Interesting Cases

SUCCESS STORY OF RUDRAKSH MAHESHBHAI KORAT

Team We Have Done It!
One more Patient Saved & Happily Discharged Home!

This is about a little patient Rudraksh Maheshbhai Korat who had come to Amruta Hospital on 15-April-2024 & was diagnosed with GBS.
Proud to say that treating Drs Rakesh Patel Sir, Dr Shivam Barchha Sir & Team PICU Drs & nursing staff within minutes had started the treatments.
After such a long stay the patient was happily discharged home.
Thanks giving patient testimonial.

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SUCCESS STORY OF BABY BOY OF AASIYA AVINASH BAJAJ

Extreme preterm 26+5 weeks

WOA 750 grams
WOD 2.250 kg

Discharged with intact survival after many ups and downs.

No IVH
No ROP
No CLD

Treating Drs Rakesh Patel Sir,
Dr Apeksha Raval Mam,
Dr Abhishek Sir

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SUCCESS STORY OF MR & MRS RATHOD

Baby born @ 27 weeks with weight of  only 650 gms

Intact Survival on Non – Invasive Ventilation only without any Sepsis Episode.

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BATTLE OF 120 DAYS – STORY OF INTACT SURVIVAL

This is a story of a patient whose intact survival made us happy to bring smiles on faces of parents of this cute little tiny preemie.
We Amruta Hospital is thankful to all such wonderful parents who put their trust in us & also thank almighty God ?? who bless our NICU Team to fulfill promises.

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JOURNEY OF PREEMIES  BORN AT 22 WEEKS

This is a story of twins who were admitted in our hospital for last 4 months.
These babies are true survivors, they showed us the power of faith and prayers.
When we talk about premature babies everyday counts. Its not the count down it’s the count-up.

Hats off to #Team_NICU_Amruta ????for your special efforts put in to save the babies.
Truly a #Miracle

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A CASE OF INTACT SURVIVAL

A little champ born as early as 31 weeks of gestation, having severe respiratory distress at birth was admitted at Amruta Hospital. On admission baby was having SEVERE ANEMIA due to Rh-Compatibility between baby and mother.

During the stay in the hospital baby required BLOOD EXCHANGE TRANSFUSION with respiratory support in the form of Ventilation and Surfactant administration with nutritional support & gentle nursing care.

Finally baby had come out of all the complications & was discharged home with happy parents.

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Public Awareness Initiative by Amrutaa Hospital in Recent Era

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Intact survival..

Elderly parents after long treatment of infertility blessed with TRIPLETS..

30 wks. Maturity, having weight of 960gms., 1000gms., 1.4kg. 

intact survival without any complications.. 🙂

 

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AMRUTA_SUPERSPECIALTY_HOSPITAL
All under one roof only..

A 10yr. male pt. with severe uncontrolled hypertension, oligouria & septic focus was admitted to AMRUTA PICU for critical management.

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GBS with ADEM..

A 4.5yr male Pt. with c/0: limb weakness admitted to Amruta PICU with challenge of  life threatening disease known as GBS ( Guilliane Barre Syndrome ).

Due to rapid progressive paralysis with involvement of Respiratory Muscles & deterioration of sensorium, mechanical ventilation was started. With associated complications of Hypertension all the possible treatment was started accordingly.

With great apprehension & hard work  recovery started slowly. Muscle power was gained with exclusive physiotherapy.

Pt. was discharged normally having great satisfaction & without any infectious complication.

Thanks to Team PICU. 🙂

 

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Service of Humanity..

A male baby of 25 weeksof gestational age with ‪650gm‬ of weight delivered by C-section, admitted at AMRUTAA HOSPITAL, Rajkot.
Surfactant was given immediately and put on ippv for 3 days. At 4th DOL baby was extubated and put on non invasive ventilation by HHHFNC for 15 days.
Baby was discharged at weight of ‪1260gm‬, hemodynamically stable & on full enteral feeds without any morbidity with happy mother & family.
It was our great pleasure to be involved in the management of this little star & extending sum financial support too.

Team Amruta rocks‬..  ??

