Study of brainstem auditory evoked response in asphyxiated neonates

The present study was undertaken to evaluate the effect of neonatal asphyxia on brainstem auditory evoked response [B A E R] and the possible reversibility of abnormal BAER on follow up after 3 months of age. Prospective case control study was done in the neonatal special care unit and neurology department, at EL-Minia university hospital. Twenty five term neonates with 5-minute Apgar score< 6, who had hypoxic ischemic encephalopathy [HIE] or asphyxia underwent BAER testing with follow up at 3 months. Twenty age and sex-matched normal neonates served as control. Denever development screening test [Denever II] was performed at 3 months of age. Twelve out of twenty five [48 percent] neonates with birth asphyxia showed abnormalities on initial BAER. The commonest abnormalities seen were raised threshold of interside latency difference in 8/12 neonates [66.7 percent], followed by prolongation of latencies of various waves in 6/12 neonates [50 percent]. Other abnormalities observed were prolonged intervene interval [16.7 percent] and prolonged interside interval difference [8.3 percent]. There were a significant association of BAER abnormalities with duration of neurological findings more than 5 days and stages of HIE. On follow up of 12 cases at 3 months of age, abnormalities in BAER reverted back to normal in 11 cases [91.6 percent]. The Denever Developmental screening test [Denever II] was suspect in 3 cases only. It was concluded that BAER abnormalities in neonatal asphyxia are transient and revert back to normal in most cases on follow up at 3 months of age and BAER is simple non invasive tool but does not appear to be a useful one for early detection of neurological handicaps

Urinary tract infection in infants with unexplained fever

This study included 150 infants [2 months to 2 years of age] presenting with fever [38.30C]; they were 68 males and 82 females. They were subjected to history taking, physical examination and laboratory investigations including complete blood count, erythrocyte sedimentation rate [ESR] and urine analysis and culture. Urine samples were obtained either by suprapubic aspiration or urethral catheterization. Renal ultrasound was done for infants with positive urine culture. Overall prevalence of UTI in the group was 11.3% [95% confidence interval "CI": 9.7-13.4]. The rate was higher in female infants [13.4%, 95% CI: 10.1-15.6], in infants less than one year [13%, 95% CI: 10.3-15.1] and I ill-appearing infants [15.6%, 95% CI: 11.5-17.9]. Prevalence was higher in infants with higher total leucocytic count [15.00/mm3] [20%, 95% CI: 15.9-23.1] and in infants with pyuria, >5 pus cells / HPF [50%, 95% CI: 44.2-51.8], hematuria, >5 RBCs / HPF [13.6%, 95 CI: 10.0-15.8] and positive nitrite test in urine [80%, 95% CI: 74.0- 87.2]. Among 17 infants with positive urine culture, 15 had infections caused by E. coli and 2 by Klebsiella and abnormal findings were encountered in 3 infants using renal ultrasonography