Search

To measure the size of the anterior fontanelle (AF) in healthy late-preterm and term newborns and correlate it with birth weight, gestational age, gender, occipito-frontal circumference, small for gestational age status and birth weight z-score. This was an observational study carried out from October 2013 through April 2015 at a tertiary care hospital. Newborns ≥ 34 wk gestation were enrolled. Fontanelle edge was palpated with index finger and size calculated by adding anterior-posterior and transverse diameters and dividing by two. A total of 1010 neonates were enrolled. The mean AF size was 2.23 ± 0.52 cm (mean ± SD). There was a significant decrease in the size of the AF with advancing gestational maturity on one-way ANOVA (F = 31.30) (P

The study was conducted on Full term neonates with birth weight > 2.5 kg born in KIMS, Hubballi with an objective to determine the first day Total Serum Bilirubin (TSB) value so as to predict subsequent development of significant hyperbilirubinemia in term neonates. All enrolled neonates were sampled for TSB and blood group on Day 1 at 20 ± 4 h and then followed up clinically by Kramer’s rule and when the clinical jaundice by Kramer’s rule was >10 mg/dl, TSB levels were repeated. A total of 180 newborns were enrolled for the study and 165 babies completed the study. Out of these, 17(10.3%) babies had significant hyperbilirubinemia by day 5 of life. Using Receiver Operating Characteristic (ROC) Curve, a cut off TSB value of 6.15 mg/dl was determined with sensitivity of 82.4%, specificity of 81.8%, positive predictive value of 32.8%, negative predictive value 97.6%. In term neonates, the first day total bilirubin level at 20 ± 4 h of life

To assess if linear growth in infant is optimal, with exclusive breast feeding for 6 mo as advised by the WHO. This prospective follow up study included 71 full term babies of middle socio economic group healthy mothers. The mothers were instructed to breast feed the babies who were followed up to 18 mo of age for assessment of linear growth. The study was conducted in Metro General Hospital, Noida, U.P. Fifty six babies weighed ≥2.5 kg, and 15 babies weighed

To determine the level and distribution of Cystatin C values in full-term and preterm healthy neonates for the purpose of diagnosis and follow-up of renal diseases of the neonates.Eighty-eight newborn infants, including 55 preterm and 33 term born in the authors' hospital having no urinary tract pathology, symptoms or signs during prenatal and postnatal follow-up, were studied .There were 25 neonates born between gestational wk of 28 and 32 (Group 1), 30 neonates born between gestational wk of 33-36 (Group 2) and 33 neonates born after gestational wk of 37 (Group 3). Average cystatin C values were determined to be 1.41 mg/l, 1.22 mg/l and 1.21 mg/l for Group 1, Group 2 and Group 3, respectively.Evaluation of cystatin C can be effective for follow-up of renal pathologies, because it is not affected by gender, body weight and muscle mass and has a constant production rate.

This paper was designed to investigate whether phototherapy is an oxidative stress in newborn infants undergoing phototherapy. A day-light continuous phototherapy was given to jaundiced 20 term and 16 preterm newborns for 72 hours. We measured serum vitamin E and the activities of red blood cell anti-oxidation enzymes (superoxide dismutase, catalase and glutathione peroxidase) before and after 72 h of phototherapy. Serum vitamin E levels were not different before and after 72 h of phototherapy in both preterm and term infants. In several studies, antioxidant enzyme activities have been shown to increase in response to oxidative stresses. In this study, however, the antioxidant enzyme activities in the hemolysate were similar before and at the end of the phototherapy in both preterm and full term. In conclusion, the results of our in vivo study do not confirm the thesis that phototherapy is an oxidative stress in newborn infants. Therefore, phototherapy would preferably seem to be safe and efficient method of treatment for all neonates presenting with hyperbilirubinemia.

