Bacteria in surface infections of neonates.

A bacteriological work on surface infections was done among live births (study group I) and neonates admitted in hospital (study group II). Out of 134 cases of conjunctivitis in group I Gram-negative bacilli predominated (48.5%) with Escherichia coli accounting for 29 (14.9%) cases, Klebsiella species 15 (11.2%) cases, Citrobacter freundii 3 (2.2%) cases, Pseudomons aeruginosa 18 (13.4%) cases and Aeromonas hydrophila 3 (2.2%) amongst pure isolates (73.9%). Gonococcus was noted in 2 (1.5%) cases. In group II, 41.7% were Staphylococcus aureus in pure growth (75%), compared to only 9.0% in group I. Skin infections were caused by both Staphylococcus aureus and Staphylococcus epidermidis. Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were the principal insolates from umbilical sepsis. Pseudomonas aeruginosa was isolated as pure growth from local site of noma neonatorum. Anaerobic cultures were negative in all except in 2 cases of umbilical sepsis with tetanus neonatorum revealing Clostridium tetani which however proved to be non-toxigenic. Blood cultures were positive in 4 out of 14 cases bearing 50% correlation with bacteria from surface infections. A source study established partial correlation with the cases of pseudomonas conjunctivitis. Phage typing of Staphylococcus aureus and biochemical typing failed to detect any definite marker of clinical entities, except that the skin infections were caused by group III phages predominantly (65.0%).

Plasma lipids and blood glucose in infants of toxemic mothers.

Maternal and cord blood of 34 toxemic and 27 non-toxemic mothers and their infants were studied for lipids and glucose. All the lipid fractions in cord blood were significantly lower (P less than .001) than that of the mother in all groups due to relative impermeability of the placenta. AFD infants of toxemic mothers had significantly higher (P less than .001) value of FFA and triglyceride as compared with AFD infants of non-toxemic mothers. However SFD infants of toxemic mothers had higher FFA only when compared with that of non-toxemic mother. This is possibly due to sympathetic stimulation related to placental insufficiency with hypoxia and hypoglycemia that lead to mobilisation of adipose tissue into FFA and glycerol in fetus. Plasma phospholipid, cholesterol, HDLC, LDLC of infants of toxemic mothers were significantly lower (P less than .001), more so in SFD infants, possibly due to impaired liver function. 53% of infants of toxemic mothers also had hyperbilirubinemia. Cord blood glucose in toxemic group was significantly lower (P less than .05) than AFD infants of non-toxemic group.

Perinatal morbidity and mortality in cesarean section.

PIP: The study purpose was to assess the incidence and indications of cesarean section; the effect of anesthesia, maternal and fetal factors on the morbidity and mortality of newborn infants; and to compare the morbidity and mortality patterns of infants delivered by cesarean section with that of infants delivered by the normal vaginal route. The morbidity and mortality pattern of 200 consecutive normally delivered infants were compared with that of 265 infants delivered by cesarean section. The incidence of morbidity in emergency cesarean section, planned section and normal vaginal delivery was 54.6%, 20.4%, and 12%, respectively. Higher incidence in emergency section was primarily because of asphyxia, intracranial stress, dysmaturity, transient tachypnea, prematurity and infection. Mortality was 7.5% in emergency section, 2.2% in planned section and 4% in normal delivery. Most of the stillbirth and neonatal deaths were because of gross asphyxia, prolonged labor due to cephalopelvic disproportion and uterine dysfunction, fetal distress, and abnormal presentation. Associated factors adversely influencing the morbidity and mortality included maternal age below 20 years and above 30 years, height below 510 centimeters, grand multiparity, low socioeconomic class, poor antenatal care, fetal distress, general anesthesia, prematurity and birth weight below 2 kilograms.^ieng

Oral rehydration in infantile diarrhoea. Controlled trial of a low sodium glucose electrolyte solution.

The paper describes the first controlled trial of an oral glucose electrolyte solution designed on the basis of the optimum pathophysiological needs for rehydration in infantile diarrahoea. The solution, having a sodium concentration of 50 mmol/l, was tried in a group of 20 infants with moderate to severe dehydration due to acute diarrhoea and was compared with a matched group of 19 infants predominantly under 2 years of age taking a 'standard' oral solution with a sodium concentration of 90 mmol/l. They could be hydrated as well with a low sodium oral solution alone as with the standard solution. Intravenous fluid was not required in either group. The group treated with the high soldium 'standard' solution appeared to develop hypernatraemia and/or periorbital oedema more frequently than the other group. Also, the low sodium solution eliminated the need for additional free water orally.