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Background: Prematurity is the major determinant of morbidity and mortality in newborns. Infants born preterm are at increased risk for impaired growth. The postnatal growth pattern is dependent on biological factors like birth weight, gestational age, sex and intrauterine growth. The present study was undertaken to study the risk factors associated with the preterm delivery and to study the weight gain pattern among the preterm neonates after NICU discharge for a period of one month. Aims and objectives to study the risk factors associated with preterm and to analyze the weight gain pattern of the preterm till one-month post NICU discharge.Methods: A total of 40 preterm were included during the study period of 2 months, the various maternal risk factors were studied and correlated with preterm delivery. The neonatal complications were studied. The neonates were divided on the basis of their gestational age and birth weight. They were then followed for a period of 1-month post NICU discharge.Results: There was significant correlation of lower gestational age with neonatal complications and prolonged duration of hospitalization. The weight gain pattern was highly variable with a maximum gain of 188 gm after first week of NICU discharge. Weight gain was significantly more in first week after discharge amongst neonates who had birth weight less than 1.5 kg and also the total weight gain was significantly more in neonates who weighed less than 1.5 kg at birth.Conclusions: Lower gestational age group 28-32 weeks was significantly associated with neonatal complications and prolonged duration of hospitalization. Immediate follow up of the preterm is necessary as there is wide variability in the weight gain pattern in various gestational age groups.
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Hyper IgM syndrome are group to disorders characterized by elevated serum level of IgM and low or absent serum levels of IgG, IgA and IgE the mechanism of HIGM is immunoglobulin Class-Switch Recombination (CSR) failure and Somatic Hyper Mutation (SHM). This diagnosis should be considered in any patient presenting with hypogammaglobulinemia, with low or absent IgG and IgA and normal or elevated IgM level. In the present case report, this was a 6-year-old male child who had history of recurrent respiratory tract infections who presented with otitis media and persistent fever spikes. Immunoglobulin studies revealed a pattern consistent with hyper IgM.
RESUMEN
Background: Syncope is the abrupt cessation of cerebral blood flow leading to temporary loss of consciousness. Identification of etiology is utmost important as any syncopal event may be life threatening. Aim was to correlate the clinical and etiological causes of syncope in children and to note their investigational profile.Methods: Among 40 patients presenting with syncope and presyncope were studied. History of the event, precipitating factors were noted. They were investigated with the help of blood pressure, Electrocardiogram (ECG), 2D Echocardiogram and Electroencephalogram (EEG).Results: Out of the 40 patients of syncope 65% were above the age of 10 years with male preponderance (60%). Vasovagal syncope (57%) was the most common cause of syncope followed by orthostatic hypotension (15%), neurological (15%), and cardiac etiology (6%). In the neurological etiology the EEG showed diffuse slow background with occasional sharp bursts in right frontal area in 2 patients while in 4 patients sharp bursts were present in the centero-temporal region. 17% were classified as presyncope, 60% as mild and 22% as having severe syncope. There was a significant correlation of etiology of syncope with duration of hospitalization of more than 4 days and with recurrence of syncope. There was significant correlation of Evaluation of Guidelines in Syncope (EGSYS) score >3 with cardiogenic syncope. On follow up, neurological syncope patients had significant decrease in the number of syncopal episodes as they were immediately started on antiepileptics.Conclusions: Electrocardiogram, 2D Echocardiogram and Electroencephalogram are important tools for the early management and treatment of cardiac and neurological etiology of syncope.