University Publications
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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 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.Item Neonatal evaluation by extended (12 area) vs. traditional (6 area) lung ultrasound scoring (NEXT-LUS): a prospective observational study(Forntieres, 2025-08-13) Chinmay Chetan; Shoham Majumder; Aninda Debnath; Ravleen Kaur; Deepak Jaybhaye; Arshpuneet Kaur; Saikat PatraBackground: Lung ultrasound (LUS) offers a safe, repeatable, radiation-free tool in management of respiratory distress in neonates. Despite wide use, limited data exists on optimal scoring approaches. Methodology: A prospective observational study was conducted over 6 months in a tertiary neonatal intensive care unit (NICU) enrolling neonates with respiratory distress within 2 h of admission after consent. LUS was performed using both 6-area and 12-area scanning approaches. Scores were assigned per Brat’s criteria. Primary outcome was prediction of need for invasive ventilation within 72 h. Secondary outcomes included optimal cut-off scores, correlation with clinical outcomes and procedural safety. Results: Among 73 neonates enrolled, the 6-area LUS score (cut-off ≥5) predicted invasive mechanical ventilation within 72 h with 75% sensitivity and 67% specificity (AUC = 0.76). The 12-area score (cut-off ≥13) had similar accuracy (sensitivity 75%, specificity 73%; AUC = 0.77). Both 6-area and 12-area scores performed better in neonates <34 weeks (AUCs: 0.83 vs. 0.86). In neonates presenting after 24 h of life (n = 19), both scores maintained good accuracy (AUCs: 0.80 for 6-area, 0.83 for 12-area). Multivariate analysis identified partial pressure of carbon dioxide (pCO2) and duration of stay as independent predictors. The 12-area score required reattempts (in 9% cases) unlike the 6-area score. Conclusion: In neonates presenting with respiratory distress, 6-area and 12-area LUS scores done within 2 h of admission show good and comparable predictive value regarding need for invasive ventilation by 72 h.Item Elizabethkingia meningoseptica With Targeted Environmental Surveillance in a Tertiary Care Hospital: A Retrospective Cohort Study(PUBMED, 2025-01-07) Garima Mittal; Rajender Singh; Manish Mittal; Mani Pant; Barnali Kakati; Saikat PatraIntroduction Elizabethkingia meningoseptica (E. meningoseptica) is a multidrug-resistant, non-fermenting Gram-negative bacillus increasingly associated with nosocomial infections, particularly in immunocompromised and critically ill patients. Its intrinsic resistance to multiple antibiotics limits treatment options and contributes to adverse clinical outcomes. Aim and objective The study aimed to investigate the clinical and microbiological characteristics of E. meningoseptica infections among ICU/NICU patients and to explore potential environmental sources through hospital-based surveillance. The objectives of this study were to describe the clinical and demographic profiles of ICU/NICU patients with E. meningoseptica infection; to assess the associated risk factors contributing to these infections; to analyze the antimicrobial susceptibility patterns of the isolated strains using standardized microbiological methods; to evaluate treatment outcomes including morbidity, mortality, and duration of ICU/NICU stay; and to identify potential environmental reservoirs of E. meningoseptica through surveillance activities coordinated by the Hospital Infection Control Committee (HICC). Methods A retrospective cohort study was conducted over 18 months (July 2023 to October 2024) at a tertiary care hospital. A total of 15 patients with culture-confirmed E. meningoseptica infection were included. Demographic, clinical, microbiological, and treatment data were collected. Identification and antimicrobial susceptibility testing were performed using the Vitek-2 automated identification system (bioMérieux, Marcy-l'Étoile, France). HICC conducted routine and targeted environmental sampling as per policy protocol. Results Among the 15 patients with E. meningoseptica infection, nine (60.0%) were adults, and 11 (73.3%) were male individuals. Sepsis was reported in nine (60.0%), and both ventilator-associated pneumonia and septic shock occurred in six patients each (40.0%). Hypertension and diabetes mellitus were present in six (40.0%) and three (20.0%) patients, respectively. Two neonates (13.3%) with low birth weight and prematurity required NICU admission. Outcomes included mortality in six patients (40.0%), discharge in five (33.3%), and four (26.7%) leaving against medical advice. Endotracheal secretions were the most frequent specimen (46.7%), followed by tracheostomy secretions (33.3%) and blood cultures (13.3%). All isolates (100%) were resistant to carbapenems, third-generation cephalosporins, aztreonam, and piperacillin-tazobactam. Resistance to gentamicin, colistin, and cotrimoxazole was observed in 73.3%, 66.7%, and 46.7% of isolates, respectively. Highest susceptibility was seen with minocycline (66.7%), vancomycin (60.0%), and fluoroquinolones (53.3%). Environmental surveillance, conducted from January to March 2023 as part of routine as well as targeted HICC monitoring (as an outbreak of suspected pathogens was suspected from the NICU and ICU), included 98 samples from high-risk ICU/NICU sites such as sinks, ventilators, humidifiers, and suction units. E. meningoseptica was identified in one sample (1.02%), isolated from a NICU sink. Conclusion E. meningoseptica infections are associated with high resistance and mortality. Minocycline, vancomycin, and fluoroquinolones may be effective. Early detection, targeted therapy, and HICC-led surveillance are essential for control.Item A Study of Clinical Profile of Retinal Diseases in Premature Infants(EuroPub, 2025-06-06) Priyanka Narula; Renu Dhasmana; Saikat Patra; Udit Raj SharmaPurpose: Retinal diseases in premature infants, particularly retinopathy of prematurity (ROP), are significant causes of childhood blindness worldwide. The prevalence and severity of these conditions are influenced by various factors, including gestational age, birth weight, and neonatal care quality. This study aims to analyze the clinical profile of retinal diseases in premature infants visiting or admitted to the Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand. Methods: The present observational study was conducted in the Department of Ophthalmology, Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Dehradun over a period of 12 months. Preterm neonates attending ophthalmology or pediatric outpatient department or admitted in neonatal intensive care unit of Himalayan hospital were included in the study. Premature infants born before 37 weeks of gestation were screened for retinal diseases using indirect ophthalmoscopy. Data on gestational age, birth weight, oxygen therapy, and other relevant clinical parameters was collected. Results: Of the total 101 patients studied, 62 (61.4%) had retinal disease. Males had significantly higher proportion of retinal disease 42 (67.7%) as compared to females 20 (32.2%). P value 0.012. The incidence of ROP was found to be 62 (61.4%). Significant risk factors for the development of retinal diseases included low gestational age, birth asphyxia, ventilator support, oxygen administration and delivew by cesarean section. Conclusion: The study highlights the need for early screening and intervention for retinal diseases in premature infants, particularly those with identified risk factors.