Perinatal Transmission and Outcomes of SARS-CoV-2 Infection.

Maternal SARS-CoV-2 infection can adversely affect the birth and neonatal outcomes. The authors prospectively enrolled 196 neonates born to 193 SARS-CoV-2-positive mothers to determine the rate of mother-to-baby transmission of SARS-CoV-2 and its effect on short-term neonatal outcomes in Indian population. Nineteen babies turned out to be RT-PCR-positive for SARS-CoV-2, carrying a perinatal transmission rate of 9.8%. Rates of prematurity and low birth weight were 12.8% and 18.9% in the neonatal group, respectively. On comparing SARS-CoV-2-positive (n = 19) and negative (n = 177) neonatal groups, rate of prematurity, hospital admission rate, and death rate were higher in the former group. The placental positivity rate for SARS-CoV-2 was 8.1%, but no relation was found between placental and neonatal infection.

Brain Injury Patterns in Neonates With Hypernatremic Dehydration: Single Center Experience.

OBJECTIVE: To find out the incidence, spectrum, and topographical distribution of brain lesions in neonatal hypernatremic dehydration. METHODS: We prospectively enrolled 100 consecutive neonates admitted with hypernatremic dehydration. 93 neonates underwent magnetic resonance imaging brain to identify the nature and site of neurological injury. RESULTS: Neuroradiological lesions were found in 42 (45.2%) babies. Edema was the most common finding in 37 (39.8%), followed by hemorrhage in 13 (13.9%) and thrombosis in 6 (6.4%). Edema predominantly affected juxtacortical/subcortical white matter followed by periventricular white matter and centrum semiovale, posterior part of internal capsule, and basal ganglia/thalamus. Occipital horns of lateral ventricle were the main sites of hemorrhage. Thrombotic lesions predominantly involved sagittal, straight and transverse sinuses. Brain lesions were observed only in severe hypernatremia group. CONCLUSIONS: In neonatal hypernatremic dehydration, edema was the most common neurological lesion, followed by hemorrhage and thrombosis. Subcortical/juxtacortical white matter was the most commonly affected site.

Incidence of Congenital Hypothyroidism in Western Rajasthan Using Cord Blood Thyroid-stimulating Hormone Levels as a Screening Tool: A Cross-sectional Hospital-based Study.

BACKGROUND: Congenital hypothyroidism (CH) is considered the most common preventable cause of intellectual impairment, with a worldwide annual incidence of 1:4000 live births. In the absence of screening program actual incidence in India is not exactly known, but in previous studies it varies from 1:500 to 1:3400. We wished to find out the incidence of CH in Western Rajasthan using cord blood TSH as a screening tool and venous TSH within 14 days of life as a confirmatory test. METHODS: This cross sectional descriptive study was conducted over a period of six months in teaching hospitals attached to Medical College. Cord blood TSH value of 20 mIU/L or >20 mIU/L was taken as cut off for screening and all screen positive neonates were re-tested for serum TSH by taking venous samples within 14 days of life. Repeat TSH levels of 20mIU/L or more tested by Enzyme Linked Fluorescent Assay were considered confirmatory. RESULTS: Total 9558 cord blood samples were analyzed for TSH levels, out of which 533 came out to be screen positive (recall rate 5.57%). Out of these 58 could not be confirmed, so were excluded from the further analysis. Effective sample size and screen positive cases dropped to 9500 and 475 respectively, and out of these 13 were confirmed as CH (incidence - 1.37 per thousand live births). CONCLUSIONS: Considering the previous studies, incidence of CH is much higher in Western Rajasthan than the anticipated. Overall in India CH seems to be more prevalent than the other parts of the world, necessitating the need of national screening program.

Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children.

CONTEXT: T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition. AIMS: The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic children. SETTINGS: Thalassemia day-care center of a teaching hospital. DESIGN: This was a cross-sectional study. SUBJECTS AND METHODS: Seventy-three transfusion-dependent beta thalassemic children belonging to 2-18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin. STATISTICAL ANALYSIS USED: Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated. RESULTS: We found poor (negative) correlation between serum ferritin level and T2* MRI liver (r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart (r = -0.221, P = 0.060). CONCLUSIONS: Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with ß thalassemia.

Reversible posterior leucoencephalopathy syndrome in post streptococcal glomerulonephritis.

Reversible posterior leukoencephalopathy syndrome is characterized by an acute, usually reversible encephalopathy, with radiological findings that mainly involve the white or grey matter of the parieto-occipital lobes. We report a case of post streptococcal glomerulonephritis presenting as reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.