In the present study vitamin D deficiency rickets has been diagnosed within 24 hrs. of birth. Seventy five full term, otherwise healthy newborns, weighing more than 2.5 kg were born with rachitic rosary. 25-Hydroxyvitamin D was lower than normal in 56 newborns and 15 mothers. Alkaline phosphatase was higher than normal in 26 and radiological changes suggestive of rickets were seen in the wrist X ray of only 14 newborns. Hyperphosphataemia was present in all the newborns. 1,25 dihydroxyvitamin D was markedly increased in six out of ten newborns.

To the Editor: A 2-mo-old girl, born of third degree consanguineous marriage was evaluated for increasing pallor, failure to thrive and loose motions since one and half months of age. The child was born full term with birth weight of 2.7 kg. Her elder sibling had died of similar illness at the age of 8 mo. Hemogram showed pancytopenia with hemoglobin of 3.6 g/dl, WBC of 2600/mm and platelet count of 9000/mm. Renal function and liver function tests were normal. Other laboratory data were as follows: LDH 1056 U/L (normal range: 313–618), serum folic acid 15.84 ng/ml (normal range: 4.6–18.7), serum vitamin B12 200.5 pg/ml (normal range: 191–663). Bone marrow aspiration revealed erythroid and megakaryocytic hypoplasia, left shifted myelopoiesis with megaloblastic changes suggestive of bone marrow failure with megaloblastic features. The patient was treated with parenteral cyanocobalamin 1 mg daily for five doses followed by four weekly doses. The patient showed dramatic clinical improvement within a week and resolution of pancytopenia by 4th wk. In view of clinical presentation and family history, hereditary transcobalamin II deficiency was suspected. The diagnosis was confirmed by holotranscobalamin level (0 pmol/L; normal range: 19.1–119.3) in the patient’s serum and mutation analysis of the patient and her parents. Sequencing analysis of TCN2 gene identified a homozygous single base pair insertion, c.703_704insA, in exon five in patient’s sample. This insertion causes frame shift and introduces a premature stop codon (T235Nfs*69) (Fig. 1). Both the parents were carriers for the same insertion. The patient was treated with intramuscular cyanocobalamin 1 mg twice a week during infancy and then weekly therapy has been advised to continue lifelong. The child is currently 4-y-old with normal neurological development and hematological paramenters. Fewer than 50 cases and a total of 29 mutations have been reported in the literature [1]. This case report highlights that transcobalamin II deficiency should be * Sandip Bartakke spbartakke@gmail.com

Blood samples from 813 newborns were spotted on to filter paper and the 17-hydroxyprogesterone concentration was measured using the Delfia (R) fluorometric immunoassay. The median, mean, and standard deviation (SD) for the total population were 20, 21 and (11) nmol/L respectively. Males had significantly higher levels than females with median, mean and (SD) of 22, 22 and (12) nmol/L. Similarly, low birth weight babies were found to have significantly higher levels than normal birth weight babies with median, mean and (SD) of 21, 24 (12) nmol/L. Preterm babies were also found to have significantly higher levels than full term babies, with median, mean and (SD) of 25, 29 (16) nmol/L. As experienced elsewhere, those factors should be taken into consideration when considering a cut-off point in any neonatal screening program for congenital adrenal hyperplasia.

