Publications by authors named "Sudhir Malwade"
Background Hypoxic-ischemic encephalopathy (HIE) in neonates results from oxygen deprivation at birth, often leading to long-term neurological issues like cerebral palsy. Early detection is key to improving outcomes, but HIE remains a significant cause of neonatal complications. Here we aim to study the risk factors and predictors of outcome in moderate to severe HIE in inborn Term babies in the neonatal intensive care unit (NICU) Methods This prospective observational study was conducted in the NICU at a tertiary care center between August 2022 and July 2024.
View Article and Find Full Text PDFNeurodevelopmental impairments are known to be more common in premature infants. Premature and low birth weight babies are now more likely to survive because of modern technologies and advancements in perinatal and postnatal care. However, long stays and exposure to harsh stimuli in neonatal intensive care units are known to have a negative impact on the developing neonatal brain.
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- Infantile hypertrophic pyloric stenosis (IHPS) is a condition in infants that causes the pylorus to thicken, resulting in gastric outlet obstruction and severe vomiting.
- This case series discusses two infants with IHPS who displayed metabolic acidosis, rather than the typical metabolic alkalosis usually seen in such cases.
- The presence of metabolic acidosis suggests there may be different underlying issues in these cases, indicating that diagnosing IHPS may require a more comprehensive approach.
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- - Cystic fibrosis (CF) is a genetic disorder that mainly affects the lungs and digestive system, making early diagnosis challenging, especially when symptoms are not typical.
- - A case study highlights a 4-month-old boy with CF who showed uncommon symptoms, including failure to thrive, feeding issues, and slight developmental delays, despite a normal prenatal and postnatal course.
- - Genetic testing ultimately confirmed CF through the identification of a mutation in the CFTR gene, emphasizing the need for genetic analysis to ensure timely treatment even when classic symptoms are absent.
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- Acute kidney injury (AKI) is when a baby's kidneys suddenly stop working well, causing problems like waste buildup in the blood and trouble with fluids and electrolytes.
- In a study of 78 baby boys and girls with AKI, most were premature and suffered from issues like infections or lack of oxygen, with a significant number sadly not surviving.
- The study showed that different causes of AKI in newborns led to different outcomes, meaning doctors need to act quickly based on what type of AKI is present.
Congenital diaphragmatic hernia (CDH) is a rare surgical cause of respiratory distress in neonates. CDH is caused by the protrusion of the abdominal contents into the thoracic cavity due to the failure of the pleuroperitoneal canal to close by eight weeks of gestation. We present the case of a full-term, female child, weighing 2.
View Article and Find Full Text PDFCongenital central hypoventilation syndrome (CCHS) is a rare cause of apnea and hypoventilation requiring long-term multidisciplinary care. In this article, we report the case of a two-month-old female child who presented with recurrent apnea and cyanosis, requiring long-term ventilation. After ruling out other common causes of apnea like sepsis, metabolic disorders, and neuromuscular disorders, a genetic study was done, which confirmed the diagnosis of CCHS.
View Article and Find Full Text PDFThe increasing prevalence of substance misuse in modern culture is contributing to the growth in neonatal abstinence syndrome (NAS) cases in India. NAS can be challenging to diagnose due to nonspecific symptoms and maternal suppression of drug history. Only a few reports of NAS have been published from India.
View Article and Find Full Text PDFCritical illness polyneuropathy (CIP) and myopathy (CIM) are underreported conditions in critically ill children with prolonged intensive care unit stays and mechanical ventilation. We report a case of a 10-year-old boy with pneumococcal meningoencephalitis with severe sepsis and multiorgan dysfunction. The child required prolonged ventilation, sedation, and inotropic support.
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- Griscelli syndrome (GS) is a rare genetic disorder that comes in three subtypes, with subtype 2 (GS2) often leading to severe immune issues and recurrent infections.
- A case study of a four-month-old boy with GS2 illustrated symptoms like fever, seizures, and distinct physical features, including silvery gray hair and hypopigmented skin, which aligned with hemophagocytic lymphohistiocytosis (HLH).
- The child's condition worsened, resulting in death due to complications from severe sepsis; prompt diagnosis is critical, as hematopoietic stem cell transplantation is the only effective treatment option.
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- - Scurvy is a disease caused by a deficiency of vitamin C and is linked to serious health issues, more common in developing countries due to poor nutrition, despite being rare in developed nations.
- - Diagnosis of scurvy can be delayed or missed because of its lower prevalence, which can lead to complications and unnecessary medical procedures.
- - A case study of a four-year-old girl with severe acute malnutrition revealed scurvy, confirmed through clinical signs and imaging, leading to her treatment with the Formula 75 diet, resulting in steady weight gain.
Background The right ventricle (RV) in the fetus is the predominant chamber, accounting for about 60% of the total cardiac output. The majority of the RV outflow volume is diverted from the pulmonary artery via the ductus arteriosus to the descending aorta. After birth, the RV undergoes extensive structural and functional modifications.
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- A study was conducted to implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, focusing on improving infection prevention and control practices in hand hygiene, aseptic techniques, and medication administration.
- Training was provided to 144 healthcare workers, leading to increased hand hygiene compliance and successful completion of central line insertion checklists, although rates of healthcare-associated bloodstream infections and all-cause mortality did not significantly change.
- The implementation of CUSP resulted in improved patient safety culture, particularly in management support for safety, teamwork, and organizational learning, but also led to an increase in overall workload for healthcare staff.
Infant massage is a highly prevalent traditional practice in India and other parts of Asia. Clear guidance on safe and effective uses of infant massage is lacking especially in the contemporary times when the traditional knowledge is on the verge of extinction and preparations may differ from in the past. This paper presents a consensus guidance in the form of a standardized protocol for routine massage of infants in home settings.
View Article and Find Full Text PDFBackground: Antimicrobial resistance (AMR) is a growing threat to newborns in low- and middle-income countries (LMIC).
Methods: We performed a prospective cohort study in 3 tertiary neonatal intensive care units (NICUs) in Pune, India, to describe the epidemiology of neonatal bloodstream infections (BSIs). All neonates admitted to the NICU were enrolled.
Objective: To study the actual cost of care per patient in private-sector level IIIa Neonatal Intensive Care Unit (NICU).
Methods: Prospective cost-analysis study. Cost incurred by the family on the treatment of baby, separately for every newborn for entire length of hospitalization, was calculated.