Inhibition of leukocyte accumulation at the site of thrombosis with rPSGL-Ig may represent a safe therapeutic intervention that could be important in accelerating thrombolysis, achieving optimal reperfusion, and reducing incidence of acute reocclusion.

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

Background: Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP) for evaluation of neonatal sepsis in teaching hospital of central India. Method: 82 neonates with clinical suspicion of sepsis were prospectively studied over a 12 month period. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS. Results: Of 82 neonates studied, 67 (81.7%) had positive CRP while 58 (70.73%) had positive blood culture. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of CRP were 81.7%, 88.0%, 95.7%, 59.5% and 83.2%. respectively. Conclusion: The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value. It is a good diagnostic test and can identify the infection in neonates at the time of initial assessment.

Introduction: Group A hemolytic streptococcal infections have a worldwide distribution among children and it poses an important health problem globally. Group A streptococcal (GAS) serology is used for the diagnosis of post-streptococcal diseases, such as acute rheumatic fever, post-streptococcal Glomerulonephritis and occasionally for the diagnosis of streptococcal pharyngitis. Upper normal limits for streptococcal serology should be determined for individual populations because of differences in the epidemiology of GAS between populations. Material & Methods: Study materials were divided in 3 groups. Group-A (normal children population), group-B (children clinically diagnosed as acute bacterial sore throat) and group-C (children clinically diagnosed rheumatic fever). ASO titer & throat culture were assessed in all three groups. Result: When cut off range of ASO titer is >200 IU/ml, it is positive in 20%, 38% and 54.4% in Group A, B and C respectively. But When titer range increased to >400 IU/ml, it was positive in 40 %, 36.84% and 44.44% cases from Group A, B & C respectively. Conclusion: Cut off point of 200 IU/ml has limitations in our setup. Use of western cut off 200 IU/ml needs to be revised in relation to local epidemiology to get less false positive results.

Introduction: Tuberculosis as a disease is of great public health problem in developing countries like India. Children contribute a significant proportion of disease burden and suffer from severe form of disease, but because of difficulty in establishing an accurate diagnosis, data of disease burden in pediatric population is lacking. This study is an attempt to assess clinical profile of tuberculosis in children upto 5 years of age. Method: present study was conducted at Kamla Raja Hospital & Gajra Raja Medical College Gwalior over a period of six months. 77 cases up to 5 years of age were selected from inpatient department, who were diagnosed to have tuberculosis. A detailed history of epidemiological factors including past history of infectious disease, history of contact contributing to disease state was recorded on predesigned Performa. Complete clinical examination and laboratory investigation was done to confirm the diagnosis. Result: approximately 70 % of study group was distributed in 2-5 years of age group. Cases of CNS tuberculosis formed the main bulk to the study contributing 70.13% followed by intrathoracic (~16.88%), disseminated (6.49%), abdominal (5.19%) & lymphoid (1.29%) tuberculosis. Severe malnutrition, low socio economic status, illiteracy of parents were the important epidemiological factor affecting the disease status of child. Conclusion: childhood tuberculosis remained the neglected part in NTCP until RNTCP was introduced. Childhood cases have shown increasing trends with the advent of HIV infection. Prompt suspicion and early diagnosis can be an important step in controlling this epidemic.