kotha rakesh | Osmania University (original) (raw)
Papers by kotha rakesh
Academic journal of pediatric and neonatology, May 2, 2024
Congenital viral infections in neonates cause severe damage. However, these same viruses cause mi... more Congenital viral infections in neonates cause severe damage. However, these same viruses cause minor damage if infected after the neonatal period. This rapid response change from fetal immunotolerance to immune activation is very interesting and necessary for survival. Immunity is immature and non-focused in neonates, particularly in preterm neonates. If we introduce a foreign body in the form of formula milk to preterm neonates with an improper innate immunity barrier, the neonate will respond aggressively, causing self-damage in the form of necrotizing enterocolitis (NEC). Due to underdeveloped innate immunity barriers, skin allergens are also common in infants. Immunotolerance is a necessary phenomenon of the fetus and early infancy; it is an adaptive response to nature, not an exact weakness. Neonatal immunity lacks memory, which is why repeated doses of immunization are necessary. Neonates will not respond to the polysaccharide vaccine, as carbohydrates are less antegenic than fat and protein. Placental immunology plays a major role in maintaining and protecting the half-matched fetus in many ways. This review discusses the clinical and practical aspects of neonatal immunology
Curēus, Apr 18, 2024
This study explores the role of room humidity levels in the neonate intensive care unit (NICU) an... more This study explores the role of room humidity levels in the neonate intensive care unit (NICU) and how they impact their growth and development in this fragile stage. The study considers seven relevant studies that have explored this factor in different settings. Humidity's role in developing neonatal conditions, such as respiratory distress and fungal infections, is also elaborated on. For the literature review, the study utilized PubMed, Embase, and Scopus databases to guarantee comprehensive findings on the role of NICU room humidity on neonates. By examining these studies' evidence, the research highlights the paramount need to ensure that the room has adequate moisture, as exposure to less desirable humidity levels increases mortality and the severity of morbidity rates among neonates. The fact that the majority of NICUs lack humidity control, which is required, stimulated us to conduct this review.
Academic journal of pediatric and neonatology, Mar 27, 2024
Asian Journal of Pediatric Research, Feb 22, 2024
Sri Lanka Journal of Child Health, Dec 4, 2023
Background: Necrotising enterocolitis (NEC) is the commonest and most serious gastrointestinal ne... more Background: Necrotising enterocolitis (NEC) is the commonest and most serious gastrointestinal neonatal emergency. In preterm infants with evidence of abnormal Doppler flow velocities in the fetal umbilical artery, suboptimal intestinal perfusion is postulated to increase the risk of feed intolerance and NEC. Objectives: To compare the effect of slow versus rapid enteral feeding in preterm neonates with abnormal antenatal umbilical artery Doppler. Method: This is a randomised controlled trial; we randomised into a slow and a fast group; we randomised separately into subcategories based on the weight. Sample size was calculated as 82. Data analysis was done using SPSS version 23. For group comparisons of categorical data, Chi-squared test was used. If expected frequency in the contingency tables was <5 for more than 25% cells, Fisher's exact test was used. For non-parametric continuous data Mann-Whitney test was applied. Statistical significance was kept at p<0.05 and power at 80%. Results: In neonates with slow and rapid feeding with birth weight <1250g, percentage of 2b (30% and 26.7% respectively) was more compared to other stages, whereas in group with birth weight ≥1250g rapid feeding group Ia (14.3%) was more in slow feeding group and 1a and 2a equal in rapid feeding group with no statistical significance. The mean duration of stay hospital was less in rapid ________________________________________ 1
Asian Journal of Pediatric Research, Sep 26, 2023
Cureus, 2024
Background: Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotr... more Background: Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotropic medications. This study aims to compare SD in patients using antipsychotics and antidepressants. Objective: To evaluate the prevalence of SD and its effect on the quality of life among psychiatric patients on medications. Methods: A cross-sectional study had been conducted with 150 participants (50 with schizophrenia, 50 with affective disorders, and 50 controls). SD was evaluated employing the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) and the Arizona Sexual Experience Scale (ASEX). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was used to measure the quality of life. Data analysis techniques included Spearman's correlation test, one-way ANOVA, chi-square test, and descriptive statistics. Results: SD prevalence was 42% in affective disorders, 64% in schizophrenia, and 18% in controls. SD significantly correlated with a longer duration of psychotropic use and negatively impacted quality of life. Conclusion: SD is prevalent among psychiatric patients on long-term medication, highlighting the need for strategies to manage these side effects.
