Thursday, 17 May 2018

Risk of Cerebral Palsy or Epilepsy in Neonates predicted by Apgar Scores

The risk of a later diagnosis of cerebral palsy or epilepsy can be predicted by an infant's scores on the so- called Apgar Scale. Researchers had observed that the risk rises with decreasing Apgar score, & the lowered scores can be linked to a higher risk of these diagnoses.

Apgar is a point system routinely used at birth to assess a neonates vitality at one, five and ten minutes after birth and the apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed . The scale range can be used to predict the risk of CP or epilepsy. Apgar also measures the baby's color, heart rate, reflexes, muscle tone and respiratory effort. If the scale ranges between 0 and 10, it indicates that child is in full health & if it ranges between 0 and 6 points at one or five minutes after birth is linked to a higher risk of CP & epilepsy, & a very low score of 0 and 3 points at ten minutes indicates a significantly higher risk of CP. Apgar score cannot be considered to be evidence of or a consequence of asphyxia, does not predict individual neonatal mortality or neurologic outcome,& shouldn't be used for that purpose.

Apgar score is considered as a tool for standardized assessment and also provides a mechanism to record fetal-to-neonatal transition & do not predict individual mortality or adverse neurologic outcome.
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Tuesday, 15 May 2018

Neonatal Abstinence Syndrome: A brief study

Neonatal Abstinence Syndrome is a variable, complex, and incompletely understood spectrum of signs of neonatal behavioral dysregulation and is the commonly referred term for a newborn infant with an opioid use disorder or taking other substances at risk for drug withdrawal.
Opioid refers to natural and synthetic substances with morphine-like activities that activate mu-opioid receptors in the central nervous system and gastrointestinal tract and the opioid dependent pregnant women with substance use disorders are generally maintained on methadone which provides multiple benefits, including improved prenatal care, reduced fetal mortality and improved fetal growth and

NAS may occur when a pregnant women takes drugs such as heroin, codeine, oxycodone, methadone or buprenorphine.  In addition to opioids, use of drugs like Antidepressants and Benzodiazepines can lead to NAS. Signs and symptoms differ for every baby and most appear within 3 days of birth & some appear right after birth or within a few weeks of birth.
NAS can be tested by using Neonatal Abstinence Scoring System that gives points for each NAS symptom depending on how severe it is; bowel movements; and baby's urine.
Two major types of NAS are Prenatal or Maternal use of substances that result in withdrawal symptoms in the newborn & Postnatal NAS secondary to discontinuation of medications such as fentanyl or morphine used fir pain therapy in the newborn.
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Monday, 14 May 2018

Type of Protein Consumption affecting Children Growth Patterns

Researchers had determined that choices of protein intake from solid foods has a significant impact on infant growth during the first year of life. Due to insufficient protein intakes, Children Growth hindering is common in low- income countries and is associated with an increased risk of child mortality, infectious disease morbidity, impaired neurocognitive development, and metabolic disease in later life.

Research on dietary protein adequacy in low- income countries indicates the vast majority of young children consume more protein than specified in published estimates of protein requirements, resulting in the common understanding that growth restriction is not due to protein deficiency. Protein requirements of infants and children are defined as the minimum intake that will allow nitrogen equilibrium during energy balance plus the amount needed for deposition of new tissues.
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Sunday, 13 May 2018

Intestinal Obstruction Syndrome in the Newborn

Intestinal Obstruction is a frequent indication for surgical intervention in newborns and presents with three classic clinical signs that include vomiting, abdominal distention and failure to pass meconium and is the most common causes for admitting a pediatric patient to the pediatrics surgery unit in his or her first weeks of postnatal life.
Neonatal Intestinal Obstruction is caused by an anatomical abnormality that produces bowel movement failure and the Obstructive syndrome is characterized by interference with the flow of  gases, liquids, and solids, & is manifested by the three clinical signs. A common  problem in neonates is the Congenital obstruction of the digestive tract which is the most frequent cause being anorectal malformations, followed by esophageal obstruction, and duodenal obstruction. Changes that occur in the course of an intestinal obstruction as a result of the existing obstacle will cause an accumulation of liquids, gases, and alterations of the secretion and absorption above the occlusive lesion, giving rise to a whole cascade of events. By using obstetrical ultrasound a timely diagnosis can be obtained but still Neonatal Intestinal Obstruction Syndrome continues to be a diagnostic challenge.
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Friday, 11 May 2018

Autism may be predicted by Pupillary Light Reflex in Children

Pupillary Light Reflex is a reflex that controls the pupil diameter in response to the light intensity that falls on the retinal ganglion cells of the retina in the back of the eye assisting in adaptation to various levels of lightness/ darkness. It requires CN II, CN III, and central brain stem connections. The pupillary light reflex functions to allow the size of the pupil to respond to light conditions by contracting and dilating and also allows both pupils to react together or consensually.

Recent Studies suggested that pupillary light reflex in infants might be a early sign of autism.
Researchers had found that autism now affects about 1 in 59 children in the United States represnting a significant increase from 6 years ago and have been looking for new ways to spot autism since it can be quite difficult to diagnose in the first years of a child life. The onset of the pupillary light reflex occurs around 30 to 34 weeks' gestation & is not fully developed until the 1 st month after birth. Ii is known that autism is sometimes accompanied by either over- or under-sensitiveness to certain stimuli, be they smells, lights or sounds. For example, a recently developed blood test detected the condition of autism with upto 92 percent accuracy, while other researchers have turned to the sensory symptoms of the condition to aid diagnosis. Research is being done to examine if the pupillary light reflex of infants controls the light intensity getting to their retinas could be a valid marker of autism,
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Thursday, 10 May 2018

Topic for #Pediatrics 2018 Conference's track 1 will be "#Pediatrics". 
Meet your peers in field of #Pediatrics & #Neonatology and expand your network.
Track 1: #Pediatrics 
#Pediatrics differs from adult medicine in many respects and the obvious body size differences are paralleled by maturational changes. Congenital defects, genetic variance, immunology, oncology, and a host of other issues are unique to the realm of pediatrics and the aim of pediatrics study is to promote the healthy lifestyles for a long infection free life and to facilitate children and adolescent problems.
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Sudden Deaths in Infants are not reduced by Safe- Sleep Recommendations

Sudden Unexpected Infant Death is the sudden, unexpected death of an apparently healthy, full term infant under 1 year of age which is not immediately apparent and encompasses a range of situations, including Sudden Infant Death Syndrome (SIDS) which refers to the unexplained death during sleep, of a healthy baby less than a year old.

Several recommended practices designed to promote breastfeeding may inadvertently contribute to SUPC risks. The practice of skin-to-skin care, in which an infant is placed in a prone position on the mother's chest has been noted in other reports to have a strong association with SUPC. If the mother is also exhausted or sedated, she may even fall asleep with the infant on her chest resulting in co-bedding, an established risk factor for SIDS.

Another recommendation that may have unintended consequences is avoiding the use of pacifiers, which some breastfeeding advocates suggest eliminating and the AAP suggests should not be used until breastfeeding is well established. Pacifier use is strongly associated with a reduced risk of SIDS. Since breastfeeding is also associated with a reduced risk of SIDS, it is recommended that safe-sleep education be integrated with lactation advice.
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