Maternal hemoglobin concentration in relation to neonatal birth weight

Background: The birth weight of an infant is the most important determinant of its chance of survival health growth and development. The prevalence of low birth weight (LBW) is higher in Asia than elsewhere. Low birth weight is a major determinant of mortality, morbidity and disability in infancy and childhood and has a long term impact on health outcomes in adult life. Objective: The purpose of this study was to assess the relationship between maternal hemoglobin concentration with neonatal birth weight. Material and methods: The maternal Hb concentration and birth weight parameters were obtain randomly in 100 women delivered from the Department of Obstetrics and Gynecology, Central Referral Hospital, Tadong 5th mile Sikkim. Out of 100 cases, 35 cases were maternal Hb (<10 gm%), 35 were maternal Hb (10-13 gm%) and 30 were maternal Hb (>13 gm%) and all the maternal age ranging from 20-45 years. All data analysis was done using SPSS V 16 statistical software. The data were presented mean ± SD, and statistical analysis was carried out using student-T test. Results: Analysis of the data shows that anemia (Hb< 10 g/dl) was associated with a significantly increase risk of low birth weight (< 2500 g) and even same for high maternal hemoglobin (> 13 g/dl). The minimum incidence of low birth weight occurs in association with maternal hemoglobin concentration of 10-13 g/dl. Conclusion: Maternal Hb concentration of 10-13gm% should be regarded as optimal for fetal growth and well-being associated with the lowest risk of low birth weight.

ENT Manifestations in Pregnancy.

A hospital based cross-sectional study to evaluate the ENT manifestations in pregnancy included 100 pregnant women attending departments of Obst & Gynae and ENT, SMGS Hospital, GMC Jammu for ENT manifestations. In the present study, majority of pregnant women were primigravidas in age group of 21-30 years and mostly reported in third trimester. Out of 49 cases diagnosed with otological conditions, tinnitus was found in 10 cases (20.4%), ET dysfunction in 10 cases (20.4%) and least common was otosclerosis in only one case (2%). Out of 52 cases diagnosed with rhinological conditions, most common condition was epistaxis in 22 cases (42.36%), rhinitis in 15 cases (28.8%) and only one case (1.9%) of nasal pyogenic granuloma. Out of 30 cases diagnosed with laryngopharyngeal and esophageal condition, GERD was most common i.e. in 29 cases (96.6%) and dysphonia in only one case (3.33%). Out of 100, 11 cases were related to neck, out of which hypothyroidism was most common i.e in 7 cases (63.6%). Out of 100, 17 pregnant women were reported with oral cavity conditions with 8 cases (47%) of dysguesia, 2 cases (11.7%) of ulcerative stomatitis, 1 case each of gingivitis, pyogenic granuloma palate, pyogenic granuloma of gingiva, submandibular abscess and Parotid abscess. The changed hormonal milieu during pregnancy causes otological conditions leading to hearing impairment, epistaxis, rhinitis , GERD etc. Hypothyroidism is common as our area falls in the area of goiter belt.

Atypical presentations of falciparum malaria.

To identify the uncommon presentations of falciparum malaria in an endemic area and to assess the outcome of treatment, a study was carried out on 35 proved cases whose clinical presentations were either dominated by features other than fever or the history of fever was totally absent. Both urban and rural patients were included. Seventeen cases (48.3%) presented with features of cerebral malaria. Acute abdomen, urticaria, and unexplained shock were the other atypical presentations. Five cases (14.3%) of cerebral malaria died. We conclude that awareness of atypical presentations is important to detect cases of falciparum malaria in an endemic area. Intravenous quinine may need to be given promptly even when cerebral malaria is diagnosed empirically.