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Publisher: Medknow Publishers   (Total: 429 journals)

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Showing 1 - 200 of 429 Journals sorted alphabetically
Acta Medica Intl.     Open Access   (SJR: 0.101, CiteScore: 0)
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advanced Biomedical Research     Open Access  
Advances in Human Biology     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
African J. for Infertility and Assisted Conception     Open Access  
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.25, CiteScore: 1)
African J. of Trauma     Open Access   (Followers: 1)
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Alexandria J. of Pediatrics     Open Access  
Ancient Science of Life     Open Access   (Followers: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.258, CiteScore: 1)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, SJR: 0.308, CiteScore: 1)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Indian Psychiatry     Open Access  
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 8, SJR: 0.352, CiteScore: 1)
Annals of Saudi Medicine     Open Access   (SJR: 0.238, CiteScore: 1)
Annals of Thoracic Medicine     Open Access   (Followers: 5, SJR: 0.524, CiteScore: 1)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 13, SJR: 0.152, CiteScore: 0)
Annals of Tropical Pathology     Open Access  
Apollo Medicine     Open Access  
APOS Trends in Orthodontics     Open Access  
Arab J. of Interventional Radiology     Open Access  
Archives of Cardiovascular Imaging     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Archives of Intl. Surgery     Open Access   (Followers: 10, SJR: 0.302, CiteScore: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Pharmacy Practice     Open Access   (Followers: 6, SJR: 0.102, CiteScore: 0)
Archives of Trauma Research     Open Access   (Followers: 3, SJR: 0.37, CiteScore: 2)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 4)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.856, CiteScore: 2)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.35, CiteScore: 1)
Asian Pacific J. of Reproduction     Open Access   (SJR: 0.227, CiteScore: 1)
Asian Pacific J. of Tropical Biomedicine     Open Access   (Followers: 2, SJR: 0.491, CiteScore: 2)
Asian Pacific J. of Tropical Medicine     Open Access   (Followers: 1, SJR: 0.561, CiteScore: 2)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
Biomedical and Biotechnology Research J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Canadian J. of Rural Medicine     Full-text available via subscription   (SJR: 0.202, CiteScore: 0)
Cancer Translational Medicine     Open Access   (Followers: 2)
Cardiology Plus     Open Access  
Chinese Medical J.     Open Access   (Followers: 10, SJR: 0.52, CiteScore: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Cancer Investigation J.     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 2)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 10, SJR: 0.811, CiteScore: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 4, SJR: 0.353, CiteScore: 1)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.543, CiteScore: 1)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.152, CiteScore: 0)
Dental Research J.     Open Access   (Followers: 11, SJR: 0.416, CiteScore: 1)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 6, SJR: 0.242, CiteScore: 0)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1, SJR: 1.799, CiteScore: 2)
Egyptian J. of Chest Diseases and Tuberculosis     Open Access   (Followers: 3, SJR: 0.155, CiteScore: 0)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access   (Followers: 1)
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Nursing J.     Open Access  
Egyptian Orthopaedic J.     Open Access   (Followers: 2)
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.822, CiteScore: 2)
Environmental Disease     Open Access   (Followers: 2)
Eurasian J. of Pulmonology     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.749, CiteScore: 2)
European J. of General Dentistry     Open Access   (Followers: 1, SJR: 0.12, CiteScore: 0)
European J. of Prosthodontics     Open Access   (Followers: 3)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11, SJR: 0.113, CiteScore: 0)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.112, CiteScore: 0)
Genome Integrity     Open Access   (Followers: 3, SJR: 0.153, CiteScore: 0)
Glioma     Open Access  
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Gynecology and Minimally Invasive Therapy     Open Access   (SJR: 0.311, CiteScore: 1)
Hamdan Medical J.     Open Access  
Heart and Mind     Open Access  
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
Ibnosina J. of Medicine and Biomedical Sciences     Open Access  
IJS Short Reports     Open Access  
Imam J. of Applied Sciences     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.478, CiteScore: 1)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (Followers: 1, SJR: 0.361, CiteScore: 1)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.37, CiteScore: 1)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.604, CiteScore: 1)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.266, CiteScore: 1)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.468, CiteScore: 1)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 5, SJR: 0.445, CiteScore: 1)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1, SJR: 0.791, CiteScore: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4, SJR: 0.568, CiteScore: 1)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.425, CiteScore: 1)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.503, CiteScore: 1)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.656, CiteScore: 1)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.347, CiteScore: 1)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.23, CiteScore: 0)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 3, SJR: 0.225, CiteScore: 1)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.498, CiteScore: 1)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 8, SJR: 0.392, CiteScore: 1)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.199, CiteScore: 0)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.454, CiteScore: 1)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 2, SJR: 0.276, CiteScore: 1)
Indian J. of Pharmacology     Open Access   (SJR: 0.412, CiteScore: 1)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.311, CiteScore: 0)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.408, CiteScore: 1)
Indian J. of Psychological Medicine     Open Access   (SJR: 0.368, CiteScore: 1)
Indian J. of Public Health     Open Access   (Followers: 1)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Respiratory Care     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.119, CiteScore: 0)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.34, CiteScore: 0)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Transplantation     Open Access  
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Indian Spine J.     Open Access  
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intervention     Open Access   (Followers: 1)
Intl. Archives of Health Sciences     Open Access  
Intl. J. of Abdominal Wall and Hernia Surgery     Open Access  
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Clinicopathological Correlation     Open Access  
Intl. J. of Community Dentistry     Open Access  
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 3, SJR: 0.142, CiteScore: 0)
Intl. J. of Growth Factors and Stem Cells in Dentistry     Open Access  
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.535, CiteScore: 1)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4, SJR: 0.17, CiteScore: 0)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 2)
Intl. J. of Orofacial Biology     Open Access  
Intl. J. of Orofacial Research     Open Access  
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 1)
Intl. J. of the Cardiovascular Academy     Open Access   (SJR: 0.105, CiteScore: 0)
Intl. J. of Trichology     Open Access   (SJR: 0.4, CiteScore: 1)
Intl. J. of Yoga     Open Access   (Followers: 13)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 5)

