Newborns In India Research Articles

A Comparative Analysis of Sector Classification and the Impacted Canine Grading System by Kumar and Daigavane in Patients With Unilateral Cleft Lip and Palate Utilizing Orthopantomogram (OPG) as a Diagnostic Tool.

Introduction Non-syndromic oral clefts, affecting one in 700 newborns in India, are the most prevalent craniofacial anomalies, with genetic or environmental causes impacting various life aspects. Studies indicate higher dental disturbances, particularly impacted canines, in cleft lip and palate (CLP) patients compared to non-cleft individuals. Impacted canines, trapped by hard tissues, require early diagnosis to prevent orthodontic issues. The widely used Ericson and Kurol method employs orthopantomograms (OPGs) to classify canine impaction in typical children. However, diagnosing canines in CLP patients is challenging due to palate defects and post-grafting complications. This study aims to compare the utility of the Kumar and Daigavane (KD) grading system and the sector classification to determine the best method for diagnosing impacted canine eruption paths. Method This cross-sectional comparative observational study was conducted at Sharad Pawar Dental College's Department of Orthodontics and Dentofacial Orthopaedics. The sample size, calculated using a significance level of 5% and a prevalence of 1%, required a minimum of 16 participants aged 9-11 years with non-syndromic clefts and impacted canines. Patients with systemic diseases or over 12 years of age were excluded. The sectoral and KD classification systems collected and evaluated OPGs from qualifying cleft patients. Sector classification considered the angle between the occlusal plane or canine tip and the adjacent tooth's long axis, while KD's classification considered the Frankfort horizontal plane, occlusal plane, vertical height from the occlusal plane, canine apex root position, and canine exposure to the cleft defect. Results The study found an 81.25% agreement between the KD grading system and the sector classification, with a Cohen's kappa value of 0.586, indicating a moderate agreement. The KD system showed 81.82% sensitivity and 80.00% specificity, with positive and negative predictive values of 90.00% and 66.67%, respectively. The receiver operating characteristic (ROC) curve analysis revealed the KD system's superior performance in identifying impacted and non-impacted canines compared to the sector classification. Conclusion The KD grading system demonstrated higher efficacy than the sector classification for evaluating the impacted canines in children with unilateral cleft lip and palate (UCLP). The KD system's high sensitivity and specificity make it a valuable tool for predicting canine eruption paths and addressing anatomical challenges in cleft conditions. This study highlights the need for accurate diagnostic tools tailored to cleft patients and contributes to advancing orthodontic treatment outcomes through improved classification systems.

A multi-centric, single-blinded, randomized, parallel-group study to evaluate the effectiveness of nasoalveolar moulding treatment in non-syndromic patients with complete unilateral cleft lip, alveolus and palate (NAMUC study): a study protocol for a randomized controlled trial

BackgroundCleft lip and palate (CLP) are among the most common congenital anomaly that affects up to 33,000 newborns in India every year. Nasoalveolar moulding (NAM) is a non-surgical treatment performed between 0 and 6 months of age to reduce the cleft and improve nasal aesthetics prior to lip surgery. The NAM treatment has been a controversial treatment option with 51% of the cleft teams in Europe, 37% of teams in the USA and 25 of cleft teams in India adopting this methodology. This treatment adds to the already existing high burden of care for these patients. Furthermore, the supporting evidence for this technique is limited with no high-quality long-term clinical trials available on the effectiveness of this treatment.MethodThe NAMUC study is an investigator-initiated, multi-centre, single-blinded randomized controlled trial with a parallel group design. The study will compare the effectiveness of NAM treatment provided prior to lip surgery against the no-treatment control group in 274 patients with non-syndromic unilateral complete cleft lip and palate. The primary endpoint of the trial is the nasolabial aesthetics measured using the Asher McDade index at 5 years of age. The secondary outcomes include dentofacial development, speech, hearing, cost-effectiveness, quality of life, patient perception, feeding and intangible benefits. Randomization will be carried out via central online system and stratified based on cleft width, birth weight and clinical trial site.DiscussionWe expect the results from this study on the effectiveness of treatment with NAM appliance in the long term along with the cost-effectiveness evaluation can eliminate the dilemma and differences in clinical care across the globe.Trial registrationClinicalTrials.gov CTRI/2022/11/047426 (Clinical Trials Registry India). Registered on 18 November 2022. The first patient was recruited on 11 December 2022. CTR India does not pick up on Google search with just the trial number. The following steps have to be carried out to pick up.How to search: (https://ctri.nic.in/Clinicaltrials/advsearch.php—use the search boxes by entering the following details: Interventional trial > November 2022 > NAMUC).

