Search

Objective There is no established diagnostic test available to diagnose neonatal sepsis. Tumor necrosis factor a (TNFα), interleukin 1b (IL1β) and interleukin 6 (IL6) showed some promising results in some recent studies in this respect, but their roles in diagnosis and prognosis of neonatal sepsis are not yet conclusive. In this study, we have tried to identify diagnostic and prognostic ability of these biomarkers in neonatal sepsis. Methods In this cross-sectional study, blood sample for 3 cytokines were collected at diagnosis of neonatal sepsis fulfilling diagnostic criteria by purposive sampling and values were compared with normal healthy newborns. Each of the cytokines was evaluated separately to identify, whether they can detect neonatal sepsis with at least 70% sensitivity and specificity. At the same time, their prognostic values were also evaluated in terms of disease severity and mortality. Results Among twenty normal newborns, standard deviation values of TNFα, IL1β and IL6 were 39.7±21.5 pg/ml, 34.6±20.9 pg/ml and 44.4±33.0 pg/ml, respectively. In sepsis group (n=40), these values were 69.6±26.0 pg/ml, 57.7±29.0 pg/ml and 204.6±169.2 pg/ml, respectively. All these differences were statistically significant (p

Background and objectives The Score for Neonatal Acute Physiology II with Perinatal Extension (SNAPPE-II) is a vital tool for prognostication in newborns. The study was conducted with the hypothesis that the performance of the SNAPPE-II score might be affected by the presence of sepsis in newborns admitted with possible early onset septicemia and whether score performance varies between culture positive and culture negative sepsis. Methods The prospective observational study was conducted over a period of 1 year (January 2014 to January 2015) in neonates presenting with clinical suspicion of sepsis to the Sick Newborn Care Unit (SNCU) of a tertiary care hospital in Eastern India. Results SNAPPE-II score cut-off of ≥20 offered the highest sensitivity of 74.5% with specificity 48.3%, PPV 27.6% and NPV 87.7%. Comparison of mortality proportions between the two subgroups defined by this cut-off returned p= 0.005 with OR 3.47 (95% 1.40 to 8.64). No significant association was found between SNAPPE-II score and blood culture results; mean scores for culture positive (25.16 ± 15.6) and negative groups (24.49 ± 15.6) were comparable (p= 0.920). Conclusions At a cut-off value of ≥20 in presence of sepsis, SNAPPE-II score offers acceptable indices to predict mortality outcome. Prediction of outcome by SNAPPE-II score is not affected by positive or negative blood culture sepsis.

// Arijit Bhowmik 1 , Sayak Chakravarti 1, * , Aparajita Ghosh 2, * , Rajni Shaw 1, * , Suman Bhandary 2 , Satyaranjan Bhattacharyya 3 , Parimal C. Sen 2 and Mrinal K. Ghosh 1 1 Signal Transduction in Cancer and Stem Cells Laboratory, Translational Research Unit of Excellence (TRUE), Division of Cancer Biology and Inflammatory Disorder, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology (CSIR-IICB), Kolkata 700091, India 2 Division of Molecular Medicine, Bose Institute, Centenary Campus, Kolkata 700054, India 3 Division of Surface Physics, Saha Institute of Nuclear Physics, Kolkata 700064, India * These authors have contributed equally to this work Correspondence to: Mrinal K. Ghosh, email: mrinal.res@gmail.com Keywords: glioma, blood brain barrier, 3,3’-diindolylmethane encapsulated nanoparticle, somatostatin receptor 2 peptide, epidermal growth factor receptor Received: November 22, 2016 Accepted: May 22, 2017 Published: June 27, 2017 ABSTRACT Current therapy for Glioblastoma is insufficient because of the presence of blood brain barrier. It limits the transport of essential drugs to the tumor sites. To overcome this limitation we strategized the delivery of an anticancer compound 3,3’-diindolylmethane by encapsulation in poly (lactic-co-glycolic acid) nanoparticles. These nanoparticles were tagged with a novel peptide against somatostatin receptor 2 (SSTR2), a potential target in glioma. The nanoformulation (27-87nm) had loading and encapsulation efficiency of 7.2% and 70% respectively. It was successfully internalized inside the glioma cells resulting in apoptosis. Furthermore, an in vivo bio-distribution study revealed the selective accumulation of the nanoformulation into rat brain tumor sites by crossing the blood brain barrier. This resulted in abrogation of epidermal growth factor receptor pathway activation in glioma cells. Our novel nanopreparation therefore shows great promise to serve as a template for targeted delivery of other therapeutics in treating GBM.

