Aim: To find out association between vitamin D level and early onset neonatal sepsis (EONS). Methods: This case control study was conducted at a tertiary care center in Northern India during June 2018 to May 2019. Neonates with culture-proven EONS were included as case and neonates without EONS were enrolled as control. 25OH-D levels were evaluated with other routine blood samples. Statistical analysis was done by using unpaired t test and chi-square test. Results: Sixty-two infants were enrolled in each group; baseline characteristics were comparable in both groups. Risk of EONS increased 8 times in neonates with 25OH-D level <30 ng/mL (odds ratio = 8.2; 95% confidence interval [CI]: 3.08-21.82; P = .000). The 25OH-D level was significantly lower in EONS group than control group. Optimal cut-off for 25OH-D was 25 ng/mL to predict EONS with a sensitivity and specificity of 88.7% and 79%, respectively (area under the curve: 0.84; 95% CI: 0.76-0.92; P = .000). Conclusions: Vitamin D insufficiency is significantly associated with EONS. Vitamin D deficiency significantly increases risk of EONS. Maternal vitamin D supplementation may improve neonatal vitamin D levels and may decreases risk of EONS. Further studies including maternal vitamin D level are required for implementation.
Chylothorax is the accumulation of lymphatic fluid in pleural space following traumatic injury to lymphatic vessels, systemic venous obstruction, dysfunction of the right ventricle, thrombosis of the duct, superior vena cava or subclavian vein, or postoperatively. A 2 ½-year-old male child operated for transposition of great arteries (TGA), tricuspid atresia (TA), and hypoplastic right ventricle 15 days ago developed chylothorax and left internal jugular vein thrombus. The child was initially managed conservatively with nutritional management, anticoagulation, and octreotide followed by interventional radiological management with lipoidol injection. Early suspicion and diagnosis are crucial. The management was difficult owing to a lack of proper guidelines. Further research is warranted.
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