Neonatal Sepsis - ECAB

Neonatal Sepsis - ECAB
Author: N B Mathur
Publisher: Elsevier Health Sciences
Total Pages: 179
Release: 2009-12-15
Genre: Medical
ISBN: 8131232425
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Neonatal sepsis contributes significantly to neonatal morbidity and mortality. The incidence of neonatal sepsis as per National Neonatal Perinatal Database (NNPD 2002-2003) is 30 per 1,000 live births among intramural neonates. Among extramural neonates, sepsis accounts for nearly 40% of admissions to the NICU. It accounts for 18% of neonatal mortality among intramural neonates and nearly 40% of mortality among extramural neonates. The incidence and mortality is much higher in VLBW neonates as compared to term neonates. Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection and accompanied by bacteremia in the first month of life. Once bacteria gains access to the bloodstream, mechanisms are activated by the host to eliminate it. Usually, the bacteria are efficiently cleared by the monocyte macrophage system after opsonization by antibody and complement. Sometimes, however, a systemic inflammatory response syndrome is established and can progress independently of the original infection. In many patients with sepsis, it is difficult to document a bacterial cause. The term "systemic inflammatory response syndrome" includes several stages of infection ranging from sepsis, sepsis syndrome, and early septic shock to refractory septic shock, which can eventuate in multiple organ dysfunction syndrome (MODS) and death. Prevention of sepsis is probably the best management strategy as far as neonatal sepsis is concerned. Strategies include prevention of early-onset sepsis and prevention of late-onset sepsis. For the former, appropriate obstetric care is the key; for the latter, decreasing interventions, promoting breast feeding, and maintaining proper hand hygiene are essential.

Neonatal Sepsis

Neonatal Sepsis
Author: Mathur
Publisher: Elsevier Health Sciences
Total Pages: 123
Release: 2009
Genre:
ISBN: 8131221768
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Obstetrics Counseling - ECAB

Obstetrics Counseling - ECAB
Author: Uday Thanawala
Publisher: Elsevier Health Sciences
Total Pages: 127
Release: 2012-07-05
Genre: Medical
ISBN: 8131232247
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Informed choice is the right of an individual. Gynecologists have immense responsibility and a unique opportunity to guide their patients through the various milestones/changes in their life by good counseling—menarche, sexuality, pregnancy, pelvic operations, and menopause. Adolescents should be taught about safe sex practices, premarital counseling, and contraception. Preconception counseling is also important in the identification of risk factors, disease states, and potential teratogens in the pregnancy. The availability of first-trimester prenatal diagnosis and the advent of presymptomatic diagnosis by DNA analysis have created increasing opportunities to avoid disorders characterized by early death, severe disease, or irreparable mental retardation, for example, periconceptional maternal folic acid supplementation has now been shown to provide high protective effect against neural tube defects. Similarly, certain maternal diseases, including diabetes, lupus, and myotonic muscular dystrophy, impose potential maternal, fetal, neonatal, and other complications. The preconception visits provide important opportunities for intervention, avoidance, or prevention in these cases. The patients’ ethnicity and medical and genetic family history are key elements in their evaluation, whereas patients with prolonged infertility of unknown cause or recurrent spontaneous abortion may have a 3–10% risk of a parental chromosome abnormality, which may also require chromosome analysis, as do their spouses.

Allergy and Asthma - ECAB

Allergy and Asthma - ECAB
Author: S K Kabra
Publisher: Elsevier Health Sciences
Total Pages: 163
Release: 2013-01-10
Genre: Medical
ISBN: 8131232433
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Prevalence of allergic diseases has increased several folds in western world over the last two decades, and similar trend is being observed recently in India. There have been several postulations to explain increasing occurrence of allergic diseases. "Allergic march" refers to sequence of events that starts during fetal life as a result of sensitization to foods and may manifest as eczema, gastrointestinal symptoms, asthma, or hay fever, or combinations of any of these symptoms. A link between genetics and immunology is hypothesized that results in such allergic diseases.

Perinatal Medicine - ECAB

Perinatal Medicine - ECAB
Author: Shirish N Daftary
Publisher: Elsevier Health Sciences
Total Pages: 182
Release: 2012-07-05
Genre: Medical
ISBN: 8131232239
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Perinatal medicine encompasses various current topics in fetal diagnosis and management, besides preconception counseling. The concept of preconception counseling and healthcare evaluation optimizes a couple’s readiness for childbearing. This helps to minimize any foreseeable adverse factors through a careful diagnostic review and provision of appropriate intervention and therapy in advance. This has been dealt with in detail. The section on etiology and management aspects of Intrauterine Growth Retardation (IUGR) covers investigation and management of suspected or known fetal abnormalities, placental failure, and fetal growth retardation. Prenatal diagnostic procedures had limited access and safety so far, but this is a thing of the past today, especially after the advent of real-time ultrasonography. It brings an increasingly clearer visualization of the intrauterine space and has vastly broadened the scope for fetal diagnosis and treatment. The currently available ultrasound-guided procedures for fetal diagnosis and therapy are discussed at length in the chapter invasive ultrasound procedures. The discussed invasive ultrasound procedures include amniocentesis, cordocentesis, and chorionic villus sampling, done to detect neural tube defects, fetal lung maturity, and chromosomal abnormalities. The controversies surrounding the evaluation of fetal anomalies by ultrasound procedures are covered at length which we expect would be of special interest to the readers. Opinions abound as well as differ on the interpretation of the findings and counseling of couples, based on the same. This section focuses on the implications of missed fetal anomalies in this background and its impact on pregnancy outcome.

Critical Issues in Obstetrics - ECAB

Critical Issues in Obstetrics - ECAB
Author: Prakash Trivedi
Publisher: Elsevier Health Sciences
Total Pages: 150
Release: 2009-09-15
Genre: Medical
ISBN: 8131232263
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Globally, pregnancy and childbirth are periods of high morbidity and mortality for women. The key to reducing the risks associated with pregnancy and childbirth is early recognition and provision of high quality care. The aims of critical care issues’ management are broad, the need to address the defects in conceiving followed by early recognition, prevention, and management of preterm births and threatened miscarriages along with studying the essential factors responsible for the same. Infertility has been ranked as one of the greatest sources of stress in a person’s life, comparable to a somatic disease such as cancer and ranked second to that involving the death of a family member or divorce. The role of stress and immunomodulation as a causative factor for infertility has been studied in greater details in recent times due to the changing lifestyles and a relevant discussion has been provided by the author with specific considerations in the Indian clinical settings. Endometriosis is the disease of the millennium, a sticky, perplexing and unconquerable pathology, which has remained an enigma. With increased awareness about endometriosis, improved methods of diagnosis like transvaginal sonography, liberal use of laparoscopy and more frequent evaluation of CA 125, the incidence of endometriosis is rising and thus, a clear understanding of the condition with application of the various advances in the recognition and also the new management protocols being followed, are the need of the day for the practitioners across the country. The polycystic ovary syndrome (PCOS), which features amenorrhea, hirsutism, and obesity, which was initially considered a reproductive and cosmetic concern of young women of reproductive age group, has more recently been recognized to have metabolic and cardiovascular associations that make it of major consequence for women of all age groups worldwide. Keeping in mind the requirements of the society, the practitioners need to update themselves on the current approach and the wide variety of choices now available. This book encompasses the rich experience of the specialists in India who are among the stalwarts in this field.