Spectrum of rare and common mitochondrial DNA variations from 1029 whole genomes of self-declared healthy individuals from India

Mitochondrial disorders are a class of heterogeneous disorders caused by genetic variations in the mitochondrial genome (mtDNA) as well as the nuclear genome. The spectrum of mtDNA variants remains unexplored in the Indian population. In the present study, we have cataloged 2689 high confidence single nucleotide variants, small insertions and deletions in mtDNA in 1029 healthy Indian individuals. We found a major proportion (76.5 %) of the variants being rare (AF<=0.005) in the studied population. Intriguingly, we found two ‘confirmed’ pathogenic variants (m.1555 A>G and m.14484 T>C) with a frequency of ∼1 in 250 individuals in our dataset. The high carrier frequency underscores the need for screening of the mtDNA pathogenic mutations in newborns in India. Interestingly, our analysis also revealed 202 variants in our dataset which have been ‘reported’ in disease cases as per the MITOMAP database. Additionally, we found the frequency of haplogroup M (52.2 %) to be the highest among all the 18 top-level haplogroups found in our dataset. In comparison to the global population datasets, 20 unique mtDNA variants are found in the Indian population. We hope the whole genome sequencing based compendium of mtDNA variants along with their allele frequencies and heteroplasmy levels in the Indian population will drive additional genome scale studies for mtDNA. Furthermore, the identification of clinically relevant variants in our dataset will aid in better clinical interpretation of the variants in mitochondrial disorders.

Palliative Care for Newborns in India: Patterns of Care in a Neonatal Palliative Care Program at a Tertiary Government Children's Hospital.

Neonatal palliative care is a specialized area within children's palliative care, which focusses on the needs of infants with life-limiting or life-threatening conditions. Nearly one quarter of global neonatal deaths occur in India, where neonatal palliative care evidence is limited. This study describes the development and implementation of a neonatal palliative care program within a neonatal intensive care unit (NICU) at a government hospital, describing the implementing an 8-month pilot palliative care program for neonates, including the patterns of care, and barriers and enablers of success. The hospital-based palliative care team included trained pediatric palliative care physicians, a nurse, and a counselor. There was a steady increase in monthly referrals. There were 110 referrals in total, including 89 (81%) deaths and 18 (16%) babies were alive at the time of final follow-up, 10 months after the pilot program was completed. The program addressed physical symptoms, including providing morphine, as well as psychosocial and spiritual concerns of families. A model of hospital-based palliative care for neonates can be implemented within NICUs in tertiary government hospitals in India. Neonatal palliative care programs should include partnerships with charitable organizations to support implementation costs and provide palliative care training, mentorship, and capacity-building support.

Care of Healthy as well as Sick Newborns in India: A Narrative Review.

Majority of neonatal deaths occur in developing countries. There is an increase in the proportion of neonatal deaths as part of the under-5 mortality over the past decade. Hence we need to accelerate further to achieve the goal of single digit neonatal mortality rate (NMR) by 2030. The two major arms of NMR reduction include facility-based neonatal care (FBNC) and home-based neonatal care (HBNC). FBNC addresses care at birth, care of the normal newborn, and care of small and sick newborns. HBNC provides continuum of care for newborn and post-natal mothers facilitated by Accredited Social Health Activist (ASHA) workers. One of the main challenges is to maintain good quality of neonatal care. Zero separation, linkage of community & facility and roles of professional bodies are considered way forward to achieve India Newborn Action Plan(INAP) goals. This review summarizes existing programs for newborn health and diseases and provides an over-arching view of the way-forward.

