Background: Hyperbilirubinemia is one of the common causes of neonatal admission. As clinical evaluation may cause a delay in identification and subsequent initiation of medical therapy, there is a need for the sensitive and inexpensive predictive marker for hyperbilirubinemia in neonates. Measurement of cord albumin and its correlation with the serum bilirubin is one of the noninvasive predictive markers for Hyperbilirubinemia. The present study carried out to know the significance of umbilical cord albumin level as a predictor of neonatal hyperbilirubinemia.Methods: It is a hospital-based prospective cohort study, total 100 healthy term new-borns admitted in the Neonatal Intensive Care Unit, were included in the study as per study protocol over a period of one year. The blood sample was collected from umbilical cord blood for the analysis of bilirubin and albumin, and post 72 hours of life venous blood obtained for estimation of serum bilirubin and albumin along with direct and indirect Coombs test.Results: In this study most of the patients were in the gestational age of 37-38 weeks (71%) followed by 38-40 weeks (27%) and only 1% are >40 weeks. A positive correlation was observed between cord blood bilirubin, serum bilirubin, serum albumin, and cord blood albumin levels. Cord blood albumin was a better marker for neonatal hyperbilirubinemia with a sensitivity of 83%, and a specificity of 48%; as compared to cord blood bilirubin with a sensitivity and specificity of 73% and 39% respectively.Conclusions: From this study, cord blood albumin level was demonstrated as a good predictive marker for neonatal hyperbilirubinemia with a sensitivity of 83.1%. and specificity 48.8%. Hence, cord blood albumin may be used as a non-invasive predictor for neonatal hyperbilirubinemia.

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Introduction:Lower respiratory tract infection is an infection beneath the larynx which includes: Pneumonia, Wheeze associated Lower respiratory tract infection, Bronchiolitis and Empyema. The aim of this study was to find out the association among hyponatremia and LRTI in tertiary care center. Materials and Methods: The sample size was calculated to be a minimum of 50 subjects. Based on clinical signs and symptoms (as defined by WHO) and infiltrates present on chest X-ray diagnosis of LRTI such as Pneumonia, Bronchiolitis was made. Then patients were subjected to routine investigations such as: Complete blood count, Serum electrolyte (serum sodium) at the time of admission, on day 2 and day 3 by Ion selective electrodes. Results: Mild hyponatremia was found among 11 patients (16.92%), moderate among 9 (13.85%) and severe among 2 (3.08%) patients. Hyponatremia was found to be more common among 1 to 5 years age group as compared to ≥ 2months to 12 months and > 5 to 12 years age groups. Conclusion: Hyponatremia is a significantly common association among hospitalized children with lower respiratory tract infections and it is mainly due to syndrome of inappropriate antidiuretic hormone secretion (SIADH).

A 5-year-old girl presented with complaints of fever for 2 days, no documentation, no diurnal variation, not associated with chills and rigors. Complaints of seizure for 1 day, 3 episodes, in the form of tonic posturing of all 4 limbs lasting for approximately 2-3 minutes with up rolling of eyeballs with clenching of teeth without any urinary or stool incontinence followed by altered sensorium since then. The child was developmentally normal, with no history of ear discharge, fall, trauma, contact with tuberculosis, vomiting, loose stool, no history of seizure in the past. On the day of admission, the GCS was 12/15 (E4 V2 M6), tone was normal, deep tendon reflexes could not be elicited bilaterally, bilateral planter was flexor, pupils were normal reacting to light bilaterally and the fundus was normal, with no signs of meningeal irritation. Other systems were within normal limits. On 2nd day of admission, GCS of the child was 9/15 (E2V2M5). Patient had a bout of vomiting, nonprojectile, non-bilious, containing Ascaris worm 4 in number on 3rd day of admission. There was no improvement in sensorium. The patient was treated with pyrantel pamoate and showed a dramatic recovery within 72 hours of antihelminthic treatment.