Analysis of blood-culture isolates from neonates of a rural hospital

All blood culture reports obtained from newborns admitted in a neonatal care unit during 1983-87 were reviewed to determine the current bacteriological profile of neonatal septicemia. A total of 1160 neonates of high risk category or having clinical features suggestive of septicemia were subjected to blood culture study during this period. The culture positivity rate was 73%. Of these, 24.9% cultures were polymicrobial. Among the 1059, growths obtained, 60.1% were Gram negative, with Klebsiella, E. coli and Pseudomonas as the commonest pathogens. In Gram positive group, coagulase negative Staphylococci were most frequent, constituting 24% of the total isolates. An increasing incidence of coagulase positive Staphylococci and Pseudomonas infections was observed in recent years. Another significant finding was a comparatively high prevalence of Group D beta hemolytic isolates among streptococcal growths, with S. fecalis as the single commonest streptococci isolate.     

Acute laryngeal stridor — Controversies in current management

Conclusion The successful management of acute laryngeal stridor in infants and small children depends upon a close cooperation and team work of pediatrician, otolaryngologist and specialised nursing care in a pediatric intensive care unit. The overall opinion is in favour of steroid, racemic epinephrine and intubation or tracheostomy in severe croup. Endoscopy should be performed in all the cases, either immediately, prior to or con-commitant with the establishment of airways. This helps in achieving correct diagnosis and rationalising the treatment. Mortality and morbidity has been significantly reduced by close monitoring and quality nursing of intubated or tracheostomised child. Early extubation can be achieved by regular examination of laryngeal mucosa by direct laryngoscopy in an intensive care unit. Cases of severe croup should be followed up, as they have increased susceptibility to develop bronchial asthma.     

Viral aetiology of acute respiratory infections in children in north India

Two hundred and thirty children clinically diagnosed as suffering from acute respiratory infection were tested for four major groups of viral aetiological agents, i.e. influenza para-influenza, respiratory syncytial virus (RSV) and adenoviruses using indirect immunofluorescence technique. At least one of the respiratory viruses was identified in 51 (22 per cent) specimens, which included influenza A in 6 (3 per cent), influenza B in 3 (1 per cent), para-influenza type 1 in 3 (1 per cent), para-influenza type 3 in 13 (6 per cent), RSV in 11 (5 per cent) adenovirus in 12 (5 per cent), and dual virus infections in 3 (1 per cent) cases. Maximum number of virus identification was noted in children below 1 year of age, particularly infection with RSV followed by para-influenza and adenoviruses. Value of rapid diagnosis by indirect immunofluorescence technique is stressed.     

Neonatal mortality pattern in rural based medical college hospital

The present study was undertaken to establish priorities in neonatal care and to find out neonatal mortality pattern in a rural based medical college hospital. One hundred and twentythree neonatal deaths out of 1461 live births constituted the study material. The neonatal mortality rate was 84.2/1000 live births. The mortality in preterm, full term and post term infants was 43.13,4.02,7.02 percent respectively (p<0.001). The mortality in relation to birth weight was 100 percent (<1000 g); 71.43 percent (1000–1499 g); 37.14 percent (1500–1999 g); 7.63 percent (2000–2499 g) and 2.94 percent (>2500 g). Almost 70 percent of all deaths were because of severe birth anoxia and septicemia (including meningitis) either alone or in combination.     

G6PD deficiency in newborn infants

Five hundred consecutive newborns were screened for erythrocytic G6PD deficiency in cord blood. The overall incidence of G6PD deficiency was found to be 2.80 percent. The incidence of G6PD deficiency was higher among males (3.77%) compared to females (1.44%). The incidence of erythrocytic G6PD deficiency was higher in Muslims (16.67%) compared to Hindus (2.63%). No definite relationship of erythrocytic G6PD deficiency was observed with consanguinity. Fifty per cent mothers of G6PD deficient newborns were also found to be G6PD deficient. Among brothers and sisters of G6PD deficient children the incidence of G6PD deficiency was 50.00 and 9.10 per cent respectively. There was no significant difference in the incidence of hyperbilirubinemia between erythrocytic G6PD deficient and non deficient newborns.     

Neonatal mortality pattern in rural based medical college hospital

The present study was undertaken to establish priorities in neonatal care and to ascertain the neonatal mortality pattern in a rural based medical college hospital. 123 neonatal deaths out of 1461 live births constituted the study material. The neonatal mortality rate was 84.2/1000 live births. The mortality in preterm, fullterm, and postterm infants was 43.13, 4.02, and 7.02% respectively (P0.001). The mortality in relation to birthweight was 100% (1000 g); 71.43% (1000-1499 g); 37.14% (1500-1999 g); 7.63% (2000-2499 g), and 2.94% (2500 g). Almost 70% of all deaths were due to severe birth anoxia and septicemia (including meningitis), either alone or in combination.