Dr. Rabindran Rabindran's scientific contributions

Introduction: VLBW is associated with increased mortality and morbidity. In country like India where poverty, illiteracy & low socio-economic factors play a major role, incidence of VLBW & its complications can be reduced by targeting on the socio-demographic, obstetric factors, maternal nutrition & health education. Methodology: This is a Prospective study in a single centre over a period of 1 year. All newborns admitted to the neonatal unit during the study period with birth weight < 1500 gram were included and Still births & babies with major congenital malformations were excluded. An equal number of newborns with birth weight > 2500 gram were selected by simple randomized technique on same day of the selection of study group & were used as a control population to study maternal factors. Maternal factors analyzed in the study include Age of mother, Parity, Birth interval, Height, Weight, Mid arm circumference, Literacy level, Per capita income per month, Family structure, Mother's occupation, Antenatal care, Bad obstetric history, Maternal disease during the antenatal period Neonatal details of birth weight, gestational age, sex of the baby was collected. Results: Higher incidence of VLBW babies were noted among young mothers, primiparity, when birth interval was < 2 years, maternal weight < 40kg and with MAC < 20 cm. Incidence of VLBW was more in mothers who were illiterate and with bad obstetric history. Conclusion: A well-nourished multiparous mother between 20-30 years with birth interval of > 2years with good literacy & without any BOH has the best chance of producing a good weight baby.

There are only few case reports of congenital anterior staphyloma, an extremely rare condition. We report a case of congenital anterior staphyloma presenting as corneal clouding. A preterm girl baby was noted at birth to have bilateral corneal opacity with left sided microcornea. Ophthalmological evaluation revealed anterior staphyloma in right eye &total leucomatous corneal opacity in left eye. Despite antiglaucoma treatment, right sided bupthalmos & corneal thinning worsened. Corneal transplant was done at 7 months of age & baby improved symptomatically.Congenital anterior staphyloma occurs due to developmental aberration or secondary to inflammation. There are various genetic, metabolic, developmental & idiopathic causes of congenital corneal clouding like congenital glaucoma, birth trauma, peters anomaly, dermoid tumors, sclerocornea, infectious/inflammatory processes, metabolic causes & excess prenatal maternal consumption of alcohol. Complete evaluation of congenital corneal clouding include slit lamp biomicroscopy, funduscopy, tonometry, gonioscopy, ultrasonography, photo screening, ultrasound biomicroscopy & CT scanning in selected cases. Treatment is primarily surgical followed by management of amblyopia & optical therapy. Early penetrating keratoplasty, primary combined trabeculotomy-trabeculectomy & corneal grafting are associated with a favorable visual outcome. Early identification of ophthalmological problems in infancy & prompt intervention is mandatory for conditions like congenital corneal clouding.

Introduction: Hyperbilirubinemia is a common problem among term newborns. Cord bilirubin level has been found to correlate well with day 3 bilirubin level. We studied whether cord bilirubin could predict risk of development of significant hyperbilirubinemia among term neonates. Methodology: Prospective study from October 2009 -July 2010. All newborns between 37 weeks -42weeks, birth weight > 2500 gram, Apgar score > 7 at 1st& 5th minute of life were included in the study. Cord blood, day 3 & day 5 bilirubin was collected. Maternal data & bilirubin values were collected & analyzed using SPSS software. Results: About 115 babies were studied. There was no significant difference in cord bilirubin & day 3 bilirubin between babies born to mothers < 30 years &> 30 years. There was no significant difference in bilirubin values bassed on mode of delivery. About 29.6% babies developed clinical jaundice & received phototherapy. Cord bilirubin levels had significant association with need of phototherapy. Cord bilirubin >/= 2.1 mg/dl predicted need for phototherapy with PPV of 90.3%. Maternal age, sex of baby, birth weight & gestational age had no significant effect on cord bilirubin levels. Cord bilirubin >/= 2.1 mg/dl predicted day 3 serum bilirubin > 15 mg/dl with sensitivity of 88 % & PPV of 77.49 %. The likelihood ratio with cord bilirubin > 2.1 mg/dl & day 3 serum bilirubin > 15 mg/dl was 9.316. Conclusion: Cord bilirubin is predictive of need of phototherapy & correlated well with day 3 bilirubin levels which would facilitate early management of neonatal hyperbilirubinemia.