Predictors of morbidity and mortality of extramural neonates with respect to TOPS score: prospective experience from a tertiary care centre of western India

Background: The transport of sick newborns in India is still at a premature stage. Many of these newborns thus transported are cold, blue, and hypoglycaemic, and 75% of the babies transferred this way have serious clinical implications. The aim of this study was to study the clinical status of neonates transported to our hospital and predict the outcome in terms of morbidity and mortality, based on the TOPS score. Methods: This prospective, observational, longitudinal, simple randomized study was carried out over 12 months in the Department of Paediatrics, Civil Hospital Ahmedabad, Gujarat, and a total of 750 patients were enrolled. A detailed history and clinical examination were carried out through a preformed proforma. Results: The parameter that was found to be most altered was temperature (70.6%), 52% had hypoxia, 48.6% had poor perfusion and 20% patients had hypoglycemia. Hypoxia was the strongest predictor of mortality. 74.8% of the neonates referred to our hospital had TOPS score of 4-6, and had the highest mortality (41.3%). 25.2% of the newborns were having a TOPS score of 7-8. Conclusions: TOPS is a simple, reliable score which can help in the quick assessment of neonates on arrival. Hypothermia was the most common altered parameter at the time of presentation followed by hypoxia and hypoperfusion. Mortality was found to be statistically significant in those sick newborns, who presented with more than one altered parameter of TOPS.

The association between institutional delivery and neonatal mortality based on the quality of maternal and newborn health system in India

Over 600,000 newborns in India died in their first month of life in 2017 despite large increases in access to maternal health services. We assess whether maternal and newborn health system quality in India is adequate for institutional delivery to reduce neonatal mortality. We identified recent births from the cross-sectional 2015–2016 National Family Health Survey and used reported content of antenatal care and immediate postpartum care averaged at the district level to characterize health system quality for maternity and newborn services. We used random effect logistic models to assess the relationship between institutional delivery and neonatal (death within the first 28 days of life) and early neonatal (death within 7 days of live births) mortality by quintile of district maternal and newborn health system quality. Three quarters of 191,963 births were in health facilities; 2% of newborns died within 28 days. District-level quality scores ranged from 40 to 90% of expected interventions. Institutional delivery was not protective against newborn mortality in the districts with poorest health system quality, but was associated with decreased mortality in districts with higher quality. Predicted neonatal mortality in the highest quintile of quality would be 0.018 (95% CI 0.010, 0.026) for home delivery and 0.010 (0.007, 0.013) for institutional delivery. Measurement of quality is limited by lack of data on quality of acute and referral care. Institutional delivery is associated with meaningful survival gains where quality of maternity services is higher. Addressing health system quality is an essential element of achieving the promise of increased access to maternal health services.

Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study

IntroductionPregnant women are at increased risk of contracting COVID-19 due to several factors and therefore require special attention. However, the consequences of the COVID-19 pandemic on pregnant women and their...

Serum Level of Alanine- and Aspartate-Aminotransferase Levels in Newborns in India

Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤40 IU/L is normal. This cutoff, although determined in adults, is widely used for newborns. We studied the reference ranges for ALT and AST in newborns in India. We prospectively included babies with gestational age (GA) between 34 and 41weeks and birth weight (BW)≥1500g. We excluded the babies who either themselves or their mother had risk factors, which could cause elevation of serum levels of liver enzymes. Serum ALT and AST were measured in venous cord blood. The estimated percentile curves for ALT and AST, for BW and GA covariates, were drawn with General Additive Model for Location Scale and Shape (GAMLSS) with Box-Cox Power Exponential (BCPE). Five-hundred thirty-seven babies (Boys 53.3%; GA 34-36wks 19.7%; appropriate for GA 74.9%; BW<2500g 20.5%) were included. Overall, mean [SD] serum ALT and AST were 4412 IU/L and 5218 IU/L, respectively. The serum AST was significantly higher than the ALT level, regardless of gender, BW, GA, or fetal growth categories. The percentile curve against GA remained flat for ALT, although it showed a slight rise for AST. Serum levels of ALT and AST plotted against BW were also similar and showed an increase up to 2000g and then remained stationary after that. The serum levels of ALT and AST up to 44 IU/L and 52 IU/L, respectively, can be taken as normal in newborns with BW≥2000g or GA ≥34 weeks.

Gaps in the coverage of vitamin K1 prophylaxis among newborns in India: insights from secondary analysis of data from the Health Management Information System.