cures, 2024
In newborns, especially premature babies, there is a high association between thrombocytopenia an... more In newborns, especially premature babies, there is a high association between thrombocytopenia and bleeding, particularly intraventricular hemorrhage, which may be due to immaturity. It was usual clinical practice that neonates should be transfused with higher platelet counts than older children or adults to reduce their risk of bleeding. However, after keen observations, we noticed that bleeding and mortality were more common in newborns who received more platelet transfusions. The mechanisms underlying the adverse effects of platelet transfusions in neonates may be due to higher antigenicity and immunological factors. We know that neonatal platelets are hyporeactive; this hyporeactivity is balanced by factors in the neonatal blood that promote coagulation, such as increased hematocrit, von Willebrand factor, and fibrinogen, which, on balance, leads to normal primary neonatal hemostasis. Platelets are very similar to adults in number, but functional capabilities were less, and for the reasons mentioned above, particularly bleeding time was short. Theologically, neonatal platelet lifespan was high to compensate for less production. We started this review because we observed that many babies were not having bleeding symptoms in some instances of severe thrombocytopenia. Many well-active babies are receiving unnecessary transfusions, as human blood is precious, and many young neonatologists are going on protocol-based excessive transfusions. This stimulated us to write a review.
International Journal of Science and Research (IJSR), 2024
Prematurity is a major global problem because nature pushes people to be born early. This article... more Prematurity is a major global problem because nature pushes people to be born early. This article addresses the common concern about adding fortifier to breast milk for premature babies. This article aims to educate parents about the different forms of breast milk fortifiers and their advantages and disadvantages. This article suggests that the better tolerability, less intestinal inflammation and availability in liquid form, which allows us to start earlier, as well as the less denaturation of the inflammatory mediators of milk, leads people to prefer human milk-based fortifiers over cow's milk-based fortifiers. The biggest disadvantage, however, was the high cost.
Background: Hypertensive disorders during pregnancy pose significant risks to both maternal and f... more Background: Hypertensive disorders during pregnancy pose significant risks to both maternal and fetal health. Maternal hypertension has the potential to affect all the systems of the newborn, including the hematological system. Objective: To identify deviations in hematological parameters and birth outcomes in babies born to mothers with hypertensive disorders of pregnancy. Materials and Methods: An observational case-control study was carried out on neonates born to hypertensive mothers in Niloufer Hospital, Hyderabad, India. The study was done over 18-month period from January 2021 to August 2022. The cases comprised babies born to mothers with hypertensive disorders of pregnancy, while controls were babies of normotensive mothers. The hematological parameters measured included hemoglobin (Hb) level, platelet count, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and white blood cell (WBC) count. Results: The neonates of hypertensive mothers had significantly lower levels of Hb (P = 0.02), WBC (P = 0.001), MCH (P = 0.01), and MCHC (P = 0.004). Also, platelet counts were significantly lower among neonates of hypertensive mothers (P = 0.001). They also had significantly lower birth weights than the controls (P = 0.01). Conclusion: This study pinpointed substantial changes in the hematological profile and birth outcomes of neonates born to mothers with hypertensive disorder of pregnancy. These findings underscored the importance of considering these alterations when interpreting hematological values in these infants, necessitating early detection and comprehensive healthcare strategies for neonates at high risk in India. Future research should consider the longterm outcomes of these hematological parameters to elevate the understanding and guide interventions.
