indrani bhattacharjee | All India Institute of Medical Sciences, New Delhi (original) (raw)

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Papers by indrani bhattacharjee

Objective It is that febrile neonates with low risk criteria (LRC) can be carefully observed with... more Objective It is that febrile neonates with low risk criteria (LRC) can be carefully observed without being administered antimicrobial therapy; but yet, reliability of LRC to exclude serious bacterial infection (SBI) is uncertain.SettingsNeonatal and Paediatric Ward of R.G. Kar Medical College.ParticipantsAll febrile term neonates admitted to the Neonatal and Paediatric Ward of R.G. Kar Medical College and Hospital from January 2010 to July 2010.Methods The records of all febrile term neonates, admitted in Neonatal and Paediatric Ward of R.G. Kar Medical College, Kolkata, India from January 2010 to July 2010 were reviewed. All of them underwent full sepsis workup. The prevalence of SBI in total population and LRC positive and negative neonates were calculated.ResultsA total of 172 records of previously healthy febrile neonates were evaluated. SBI was shown in 38 (22.09%). The most common type of SBI was urinary tract infection (UTI). Fifty-three (30.8%) neonates had LRC, and only one...

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

BACKGROUND Extremely low birth weight (ELBW) infants have significant morbidities and higher mort... more BACKGROUND Extremely low birth weight (ELBW) infants have significant morbidities and higher mortality. The major morbidities are bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP). Release of proinflammatory cytokines has been implicated in the development of systemic inflammation that contributes to BPD aND ROP. Also, cumulative oxygen exposure in the first 3 days of life and use of mechanical ventilation was associated with 3-fold increase in severe IVH. Therefore, early ventilation and oxygenation may contribute significantly to morbidities in ELBW infants. Respiratory severity score (RSS), a product of Mean airway pressure (MAP) and FiO2, is a steady-state noninvasive assessment tool useful in infants to monitor the severity of respiratory failure. We used RSS, in the first 3 days of life of ELBW infants, to predict neonatal morbidities and mortality. STUDY DESIGN In a single-center retrospective cohort study in an urban setting, convenience sampling of ELBW infants meeting the study criteria who were mechanically ventilated at birth for the first 3 days of life were included. Time-weighted average RSS was plotted on receiver-operating characteristic (ROC) curve in the first 3 days of life to predict outcomes. Sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios were calculated. RESULTS A total of 69 infants qualified for the study. RSS in the first 3 days significantly predicted the composite outcome of death, ROP, IVH or BPD with an area under the curve (AUC) of 0.82 (p < 0.001). Individually, RSS predicted death, severe ROP and IVH with an AUC of 0.86, 0.77 and 0.71 respectively; but did not predict severe BPD (AUC 0.61). RSS was more sensitive and specific than each of its component; FiO2 and MAP. Weighted RSS in the first 3 days had high-negative predictive value of 98.1% for death between 7 days and 36 weeks, 94.6% for ROP and 91.7% for IVH. CONCLUSIONS This study is the first to show that RSS in the first 3 days of life is a good predictor of composite neonatal outcomes: severe IVH, BPD, ROP, or mortality. Early RSS had a high positive predictive value for the composite outcome of morbidities/mortality and a high specificity for mortality, ROP, and IVH individually.

Journal of Pediatric Neurology, 2020

Congenital myasthenic syndromes (CMS) are rare and challenging diagnoses in preterm neonates. We ... more Congenital myasthenic syndromes (CMS) are rare and challenging diagnoses in preterm neonates. We presented in this case report a preterm infant with recurrent extubation failures. An exhaustive workup to rule out common etiologies of chronic ventilator dependence was negative including a neostigmine trial, acetylcholine receptor antibodies, and chromosomal microarray. Electromyography (EMG) showed features of a neuromuscular junction defect. After ruling out metabolic, inflammatory, and immune mediated causes, a rapid exome sequencing demonstrated CHRNB1 gene mutation diagnostic of autosomal dominant slow channel CMS. The patient was started on fluoxetine and nebulized salbutamol with a gradual improvement in her respiratory function over time with minimal ventilator support.

Journal of Pediatric Gastroenterology and Nutrition, 2019

Journal of Perinatology, 2019

Objective The objective of this study is to compare glomerular and tubular functions in small for... more Objective The objective of this study is to compare glomerular and tubular functions in small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants. Study Design A prospective controlled study was conducted on SGA and AGA infants with gestational ages between 32 0/7 and 36 6/7 weeks, who received gentamycin in the first 72 h of life. Glomerular and tubular functions were assessed on days 1 and 5. Results Fifty (25 SGA and 25 AGA) infants were included. On day of life 1, SGA group had higher serum sodium, serum urea, and urinary creatinine. On day 5, SGA infants had significant increase in serum creatinine (p = 0.04). Urinary NAG and FeNa were comparable among the two groups on days 1 and 5. Conclusions Glomerular functions were compromised in SGA preterm infants. Tubular functions were comparable.

Journal of Pediatric Gastroenterology & Nutrition, 2019

Critical Care Pediatric Nephrology and Dialysis: A Practical Handbook, 2019