Anita Sharma

Nebulized salbutamol vs salbutamol and ipratropium combination in asthma.

Objective : To see the additional benefit of combined frequent nebulization with salbutamol and ipratropium bromide in acute attack of asthma with moderate severity.Methods : Fifty asthmatic children in the age range of 6–14 years were divided into two equal groups. Group I children were nebulized with three doses of Salbutamol alone (0.03 ml/kg/dose) and Group II children were given combined nebulization of Salbutamol (dose as in group I) and Ipratropium bromide (250 Μgm/dose for three doses) at 20 minutes interval. Children were observed at 15, 30, 60,120,180 and 240 minutes interval.Results : A significant improvement in % of PEFR starting at 30 minutes and lasting the entire study period of 4 hours was noted in both the groups. However on analysis of varience the results were better in group II.Conclusion : Frequent combined nebulization with Salbutamol and Ipratropium bromide is beneficial in acute asthma of moderate severity.

Evaluation of sepsis screen for diagnosis of neonatal septicemia

Fifty clinically suspected cases of neonatal septicemia were studied for evaluating the role of sepsis screen. Sensitivity and specificity of C-reactive protein test, micro-ESR, gastric aspirate cytology for polymorphs and toxic granules in neutrophils were studied singly and in combinations of two and three tests. Positive blood culture was obtained in only 20% cases, thereby underlying the need for a sepsis screen in the diagnosis of neonatal septicemia, especially in areas where adequate micro-biological facilities are lacking.

Lipid peroxidation in bronchial asthma

Objective: To study the levels of free oxygen radicals in children with bronchial asthma during an attack and symptom free interval.Methods: Serum Malondiadehyde (MDA) levels were studied in 25 children between the age of 6 years-14 years who presented with an acute attack of bronchial asthma. In each patient, serum MDA levels were measured at the time of admission, 24–48 hours after good response to treatment and after a symptom free interval of 3 weeks. Results were compared with control group.Results: In study group serum MDA levels were highest at the time of admission, which decreased significantly at 24–48 hours with treatment. After a 3 weeks symptom free interval serum MDA levels had decreased further but were still higher than healthy control group.Conclusion: Lipid peroxidation is increased in bronchial asthma during an acute attack and symptom free period.

Spontaneous gastric perforation in neonates

1. Khod AS, Thompson MH. Visceral leishmaniasis contracted in the Mediterranean area. Arch Dis Child 1983; 58 : 930-931. 2. Manson Bahr PEC, A,pted FLC. Mansons Tropical Diseases. 18th edition. London : Balliare Tindall. 1982 : 93-104. 3. Cachia EA, Fenech FF. A review of kalaazar in Malta from 1947 to 1962. Trans R Soc Trop Med Hyg 1964; 58 : 234-241. 4. Ozsoylu S, Hicsonmez G. Mediterranean leishmaniasis. Lancet 1980; i : 736. 5. Badoro R, Jones TC, Lorenco R et al. A prospective study of visceral leishmaniasis in an endemic area of Brasil. J Infect Dis 1986; 154 : 639-649. 6. Sidding M, Ghalib H, Shillington DC et al. Visceral leishmaniasis in Sudan : Clinical features. Trop Geogr Med 1990; 42 : 107112. 7. Berentsen S, Langholm R, Reitan O. Visceral leishrnaniasis (kala-azar). Tidsskr Nor Leasgeforen 1990; 110 : 3491-3493. 8. Hicsonmez G, Ozsoylu S. Kala-azar in childhood. A survey of clinical and laboratory findings and prognosis in 44 childhood cases. Clin Pediatr 1972; 11 : 465-467. 9. Hicsonmez G, Ozsoylu S. Studies of the anemia of kala-azar in 68 childhood cases. Specific antiparasitic chemotherapy is the most effective treatment. Clin Pediatr 1977; 16 : 733-736.

Subcutaneous epinephrine vs nebulized salbutamol in asthma.

Objective: This study was conducted to compare the efficacy of the subcutaneous epinephrine with nebulized salbutamol.Methods : Fifty asthmatic children in the age range of 6–14 years were divided into two equal groups. Group I children were given subcutaneous epinephrine and Group II were nebulized with salbutamol. Patients were observed at 15, 20, 30, 60, 120, 180 and 240 minute intervals. Both the groups had comparable mean increase in peak expiratory flow rate (PEFR %) (Group 127.7 ±0.7; Group II 28.8 ±0.06, p >0.05).Result : In Group I there was significant increase in systolic blood pressure, 30 minutes after the start of treatment, however it settled on its own by 60 minutes.Conclusion : Both the groups had satisfactory improvement in clinical parameters which continued upto 4 hours after start of treatment. Subcutaneous epinephrine can be safely used if nebulizers are not available.

Foreign Body Airway in Neonates

Two cases of foreign body in neonates less than one month of age are reported. Although foreign bodies in neonates are unknown but the possibility should not be overlooked even in neonates especially with sudden onset of respiratory distress, cough or hoarseness in absence of fever.

Neonatal adrenal hemorrhage with intraperitoneal spill managed conservatively

A neonate presented with anemia, hyperbilirubinemia and bilateral flank fullness at 23 days of age. Ultrasound abdomen showed bilateral adrenal hemorrhage with intraperitoneal extension on the left side. This was managed nonoperatively and the hematoma resolved completely. Literature regarding this rare entity is described.

Sociocultural and ethical dilemmas of genetic counseling—A suggested working approach

smear cultures. Unfortunately, a large number of paternity cases will require the need for prenatal diagnostic techniques, which places these patients back on the doorstep of a genetics center. As the desire for paternity testing continues to grow, it is imperative that we as a profession devise and implement clear policies and guidelines that ensure equitable services to all patients, without placing undue stress and legal consequence on the genetics professionals involved.

Mummified insect as foreign body in the respiratory tract

A case report of a child with a cockroach in bronchus is described.

Study of congenital duodenal obstruction

A study of 23 neonates with congenital duodenal obstruction is reported. Their mean gestational age was 38 weeks and mean weight was 2.2 kg. Main clinical features observed were vomiting (100%), which was bilious in 74%, and epigastric fullness with visible peristalsis (74%). Plain X-ray abdomen confirmed the diagnosis in 78%. Associated congenital malformations were seen in 39% of cases. Eleven babies had an intrinsic defect, 11 had extrinsic defect and one baby had combination of intrinsic and extrinsic defect. Malrotations along with band was seen in 39% of cases. Reported mortality was 39%.