Our data, although, inconclusive favor the need for a study with a larger sample size to clearly define role of low-dose hydrocortisone in pediatric septic shock in developing countries, while taking in consideration effect of malnutrition, delayed presentations, and their interactions with the hypothalamic-pituitary-adrenocortical axis.

Background: Neonatal jaundice is the most common problem in the first week of life leading to delayed hospital discharge and readmissions. Early recognition of neonatal hyperbilirubinemia is important to prevent serious complications. This study was done in a teaching hospital (KMCT Medical College, Mukkam, Kozhikode), in a rural area of North Kerala. It is an attempt to identify the common aetiological factors of neonatal jaundice in this setting.Methods: This observational study was conducted over a period of 6 months from January 2014 to June 2014. A total of 110 jaundiced neonates were enrolled. Data collection was done by history taking, clinical examination and relevant laboratory investigations.Results: In this study, out of 110 jaundiced neonates, 102 (92.5%) were term babies and 8 (7.3%) were preterm, 69 (62.75%) were males and 41 (37.27%) females. Physiological jaundice was seen in 44 (40%) of neonates. Various other aetiologies were ABO incompatibility 24 (21.8%), sepsis 11 (10%), Rh incompatibility 9 (8%), idiopathic 9 (8%), prematurity 8 (7.3%), cephalhematoma 7 (6.4%), breast feeding jaundice 7 (6.4%) and haemolytic anaemia 1 (0.9%).Conclusions: Physiological jaundice accounted for the bulk of cases of neonatal jaundice in our area. This was followed by ABO incompatibility. This highlights the importance of appropriate monitoring of neonates with this underlying risk factor.

Background: Acute nephritic syndrome (ANS) is major cause of morbidity in developing countries. This study is an attempt to evaluate the clinical characteristics, complications and outcome of acute nephritic syndrome.Methods:This hospital based descriptive study was conducted at a tertiary care hospital in Kerala, South India. 103 children with ANS were analysed. Detailed clinical examination and relevant laboratory investigations were done. These children were followed up for 1 year.Results: Out of 103 patients studied 64% were male and 36% were female. The peak age group was 6 to 8 years. Skin infection was the most common predisposing condition (68.9%). Hypertension was present in 60.1% of patients. 26.2% of patients developed complications. Of these Acute renal failures was the most commonly encountered complication (18.4%). Proteinuria (87.4%) and microscopic hematuria (80.6%) were the most consistent features.  82.5 % patients had low C3 at the time of diagnosis. Majority of patients with low C3 level had positive ASO titre. (p = 0.014). At 3month follow up C3 became normal in 95.2% of patients. At 3 months’ majority of patients with normal C3 had incomplete recovery. (p = 0.010). At the end of 12m, microscopic heamaturia was present in 4 patients, persistent hypertension in 2 patients, 11 patients had proteinuria. These patients are kept under long term follow up.Conclusions:Complications and morbidity is significantly high during the acute phase in ANS. This study highlights the need for long term follow up of these patients.