Serum zinc level in cord blood of 159 neonates was estimated by atomic absorption spectrophotometer. The cases were classified according to birth weight and gestation of babies as Term appropriate for date (TAFD), Term small for date (TSFD), Term large for date (TLFD), Preterm appropriate for date (PAFD), Preterm small for date (PSFD) and Preterm large for date (PLFD). The zinc level were also estimated in mothers of these groups at the time of delivery, and compared with cord blood levels of those in non-pregnant mothers. Mean serum zinc level in infant born full term AFD, full term SFD, full term LFD, preterm AFD, preterm SFD and preterm LFD were 79.6 +/- 17.8 micrograms/dl, 58.2 +/- 13.4 micrograms/dl, 84.1 +/- 21.1 micrograms/dl, 81 +/- 25.2 micrograms/dl, 51.2 +/- 51.7 micrograms/dl and 76 +/- 14.7 micrograms/dl respectively. The maternal zinc levels in respective groups were 67 +/- 9.6 micrograms/dl, 56.5 +/- 7.5 micrograms/dl, 63.6 +/- 14.4 micrograms/dl, 62.7 +/- 21.1 micrograms/dl, 54.5 +/- 5.4 micrograms/dl, and 58.2 +/- 2.7 micrograms/dl. The mean serum zinc values in mothers and babies in birth weight group ranging from 1500-2000 gm were 55.3 +/- 4.3 micrograms/dl and 60 +/- 23.1 micrograms/dl, 2001-2500 gm were 59.5 +/- 11.3 and 65.8 +/- 17 micrograms/dl, 2501-3000 gm were 69.2 +/- 9.5 and 84.7 +/- 14 micrograms/dl, 3001-3500 gm were 65.8 +/- 12.7 micrograms/dl, 82.2 +/- 20.8 micrograms/dl and 3501 and above were 70.5 +/- 8.2 micrograms/dl and 85 +/- 14.3 micrograms/dl respectively. Statistically significant low zinc levels were observed in SFD babies and their mothers.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemostatic profile was studied in 25 full term, non-asphyxiated neonates with blood culture-proven septicemia. Nine (36%) of these neonates manifested bleeding. Detailed coagulation tests and platelet studies were deranged in 24 (96%) of neonates with septicemia. Abnormalities in coagulation tests did not differ in those with and without bleeding. Only platelet aggregation with ADP was deranged to a significantly greater extent in those with bleeding as compared with those without bleeding.

Hemostatic profile was studied in 25 full term non-asphyxiated neonates with blood culture-proven septicemia. Observations were compared with that of 25 healthy, non-asphyxiated, full term, birth weight and age-matched controls. Detailed coagulation tests & platelet studies were done in each of the 50 neonates by standard techniques. Hemostatic defects occurred in 96% of the septicemic neonates and none in the control group irrespective of the occurrence of clinical bleeding. The coagulation tests were deranged in 805 and platelet function tests in 92% of patients. These tests were significantly deranged in septicemic neonates as compared to control group.

Selenium is a part of the enzyme glutathione peroxidase and has an important role in the prevention of oxygen free radical injury. Hence good selenium nutrition is of special relevance to the neonate. The present study evaluated plasma selenium levels in cord plasma of 82 full term, appropriate for gestational age babies and their mothers at delivery. The plasma selenium levels in babies were 54.17 +/- 1.34 ppb which was significantly lower than 70.63 +/- 1.62 ppb seen in their mothers. Anemic mothers with a Hb8 g/dl had a plasma selenium level (60.74 +/- 4.57 ppb) which was lower than those with a Hb8 g/dl i.e. 74.19 +/- 2.17 ppb. Maternal age, parity, literacy and socio-economic status did not affect the plasma selenium levels.

Fortyfive cases of blood culture positive neonatal septicemia treated during 1985 and 1986 were studied. Klebsiella was the most common causative organism (68.8%). This remained the predominant organism in early as well as late onset septicemia, in preterm as well as full term babies and in low birth weight as well as normal weight babies. Even in neonates referred to our hospital from outside and blood cultured on hospital admission, commonest causative bacteria was Klebsiella. The organism had a high order of in-vitro sensitivity to a gentamicin, streptomycin and cephaloridine. A combination of cephaloridine and gentamicin covered all the Klebsiella isolates. Overall mortality was 53.3%.

Fifty small for date and fifty full term appropriate for date (control) babies were studied longitudinally for a period of six months, to determine the physical growth and morbidity pattern.

The detailed anthropometric parameters including double-skinfold thickness of 100 full term appropriate-for-gestational age infants are presented. The data can be used to identify and classify an individual infant with intrauterine growth retardation.

