Septicaemia is a major threat to survival during the early stages of life. There are several reports that suggest that reactive oxygen species (ROs) play a role in a wide variety of diseases. We estimated the activity of xanthine oxidase (XO), malondialdehyde (MDA) content, creatine phosphokinase (CPK) activity, activities of key enzymatic antioxidants, such as superoxide dismutase (SOD), glutathione peroxidase (GPx) and peroxidase (PO), and non-enzymatic antioxidants, viz. uric acid (UA) and albumin (ALB), in 30 neonates with sepsis and 20 age-matched controls. The babies were categorized as preterm/term, early onset/late onset, and shock/without shock, as per clinical and laboratory investigations. The study was carried out to evaluate the status of antioxidant enzymes and non-enzymatic antioxidants with a view to suggesting the introduction of antioxidant therapy in neonatal sepsis. The activities of serum XO, CPK, SOD and GPx, and the content of MDA were found to be significantly elevated in the neonates with sepsis when compared with controls. Conversely, the activity of PO and the levels of UA and ALB were decreased. The septic, full-term neonates registered significantly higher CPK activity (70%) than the preterm septic neonates. However, infants with late-onset and shock sepsis had a significant decrease in CPK activity (p < 0.05) compared with their corresponding sub-groups. Likewise, UA levels were found to be 28% depressed (p < 0.05) in the babies with late-onset sepsis and 51% increased (p < 0.001) in babies with shock compared with their respective sub-groups. Neonates with septic shock also registered a significant elevation in GPx activity (28%) compared with those without shock. This study suggests increased production of ROs in neonates with sepsis, as evidenced by the positive regulation of XO, SOD and GPx activity. The elevation of antioxidant enzymes, however, was not so effective as to protect from cellular damage and thereby result in higher MDA production. It is evident that antioxidant therapy might be useful in the management of neonates with sepsis but further detailed clinico-biochemical investigations are required to define effective antioxidant therapy.

Fifty mothers of hospitalized infants less than 4 months old with partial or complete lactation failure (LF) were randomly assigned to two groups of 25 each for relactation. Majority of enrolled mothers (86 per cent) had complete LF and 14 per cent had partial LF. Relactation was attempted in both the groups with motivation, support, and repeated suckling. Group II mothers, in addition, were given metoclopramide. The characteristics of mothers and babies, and socio-economic background were comparable in both groups (P > 0.05). The primary outcome variables measured included the time of appearance of first breast milk secretion (in complete LF), time for partial and complete relactation. Relactation attempt was successful in 49 mothers (98 per cent), with complete relactation in 46 (92 per cent) and only partial relactation in three mothers (6 per cent). Nipple confusion and frustration of the baby (4 per cent) in complete LF, small/retracted nipples (8 per cent), and sore/fissured nipples (4 per cent), which influenced the initiation of relactation, were overcome with drop and drip method, lact-aid support and proper positioning of the baby. All the outcome variables of the two groups were comparable (P > 0.05). The pattern of weight gain, the rate of reduction in the amount of top milk and subsequent weight gain in the follow-up was also comparable in both the groups (P > 0.05). Maternal factors like breast conditions, nutrition, parity, feeding practices in previous babies, lactation gap, and infants' initial refusal to suck at the breast did not influence the outcome variables as long as repeated suckling was ensured. We conclude that relactation is possible in most of the mothers without the help of lactagogues. Apart from educating and motivating the mother for exclusive breastfeeding during first 4-6 months, a strong professional support by a skilled health worker is needed to overcome the initial problems during relactation.

HighlightsCharacteristics of free and immobilized catalase.The kinetic parameters and stability of free and immobilized catalase were studied.FTIR spectra of free and immobilized catalase were studied.

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