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Journal Cover
Journal of Clinical Neonatology
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2249-4847
Published by Medknow Publishers Homepage  [429 journals]
  • Pediatric physiotherapists' role in the neonatal intensive care unit:
           Parent and health-care providers' perspectives

    • Authors: Neha Sharma, Asir John Samuel, Vencita Priyanka Aranha
      Pages: 111 - 115
      Abstract: Neha Sharma, Asir John Samuel, Vencita Priyanka Aranha
      Journal of Clinical Neonatology 2018 7(3):111-115
      Neonatal Intensive Care Unit (NICU) is a specialized unit created for sick and premature newborns. Parents of admitted newborns came in stress when they came to know that their child is admitted to the NICU. In developing countries such as India, people having very less knowledge regarding physiotherapy interventions adopted in the NICU. Previously available literature from inception to 2017, searched with the keywords: “Parents perceptions,” “NICU Physiotherapy,” and “Medical staff perceptions” highlight the experiences of parents or stress levels in parents of hospitalized newborns in the NICU and perceptions of health-care providers' (HCP) toward patients' safety or the NICU research procedures adopted. Until now, there is no documentation on perceptions of both parents and HCP toward physiotherapy interventions adopted in the NICU.
      Citation: Journal of Clinical Neonatology 2018 7(3):111-115
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_26_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Does prolonged initial empirical antibiotics treatment increase morbidity
           and mortality in preterm infants <34 weeks?