cures, 2024
This systematic review analyzes the research evidence on the psychosocial risks faced by graduate... more This systematic review analyzes the research evidence on the psychosocial risks faced by graduates of Neonatal Intensive Care Units (NICUs) during childhood. NICUs hold enormous value in uniting preterm or critically ill infants and their families; however, excess NICU exposure affects infants in numerous negative psychosocial ways. Developmental, behavioral, emotional, and social issues faced by NICU graduates are the focus of this systematic review, which aims to summarize the available evidence from published literature. It points to the incidence of such problems and how they emerged, and it insists on the importance of early detection, complex interference, and constant assistance to children and their families dealing with such issues. The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to assess methodological quality and includes data from various electronic databases. This review emphasizes the concurrent applications of family-centered care, early neurodevelopmental screens, and specialized intervention strategies and also, explains the different types of childhood psychosocial problems in NICU graduates.
Srilanka journal of pediatrics, 2024
Introduction: The proximity of the mother to the newborn following delivery is essential for the ... more Introduction: The proximity of the mother to the newborn following delivery is essential for the early initiation and establishment of exclusive breast feeding. It leads to the conditioning of the oxytocin reflex, allowing the expression of breast milk. However, preterm and sick babies are nursed in an environment away from their mothers in the NICU, thus leading to delayed initiation and inadequate expression of breast milk. Objective: To estimate the volume of breastmilk expressed close to the baby in comparison to breastmilk expressed away from her baby. Method: This quasi-experimental study was conducted in a tertiary healthcare hospital in Hyderabad over a duration of one month. Postpartum mothers of newborns delivered in this hospital and admitted to the NICU were included in the study. The enrolled mothers were shown a video and poster on manual expression of breast milk and were assisted by lactational counselors for support. The enrolled mothers initially expressed milk in the mother's room, and an average of three expressions was taken. The next day, the mother was asked to go near the baby in the NICU and express milk in front of her baby, and the average of three feeds was determined in a similar fashion. Data analysis was done using a paired t-test. Results: A total of 30 postnatal mothers were enrolled in the study. The mean volume of breast milk expressed by the mother in the mother's room was 9.9 ± 2.5ml and the mean volume of breast milk obtained when expressed close to her baby in the newborn care unit was 11.2 ± 2.7ml. The volume of milk expressed near the baby was significantly higher when compared to milk expressed away from the newborn (p<0.001). Conclusions: This study showed that mothers who expressed their feed near their admitted newborns in the newborn care unit had a significant increase in the volume of expressed breastmilk in comparison to expressing the milk away from their babies.
This article addresses the common concern among parents about noisy breathing in infants, often c... more This article addresses the common concern among parents about noisy breathing in infants, often caused by small nasal passages and conditions like laryngomalacia. Laryngomalacia, characterized by soft tissues in the voice box, leads to noisy respiration, typically starting a few weeks after birth. This condition is generally benign but can cause distress if it interferes with feeding or causes chronic discomfort. The article aims to inform parents about the causes, symptoms, and management of laryngomalacia, emphasizing the importance of observing the baby's breathing patterns and seeking medical advice if necessary to ensure the infants health and alleviate parental anxiety.
SLJCH, 2024
Dear Editors, Read with great interest the article published in the Sri Lanka Journal of Child ... more Dear Editors,
Read with great interest the article published in the Sri
Lanka Journal of Child Health, 2023; 52(4): 430-436 on
slow versus rapid advances feeding in newborn with
abnormal umbilical Doppler. I congratulate all authors for
this novel research.
