Medico Research Chronicles

A study of hematological profile and outcome in neonates born to mothers with pre-eclampsia and eclampsia in a rural tertiary care hospital in western Maharashtra

Kevin Dr. Kevin Shah, Bhushan Deo, Jayashree P Jadhav — Fri, 02 Feb 2024 00:00:00 +0530

Aims and objectives: To study the hematological profile and outcome of neonates born to preeclampsia and eclampsia mothers in rural tertiary care hospital.

Materials and methods: This was a hospital based descriptive type of cross-sectional study in Dr.Vitthalrao Vikhe Patil Pravara Rural Hospital, Loni. It was carried out over a period of 1 year that is from September 2022 to September 2023.All neonates born to preeclampsia and eclampsia mothers being admitted in Dr.B V P Pravara Rural Hospital were included in the study.

Babies born with Congenital malformation and those born to mothers with other problems like rhesus incompatibility, severe anemia, renal disease, heart disease, and connective tissue disease were excluded from the study.

Results: In the present study 65% of babies were preterm, 34% of babies were more than 37 weeks, 54.5% of babies were born via normal vaginal delivery 45.5% of babies were born via cesarean section,15 % of babies have thrombocytopenia, 6 % of were <1kg birth weight,14% were in 1-1.5 kg range,79 % were in >1.5 to 2.5 kg range.

Conclusion: Babies delivered to hypertensive mothers are more likely to experience a variety of difficulties, it is important to closely monitor these infants to reduce morbidity and promote better growth, development, and survival.

A study of the complications in infants of diabetic mothers in a rural hospital in Western Maharashtra

Jayna Dinesh Mehta, Jayashree. P. Jadhav — Thu, 22 Feb 2024 00:00:00 +0530

Background: Diabetes Mellitus is a group of metabolic diseases characterized by chronic hyperglycaemia associated with disturbances of carbohydrate, fat and protein metabolism due to absolute or relative deficiency in insulin secretion and or action. Historically, infants of diabetic mothers (IDMs) have been at significantly greater risk for spontaneous abortion, still birth, congenital malformations and perinatal morbidity and mortality. IDMs have quadruple the incidence of admission to a new-born intensive care unit.

Aims and objectives: To know complications in infants of diabetic mothers.

Methods: This is a descriptive cross-sectional study that was conducted at the department of paediatrics, Dr. Vitthalrao Vikhe Patil Pravara Rural hospital Loni, Maharastra, India, performed on infants born to diabetic mothers from Feb 2022 to Dec 2023.

Results: 34 infants were included in the study. 2 infants were born of twin pregnancy. So total 33 mothers formed mothers of the sample size. Low birth weight (<2.5 Kg) was observed in 20.6 % of babies and macrosomia (>4 Kgs) was seen in 6% of the babies. 44.1 % weighed between 3-4 Kgs at birth. Hypoglycaemia was the commonest complication seen in 28 (84.8%) IDMs followed by respiratory distress in 11 (33.3%) and congenital anomalies in 11 (32.4%) IDMs. Hypocalcaemia was the least common complication seen in 1 (3%) IDM. None of the IDMs sustained any birth injuries. One baby with a major congenital malformation (sirenomelia) dies within 20 minutes of birth. Hypoglycaemia was more commonly observed in IDMs with birth weight <2.5 Kgs (83.3%) and >3 Kgs (100%) whereas this complication was least common in IDMs weighing 2.5-3 Kgs at birth (P<0.049). Hypoglycaemia was most commonly observed in IDMs at less than 6 hours of postnatal age whereas it was less common at 6-24 hours (12.1%) and 24-48 hours (9.1%) of postnatal age (P < 0.000). This observation was highly statistically significant. ASD was the most common cardiac anomaly observed in IDMs (27.3%) and only 1 (3.0%) IDM had a combination of ASD, VSD, and PDA (P < 0.01).

Conclusion: The neonatal complications commonly seen in infants of diabetic mothers are macrosomia, birth asphyxia, congenital anomalies, respiratory distress, hypoglycaemia, hypocalcaemia, hyperbilirubinemia, and polycythaemia. There are no significant differences in neonatal morbidity profiles of IDMs born to pre-gestational and gestational diabetic mothers. Management goals in pregnancies complicated by diabetes mellitus should be to achieve optimal glycaemic control, as neonatal complications are more common in women with suboptimal glycaemic control.

Tuberculosis and Superior Vena Cava Obstruction

Ashar Jamal — Wed, 27 Mar 2024 23:04:54 +0530

Superior Vena Cava (SVC) obstruction is a rare but serious medical condition characterized by the blockage of the second largest vein in the human body, leading to various symptoms including swelling in the upper body, shortness of breath, and dizziness. Causes of SVC obstruction range from malignancies such as lymphoma and breast cancer to infectious diseases like tuberculosis, along with other factors like blood clots and constrictive pericarditis. Diagnosis typically involves clinical examination and imaging studies like MRI, CT, and venography. A proposed classification system categorizes symptoms into hemodynamic, respiratory, and neurological manifestations, aiding in treatment urgency determination. Management focuses on relieving the blockage and addressing the underlying cause, which may include antibiotics, anticoagulants, chemotherapy, or radiotherapy. We present a case study of a 40-year-old male with neck pain and dizziness, ultimately diagnosed with sub-acute thrombosis of the internal jugular veins leading to SVC compression, potentially due to tuberculosis. This case underscores the importance of considering tuberculosis as a differential diagnosis, particularly in endemic regions, facilitating timely and appropriate treatment interventions.