The study was carried out to determine the role of plasma fibrinogen in diagnosis of neonatal sepsis and to evaluate its role in predicting short term outcome. Sixty five neonates with clinical features suggestive of neonatal sepsis were included in this study. Seventy five neonates served as the control group. Plasma fibrinogen, prothrombin time, activated partial thromboplastin time and platelet counts were performed in all the neonates. Cut-off value of plasma fibrinogen for diagnosis of neonatal sepsis was determined with the help of receiver operating characteristic curve. Plasma fibrinogen level was found to be significantly higher among neonates with sepsis when compared to neonates in control group ( < 0.0001). It had sensitivity of 70.8 %, specificity of 82.7 %, positive predictive value (PPV) of 72.3 % and negative predictive value (NPV) of 81.6 % for diagnosis of neonatal sepsis at cut-off value of 301.90 mg/dL. When neonates with septic shock and/or disseminated intravascular coagulation (DIC) were excluded from study population, sensitivity and NPV rose to 91.9 % and 95.4 % at the same cut-off value while specificity and PPV remained the same. Lower level of plasma fibrinogen was detected in neonates with septic shock and/or DIC ( < 0.0001) and in neonates who died ( < 0.0001). Hence plasma fibrinogen can serve as an effective tool in diagnostic work up of neonatal sepsis as well as in assessing development of complications and outcome.

Objectives:Magnesium historically has been used for treatment and/or prevention of eclampsia. Considering the low body mass index of Indian women, a low-dose magnesium sulfate regime has been introduced by some authors. Increased blood levels of magnesium in neonates is associated with increased still birth, early neonatal death, birth asphyxia, bradycardia, hypotonia, gastrointestinal hypomotility. The objective of this study was to assess safety of low-dose magnesium sulfate regimen in neonates of eclamptic mothers treated with this regimen.Materials and Methods:This was a cross-sectional observational study of 100 eclampsia patients and their neonates. Loading dose and maintenance doses of magnesium sulfate were administered to patients by combination of intravenous and intramuscular routes. Maternal serum and cord blood magnesium levels were estimated. Neonatal outcome was assessed.Results:Bradycardia was observed in 18 (19.15%) of the neonates, 16 (17.02%) of the neonates were diagnosed with hypotonia. Pearson Correlation Coefficient showed Apgar scores decreased with increase in cord blood magnesium levels. Unpaired t-test showed lower Apgar scores with increasing dose of magnesium sulfate. The Chi-square/Fisher's exact test showed significant increase in hypotonia, birth asphyxia, intubation in delivery room, Neonatal Intensive Care Unit (NICU) care requirement, with increasing dose of magnesium sulfate. (P ≤ 0.05).Conclusion:Several neonatal complications are significantly related to increasing serum magnesium levels. Overall, the low-dose magnesium sulfate regimen was safe in the management of eclamptic mothers, without toxicity to their neonates.

Objectives: Thalassemia and hemoglobinopathies are major causes of microcytic anemia in pediatric age group. The present study was done to calculate the proportion of children suffering from thalassemias and hemoglobinopathies amongst the patients of microcytic anemia and assessment of the clinical and hematological parameters of selected patients. Materials and Methods: Children of the age group 0-12 years attending the pediatrics outpatient department of Burdwan Medical College who showed microcytic anemia (i.e. MCV less than 80 fl) were included in the study. Among them, those showing features of thalassemia or hemoglobinopathy on HPLC underwent detailed clinical examination and history taking. Results: 64 (22%) children out of the total 292 patients had thalassemia or hemoglobinopathies. Rest 228 had microcytic anemia due to other causes. Hemoglobin disorders found, in decreasing order of occurrence, were E Beta-thalassemia (45%), Beta thalassemia major (26%), Beta thalassemia trait (17%) and E trait (8%). E homozygous and Beta thalassemia-HPFH had one case each. 42 children had history of blood transfusion. The average age of first transfusion was 14 months for Beta thalassemia major patients and 3 years for E Beta thalassemia patients. The age of first transfusion is highly variable in case of E Beta thalassemia. Hepatomegaly, splenomegaly and skeletal changes were almost exclusively found in transfused children. 56.3 % children suffering from hemoglobin disorders were malnourished; most of them having beta thalassemia major and E beta thalassemia. Beta thalassemia major and E beta thalassemia patients had more severe anemia and anisocytosis than the other hemoglobin disorders which were milder in nature. Conclusion: Hemoglobin disorders happen to be the cause of ailment in a considerable proportion of children suffering from microcytic anemia. So hemoglobin analysis, preferably by HPLC is very much helpful for early diagnosis and treatment..

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