Browsing by Author "Biswas, Ratan Kumar"

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    The Early use of CPAP in Neonatal Pneumonia: Randomized Control Trial
    (Society for Health Care & Research Development, 2018-03) Munian, Dinesh; Biswas, Ratan Kumar; Mukherjee, Ranajit
    Background: Aim- To assess clinical resolution of neonatal pneumonia by early use of CPAP. Study design- Randomized control trial.Methods: Neonates with a gestational age of >35 weeks having tachypnea (RR≥ 60/min) and respiratory distress were included in the study. The neonates were subjected to a radiological examination for confirmation of pneumonia. Further a sepsis screen was performed, if the screen was positive, the patient was enrolled for inclusion in the study. The randomization allocation was done and the babies allotted to the study (CPAP) group or the control group. Babies in study group were put on CPAP soon after randomization allocation and the babies in the control group were managed as per the unit protocol. Results: It has shown that the early use of CPAP in addition to standard treatment results in early resolution of clinical pneumonia & significant reduce the duration of oxygen therapy. Further it lowered the need for mechanical ventilation. However there was no difference in the duration of hospital stay in the two groups. CPAP was well tolerated by the neonates (both late preterm and term) with few complications. No baby’s condition gave concern that there could be a significant air leak. Conclusion: In our study, the early use of CPAP in addition to standard treatment results in early resolution of clinical pneumonia & significant reduce the duration of oxygen therapy. Further it lowered the need for mechanical ventilation. CPAP was well tolerated by the newborn (both late preterm and term) with few complications.
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    A Randomized Controlled Trial Comparing the Duration of Phototherapy Following NICE and AAP Guidelines in Neonatal Hyperbilirubinemia
    (Society for Health Care & Research Development, 2019-07) Biswas, Ratan Kumar; Munian, Dinesh; Mukherjee, Ranajit
    Aims and Objectives: To compare duration of phototherapy between AAP and NICE guidelines in neonatal hyperbilirubinemia. Methods: In an open labelled study 130 babies with non-haemolytic hyperbilirubinemia were randomised to receive phototherapy following one guidelines between AAP and NICE. In this study we compared AAP 2004 and NICE 2010 guidelines to see whether following any of these two guidelines leads to phototherapy for longer duration. The primary outcome variable was duration of phototherapy and the secondary outcome variable was failure of phototherapy, defined as inability to reduce the TSB level of 2-3 mg/dl from baseline within 6 hours of phototherapy or inability to reduce TSB below exchange level. Results: Median age at onset of phototherapy was 77.55(19.43)hours in AAP group and 73.57(12.93) hours in NICE group, median gestational age was 37weeks in AAP group and 38weeks in NICE group, mean birth weight 2377.92gm in AAP group and 2457.10 gm. in NICE group, mean serum bilirubin at the onset of phototherapy was 18.77(1.570) mg/dl in AAP group and 18.24(1.89)g/dl in the NICE group. Average spectral irradiance was 55.8(µw/cm2/nm) in the study. Median duration of phototherapy in NICE as well as AAP group was 18 hours. There was no treatment failure in either group. Neurological examination was done at 40 weeks and 3 moths of corrected age. No abnormal neurological examination or BERA finding was reported in any of the babies. Conclusion: There is no difference in duration of phototherapy in any of the guidelines.