Background: Neonatal sepsis (NS) has significant morbidity and mortality rates and it is still difficult to diagnose on presentation. Early diagnosis and treatment decreases the mortality and morbidity of neonatal sepsis (NS). The study’s aim was to detect the levels of IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease.Methods: The case control study consists of 70 neonates of whom 36 were clinically suspected case of sepsis admitted in NICU of paediatric department and were taken as cases and 34 were normal healthy neonates taken as control subjects. The cases as well as controls were within 28 days of age. Preterm and term neonates (<28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. About 4 ml of venous blood was taken for measurement of hs CRP and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL 6 was measured by immunoassay Kits (Raybiotech, USA).Results: Serum IL 6 levels were increased in sepsis cases as compared to controls and were statistically significant (68.94±36.32 versus 8.26±3.82 pg/ml; P <0.0001). However, a high positive correlation was observed between ESR with serum IL 6 level (r=0.825; P = <0.001) among neonatal sepsis subjects while no correlation was seen in controls (r=0.279; P=0.098).Conclusions:It was observed that a significant rise in IL-6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis.  The combination of IL-6 or CRP or hs-CRP could therefore be vital for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease.

Background: Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Obstetric ultrasound provides a cornerstone to other modalities used for assessing hypertensive disorders of pregnancy. This study was designed to detect the placental changes in hypertensive disorders of pregnancy and correlation with neonatal outcome.Methods: The study group comprised of 42 patients with pregnancy complicated with hypertension with period of gestation above 20 weeks and B.P. more than 140/90 mm of Hg measured on two occasions 6 hours or more apart. The control group consists of 42 normotensive patients matched with age and parity. One ultrasonic examination were performed between 28 weeks and 34 weeks and another after 34 weeks till term. Apart from routine parameters i.e. BPD, AC, FL, Amniotic fluid index, EBW and gestational age routine placental grading were performed according to the classification proposed by Grannum and associates. To evaluate perinatal outcome following measurement were studied – birth weight immediately after delivery, mode of delivery, perinatal morbidity and mortality , APGAR  score , presence of fetal distress.Results: In 97.62%  cases (41 out of 42 ) of control group showed Grade–II changes as opposed to 57.14% of cases (24 out of 42) in study group before 34 weeks.Conclusions: Accelerated maturation of placenta in pregnancy complicated with hypertension are more common in the hypertensive group.

Background: Febrile convulsion (FC) is the most common seizure disorder in childhood. White blood cell (WBC) and C reactive protein (CRP) are commonly measured in FC. Aims and Objectives: To compare WBC and CRP in febrile children, aged 6 months to five years, with and without FC, in order to determine whether leukocytosis and elevated CRP can be used as diagnostic tool for febrile seizure.. Materials and Methods: In this cross sectional study 214 children (112 with FC), aged 6 months to 5 years, admitted to in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over a 12 months period. Age, sex, temperature; WBC, CRP and hemoglobin were recorded in all children. There was a significant increase of WBC (P <0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. Results: When comparing FC and non-FC children, we encountered a significant increase of WBC (P =0.0005) in children with FC, measured at the time of admission to pediatric medicine ward. There was no significant difference regarding CRP between the two groups. In fact, elevated CRP is a result of underlying pathology.Conclusion: In stable patients, if there's no reason to suspect a bacterial infection or who don't have any indication of lumbar puncture, there's no need to assess WBC as an indicator of underlying infection. Any child with febrile seizure with a high CRP value should be evaluated for infection

Background: The first few years of life are the most crucial period as this age is known for accelerated growth and development and any adverse influences during this period may result in severe limitations in their development which warrants regular monitoring. Methods: The present study had been conducted to find out the total growth profile in relation to skeletal age, nutritional status and the disease pattern so as to give a clear idea of total growth profile in the age group of 3 months to 5 years. The cases were evaluated after proper history taking, clinical examination and conventional anthropometric measurements. The patients were divided in three different age groups as 3 months to 1 year, ≥1 to 3 years, and ≥3 to 5 years. Bone age was determined in all 52 cases by taking proper radiographs of both wrists and hands. Results: It was observed that 16 (30.77%) were normal, 11 (21.15%) were in both grade I and II, 10 (19.23%), 4 (7.7) were grade III and IV respectively among 52 children. The mean weight was 7.06±1.65, 9.33±1.92 and 11.18±2.90 in the age groups of 3 months to 1 year, 1-3 years and 3-5 years respectively. The length/heights were 68.55±5.54, 79.44±7.54 and 91.97±10.15 in the age group of 3 months to 1 year, 1-3 years and 3-5 years respectively. Conclusions: This study gave a true reflection of total growth of a child which comprised of anthropometrical measurement and skeletal development as the distribution of sex and racial distribution were not a factor. There was a statistical significant result in different three groups in regard to weight, length/height, head and chest circumference.

Background: Tubercular meningitis (TBM) is an endemic disease in developing countries. Adenosine deaminase activity (ADA) has been of great importance for many years in TBM diagnosis. The objective of this study was to determine the CSF-ADA levels in different CNS disorders, to compare the CSF-ADA activity in different types of meningitis, to find out the sensitivity and specificity of CSF-ADA in the diagnosis of TBM and to establish the prognostic value of CSF-ADA in TBM in comparison to Control group.Methods: For control group CSF was collected from the patients of simple febrile convulsions and idiopathic epilepsy.Results: The present study was carried out in the 112 cases of different CNS disorders, age ranging from 4 months to 12 years with a mean age of 4.12 years and 38 cases (27+11) of control group (simple febrile convulsion and idiopathic epilepsy). In the present study CSF-ADA level was statistically significantly increased in all types of meningitis (p<0.05). In case of TBM, the mean CSF-ADA level increased statistically significantly with increase in CSF protein level (p<0.05). In case of TBM, there was no significant difference in the mean ADA value according to CSF sugar level (p<0.10). In case of TBM, the mean CSF-ADA level increased significantly with increase in CSF cell count (p< 0.01) mainly lymphocytes.Conclusions: Thus it can be concluded from our study that CSF-ADA estimation is relatively simple and inexpensive procedure in the early diagnosis of tuberculous meningitis with high sensitivity (100%) and specificity (97.5%) at a cut-off level of 5IU/L and can be used in differentiating TBM from other types of meningitis. Along with diagnostic utility of CSF-ADA, it has also prognostic value in the follow-up case of tuberculous meningitis.