Browsing by Author "Suryawanshi, Pradeep"
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Publication Cerebral Hemodyanamics in Stable Preterm Infants Before and After Packed Cell Transfusion Authors(Nepal Paediatric Society (JNPS), 2021) Chetan, Chinmay; Zaw, Nyein Nyein; Suryawanshi, Pradeep; Banait, Nishant; Pareek, Prince; Deshpande, Sujata; Gupta, Bhvya; Garegrat, ReemaAbstract: Introduction: In a year, around 3.5 million preterm deliveries occur in India alone. Some of these babies will require packed cell volume (PCV) transfusion. There is a paucity of robust data on effect of blood transfusions on the cerebral hemodynamic from India. This study was done to see the effect of PCV transfusion on blood flow velocities and resistive index (RI) of anterior cerebral artery (ACA) in stable preterm infants. Methods: A prospective observational study was conducted in a tertiary care hospital in Pune, India. All stable preterm infants (< 37 weeks) receiving PCV transfusion were enrolled. USG Doppler study of ACA was done before and after PCV transfusion. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and RI were measured pre and post PCV transfusion. Results: Thirty infants were included in the study, with median gestation age of 28.8 {interquartile range (IQR), 27-30.55} weeks and median birth weight of 970 {interquartile range (IQR), 869.5 - 1190} grams. There was a significant decrease in PSV pre and post PCV transfusion - 58.46 (± 18.44) cm / sec and 46.34 (± 13.93) cm / sec respectively (p value < 0.001). Changes in RI and EDV were non-significant. Conclusions: PCV transfusion significantly decreased PSV, reflecting improved cerebral oxygenation, and decreased cardiac output after correction of anaemia. Laboratory threshold for PCV transfusion in stable preterm infants are not known. USG Doppler study has the potential to provide one of the objective criteria for PCV transfusion in these infants though large scale randomized controlled trials are needed to prove its efficacy.Publication Cerebral Hemodynamics in Late Onset Neonatal Sepsis in Preterm Neonates: A Prospective Observation Study(Nepal Paediatric Society (JNPS), 2023) Chetan, Chinmay; Gupta, Bhvya; Pareek, Prince; Suryawanshi, Sonali; Maheshwari, Rajesh; Suryawanshi, PradeepAbstract: Introduction: Late onset neonatal sepsis (LONS) is one of the most prevalent conditions in neonates in developing countries. The aim of this study was to assess the changes in cerebral hemodynamics in neonates with LONS. Methods: Preterm neonates (N = 60) with suspected LONS were enrolled over a period of 21 months and divided into three cohorts: Group A with clinical sepsis but with negative septic markers and culture report, group B, where septic markers were positive, but cultures were sterile and group C, where either blood or CSF culture was positive. Ultrasound doppler of the anterior cerebral artery was done at 0 hrs, 48 hrs and 5th day after suspecting sepsis. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured and compared in three groups and sequentially at specific time points. Results: A total of 60 neonates with a median gestational age of 30.5 [IQR (28 - 32.6)] weeks were enrolled: 21 in group A, 20 in group B and 19 in group C. RI was lowest in Group C at zero hours with a mean of 0.72 (SD ± 0.09) [p < 0.05], which gradually improved after starting antibiotics. Klebsiella sp. was the most common organism isolated. Conclusion: Neonates with culture-positive LONS had the least resistive index. This parameter may have diagnostic implications and significance on the hemodynamic management in LONS.Publication Cranial Ultrasound in Moderate and Late Preterm Neonates: A Prospective Observational Study(Nepal Paediatric Society (JNPS), 2021) Pathak, Om Krishna; Singh, Yengkhom Rameshwor; Mugurkar, Rahul; Suryawanshi, PradeepAbstract Introduction: Preterm infants’ brain is vulnerable to ischemic and hemorrhagic injuries due to structural and molecular immaturities as well as associated co-morbidities, which is usually detected by bedside cranial ultrasound. Cranial ultrasound findings are common in preterm infants’ of < 32 weeks, so cranial ultrasound is routinely recommended in them but there is no such recommendation regarding moderate and late preterm infants. The objective of this study is to find the cranial ultrasound abnormalities in moderate and late preterm infants. Methods: This prospective observational study was conducted in a tertiary level neonatal care unit. Hundred moderate and late preterm neonates delivered or admitted within seventh day of life were included in the study. Cranial ultrasound scan was performed between third and seventh day of life and before discharge and ultrasound findings were noted. Data were collected in predesigned case record form and analysed using Fischer Exact test. Results: Out of 100 neonates, 47 (47%) were males and 53 (53%) females. There were 43 (43%) moderately preterm and 57 (57%) late preterm infants. Mean day of life for performing first and second cranial ultrasound was 4.17 (3 - 7) days and 13.24 (3 - 40) days respectively. Cranial abnormalities were noted in 26% neonates. Intra-ventricular haemorrhage grade 1 or 2 was the commonest abnormality noted. Choroid plexus cyst (4%), cerebral edema (3%), periventricular hyperechogenicity (3%) and hydrocephalus (1%) were the other abnormalities noted. Neonates having APGAR < 6 at one minute, mechanically ventilated and having co-morbidities had significantly higher incidence of abnormal findings. Conclusions: It is reasonable to perform screening cranial ultrasound in high risk moderate and late preterm infants having low APGAR score, mechanically ventilated and having co-morbidities.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.