University Publications
Permanent URI for this communityhttp://10.0.2.71:4000/handle/123456789/259
This community contains all the publications of the university, including research papers. manuscripts, videos, conference papers, project reports, etc.
Browse
14 results
Search Results
Item Yellow Fibrous Cord‑Like Penile Discharge in a Preterm Neonate — Fungal Balanoposthitis(PUBMED, 2024-03-01) Chinmay Chetan; Saikat Patra; Brajendra Singh; Girish GuptaA 1785 g male neonate was born at 31 wk gestation, to an inadequately treated syphilitic mother. The neonate was diagnosed with congenital neurosyphilis. Injection benzathine penicillin G stat dose along with injection ceftriaxone was started through peripherally inserted central catheter. At DOL 24 he developed thick yellowish cord-like gelatinous odourless discharge from the penis, measuring 9 mm×4 mm (Fig. 1). Physiological phimosis was present, with no signs of inflammation and urinary retention. No perianal rashes were noted. Oral thrush was present. Histopathological examination of discharge and suprapubic urine KOH mount revealed budding yeast cells with pseudohyphae. Local clotrimazole cream and injection fluconazole was started. Local hygiene was maintained. The discharge culture grew Candida albicans sensitive to fluconazole.Item Correlation of Point-of-Care Lung Ultrasound Scoring System with Clinical Score and Chest X-ray Score for Newborns with Respiratory Distress(PUBMED, 2025-07-07) Brajendra Singh; Chinmay Chetan; Saikat Patra; Girish Gupta; Vinayak Madhukar Jedhe; Shoham MajumderObjectives To determine correlation between the lung ultrasound score with the chest X-ray score and the Downes score in neonates with respiratory distress. Methods All consecutive neonates admitted in the neonatal intensive care unit (NICU) with respiratory distress were checked for eligibility at admission. Clinical scoring was done using Downes score immediately. 12 area lung ultrasound scoring was done using Brat Score by trained experts. Chest X-ray scoring was done from high quality anteroposterior images. The findings of the three scores were then compared and correlated using Pearson correlation coefficient. Results One hundred neonates were enrolled with mean gestational age of 34.8 ± 3.6 wk and mean birth weight of 2063.7 ± 722 g. A positive correlation was found between Downes score and lung ultrasound score (Pearson correlation coefficient 0.712, p-value < 0.001) but not between lung ultrasound score and chest X-ray score. In the subgroup analysis, a statistically significant correlation was found between lung ultrasound score and Downes score for babies > 32 wk gestation but not for those < 32 wk gestation. Conclusions In neonates admitted to NICU with respiratory distress, lung ultrasound score correlates well with Downes score, especially in babies with gestational age > 32 wk.Item Facial Scalds due to Steam Inhalation in a Neonate – A Case Report(Journal of Nepal Paediatric Society, 2024-08-01) Chinmay Chetan; Saikat Patra; Aisha Naaz; Girish GuptaSteam inhalation is a traditional remedy used in all age groups for treating respiratory problems like cough, coryza, pharyngitis, bronchiolitis, etc. Though equivocally beneficial, should be avoided in neonates, due to the risk of burns if not used correctly. We present a case of a term neonate with scalds on his face due to steam inhalation, given by his mother, to treat cough and coryza. First and second-degree burns were present on the face. Oral, nasal cavities, and eyes were unaffected. This case highlights the probable side effects of steam inhalation, a therapeutic approach lacking proven advantages. This reemphasizes the need to avoid such treatment strategy, especially in neonates who are predisposed to such injuries.Item Unraveling Patterns of Congenital Structural Malformations in Infants: A Hospital-Based Descriptive Study(PUBMED, 2024-05-15) Savita Pandey; Yasir A. Lone; Saikat Patra; Braham P. Kalra; Sanyam ModiIntroduction Congenital malformation studies serve several purposes, including establishing baseline rates, monitoring changes over time, exploring the origins of these defects, and helping in planning health services. Increasing public awareness about pediatric surgical interventions is another goal of these studies. However, the impact of congenital malformations is often underestimated in developing countries due to insufficient healthcare data and diagnostic facilities, particularly in rural areas. Families affected by the birth of a child with congenital malformations face significant stress and hardship. Methods The main aims of this study were to evaluate the clinical pattern of congenital structural malformations in our region (Uttarakhand, India), identify possibly associated factors of congenital malformations, and find out the immediate outcome of congenital malformations in enrolled participants. Results Among a total of 150 cases, 73 (48.7%) cases were inborn, whereas 77 (51.3%) cases were outborn. Investigation of congenital malformation