African journal of biological sciences
Aim and Objectives: To study the comparative efficacy of Thal's fundoplication and Nissen's fundo... more Aim and Objectives: To study the comparative efficacy of Thal's fundoplication and Nissen's fundoplication done to prevent gastroesophageal reflux (GER) after esophagocardiomyotomy for achalasia of the esophagus in children. Materials and Methods: This study was done over a period of seven years at the Niloufer Institute of Women and Children, Red Hills, Hyderabad. 12 cases of achalasia cardia were admitted to our institution. All cases underwent laparotomies and modified Heller's esophago-cardiomyotomies. Results: There were 7 males and 5 females, with a male-female ratio of 1.4:1. The age at presentation is between 5 months and 11 years, with 11 or 12 patients presenting at less than 5 years of age. There were three patients who have been symptomatic since birth. A small accidental mucosal perforation occurred in one of the patients who underwent Nissen's fundoplication. The perforation was closed with Vicryl. On the 3rd POD, the patient developed an intraperitoneal leak and was taken up for an immediate laparotomy. The fundoplication was dismantled, the perforation was repaired, and Thal's procedure was done. The postoperative recovery was uneventful. In another patient who underwent. Thal's fundoplication had an accidental mucosal perforation, which was uneventful. In 1 patient, relaparotomy was done, Nissen's wrap was dismantled, and Thal's wrap was applied. The other patient did not come for a follow-up. The other 2 patients with Nissen's procedure showed symptomatic relief in the long-term follow-up. All the cases who underwent Thal's procedure have shown relief of symptoms within the first 3 months of follow-up, with good weight gain without reflux. A barium oesophagogram done 6 months after the procedure showed a decrease in the size of the lower end of the oesophagus with no evidence of GER. No mortality was recorded. Conclusion: Thal's findoplication shows 100% efficacy in preventing GERD and relieving symptoms following Heller's esophagocardiomyotomy and proved to be an effective procedure in comparison with Nissen's fundoplication. In cases of accidental mucosal perforation, Thal's wrap is a better procedure for preventing leaks.
Academic journal of pediatric and neonatology, May 2, 2024
Congenital viral infections in neonates cause severe damage. However, these same viruses cause mi... more Congenital viral infections in neonates cause severe damage. However, these same viruses cause minor damage if infected after the neonatal period. This rapid response change from fetal immunotolerance to immune activation is very interesting and necessary for survival. Immunity is immature and non-focused in neonates, particularly in preterm neonates. If we introduce a foreign body in the form of formula milk to preterm neonates with an improper innate immunity barrier, the neonate will respond aggressively, causing self-damage in the form of necrotizing enterocolitis (NEC). Due to underdeveloped innate immunity barriers, skin allergens are also common in infants. Immunotolerance is a necessary phenomenon of the fetus and early infancy; it is an adaptive response to nature, not an exact weakness. Neonatal immunity lacks memory, which is why repeated doses of immunization are necessary. Neonates will not respond to the polysaccharide vaccine, as carbohydrates are less antegenic than fat and protein. Placental immunology plays a major role in maintaining and protecting the half-matched fetus in many ways. This review discusses the clinical and practical aspects of neonatal immunology
Curēus, Apr 18, 2024
This study explores the role of room humidity levels in the neonate intensive care unit (NICU) an... more This study explores the role of room humidity levels in the neonate intensive care unit (NICU) and how they impact their growth and development in this fragile stage. The study considers seven relevant studies that have explored this factor in different settings. Humidity's role in developing neonatal conditions, such as respiratory distress and fungal infections, is also elaborated on. For the literature review, the study utilized PubMed, Embase, and Scopus databases to guarantee comprehensive findings on the role of NICU room humidity on neonates. By examining these studies' evidence, the research highlights the paramount need to ensure that the room has adequate moisture, as exposure to less desirable humidity levels increases mortality and the severity of morbidity rates among neonates. The fact that the majority of NICUs lack humidity control, which is required, stimulated us to conduct this review.