    • Authors: Tariq Rushdi Alsafadi, Basslah Alotaibi, Hibah Banabilah, Esra Bukhary, Shadi Garrada, Abdulwahid Alghamdi, Mohammad Almohammal, Nawaf Alshumrani, Mohammad Alqasim, Shima Akhter Abdulkhahar
      Pages: 116 - 120
      Abstract: Tariq Rushdi Alsafadi, Basslah Alotaibi, Hibah Banabilah, Esra Bukhary, Shadi Garrada, Abdulwahid Alghamdi, Mohammad Almohammal, Nawaf Alshumrani, Mohammad Alqasim, Shima Akhter Abdulkhahar
      Journal of Clinical Neonatology 2018 7(3):116-120
      Background: Antibiotics are commonly used in the early postnatal period in preterm infants; its overuse can affect gut colonization and increased the risk of invasive infection. Aims: This study aims to determine whether the prolonged initial empirical antibiotic treatment (PIEAT) increased the risk of necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and death in preterm infants <34 weeks. The secondary study objective was to reveal if severity of illness and sepsis laboratory tests were potential causes for PIEAT. Design: The study was a retrospective study. Setting: This study was conducted at three Neonatal Intensive Care Units (NICUs). Materials and Methods: NICUs medical records from January 2013 to March 2017. Inclusion criteria: (1) preterm infants < 34 weeks, (2) antibiotics started in the 1st postnatal day, (3) negative initial blood culture, (4) patients survived ≥5 days, (5) patients free of NEC in the first 4 postnatal days, and (6) patients without major congenital anomalies. Statistical Analysis: Logistic regression analysis. Results: Five hundred and eighty-seven neonates were eligible. Mean gestational age ± standard deviation (SD): 31.1 ± 2.8 weeks. Mean birth weight ± SD: 1440 ± 380 g. Mean of the duration of initial empirical antibiotic treatment ± SD: 7 ± 3.6 days. PIEAT increased the risk of NEC (odds ratio [OR]: 1.11, confidence interval [CI]: 1.011—1.219), and LOS (OR: 1.133 CI: 1.027—1.251). PIEAT did not significantly increase mortality (OR: 1.083 CI: 0.82—1.42). Sepsis laboratory tests that predicted PIEAT were abnormal leukocytes counts (OR: 1.078 CI: 1.012—1.167) and positive C-reactive protein (CRP) (OR: 1.15 CI: 1.036—1.277). The indicators of severity of illness, high-frequency oscillation ventilation (OR: 0.956 CI.826—1.106), and inotrope use (OR: 1.108 CI: 0.95—1.22) did not predict PIEAT. Conclusion: PIEAT ≥4 days for suspected early-onset sepsis with negative initial blood culture increased the risk of NEC and LOS in preterm infants < 34 weeks. Abnormal white blood cell count, thrombocytopenia, and positive CRP in the first 4 days with negative initial blood culture were potential causes of PIEAT.
      Citation: Journal of Clinical Neonatology 2018 7(3):116-120
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_86_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Oral paracetamol versus intravenous paracetamol in the closure of patent
           ductus arteriosus: A proportion meta-analysis

    • Authors: Jesmin Hossain, Mohammad Kamrul Hassan Shabuj
      Pages: 121 - 124
      Abstract: Jesmin Hossain, Mohammad Kamrul Hassan Shabuj
      Journal of Clinical Neonatology 2018 7(3):121-124
      Background: Patent ductus arteriosus (PDA) is a common cause of neonatal morbidity. We aimed to do this meta-analysis to compare the efficacy of oral paracetamol/acetaminophen and intravenous (IV) paracetamol for the closure of hemodynamically significant PDA (hsPDA) in preterm infants. Methodology: Medline, Embase, and Google Scholar databases were searched for citations. We included 14 studies with significant PDA and used either oral or IV paracetamol for PDA treatment. Pooled proportion of PDA closured was analyzed. Results: We included 14 studies with 454 premature infants having PDA. Pooled proportion of PDA closure with oral paracetamol was 77.79% (95% confidential interval [CI] 72.92—82.15) in fixed effect and 75.77% (95% 65.48—84.74) in random effect model. In case of IV paracetamol group, pooled portion of PDA closure was 81.52% (95% 74.00—87.64) and 81.52 (95% CI 74.62—87.55) in fixed and random model, respectively. The difference of proportion in the fixed effect model was 3.75% (95% CI, −5.08—11.64) (P = 0.37), and in the random effect model, it was 5.75 (95% CI, 3.14—13.74) (P = 0.181). Conclusion: Our study concluded that pooled proportion of PDA closure is comparable with oral versus IV route of paracetamol use.
      Citation: Journal of Clinical Neonatology 2018 7(3):121-124
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_119_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Omphalocele: 15-years experience from a single center in developing
           country

    • Authors: Kamal Nain Rattan, Jasbir Singh, Rakesh Jakhar, Poonam Dalal, Pallavi Sonika
      Pages: 125 - 129
      Abstract: Kamal Nain Rattan, Jasbir Singh, Rakesh Jakhar, Poonam Dalal, Pallavi Sonika
      Journal of Clinical Neonatology 2018 7(3):125-129
      Background: Omphalocele is one of the most common anterior abdominal wall defects and still remains a management challenge in developing countries. A multidisciplinary team approach involving various prenatal and postnatal interventions is required to have a favorable outcome. In this study, we had analyzed the clinical profile and outcome of the neonates with omphalocele in a developing country. Materials and Methods: We had done a retrospective analysis of medical records of neonates who were admitted with omphalocele at our center from 2002 to 2016. Results: A total of 65 neonates were enrolled in the study with a male-to-female ratio of 1.6:1. Mean birth weight was 2550 ± 670 g and mean gestational age was 37.2 ± 3.4 weeks. Polyhydramnios was present in 40% pregnancies and only 30% (20/65) were diagnosed on prenatal ultrasound screening. Nearly 31 neonates (48%) were having omphalocele minor, and 34 (52%) were diagnosed with omphalocele major. The incidence of associated anomalies was 40% (26/65) with cardiac diseases being the most common followed by gut anomalies. Primary closure of defect was done in 78.5% (51/65) neonates, and delayed surgical repair was performed in 21.5% (14/65) neonates. Mean duration of postoperative hospital stay was 15.5 ± 3.5 days. Five patients (7.6%) expired during study period including two with associated congenital anomalies and one with rupture of omphalocele major sac membrane. Conclusion: Despite significant improvements, management of omphalocele still poses a challenge due to variable size of the defect and associated anomalies. Whenever feasible, early primary surgical repair remains the ideal procedure to have a good outcome.
      Citation: Journal of Clinical Neonatology 2018 7(3):125-129
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_124_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Morbidity and mortality patterns among outborn referral neonates in
           central India: Prospective observational study

