Neurodevelopmental Outcomes of Very Low Birth Weight Infants at 18-24 Months, Corrected Gestational Age in a Tertiary Health Centre: A Prospective Cohort Study.

Objective: To determine the prevalence and risk factors for poor neurodevelopmental outcome in a cohort of very low birth weight (VLBW) infants.

Subjects And Methods: Four hundred and twenty-two infants of a total of 643 VLBW survivors from a teaching hospital in South India were followed up to assess their neurodevelopmental outcomes.

Results: Among the 422 children who completed the assessment, results of 359 children whose assessments were done between 18 and 24 months were analysed.

A prospective observational study comparing cardiac function of small for gestational age with appropriate for gestational age babies using serial echocardiographic studies.

Background: Approximately 30% of babies born in India are low birth weight (LBW) and about 70% of LBW babies are small for gestational age (SGA). Though there are several trials that have evaluated cardiac function of intrauterine growth restricted (IUGR) babies in utero, there is limited data about postnatal cardiac function in SGA babies during early neonatal period. This study was conducted to evaluate the cardiac functions of SGA babies by serial echocardiographic measurements and compare this with appropriate for gestational age (AGA) babies during the early postnatal period.

Perinatal Risk Factors for Neonatal Early-onset Group B Streptococcal Sepsis after Initiation of Risk-based Maternal Intrapartum Antibiotic Prophylaxis-A Case Control Study.

Objectives: To identify the perinatal risk factors for early-onset Group B Streptococcus (EOGBS) sepsis in neonates after inception of a risk-based maternal intrapartum antibiotic prophylaxis strategy in 2004.

Design: Case control study.

Methods: All newborn with early onset GBS sepsis (born between 2004 and 2013) were deemed to be "cases" and controls were selected in a 1:4 ratio.

Comparison of neonatal outcomes in women with gestational diabetes with moderate hyperglycaemia on metformin or glibenclamide--a randomised controlled trial.

Background: Two oral hypoglycaemic agents, metformin and glibenclamide, have been compared with insulin in separate large randomised controlled trials and have been found to be as effective as insulin in gestational diabetes. However, very few trials have compared metformin with glibenclamide.

Materials And Methods: Of 159 South Indian women with fasting glucose ≥5.

A modified technique for umbilical arterial catheterization.

A modified technique for umbilical artery catheterization was assessed in babies in whom conventional method failed or if the cord was dry. Success rate attained with the modified technique was 90% (19/21). This modified technique could provide an easier and faster method for successful umbilical arterial catheterization.

Neonatal hearing screening--experience from a tertiary care hospital in southern India.

Objective: To implement a neonatal hearing screening program using automated auditory brainstem response audiometry in a tertiary care set-up and assess the prevalence of neonatal hearing loss.

Design: Descriptive study.

Setting: Tertiary care hospital in Southern India.

Development of the gut microbiota in southern Indian infants from birth to 6 months: a molecular analysis.

Acquisition of the gastrointestinal microbiota at birth may have long-term health impacts. We longitudinally characterised major microbial communities in the faeces of a cohort of infants using molecular methods. Faecal samples were prospectively obtained at several time points after birth from eighty-three infants.

Perinatal outcome of infants born to diabetic mothers in a developing country--comparison of insulin and oral hypoglycemic agents.

Objective: To study the perinatal outcomes of infants born to mothers with gestational diabetes treated with insulin or oral hypoglycemic agents in a developing country.

Design: Prospective observational cohort study.

Setting: Tertiary-care perinatal center in southern India.

Microvillous inclusion disease diagnosed by gastric biopsy.

Protracted diarrhea in neonates is uncommon and usually requires an intestinal biopsy for etiological diagnosis. Gastric biopsy has not been used in the routine diagnosis of this condition. We report the first documented patient with microvillous inclusion disease from India, where the diagnosis was established by a gastric biopsy.

Retrospective cohort study comparing neonatal outcomes of women treated with glyburide or insulin in gestational diabetes: a 5-year experience in a South Indian teaching hospital.

Objective: To assess the effectiveness of glyburide in preventing complications of gestational diabetes in neonates as compared to insulin.

Materials And Methods: Information from birth register, maternal and neonatal records were obtained. Five hundred and seventy-seven gestational diabetics with moderate hyperglycemia i.

A randomized control trial comparing two enteral feeding volumes in very low birth weight babies.

Poor post-natal growth of preterm neonates is common and fortification is recommended. However, this is not always practical in low-resource areas. Hypothesizing that increasing the volume of feeds would be safe and lead to better post-natal weight gain, we randomized 64 babies with birth weight <1500 g, once they reached full feeds, to continue feeds at 200 ml/kg/day (standard volume) or increase to 300 ml/kg/day (high volume) of expressed breast milk.

Whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting: a feasibility trial.

Objective: To determine the feasibility and safety of whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting.

Design: Feasibility trial.

Setting: Tertiary care perinatal centre.

Comparison of viral load and duration of virus shedding in symptomatic and asymptomatic neonatal rotavirus infections.

A single rotavirus strain causing asymptomatic infections as well as severe gastrointestinal disease has been described in the neonatal nurseries of the Christian Medical College, Vellore. In this study, quantitative real-time RT-PCR was used to determine the association of viral load with the presence of gastrointestinal symptoms in neonates. Viral load was estimated in terms of the crossing point [C(t) value] at which the amplicon could be detected in the real-time PCR assay.

Genogroup IIb norovirus infections and association with enteric symptoms in a neonatal nursery in southern India.

Noroviruses (NoVs) are increasingly recognized as an important cause of acute gastroenteritis in children worldwide. However, there are limited data on the role of NoVs in neonatal infections and disease. The objectives of the present study were to determine the prevalence of NoVs in neonates with gastrointestinal disease using a case-control study design and to characterize the NoV strains infecting neonates.

Prevalence of extended- spectrum beta-lactamase producing Escherichia coli and Klebsiella spp in a neonatal intensive care unit.

This study reports the prevalence of extended-spectrum b-lactamase producing Escherichia coli and Klebsiella spp among septicemic neonates. Over a five year period, there were 94 isolates of Klebsiella spp and E .coli.

Whole genome characterization of reassortant G10P[11] strain (N155) from a neonate with symptomatic rotavirus infection: identification of genes of human and animal rotavirus origin.

Background: Rotavirus G10P[11] strains have long been associated with asymptomatic neonatal infections in some parts of India. We have previously reported G10P[11] strains associated with both asymptomatic infections and severe gastrointestinal disease in neonates from Vellore in southern India, with >90% partial nucleotide and amino acid identity to the VP4, VP6, VP7 and NSP4 genes of the exclusively asymptomatic G10P[11] strain I321.

Objectives: In this study, the whole genome of a G10P[11] isolate (N155) from a neonate with severe gastrointestinal disease was characterized to determine whether there were significant differences in its genetic makeup in comparison to G10P[11] strain I321 and to establish the origin of the G10P[11] strains in Vellore.

Rotavirus infection in the neonatal nurseries of a tertiary care hospital in India.

Background: The majority of neonatal rotavirus infections are believed to be asymptomatic, and protection from subsequent infection and disease has been reported in neonatally infected children. In this study, we present the results of a 4-year prospective surveillance in the neonatal nurseries of a tertiary care hospital in south India.

Methods: Stool samples from neonates admitted for >48 hours either with gastrointestinal (GI) symptoms or with nonenteric pathology were screened for rotavirus.

Investigation of the environment and of mothers in transmission of rotavirus infections in the neonatal nursery.

A distinct feature of neonatal rotavirus infection is the association of unusual strains that appear to be prevalent only in neonatal units and persist for long periods of time. The main aims of this study were to determine if rotavirus can be detected on environmental surfaces in the neonatal nursery and whether the infection occurs in mothers of infected and uninfected neonates. Thirty rotavirus positive neonates and an equal number of negative neonates were enrolled in this study.

Determination of extended-interval gentamicin dosing for neonatal patients in developing countries.

Background: Infectious diseases account for an estimated 36% of neonatal deaths globally. The purpose of this study was to determine safe, effective, simplified dosing regimens of gentamicin for treatment of neonatal sepsis in developing countries.

Methods: Neonates with suspected sepsis in the neonatal intensive care unit (NICU) at Christian Medical College and Hospital (CMC), Vellore, India (n = 49), and Dhaka Shishu Hospital (DSH), Bangladesh (n = 59), were administered gentamicin intravenously according to the following regimens: (1) 10 mg every 48 hours for neonates <2000 g; (2) 10 mg every 24 hours for neonates 2000-2249 g; and (3) 13.

Neonatal hydrothorax following migration of a central venous catheter.

The use of a central venous catheter may occasionally be associated with complications like sepsis, effusions and thrombosis. Migration of the central catheter is an unusual complication that often goes unrecognized. This case report is of a neonate who developed hydrothorax resulting from a migrating central line and highlights the need for a high level of clinical suspicion in diagnosing catheter related problems.

Is C-reactive protein level useful in differentiating infected from uninfected neonates among those at risk of infection?

Objective: To document effects of intrapartum risk factors for early onset sepsis (EOS) on CRP levels in neonates and to assess the suitability of this test in diagnosing EOS.

Design: Cohort study.

Setting: Labour and post natal wards in a tertiary level teaching hospital in India.