INTRODUCTION:Neonatal mortality is increasingly recognized as an important global public health challenge. The spectrum of organisms that cause neonatal sepsis changes over time and varies from region to another. This study was conducted to determine the profile, antibiotic sensitivity pattern of bacterial isolates and outcome of confirmed neonatal sepsis in a tertiary care center. STUDY DESIGN: All blood culture reports (n = 285), obtained during the study period (January 2012-September 2012) from the neonatal intensive care unit were analyzed. RESULTS: Blood culture positivity rate was 22.1% (67/285). Seventy-three percent babies were outborn. Sixty-two percent babies were preterm and 80% were low birth weight. Thirty-six (57%) babies had early onset and remaining 27 (43%) had late onset neonatal sepsis. Blood culture isolates included Gram-negative bacilli (38/67, 56.7%), Gram-positive cocci (20/67, 29.8%), and Candida species (9/67, 13.4%). Staphylococci and Klebsiellae were the most common organisms responsible for infections, accounting for 25.4% (17/67) and 19.4% (13/67) of the isolates, respectively. All Gram positive isolates were sensitive to vancomycin, while 50-65% Gram negative isolates were sensitive to amikacin, ciprofloxacin and meropenem. Fifty-eight percent babies were discharged after completion of the antibiotic therapy, while 28.6% babies expired. CONCLUSION: Multidrug resistant Gram negative isolates pose serious challenge, particularly in setting of emerging resistance to fluoroquinolones and carbepenems.

BACKGROUND/AIMS: Birth asphyxia occurs when a baby does not receive enough oxygen before, during or after birth . It is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and /or a lack of perfusion (ischemia) to various organs . Fetus totally depends for its oxygen supply and other nutrients on the blood supplied through placenta. In any case, if blood supplied through placenta is hampered, it leads to asphyxial injury. We performed this study to determine the incidence of liver failure in birth asphyxia and to correlate the severity of hepatic disorder with asphyxia by estimating serum AST and ALT. MATERIAL AND METHODS: The study included 70 asphyxiated neonates and 50 healthy neonates as controls. Serum AST and ALT were estimated by IFCC method for Aspartate aminotransferase and IFCC method for Alanine aminotransferase respectively. RESULT: Serum AST and ALT were found significantly higher in asphyxiated babies compared to control groups (p<0.001). The mean AST and ALT of asphyxiated babies were 80.3±47.4 U/L and 88.8±43.5 U/L, respectively and those of normal babies were 20.5±8.5 U/L and 27.5±8.5 U/L respectively. The rise of AST and ALT also showed a significant positive correlation with the severity of asphyxia. Hence it can be concluded from present study that estimation of hepatic enzymes can be used as markers to diagnose the incidence of perinatal asphyxia and also to assess its severity.

Sturge–Weber syndrome (SWS) is a rare, sporadically occurring neurocutaneous disorder with a frequency of approximately 1 per 50,000. The hallmark is an intracranial leptomeningeal vascular angioma in association with a port wine nevus, usually involving ophthalmic or maxillary distribution of trigeminal nerve. Other clinical findings associated with SWS are seizures, glaucoma, hemiparesis and mental retardation. The radiological hallmark is “Tram-line” or “Gyri-form” calcification. 25 to 56% of patients experience recurrent episodes of paroxysmal focal neurological deficits in form of transient hemiparesis, which may be due to vascular ischemia or postictal in origin. EEG helps to differentiate the exact etiology, as it is normal in former. Aspirin prophylaxis in those, due to ischemia decreases their recurrences and improves overall neurological prognosis. We report a 25-month-old child of SWS with recurrent episodes of transient hemiparesis and atypical midline location of facial vascular nevus.

BACKGROUND Neonatal transport is the most important component of regionalized perinatal health care system, but still there are no legal regulations on regionalized perinatal care and transport of sick new-borns in our country. Although hospital-based deliveries have increased, level I & II centers still have extremely limited resources. The need for the systematic transport from these far situated, level I & II centers with inadequate staffing and equipment, indicates the need for better regionalization with special care newborn units at district level. The present study was done to assess the effect of available Neonatal Transport System on morbidity and mortality of out born neonates; including modes, organized transport, special needs and care during transport. MATERIALS AND METHODS In this prospective observational study, we included all neonates (from birth to 28 days of life) born outside SAIMS hospital and referred to SAIMS, Neonatal Intensive Care Unit (NICU) for tertiary care centre for a period of one year. Cases who were found to be dead at the time of arrival to the institute were excluded from the study. RESULTS We observed that immediate and long-term outcome varies with the place of delivery, mode of transport, travelling distance and initial stabilization of the baby. We also found that biochemical and temperature disturbances are more common in babies transported on their own and a specialized neonatal transport service could improve the survival of these new-borns. CONCLUSION All Neonatal health care facilities should have some basic referral guidelines so that events like hypothermia, hypoglycaemia and hypoxia can be prevented.

Background: Globally, in 2015, 1 million children died on first day of their life. The neonatal mortality rate is declining less rapidly than the mortality rate for children between 1month and 5 years of age. Thus, contribution of the neonatal mortality to the under-five deaths is increasing. Usually as average income of a country increases, it leads to decline in child mortality yet some countries in the fast lane for global economic growth such as India have been in the slower lane for child mortality reduction.Methods: This study was conducted at Sri Aurobindo Medical College and PG Institute, Indore from October 2015 to March 2017 for period of 18 months. Total of 800 live new-borns were included in this study by simple random technique. The statistical analysis of data was done using SPSS for Windows (Version 20.0) software. The correlation of gestational age with new-born foot length and new-born chest circumference was analysed by applying correlation and regression analysis.Results: Foot length is significantly correlated with both gestational age and birth weight with p value of < 0.05 and highly positive correlation coefficient. Chest circumference is significantly correlated with both gestational age and birth weight with p value of < 0.05 and highly positive correlation coefficient.Conclusions: This study tried to identify anthropometric parameter (foot length and chest circumference) which allows for rapid evaluation of the infant for gestational age and provide at risk infants with timely care.