levels after phototherapy and age at starting phototherapy (in hours) with the serum ionic calcium levels after phototherapy.
Conclusions: The present study concludes that there is significant decrease in the levels of ionised calcium after phototherapy, however there was no significant decrease in the total serum calcium levels and none of the neonates were symptomatic. Hence, we do not recommend regular serum calcium monitoring in healthy term neonates receiving phototherapy and find no indication for the prophylactic use of calcium supplementation in these neonates.
Comparative evaluation of pain perception in pediatric patients during administration of local anesthesia with and without three preanesthetic procedure-Buzzy system, topical anesthesia and precooling agent
Authors: Naidu Srinivas Y. , Eregowda Neena Indavara , Parameshwarappa Poornima , Kenchappa Mallikarjuna , Korishettar Roopa , S. Kavya Rani B.
Published: May 2023

Background: Pain management in paediatric dental care is a critical aspect of anxiety, which is frequently related to the induction of pain and exacerbates pain perception local anaesthetics are used to relieve and prevent pain. However, the administration of these drugs causes fear and anxiety in patients. As a result, there is an urgent need to develop methods for reducing pain during injection. Aim and objectives were to evaluate and compare the pain perception in pediatric patients by comparing different local anesthesia delivery system before local anesthesia (preanesthetic procedure) using Buzzy system, topical anesthesia and precooling agent with conventional technique.
Methods: A total of 140 children aged between 8-13 years visiting department taken for study. Patients indicated for invasive procedure and requiring administration of LA taken for study. The blood pressure, oxygen saturation, Wong Baker pain rating scale and FLACC scale was recorded in patients before and after administration of LA. Groups are, group A conventional syringe technique without any preanesthetic procedure. Group B: Buzzy system group C: Topical anesthetic gel (Progel B-20% benzocaine), group D: Precooling agent (flouron-1,1,1,2 tetraflouroethane). Obtained data statistically analysed by using one way ANOVA and paired t test in SPSS software 21.0.
Results: Statistically significant results were obtained in intergroup comparison where group B buzzy system found to be effective compared to another group. In intra group, comparison, there was statistically significant in all 4 groups.
Conclusions: Buzzy system can be used as a preanesthetic medication to decrease the pain perception in children during administration of local anesthetic.
Sleep pattern and sleep disorders in school-going children aged 6-12 years and its association with screen time: a cross-sectional study from South Kerala during the COVID-19 pandemic
Authors: Beena Nanditha , Cherian Carol Sara , Abraham Jacob
Published: May 2023

Background: Poor sleep quality in school children can negatively impact their neurocognitive abilities and academic achievement. Increased screen time was shown to interfere with children’s sleep habits and disrupts their sleep pattern. This study aimed to understand the sleep patterns and sleep disorders in school children and the influence of screen time on sleep in children during the COVID-19 pandemic.
Methods: This cross-sectional observational school-based study was done on 443 children aged 6-12 years. Data was collected through parent filled online questionnaire having a proforma and child sleep habit questionnaire (CSHQ), a validated questionnaire to assess sleep disorders in children
Results: Out of 443 children studied, the average sleep duration of the study population was 9:06 hours ±42:18 min and, 34.3% of the children slept less than 9 hours per day. The prevalence of sleep disorders was found to be 76.52%. Significant screen time after 8 PM was observed in 65.9% and 62.2 % of children had a total screen time of more than 2 hours. Increased screen time after 8 PM, delayed bedtime and wake-up time in children and also contributed to sleep disorders. Bedtime resistance and daytime sleepiness were more commonly observed in children with increased screen time.
Conclusions: Sleep disorders in children are more predominant than sleep deprivation. Increased screen time before bed was found to alter sleep patterns in children and increases bedtime resistance, daytime sleepiness, and sleep disorders.
A study on perinatal factors associated with low-birth-weight neonates in a tertiary care centre in central India
Authors: Barange Shubham , Anand Shweta
Published: May 2023

Background: Low birth weight is a major public health issue worldwide, with a variety of both short- and long-term implications. Estimated to account for 15% to 20% of all births worldwide, India constitutes about 30% of all live births, i.e., nearly 3 million LBW babies are born per year in India. The study focuses on the factors which contribute to the low birth weight in a newborn.
Methods: The present study was conducted as a cross sectional case control study at department of pediatrics, LN medical College and Research Centre, Bhopal for duration of 1.5 years i.e. from 1st February 2021 to 31st August 2022. 420 participants were enrolled of which 210 were of cases (low birth weight group) and 210 were taken to the control group (normal birth weight group). After obtaining ethical clearance from institute’s ethical committee, all the participants fulfilling the inclusion criteria were enrolled. Chi square test was used to test the association between categorical variables.
Results: Maternal age, weight, height, maternal diseases came out to be significant factors associated to the low birth weight of the neonate in this study.
Conclusions: The study gains new insights into the perinatal factors associated with low-birth-weight newborn. Many risks for LBW can be identified even before pregnancy. As revealed by the study, well established socio-economic, obstetric, medical and behavioural health related determinants of LBW are seen quite prevalent in our tertiary care centre.
An evaluation study of behavioural management technique-thaumaturgy, live modeling and tell show do
Authors: Eregowda Neena Indavara , Naidu Srinivas Y. , Parameshwarappa Poornima , Kenchappa Mallikarjuna , Korishettar Roopa , S. Kavya Rani B.
Published: May 2023