    • Authors: Chandrakant M Bokade, Rajkumar Motiram Meshram
      Pages: 130 - 135
      Abstract: Chandrakant M Bokade, Rajkumar Motiram Meshram
      Journal of Clinical Neonatology 2018 7(3):130-135
      Background: Accurate assessment of morbidity and mortality patterns of neonates are reported of inborn babies treated in neonatal intensive care unit, but data on outborn neonates treated suboptimally in general pediatric ward is lacking. Objective: The objective of the study is to document the morbidity and mortality pattern of outborn referral neonates. Materials and Methods: This was a prospective observational study undertaken at a tertiary care teaching government hospital, for 1 year. All outborn referral neonates admitted were included in the study. Relevant maternal and neonatal data were included and analyzed. Results: A total of 1077 outborn referral neonate were admitted during the study, out of which 39 were excluded from the study. As a result, 1038 neonates were included for analysis with 58.96% male and 41.04% female giving a male to female ratio 1.4:1. Most of them were from rural area and lower socioeconomic class. About 96.92% mothers were registered either at primary, secondary, or tertiary health-care facilities. The average distance traveled by neonate was 84.81 km. The leading cause of admission was sepsis (37.37%), prematurity with respiratory distress syndrome (14.55%), perinatal asphyxia (17.53%), jaundice (9.73%), and others such as malformations, meconium aspiration syndrome, genetic syndrome, and metabolic complication. Neonatal mortality rate was 31.98% and more than two-thirds deaths were within 1st week of life, with no sex predilection. The most common cause of mortality was sepsis (34.94%), followed by perinatal asphyxia (22.29%) and prematurity with respiratory distress. Conclusion: Neonatal mortality was 31.98% in our study. Systemic infection, prematurity with respiratory distress and perinatal asphyxia were the leading causes of admission in our study. These preventable causes should be urgently addressed if we hope to achieve the millennium developmental goal.
      Citation: Journal of Clinical Neonatology 2018 7(3):130-135
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_27_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Elevated glycated hemoglobin during pregnancy in diabetic women as a
           predictor of large-for-gestational age infants in an Asian cohort

    • Authors: Sarah Chong Xin, RR Pravin, Victor Samuel Rajadurai, Suresh Chandran
      Pages: 136 - 140
      Abstract: Sarah Chong Xin, RR Pravin, Victor Samuel Rajadurai, Suresh Chandran
      Journal of Clinical Neonatology 2018 7(3):136-140
      Introduction: Diabetes mellitus in pregnancy is often associated with large-for-gestational-age (LGA) infants. However, there is substantial variation in the reported relationship between LGA infants and glycated hemoglobin (HbA1c) values in pregnancies complicated by diabetes mellitus. Our study aims to investigate whether elevated HbA1c values (≥6.5%) during pregnancy are associated with a higher risk of an LGA infant (birth weight ≥90th percentile for gestational age). Methods: A retrospective study was done on a study population of 202 women with diabetes in pregnancy, whose babies were born healthy and at term (37 + 0—41 + 6 weeks) at KK Women's and Children's Hospital, Singapore, between January 1, 2012, and December 31, 2013. Relevant maternal and neonatal data including maternal HbA1c values were extracted from the electronic medical records system. Results: Mothers who had LGA infants had significantly higher HbA1c values as compared against those without (6.8 ± 1.2 vs. 5.8 ± 0.9, P < 0.001). After adjusting for demographics and gestational age, the odds of an LGA infant for women with HbA1c values of ≥6.5% was 8.5 times greater than those with HbA1c <6.5% (odds ratio [OR] 8.5, 95% confidence interval [CI]: 3.6—20.2, P < 0.0001). For each percent increase in HbA1c, the odds of an LGA infant doubled (OR: 2.1, 95% CI: 1.4—3.0, P < 0.0001). Conclusion: Women with HbA1c ≥6.5% during pregnancy have more than eight times the risk of having an LGA infant as compared to women with HbA1c levels <6.5% during pregnancy. Moreover, every 1% increase in HbA1c levels during pregnancy doubled the odds of having an LGA infant.
      Citation: Journal of Clinical Neonatology 2018 7(3):136-140
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_13_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • A retrospective cohort study patient chart review of neonatal sepsis
           investigating responsible microorganisms and their antimicrobial
           susceptibility

