Introduction: Osteoarthritis (OA) is commonly prevalent disorder seen in Indian population. Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) are used as primary drugs for its symptomatic treatment. However, its use is limited by its long-term adverse effects. Many clinical studies have shown that diacerein reduces clinical symptoms of OA. Aim: To evaluate whether diacerein has beneficial anti-arthritic property when used prophylactically in Freund’s Complete Adjuvant (FCA) induced arthritis in rats. Materials and Methods: An experimental study was conducted over a period of about two months in the Department of Pharmacology, SCBMC, Cuttack. Thirty albino rats of Wistar strain was divided into 5 groups with 6 animals in each group. The basal body weight and the hind paw volumes of both right and left paw of all the animals was noted in day 0 and then on 4th, 8th, 14th and 21st day. Arthritis was induced in all animals by injecting FCA on day 0 into the plantar surface of right hind paw. Normal saline, diclofenac 5 mg/kg, three doses of diacerein (50 mg/kg, 100 mg/kg, 200 mg/kg), was administered orally once daily to groups I, II, III, IV and V respectively. Paw volumes and body weight was measured for arthritic parameters. On day 22 radiological and histopathologic evaluation was done. Results: Maximum inhibition of Freund’s adjuvant induced arthritic paw volume was on the 21st day with 100 mg/kg of diacerein and with diclofenac 5 mg/kg was from 8th to 14th day. There was a decrease in body weight due to freund’s adjuvant in normal saline group from 4th to 21st day, still greater decline with diclofenac 5 mg/kg group, but in diacerein treated group there was an increase in body weight from 4th to 21st day in all the three doses. Radiologically and histopathology maximum benefit was noted with 100 mg/kg of diacerein. Conclusion: Three weeks treatment of oral diacerein can significantly inhibit arthritic swelling of the injected paw at all the 3 doses in adjuvant induced arthritis model in rats and can be a promising disease modifying drug for OA.

Introduction: With better healthcare facilities, despite an increase in neonatal survivor rates, the outcomes in the survivors still remains uknown to a great extent. In overburdened centres following an early discharge policy, a structured follow-up plan to evaluate growth, development and problems faced by the high-risk babies is essential. Aim: To assess the growth, development at 52 and 64 weeks Post Menstrual Age (PMA) and association of postnatal growth failure with developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies. Materials and Methods: This was a prospective cohort study carried out amongst the newborn babies discharged from a tertiary care hospital, Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India. within 2 months period and followed-up till 64 weeks PMA. Out of 189 newborns discharged during study period, 168 met the inclusion criteria and only 114 babies could complete the follow-up till 64 weeks postmenstrual. The weight, length and head circumference were documented at discharge, 44, 52 and 64 weeks PMA and compared using INTERGROWTH 21st postnatal standards. Denver Developmental Screening Test was used for developmental screening at 52 and 64 week PMA. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS) version 20.0 and categorical data was compared using Chi-square test in trend using Epi Info software. Results: Out of 114 patients, 51 (44.7%) were females and 63 (55.3%) were males. At birth, 72 (63.16%) of study population was below 10th centile which increased to 77 (67.54%) at 44 weeks PMA. By 64 weeks PMA, 62 (54.39%) infants were showing catch up. Out of total, 18 (15.79%) showed delayed developmental milestones. 11 out of 18 (61.11%) babies were with delayed development, i.e., below 3rd centile of weight for age showing that at lower postnatal weight odds of patients having developmental delay were increased. Conclusion: Postnatal growth pattern of the study population was along the lower centiles of INTERGROWTH 21st chart. Incidence of developmental delay was higher in babies with postnatal growth failure.

Background: Diacerein has been known as an anti-osteoarthritic agent that is usually given along with other analgesic drugs. Still there is no evidence of the analgesic effect of diacerein alone. So this pilot study was undertaken to assess the analgesic property at supra-spinal level by using the tail-flick method.Methods: Diacerein at doses of 50, 100 and 200 mg/kg was given to Albino wistar rats weighing approximately 100-200 grams along with distilled water as placebo. All drugs were given by oral routes and the analgesic effect was evaluated using analgesiometer at baseline, 15 min, 30 min, 60 min and 120 min. Analgesic activity was measured as change in tail flick latency from baseline in animals.Results: Diacerein showed significant increase in tail flick latency and showed promising analgesic activity compared to placebo starting from 15 mins till 60 mins. However the effect persisted up to one hour only and after which it started decreasing.Conclusions: Diacerein at all the three doses possess dose dependant analgesic activity that is maximally effective up to 60 minutes.

Telmisartan is an antihypertensive medication, which acts as an angiotensin II receptor blocker, and has an inhibitory effect on the renin-angiotensin system. Angiotensin receptor blockers(ARBs) are contraindicated in pregnancy (category D); adverse effects have been reported in both animal and human pregnancies, but still pregnant mothers do come with this medication with consequent neonatal adverse complications. We report 2 such cases of adverse neonatal outcomes in hypertensive mothers exposed to Telmisartan during pregnancy.Cite this article as: Agrawal P, Upadhyay M, Upadhyay R, Satpathy SK. Case report on neonatal renal failure due to prenatal exposure of Telmisartan. Int J Contemp Pediatr 2017;4:1549-50.

Introduction: Nosocomial infections are a major problem for hospitalised neonates due to increase in morbidity, mortality, duration of hospitalisation and costs of treatment. The magnitude of this problem varies from place to place and is unique to each place as per the organisms and their resistance pattern is concerned. There is need to develop local level surveillance data on incidence of nosocomial sepsis, causative organisms, their sensitivity pattern and periodically review antibiotic policy based on this information. Aim: To determine the aetiological agents of nosocomial sepsis and their antibiotic sensitivity and resistance pattern. Materials and Methods: This was a cross-sectional study in which the cases of nosocomial infections in neonates of > 35 weeks were studied from November 2018-October 2019 at Sriram Chandra Bhanja Medical College and Hospital (S.C.B.M.C.H) and Sardar Vallabh Bhai Patel Postgraduate Institute of Paediatrics (S.V.P.P.G.I.P) based on clinical findings, sepsis screen and blood culture. Blood culture is considered as gold standard for diagnosis of sepsis. Blood sample (1 mL) was collected under strict asepsis in Becton Dickinson and Company (BACTEC) and was sent for performing blood culture. The data was processed and arranged into distribution tables and cross tables using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Out of total 100 suspected cases of nosocomial sepsis, blood culture was positive in 46 (46%) of cases. Candida spp. was the most common obtained organism 9 (19.5%) followed by Klebsiella pneumoniae 8 (17.3%) and Staphylococcus aureus 8 (17.3%) each respectively. There was increased incidence of bacterial resistance to commonly used antibiotics and combinations of it, like ampicillin, gentamicin, cefotaxime, amikacin and piperacillin+ tazobactam among these bacterial isolates. Among the possible new combinations deduced from the observation, the combination of vancomycin+amikacin had sensitivity of 67.6% and can be considered as initial antibiotic combination of choice while combination with colistin and tigecycline should be reserved only for culture proven resistant cases or babies who continue to be deteriorating and critically sick while on previous combination. Conclusion: Candida spp. is the leading cause of nosocomial sepsis. Among bacterial organisms, Klebsiella pneumoniae and Staphylococcus aureus are most common. Most isolates are resistant to traditional antibiotics, hence new combination like vancomycin+amikacin are more appropriate empiric choice in present context and combination with colistin and tigecycline are reserved only for culture proven resistant sepsis.