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Cystic fibrosis

1yr old pt. admitted to Amruta Hospital with obscure diagnosis. Pt. had consulted multiple time outside for the
c/o: Wt. loss , chronic cough, poor oral intake & low grade fever.
On admission pt. was having dehydration with respiratory distress.
With this history & examination, basic workup done & ‪‎f-508 gene mutation study‬ was done that was Positive and diagnosis get confirmed as ‘CYSTIC FIBROSIS.’
Treatment was started accordingly under supervision of Pediatric intensivist.
Pt. got improved hence, given discharge.

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Prematurity with Hypoglycemia..

A girl child  was born with prematurity of 28wks & ELBW of 770gms only at Porbandar area.

Due to recurrent Hypoglycaemic episodes she was transferred to AMRUTA Hospital – Rajkot on time for  the effective management of survival.

To combat with Hypoglycemic episodes successfully, baby was kept in NICU for few days & finally Discharged with wt. of 1.069 kg. On RT feeding & advice of KMC to parents.

   

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Case of  VACTERL Syndrome..

V : Vertebral Defect

A : Anal Malformation

C:  Cardiac Anomalies

Te: Tracheo-esophageal Fistula

R:  Renal malformation

L:  Limb Anomalies

A full term baby having many congenital abnormalities  was admitted at AMRUTA Hospital – Rajkot for surgical management of TOF.

After complicated surgery with accompanied malformations today baby is well settled with all normal parameters & on full feed.

Thanks to Whole team for genuine care.

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Cornelia De Lange Syndrome..

 A  full term  baby with IUGR Was admitted @ AMRUTA Hospital –Rajkot for the management of  IUGR+MSAF+RDS+DYSMORPHISM.

Having c/o,

–          DYSMORPHISM

–          MICROBRACHYCEPHALY

–          SYNOPHRYS

–          LONG PHILTRUM

–          HIGH ARCH PALATE

–          SHORT NECK & FLEXION CONTRACTURE OF ELBOW

–          OVERLAPPING OF FINGERS WITH PROXIMAL IMPLANTATION OF THUMB

–          DEPRESSED NASAL BRIDGE

–          PDA

With all above abnormalities baby was kept in NICU for exclusive care & was discharged having all normal vitals for life.!

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PICU :        

Well designed and fully equipped PICU with round the clock availability of Pediatric Intensivist to make the pediatric care more efficient and valuable in reliable way..

With the successive completion of almost 2 yrs. we came across the different kind of cases and with the grace of God we have given satisfactory outcome also..

Few of the interesting cases are…

• GBS
• Congenital laryngeal malacia
• Pyogenic meningitis
• DKA
• Wilson’s Disease
• PRES syndrome
• Transverse myelities
• Poisoning ( Snake bite, insect bite, OP, kerosene etc..)
• Epilepsy
• Dilated Cardiomyopathy
•  Steroid resistant Nephrotic syndrome & etc..

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Recurrent Apnea

Baby “Trisha” was born at preterm age with ELBW of 800gms. only .! Hence, she was referred to Amrutaa Hospital – Rajkot with c/o – RDS & AOP for further management.

During Stay of NICU recurrent attacks of apnea were well managed by Hospital team without any complications.

After successive reassurance baby was discharged with wt. of 1.255kg. having total negative septic screening.

God bless her.. 🙂

 

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Smallest Baby ever..

Its a case of that precious baby which is considered as the smallest baby in the region as well as in history of Amruta Pediacare till now. In the ever expanding Health care sector a preterm baby of 31 wks and extreme low birth weight of 600gms only.. shifted to   Amrutaa Hospital – Rajkot for tertiary care. with the complaints of RDS,SGA,HYPOGLYCEMIA & ELBW the life span was considered  too short.!!

As per Gujrati saying – “RAM RAKHE ENE KON CHAKHE..” ; team amruta proved its efficiency with the bless of God and provide real Amrit of life to pt.

In the stay of 35 days baby fought for life and finally stood up with new aura to challenge the life.!! 🙂

Today Harit is of 1.6 yr old having all normal neurological development and obligating the whole Team

may God bless Him.