    • Authors: Mountasser M Al-Mouqdad, Faisal A Alaklobi, Fahad H Aljobair, Tariq M Alnizari, Muhammed Yassen Taha, Suzan S Asfour
      Pages: 141 - 145
      Abstract: Mountasser M Al-Mouqdad, Faisal A Alaklobi, Fahad H Aljobair, Tariq M Alnizari, Muhammed Yassen Taha, Suzan S Asfour
      Journal of Clinical Neonatology 2018 7(3):141-145
      Background and Aims: Microorganisms responsible for neonatal sepsis have developed increased drug resistance to commonly used antibiotics making treatment extremely difficult. To select an appropriate antibacterial therapy, the common pathogens causing sepsis in neonates and their bacterial resistance should be known first. The present study was designed to investigate the microorganisms responsible for neonatal sepsis in King Saud Medical City Neonatal Intensive Care Unit (NICU). In addition, we sought to determine the antibiotic susceptibility of the isolated microorganisms for planning a strategy for the management of neonatal sepsis. Subjects and Methods: This study is a retrospective cohort study, was conducted at the NICU of King Saud Medical City. A total of 295 inborn premature infants aged ≤180 days and received antibiotics. The study lasted for 12 months. The primary outcome measures were the incidence of the bacterial infection and its etiology in cases with suspected sepsis. The secondary outcome measure was the bacterial sensitivity to antibiotics used. Results: A total of 70 different microorganisms were isolated from culture-positive samples from 57 neonates. Gram-positive organisms (57%) were more common than Gram-negatives (38.5%), coagulase-negative staphylococci were the most isolated pathogens (44%), and the prevalence of fungal sepsis was low (4.3%). The prevalence of antimicrobial resistance was low. Among Gram-positives, there were only three methicillin-resistant Staphylococcus aureus isolates, and no vancomycin-resistant enterococci. Whereas three of the Gram-negative isolates were resistant, two Enterobacter cloacae and one Pseudomonas aeruginosa, and none of Candida species were resistant. Conclusion: Antimicrobial resistance was low in our study, mostly because of the restriction of broad-spectrum antibiotics.
      Citation: Journal of Clinical Neonatology 2018 7(3):141-145
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_18_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Use of a single C-reactive protein level in decision-making during
           neonatal sepsis evaluation

    • Authors: Rubia Khalak, Aditi Malhotra, Roberto P Santos
      Pages: 146 - 150
      Abstract: Rubia Khalak, Aditi Malhotra, Roberto P Santos
      Journal of Clinical Neonatology 2018 7(3):146-150
      Background: Use of a single C-reactive protein (CRP) level has been studied in the pediatric population, but limited information is available for the neonatal, particularly Neonatal Intensive Care Unit (NICU) infants. Objective: The objective of this study is to determine if a single CRP level in the context of other laboratory and clinical parameters, can assist in decision-making for antibiotic management. Materials and Methods: We reviewed the medical records of infants admitted to a large regional perinatal center NICU over a 2-year period. Infants in whom a CRP level had been measured were divided into sepsis-treated group if antibiotic therapy was instituted for ≥7 days or the no sepsis group if antibiotics were discontinued after 48 h. Characteristics of delivery, general characteristics of the infant and data at the time of sepsis evaluation were collected. This was a powered study to detect at least 10% difference in the proportion of those with CRP <8 mg/L versus elevated CRP levels. Results: There were 87 infants with CRP levels in the sepsis-treated group and 106 infants in the no sepsis group. Infants in the sepsis group had a significantly lower gestational age and birth weight but a significantly higher median CRP compared to infants in the no sepsis group (37.5 mg/L vs. 18.1 mg/L, P = 0.0016). When infants were evaluated based on CRP level, we found that 67% of the infants with CRP <8 mg/L had their antibiotics discontinued compared to 43% of the infants with CRP ≥8 mg/L (P = 0.002). Conclusion: A single CRP level done at the time of a neonatal sepsis evaluation can assist in decision-making regarding the continuance of antibiotic therapy. The use of CRP among infants undergoing sepsis evaluation in the NICU significantly affected the decision of medical providers to discontinue antimicrobial agents. This is consistent with the American Academy of Pediatrics Committee on Fetus and Newborn recommendation that bacterial sepsis is unlikely with normal CRPs and antibacterial agents may be discontinued.
      Citation: Journal of Clinical Neonatology 2018 7(3):146-150
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_32_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Failure to establish spontaneous breathing at birth: A 5-year longitudinal
           

