Cord Blood Cortisol Level - A Possible Predictor for Respiratory Distress Syndrome in Preterm Neonates.

BACKGROUND: Respiratory Distress Syndrome (RDS) is a leading cause of death in premature infants. There are different clinical/ biochemical markers associated with the RDS. One of the potential biochemical markers is cortisol in cord blood. PURPOSE: This study aims to correlate cortisol levels in preterm neonates with RDS and to establish whether cord blood cortisol is a reliable predictor for RDS. MATERIALS AND METHODS: This prospective analytical study was conducted in a tertiary care hospital over nine months among fifty preterm neonates. Data were collected using proforma, and cord blood was collected at the time of delivery. Cortisol levels were compared and correlated to the development of RDS. RESULTS AND DISCUSSION: The mean ± SD cord blood cortisol level among preterm neonates was 5.97 ± 2.74 (SD) µg/dl. The levels were higher in neonates whose mothers received antenatal steroids and were significantly lower (2.86 ± 1.66 µg/dl) in those who developed RDS. Association between cord blood cortisol level and RDS was found with an odds ratio of 57.4, which was statistically significant. The percentage of babies developing RDS in mothers not covered with antenatal steroids was significantly higher than those covered (p-value is 0.000). The mean cord blood cortisol levels were exceptionally low (1.89 µg/dl) in neonates who expired compared to those who survived (7.02 µg/dl). CONCLUSION: There is an association between cord blood cortisol levels and RDS. Hence, Cord blood cortisol levels may be used to predict RDS and help initiate early treatment, thus preventing mortality and morbidity.

Gripe Water Administration in Infants 1-6 months of Age-A Cross-sectional Study.

INTRODUCTION: Gripe water (GW) administration to young infants is common practice in this part of country. In order to ascertain why mothers administer gripe water to their infants and to find out what benefits or health risks it poses, we proposed to study the practice of mothers giving GW to their babies. MATERIALS AND METHODS: Three hundred and thirty five eligible mothers of infants aged 1-6 months (who after qualifying inclusion and exclusion criteria of the study) who attended the well baby clinic during the study period, were interviewed using a semi structured questionnaire which contained both open and close ended questions after obtaining informed written consent. The study population was then divided into two groups based on administration of GW or not and the results were compared and analysed among the two groups using odds ratio with 95% C.I. For calculation of statistics, the statistical package SPSS 13 was used. RESULTS: 64.18% of the mothers were administering GW for their infants. Most mothers believed that GW helps in digestion and prevents stomach ache. Infantile colic, vomiting and constipation were common in GW administered infants, when compared to those who did not receive GW and the difference was significant with p-values of 0.0001, 0.0373, 0.0007respectively. CONCLUSION: GW administration is a common problem in infants and remains a significant challenge that thwarts exclusive breast feeding. More over GW administration does not seem to prevent infantile colic and on the other hand, may be associated with vomiting and constipation. Misconceptions prevailing among mothers have to be removed by effective counseling so that the mothers are aware of safe and healthy feeding practices to be adopted for feeding their babies.

First Degree Heart Block with Multi-focal Atrial Ectopics in an Adolescent Girl Due to Hypomagnesemia.

Nutritional deficiencies are common in adolescent children and include deficiencies of both micro- and macronutrients. Magnesium is an important mineral that is essential for maintenance of numerous electrophysiological and biochemical processes in the body. We report an adolescent girl who developed an episode of syncope with first degree heart block on electrocardiography and run of multifocal atrial ectopics on 24 h holter monitoring. Serum magnesium was found to be low with decreased urinary magnesium excretion. There were no other electrolyte abnormalities. Structural heart disease was ruled out by a normal echocardiogram. The rhythm changes were attributable to nutritional hypomagnesemia and were promptly reversed on correcting the hypomagnesemia.

Hypersensitivity due to ceftriaxone mimicking measles in a child.

Ceftriaxone is a commonly used antibiotic in children for various infections like respiratory tract infection, urinary tract infection and enteric fever. Hypersensitive reactions following ceftriaxone therapy are uncommon but are potentially life-threatening. The rash can resemble viral exanthems and may lead to a delay in the recognition and prompt treatment. Here we report a 7-year-old boy who presented with fever and rash with emphasis on recognizing ceftriaxone hypersensitivity and its management.

Tuberculous Otitis Media and Staphylococcus aureus Coinfection in a Five-Year-Old Boy with Miliary Tuberculosis.

A five-year-old boy with acute on chronic ear discharge and fever was diagnosed to have tubercular otitis media (TOM) with Staphylococcus aureus co-infection. His chest X-ray was suggestive of miliary tuberculosis. The clinical presentation of the child with a brief review of the literature pertaining to the case is being discussed in this report.

Too short and too poor: A tale of two siblings.

Two short siblings who were brought for evaluation of short stature are described with emphasis on availability of resources in the diagnosis and management of the cause of short stature in them.