Despite operational guidelines, anecdotal evidence suggests that newborn vitamin K1 prophylaxis is not practiced routinely in India. This study determined the coverage of vitamin K1 prophylaxis among newborns in the country. Nationwide cross-sectional data on live births and newborns receiving vitamin K1 during the 2019-2020 reporting period were abstracted from the Health Management Information System (HMIS). The coverage estimates of newborn vitamin K1 prophylaxis were derived nationally and also for individual states and union territories (UT). Additionally, coverage heterogeneities were investigated using classifiers, viz. geography, socio-demographic index (SDI), special developmental categories and institutional birth rate (IBR). India. 20 208 804 newborns documented with HMIS. Vitamin K1 was administered to overall 62·36 % newborns (95 % CI: 62·34 to 62·38 %). The Central zone (49·0 %), low SDI states (54·39 %), Empowered Action Group states (53·32 %) and states with low IBR (44·69 %) had the lowest coverage amongst their respective groupings. Across the individual states and UT, the coverage ranged widely from 22·18 % (in Tripura) to 99·38 % (in Puducherry), exhibiting considerable variability (coefficient of variation: 33·74 %) and inequality (Gini coefficient: 0·17). While the coverage in eight states/UT (i.e. Arunachal Pradesh, Manipur, Nagaland, Tripura, Uttar Pradesh, Uttarakhand, Telangana and Andaman & Nicobar Islands) was below 50 %; only five states/UT (i.e. Chandigarh, Gujarat, Goa, Puducherry and Tamil Nadu) achieved above 90 % coverage. Vitamin K1 prophylaxis was not practiced in more than one-third newborns in India. It calls for identifying the barriers, addressing the gaps and implementing newborn vitamin K1 prophylaxis more effectively throughout the country.

Determinants of postnatal care coverage among mothers and new-borns in India: Evidence from a nationally representative survey.

Despite efforts taken by the Government of India, still mothers and new-borns are excluded from the postnatal care services, especially during the critical first 24 h after delivery. Hence, we have done this study to find the determinants of postnatal care for mothers and new-borns in India. We have analysed the NFHS-4 data gathered from Demographic Health Survey programme. Stratification and clustering in the sample design was accounted using svyset command. Point estimates were reported as proportions with 95% Confidence Interval (CI). In total, 190,797 women who had at least one live birth were included. About 25.2% and 27.1% of the new-born received post-natal care within 24 and 48 h of delivery. The proportion of women who received post-natal care within 24 and 48 h after delivery was 63.4% and 65.2% respectively. Higher socioeconomic status, women living in Southern region, utilization of proper antenatal and intranatal care, and Caesarian mode of delivery had significantly higher postnatal care coverage among mothers and new-borns. This finding informs the policy makers regarding the status of postnatal care coverage, that can be incorporated to identify target populations for further strengthening of service delivery.

Illegal practice of abortions

Abortions that are unsafe or illegal are one of the leading causes of violations of women's and children's human rights throughout the globe. Lack of access to safe abortion procedures results in a significant number of fatalities and severe immobility. In India, it is estimated that 15.6 million pregnancies occur on a regular basis. A significant portion of them are thought to be dangerous. Unsafe fetal removal is the third leading cause of maternal death, claiming the lives of 10 women every day and leaving thousands more with morbidities. There is a need to strengthen access to abortion advantages while also preventing women's passing and inabilities. In 2002, as part of the Abortion Assessment Project, the Abortion Assessment Project led an immense focus on incited fetal removal in India. The exams, which were a significant part of this project, assessed 6.4 million preterm newborns in India each year. Even while the act of removing a fetus is not inherently immoral, the unlawful manner in which it is carried out makes it highly damaging and should be banned.

Equity in coverage of maternal and newborn care in India: evidence from a nationally representative survey.

Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in antenatal care (ANC), intranatal care and postnatal care (PNC) coverage for mothers and newborns in India. We have analysed the NFHS-4 data gathered from the Demographic Health Survey programme. Stratification and clustering in the sample design were accounted for using 'svyset' command. Point estimates were reported as proportions with 95% confidence interval. The concentration curve and index were used to represent the socio-economic inequities. Theil index was computed to report inequities across geographical regions and place of residence. In total, 190 797 women who had at least one live birth in the preceding 5 years were included. About 52.1% of women had at least four ANC visits and 81.4% had institutional delivery. About 25.2% and 27.1% of the newborn received PNC within 24 and 48 h of delivery. The proportion of women who received PNC within 24 and 48 h after the delivery was 63.4% and 65.2%, respectively. Maximum inequity was observed for ANC (concentration index-0.195) followed by receipt of PNC by mothers within 24 and 48 h (concentration index-0.106 and 0.103). Women from the rural areas had a disproportionately high proportion of home deliveries (Theil index-3813.6). The findings from this study inform the policymakers and planners about the socio-economic inequity existing across various maternal and child health indicators. This will help them in making informed decisions and strengthen the maternal and child health programme in our country.