    • Authors: Chidiebere D I Osuorah, Uchenna Ekwochi, Nwabueze Isaac Asinobi
      Pages: 151 - 157
      Abstract: Chidiebere D I Osuorah, Uchenna Ekwochi, Nwabueze Isaac Asinobi
      Journal of Clinical Neonatology 2018 7(3):151-157
      Background: Birth asphyxia is a leading cause of death in neonates and long-term neurodevelopmental disability in children. Identification of risk factors and implementing adequate obstetric care could help prevent its occurrence, thus averting the psychosocial and economic burden of the disease on family and society. Materials and Methods: This 5-year longitudinal study enrolled newborns admitted for birth asphyxia in the Neonatal Intensive Care Unit (NICU) of the Enugu State University Teaching Hospital and followed them up until discharge or death. Multi-level regression analysis was used to determine the factors that predicted the outcome in the admitted newborn. Results: Two thousand four hundred and fifty newborns were admitted into the NICU during the study period, and 180 were managed for birth asphyxia which resulted to an in-hospital incidence rate of 73.5 per 1000 admitted newborns (95% confidence interval 63.1—84.2). The mean age at presentation was 1.51 ± 1.59 days and mean birth weight at admission was 3.05 ± 0.67 kg. There was no significant difference in the mean age at presentation (T = 0.412, P = 0.681) and weight at admission (T = 1.295, P = 0.197) between neonates who survived and those who did not. Significant predictive association was seen between management outcome and maternal and neonate socio-demographic parameters such as gestational age at birth (P = 0.020), maternal occupation (P = 0.041), place of birth (P = 0.020), and asphyxiation score at presentation (P = 0.024). Prolonged labor (45.6%), obstructed labor (10.4%), and prematurity (8.0%) were the most common causes of asphyxiation encountered in surveyed neonates. No cause was obvious in 12% of cases. Conclusion: The incidence of birth asphyxia is unacceptably high in our setting. Practical and hands-on measures to control modifiable risk factors and prevention of causes identified in this study need to be sustained to reduce neonatal mortality and morbidity associated with birth asphyxia in resource-limited settings like ours.
      Citation: Journal of Clinical Neonatology 2018 7(3):151-157
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_34_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Severe metabolic disturbance in an human immunodeficiency virus-exposed
           newborn: Possible effect of In utero antiretroviral exposure

    • Authors: Liane Eng, Manish Raisingani, Aditya Kaul, Shilpa Mehta, Kris Prasad, Raphael David, Bina Shah
      Pages: 158 - 161
      Abstract: Liane Eng, Manish Raisingani, Aditya Kaul, Shilpa Mehta, Kris Prasad, Raphael David, Bina Shah
      Journal of Clinical Neonatology 2018 7(3):158-161
      The use of antiretroviral (ARV) medications has successfully reduced maternal transmission of human immunodeficiency virus (HIV)-1 to newborns, but metabolic and mitochondrial toxicities in newborns continue to be a concern. We report the case of a 10-day-old full-term female infant born to an HIV-positive mother presenting with lethargy and respiratory distress. Maternal ARV medications included nucleoside reverse transcriptase inhibitors (NRTIs) and an integrase strand transcriptase inhibitors (INSTIs). Infant ARV prophylaxis included two NRTIs and a nonnucleoside reverse transcriptase inhibitor. At presentation, laboratory tests were significant for hyponatremia, hyperkalemia, severe metabolic acidosis, and acute kidney injury. She was resuscitated with fluids and a stress dose of hydrocortisone (HC), which resulted in improvement of her condition within 48 h. Adrenal profile on the day of admission revealed elevated levels of 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, androstenedione, aldosterone, and elevated plasma renin activity. HC was tapered and the patient was discharged on the day of life (DOL) 26. Adrenocorticotropic hormone (ACTH) stimulation test off HC for one night that was performed on DOL31 showed a normal cortisol response of 35.8 mcg/dL at 60 min. HC was later discontinued. A repeat ACTH stimulation test off HC for 7 days that was performed on DOL59 yielded a normal cortisol response of 27.6 mcg/dL at 60 min. This report reveals severe metabolic disturbances suggestive of adrenal insufficiency (AI) in a neonate exposed to a combination of ARV medications in utero and postnatally with improvement of symptoms after glucocorticoid treatment. The AI was transient in nature, which resolved after cessation of ARV therapy.
      Citation: Journal of Clinical Neonatology 2018 7(3):158-161
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_118_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Beckwith&#8212;Wiedemann syndrome in the two newborns

