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Background: Hypertensive disorders during pregnancy pose significant risks to both maternal and fetal health. Maternal hypertension has the potential to affect all the systems of the newborn, including the hematological system. Objective: To identify deviations in hematological parameters and birth outcomes in babies born to mothers with hypertensive disorders of pregnancy. Materials and Methods: An observational case–control study was carried out on neonates born to hypertensive mothers in Niloufer Hospital, Hyderabad, India. The study was done over 18-month period from January 2021 to August 2022. The cases comprised babies born to mothers with hypertensive disorders of pregnancy, while controls were babies of normotensive mothers. The hematological parameters measured included hemoglobin (Hb) level, platelet count, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and white blood cell (WBC) count. Results: The neonates of hypertensive mothers had significantly lower levels of Hb (P = 0.02), WBC (P = 0.001), MCH (P = 0.01), and MCHC (P = 0.004). Also, platelet counts were significantly lower among neonates of hypertensive mothers (P = 0.001). They also had significantly lower birth weights than the controls (P = 0.01). Conclusion: This study pinpointed substantial changes in the hematological profile and birth outcomes of neonates born to mothers with hypertensive disorder of pregnancy. These findings underscored the importance of considering these alterations when interpreting hematological values in these infants, necessitating early detection and comprehensive healthcare strategies for neonates at high risk in India. Future research should consider the long-term outcomes of these hematological parameters to elevate the understanding and guide interventions.

Background and Objective: Niemann-Pick type C is a rare lysosomal storage disorder causing cholesterol intracellular transport deficiency. Typically found in children, it causes neurological deterioration and age-related symptoms. In this article, two cases of Niemann-Pick type C1 with cholestasis and another case with a compound heterozygous mutation that included Niemann-Pick type D are presented. Although neonatal diseases are the most common cause of early cholestasis, this report emphasizes the importance of considering storage disease in cholestasis. Case Report: A 34-day-old female baby born to a third-degree married couple at 38 weeks gestation presented with cholestatic jaundice. Whole-exome sequencing suggested an NPC1 gene mutation and Niemann-Pick type C. A 35-day-old female baby born at 39 weeks gestation presented with ecchymotic patches, decreased feed acceptance, greenish discoloration of the eyes, high-color urine, and firm hepatosplenomegaly. The child was worked up for conjugated hyperbilirubinemia and a liver biopsy in favor of Niemann-Pick disease. Whole exome sequencing showed an NPC1 gene heterozygous mutation, suggesting Niemann-Pick disease types C and D. Conclusion: Pediatricians should consider Niemann-Pick disease in neonates with persistent cholestasis. [ABSTRACT FROM AUTHOR]

Background and Objective: Previously, the coincidence of two different disease phenotypes in a single patient was considered to be a new phenotype or a phenotypic extension of a single known disease. However, with the advent of whole exome sequencing, it has become clear that in many cases it is a new phenotype or phenotypic extension. This case report represents a blended phenotype of Marfan and Larsen syndrome. Up to the time of reporting this case, we could not find a similar case in the sources. Case Report: A full-term male infant delivered vaginally by a primi-mother in a non-consanguineous marriage was transferred to the intensive care unit because of respiratory distress, meningomyelocele and dysmorphism. On clinical examination, the baby had a heart murmur. The baby required oxygen support but no pressure. We slowly weaned off oxygen and gradually started feeding. An ultrasound and echocardiography were performed to rule out malformations. Using molecular and next-generation exome sequencing techniques, the infant was found to have heterozygous variations of the FBN1 gene c.6094A>T p. Thr2032Ser (depth -36x), a novel variant, and the FLNB gene c.2956C>Tp.Arg986Trp (depth -48x), suggesting for neonatal Marfan syndrome (nMFS) and Larsen syndrome phenotype, which was compatible with the phenotypic findings of the neonate. Unfortunately, the infant died because of sepsis and aspiration. Conclusion: In extremely rare cases, there may be more than one syndrome. Under these circumstances, the prognosis is grim, as usual. When the syndromic phenotype varies, advanced genetic testing is preferred. [ABSTRACT FROM AUTHOR]

