Neonatal Sepsis is Still a Major Problem in Tertiary Care Hospitals.

In a developing country like India, one of the most important health hazards is neonatal sepsis. The ever full SNCUs of the hospitals are living proof of this. The neonates both early and late are extremely vulnerable to all organisms, both in the community and much more so in the hospital. Neonatal sepsis contributes to infant mortality rate in a very significant way. Nosocomial neonatal sepsis is much more dangerous and contributes to morbidity and mortality in a very big way.METHODSIn this study, neonatal sepsis was assessed by culture of blood, pus from infected umbilical stump, and CSF sample received from SNCU. The isolated organisms were identified phenotypically following our laboratory protocol. Antibiotic sensitivity testing was done by Kirby-Bauer method, following CLSI guidelines.RESULTSIt was found that 48% of the total samples received from SNCU were growth positive. Klebsiella pneumoniae was isolated in maximum number of cases, 42.85% followed by Staphylococcus aureus 18.53%. Antibiotic sensitivity test by Kirby- Bauer method showed that all Gram-positive cocci were sensitive to vancomycin. There was only one linezolid resistant Staphylococcus aureus. Among the Gram-negative bacilli 100% isolates were sensitive to carbapenems. Acinetobacter baumannii and Pseudomonas aeruginosa isolates were multidrug resistant.CONCLUSIONSSNCU admitted babies are extremely vulnerable to septicaemia. The ever-changing drug resistant patterns of the infecting organisms is a perineal problem. Thus, infection control measures are to be strictly enforced in this setting.

Relationships of Nerve Conduction Parameters with the Thyroid Hormones in Hypothyroid Patients.

Background: Impairment of nerve conduction may occur in hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. Objectives: To evaluate the thyroid hormone status and the clinical and electrophysiological changes in hypothyroid patients in order to observe their relationships with nerve conduction changes. Methods: Thirty healthy euthyroid subjects with the age range from 20 to 50 years of both sexes were as control and 15 hypothyroids with TSH with <60 MIU /L and the duration of 6 months to 5 years were as experimental. Serum TT3, TT4 were measured by RIA and IRMA method. The distal latency (D L) and Nerve Conduction Velocities (NCV) for sensory and motor function were measured by a standard electrophysiological technique in median and ulnar nerve for upper limb and for lower limb, in sural nerve for sensory function and common peroneal nerve for motor function. Data were analyzed statistically by unpaired ’t’ test, Z test, Pearson’s correlation coefficient test. Results: Both TT3, TT4 levels were significantly (P<0.001) lower in hypothyroids. Again, 60% hypothyroids and 10% euthyroids (P<.001) had abnormal NCV. The relationships of TSH with both the median and ulnar sensory and motor distal latencies, common peroneal motor and sural sensory distal latencies and ulnar sensory conduction velocity were positive. But these relationships were negative with the median and common peroneal motor nerve conduction velocities, sural sensory conduction velocities. Only the relationships between median sensory distal latency and TSH was statistically significant (P <0.05). Again, a positive correlation of TT3 and TT4 with the median, and sural sensory and common peroneal motor conduction velocities, but negative correlation with median motor and sural sensory latencies were found. In addition, positive correlation between TT3 and ulnar sensory and between TT4 and Ulnar motor conduction velocities were observed. Again the relationships median and ulnar sensory latencies were negative with TT4 only. The value of coefficient between TT4 and sural distal latency and conduction velocities were statistically significant (P<0.05). Conclusion: Results of this study showed that the impairment of nerve conduction occurs in hypothyroidism.

Combination of two rare mutations causes β -thalassaemia in a Bangladeshi patient

Screening of mutations that cause β-thalassaemia in the Bangladeshi population led to the identification of a patient with a combination of two rare mutations, Hb Monroe and HBB: -92C>G.The β-thalassaemia major male individual was transfusion-dependent and had an atypical β-globin gene cluster haplotype. Of the two mutations, Hb Monroe has been characterized in detail. Clinical effects of the other mutation, HBB: -92C>G,are unknown so far. Bioinformatics analyses were carried out to predict the possible effect of this mutation. These analyses revealed the presence of a putative binding site for Egr1, a transcription factor, within the HBB:-92 region. Our literature survey suggests a close relationship between different phenotypic manifestations of β-thalassaemia and Egr1 expression.