To generate data of electrocardiogram (ECG) parameters according to gestational age in Indian newborns. An observational study was carried out over 7 months in neonatology unit of a tertiary care teaching hospital. Following auscultation, ECG parameters were recorded simultaneously in 12 leads, on third day of life, in hemodynamically stable neonates. Data from 364 babies were analyzed, keeping at least 30 records for each gestational age between 30 to 42 weeks. There was no difference in mean heart rate recorded through auscultation and ECG traces. The mean (SD) values recorded were: P wave duration 0.04 (0.01) s, P wave amplitude 1.3 (0.4) mm, T wave duration 0.07 (0.02) s, T wave amplitude 1.1 (0.6) mm, PR interval 0.09 (0.02) s, QRS duration 0.04 (0.01) s, QT interval 0.26 (0.02) s, QTc 0.4 (0.03) s and QRS axis 127 (22) degree. Gestation age-wise percentile charts of different ECG parameters were generated. These gestational age-wise percentile charts of different ECG parameters for Indian newborns can be used as reference for neonatal ECG.

Glioma and cerebral ischemic stroke are two major events that lead to patient death worldwide. Although these conditions have different physiological incidences, ~10% of ischemic stroke patients develop cerebral cancer, especially glioma, in the postischemic stages. Additionally, the high proliferation, venous thrombosis and hypercoagulability of the glioma mass increase the significant risk of thromboembolism, including ischemic stroke. Surprisingly, these events share several common pathways, viz. hypoxia, cerebral inflammation, angiogenesis, etc., but the proper mechanism behind this co-occurrence has yet to be discovered. The hypercoagulability and presence of the D-dimer level in stroke are different in cancer patients than in the noncancerous population. Other factors such as atherosclerosis and coagulopathy involved in the pathogenesis of stroke are partially responsible for cancer, and the reverse is also partially true. Based on clinical and neurosurgical experience, the neuronal structures and functions in the brain and spine are observed to change after a progressive attack of ischemia that leads to hypoxia and atrophy. The major population of cancer cells cannot survive in an adverse ischemic environment that excludes cancer stem cells (CSCs). Cancer cells in stroke patients have already metastasized, but early-stage cancer patients also suffer stroke for multiple reasons. Therefore, stroke is an early manifestation of cancer. Stroke and cancer share many factors that result in an increased risk of stroke in cancer patients, and vice-versa. The intricate mechanisms for stroke with and without cancer are different. This review summarizes the current clinical reports, pathophysiology, probable causes of co-occurrence, prognoses, and treatment possibilities.

Background: Perinatal asphyxia is a significant cause of neonatal mortality and morbidity. MRI is useful for assessing the severity and pattern of brain injuries. There is less data of MRI findings of perinatal asphyxia from India and the subcontinents. This prospective observational study was done to describe MRI brain findings in neonates with perinatal asphyxia with respect to various determinants.Methods: Initial MRI brain was done when babies were stable after fulfilling inclusion criteria. Immediate outcome was assessed at the end of hospital stay. They were followed up for presence of any sequel up to 1 year. Repeat MRI brain was done in few selected babies. Data was collected and statistically analyzed.Results: Total 55 babies were included in the study (term 27, preterm 28). There were 9 babies in stage 1, 17 babies in stage II and 22 babies in stage III. MRI brain findings were normal in 8 and abnormal in 47 patients. There were Deep gray matter injury (DG) in 22, Para Sagittal subcortical white matter injury (PS) in 6, Germinal matrix haemorrage (GMH), intraventricular haemorrage (IVH) and Periventricular leucomalacia (PVL) in 12 and Mixed pattern of injury in 7 babies. Findings among 9 expired babies were: 4 (44.4%) DG, 2 (22.2%) GMH+IVH and 3 (33.3%) mixed. There was neurological sequel in 13 babies (48.1%). Babies with normal MRI initially had no sequel.Conclusion: Brain injury due to perinatal asphyxia follows several patterns according to gestational age and severity. Early and accurate recognition of these patterns with the help of MRI brain helps in managing the baby and predicting the prognosis.

