Browsing by Author "Sah, Love Kumar"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Conservative management of a severe extravasation injury: A therapeutic nightmare(Madhesh Institute of Health Sciences (MIHS), 2025) Sah, Love Kumar; Jha, Ashish; Jayswal, Jitendra Prasad; Sah, Shiv Kumar; Yadav, Rakesh; Jha, SwetaABSTRACT: Intravenous calcium gluconate is commonly used in neonatal intensive care units (NICU) to treat hypocalcemia in preterm infants, who are especially prone to metabolic disturbances. Although effective, it carries the risk of extravasation injury, which can lead to local tissue necrosis and, rarely, systemic complications such as septic shock. We report a male preterm neonate (gestational age 31+4 weeks; birth weight 1750 g) who developed a significant extravasation injury following intravenous infusion of 10% calcium gluconate on day 1 of life for symptomatic hypocalcemia. Within 24 hours, progressive swelling and superficial skin and subcutaneous tissue necrosis extended from the dorsum of the right ankle to the knee. At presentation to our center on day 16 of life, the neonate was in septic shock, necessitating fluid resuscitation, inotropic support, and mechanical ventilation for 72 hours. Conservative wound management with daily dressing using normal saline and Vaseline gauze was undertaken. The patient’s sepsis resolved with antibiotics, and gradual wound healing occurred without the need for surgical intervention. Extravasation injuries from calcium gluconate are uncommon but can be severe, especially in preterm neonates with fragile skin and immature vasculature. Septic shock as a complication is rarely reported but highlights the critical need for vigilant monitoring. Management typically varies; however, this case demonstrates that timely conservative wound care, combined with supportive therapy, may result in favorable outcomes. This report underscores the importance of prevention, early recognition, and multidisciplinary management to reduce morbidity in this vulnerable population.Publication Trend of bacteriological profile and antibiotics sensitivity pattern in neonates with late onset sepsis(Madhesh Institute of Health Sciences (MIHS), 2025) Sah, Love Kumar; Pareek, Prince; Suryawanshi, Sonali; Banait, Nishant; Suryawanshi, PradeepABSTRACT: Background: Neonatal sepsis is a major cause of morbidity and mortality in low- and middle-income countries (LMICs). It is categorized as early onset sepsis (EOS, ≤72 hours) and late onset sepsis (LOS, >72 hours). The World Health Organization (WHO) has emphasized antibiotic stewardship. In LMICs, antibiograms are crucial where sepsis significantly contributes to neonatal deaths. Objective: To analyze trends in bacteriological profile and antibiotics sensitivity in neonates with Late Onset Sep- sis (LOS). Methods: This was a 10-year retrospective study of culture-proven LOS cases. Demographics, isolate types, and sensitivity patterns were recorded. Multidrug-resistant (MDR) gram-negative isolates were defined as resistance to ≥3 of 5 antibiotic classes: extended-spectrum cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Results: Among 14,336 NICU admissions (2010–2019), 6092 (42.5%) were evaluated for sepsis, and 647 (10.6%) had culture-positive LOS. Gram-negative organisms comprised 488 (75.3%) isolates—Klebsiella (35.3%), E. coli (13.3%), and Acinetobacter (10.5%) were most common. Gram-positive isolates (24.7%) included S. aureus (9.4%), coagulase- negative staphylococci (10.5%), and Enterococcus (4.8%). High MDR rates were observed in Klebsiella (56.3%), E. coli (56.9%), and Acinetobacter (86.8%). Methicillin resistance was seen in 77.3% of S. aureus and 74.2% of Enterococcus. Conclusions: Alarming antimicrobial resistance in both gram-negative and gram-positive organisms calls for urgent at- tention. Antibiotic stewardship and regular antibiogram surveillance are essential to develop effective hospital policies.