Brevundimonas vesicularis bacteremia in a neonate: a rare case report.

There are very few cases of Brevundimonas vesicularis reported worldwide. We present a case of bacteremia in a neonate who had aspirated meconium . A blood culture showed growth of a non hemolytic yellow colored colony at 37°C. It was identified as Brevundimonas vesicularis by Vitek 2 automated system (BioMeriuex). There are only a couple of reported cases of bacteremia caused by Brevundimonas vesicularis . To our best of knowledge this is the third case report of Brevundimonas vesicularis bacteremia from India.

Utilisation pattern of blood in a teaching hospital of Kolkata.

An annual utilisation of blood transfusion services at several depts. of R.G. Kar Medical College and Hospital, Kolkata were assessed among a sample of 3122 patients selected by Systematic Random Sampling Technique from the register made available in the blood bank there. Record analysis revealed that overall 79.4% of supplied blood units were actually transfused, wastage of 21.6%. Wastage was maximum in the Department of Gynae & Obstetrics (33.11%) and Surgery (32.87%). Only single unit of blood was requisitioned and transfused for 5.44% & 30.90% of the patients respectively. Most common indications of blood transfusion were for surgical cases (37.92%), followed by anaemia (34.80%) and haemorrhage (26.92%). The use of blood and blood products merit attention, appraisal and instructional guiding accordingly.

Status of maternal and new born care at first referral units in the state of West Bengal.

A study was conducted in 12 First Referral Units (FRUs), selected through multistage sampling, from 6 districts of West Bengal. Infrastructure facilities, record keeping, referral system and MCH indicators related to newborn care were documented. Data was collected by review of records, interview and observation using a pre-designed proforma. Inadequate infrastructure facilities (e.g. no sanctioned posts of specialists, no blood bank at rural hospitals declared as First Referral Units etc.); poor utilization of equipment like neonatal resuscitation sets, radiant warmer etc, lack of training of the service providers were evident. Records/registers were available but incomplete. Referral system was found to be almost nonexistent. Most of the deliveries (86.1%) were normal delivery. Deliveries (87.71%) and immediate neonatal resuscitation (94.9%) were done mostly by nursing personnel. Institution based maternal, perinatal and early neonatal mortality rates were found to be 5.6, 62.4 and 25.2 per 1000 live births respectively. Eclampsia (48.9%), hemorrhage (17.7%), puerperal sepsis (7.1%) were reported to be major causes of maternal mortality. Common causes of early neonatal mortality were birth asphyxia (54.3%), sepsis (14.6%) and prematurity/LBW (12.4%).

A patient with optic pathway glioma, scoliosis, Chiari type I malformation and syringomyelia: is it Neurofibromatosis type 1?

A 22 years old girl had features of optic pathway glioma, scoliosis, Chiari type 1 malformation and cervical syringomyelia. She had no cutaneous lesions. We considered this combination to be more than coincidental and argue in favour of considering the case as a variant form of Neurofibromatosis type 1. The relevent literature in favour of our contention has been reviewed.

Missed opportunities for immunisation in children.

All opportunities for immunisation in children should be utilised properly, as sustaining high levels of full immunisation coverage is essential to meet the goal of eradication of poliomyelitis as well as control the other vaccine-preventable diseases; yet many opportunities for immunisation are missed in all types of health facilities, even in teaching hospitals. Reducing such missed opportunities is the cheapest way to increase immunisation coverage. The present study discusses the problem of missed opportunities for immunisation in children in Paediatric Outpatient Department and Immunisation Clinic of R.G. Kar Medical and Hospital, Calcutta and the underlying factors of the problem. Prevalence of missed opportunities in Paediatric OPD and Immunisation clinic was 37.8% and 1.4% respectively. Most of the missed opportunities were attributed to health care providers and delivery system of health care of the studied hospital.