ABSTRACT
Background: Maternal and fetal vitamin D deficiency has nowadays emerged as a frequent morbidity. Adequate vitamin D concentrations during pregnancy are necessary to maintain neonatal calcium homeostasis, bone maturation and mineralization. Objectives of this study were to evaluate serum vitamin D concentration in mothers and its correlation with neonatal cord blood vitamin D at the time of delivery and to study the impact of hypovitaminosis on neonatal anthropometry. Effect of related factors like calcium (Ca), alkaline phosphatase (ALP) and parathyroid hormone (PTH) on maternal vitamin D levels were to be evaluated.Methods: Cross sectional study was done on a total of 220 healthy uncomplicated antenatal females with singleton pregnancy attending labor room at the time of delivery. Maternal and neonatal cord blood samples were drawn in the delivery room and analyzed. Neonatal anthropometry was recorded. Correlations among various maternal and neonatal factors were studied.Results: Widespread vitamin D deficiency was observed in expectant subjects and neonates with 70.91% having deficient levels which were also reflected in newborns (71.82%). Maternal ALP (r= -0.5503, p=0.000) bears a weak negative correlation (p<0.05), maternal serum Ca positive correlation (r = 0.7486, p=0.000) and plasma PTH levels a negative correlation (r = -2.084, p=0.000) with hypovitaminosis. No significant correlation was observed between neonatal anthropometry and vitamin D levels.Conclusions: High prevalence of hypovitaminosis was observed among pregnant women and their neonates in this study. A positive linear relationship was seen between maternal and cord blood vitamin D (r 0.974, p 0.0001).
ABSTRACT
Background: Hepatitis-A virus (HAV) and Hepatitis E virus (HEV) are two major hepatotropic viruses of great public health importance in the developing countries like India. Both HAV and HEV are enterically transmitted and there are speculations that their co-infection might be associated with a more severe clinical course and increased rate of mortality. The objective of this study is to determine the prevalence, clinical features and biochemical parameters of Hepatitis A and Hepatitis E co-infection in hospitalized patients at a tertiary care centre in Uttarakhand.Methods: It is a retrospective study, covering a period of 4years and conducted in Himalayan Institute of Medical Sciences, SRHU Jolly Grant, Dehradun. Records of the patients with Hepatitis A and Hepatitis E co-infection were retrieved and analyzed.Results: Out of total 125 patients of acute viral hepatitis, 13 patients had HAV and HEV co-infection. 100% of the patients with co-infection presented with complaints of fever and jaundice, followed by 76.92% with vomiting, 69.23% with pruritis, 61.53% with pain in abdomen and 23.07% with altered sensorium. Mean Bilirubin, ALT, AST were 8.69'7.27 mg/dl, 2030.69'1726.93IU/L and 1880.07'1881.11IU/L respectively. Average duration of stay was 8.2 days. Encephalopathy was seen in 2 patients. However, no mortality was reported.Conclusions: Co-infection of HAV and HEV is not rare in pediatric age group. Knowledge about this will be of immense help for planning of future vaccination strategies and for better sanitation program in developing countries like India.
ABSTRACT
Objective: To evaluate serum phenobarbitone levels in neonates with seizures and to evaluate the effect of repeated loading dose on serum phenobarbitone levels. Methods: In this prospective observational study conducted in a tertiary care centre of Northern India during 2011- 2012, 99 neonates admitted with seizureswere included.Serum phenobarbitone levels in neonates with seizures at 20 minutes and 12 hours after the first loading dose of phenobarbitone were measured. Results: Serum phenobarbitone levels [mean (SD)] at 20 min and 12 hours was 27.3 (28.4) µg/mL and 23 (19.1) µg/mL, respectively (P=0.07). The mean serum phenobarbitone levels 12 hours after the loading dose, and proportion of neonates with toxic levels increased with each loading dose of intravenous phenobarbitone. Conclusion: Monitoring of serum level of phonobarbitone may not be essential because seizure control in neonates appears to be independent of whether serum level is subtherapeutic, therapeutic or toxic range.