Browsing by Author "Rahul, Aswathy"
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Publication Clinical Profile of Neonatal RSV Bronchiolitis - A Descriptive Study(Perinatal Society of Nepal (PESON), 2025) Rahul, Aswathy; Venugopal, Aishwarya; Raj, Raunak; Padmanabhan, Athul; Nema, Meghna; Sujatha, RadhikaAbstract: Introduction: Newborns with viral bronchiolitis may have a turbulent clinical course and Respiratory syncytial virus (RSV) is the most common viral agent causing bronchiolitis in childhood. Methods: This ambispective study was conducted in the outborn nursery of a tertiary care Government Medical College in neonates who were admitted with a working diagnosis of acute bronchiolitis or respiratory tract infection. A retrospective chart review was done for the cases admitted during the outbreaks of August to November 2022 and a prospective study was done from September to December 2023. Results: During the study period, a total of 100 neonates (60 cases in 2022 and 40 cases in 2023) were admitted with respiratory tract infection or bronchiolitis. 75% of the babies had moderate to severe bronchiolitis. Thirteen babies with severe bronchiolitis required invasive ventilation. The most common virus detected was RSV followed by Rhino virus. Among the neonates with RSV infection, 65.71% were term babies. There was no mortality. The most common clinical presentation was cough (N =89) (89%) and the threatening symptom was apnea with cardiorespiratory arrest. Remedesivir, an antiviral agent, was given to two babies with severe RSV bronchiolitis on compassionate ground. Conclusions: Apnea and cardiorespiratory arrest should be anticipated in neonatal bronchiolitis. Remdesivir is an antiviral agent which can be life saving in severe RSV bronchiolitis.Publication The Threat Beyond Weight Loss: A Case Series on Severe Neonatal Hypernatremic Dehydration(Perinatal Society of Nepal (PESON), 2025) John, Sangeetha Rachel; Rahul, Aswathy; Sujatha, RadhikaAbstract: Neonatal hypernatremic dehydration, often resulting from suboptimal breastfeeding, is a life-threatening condition characterized by severe electrolyte imbalances. Lack of awareness about postnatal weight monitoring delays diagnosis. Severe hypernatremia (Serum sodium > 170 mEq / L) can cause acute kidney injury (AKI), disseminated intravascular coagulation (DIC), cerebral edema and death. We wanted to describe the clinical profiles, complications, and outcomes of neonates with severe hypernatremic dehydration due to suboptimal breastfeeding. The case series describes eight neonates admitted with severe hypernatremic dehydration in our NICU. All neonates were exclusively breastfed. Poor feeding was noted in 87.5% neonates. 12.5% presented in gasping respiration with severe metabolic acidosis requiring intubation, 62.5% had shock, 87% had AKI, 37.5% had seizures and 20% had intracranial bleeding. One neonate died from cerebral edema; another developed limb gangrene. This case series highlights the importance of prevention of dehydration from suboptimal breastfeeding with early postnatal weight monitoring and timely interventions.