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.     

A study of perinatal mortality rate from rural based Medical College Hospital

The present study conducted in a rural medical college aimed at analysing the perinatal mortality and its determinants in a rural set up. Fiftyeight still births and sixty two early neonatal deaths among 1107 consecutive deliveries gave a perinatal mortality rate of 108.4 per 1000 deliveries. Fifty percent of the total deliveries were unbooked. The perinatal mortality was higher in unbooked cases (16.3%), twins (33.2%) and preterms (33.9%) as compared to that in booked cases (5.3%), singletons (9.6%) and term deliveries (6.7%). Sixty nine percent of the still births were due to causes like obstructed labour, toxemia of pregnancy, antepartum hemorrhage, hand prolapse, and cord prolapse where timely intervention would have reduced the perinatal mortality significantly. Early neonatal deaths were mainly associated with prematurity and were largely due to birth anoxia, intraventricular hemorrhage, aspiration and infections.     

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.     

Oral contraceptives and the risk of thrombosis and atherosclerosis

Oral contraceptives containing synthetic oestrogens have been used successfully as birth control for > 40 years and are currently prescribed to > 100 million women worldwide. Several new progestins have been introduced and the third generation of progestins has now been available for two decades. Oral contraceptives are prescribed over a prolonged period of time and therefore substantially impact on hormonal, metabolic and plasmatic functions. Oral contraceptives increase the risk for venous thrombosis and pulmonary embolism, particularly if associated with confounding factors, such as genetic predisposition, smoking, hypertension or obesity. The risk of developing coronary artery disease is also increased in users with cardiovascular risk factors. This article discusses mechanistic and clinical issues and reviews the need for novel approaches targeting the considerable side effects in order to reduce cardiovascular morbidity in women using oral contraceptives.     

Acidogenic potential of Soya infant formula in comparison with regular infant formula and bovine milk: a plaque pH study

Soya infant formulas are essential for infants intolerant to cow's milk. Soya formulas contains glucose syrup or maltodextrins instead of Lactose, which has led to concern that they are potentially more cariogenic than standard infant formulas containing lactose. The study was conducted to compare the acidogenic effect of Soya Infant formula, infant formula and bovine milk. The study group consisted of 75 children in the age group of 7-10 years. The plaque pH was measured using plaque pH meter, before and after rinsing with different samples for sixty minutes Soya infant formula is found to be more acidogenic than infant formula (with lactose) and bovine milk. This study demonstrates high caries inducing potential of Soya infant formula. Further awareness of the possible role of Soya infant formula in early childhood caries is required.     

Tuberculoma en plaque: a case report

A 14 year old girl presented with a 6-month history of headaches and visual blurring. CT showed a right tentorial enhancing lesion. Angiogram showed no enhancement. Histopathological examination of the excised material was consistent with tuberculoma. The presentation of such unusual intracranial tuberculoma is reported and the literature reviewed on the subject.     

Cervical thymic cyst—A case report

A case of cervical thymic cyst in a five year old girl is reported. It was found to be extending between the greatvessels of the neck towards the pharynx. This type of presentation is rare which prompted us to document this case.     

Free oxygen radicals in acute renal failure

OBJECTIVE: To assess the levels of free oxygen radicals in acute renal failure and their predictive value in clinical outcome. DESIGN: Prospective. SETTING: Intensive care unit. METHODS: Study was conducted in 50 children (25 with acute renal failure and 25 age and sex matched controls). Blood urea, serum creatinine, serum protein, uric acid and free oxygen radical markers were estimated in both groups. Superoxide dismutase (SOD), glutathione peroxidase(GPx) and lipid peroxide (LPO) were estimated in blood by standard techniques. RESULTS: Hemolytic uremic syndrome (HUS) was a major cause of acute renal failure (52%), rest were due to acute glomerulonephritis (AGN), septicemia and renal venous thrombosis. In the renal failure group 56% of the patients were dialyzed (peritoneal) and the mortality was 28% (7/25). The levels of SOD, GPx and LPO were significantly raised in renal failure group. Higher values of LPO, SOD and GPx were documented in subjects who expired. The most important independent variable for predicting clinical outcome was LPO with a sensitivity of 89.4%, specificity of 93%, positive predictive value of 95%. CONCLUSION: Levels of free oxygen radicals (SOD, LPO and GPx) are raised in acute renal failure and these enzymes can be used as marker of renal injury. LPO levels are highly sensitivity and specific for predicting the clinical outcome     

Factors predictive of response and survival in patients with metastatic colorectal cancer in Taiwan

5-Fluorouracil in combination with leucovorin has been shown to be active in therapeutic trials of metastatic colorectal carcinoma. In this study, we administered these drugs to 72 patients with metastatic colorectal carcinoma. Thirty-six of them without previous exposure to 5-fluorouracil were treated with weekly bolus injections of 5-fluorouracil (425 mg/m2) and leucovorin (25 mg/m2) supplemented with oral levamisole. Another 36 patients with or without prior 5-fluorouracil treatment received 5-fluorouracil 3,000 mg/m2 and leucovorin 300 mg/m2 in a 48-hour continuous infusion every two weeks. Clinical efficacy and toxicity were assessed by WHO criteria. Variables were tested for relations to response and survival by univariate and multivariate analysis. The response rate was 19.4% in weekly bolus arm and 13.9% in biweekly high-dose infusion arm (P = 0.527). Median survivals in the two arms were 18.4 months (weekly) and 21 months (biweekly) respectively (P = 0.708). Gastrointestinal side effects including nausea, vomiting, diarrhea and mucositia were the major toxicities of these regimens. By multivariate analysis, the only factor to influence response rate was the site of metastases (P = 0.009). The only factor to affect survival was performance status of the patient (P = 0.0001). We concluded that the two 5-fluorouracil based regimens are well-tolerated and shown to have a response rate comparable with previous reports of similar regimens in patients with metastatic colorectal cancer. Only liver metastases seemed to have a better response to therapy. Performance status is the most important prognostic factor in patients with metastatic colorectal cancer.