    • Authors: Aditya Pratap Singh, Arun Kumar Gupta, Rajlaxmi Pardeshi, Ramesh Tanger
      Pages: 162 - 165
      Abstract: Aditya Pratap Singh, Arun Kumar Gupta, Rajlaxmi Pardeshi, Ramesh Tanger
      Journal of Clinical Neonatology 2018 7(3):162-165
      The baby with Beckwith—Wiedemann syndrome (BWS) usually presents with exomphalos, macroglossia, and gigantism. As children with BWS are at increased risk of childhood cancer, they should be followed-up strictly for cancer screening. Here, we are reporting two cases with exomphalos, macroglossia, gigantism, and hemihypertrophy. We have corrected the exomphalos and advised him for follow-up for cancer screening.
      Citation: Journal of Clinical Neonatology 2018 7(3):162-165
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_126_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Supraventricular tachycardia associated with umbilical venous
           catheterization in neonates

    • Authors: Ayman Sheta, Essa Hamdan Al-Awad, Amuchou Singh Soraisham
      Pages: 166 - 169
      Abstract: Ayman Sheta, Essa Hamdan Al-Awad, Amuchou Singh Soraisham
      Journal of Clinical Neonatology 2018 7(3):166-169
      Umbilical venous catheters (UVCs) are commonly used central venous access in the Neonatal Intensive Care Unit, especially in very low birth weight infants. Chest and abdominal radiograph, taken soon after catheter insertion, is the most common method for confirming catheter tip position. UVC-related complications commonly result from catheter malposition; hence, it is important to determine the catheter tip position accurately. However, complacency when a UVC is initially normal positioned can lead to late detection of subsequent UVC-related complications. We describe two cases of supraventricular tachycardia related to UVC, despite the initial UVC was in optimum position. The use of point-of-care echocardiography helped in the diagnosis of catheter malposition and minimized further medical intervention. We suggest point-of-care ultrasound assessment at regular intervals in all infants with UVC to ensure that the catheter is maintained in the optimum position.
      Citation: Journal of Clinical Neonatology 2018 7(3):166-169
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_127_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Neonatal brief resolved unexplained events like episode associated with
           long QT syndrome and novel missense mutation (Thr1502Ile)

    • Authors: Niraj Kumar Dipak, Swati Garekar, Shilpa Pandya, Sangita Mahadevrao More
      Pages: 170 - 173
      Abstract: Niraj Kumar Dipak, Swati Garekar, Shilpa Pandya, Sangita Mahadevrao More
      Journal of Clinical Neonatology 2018 7(3):170-173
      Fetal and neonatal manifestations of long QT syndrome are not well documented except few case reports. We report a neonate presenting with potential brief resolved unexplained events like episode, long QT interval was noted on surface electrocardiogram, and molecular diagnosis revealed a novel heterozygous nonsynonymous missense substitution in exon 17 of the A-kinase anchor protein 9 gene. The proband responded to propranolol at a dose of 1 mg/kg/day.
      Citation: Journal of Clinical Neonatology 2018 7(3):170-173
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_132_17
      Issue No: Vol. 7, No. 3 (2018)
       
  • Neonatal Fournier&#39;s gangrene

    • Authors: Aditya Pratap Singh, Arun Kumar Gupta, Rajlaxmi Pardeshi, Dileep Garg
      Pages: 174 - 176
      Abstract: Aditya Pratap Singh, Arun Kumar Gupta, Rajlaxmi Pardeshi, Dileep Garg
      Journal of Clinical Neonatology 2018 7(3):174-176
      Necrotizing fasciitis of the perineum and external genitalia is a life-threatening infective gangrene. Primarily, it is seen in adults but it may be seen at any ages. It is rare in neonates and infants. Early surgical debridement with appropriate antibiotics and aggressive supportive care gives good results. It is a preventable condition to some extent. We are reporting here a case of Fournier's gangrene in a 25-day-old male neonate who was treated aggressively with broad-spectrum antibiotics and early surgical debridement. Even though no obvious precipitating cause was identified, hygiene was thought to be the inciting factor.
      Citation: Journal of Clinical Neonatology 2018 7(3):174-176
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_3_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Cyclopia-otocephaly-agnathia-synotia-astomia complex: A case report