Background: The aim of behavior management is to instill a positive dental attitude in the anxious patient. It is the means by which the dental team can effectively and efficiently perform treatment, and encourages a child to have a long-term interest in improving dental health and the ongoing prevention of disease. Aim of the study was to evaluate the behavior of the children by using various behavior management techniques like thaumaturgy, live modelling and tell show do.
Method: A total of 120 children, aged between 5-6 years fulfilling eligibility criteria were taken for the study. three groups were made and comparison was done between three behaviour management techniques: thaumaturgy, live modelling and tell show do. behaviour was recorded using Frankel behaviour rating scale was recorded before and after the procedure.
Results: there was significant difference between thaumaturgy and other behaviour management techniques live modelling and tell show do (p=0.005). there was no statistical change in the behaviour between tell show do and live modelling.
Conclusions: Thaumaturgy technique is better at reducing anxiety levels and all the three behaviour management techniques were effective in installing positive behaviour.
Prevalence and pattern of sleep disorders in childhood
Authors: Ahmed Zeenoor , Malagi Naushad Ali N. , Bavalatti Rajesh Ashok , Bala Anbumani , Muthuraja K. , Visvanathan Jayanthini , Gangawati Sujay P.
Published: May 2023

Background: Sleep disorders are very common in the population of children, with prevalence rates ranging from 25-40%, and they are often persistent. The aetiology of sleep problems is very complicated and depend on many varied factors. Psychological factors concerning family life and general state of health have a significant impact on children.
Methods: A hospital based descriptive study was carried out among 1024 children visiting the paediatric outpatient departments of Madras medical college, Chennai and Al-Ameen medical college and hospital, Vijayapura over a period of 1 year from March 2022 to March 2023. An appropriate questionnaire was formulated that had to be filled by parents and those children with sleep problems interviewed and assessed using appropriate statistical methods.
Results: Out of 1164 questionnaires, 1024 (88.97%) were filled completely and returned. The 497 (48.54%) boys and 527 (51.46%) girls were included in this study. Of the 1024 children, 621 (60.64%) had no sleep related problems. The 403 (39.36%) had one or more sleep related problem, which included 211 (52.36%) boys and 192 (47.64%) girls. Male children were more commonly affected with sleep disorders and there is statistically significant difference at 5% level among males and females in having sleep disorders (p<0.05).
Conclusions: Most of the children studied had only 1 of sleep disorders of which males outnumbered females. Sleep disorders were predominantly found in the age group of 7-10 years among which most common sleep related disorder was nocturnal enuresis. The study also showed that sleep walking is usually associated with another sleep disorder.
The impact of COVID-19 pandemic on child development: systematic review
Authors: Kaur Ravneet , Dahiya Dipsha
Published: May 2023

The Coronavirus disease 2019 (COVID-19), emerged as a global health issue in December 2019 which lead to the sudden implementation of social distancing norms worldwide, including school closures. This stress scenario can alter physical activity and sleep, which are shown to have a profound impact on brain plasticity. The PubMed, Europe PMC, Google Scholar and Science Direct database was searched between July 1st 2022 and September 20th 2022. The inclusion criteria was a) articles in English, b) Articles with study population as children and the exclusion criteria was a) Articles whose full text couldn't be obtained, b) journals not accessible online. After thorough analysis of 2371 records and removing the studies following the exclusion criteria, a total of 7 studies were included in this review. The results of these studies were tabulated. Among the 4.4 million COVID-19 deaths reported in the MPIDR COVerAGE database, 0.4% occurred in children and adolescents under 20 years of age. Expectant mothers were reluctant to attend clinics and were delayed in seeking treatment, due to the fear of being exposed to the virus. Maternal stress is thought to affect early structures of the developing limbic system. These can be potentially related factors and causes of neuropsychiatric disorders in children. Due to the protracted lockdown’s impact on the economy, food shortages and an increase in food prices resulted in children not receiving the required nutrients. Before being confined to the home, toddlers had more opportunity to advance their motor development at a more complex level while acquiring more communication structures. Information about the impact of lockdown due to an epidemic on motor development of children is relevant to policy makers to aid them in developing strategies to help children cope with epidemic/pandemic-driven adversity and ensure their healthy development.
Outcome of neonates born to mothers with pregnancy induced hypertension/preeclampsia: a systematic review
Authors: Arulparithi C. Subramanian , Manjani Sekar , Prakash Petchimuthu
Published: May 2023