Ref. : Mitalben V. Joshi

Porbandar

     

 

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A case of Precious pregnancy…

It is to be said that only God is the author of book called Life & he only decides what is to be written on each page.!
on the auspicious occasion of Dr’s day its a case of precious pregnancy of Paramedic mother..

 

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A CASE OF ELDERLY GRAVID MOTHER WITH ELBW..

On the age of 50yrs. with bless of almighty God she conceived twins.!! But unfortunately baby was delivered on 28/04/2015 with preterm age of 30wks. only. 

with this prematurity it was EXTREME LOW BIRTH WEIGH of 720gm. with resp. distress with PDA with early NEC.!; hence, considering impossible to survive for best possible care it was shifted to AMRUTA HOSPITAL – RAJKOT.

During 1st wk. of stay it was very difficult to save her as having positive septic screening ( Pseudomonas Aeru. ) with such complications.. therefor, ventilator support was started as a tertiary care.

Finally after stay of few wks. baby challenged the death and Life Wins..!! 🙂

today baby is of 2 months having 1.5kg. wt. with all normal neurological development.

Team Amrutaa wishes her best life ahead and also being

to parents for giving kind support to save FEMALE CHILD.!!

Ref. : Shantiben Balabhai Chudasama ( Porbandar )

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A case of Preterm with ELBW with Intact survival..

Once again Team Amrutaa proved its efficiency for quality care in Preterm baby of 26+4 wks. with 900 gms. weight only.!

With the 1st breath of baby it was considered impossible to be alive with this PRE-MATURITY  & EXTREME LOW BIRTH WEIGHT WITH SEVERE RESPIRATORY DISTRESS, hence; baby was shifted to Amrutaa Pediacare for best possible care & survival on 09/09/2014.

With the great confused mind parents came to Hospital with preparation of FUNERAL & Rays of Hope both.!!

“AS ONLY GOD IS THE ACCOUNTANT FOR LIFE..”

On  Admission  support of C-PAP and Exclusive care by whole team make it possible & baby started normal breathing at room air on the 4th day of life.!

In the successive  stay of 37 days, with total aseptic screening baby improved and discharged with wt. of 1.26kg.!!

Today baby (CHINMAY)  is of 9 months with NORMAL NEUROLOGICAL DEVELOPMENT & healthy life.

GOD bless him.!!! 🙂

Ref.: Meenaben Chauhan ( Mother )

 

 

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A case of Micropremiee baby..!

Micropremiee baby with  just 24 wks & 5 days of gestational age,

birth weight 365 gms,

length 11 inch is under NICU care at Amruta Hospital since 14th March 2015. 
Team Amrutaa giving their best to save the baby.
May Almighty God bless the baby, the parents & the Team Amrutaa.

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A Case of  Snake bite (Neurotoxic type) –Respiratory failure :-

                             A 3 ½  years  old child  named was admitted  at 9.30 pm on  Dt 2.07.12 with history of Snake bite on Lt foot before 2 hours of admission .Child had complaints of vomiting , altered sensorium  and breathing difficulty.

                             Child was immediately shifted to PICU, following which child was resuscitated and stabilized. In view of labored breathing, was put on Ventilatory support within half hour of admission. Child was treated with Anti-Snake Venom & Neostigmine –atropin regimen. Child was improved on the line of management and was extubated after 36 hours of ventilation.  No other complications were found in the patient and oral intake was initiated after 48 hours of admission.

                              Child  improved and discharged on request on 6^th day of admission. 

 

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A Case of Full term –Left Congenital Diaphragmatic Hernia with Pneumothorax – PPHN-EOS.

DISCUSSION: Full term male AGA, delivered on 13 .07.2012 at Jamnagar admitted on 2^nd DOL for management of congenital diaphragmatic hernia.  Baby was shifted with IPPV with ET tube in situ from Jamnagar.  On admission baby was pale, had bradycardia with retractions and low pulse volume. Baby was stabilized for next 24 hours. Baby was resuscitated and was put on ventilator on SIMV mode. Hernia was operated by pediatric surgeon on 3^rd day of life. Baby had pneumothorax on following day of operation and inter costal drainage was done in emergency. 2D Echo was done on 5^th day of life and found to have high PPHN .Baby needed 1 day of high frequency ventilation support to maintain saturation.  Nasogastric feeds were initiated since 5^th day of life. Baby was well after 9 days of ventilation and drain was removed on10th day. Baby was treated with appropriate antibiotics. Medications to reduce PPHN were used.

