Melendez Shore (dayharbor5)

OBJECTIVE To assess the prevalence and predictors of language and visuomotor delay in very low birthweight (£1250 grams) children at corrected age (CA) of 2 years. DESIGN Design Prospective observational. SETTING Neonatal follow-up clinic of a level III center. PARTICIPANTS Children with birthweight £1250 grams and discharged alive (n=164) from April 2012 to April 2013 were followed up till 2 years CA (n=126). METHODS Development, neurological status, and language/visuomotor cognitive skills were assessed by Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). Development Quotient *DQ) was calculated. Main Outcome Prevalence and predictors for the language and visuomotor delay. RESULTS At 2 years (n=123 CAT, 126 CLAMS), 30 (24%) children had below average DQ ( less then 90) and 93 (74%) average and above average DQ (≥90) in full scale CAT/CLAMS test. Small for gestation infants (n=86) have higher risk of below average DQ (P=0.036). Gestational age and socioeconomic status have a positive correlation with language development at 9 months and 2 years, respectively. CONCLUSIONS In VLBW (birth weight ≤1250 g) infants, the prevalence of language/visuomotor delay is high. Small for gestational age infants are at higher risk for language and visuomotor development delay at 2 years corrected age.OBJECTIVE To evaluate the time course and predictors of cerebral edema in diabetic ketoacidosis (DKA). METHODS Review of hospital records of 107 episodes of DKA between January 2013 to March 2019. RESULTS Cerebral edema was identified in 26 (24.3%; 22 at presentation and 4 during treatment). Cerebral edema at presentation was associated with lower ( less then 10 mmHg) arterial carbon dioxide (OR 3.6, 95% CI 1.0,12.7; P=0.04), prior fluid treatment (OR 4.7, 95% CI 1.8,12.7; P=0.001) and new onset diabetes (OR 3.5, 95% CI 1.1,11.1; P=0.03). Prior fluid was the only significant predictor on multivariate analysis (P=0.013). Cerebral edema resulted in a longer ICU stay [4.1 (2.3) vs 1.8 (0.9) d; P less then 0.001]. CONCLUSIONS Cerebral edema at admission is common in Indian children with DKA and should be suspected with severe metabolic acidosis and inappropriate prior fluid treatment.OBJECTIVE To study the effectiveness of a hypothermia monitoring device in reducing neonatal mortality and increasing Kangaroo Mother Care compliance. DESIGN Non-randomized controlled trial. SETTING 3 government Sick Newborn Care Units and 7 Primary Health Centers in Udaipur and Dungarpur districts of Rajasthan for 4 months. The follow-up period was 4 weeks for each baby. PARTICIPANTS Total 386 neonates were included in the study. 250 (64.76%) new-borns in the study group (BEMPU bracelet) and 136 (35.23%) enrolled in the control group. Clinically stable babies discharged below 2500 grams, whose parents could be reached by phone, and who could visit the facility for 4 weekly follow-ups were eligible for participation. Infants with complications or those leaving against medical advice were not eligible. INTERVENTION The BEMPU Bracelet is a medical device that provides 4 weeks of continuous hypothermia monitoring for new-borns, and emits an audio-visual alarm when the temperature of the newborn is below 36.5°C. Transmembrane Transporters inhibitor OUTCOME Neonatal mortality over the 4-week period. RESULTS Mortality data was obtained for 92% (229 babies) of the study group and 91% of the control group (124 babies) at the end of the 4-week period. The intervention group had a significantly lower mortality rate as compared to the control group (6% vs. 14%, P=0.013). Weight data from 51% of the study group (128 babies) and 32% of the control group (44 babies) did not show a significant difference in weight gain between the groups. CONCLUSIONS The observed effect on mortality and qualitative feedback on KMC compliance suggest the utility of the device in the community settings.Purpose A variety of enteral formulas for various diseases have