Preeclampsia affects 3-10% of pregnancies worldwide. It has significant adverse effect on both the fetus and the neonate. Hence there is a need to study the impact of pregnancy induced hypertension (PIH) on the fetus and the neonate. Databases like PubMed and Cochrane are searched independently by two authors to identify relevant studies. Data were collected for outcomes like birth weight, gestational age, fetal death/stillbirth and intrauterine growth retardation (IUGR). Preeclampsia is associated with significant increase in the incidence of low birth weight (LBW), IUGR and prematurity compared to normotensive women. Also, there is an increased rate of fetal death/ stillbirths in preeclampsia. In addition, there is an increased need for neonatal intensive care unit (NICU) admission in neonates born to PIH mothers. Maternal preeclampsia results in significant adverse effect on the fetus and neonate. There is an increased incidence of stillbirth, LBW, IUGR and preterm deliveries in neonates born to preeclamptic mothers. There is an overall increase in the composite outcomes of neonates of PIH mothers. The objective of the study is to compare the neonatal outcomes of preeclamptic or women with gestational hypertension with that of normotensive women.
Scrub typhus: emerging as a co-infection of acute undifferentiated febrile illness in children in a district hospital of Eastern India
Authors: Bandyopadhyay Santanu , Amin S. Ruhul
Published: May 2023

Scrub typhus, a zoonosis, caused by Orientia tsuttsutgamushi is transmitted to man through bite of infected tromboculid mite. It is endemic in India as other other South-east Asia countries of Tsuttsutgamuhi triangle and affects children as well. It generally presents as an acute febrile illness with non-specific features like headache rash, lymphadenopathy resembling many other commonly prevalent febrile infections. An eschar, though pathognomonic of Scrub typhus, is often missed clinically. Therefore, a high index of clinical suspicion is essential to establish a diagnosis of Scrub typhus and hence it remains usually under-diagnosed in any undifferentiated febrile illness. In this case series including three cases, we decided to rule out Scrub typhus as a co-infection when there was persistence of fever associated with thrombocytopenia even after ongoing treatment of the primarily diagnosed infection. An eschar was incidentally detected in one case only.
Vanishing white matter disease: a case of combined saposin deficiency
Authors: Aly Aly , Villanos Maria Theresa , Zientek Emily , Riddle Malini , Moreno Ittay
Published: May 2023

Vanishing white matter disease (VWMD) is an autosomal recessive neurodegenerative disease often present during childhood and is exacerbated by trauma and other stressors. VWMD is caused by EIF2B gene mutation, which encodes eukaryotic initiation factor 2 B (EIF2B), a transcription factor activated by insulin that is a major protein synthesis regulator during the integrated stress response. Autosomal recessive combined saposin deficiency is a metachromatic leukodystrophy, a progressive neurological disorder characterized by motor delay, regression of gained skills, and nerve demyelination. Here, we present the case of an 11-year-old Hispanic male presenting with ataxia, dysphagia, and global developmental delay which was found to have VWMD on imaging. A genetic panel reveals the PSAP gene, a novel presentation in the setting of VWMD.
Multicentric Castleman’s disease: a rare case presentation
Authors: Kumar Nitish , Dayal Akshaya
Published: May 2023

Castleman’s disease (CD), also known as Angiofollicular lymph node hyperplasia, is a rare lymphoproliferative disorder first reported by dr. Benjamin Castleman in 1956. The estimated incidence rate is 5 to 25 per million person-years. Histologically, the CD can be classified as hyaline-vascular type, plasma cell type and mixed type. HHV-8-associated MCD (Multicentric CD) is most commonly diagnosed in HIV-infected or otherwise immunocompromised individuals. Co-occurrence of polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder and skin changes is known as POEMS syndrome. Treatment of iMCD (idiopathic CD) is challenging, and outcomes are poor because of no uniform treatment guidelines. The anti-interleukin-6 monoclonal antibody Siltuximab with or without corticosteroids is the preferred first-line therapy for iMCD.
Maintenance of space by innovative clinical application of flexible partial denture: a case report
Authors: Mahato Manojit , Saxena Nivedita , Samani Khushbu , Marwah Nikhil , Chalana Srishty
Published: May 2023

The permanent first molar is more susceptible to dental caries than other permanent tooth. Loss of permanent first molar at an early age can cause several issues. It becomes a challenge for a pediatric dentist to provide a prosthesis to the child which would be functional, and act as a space maintainer till dental implant or fixed prosthesis can be planned for the same. This case report describes the unique use of flexible denture for space maintenance upon early loss of permanent first molar.
Percutaneous patent ductus arteriosus closure in extremely low birth weight baby using Amplatzer Piccolo Occluder device
Authors: Kapoor Saurabh , Kaur Ramanjot , Baidwan Amitoj Singh
Published: May 2023

Hemodynamically significant patent ductus arteriosus (PDA) is one of major morbidities seen in preterm babies. It can be closed using conservative, surgical and percutaneous device occlusion techniques. Transcatheter Amplatzer Piccolo Occluder is 1st FDA approved device available in India for closure of PDA in very preterm babies with weight >700 gm. In India, insufficient data is available pertaining to this procedure in extremely low birth weight babies.