Bacillus cereus-Attributable Primary Cutaneous Anthrax-Like Infection in Newborn Infants, India.

During March 13–June 23, 2018, anthrax-like cutaneous lesions attributed to the Bacillus cereus group of organisms developed in 12 newborns in India. We traced the source of infection to the healthcare kits used for newborn care. We used multilocus sequence typing to characterize the 19 selected strains from various sources in hospital settings, including the healthcare kits. This analysis revealed the existence of a genetically diverse population comprising mostly new sequence types. Phylogenetic analysis clustered most strains into the previously defined clade I, composed primarily of pathogenic bacilli. We suggest that the synergistic interaction of nonhemolytic enterotoxin and sphingomyelinase might have a role in the development of cutaneous lesions. The infection was controlled by removing the healthcare kits and by implementing an ideal housekeeping program. All the newborns recovered after treatment with ciprofloxacin and amikacin.

Onsite mentoring of special newborn care unit to improve the quality of newborn care.

It has been possible to set up special newborn care units (SNCUs) and to improve the survival of newborns in India. However, several challenges remain affecting their effective functioning. Different approaches have been attempted and several policies have also been implemented to address this issue. To evaluate the feasibility of implementing best practices in neonatal care by onsite mentoring in an SNCU over 4 months. The mentoring team was from a tertiary care hospital in Karnataka. The SNCU was functioning at the district hospital, catering to approximately 3500 live births per year. Onsite mentoring was carried out from August 2016 to November 2016. This was a prospective implementation research. Framework focused on infection control, preterm care, care at birth, advocacy for infrastructure and resources, and facility-based refresher training. A total of 16 visits were done by the mentoring team and 2 weeks of in-house residency. There were improvements in hand hygiene compliance from 0% to 87.5%, in cleaner IV site (from 50% to 100%), decreased unnecessary oxygen administration (from 75% to 33.3%), decreased antibiotic usage (from 70.5% to 35.5%), decrease in the number of babies receiving >5 days of antibiotics (from 41.6% to 0%), and increased kangaroo mother care initiation rate from 0% to 41.6%. The facility got level IIA accreditation by the end of the intervention period. Onsite mentorship program of SNCU is feasible and planning should be contextual. With the problems being uniform across most facilities, the model could be replicated across the country.

Clinical profile and outcome of newborns admitted to a secondary-level neonatal intensive care unit in tribal region of Odisha

Introduction: Neonatal deaths constitute major proportion of under-five mortalities in India. Secondary-level neonatal intensive care units (NICUs) currently provide care to majority of sick newborns in India. Only few clinical studies have described the management outcome of newborns admitted into these secondary-level NICUs in India. Methods: The current study was conducted in Koraput District Headquarter Hospital and associated Medical College Hospital located in tribal regions of Odisha catering to 13.8 lakhs population of predominantly lower socioeconomic status. The study included in-depth retrospective case record analysis of all the NICU admissions in 3 months between April and June 2018, after a broad overview of all admissions in 3 years between July 2015 and June 2018. Predesigned pro forma was used to document clinical profile, indication for admission, microbiological characteristics of neonatal sepsis, and outcome in terms of discharge, death, referral, or left against medical advice. Results: Of 4127 total NICU admissions between July 2015 and January 2018, 3159 (76%) newborns were discharged. The most common indications for admissions in inborn babies were prematurity and related complications (23%), birth asphyxia (19%), and neonatal hyperbilirubinemia (18%). For outborn newborns, along with these causes, neonatal sepsis (20%) was another important cause of NICU admission. Escherichia coli and Klebsiella species were predominant microorganisms to be isolated in blood culture. About 11% of newborns received kangaroo mother care, with median duration of 6 days. Predominant causes of death among newborn babies were prematurity-related complications (51%) and neonatal sepsis (37%). Conclusion: Prematurity-related complications, birth asphyxia, neonatal hyperbilirubinemia, and sepsis are the predominant indications for admission to a secondary-level NICU in India. About three-fourth of neonates can be treated successfully within the existing infrastructure.

