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Biomedical subjects

N B Mathur

Publications and source records attributed to N B Mathur.

At least 37 records · Page 2Linked to original sources
PubMed1997

Exchange transfusion in septic neonates with sclerema: effect on immunoglobulin and complement levels.

OBJECTIVE: To study the effect of exchange transfusion (ET) on the levels of immunoglobulins (Ig) and C3 in neonatal sepsis with sclerema. DESIGN: Randomized controlled trial in a referral neonatal unit of a teaching hospital. SUBJECTS: Consecutive culture positive septic neonates with sclerema were enrolled and were randomized to undergo ET (study group, n = 20) or no ET (controls, n = 20). RESULTS: Mortality was 50% in the study group and 95% in controls. Gram negative organisms accounted for 85% in study group and 90% in controls. IgG, IgA and IgM levels rose significantly while C3 levels did not show significant rise 12-24 hours after ET. Ig and C3 levels did not change significantly in the controls. CONCLUSION: ET with fresh whole blood in septicemic newborns with sclerema improves survival, particularly in the more premature group and significantly enhances, IgG, IgA and IgM levels.

Bacteremia↗
PubMed1996

Neonatal sepsis.

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Exchange Transfusion, Whole Blood↗
PubMed1996

Evaluation of risk factors for fatal neonatal sepsis.

OBJECTIVE: To evaluate risk factors for fatal neonatal sepsis. DESIGN: Prospective study. SETTING: Referral neonatal unit of a teaching hospital. SUBJECTS: 171 neonates admitted with sepsis. METHODS: Clinical examination and investigations on the day of admission were recorded and the neonates followed up to determine the final outcome. RESULTS: The overall fatality was 48.5%. In the univariate analysis, the factors significantly associated with death were weight, gestational age, age at onset of sepsis, hypothermia, requirement of IPPV, presence of refractory septic shock, neutropenia, metabolic acidosis and raised prothrombin time. However, in the multivariate analysis, only neutropenia, metabolic acidosis, increased prothrombin time and refractory septic shock retained their significance. The adjusted odd's ratio (95% confidence interval) were 0.095 (0.04 = 0.22), 1.14 (1.04-1.25), 1.04 (1.002-1.08) and 11.82 (5.47-69.40), respectively. CONCLUSION: Even in a setting with high fatality rates, high risk of mortality in neonatal sepsis can be identified and targeted for intensive intervention.

Analysis of Variance↗
PubMed1993

Exchange transfusion in neutropenic septicemic neonates: effect on granulocyte functions.

Depletion neutropenia caused by overwhelming bacterial infection is associated with fatal outcome and is an objective indicator of the severity of sepsis. Studies on controlled evaluation of exchange transfusion in the management of severe neonatal sepsis have not considered neutropenia as an inclusion criterion, and randomized, controlled trials on evaluation of neutrophil functions after exchange transfusion are scarce. This prompted us to carry out the present study. Septicemic neonates were enrolled if they had neutropenia and were randomized to undergo exchange transfusion (study group, n = 20) or not (controls, n = 10). Granulocyte functions were assessed using the nitro blue tetrazolium (NBT) reduction test and the staphylococcidal index. Blood was drawn for granulocyte function tests once from controls and donors, and before, immediately after and 6 h after exchange transfusion in the study group. Mortality was 35% in the study group and 70% in controls. Gram-negative organisms accounted for 80% in the study group and 90% in controls. Mean total leukocyte count and neutrophil count increased significantly immediately after exchange transfusion and 6 h later. Absolute band count decreased significantly immediately after exchange transfusion and increased 6 h later. NBT reduction in septicemic neonates in the study group, as well as in controls, was significantly decreased as compared to donor cells. NBT reduction improved significantly immediately after exchange transfusion and 6 h later. The values of the percentage of viable staphylococci recovered from neutrophils also improved significantly immediately after exchange transfusion and 6 h later.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteremia↗
PubMed1991

A comparative study of cells and anti-microbial proteins in colostrum of mothers delivering pre- and full-term babies.

The different anti-infective factors in the colostrum of 25 mothers delivering pre-term (33.04 +/- 2.18 weeks gestation) and 10 mothers full delivering term (39.1 +/- 0.87 weeks gestation) babies were measured. The mothers of both the groups were comparable with respect to age, parity, nutrition, and haemoglobulin levels. Although the mean volume of colostrum (12 hours) was significantly lower in pre-term (32.28 +/- 7.92 ml) than in full term (44 +/- 4.83 ml) colostrum (P less than 0.05), the concentrations of total protein, sIgA, lysozyme, and lactoferrin were significantly higher in preterm than in full-term colostrum. IgG and IgM levels were similar in both the groups of colostrum. In both the groups, s-IgA was the predominant immunoglobulin. Moreover, the absolute counts of total cells, macrophages, lymphocytes, and neutrophils were significantly higher in pre-term compared to full-term colostrum. Macrophage were the predominant cells. Degree of prematurity has been found to have profound influence on the volume, protein concentration, and cell and macrophage counts of colostrum. Thus, more pre-term the newborn was, the mother produced less amount of colostrum. Total protein concentration and absolute cell count were significantly higher in the colostrum samples of mothers delivering between 28 and 32 weeks as compared to those delivering between 33 and 36 weeks. It is concluded that the colostrum of mothers delivering pre-term, though less in amount, is rich in soluble anti-infective agents and cells. The higher concentration of protective factors compensates for the limited capacity of milk intake in the pre-term infant.

