Thirty patients with thalassemia major receiving repeated blood transfusion were studied to see their serum parathyroid hormone (PTH) and calcium status. Serum PTH, serum and 24 h urinary calcium, and serum alkaline phosphatase, phosphorus, and albumin-corrected calcium levels were determined. Half of these patients, in addition to transfusion, were also supplemented with vitamin D (60,000 IU for 10d) and calcium (1500 mg/day for 3 months). Serum PTH, and serum and 24 h urinary calcium concentrations of the patients receiving transfusions were found to be significantly reduced while their serum alkaline phosphatase, phosphorus, and albumin-corrected calcium levels were not significantly altered when compared to the respective mean values for the control group. Vitamin D and calcium supplementation significantly increased their serum PTH and calcium levels. Supplementations also increased urinary excretion of calcium. The results thus suggest that patients with thalassemia have hypoparathyroidism and reduced serum calcium concentrations that in turn were improved with vitamin D and calcium supplementation.

No abstract

We conclude that cefepime monotherapy and piperacillin-tazobactam are equally efficacious and safe in treating patients with febrile neutropenia. Empirical monotherapy with cefepime would prevent an unnecessary extra economic burden as well as avoiding the serious adverse or toxic effects of multi-drug regimes, especially in low- and middle-income countries.

Thirty full term newborns appropriate for gestational age with icterus neonatorum were divided into two groups of 15 each. Group I (study group) newborns had serum bilirubin in the range of 12.1 to 15.0 mg/dl. Group II (control group) included neonates with serum bilirubin in the range of 8 to 12.0 mg/dl. Only the study group was given phototherapy. The comparative study of neonatal behaviour in both these groups was done using BNBAS (Brazelton's neonatal behaviour assessment scale), 24 to 48 hrs, both after initiation and cessation of phototherapy in the study group and at corresponding postnatal ages in control group. Many newborns in the study group were on top feeds and had more crying episodes. The study group scores were significantly poorer in orientation response to visual inanimate, visual animate and visual and auditory animates in the cluster interactive processes. Followup assessment showed similar results in the same items. Other items in the same cluster and all items in the other clusters showed no significant difference in the two groups in the initial as well as followup assessments. As maternal separation during phototherapy also possibly affects neonatal behaviour, the effect of this factor can be minimized by keeping the phototherapy unit with the mother of the jaundiced baby. The mother should be encouraged to breast feed her baby regularly and have more mother-baby interaction.

Thyroid hormonal status was measured in 80 malnourished children of different grades (I-IV) of protein energy malnutrition (PEM). Serum levels of tri-iodo thyronine (T3) , thyroxine (T 4) and thyroid stimulating hormone (TSH) were measured by radioimmunoassay. The results were compared with 20 healthy, age and sex matched controls. Levels of T 3 and T 4 were significantly low in PEM cases whereas TSH levels were similar in PEM cases when compared to controls.