                              IV Fluids, IV antibiotics, Inj Dopamine, Inj Dobutamine, Inj Mgso4, Oral Sildenafil, Inj FFP, Inj Fentanyl, Inj PCV, Inj Aminoven & supportive care were given.

                             Baby was discharged on 12^th day of life.

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A Case of  Neonatal Encephalopathy – Maple Syrup Urine Disease(MSUD).                                                                                                                                        

Full term male baby , delivered on 29.03.2012, uneventful birth, birth wt. 3.1 kg, admitted on 03.04.2012 with complaints of  fever, not taking feeds & decreased activity since 1 day. On admission baby had Fever-102 F, not taking feeding well, vomiting, Irritability, seizure & lethargy. Septic screening was negative.  CSF & electrolytes were normal. S.ammonia &  blood lactate were normal.  MRI Brain s/o hypoxic damage ? metabolic disorder.  We had thought  about  metabolic disorders. Metabolic screening s/o MSUD. Pediatric Neurophysician opinion was taken. IV Fluids, IV gardenal, Multivitamin & supportive care were given. Special diet formula for MSUD – Ketonex powder with L-isoleusine, L-valine powder solutions were started through RT feeding. Baby had responded to line of management & gradually activity & reflexes were improved. On 20^th DOL, baby was on full RT feeds & discharged on 26^th DOL.

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A Case of  Nephrotic Syndrome- uncontrolled, huge ascites-severe hypoproteinemia:                                                                                  

4 years old female child reffered for the management of nephotic syndrome.  Patient had taken treatement at private hospital for 10 days but no improvement. On admission, patient had severe generalized oedema, oliguria & urine albumin +4. Patient was treated for nephrotic syndrome. Restricted IV fluids, IV antibiotics, oral prednisolone , diuretics & supportive care were given. On 5^th DOA, patient had respiratory discomfort due to severe ascites. Peritoneal drainage was done. On 10^th DOA, Patient was improved with urine albumin +2 & decreasing weight & edema. On 15^th DOA,  Patient was symptomatically well, oedema decreasing, urine albumin nil since last 3 days & taking orally well. So, discharge is given with advices for salt restricted, high protein diet, urine albumin monitoring & steroid dosages.

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 A Case of Preterm(35wks)-AGA-mild RDS-supraventricular tachyarrythmia-CMV septicemia:

Preterm(35 wks), male, 2.2 kg, LSCS, uneventful birth, admitted soon after birth for prematurity, RDS with tachycardia. On admission, baby had tachypnoea, grunting & respiratory distress & HR was 250 bpm. Septic screen was positive.CXR s/o mild HMD. Iv fluids, calcium, antibiotics, TPN & oxygen through hoodbox were given. ECG s/o supraventricular tachyarrythmia. 2-D echo was normal. Inj. Adenosine & inj. Amiodarone were given, but no responce to it. Inj. Betaloc & inj. Digoxin were started. SVT was gradually controlled over 48 hrs. On admission, 1st CBC counts s/o thrombocytopenia- 40000/cumm. Platelet was gradually decresed & on 5th DOL PC was 5000/cumm & persistently low for next 10 days, platelet transfusion & antibiotics were changed. Baby had GI bleeds & pulm. Haemorrage. So, put on TCPL mode of ventilator on 10th DOL. Patient was evaluated for persistently low platelets. TORCH titre s/o CMV infection. Inj. Ganciclovir was given. Baby was improved on line of management & extubated on 20th DOL. 1st feed was given on 18th DOL & gradually increased. Baby was on full enteral feeds on 35th DOL. Oxygen was stopped on 46th DOL & baby was discharged on exclusive breast feeding on 50th DOL with smiling face.