Introduction: On March, 2020, the World Health Organisation (WHO) declared COVID-19 a pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In adults it causes mild to severe infections, but in children it usually causes asymptomatic or mild illness. Being a new pandemic, it is prudent to analyse the clinical profile, laboratory parameters and severity interpreters in children to formulate optimal management protocols. Aim: To determine the clinical and laboratory profile of children hospitalised for Severe Acute Respiratory Infections (SARI) and to evaluate the correlation between clinical severity and laboratory parameters-C-Reactive Protein (CRP), Neutrophil to Lymphocyte Ratio (NLR) and thrombocytopenia. Materials and Methods: The present study was a prospective observational study which was undertaken for the duration of seven months from 1st April to 30th November 2020. The study included children aged 1 month to 12 years with the criteria of SARI and who were Coronavirus Disease-2019 (COVID-19) positive. Test parameters such as Complete Blood Count (CBC), CRP, serum electrolytes and kidney function tests were performed at local laboratory as per standard guidelines. The correlation of laboratory parameters (thrombocytopenia, CRP and NLR) with disease severity was done with Pearson's Rho correlation coefficient. Chi-square test was used for statistical analysis. Results: A total of 118 (10.2%) children were tested positive for COVID-19, 71 (60.17%) were boys and 47 (39.83%) were girls. The commonest clinical symptoms were fever and tachypnea. Gastrointestinal symptoms were found in 54 (45.76%) of the cases. Myocarditis and shock were noticed in 10 (8.47%) children. In 25 (59.52%) of severe COVID-19 cases, NLR was >3.5 and 18 (42.86%) had thrombocytopenia. Seventeen children died of the disease with a mortality rate of 14.41%. Platelet count and NLR ratios were significantly correlated with disease severity (p≤0.05). Conclusion: Markers such as NLR and thrombocytopenia which can be used efficiently to assess the severity even in low resource settings, are relevant to a developing country like India. The ratio of neutrophils to lymphocytes can be used as a prognostic marker in resource-constrained settings. [ABSTRACT FROM AUTHOR]

Background:Dengue is a febrile illness that is a major cause of morbidity and mortality throughout the tropical and subtropical regions. Vitamin D3 was also reported to influence the ex-pression of DENV receptors in immune cells. Few studies have also discussed the role of Vitamin D in reducing the severity of Dengue fever.Material and Methods:The study was conducted at Niloufer hospital, Hyderabad. A Cross-sectional study from November 2019-november 2021.Data were analyzed using Microsoft Excel 2010 and Epi Info 7.2.0.Results:The overall mean of Serum Vitamin D level was 18.58 ng/ml. The mean of Serum Vit-amin D level was 20.38 ng/ml, 16.92 ng/ml. 11 ng/ml, as per increasing severity. With a P-value of 0.0000005, the difference between the mean of Serum Vitamin D levels according to the grading of Dengue Fever was statistically significant.Conclusion:As serum Vitamin D levels decreased, dengue illness severity increased, and the associ-ation between the two was statistically significant. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of therapeutic hypothermia on myocardial dysfunction in term neonates with perinatal asphyxia.Material and Methods: This randomized controlled trial (RCT) conducted in a tertiary care teaching hospital, south India included 120 newborns with perinatal asphyxia that were randomized to two groups (therapeutic hypothermia and normothermia). Cardiac enzyme profile changes between groups were assessed at 0, 24, 72 h CPK-MB and troponin I levels were estimated by immune inhibition and quantitative immunochromatography methods, respectively. Electrocardiography (ECG) and Echocardiography (ECHO) were done at 0 and 72 h to evaluate the cardiac function and pulmonary hypertension. Neurodevelopment was assessed at 6 months of age in both groups using Developmental Assessment Scales for Indian Infants.Results: The median values of CPK-MB in the normothermia and hypothermia groups at 0, 24, and 72 h were 198, 127, and 92 IU/L and 202, 111 and 64 IU/L, respectively. The median values of troponin I in normothermia and hypothermia groups at 0, 24, and 72 hrs were 2.45, 1.53, and 0.9 ng/mL and 1.97, 0.93, and 0.01 ng/mL, respectively. ECG and ECHO findings also suggest lesser myocardial dysfunction in therapeutic hypothermia group compared with the normothermia group.Conclusions: Therapeutic hypothermia significantly decreases the myocardial damage in term asphyxiated neonates. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotropic medications. This study aims to compare SD in patients using antipsychotics and antidepressants., Objective: To evaluate the prevalence of SD and its effect on the quality of life among psychiatric patients on medications., Methods: A cross-sectional study had been conducted with 150 participants (50 with schizophrenia, 50 with affective disorders, and 50 controls). SD was evaluated employing the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) and the Arizona Sexual Experience Scale (ASEX). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was used to measure the quality of life. Data analysis techniques included Spearman's correlation test, one-way ANOVA, chi-square test, and descriptive statistics., Results: SD prevalence was 42% in affective disorders, 64% in schizophrenia, and 18% in controls. SD significantly correlated with a longer duration of psychotropic use and negatively impacted quality of life., Conclusion: SD is prevalent among psychiatric patients on long-term medication, highlighting the need for strategies to manage these side effects., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, Osmania Medical College, Hyderabad issued approval ECR/300/AP/2023/RR-16, dated January 5, 2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Damam et al.)

