No abstract

Objectives To study the rational use of the blood components in pediatric and neonatal wards. Methods It was a retrospective study conducted by department of pediatrics of a tertiary care centre in western part of India. The patients were included from the pediatric ward, pediatric surgery ward, neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) over a period of three months. All the patients below 12 y of age receiving blood components, admitted in general pediatric wards, pediatric intensive care unit, neonatal intensive care unit and pediatric surgery ward were included in the study. Each transfusion episode was assessed as per predetermined guidelines. Results Of the total 336 episodes of blood component transfusions, 244 episodes were appropriate and 92 episodes were inappropriate. Among these, platelets had highest inappropriate (36.84%) episodes followed by fresh frozen plasma (FFP) (28.95%) and packed red blood cell transfusions (PRBC) (21.21%). Majority inappropriate transfusions were seen in intensive care settings. Conclusions Almost one-third of blood component transfusions (FFP, platelets and PRBC) were given without any definitive indication. Judicious use of various blood products by following recommended guidelines may help in decreasing the inappropriate use of blood components.

Metabolic alkalosis is an uncommon acid/base disorder in children in which serum bicarbonate concentration is increased. Two most important causes of metabolic alkalosis are emesis and diuretic use. However, in the absence of these two etiologies, a thorough investigative workup is of paramount importance to reach a definitive diagnosis. A case having severe metabolic alkalosis diagnosed as a case of Bartter syndrome is being reported.

Introduction: The high incidence of low birth weight babies in India is due to the neglect of health and education of females, teenage marriages, frequent pregnancies, maternal malnutrition, ?nemi?, and infections. Objective: The objective of his study was to identify the role of various maternal factors such as maternal age, parity, regular antenatal care (ANC) visits, weight, anemia, socioeconomic status, and maternal pre-eclampsia affecting the nutrition of the fetus. Materials and Methods: In this observational study, 500 mother-infant pair recruited, consecutively. A detailed antenatal and postnatal history of the mother was recorded. Information obtained were age, the weight of mother, parity, number of antenatal visits, and maternal hemoglobin (Hb). Newborn taken for the study was weighed and assessed for their nutritional status using the clinical assessment of nutrition score. Results: Of 500 babies, 51.4% of babies were born to mothers aged ?20 years; and out of them, 76.5% of babies had fetal malnutrition. About 45.2% of babies born to primigravidae mother; of which, 85.9% had fetal malnutrition (FM). About 54.8% of babies born to multigravida mothers; of which, 45.3% had FM. Of 69.2% of mothers, who had irregular or no ANC, 75.1% of babies had FM. Mothers with weight ?50 kg were 45.6% and 78.9% of their babies had FM. In 44% of mothers, Hb was ?10 g% and 91.8% of babies born to these mothers had FM. Of 48.80% of babies born to pre-eclamptic babies, 77.5% of babies had FM. All these maternal factors were statistically significant in their impact on FM (p<0.05). Conclusion: Maternal nutrition and well-being are essential to bring down the percentage of FM in babies. Proper education not only of the mother but also of society as a whole, recognition of these factors and timely intervention will go a long way not only in improving the quality of life of babies born to such mothers but also in reducing the economic burden on a precariously balanced health-care system.