Adult↗
PubMed1991

Hemobilia in a child with liver abscess.

Hemobilia in children is rare and has so far been described only as a complication of blunt abdominal trauma. A case of hemobilia secondary to liver abscess treated successfully by selective arterial embolization is described. Hemobilia should be considered in any case of gastrointestinal hemorrhage before any operative intervention is undertaken.

Angiography↗
PubMed1991

Cellular composition including lymphocyte subsets in preterm and full term human colostrum and milk.

The cellular composition of colostrum (within 72 hours post partum) and mature milk samples (5th-7th day post partum) from 20 mothers delivering preterm babies and 20 mothers delivering full term babies was examined. Lymphocyte subsets including T cells, B cells, T4 and T8 cells were quantitated by indirect immunoperoxidase staining using specific monoclonal antibodies. The mean total cell count in preterm colostrum (9,338/mm3) was significantly higher than in full term colostrum (5,594/mm3). Similarly, counts for macrophages, neutrophils and lymphocytes were significantly higher in preterm colostrum and milk as compared to full term colostrum and milk. B and T lymphocytes including T4 and T8 cells were identified in both preterm and full term breast milk. The absolute count of T, B, T4 and T8 cells was significantly higher in preterm colostrum compared to term colostrum, though the relative percentage distribution of lymphocyte subsets showed no significant difference between the two groups. T and B cells constituted about 74% and 26% of total lymphocytes, respectively in preterm as well as full term colostrum and about 69% and 31% in preterm and full term milk. The mean T4/T8 ratio was higher in preterm colostrum than term colostrum, being 1.82 and 1.60 respectively. However, this difference was not significant statistically and did not change statistically in the milk sample.

B-Lymphocytes↗
PubMed1991

Periventricular hemorrhage in term newborns originating from germinal matrix.

Six term newborns, presenting with seizures, in whom cranial sonogram showed isolated periventricular hemorrhage (SEH) are described. Age of onset of seizures ranged from day one of birth to day twenty-one. Seizures appeared spontaneously in previously healthy newborns in three cases. All but one survived, and three have near normal development. Isolation of hemorrhage to the periventricular area suggests germinal matrix to be the source of hemorrhage in these cases. These cases also emphasize the need to consider diagnosis of IVH in term-newborns presenting with seizures.

Cerebral Hemorrhage↗
PubMed1991

Mortality in neonatal septicemia with involvement of mother in management.

In most Special Care Neonatal Units (SCNUs) in India, mothers are excluded from the care of their sick babies for fear of over-crowding and dislocation. We have attempted to study the feasibility of involving mothers in the care of their babies admitted for neonatal septicemia and to analyse whether this changed the sepsis related case fatality rate. The study material consisted of 158 neonates with blood culture positive neonatal septicemia whose mothers were actively involved in their care during their stay in the SCNU of LNJPN Hospital throughout 1987-88. The mothers lived in with their sick neonates and were extremely useful in feeding, cleaning, and monitoring for some important signs and symptoms. There were no epidemics of infection in the nursery during this period. All the babies discharged were receiving breast feeds, and the mothers were confident in taking care of them before discharge. The mortality in this group was 43%. The onset of septicemia was most often in the first week (36%) being 25.9% in second week, 26.6% in the third, and 11.4% in the fourth. Mortality was maximum (64.5%) when the onset of illness was in the first 3 days. Klebsiella and S. aureus were commonly isolated organisms (38.6 and 21.5%, respectively). Gram negative organisms were isolated in 66.5% cases with higher mortality in this group. Nearly 46% of the babies weighed 2 kg or less, with a mortality of 60.2% compared to 28.2% in those more than 2 kg. Only 3 to 5% and 40 to 66.7% of Gram negative and 23 and 70% of Gram positive organisms were sensitive to ampicillin and gentamicin, respectively.

Bacteremia↗
PubMed1990

Anti-infective factors in preterm human colostrum.

Feeding of the infection prone preterm neonate with concentrated immunologically active ingredients in the form of colostrum may have even more significant clinical implications than in the full term infants. The scarcity of knowledge on anti-infective factors in colostrum of mothers delivering prematurely prompted us to carry out this study. Colostrum was collected and analysed from 25 mothers delivering prematurely (Study group) and 10 delivering at term (Control group). Major anti-infective factors namely IgA, IgG, IgM, lactoferrin and lysozyme were quantitated and total cell, macrophage, lymphocyte and neutrophil counts were performed. The mean concentrations of IgA, lysozyme and lactoferrin of preterm colostrum were significantly higher than in full term colostrum (p less than 0.001). IgG and IgM were found to be similar in both groups. The absolute counts of total cells, macrophages, lymphocytes and neutrophils were found to be significantly higher in the preterm colostrum as compared to the full term colostrum (p less than 0.001). Though in both the groups IgA was the predominant immunoglobulin, the mean percentage of IgA in the study group was significantly higher as compared to the control group. Degree of prematurity did not have any influence on the anti-infective protein levels in colostrum. However total cells and macrophages were significantly higher in colostrum of mothers delivering severely preterm babies.

Adult↗