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Introduction: Early diagnosis of neonatal sepsis and appropriate management can prevent permanent disability and death. The knowledge of the nurses regarding sepsis and their ability to detect early cues and actions taken on suspicion of sepsis are of paramount importance in this respect. Objective:To assess knowledge regarding neonatal sepsis among nursing officers caring for neonates at Sri Jayewardenepura General Hospital (SJGH). Method:A descriptive cross-sectional study was done recruiting nurses from the neonatal intensive care unit (NICU), post-natal wards, paediatric ward and the labour ward of SJGH. Data were collected through an interviewer administered questionnaire and analysed using SPSS. Results: Eighty one nursing officers from the above mentioned units participated in the study. Of the nurses, 72.8% had an overall good knowledge on neonatal sepsis and the rest (27.2%) had a satisfactory knowledge. Ninety five percent of nurses had good or satisfactory knowledge about what neonatal sepsis meant. All participants knew bacteria as a causative organism of neonatal sepsis. Regarding the knowledge on risk factors, majority (80.2%) had a satisfactory or greater knowledge, while the knowledge was unsatisfactory in 19.8%. Of the nurses, 85.5% knew what actions to take upon identification of neonatal sepsis. All the nurses with a working experience less than 1 year, 87.5% of BSc degree holding nurses and 71.2% of nurses with NTS training had a good knowledge. The authors declare that there are no conflicts of interest Personal funding was used for the project. Open Access Article published under the Creative Commons Attribution CC-BY License Conclusions: Seventy three percent of the nurses had an overall good knowledge on neonatal sepsis and the rest had a satisfactory knowledge. Knowledge deficiencies were identified regarding risk factors of neonatal sepsis, initial action upon identification of sepsis and the cues in identifying sepsis. No significant association was found between the knowledge on neonatal sepsis and the institute of training or duration of exposure. However, some degree of association was tracked between the unit of work and knowledge on sepsis. DOI: http://dx.doi.org/10.4038/sljch.v48i4.8825 (

Background Van Wyk-Grumbach syndrome refers to the development of isosexual precocious pseudopuberty and multicystic enlarged ovaries in the presence of hypothyroidism and delayed bone age. It is a rare presentation of untreated hypothyroidism. The prepubertal response in Van Wyk-Grumbach syndrome is always isosexual and mediated by very high thyroid-stimulating hormone levels acting through the follicle-stimulating hormone receptors inducing a follicle-stimulating hormonal effect. Early recognition and thyroid hormone replacement can completely regress precocious puberty and ovarian enlargement, while improving the final height achievement. Oligosyndactly is a congenital bony abnormality and can manifest either as an isolated malformation or as a component of a syndromic diagnosis. However, development of hypothyroidism in children with this peculiar bony deformity has rarely been described in the medical literature, with the exception of Cenani-Lenz Syndactyly syndrome. Case presentation We report the case of a 6-year-old Sri Lankan girl who presented with a 2-day history of vaginal bleeding and exertional dyspnea. She had marked short stature (well below −3 standard deviations) with an upper segment to lower segment ratio of 1.47. This girl had isolated breast development of Tanner stage 2. She was diagnosed to have acquired hypothyroidism secondary to autoimmune thyroiditis and also had macrocytic anemia, pericardial effusion, gonadotropin-releasing hormone-independent precocious puberty with radiological evidence of pubertal changes in the uterus, and multicystic ovaries. Interestingly, she also had post-axial oligosyndactyly in both feet and right-sided clubfoot. The diagnosis of Van Wyk-Grumbach syndrome was made based on the clinical and laboratory features. Her symptoms were successfully managed with L-thyroxine therapy. Conclusions Acquired hypothyroidism is a relatively common endocrine disorder among children and early recognition is important to prevent serious complications like Van Wyk-Grumbach syndrome. Sexual precocity with delayed bone age and stunting should direct our minds toward this unique diagnosis. It is always necessary to identify the other associated anomalies in addition to the primary diagnosis since these features may direct to a syndromic diagnosis.

Objective: To evaluate the trends, age at death, causes and birth weights of neonatal deaths from 2008 to 2017 in a tertiary care centre in Sri Lanka. Method:All neonatal deaths from 2008 to 2017 were included in the analysis.Results: During this 10-year period, there have been 181 neonatal deaths. Male deaths (54.1%, n=98) outnumbered female deaths. Majority (62.9%) were early neonatal deaths and 45.6% of them had died within the first 24 hours of birth. The leading causes of deaths were extreme prematurity (46.4%), congenital malformations, neonatal respiratory distress syndrome, birth asphyxia and septicaemia. Low birth weight was a significant risk factor for the increased neonatal mortality.Conclusions: Perinatal mortality rate (PNMR) showed a downward trend except in the last two years of the study period. The neonatal mortality rate (NMR) is lower than the national figures and is well below the global and south Asian figures. Majority (63%) were early neonatal deaths with 45.6% dying within first 24 hours of birth. Leading causes of deaths were extreme prematurity, congenital malformations, respiratory distress syndrome, birth asphyxia and septicaemia.

Introduction: Respiratory distress (RD) is a leading cause of admission of all gestational ages to neonatal intensive care units. RD develops in 7% neonates and causes significant morbidity and mortality. The aetiology of RD could be respiratory and nonrespiratory and the presence of some risk factors may predict the development of RD. Newborns with RD are at 2-4 times higher risk of death.Objectives: To determine the incidence and aetiology of RD and to identify risk factors and adverse outcomes of RD in term neonates. Method:A descriptive cross-sectional study was conducted at Sri Jayewardenepura General Hospital for a period of eighteen-months, including 105 term newborns with RD, defined by the Silverman score of more than 3. Statistical analysis was done with the SPSS beta version. Results:The incidence of RD with Silverman score of more than 3 was 2.2%. Aetiologies of RD in decreasing order of frequency were congenital pneumonia, transient tachypnoea of the newborn (TTN), early-onset sepsis (EOS) without pneumonia, respiratory distress syndrome (RDS), meconium aspiration syndrome, persistent pulmonary hypertension of the newborn and critical congenital heart disease. There were significant associations between prolonged rupture of membranes (PROM), 3 or more vaginal examinations, congenital pneumonia and EOS. Caesarean delivery increased the risk of developing TTN and RDS. There were 4 neonatal deaths and 2 _________________________________________ 1