revealed cleft lip or palate in 37 (24.7%) cases, congenital heart disease (CHD) in 33 (22%) cases, meningomyelocele (MMC) in 18 (12.0%) cases, anorectal malformation (ARM) in 11 (7.3%) cases, hypospadias in 10 (6.7%) cases, congenital talipes equinovarus (CTEV) in nine (6.0%) cases, tracheoesophageal fistula (TEF) in nine (6.0%) cases, polydactyly in seven (4.7%) cases, pelviureteric junction obstruction (PUJO) in four (2.7%) cases, duodenal atresia in three (2.0%) cases, midgut volvulus in three (2.0%) cases, umbilical sinus in two (1.3%) cases, sacrococcygeal teratoma (SCT) in one (0.7%) case, phimosis in one (0.7%) case, microtia in one (0.7%) case, and micrognathia in one (0.7%) case. Mortality was observed in 11 (7.3%) cases, whereas 105 (70%) cases were successfully discharged. Among 11 mortality cases, the cause of death was CHD in seven (63.2%) cases, TEF+CHD in two (18.1%) cases, MMC in one (9%) case, and duodenal atresia in one (9%) case. Conclusion Contrary to the common belief that advanced maternal age of greater than 35 years is a major cause, 86.6% of the congenital structural anomalies in our hospital-based study in Uttarakhand occurred in babies of mothers belonging to the age group of 18-30 years. Also, consanguineous marriage was observed in only 3.3% of cases, indicating that it may not be a major contributing factor causing congenital structural malformations in our region. External congenital anomalies are most commonly observed (60.7%), with cleft lip and cleft palate being the most common. The most frequently observed internal congenital anomaly is CHD (22%) followed by gastrointestinal (GI) (18.6%) and urinary anomalies (10.1%). Death and referral are commonly seen in CHD.Item Infective Endocarditis due to Unusual Pathogens Complicated with Pulmonary Thromboembolism: A Rare Occurrence in a Premature Infant(SCOPUS, 2024-05-13) Saikat Patra; Prachi Patwal; Chinmay Chetan; Girish GuptaBackground: Survival of low birth weight preterm neonates has increased with the availability of better neonatal care, however, the use of central lines for longer duration increases the risk of bacterial and fungal sepsis. Neonatal infective endocarditis (IE) is a rare presentation of neonatal sepsis and is often associated with complications and high mortality. Clinical Description: A 36 weeker, premature baby, hospitalized for early onset sepsis, was transferred to our hospital on day 15 of life, with an umbilical catheter in situ, with fever, respiratory distress, and persistent thrombocytopenia. Clinical examination revealed decreased oxygen saturation, crepitations in the right lung field, systolic murmur, and hepatomegaly. Management and Outcome: Baseline investigations revealed positive septic screen with thrombocytopenia with meningitis, neonatal cholestasis, and right sided consolidation on chest X ray. A two dimensional echocardiography (ECHO) revealed vegetation on the tricuspid valve, and blood culture from two sites revealed growth of Candida tropicalis and Serratia marcescens. Colistin, tigecycline, and amphotericin B therapy were initiated as per sensitivity along with low molecular weight heparin for prevention of embolization. The baby developed acute worsening in respiratory distress after 4 weeks of therapy. Repeat ECHO revealed increased size of cardiac vegetation and computed tomography of thorax with pulmonary angiography revealed pulmonary thromboembolism. Unfortunately, the baby succumbed to complications of IE. Conclusion: Invasive instrumentations such as umbilical catheterization and prolonged hospitalizations of premature newborns predispose them to develop IE, especially with unusual organisms. Such infections have a complicated course and may be fatal.Item Alarming medication error with prostaglandin E1 (PGE1) in a term neonate with critical congenital heart disease(BMJ case report, 2024-04-08) Saikat Patra; Prachi Patwal; Chinmay Chetan; Girish GuptaAn outborn full-term female newborn with birth weight 2.45kg was admitted to our centre at 24 hours of life with respiratory distress and cyanosis. The baby had tachycardia and oxygen saturation (SpO2 ) 40% at admission to neonatal intensive care unit (NICU). She was mechanically ventilated on synchronized intermittent mandatory ventilation (SIMV) mode. Clinical evaluation raised suspicion of critical congenital heart disease; echocardiogram revealed transposition of the great arteries with 6mm ostium secundum atrial septal defect and small patent ductus arteriosus. The baby was started only on intravenous prostaglandin E1 (PGE1) as per unit protocol, where 1 ampoule (500 µg) of PGE1 is mixed in 49mL of 5% dextrose yielding a concentration of 10 µg/mL and is then started using an infusion pump at a rate of 0.6mL/kg/hour to provide a dose of 0.1 µg/kg/min. She developed tachycardia along with confluent erythematous macules over the scalp, face, neck and trunk, 10 hours after starting PGE1 infusion (figure 1). There was no associated fever or hypertension, while lowest blood pressure