Academic journal of pediatric and neonatology, Mar 27, 2024
Asian Journal of Pediatric Research, Feb 22, 2024
Sri Lanka Journal of Child Health, Dec 4, 2023
Background: Necrotising enterocolitis (NEC) is the commonest and most serious gastrointestinal ne... more Background: Necrotising enterocolitis (NEC) is the commonest and most serious gastrointestinal neonatal emergency. In preterm infants with evidence of abnormal Doppler flow velocities in the fetal umbilical artery, suboptimal intestinal perfusion is postulated to increase the risk of feed intolerance and NEC. Objectives: To compare the effect of slow versus rapid enteral feeding in preterm neonates with abnormal antenatal umbilical artery Doppler. Method: This is a randomised controlled trial; we randomised into a slow and a fast group; we randomised separately into subcategories based on the weight. Sample size was calculated as 82. Data analysis was done using SPSS version 23. For group comparisons of categorical data, Chi-squared test was used. If expected frequency in the contingency tables was <5 for more than 25% cells, Fisher's exact test was used. For non-parametric continuous data Mann-Whitney test was applied. Statistical significance was kept at p<0.05 and power at 80%. Results: In neonates with slow and rapid feeding with birth weight <1250g, percentage of 2b (30% and 26.7% respectively) was more compared to other stages, whereas in group with birth weight ≥1250g rapid feeding group Ia (14.3%) was more in slow feeding group and 1a and 2a equal in rapid feeding group with no statistical significance. The mean duration of stay hospital was less in rapid ________________________________________ 1
Asian Journal of Pediatric Research, Sep 26, 2023
Cureus, 2024
Background: Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotr... more Background: Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotropic medications. This study aims to compare SD in patients using antipsychotics and antidepressants. Objective: To evaluate the prevalence of SD and its effect on the quality of life among psychiatric patients on medications. Methods: A cross-sectional study had been conducted with 150 participants (50 with schizophrenia, 50 with affective disorders, and 50 controls). SD was evaluated employing the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) and the Arizona Sexual Experience Scale (ASEX). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was used to measure the quality of life. Data analysis techniques included Spearman's correlation test, one-way ANOVA, chi-square test, and descriptive statistics. Results: SD prevalence was 42% in affective disorders, 64% in schizophrenia, and 18% in controls. SD significantly correlated with a longer duration of psychotropic use and negatively impacted quality of life. Conclusion: SD is prevalent among psychiatric patients on long-term medication, highlighting the need for strategies to manage these side effects.
cures, 2024
In newborns, especially premature babies, there is a high association between thrombocytopenia an... more In newborns, especially premature babies, there is a high association between thrombocytopenia and bleeding, particularly intraventricular hemorrhage, which may be due to immaturity. It was usual clinical practice that neonates should be transfused with higher platelet counts than older children or adults to reduce their risk of bleeding. However, after keen observations, we noticed that bleeding and mortality were more common in newborns who received more platelet transfusions. The mechanisms underlying the adverse effects of platelet transfusions in neonates may be due to higher antigenicity and immunological factors. We know that neonatal platelets are hyporeactive; this hyporeactivity is balanced by factors in the neonatal blood that promote coagulation, such as increased hematocrit, von Willebrand factor, and fibrinogen, which, on balance, leads to normal primary neonatal hemostasis. Platelets are very similar to adults in number, but functional capabilities were less, and for the reasons mentioned above, particularly bleeding time was short. Theologically, neonatal platelet lifespan was high to compensate for less production. We started this review because we observed that many babies were not having bleeding symptoms in some instances of severe thrombocytopenia. Many well-active babies are receiving unnecessary transfusions, as human blood is precious, and many young neonatologists are going on protocol-based excessive transfusions. This stimulated us to write a review.
International Journal of Science and Research (IJSR), 2024
Prematurity is a major global problem because nature pushes people to be born early. This article... more Prematurity is a major global problem because nature pushes people to be born early. This article addresses the common concern about adding fortifier to breast milk for premature babies. This article aims to educate parents about the different forms of breast milk fortifiers and their advantages and disadvantages. This article suggests that the better tolerability, less intestinal inflammation and availability in liquid form, which allows us to start earlier, as well as the less denaturation of the inflammatory mediators of milk, leads people to prefer human milk-based fortifiers over cow's milk-based fortifiers. The biggest disadvantage, however, was the high cost.
