Gestational Age Assessment with Anthropometric Parameters in Newborns.

OBJECTIVES: We sought to evaluate the relationship between gestational age (GA) and neonatal anthropometric parameters, namely head circumference (HC) and crown-heel length (CHL). METHODS: We conducted a cross-sectional study in a tertiary care hospital with 530 consecutively live-born newborns of 28-41 weeks gestation. Anthropometric parameters were measured after three days of life. We summarized the variables using descriptive statistics, including percentile values, and the strength of association was determined through correlation analysis. The correlation was strong for HC and CHL, and linear regression analysis was done to develop predictive equations. RESULTS: HC and CHL correlated well with GA with r-values of 0.863 and 0.859, respectively. The regression equations derived were GA (week) = 9.2671 + [0.8616 × HC (cm)] and GA (weeks) = 7.2489 + [0.621 × CHL (cm)]. Multiple regression gave the relationship as GA (weeks) = 4.0244 + [0.4058 × HC (cm)] + [0.4249 × CHL (cm)]. Application of this multiple regression equation to a test cohort of 30 babies for prediction of GA gave a mean margin of error of 2.9%, indicating that it is a satisfactory tool for prediction. CONCLUSIONS: HC and CHL can be used as simple tools for predicting GA in babies when this is in doubt. This can help in identification of high-risk newborns at primary care level without recourse to imaging modalities.

Early Onset Neonatal Septicaemia Caused by Pantoea agglomerans.

Pantoea agglomerans is an opportunistic pathogen causing infection in the immunocompromised patients. It is a plant pathogen and a rare human pathogen causing neonatal sepsis, joint infection, urinary tract infection and bloodstream infections. Neonatal Gram negative septicaemia may have an unusual presentation of subtle generalised neonatal seizures without any other cardinal features of sepsis. An appropriate diagnosis is therefore the key to proper management. P. agglomerans being an unusual cause of neonatal sepsis should be diagnosed early with proper antibiogram for clinical cure. Here, we report a case of neonatal sepsis caused by P. agglomerans in a tertiary care hospital in Eastern India.

Growth of children with juvenile idiopathic arthritis.

OBJECTIVE: To evaluate the growth pattern in children with juvenile idiopathic arthritis and its subtypes in comparison with age, sex and temporally matched controls. STUDY DESIGN: Prospective study. SETTING: Pediatric rheumatology clinic of a tertiary care hospital in Eastern part of India. PARTICIPANTS: Seventy-five children (2-12 years) diagnosed as juvenile idiopathic erthritis by International League of Associations for Rheumatology criteria and 75 age- and sex- matched controls. INTERVENTION: Weight, height and body mass index were recorded at six monthly interval in both groups over a period of 3 years. MAIN OUTCOME MEASURES: weight, height and body mass index. RESULTS: Subtype distribution of juvenile idiopathic arthritis was: oligoarthritis (49%, n=37), rheumatoid factor negative polyarthritis (27%, n=20), rheumatoid factor positive polyarthritis (8%, n=6), systemic onset (15%, n=11) and enthesitis related arthritis (1.3%, n=1). Anthropometric parameters in children with juvenile idiopathic arthritis were not significant different from controls. Comparison between the subtypes showed significant differences in height (P=0.011), weight (P=0.005), and growth velocity (P=0.005), but not in body mass index. Systemic onset disease led to significant restriction in height (P=0.018; 95% CI 2.13-33.77) and weight (P=0.008; 95% CI 1.47-14.43) compared to controls. Growth velocity was significantly affected in rheumatoid factor positive polyarthritis (P=0.003; 95% CIO. 46-3.14). CONCLUSIONS: Children with juvenile idiopathic arthritis do not have significantly lower values of anthropometric parameters compared to controls. Significant restriction in height and weight is seen in systemic onset disease, and growth velocity is significantly reduced in rheumatoid factor positive subjects.

Spirometric evaluation in juvenile idiopathic arthritis: data from eastern India.

OBJECTIVE: To evaluate lung function in juvenile idiopathic arthritis (JIA) patients. METHODS: This was a case control study carried out at Institute of Post-Graduate Medical Education & Research, Kolkata, involving JIA patients between 5 and 12 y. They were diagnosed and classified on the basis of International League of Associations for Rheumatology (ILAR) criteria and compared with same number of age, sex, height and weight matched controls. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, forced expiratory flow between 25 and 75% of vital capacity (FEF25-75%) and peak expiratory flow rate (PEFR) of cases were compared to those of matched controls. RESULTS: Among 36 JIA patients initially recruited, 9 were excluded. Of the remaining 27 patients, male: female ratio was 17:10. Mean age, height and weight of JIA patients were 9.15 y, 124.67 cm and 23.78 kg respectively. Six patients had oligoarthritis, 3 had rheumatoid factor positive (RF+) polyarthritis, 10 had rheumatoid factor negative (RF-) polyarthritis and 8 had systemic JIA. Eleven patients had active disease and 15 patients required methotrexate. None had respiratory symptoms. Mean duration of the disease was 2.96 y. Mean FVC and FEV1 were significantly less in JIA patients compared to controls (p value=0.0003 and 0.0007, respectively). FEV1/FVC in both the groups was similar (p value=0.96). Mean Z scores for FVC and FEV1 were significantly higher in JIA patients (p value=0.0064 and 0.0030, respectively). CONCLUSION: Spirometry in JIA patients demonstrated statistically significant restrictive pattern of alteration in pulmonary function.

Unilateral pulmonary hypoplasia with abdominal situs inversus.

A case of unilateral pulmonary hypoplasia in association with abdominal situs inversus (Situs Inversus Partialis) is described here in a 2-mo-old baby. The normally related heart (levocardia) is dextroposed due to the hypoplastic right lung and compensatory hyper-inflation of the opposite lung which clinically mimicked a mirror-image situs inversus totalis. Such a combination, to the best of authors' knowledge, has never been reported in the world literature.