Low birth weight babies; frequently encountered problems at secondary level care

To determine the spectrum of problems in LBW neonates at Secondary care level and their immediate outcome. Descriptive Study. Agha Khan Hospital for Women and Children, Kareemabad and Agha Khan Hospital for Women and Children, Kharadar, from January 2009 till December 2009. Of the 4500 babies born in Agha Khan secondary hospitals, 429 were Low Birth Weight and 191 were admitted to the nursery. The ratio of males to females was 0.86:1.0 [199 males and 230 females]. Approximately 41% of the babies were less than 2 kgs and Preterm babies made up 20.9% of total low birth weight. Of the 191 babies, 99 [51.8%] had hyper bilirubinemia; 16[8.3%] had respiratory distress syndrome of the newborn; 16[8.3%] had vomiting and they were observed for necrotizing enterocolitis; 21[10.9%] had presumed sepsis; 12 [6.2%] had hypocalcemia; 11[5.7%] had hypoglycemia 08 [4.1%] had Meconium Aspiration Syndrome; 05 [2.4%] had thrombocytopenia; and 02 [1.04%] had hyperviscosity with hematocrit of more than 65%. Common causes of morbidity in LBW babies are jaundice, sepsis, Respiratory distress, hypoglycemia and hypothermia. Introduction of standard management guidelines aid in reduction of morbidity. With careful selection of cases and predetermined criteria for transfer to the tertiary level nursery, it is possible to care for a vast majority of the newborns in nurseries at secondary level

Failure to thrive, can this be Bartter's syndrome?

A case series of four children, of different age groups, having complaints of polyuria and failure to thrive. These cases include two infants, a toddler and a child and investigations revealed that they had hyponatremia, hypokalemia, hyperchloremia and metabolic alkalosis, leading to a diagnosis of Bartters syndrome. Two of the patients also had hypomagnesemia. All the children were put on treatment for Bartter's Syndrome, and they responded well but unfortunately one of them was lost to follow-up