 A 9.5-year-old boy from Kolkata, presented to pediatric outpatient department with severe headache and mild fever of one month duration. Headache was bilateral, persistent and associated with neck pain. There were no visual disturbances or any ear discharge. Fever was continuous in nature and gradually increasing in intensity. There was no associated cough, respiratory distress, dysuria, abdominal pain, joint pain or joint swelling, myalgia, convulsion, altered sensorium. His sister was suffering from active pulmonary tuberculosis and she was on antituberculosis drugs for last 2 months. On examination, pulse was 88/min, blood pressure 116/84 mmHg. Temperature was mildly elevated (38.3oC). Patient had no hepatosplenomegaly, no sternal tenderness, and no lymphadenopathy. Sensorium was normal. Neck rigidity was absent. Neither sign of raised intracranial tension nor cranial nerve palsy were noted. Ophthalmoscopic examination was normal. Planter reflex bilaterally flexor. Power and tone in all four limbs were normal. On laboratory examination, hemoglobin 14.2 g/dL, total count 9400/mm 3 (neutrophil 62%, lymphocyte 24%, eosinophil 12%). Liver function tests, urea, creatinine were within normal range. Routine urine examination was normal. Blood and urine culture showed no growth. Malarial dual antigen

Urinoma (or perirenal uriniferous pseudo cyst) occurs due to extravasation of urine in the perirenal space. Common causes include traumatic renal injury or an obstruction in the outflow tract as in a posterior urethral valve. Though rare, such diagnosis should be considered in neonates presenting with expanding cystic masses in the abdomen. Here, we present a case of a four-day-old neonate, who presented to us with abdominal distension and bilious vomiting. The initial radiographic studies showed a cystic mass surrounding the right kidney. Urine was aspirated from the mass and Micturating Cysto-Urethrogram (MCU) showed the presence of a Posterior Urethral Valve (PUV). A diagnosis of urinoma secondary to PUV was confirmed. After relieving the obstruction by vesicostomy, symptoms of intestinal obstruction resolved. On later follow up, size of urinoma also gradually decreased. This proves that not every case of a distended abdomen and bilious vomiting in a neonate, necessarily points towards Necrotising Enterocolitis (NEC) or intestinal obstruction.

Genetic variations in cancer cells are the underpinning for the development of resistance and failure of the treatment by current anticancer drugs. Thus, an ideal drug must overcome failure of treatment and prevents development of drug resistance. There are a wide variety of emerging, easy to prepare and cost effective group of drugs that are collectively called peptoids or peptidomimetics. These new set of drugs exhibit distinct features including protease resistance, are non-immunogenic, do not hinder functionality and backbone polarity, and can adopt different conformations. These drugs have shown promise as diagnostic and therapeutic tools in a wide variety of diseases. Here, we discuss the recent advancement in the design and synthesis of peptoids and use of these drugs in the diganosis and treatment of a wide number of cancers of the lung, prostate, and breast.

Background: Kangaroo mother care (KMC) is an effective way to reduce mortality and morbidity of low-birth-weight babies. KMC feeding aims at the establishment of exclusive breastfeeding (EBF) for every baby. This study was conducted to analyze the actual feeding pattern and factors influencing it. Methods: Babies getting KMC were prospectively observed and the data related to feeding practice were collected. At discharge, the babies were divided into two groups: EBF and non-EBF. Different factors were compared between these groups. Results: Among 387 babies, 63.56% were on EBF. Postnatal counseling, early contact and initiation of feeding, early expression of breast milk, and first feeding with EBM played a pivotal role behind the establishment of EBF (P

Brain tumors are one of the most formidable diseases of mankind. They have only a fair to poor prognosis and high relapse rate. One of the major causes of extreme difficulty in brain tumor treatment is the presence of blood brain barrier (BBB). BBB comprises different molecular components and transport systems, which in turn create efflux machinery or hindrance for the entry of several drugs in brain. Thus, along with the conventional techniques, successful modification of drug delivery and novel therapeutic strategies are needed to overcome this obstacle for treatment of brain tumors. In this review, we have elucidated some critical insights into the composition and function of BBB and along with it we have discussed the effective methods for delivery of drugs to the brain and therapeutic strategies overcoming the barrier.

Prolonged neonatal jaundice has been previously reported in neonates with congenital hypothyroidism. Isolated central hypothyroidism is a rare disease which may be missed by newborn screening programs. Here, we report a case of isolated central hypothyroidism presenting with neonatal hyperbilirubinemia, anemia, and hepatosplenomegaly, which showed marked improvement with levothyroxine supplementation.

Systemic Lupus Erythematosus (SLE) may have different neurological manifestations. Mononerits multiplex is the most common type of peripheral nervous system involvement in adult population, but case reports in pediatric population are sparse. We are reporting a case of pediatric SLE, presenting with polyarthritis and subsequently developing mononeuritis multiplex, identified by NCV.