recorded was 52/30mm Hg. The skin rash, characterised by bright erythematous macular lesions, rapidly spread to the extremities. It was noticed that PGE1 was wrongly administered at 10 times the expected dose for the last 2hours prior to the cutaneous manifestation. The infusion was immediately stopped, and the baby was givenItem To Validate Use of Transmittance Sensor of Peripheral Pulse Oximeter for Forehead Pulse Oximetry in Newborns(SAGE Publications, 2024-10-01) Talha Rehman; Girish Gupta; Saikat Patra; Chinmay Chetan; Rakesh Kumar; Sanober WasimIntroduction Peripheral pulse oximeters with continuous monitoring of heart rate and saturation have revolutionized neonatal care. Motion artifacts, hypothermia, and poor perfusion are some of the barriers for reliable reading in the transmittance type of peripheral pulse oximeters. This study was planned to assess the effectiveness of transmittance sensors applied over the forehead for monitoring the heart rate and saturation. Material and Methods An observation study was conducted over a period of 1 month. Two pulse oximeters (Masimo RAD97) were applied simultaneously, one over the periphery (right hand/wrist) and the other over the forehead using an innovative headband. A total of 540 readings of heart rate and saturation (SpO2) from each site were recorded. A difference of more than 5 beats/minute in heart rate and 2% saturation were considered clinically significant. Results Forty-five neonates with mean gestational age of 35.3 ± 3.2 weeks and birth weight of 2109 ± 683 grams were enrolled. Forehead pulse oximeter could pick up the heart rate and SpO2 readings in all the babies. A statistically significant difference of 3.8 beats/minute in heart rate and 2.5% in SpO2 was noted (p-value < 0.0001). The difference in heart rate was not clinically significant. Conclusion We propose that the transmittance type peripheral pulse oximeter sensors can be used over the forehead. It has the potential to avoid erroneous readings due to motion artifacts, hypothermia, or shock. Saturation nomograms for the forehead pulse oximetry need to be established before it can be used to monitor and manage the neonates for the same.Item Biotinidase deficiency-masquerade of primary immunodeficiency disease in neonate(PUBMED, 2024-12-15) Chinmay Chetan; Brajendra Singh; Saikat Patra; Girish GuptaBiotinidase deficiency, a rare metabolic disorder characterised by abnormal biotin metabolism, affects the biotin-dependent carboxylase functions. Primarily characterised by neurological and skin disorder, it may present with myriad features. Early recognition is important for preventing long-term morbidities. Here, we describe a case of a neonate presenting with seizures and a clinical picture suggestive of immunodeficiency. Multiple superficial abscesses along with septic arthritis of the left knee and left hip led to suspicion of primary immunodeficiency disorder. On evaluation, there was severe biotinidase deficiency. The neonate was supplemented with biotin, after which there were no further episodes of severe infection requiring hospitalisation, seizures or skin manifestation. This case report highlights the wide spectrum of clinical picture these disorders may present with and the low threshold for their evaluation and treatment.Item Overcoming odds: neonatal survival in absent right main pulmonary artery with unilateral right pulmonary hypoplasia(PUBMED, 2025-03-07) Debajyoti Banerjee; Brajendra Singh; Saikat Patra; Girish GuptaA unilateral absent pulmonary artery with unilateral pulmonary hypoplasia is an exceptionally rare congenital anomaly. This case report details the management of a neonate diagnosed antenatally with absent right main pulmonary artery and right pulmonary hypoplasia. The neonate developed respiratory failure within 24 hours of birth and was successfully managed with invasive ventilation and conservative treatment. Despite episodes of bronchiolitis during infancy, the child demonstrated normal growth and development at 1 year. This case highlights the importance of early diagnosis, multidisciplinary care and vigilant follow-up in achieving favourable outcomes in rare congenital conditions.Item Role of point-of-care ultrasound in the management of congenital diaphragmatic palsy(PUBMED, 2025-06-27) Ravleen Kaur; Kanishka Bahuguna; Chinmay Chetan; Saikat PatraIn newborns, brachial plexus injury is the most common peripheral nerve injury during the delivery. It may also lead to phrenic nerve injury causing diaphragmatic palsy. Conservative management remains the mainstay of treatment for congenital diaphragmatic palsies. Surgical plication is a potential management strategy for the persistent cases, but the timing and outcomes are not clear. Here, we present a case where diaphragmatic palsy was diagnosed and monitored using point-of-care ultrasound. The surgical intervention was avoided by serial monitoring of diaphragmatic excursion on ultrasound, which revealed improvement despite persistent requirement of respiratory support.