Non-sucrose sweetener for pain relief in sick newborns.

A prospective controlled blind study was carried out in the Special Care Unit for Newborns to assess the effect of commercially available sweetener on pain relief in newborns. Response to intramuscular injection and the pain stimulus was studied in twenty-five sick newborns, 13 preterm and 12 term, in a blinded fashion. Pain score, duration of cry, heart rate and oxygen saturations were studied. Basal response, responses with sterile water or sweetener were recorded in each baby. Responses to sweetener versus no solution and sweetener versus sterile water were compared by applying paired t-test. The reduction in pain score with sweetener was significant when compared with no solution. The difference was not significant when compared with sterile water. Similarly, duration of cry and heart rate with sweetener were significantly less when compared to sterile water or to no solution. However, the difference in oxygen saturation was not significantly different. Sweetener has an analgesic effect in sick babies. This can minimise adverse effects associated with painful procedures.

Management of gap non-union of tibia by tibialisation of ipsilateral vascular fibula.

Gap non-union of tibia following traumatic bone loss or infection dramatically emphasizes the limitation of conventional reconstructive techniques. With presence of significant skin loss or poorly vascularised recepient bed, complications and failure rate increase and solution often lies in amputation. Vascularised ipsilateral fibular grafting offers a viable alternative to this. This is a series of 16 cases of gap non-union of tibia treated by tibialisation of fibula at KEM Hospital, Bombay. All the cases were secondary to osteomyelitis following compound fracture of tibia-fibula or hematogenous osteomyelitis with a large sequestrum. 15 cases had good results with good hypertrophy of bone after union. One case had poor result with fracture going into delayed union with no hypertrophy. We discuss the technique, complications and results of this procedure.

Raised serum IgE levels in chronic inflammatory lung diseases.

OBJECTIVE: To study the serum IgE response in nonallergic subjects with chronic inflammatory lung diseases. SETTING: Christian Medical College Hospital, Vellore. SUBJECTS: Twenty six patients with bronchiectasis, five with pulmonary mycosis referred from all over India and 30 healthy subjects. MAIN OUTCOME MEASURES: Serum IgE value (determined by radioimmuno assay) above the upper limit of normal control range (136 to 948 iu/ml) was considered as raised level. RESULTS: Of the 26 patients with bronchiectasis 13 had pyogenic infections, six had pulmonary tuberculosis; in six patients sputum culture was sterile while another patient had herpes zoster. Five cases of mycosis included one each of actinomycosis, aspergillosis, blastomycosis, cryptococcosis and nocardiasis. The serum IgE levels were raised in 20 (65%) of the 31 patients. CONCLUSION: Associated bacterial, fungal and parasitic infections were probably responsible for inducing an hyper-IgE response in these non-allergic subjects.