ABSTRACT
The route of the birth delivery influences new born's health. Children born via Cesarean section are at increased risk of developing asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies and leukemia. Part of these diseases is believed to be related to maturation of neonatal immune system. During vaginal delivery, the contact with the maternal vaginal and intestinal flora is an important source for the start of the infant's colonisation. During Caesarean delivery, this direct contact is absent, and non-maternally derived environmental bacteria plays an important role for infant's gastro-intestinal colonisation. The primary function of microbial colonisation during the foetal period, intrapartum and after the birth is crucial in maturation and development of new-bornimmune system. This review supports the choice of the route of birth delivery and consequently favours a decrease in unnecessary Cesarean sections. It is crucial to provide this information to pregnant women and/or couples and health workers to make informed and educated decisions
ABSTRACT
Thalassemia occurs due to defects in normal hemoglobin production. Globally it is most common inherited anaemia. Diabetes is a complication of b-thalassemia major. We report a case of Diabetes mellitus in a known case of beta thalassemia major. Patient had undergone splenectomy 1 year back. Patient is taking chelating agent Defasirox 1000mg orally once a day in the morning. Family history reveals, born through third degree consanguineous marriage. The patient was then subjected for laboratory examination reveals BSLwas 490, urine ketone 2+, urine sugar 3+, ABG was normal, HbA1c was 13 & 3 month old report of serum ferritin 1200 ng/dl. TFTand GH studies normal. Multidisciplinary management was instituted. Blood sugar level got controlled over subcutaneous insulin. Patient may have landed in Diabetic ketoacidosis but was promptly diagnosed & treated. This case is presented for its rarity. Due to increase in life expectancy of patient with thalassemia major, patient will expose more years of hyperglycemia and diabetes. Sustaining metabolic control and controlling cardiovascular risk factors helps to prevent future complications.
ABSTRACT
Asphyxia is an insult to the fetus or newborn due to lack 1 of oxygen or lack of perfusion to various organs.National Neonatology Forum of India has de?ned asphyxia as gasping or ineffective breathing or lack of 2breathing at 1 min of life.Birth asphyxia is one of the most important causes of neonatal brain injury whose incidence ranges from 3.7 to 9/1000 deliveries in the 3west.With the advent of therapeutic hypothermia (TH), improved outcomes are being reported in moderate HIE. TH, however, has not demonstrated improvement in outcomes related to severe HIE. . This has led clinicians and researchers to continue evaluating complementary and/or alternative therapies for infants with HIE. In this review, we will discuss current and emerging therapies in the management of HIE, other than hypothermia. With issues of access to health care and the burden of birth asphyxia shifting to developing and least developed nations, there is a need for alternative and supplementary neuroprotective agents. Low cost and easy availability along with ease of use would assist in ensuring that these therapies have global applicability. So global efforts must be taken to increase such studies as birth asphyxia is causing more morbidity & mortality globally