A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

Neural tube defects and maternal characteristics in a North Indian Province

Background: Neural tube defects (NTD) affect fewer than 2 per 1000 pregnancies, account for a major burden on healthcare globally and have wide geographic prevalence. The present study was carried out with the aim to evaluate the maternal characteristics in cases of babies born with various neural tube defects in a tertiary care centre in Northern India. Methods: This retrospective analytical study was carried out by accessing and analyzing the medical case records of women who delivered babies with neural tube defects between January 2005 to December 2008 in the Department of Obstetrics and Gynaecology at Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India. Results: Sixty seven babies had neural tube defects thus accounting for a NTD prevalence of 2.62/1000 births. Among these, there were 48 cases of anencephaly, 15 cases of meningocele and/or meningomyelocele, 4 cases of spina bifida occulta. Anencephaly was most prevalent in primiparous women of low literacy aged between 21–25 years. Similar trends were visible in meningomyelocele and spina bifida groups. Most women in the study were homemakers with almost equitable distribution in rural and urban areas. No preponderance of any particular blood group was evident for any of the neural tube defects. Conclusion: Neural tube defects affect a substantial number of newborns in India. Lower age and parity, low literary and rural residence are some of the maternal factors associated with increased risk of these disorders. Preventive strategies like periconceptional folic acid supplementation and health education may help reduce the incidence of these conditions even in low resource settings.

Vitamin K supplementation to prevent hemorrhagic morbidity and mortality of newborns in India and China

Vitamin K deficiency bleeding (VKDB) can cause prolonged and bleeding (intracranial hemorrhage) among newborns, which can be life-threatening or lead to long-term morbidity. The aim of this review article is to reiterate empirical evidence to support the argument that vitamin K should be mandatory for newborns in India and China, as well as in other countries with a high burden of neonatal deaths. Studies were integrated from the PubMed/MEDLINE database search, as well as related literature available elsewhere. Both India and China have been slow in adopting an effective program for administering vitamin K injections to newborns to prevent VKDB-related morbidity and mortality. VKDB cases in China and India have shown inadequate attention to routine use of vitamin K by injection. While no reliable data are publicly available, the issue of VKDB is at last receiving some attention from the Chinese public health system as well as the Indian government. In both countries, routine vitamin K administration to newborns would prove to be a cost-effective intervention to reduce preventable neonatal morbidity and mortality. VKDB is a global neonatal care issue, including countries where parental resistance is preventing babies from defense against this life-threatening condition.

Clinical Study on Prevalence of Cutaneous Lesions in New Born Babies in India

Background: Skin being the major organ of human body, any lesion on the newborn can cause concern and anxiety to parents. Many such lesions can be physiological and transient. There are very few reports in the literature regarding the cutaneous manifestations in newborns in India. Aim: This study is undertaken to determine the prevalence and pattern of various skin lesions in neonates and to correlate the relationship between new born skin lesions to gestational age, birth weight, mode of delivery, sex and maternal factors. Materials and methods: All new born delivered at a referral hospital between 2013-2015 were included for the study. Data regarding maternal age, illness, drugs, gestational age, mode of delivery, birth weight, sex of new born were noted. All the new born were clinically examined for skin lesions during their stay in hospital. Results: Total of 1427 live births was included. Out of this 92.1% of newborns had skin lesions and 7.9% had no skin lesions. The incidence of single lesion was 25.4% and multiple in 66.5%. Common manifestations included mangolian spots, milia, ebstein pearls, erythema toxicum neonatorum. Our study showed increased incidence of mangolian spots, lanugo hairs and cutis marmorata in new-borns of mothers having illness and in preterms. Birth injuries were more in instrument assisted deliveries. The skin peeling and birth marks were more in posterms. However there was no difference in the manifestations between male and female babies. Conclusion: Majority of the skin lesions are transient and physiological which does not require any treatment. Recognizing these transient lesions in new born will avoid unnecessary therapy to the new-borns and it will enable the paediatrician to allay parental concern and anxiety.