Shanti Ghosh

Hepatic dysfunction in childhood malaria.

Hepatic function of 80 children aged under 3 years with Plasmodium vivax malaria were studied during the acute attack and 6 weeks after antimalarial treatment. Raised levels of serum aspartate transaminase (serum AST; SGOT), serum alanine transaminase (serum ALT; SGPT), and alkaline phosphatase were observed in 68%, 39% and 46% of cases respectively. AST levels were higher than ALT ones and the mean level of both enzymes was much higher in patients with hepatomegaly. The hepatic dysfunction which these observations reflect is transient, as these enzymes were found to be at their normal levels 6 weeks after treatment. A transient derangement of liver function is thus a common feature of childhood malaria, and hepatic dysfunction takes place to a significant degree even in P. vivax malaria.

Perinatal mortality—report of a hospital based study

The perinatal mortality rate (PNMR) per 1000 births is reported in 27,394 consecutive births. It was 75.6, of which 40.0 were neonatal deaths and 35.6 were fetal losses. The PNMR was significantly higher at the two extremes of maternal age, in parity five and above, and with a previous history of fetal or neonatal loss. Other maternal contributing factors were antepartum haemorrhage, hydramnios and infections. One-third of the babies weighed 2500 g or less. The PNMR dropped precipitously from 340.48 in the birth weight group 1501 to 2000 g, to 46.6 in the group 2001 to 2500 g, indicating a cut-off point at 2000 g for a baby at high risk needing special care. The common necropsy causes of death were asphyxia (24.33%), pulmonary conditions (20.02%), congenital malformations (13.6%), and infections (6.19%). No cause of death could be detected at necropsy in 22.12% and no clinico-pathological cause of death could be assigned in 26.76% of deaths. A majority of deaths due to asphyxia could have been prevented by better antenatal and intranatal care. Low birth weight was an important cause of perinatal deaths, and better maternal nutrition and antenatal care could play an important role in reducing this.

Growth monitoring - Lessons from India

Growth monitoring of individuals and growth surveillance of populations are 2 very different tools and need to be distinguished from one another. Individual monitoring is an invaluable tool for the detection of early undernourishment, since malnutrition is not readily visible without an objective measurement. It is important to catch malnutrition at an early stage and to prevent further harm. It is also important for the mothers to understand the value of growth monitoring and of nutrition. In the 70s, the Safdarjung Hospital in New Delhi followed the weights and illnesses of children under 5. Currently, there are a few programs in India which utilize growth monitoring: The Integrated Child Development Services (ICDS); the Tamil Nadu Integrated Nutrition Project (TINP), and the Child in Need Institute (CINI). Successful growth monitoring must include a growth card, comprehension of the growth card by the mother, an active and motivated health worker, weighing scales that are accurate, durable, and easy to repair, adequate training for the health workers, supportive and educative supervision, back-up health care support, and active community participation.

Maternal Nutrition and Fetal Growth Retardation

This paper reports on the association of maternal nutrition and other factors with the length of gestation and the intrauterine growth of the offspring. 122 mothers with almost similar poor socioeconomic background reliable menstrual history and with newborns of clinically consistant gestational age were investigated to determine the influence of maternal nutrition on fetal growth retardation. The maternal height weight and hemoglobin did not show any significant differences in mothers of the 3 groups of preterm term small for date and term normal infants. The maternal serum albumin levels were low in preterm and small for date as compared to normal infants but the differences were statistically significant only between small for date and normal infants. The results suggest the possible role of poor maternal nutrition in causation of fetal growth retardation. (authors modified)

Child mortality differentials : census of India, 1981

A detailed study of this data is essential for everyone interested in child health. There are vast variations related to socio-economic, cultural and behavioural differences, as well as the levels of development, literacy etc. An understanding of these is necessary if any dent is to made in child mortality. the sex-differential too in something we have to worry about. The solution lies in alleviating socio-cultural and behaviour patterns, which lower the status of a girl child, and put less value on her. For detailed information please refer to Census of India 1981, Occasional papers no. 5, of 1988. Child Mortality Estimates of India, Office of the Registrar General, India.

Congenital afibrinogenemia: Report of a case

SummaryA 11/2-year-old female child with bleeding from the umbilical stump at birth and repeated episodes of hemorrhages was investigated. The hematological investigations confirmed the diagnosis of congenital afibrinogenemia and both parents showed low levels of fibrinogen.

Relationship of chloramphenicol therapy with typhoid relapse

SummaryChloramphenicol in therapeutic doses did not inhibit the rise in Widal titres in normal children receiving T.A.B. vaccine. The Widal titres were depressedin vitro when higher concentrations were used.197 cases of typhoid fever were studied during 1964–67. A relapse rate of 10.6% was observed. The incidence of relapse was lower when total therapy was given for at least 2 weeks or continued for 7 or more afebrile days.