Role of corticosteroids in reducing respiratory morbidity in neonates delivered by elective cesarean section before 39 weeks

Objective: to determine the effect of dexamethasone administration to women between 37 to 39 weeks of gestation on neonatal outcome in terms of respiratory morbidity and the need for NICU admission

Study Design: an experimental study

Place and Duration of Study: department of Obstetrics and Department of Neonatology, Military Hospital, Rawalpindi, Pakistan, from February to July 2017

Methodology: women with singleton pregnancies, undergoing elective cesarean section between 37-39 weeks. Neonates were evaluated for any respiratory morbidity and need for NICU admission as well as need of mechanical ventilation, length of hospital stay and final outcome

Results: out of 535 patients, 240 [44.8%] patients received steroid cover before their elective cesarean section [group 1]. Two hundred and ninety-five [55.2%] patients who did not receive steroid cover, were allocated group 2. Mean age of mother's in-group 1 was 29.20 +4.50 years and in-group 2, it was 29.34 +4.50 years. The mean gestational ages were 37.56 +0.66 weeks and 38.11 +0.79 weeks in groups 1 and 2, respectively. In-group 2, 14 [4.74%] newborns developed transient tachypnea of newborn [TTN], which was higher than the newborns in-group 1 [04 [1.66%], p = 0.049]. Also the number of neonates being admitted to NICU was greater in group 2 than in group 1 [23 [7.79%] vs. 06 [2.5%] respectively, p = 0.007].However, there was no statistically significant difference between the two groups with regard to final outcome, requirement for mechanical ventilation, length of hospital stay and APGAR scores at one and five minutes

Conclusion: steroid cover significantly reduced the risk of respiratory morbidity in babies delivered by elective cesarean section between 37-39 weeks

Neonatal Sepsis in a tertiary care hospital: Bacteriological profile and Its Antibicrobial sensitivity

Objective: To study the spectrum and antimicrobial sensitivity of bacterial pathogens causing neonatal sepsis, in neonatal intensive care unit [NICU] of Pak Emirates Military Hospital, Rawalpindi

Study Design: Prospective cross sectional study

Place and Duration of Study: This was a prospective cross sectional study, conducted at NICU of Military Hospital, Rawalpindi, from Jul 2017 to Dec 2017

Material and Methods: All neonates admitted to our department who underwent evaluation for sepsis, from Jul 2017 to Dec 2017

Results: Out of 2,480 admitted neonates, 733 were suspected with sepsis, making an incidence of suspected neonatal sepsis to be 29.5 percent. 421 [57.4 percent] babies were suspected with early onset sepsis [EOS] and 312 [42.6 percent] with late onset sepsis [LOS]. Majority of the babies [70.3 percent] were preterm. In 281 [11.3 percent] neonates, blood culture came out to be positive. 73/281 neonates with culture proven sepsis died making a mortality rate of 25.9 percent. Gram negative bacilli were most predominant among isolated bacteria. Most of the organisms showed resistance to the first line antibiotics

Conclusion: Sepsis has a high mortality rate in neonates admitted to our department. Gram negative organisms are the most common cause. Most of the isolated organisms are resistant to empirical antibiotics

Antioxidant, anticancer and antibacterial potential of zakhm-e-hayat rhizomes crude extract and fractions

Bergenia ciliata [locally known as Zakhm-e-hayat; wound healer] is commonly employed for wound healing, curing diarrhea and vomiting, fever, cough and pulmonary affections. Local community uses this plant as tea decoction with table salt. B. ciliata crude extract and its fractions were subjected to antibacterial, antioxidant effects as well as determination of total flavonoids and phenolics, DNA damage and anticancerous activities following standard protocols. Increased percentage inhibition of free radical in DPPH assay as well as elevated phenolic and flavonoid contents revealed antioxidant potential of this potent herb. Ethyl acetate and aqueous extracts showed IC50 of 0.7 and 0.3 mg/ml respectively, against H157 cell line. Antibacterial analysis showed MIC 0.4-10mg/ml for crude extract and fractions. The results obtained conclude that extracts of B. ciliata contain remedial latent and can be used as possible source for drug development by pharmaceutical industries