Browsing by Author "Jain, Ashish"
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Publication Better Prediction of Neuro - Developmental Outcome in Babies Using Combined Vojta’s Neurokinesiological Examination, Amiel Tison Angles and Head Holding Grades(Nepal Paediatric Society (JNPS), 2021) Jain, Ashish; Veerabhadrappa, H; Shrikant, SW; Kumari, NishaAbstract: Introduction: With the advances in medical technology, the survival rate has increased amongst the high-risk neonates. Changes occurring in the neuro-motor function during the first year of life are closely related to the maturation of the central nervous system of babies and the presence or absence of injury to brain. These should be detected as early as possible, so that intervention programmes can be started. Methods: A prospective study was done in NICU of a teaching hospital, to find the predictive value of combined assessment by three neuro-developmental examinations Viz. Vojta’s Neurokinesiological examination, Amiel-Tison angles and head holding grades. Total 375 babies with various high risk category were included, out of which only 114 infants completed one-year follow-up. On the first visit a detailed neurological examination was performed using Vojtas Neurokinesological postures, Amiel- Tison angles and head holding grades based on Trivandrum Developmental Screening Chart (TDSC). At one year, the milestones attained were plotted against the BSID percentiles and babies assigned as developmentally delayed, if it was below 97% pass level. Sensitivity and specificity were calculated and propositions evaluated by chi-square test. Results: 23% babies had developmental delay at one year. The important high risk factors were maternal risk factors 39%, HIE with MAS, HIE stage-III, complications during NICU stay. Conclusions: Vojta’s Neurokinesiological examination is an effective screening test that can be applied to all high-risk neonates. The predictive value could be enhanced to 100%, by using other simple tests, like Amiel-Tison Angles and Head holding grades by TDSC.Publication Nasal Anthropometry among Term and Preterm Indian Neonates- Does Size Matter?(Nepal Paediatric Society (JNPS), 2022) Jain, Ashish; Chitgupikar, Sudharshan Raj; Bhardwaraj, Madhavi; Subramanian, PreethiAbstract: Introduction: The binasal prongs are used in neonatal intensive care unit (NICU) to provide nasal Continuous Positive Airway Pressure (n-CPAP) in preterm neonates. A variable degree of nasal trauma is the most common complication of n-CPAP therapy. This can be reduced by use of appropriately sized binasal prongs that are customized to the anatomical measurements of noses. The aim was to estimate the nasal two-dimensional anthropometrical parameters among Indian neonates across different gestations; to compare between both sexes and between neonates with different intra uterine growth status and gestational ages. Methods: Hundred and one neonates across different gestational ages (24 – 42 weeks) and intrauterine growth status who were admitted to the NICU of a tertiary teaching hospital were enrolled and grouped into five categories based on their gestational ages viz. 37 – 42 weeks, 34 – 36 weeks, 31 – 33 weeks, 28 – 30 weeks, and 24 – 27 weeks. Seven nasal and para-nasal measurements were taken (nostril width, nostril length, columella width, columella length, nose width, nose length and philtrum length) for each neonate using a vernier caliper. Results: All anthropometrical measurements differed significantly across gestations especially between 37 - 42 and 24 - 27 wks (p = 0.00). Males differed from females only with respect to nostril width (p = 0.032). The measurements varied significantly when compared among small for gestational age, appropriate for gestational age and large for gestational age neonates. Conclusions: The nasal parameters differed significantly among various GA and intra-uterine growth statuses, which should help design appropriate sizes of bi-nasal prongs.