Background: Hypertensive disorders during pregnancy pose significant risks to both maternal and f... more Background: Hypertensive disorders during pregnancy pose significant risks to both maternal and fetal health. Maternal hypertension has the potential to affect all the systems of the newborn, including the hematological system. Objective: To identify deviations in hematological parameters and birth outcomes in babies born to mothers with hypertensive disorders of pregnancy. Materials and Methods: An observational case-control study was carried out on neonates born to hypertensive mothers in Niloufer Hospital, Hyderabad, India. The study was done over 18-month period from January 2021 to August 2022. The cases comprised babies born to mothers with hypertensive disorders of pregnancy, while controls were babies of normotensive mothers. The hematological parameters measured included hemoglobin (Hb) level, platelet count, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and white blood cell (WBC) count. Results: The neonates of hypertensive mothers had significantly lower levels of Hb (P = 0.02), WBC (P = 0.001), MCH (P = 0.01), and MCHC (P = 0.004). Also, platelet counts were significantly lower among neonates of hypertensive mothers (P = 0.001). They also had significantly lower birth weights than the controls (P = 0.01). Conclusion: This study pinpointed substantial changes in the hematological profile and birth outcomes of neonates born to mothers with hypertensive disorder of pregnancy. These findings underscored the importance of considering these alterations when interpreting hematological values in these infants, necessitating early detection and comprehensive healthcare strategies for neonates at high risk in India. Future research should consider the longterm outcomes of these hematological parameters to elevate the understanding and guide interventions.
cures, 2024
This systematic review analyzes the research evidence on the psychosocial risks faced by graduate... more This systematic review analyzes the research evidence on the psychosocial risks faced by graduates of Neonatal Intensive Care Units (NICUs) during childhood. NICUs hold enormous value in uniting preterm or critically ill infants and their families; however, excess NICU exposure affects infants in numerous negative psychosocial ways. Developmental, behavioral, emotional, and social issues faced by NICU graduates are the focus of this systematic review, which aims to summarize the available evidence from published literature. It points to the incidence of such problems and how they emerged, and it insists on the importance of early detection, complex interference, and constant assistance to children and their families dealing with such issues. The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to assess methodological quality and includes data from various electronic databases. This review emphasizes the concurrent applications of family-centered care, early neurodevelopmental screens, and specialized intervention strategies and also, explains the different types of childhood psychosocial problems in NICU graduates.
Srilanka journal of pediatrics, 2024
Introduction: The proximity of the mother to the newborn following delivery is essential for the ... more Introduction: The proximity of the mother to the newborn following delivery is essential for the early initiation and establishment of exclusive breast feeding. It leads to the conditioning of the oxytocin reflex, allowing the expression of breast milk. However, preterm and sick babies are nursed in an environment away from their mothers in the NICU, thus leading to delayed initiation and inadequate expression of breast milk. Objective: To estimate the volume of breastmilk expressed close to the baby in comparison to breastmilk expressed away from her baby. Method: This quasi-experimental study was conducted in a tertiary healthcare hospital in Hyderabad over a duration of one month. Postpartum mothers of newborns delivered in this hospital and admitted to the NICU were included in the study. The enrolled mothers were shown a video and poster on manual expression of breast milk and were assisted by lactational counselors for support. The enrolled mothers initially expressed milk in the mother's room, and an average of three expressions was taken. The next day, the mother was asked to go near the baby in the NICU and express milk in front of her baby, and the average of three feeds was determined in a similar fashion. Data analysis was done using a paired t-test. Results: A total of 30 postnatal mothers were enrolled in the study. The mean volume of breast milk expressed by the mother in the mother's room was 9.9 ± 2.5ml and the mean volume of breast milk obtained when expressed close to her baby in the newborn care unit was 11.2 ± 2.7ml. The volume of milk expressed near the baby was significantly higher when compared to milk expressed away from the newborn (p<0.001). Conclusions: This study showed that mothers who expressed their feed near their admitted newborns in the newborn care unit had a significant increase in the volume of expressed breastmilk in comparison to expressing the milk away from their babies.
