Muhammad Amin, Muhammad Saleem, Shamas-un Nisa, Malik Muhammad Naeem, Hafiz Muhammad Anwar-ul Haq.
Birth Asphyxia; Short-Term Outcome Of Neonates Treated With Allopurinol.
Professional Med J Jan ;24(6):796-800.

Introduction: Out of 130 million births, about four million infants die in the first four weeks of their life. Birth asphyxia is a major cause of neonatal deaths in developing countries. Birth asphyxia is estimated to account for approximately 25% of neonatal mortality worldwide. Allopurinol is a cheap and freely available medicine whereas other management options are not widely used. Objectives: To analyze the short-term outcome between allopurinol-treated and non-allopurinol-treated asphyxiated neonates. Study Design: A randomized controlled study. Setting: Pediatric unit 2, Bahawal Victoria Hospital, Bahawalpur. Duration of Study: This study was conducted from March 2015 to September 2015. Materials and Methods: A total of 62 (31 in allopurinol and 31 in non allopurinon treated group) infants having admitted within 6 hours after birth with gestational age > 36 weeks. All were suffering from stage-2 hypoxic ischemic encephalopathy, lethargy, hypotonia, flexion posture. All were having hyperactive tendon reflexes and poor moro reflex. All the admitted neonates were managed and followed up to to 7 days of admission to note the need of anti-convulsants, conscious level and length of admission in intensive care unit (< 7 days or > 7 days). Neonates who died during the stay were noted and compared between both the groups. Results: Out of 62 infants, there were 34 (54.8%) males and 28 (45.2%) females. Mean gestational age was 37.90 weeks while mean weight of newborn infants was 2.75 kg. Overall Mortality was noted in 6 (9.68%) infants. When both groups were compared, no statistically significant difference was found between the two groups in terms of sex, gestational age, birth weight or mortality (p value > 0.05). Conclusion: Short-term outcome in terms of mortality between allopurinol-treated and conventional treatment asphyxiated neonates was found to be 6.5 vs 12.9%.

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