RESUMEN
Maternal diabetes, type1, type 2 or gestational diabetes has an increased risk of congenital malformation in fetus. It is also the most common cause of perinatal mortality in these infants. Although various malformation reported in literature, our case of congenital absence of ribs and adjacent intercostal muscles in an infant of diabetic mother is not reported earlier. Poor glycemic control may be the cause of teratogenesis. Asymptomatic single rib absence is managed conservatively but for absence of multiple ribs, surgical repair is required.
RESUMEN
A Sick Newborn Care Unit (SNCU), established in a district hospital in India, substantially reduced the neonatal mortality rate in the district; it, however, suffered from a dearth of trained nurses. Local girls with 10-12 years of school education underwent structured and hands-on training for six months, followed by a six-month internship at the SNCU and were assigned to it as stipendiary 'Newborn Aides'. Based on the results of formal examinations, internal on-the-job assessment and interview of doctors, nurses, and parents and their technical skills and motivation were rated very high. Although the incremental cost of training is small, the cost of sustaining them, i.e. stipend and replacing attrition, needs to be addressed. Trained Newborn Aides may substantially alleviate human-resource constraint for SNCUs and Sick Newborn Stabilization units in smaller peripheral hospitals for care of sick newborns at an affordable cost.