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A Case of  GBS:

9 yrs old male, 25 kg, admitted with complaints of acute onset of weakness of both UL & LL since 8hrs. On admission, patient had acute flaccid paralysis-ascending in nature, very rapid progression, grade 1/5 power in LL & 3/5 in UL. CBC, electrolytes, CPK & RFT were normal. CSF s/o albuminocytological dissociation. IVIg & supportive treatment were given. On 3rd DOA, patient had grade 1/5 power in UL & bulbar involvement- difficulty in swallowing, weak gag reflex & weakness of respiratory muscles. Patient was intubated & Put on PRVC-SIMV mode of ventilator. On day 4, Gavage feeds was stared. On day 7, patient had autonomic disturbances, labile hypertension-160/100 mm hg, incrased salivation. Inj. Betaloc & sublingual nifedipine were given. On day 15, there was no improvement, so tracheostomy was done. Patient was gradually improved & shifted on PSV mode. On day 38, patient was weaned from ventilator & kept on T-piece for 1 day. On day 45, tracheostomy was removed. On day 54, patient was discharged with grade 3/5in UL & 2/5 in LL.

 

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 A case of Organic Acidemia:

A 6 month old female infant presented with history of delayed development and history of hurried breathing and poor feeding of 8 hours duration. On admission, patient was in severe respiratory distress. Blood gases were done which showed high anion Gap Metabolic acidosis. Blood sugar was normal. Serum Lactate was high. Metabolic Acidosis was gradually corrected with Sodium Bicarbonate. Urine was sent for organic acids, which came positive. Now patient is discharged with oral Carnitine, Biotin, Thiamine and Vitamine B12 and regular physiotherapy.

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A case of Rapidly Progressive Pneumonia with DIC:

A 14 months old male child came with rapidly progressive respiratory distress following history of fever, cough and cold of 1 day duration. On admission child had respiratory distress with severe bilateral rhonchi and crepitations. In view of rapid progression and clinical deterioration, child was intubated on 6^th hour of admission. Chest X Ray was done which showed Right upper and mid zone consolidation. Blood gases were done which showed Severe Respiratory with Metabolic Acidosis. At presentation, Child also had GI Bleed due to DIC. Mechanical Ventilation with Lung protective strategies was done and Broad spectrum IV antibiotics and supportive care were started. Child Gradually improved and got extubated after 5 days of mechanical ventilation. Child was discharged after 10 days of total duration of hospitalization. On follow up, Child is asymptomatic and Neurologically normal.

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A Case of Wilson’s Disease:

A 9 years old male child was referred to us with history of, on and off abdominal pain since 1 year and jaundice since 1 week. On examination child was icteric and firm hepatosplenomegaly was found. Child was investigated and diagnosed to have Wilson’s Disease with severe liver dysfunction with ascites and Right sided Pleural effusion. Child was hemodynamically stabilized and copper chelation therapy with Zinc Acetate and d-Penicllamine was started at Amrutaa Hospital. Due to rapidly increasing S. Bilirubin level child was advised liver transplant. NGOs were contacted and liver transplant was arranged in co-ordination with Transplant surgeon of Kokilaben Dhirubhai Ambani Hospital, Mumbai. Child underwent liver transplant successfully. Post transplant, child and his father (donor) are doing well.

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A case of MAS with severe PPHN with EOS :

A Full term baby boy  delivered  on 01/06/’14 @ civil Hospital, rajkot And got admitted to Amrutaa Pediacare due to Respiratory Distress on the 6th Hour of labour, hence emergency Intubation done and pt. was kept on conventional ventilation. on the 2nd DOL pt. developed Convulsion.!! it enables the team to suspect Sepsis hence screening done which was positive with S/O – EOS.

2D Echo was done which showed severe PPHN. On the 5th DOL Pt. was kept on HFOV.! Accordingly treatment was done with Antibiotic and ionotropic support. On the 10th DOL  pt shifted back to conventional ventilation with aseptic precautions and winning was done on 18th DOL.

Neurological Screening done which was normal and successfully discharged on 27th DOL on BF.

once again Team Amrutaa proved it self & wins against the Sepsis.! 🙂