Reeta Bora

Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India

Abstract Objectives: To determine the prevalence of anemia in pregnant women and characterize its effect on neonatal outcome in Northeast India. Patients and methods: Four hundred and seventy mothers and their newborn infants during a one month period were included. The association between maternal hemoglobin (Hb) at delivery and neonatal outcomes were determined. Results: Anemia (Hb < 110 g/L) was present in 421 (89.6%) mothers with 35 (8.3%) having severe anemia(Hb < 70 g/L). After adjusting for maternal and neonatal variables, each 10 g/L decrease in maternal Hb was associated with 0.18 week decrease in gestational length (p = 0.003) and 21 g decrease in birth weight (p = 0.093). Severe maternal anemia was associated with 0.63week (95% CI, 0.03–1.23week) shorter gestation, 481 g (95% CI, 305–658 g) lower birth weight and 89% increased risk of small-for-gestation (OR 1.89, 95% CI, 1.25–2.86)in the offspring, compared with those born to mothers without anemia (p < 0.001). Conclusion: Maternal anemia was highly prevalentin this population. Lower gestational age and birth weight, and increased risk of small-for-gestation were associated with maternal anemia, especially when maternal Hb was <80 g/L. Maternal anemia needs urgent attention to improve neonatal outcome in this population.

Effect of 40-cm segment umbilical cord milking on hemoglobin and serum ferritin at 6 months of age in full-term infants of anemic and non-anemic mothers

Objective:To assess the effect of early clamping and milking of a 40-cm umbilical cord LUCM (long umbilical cord and milking) on hemoglobin (Hb) and serum ferritin concentrations at 6 months of age and to evaluate whether the effect is different in infants of anemic and non-anemic mothers.Study design:Eligible term-infants of anemic (maternal Hb<11.0 g dl−1) and non-anemic mothers (Hb ⩾11.0 g dl−1) were randomized to LUCM or control groups (N=100 each). In the LUCM group, the umbilical cord was clamped at 40-cm length and milked. The control group had the cord clamped at 5 cm and not milked. Neonatal morbidities until discharge and Hb and serum ferritin at 6 months of age were compared. Effects in infants of anemic and non-anemic mothers were compared.Result:Compared with infants of non-anemic mothers, cord Hb was similar (14.50±1.90 g dl−1 vs 14.67±1.73 g dl−1), but cord ferritin lower (85.8±55.4 ng ml−1 vs 119.4±58.5 ng ml−1, P<0.01) in infants of anemic mothers. Mean Hb concentration at 6 months was 9.60±1.42 g dl−1 in the LUCM group and 9.07±1.10 g dl−1 in the control group (P=0.004). Mean serum-ferritin concentration at 6 months was 113.9±43.8 ng ml−1 in the LUCM group and 70.8±39.5 ng/ml in the control group (P<0.001). The effectiveness of LUCM did not vary with the maternal anemia status.Conclusion:Keeping the umbilical cord long and milking may be an effective method for improving Hb and iron stores at 6 months of age in term-infants.

Sneathia species in a case of neonatal meningitis from Northeast India

Here we report the detection of Sneathia species most closely related to Sneathia sanguinegens, an infrequently reported bacterium, in the cerebrospinal fluid of a neonate by a culture independent method. Even though on rare occasions, this bacterium was isolated previously from the blood of neonatal bacteraemia cases. To the best of our knowledge there exists no previous report of detection of S. sanguinegens in the cerebrospinal fluid even though recently there has been a report of isolation of closely related species, Leptotrichia amnionii. The neonate recovered following antimicrobial therapy for 21 days. We conclude that uncultivable or difficult- to-cultivate bacteria like Sneathia could be an emerging pathogen for neonatal infection.

Acute pulmonary melioidosis in a child: A case report and review of literature.

Melioidosis is a rare potentially fatal infection caused by the bacterium Burkholderia pseudomallei, which is endemic in Southeast Asia and Northern Australia and an emerging pathogen in India. It is a largely under-diagnosed disease and an imitator of tuberculosis, both clinically and radiologically.

Extended-spectrum β-lactamase & carbapenemase-producing Gram-negative bacilli in neonates from a tertiary care centre in Dibrugarh, Assam, India

The choice of first-line antibiotic for the initiation of treatment in cases of neonatal sepsis/meningitis is a challenge to a clinician. It is further complicated when it is suspected to be caused by drug-resistant bacteria. β-lactam antibiotics are used widely worldwide against infections caused by Gram-negative bacteria. Resistance is known to be due to various mechanisms among which production of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) is reported1-12.

In resource limited areas complete enteral feed in stable very low birth weight infants (1000–1500 g) started within 24 h of life can improve nutritional outcome

Abstract Objective: To evaluate feasibility of complete enteral feed (CEF) in stable very low birth weight neonates weighing 1000–1500 g. Subjects and interventions: One hundred and three stable very low birth weight (vlbw) neonates (1000–1500 g) irrespective of gestational age (GA) were randomized to receive either CEF with expressed breast milk (EBM) (n = 51) or minimal enteral feed (MEF) supplemented with intravenous fluid (IVF). (MEF) (n = 52). Feed volume was increased progressively. Primary outcome measures were feed intolerance (FI) and necrotizing enterocolitis (NEC) in first 21 days of life or discharge from NICU, whichever was earlier. Secondary outcome measures were the time taken to reach calorie intake of 110 kcal/kg/D and regain of birthweight. Results: FI was observed in n = 12 (23.53%) in CEF group versus n = 6 (11.53%) in MEF group (p = 0.1264). NEC was observed in 4 (7.8%) in CEF group versus 1(1.9%) in MEF group (p = 0.16) and results were comparable in both groups. Birthweight regain (10.6 ± 1.6 days versus 11.8 ± 1.6 days, p = 0.038), NICU discharge (11.7 ± 2.6 days versus 13.0 ± 3.45 days, p = 0.038) and time to reach 110 kcal/kg/day (9.571 ± 1.458 days versus 10.833 ± 1.655 days, p = 0.001) were significantly earlier in CEF compared to MEF group. Conclusion: Complete enteral feeds started within 24 h of life is feasible in vlbw neonates.

Clinically relevant yeast species identified by sequencing the internal transcribed spacer region of r-RNA gene and Vitek 2 compact (YST card) commercial identification system: Experience in a Tertiary Care Hospital in Assam, Northeast India

In this retrospective study from 2012 to 2015, 333 clinical isolates of yeasts were identified using Vitek 2 Compact System YST ID card (Biomerieux, France) and internal transcribed spacer (ITS) sequencing. Eighteen species were identified by ITS sequencing. Candida albicans was the most common species (46.5%), followed by Candida tropicalis (27%). The total species supported by Vitek System was 11 (61.11%). The sensitivity of the system in identifying these 11 species was 66.66%–100%; specificity 98.37%–100%; positive predictive value 70%–100%, negative predictive value 96.05%–100%, and diagnostic accuracy 96.99%–100%. Diagnostic accuracy of ITS1 and ITS2 sequences individually was 98.49% and 100% using NCBI Genbank database.