    • Authors: Kanwar Singh, Shruti Sharma, Khushboo Agarwal, Abhimanyu Kalra
      Pages: 177 - 180
      Abstract: Kanwar Singh, Shruti Sharma, Khushboo Agarwal, Abhimanyu Kalra
      Journal of Clinical Neonatology 2018 7(3):177-180
      Agnathia is an extremely rare condition. Disorder has also been termed agnathia-holoprosencephaly spectrum, agnathiaotocephaly complex, agnathia-astomia-synotia, or cyclopia-otocephaly association. The spectrum of agnathia ranges from isolated agnathia or virtual absence of the mandible to otocephaly. Agnathia-otocephaly can occur alone or in association with other abnormalities, Holoprosencephaly being the most common. A severe form of holoprosencephaly resulting in children being born with Cyclopia. It results from failure of the cerebral hemisphere to separate during fetal development. It is incompatible with life. Majority result in miscarriages or stillbirths. In this report we present a male preterm baby with cyclopia, otocephaly, agnathia, astomia and synotia (Kanwar Syndrome). As it is a lethal syndrome, knowledge of every variant of this is important for prenatal diagnosis and prognostication. To the best of our knowledge, this unique combination is the first case reported by us in the world.
      Citation: Journal of Clinical Neonatology 2018 7(3):177-180
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_23_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Prune-Belly syndrome with VACTERL association: A rare case

    • Authors: Sudhir Singh, Jiledar Rawat, Nitin Pant, Sarita Singh
      Pages: 181 - 184
      Abstract: Sudhir Singh, Jiledar Rawat, Nitin Pant, Sarita Singh
      Journal of Clinical Neonatology 2018 7(3):181-184
      Prune-Belly syndrome (PBS) is a rare congenital anomaly. It consists of genital and urinary abnormalities with partial or complete absence of abdominal wall musculature. Intrauterine consequences of this syndrome are oligohydramnios, pulmonary hypoplasia, and Potter's facies. Occasionally, the syndrome can have a broad spectrum of affected anatomy with different levels of severity. Here, we are reporting a rare case of PBS with VACTERL association. Six cases have been reported till now in English literature.
      Citation: Journal of Clinical Neonatology 2018 7(3):181-184
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_25_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Transient hyperaldosteronism and neonatal hypertension: Case series and
           literature review

    • Authors: Essa Hamdan Al Awad, Kamran Yusuf, Amuchou Singh Soraisham, Halah Obaid, Arun Sundaram, Veronica Samedi, Albert Akierman
      Pages: 185 - 189
      Abstract: Essa Hamdan Al Awad, Kamran Yusuf, Amuchou Singh Soraisham, Halah Obaid, Arun Sundaram, Veronica Samedi, Albert Akierman
      Journal of Clinical Neonatology 2018 7(3):185-189
      Neonatal hypertension is an uncommon but important problem in Neonatal Intensive Care Unit. The most common cause of neonatal hypertension is renovascular disease. In premature neonates, hypertension has been associated with the use of postnatal steroids, maternal history of hypertension, umbilical artery catheterization, acute kidney injury, and bronchopulmonary dysplasia (BPD). The exact mechanism of hypertension in BPD infants is unknown. We present a case series of premature infants with BPD and hypertension associated with transient hyperaldosteronism in the absence of any other cause for the elevated blood pressure. All infants responded to aldosterone antagonists. Transient hyperaldosteronism may have a role in the pathogenesis of hypertension associated with BPD.
      Citation: Journal of Clinical Neonatology 2018 7(3):185-189
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_57_18
      Issue No: Vol. 7, No. 3 (2018)
       
  • Incidence and predictors of acute kidney injury in birth asphyxia

    • Authors: Jogender Kumar
      Pages: 190 - 190
      Abstract: Jogender Kumar
      Journal of Clinical Neonatology 2018 7(3):190-190

      Citation: Journal of Clinical Neonatology 2018 7(3):190-190
      PubDate: Thu,2 Aug 2018
      DOI: 10.4103/jcn.JCN_116_17
      Issue No: Vol. 7, No. 3 (2018)
       
 
 
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