RH Gobbur

Abstract

Background: Deficiency of iron affects multiple organ systems, and poor neurodevelopment is the most worrisome effect. Low birth weight neonates are more likely to develop iron deficiency anemia than term counterparts. The guidelines for supplementation of iron in LBW neonates are poorly defined with varying recommendations pertaining to the intiation. Hence this study focuses on the effect of early iron supplementation and iron store status in them. Materials and Methods: In this randomized open label interventional study, 48 LBW neonates (EI group) were administered iron supplementation (at 2 weeks or earlier when full feeds were achieved), and other 48 were controls. All neonates were assessed for hemoglobin level, RBC count and iron status indicators (Hematocrit, Serum Ferritin) at or after 6 weeks of postnatal age. Results: The post-intervention values of mean haemoglobin (cases 12.68±1.51g/dl, Controls – 11.38 ± 1.03g/dl), mean serum ferritin (cases: 238.45 ng/ml, CONTROLS- 175.68 ng/ml), mean RBC count (cases: 3.94 million/mm, and mean hematocrit (cases: 33.16±3.75%, controls 34.04±3.45%)were noted, and the % change at 6 weeks follow up in mean Hb among - 25.19%, 31.45% (0.01); % change in mean ferritin at follow up: cases 15.13%, controls 32.99% (0.001); % change in mean RBC count at follow up: cases 19.21%, 33.82% (0.001)] when compared to pre- inetervention values was noted. Though the haematological parameters decreased in both groups, the levels were comparatively higher in the cases compared to the controls, and iron store status was better in early iron-supplemented infants. Conclusion: Iron supplementation in LBW neonates started as early as 2 weeks postnataly, improves the iron stores and decreases the risk of iron deficiency in these infants.   Keywords: Iron Deficiency, Early Iron supplementation, LBW, Preterm

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Abstract

Otogenic tetanus is a subtype of cephalic tetanus, limited to the head & neck, but can progress to a more generalized form. Caused by the spore-forming bacillus, Clostridium tetani, It produces a potent toxin, tetanospasmin, preventing inhibitory neurotransmitters' release, hence causing rigidity.   Keywords: Tetanus, Tetanus immunoglobulin, Toxoid, trismus.

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Abstract

Erythema Multiforme is an acute inflammatory muco-cutaneous hypersensitive reaction with varied aetiology and various degrees of blistering and ulceration. Viral aetiology is most common. We report a case of herpes induced Erythema Multiforme who was managed with acyclovir. The 11 year old boy presented with pain and ulceration over his lips, target shaped lesions on palms and fever. The episode was not drug related. The presentation suggested Herpes associated Erythema Multiforme which was confirmed by Serology positive for Herpes simplex virus. The patient was treated with acyclovir for 7 days and his illness subsided. The early suspicion and initiation of treatment is necessary in management of this life threatening mucocutaneous disorder. Keywords: Herpes simplex, Erythema Multiforme, target lesions, acyclovir

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Abstract

Objective: This study compares the efficacy of levetiracetam with phenobarbital in early onset seizures in term, late preterm neonates. Design: Prospective randomized, open label comparative study. Setting: study was carried out in tertiary care teaching hospital of south India. Participants: 78 terms, and late preterm neonates admitted in NICU with neonatal seizures. Intervention: Neonates with seizures, were randomized into 2 groups to receive levetiracetam or phenobarbital as 1st line anti consultant in each group. Results: As 1st line anti epileptic drug (AED) levetiracetam (LEV) was effective in 16 patients (41%), and phenobarbital was effective in19 patients (48.7%), where P value was not significant. But mortality was more in phenobarbital group with death of 10 patients (25.6%), and in LEV group death was only in 3 patients (7.7%) statistically significant (P value of 0.033). Conclusion: levetiracetam and phenobarbital attained seizure control in less than 50% patients, both were equally effective, levetiracetam as 1st line anticonvulsant in early neonatal seizures leads to early seizure control and less mortality than use of phenobarbital. Keywords: Levetiracetam, Neonatal Seizures.

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