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Objective: To assess the prevalence, risk factors and outcome of acute kidney injury (AKI) in neonates admitted in a neonatal intensive care unit (NICU) of developing country. Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit at Sheikh Saeed Memorial Campus (SSMC) of Indus Hospital and Health Network (IHHN), Karachi, Pakistan. Period: April 2022 to September 2022. Material & Methods: Four hundred and seventy-one newborns hospitalized to the NICU were analyzed. Demographic details along with maternal and neonatal history, vitals, and clinical signs of newborns were noted. All at-risk newborns had their urine output assessed. Serum creatinine levels were assessed to classify AKI into stages using modified KDIGO criteria. Results: Out of 471 participants, 256 (54.4%) neonates were male. The prevalence of AKI was noted in 42 (8.9%) neonates. Based on the modified KDIGO stages, 26 (61.9%), 7 (16.6%), 7 (16.6%), and 2 (4.7%) neonates met the requirements for AKI stages 0, 1, 2, and 3, respectively. In comparison to newborns with normal renal function, newborns with AKI had significantly higher serum creatinine levels (p<0.001), lower urine output (p=<0.001), and lower creatinine clearance rates (p=0.001). Multivariate analysis showed that sepsis enhanced the risk of acquiring AKI (OR: 60.50, 95% CI: 26.03-169.88). Neonates in distress, and on ventilator had a higher risk of having AKI (OR: 13.88, 95% CI: 1.26-152.91) and (OR: 20.77, 95% CI: 1.1-390.49) respectively. Conclusion: The prevalence of AKI among neonates admitted in NICU was 8.9%. Fetal distress, sepsis and mechanical ventilation were significantly associated with AKI. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the frequency of hearing impairment and the prenatal, antenatal, and postnatal variables associated with hearing impairment in neonates at the Indus hospital in Karachi. Study Design: Prospective, Observational, Cohort study. Setting: Department of Pediatrics and Neonatology, Sheikh Saeed Memorial Campus (SSMC) of Indus Hospital and Health Network (IHHN) Karachi, Pakistan. Period: July 2020 to June 2022. Material & Methods: We screened 426 neonates for hearing impairment utilizing otoacoustic emissions (OAEs) Auditory brainstem response test (ABR) and "brainstem auditory evoked response" (BERA). Babies who failed OAE and ABR test underwent BERA. Babies with abnormal BERA report were proven to have hearing impairment. Results: A total of 426 neonates were screened through the study period. Of these 426, 134 (31.5%) were unsuccessful and a second stage OAE test was conducted where 63 (47.0%) passed and 71 (53.0%) did not. The ABR test was administered to 71 neonates, 42 (59.2%) failed the test and received referrals for diagnostic BERA. Of those 42 neonates, 15 neonates tested positive for BERA, 10 of them were found to have sensor neural hearing loss while 5 had conductive hearing loss. Neonatal jaundice patients were more likely to experience hearing impairment (p=0.011). Family history of hearing loss (p=0.001) and fetal distress (p=0.043) were significantly related with hearing impairment. Conclusion: The result of our study has discovered a significant number of risk factors for hearing loss, which is crucial since it will allow for close monitoring of the kids who have these risk factors. Furthermore, our research emphasizes the need of newborn hearing screening in our country, since this screening is not generally carried out in all facilities. [ABSTRACT FROM AUTHOR]