The development of the hypothalamic-pituitary-thyroid system in the fetus occurs through three phases: thyroid pituitary embryogenesis, maturation of hypothalamus, maturation of thyroid system, neuroendocrine control and T4 tissue deiodination. Defects in early phases I and II lead to permanent disorders whereas abnormalities in phase III result in transient functional immaturities especially in preterms. Cord serum TSH, T4 and T3 were estimated in 450 newborns (390 full term>36 wk gestation and 60 preterms 3 kg and

A longitudinal study of the growth and developmental parameters of 121 low birth weight babies along with 50 full term babies as control was carried out. 24.16 percent of low birth weight babies died during the neonatal period. Fifty five low birth weight babies who attended the well body clinic regularly and all the controls were followed up for a period of one year. Their growth and development parameters have been discussed.

A clinical analysis of ten cases of neonatal tetanus treated at the Command Hospital, Central Command, Lucknow (U.P.), during a period of three years is presented. All the cases except one were delivered at home. All the neonates were full term and weighed over 2,500 G. at the time of admission. The onset of symptoms varied from the fourth to thirteenth day of birth. The diagnosis was based on clinical data. Umbilical sepsis was found in eight cases; the cord swab grew pyogenic organisms butCl. tetani were not grown. The management of all the cases was uniform throughout the period of study. Antitetanus serum (ATS) was given in one single dose on admission. Appropriate doses of sedatives and muscle relaxants were used in all the cases. Their use was judicious and adjusted as required. The survival rate of the series is 70%.

Serum iron, iron binding capacity, haemoglobin red cell count, P.C.V., M.C.V., M.C.H. and M.C.H.C. were studied in 30 anaemic and 15 nonanaemic full term mothers and their newborns. Serum iron, I.B.C. and the haematological status of the newborns were not affected by maternal anaemia. The birth weight of the newborn is not related to maternal anaemia and an increase in the birth order did not affect serum iron levels in the newborns.

The growth curve during the first month of a “normal” child born to middle class rice eating parents from Bengal or South India living in the city of Calcutta is presented. The study is based on a day to day observation of forty six babies. Each of the babies was born normally from a clinically full term uterus without any instrumental help.

A study of birth weight was conducted on 1729 singleton births recorded during the year 1970 in two local hospitals of Patiala city. The sample comprised of 915 and 814 male and female infants respectively. Male infants were found to be heavier than the female infants respectively. Male orders of birth. Summer and winter months gave higher birth weights in the two sexes; it may not, however, be directly related to thermal conditions. The birth weight showed a steady increase in both the sexes up to the 6th order of birth after which there was a general decline. Statistical analysis for differences due to sex and order of birth have been given in the text. Norms for birth weight have also been provided.

Cord blood IgG levels were estimated in fifty normal full term, preterm and small for date babies. The values were significantly lower (p

Peripheral gangrene in infancy and childhood is rare, The condition was first described by Martini in 1828. More than 65 cases have been reported so fat. Peripheral gangrene in the newborn baby is usually due to arterial thrombosis which occurs suddenly during the first few weeks. Thrombosis is believed to result from external pressure sustained during the course of difficult labour or from infection or both. Gross (1945) emphasized the etiological theory of distal arterial occlusion By emboti which may arise from the placenta, ductus arteriosus or umbilical arteries. According to Heller and Alveri (t941) systemic infection, t rauma, dehydrat ion and anoxia have been implicated as causative factors for thrombosis. Report of Cases Case 1. A fifteen-day-old female baby was admit ted to the pediatric ward on 21-8-71. The pregnancy and labour of the mother had been uneventful. She had frequency of stools, failure to nurse, and cyanosis on the day of admission. Examinat ion on admission showed a full term, well developed, nourished, ill looking, cyanosed and dehydrated infant. The breath and heart sounds were normal . All peripheral pulses were not palpable. There was a blackish *From 1he Dept. of Pediatrics, Government Medical College, Surat. Received on November 21, 1972. purple discoloration of all toes of the left foot with pitting oedema, The other limbs were cyanosed. On investigatiot~, the total leucocyte count was 15,2(30/cu. ram. with polymorphs 72%. The haemoglobin was 10 G. %. Blood culture was negative. A diagnosis of septicaemia, dehydration, shock and peripheral gangrene was made. The child was treated with fluids, oxygen, penicillin, chloramphe~ficol and steroids, No local t reatment was given for the gangrene. The baby died on the second day.