Raynorsanders3117

Immune Thrombocytopenia is the commonest cause of thrombocytopenia in young children. A thorough history, examination and peripheral smear evaluation is central to diagnosis. The recent American Society of Hematology guidelines 2019, has shed light on diagnosis and management based on latest available literature. We, herein, delineate the important aspects of these guidelines.The term integration has gained importance in Medical education over the last two decade, and is believed to facilitate knowledge, that is more meaningful to clinical practice. A move towards integration in medical education is likely to reduce fragmentation of the medical course and motivate students towards better learning, It aims to improve medical education by bridging the traditional barrier between basic and clinician sciences. Integration is one of the major changes incorporated in the new competency based curriculum for undergraduate medical program in India. There are associated changes in the assessment system too in relation to integration. However, the concept of integration/integrated curriculum lacks significant clarity as how to implement it in medical institutions with added paucity of literature on this important topic. Integrated teaching is the integration of the concepts wherein various subject-based knowledge or aspects of one theme or topic are assimilated to provide the holistic approach. Our review focusses on the need for integration with comparative analysis of the two most important models of integration (Fogarty and Harden) which are being followed, delving on their common features for simplifying this complex topic as well as for better understanding of the concept. We have also proposed six steps for implementation of integration. We conclude that the proposed change from conventional to new integrated curriculum requires robust planning and coordination amongst the various stakeholders in medical institutions.

To assess the effects of delayed cord clamping (DCC) on hemoglobin (Hb), mean corpuscular volume (MCV) and ferritin level in infants 2 months or older.

Meta-analysis of randomized control trials searched systematically from PubMed, Cochrane and Web of science. Trials published from Jan 1,1975 to Mar 12, 2018, no language and country restrictions. Twelve studies were included in this meta-analysis. In total, 993 infants were treated with DCC, while 989 cases received early cord clamping. Delayed cord clamping was defined as umbilical cord clamping time greater than 60s after delivery. Outcomes assed were (i) hemoglobin (Hb), (ii) mean corpuscular volume (MCV) and ferritin level.

The results show that DCC increased hemoglobin level (SMD=0.4678 95%CI [0.1515, 0.7841]), Ferritin level (SMD=2.1450 95%CI [1.0431, 3.2470]) and MCV (SMD=0.5751 95%CI [0.1637, 0.9865]) in infants between 2-12 months compared to ECC subject analysis noted the effects of Hb increase was greater in Asian infants.

Delayed cord clamping improved the Hb, MCV and ferritin level of infants after birth.

Delayed cord clamping improved the Hb, MCV and ferritin level of infants after birth.

To assess the prevalence of iodine deficiency disorders among school-going children in Meghalaya.

Multi-stage 30 cluster sampling with probability proportionate to size (PPS) method was used. Children (age 6-12years) were examined clinically for goiter. Urinary iodine excretion (UIE) was performed by spectrophotometric method. Iodine content in the salt was analyzed using iodized salt test kits.

A total of 195 (7.22%) out of 2700 children had goiter on examination. Goitre prevalence was significantly associated with wasting (P<0.05) and stunting (P <0.001). The median (IQR) UIE level was 150 (108.05 - 189.37) µg/dL. Nineteen (9.74%) children had severe iodine deficiency (UIE<20µg/L). Iodine content was above the recommended level of 15 ppm in 95.9% salt samples. A positive correlation was observed between household salt consumption and UIE levels (r=0.25; P<0.001).

Iodine deficiency disorder is a public health problem in Meghalaya, which needs to be addressed.

Iodine deficiency disorder is a public health problem in Meghalaya, which needs to be addressed.

To assess feasibility of ultrasound (USG) evaluation of tip position of central catheter in neonates and to determine agreement between radiograph and USG-based assessments.

This prospective observational study was conducted in a tertiary neonatal intensive care unit from April, 2019 to August, 2019. Point of care USG and radiograph were performed on infants who underwent central line placement. Agreement between the two was determined using Kappa statistics.

Of the 141 central catheters insertions performed, USG was performed for 65 central catheters. On USG, catheter tip position could be assessed and defined in 62 (95%) of cases. Of these 62 central lines, 24 (38.7%) were defined as optimally placed on radiograph and 20 (32.2%) were defined as optimally placed on USG. There was excellent agreement between radiographic and USG assessment of catheter tip position [K (95% CI) = 0.86 (0.73-0.99), P <0.001]. All 38 lines found to be mal-positioned on radiograph were assessed as sub-optimal on USG as well.

Point of care USG has excellent agreement with radiography for confirming central line tip position.

Point of care USG has excellent agreement with radiography for confirming central line tip position.

To study the excipients exposure among neonates in a neonatal intensive care unit.

Prospective observational study was conducted from January, 2017 to June, 2019. L-glutamate chemical structure Details of administered drugs were collected from the hospital case files. List of excipients of formulations and their quantities were collected from package insert leaflets or by contacting the manufacturers. Excipients were grouped into four categories based on available safety data. Calculated daily exposures to the excipients (mg/kg/day) were compared with adult acceptable daily intake.

More than half of the included 746 neonates were exposed to harmful excipients. 12.3% and 12.7% of neonates received higher than acceptable daily intake of sodium metabisulphite and sunset yellow FCF, respectively.

There is a high risk of exposure of neonates to harmful excipients, and clinicians need to be aware of this during neonatal care.

There is a high risk of exposure of neonates to harmful excipients, and clinicians need to be aware of this during neonatal care.