Amit Upadhyay

To compare the efficacy of phenobarbitone and phenytoin for treatment of neonatal seizures in term and nearterm neonates.

To compare analgesic effect of direct breast feeding, 25% dextrose solution and placebo as we give 1st intramuscular whole cell DPT injection to 6week — 3month old infants.

The primary objective was to evaluate the analgesic effect of a eutectic mixture of local anesthetics (EMLA) during whole cell DPT vaccination. The secondary objective was to evaluate if the analgesic effect of EMLA was synergistic to breastfeeding. A randomized, placebo-controlled trial was done to include infants of up to 3 months of age who came for their first DPT vaccination. The outcome variables were duration of cry, latency of onset of cry, and Modified Facial Coding Score. Thirty babies were enrolled in each of three groups. The groups did not differ significantly in baseline characteristics. Median (interquartile range) of duration of cry was least [34.6 (24.1–72.2) s] in babies receiving EMLA cream with breastfeeding (EB group), followed by 94.2 (46.1–180) s in babies receiving EMLA cream with oral distilled water (EW group), as compared to 180.0 (180–180) s in babies receiving placebo cream with oral distilled water (PCW group) (p < 0.05). Mean (SD) of latency of cry was significantly greater in EB group [2.4 (1.14) s] and EW group [1.9 (0.62) s] as compared to babies in PCW group [1.5 (0.47) s] (p < 0.05), but the difference between EB and EW groups was not significant. Modified Facial Coding Score was significantly lower in EB group as compared to the other groups (p < 0.05). Conclusions: Topical EMLA is effective in reducing pain and has a synergistic effect in analgesia when combined with breastfeeding during vaccination in infants.

To study the effect of oil massage on growth in preterm babies less than 1800 g. This randomised controlled trial was conducted in Neonatal intensive care unit of a level II hospital. Neonates with birth weight < 1800 g, gestation < 35 wk and < 48 h of age at enrolment were included in the studies. Eligible neonates were randomized to one of the two groups (a) Oil massage along with standard care of low birth weight (b) Standard care of low birth weight without massage. Weight, length and head circumference was measured in the two groups at 7 d intervals. Serum triglyceride levels were measured at enrolment and at completion of study. Primary outcome variable was weight gain at 28 d after enrolment. A total of forty-eight neonates were randomisd to either oil massage group (n = 25) or standard care of low birth weight without massage group (n = 23). Mean (SD) weight of babies in the two groups was 1466.4 ± 226.8 g in oil massage group and 1416.6 ± 229.9 g in the control group. At 28 d, weight gain in the oil massage group (476.76 ± 47.9 g) was higher compared to the control group (334.96 ± 46.4 g) (p < 0.05). At 7 d, less weight loss (7.80 ± 9.8 g) was observed in babies in oil massage group compared to control group (21.52 ± 19.4 g) (p = 0.003). However, there was no significant difference in serum triglycerides and other anthropometric parameters. Oil application has a potential to improve weight gain and cause less weight loss in first 7 d in low birth weight neonates

To compare reduction in incidence of feed intolerance in neonates born with meconium stained amniotic fluid (MSAF) by use of gastric lavage to those who did not receive lavage. This Randomized controlled trial was conducted in all vigorous newborns delivered through MSAF, with birth weight ≥1800 g and gestation ≥34 wk. In the lavage group, gastric lavage with 10 ml/kg of normal saline was done. Twelve neonates in the lavage group (n = 124) developed feed intolerance compared to 16 neonates in control group (n = 120), (p = .309; OR 0.69; 95%CI 0.27–1.58). No difference in any other morbidity was noted. Gastric lavage in neonates with MSAF does not reduce feed intolerance, irrespective of thickness of MSAF and it confers no advantages.