This article addresses the common concern among parents about noisy breathing in infants, often c... more This article addresses the common concern among parents about noisy breathing in infants, often caused by small nasal passages and conditions like laryngomalacia. Laryngomalacia, characterized by soft tissues in the voice box, leads to noisy respiration, typically starting a few weeks after birth. This condition is generally benign but can cause distress if it interferes with feeding or causes chronic discomfort. The article aims to inform parents about the causes, symptoms, and management of laryngomalacia, emphasizing the importance of observing the baby's breathing patterns and seeking medical advice if necessary to ensure the infants health and alleviate parental anxiety.
SLJCH, 2024
Dear Editors, Read with great interest the article published in the Sri Lanka Journal of Child ... more Dear Editors,
Read with great interest the article published in the Sri
Lanka Journal of Child Health, 2023; 52(4): 430-436 on
slow versus rapid advances feeding in newborn with
abnormal umbilical Doppler. I congratulate all authors for
this novel research.
African journal of biological sciences
Aim and Objectives: To study the comparative efficacy of Thal's fundoplication and Nissen's fundo... more Aim and Objectives: To study the comparative efficacy of Thal's fundoplication and Nissen's fundoplication done to prevent gastroesophageal reflux (GER) after esophagocardiomyotomy for achalasia of the esophagus in children. Materials and Methods: This study was done over a period of seven years at the Niloufer Institute of Women and Children, Red Hills, Hyderabad. 12 cases of achalasia cardia were admitted to our institution. All cases underwent laparotomies and modified Heller's esophago-cardiomyotomies. Results: There were 7 males and 5 females, with a male-female ratio of 1.4:1. The age at presentation is between 5 months and 11 years, with 11 or 12 patients presenting at less than 5 years of age. There were three patients who have been symptomatic since birth. A small accidental mucosal perforation occurred in one of the patients who underwent Nissen's fundoplication. The perforation was closed with Vicryl. On the 3rd POD, the patient developed an intraperitoneal leak and was taken up for an immediate laparotomy. The fundoplication was dismantled, the perforation was repaired, and Thal's procedure was done. The postoperative recovery was uneventful. In another patient who underwent. Thal's fundoplication had an accidental mucosal perforation, which was uneventful. In 1 patient, relaparotomy was done, Nissen's wrap was dismantled, and Thal's wrap was applied. The other patient did not come for a follow-up. The other 2 patients with Nissen's procedure showed symptomatic relief in the long-term follow-up. All the cases who underwent Thal's procedure have shown relief of symptoms within the first 3 months of follow-up, with good weight gain without reflux. A barium oesophagogram done 6 months after the procedure showed a decrease in the size of the lower end of the oesophagus with no evidence of GER. No mortality was recorded. Conclusion: Thal's findoplication shows 100% efficacy in preventing GERD and relieving symptoms following Heller's esophagocardiomyotomy and proved to be an effective procedure in comparison with Nissen's fundoplication. In cases of accidental mucosal perforation, Thal's wrap is a better procedure for preventing leaks.
amazon, 2024
Pregnancy is a profound journey, marked by excitement, wonder, and, at times, uncertainty. For mo... more Pregnancy is a profound journey, marked by excitement, wonder, and, at times, uncertainty. For mothers, it is a period of immense change— both physically and emotionally. This book is crafted as a comprehensive guide to support you through every step of this remarkable experience. Whether you are a first-time mother or have navigated this path before, the insights and practical advice contained within these pages are designed to empower you with knowledge, comfort, and confidence.
In a world filled with information, it can be overwhelming to discern what is essential for a healthy pregnancy. This book distils the most crucial aspects of prenatal care, from understanding the changes in your body to preparing for childbirth and beyond.
It emphasizes the importance of self-care, mental well-being, and informed decision-making, ensuring that you and your baby receive the best care possible.
We have collaborated with medical professionals, experienced mothers, and experts in prenatal and postnatal care to bring you a resource that is both trustworthy and accessible. Our hope is that this guide will serve as a reliable companion, offering reassurance and guidance as you embark on this life-changing journey of motherhood.
amazon kindle
This book about some uncommon points eg occipital hair usually in telogen phase that's why with m... more This book about some uncommon points eg occipital hair usually in telogen phase that's why with minimal friction they will fall,,,,,rather than position
NEONATOLOGY
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