In newborns, especially premature babies, there is a high association between thrombocytopenia and bleeding, particularly intraventricular hemorrhage, which may be due to immaturity. It was usual clinical practice that neonates should be transfused with higher platelet counts than older children or adults to reduce their risk of bleeding. However, after keen observations, we noticed that bleeding and mortality were more common in newborns who received more platelet transfusions. The mechanisms underlying the adverse effects of platelet transfusions in neonates may be due to higher antigenicity and immunological factors. We know that neonatal platelets are hyporeactive; this hyporeactivity is balanced by factors in the neonatal blood that promote coagulation, such as increased hematocrit, von Willebrand factor, and fibrinogen, which, on balance, leads to normal primary neonatal hemostasis. Platelets are very similar to adults in number, but functional capabilities were less, and for the reasons mentioned above, particularly bleeding time was short. Theologically, neonatal platelet lifespan was high to compensate for less production. We started this review because we observed that many babies were not having bleeding symptoms in some instances of severe thrombocytopenia. Many well-active babies are receiving unnecessary transfusions, as human blood is precious, and many young neonatologists are going on protocol-based excessive transfusions. This stimulated us to write a review., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kamsetti et al.)

This systematic review analyzes the research evidence on the psychosocial risks faced by graduates of Neonatal Intensive Care Units (NICUs) during childhood. NICUs hold enormous value in uniting preterm or critically ill infants and their families; however, excess NICU exposure affects infants in numerous negative psychosocial ways. Developmental, behavioral, emotional, and social issues faced by NICU graduates are the focus of this systematic review, which aims to summarize the available evidence from published literature. It points to the incidence of such problems and how they emerged, and it insists on the importance of early detection, complex interference, and constant assistance to children and their families dealing with such issues. The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to assess methodological quality and includes data from various electronic databases. This review emphasizes the concurrent applications of family-centered care, early neurodevelopmental screens, and specialized intervention strategies and also, explains the different types of childhood psychosocial problems in NICU graduates., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gajula et al.)

This study explores the role of room humidity levels in the neonate intensive care unit (NICU) and how they impact their growth and development in this fragile stage. The study considers seven relevant studies that have explored this factor in different settings. Humidity's role in developing neonatal conditions, such as respiratory distress and fungal infections, is also elaborated on. For the literature review, the study utilized PubMed, Embase, and Scopus databases to guarantee comprehensive findings on the role of NICU room humidity on neonates. By examining these studies' evidence, the research highlights the paramount need to ensure that the room has adequate moisture, as exposure to less desirable humidity levels increases mortality and the severity of morbidity rates among neonates. The fact that the majority of NICUs lack humidity control, which is required, stimulated us to conduct this review., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Urakura et al.)

The management of preterm newborns must consider the severe problem of retinopathy of prematurity (ROP). A systematic review has been conducted to effectively acknowledge how enteral and parenteral early nutrition affect the growth and progression of ROP. The study summarizes recent findings from various sources to give insight into the relationship between dietary practices and ROP risks. When untreated, retinopathy of prematurity (ROP) may cause severe vision loss or blindness in premature newborns. The latter two phases of ROP progression are the most serious. A child's early nutrition, both orally and intravenously, significantly impacts the severity and progression of ROP. This systematic review aims to examine the evidence linking early nutrition to ROP in premature infants. The study used Embase, Scopus, and PubMed to conduct our search. ROP, premature newborns, and nutrition were keywords used to find relevant papers. Nine research studies made it through the screening process and offered important information on the impact of diet on ROP. These studies support the idea that poor nutrition is a driving force behind the onset of ROP. The risk of ROP has been associated with postnatal development, hyperglycemia, polyunsaturated fatty acid levels, and the presence of breast milk. The outlook for ROP has also been discovered to be affected by the length of time the patient has received parenteral feeding. The incidence and severity of ROP may be mitigated by providing better nutrition to premature newborns. This comprehensive study concludes that early nutrition, both enteral and parenteral, substantially influences the development and progression of ROP in premature newborns. The significance of nutrition in newborn care is highlighted by the possibility that improved dietary methods might aid in preventing and treating this vision-threatening illness., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mandala et al.)

Pneumoperitoneum is typically caused by breached hollow viscera and necessitates surgical intervention. This may have various etiologies, including spontaneous, necrotizing enterocolitis (NEC), and obstruction. In these cases, spontaneous intestinal perforation (SIP) is a unique clinical entity with a better outcome than newborns with NEC-related intestinal perforation. Here, we present a rare case of SIP manifested in the form of pneumoperitoneum in the first eight hours of life, emphasizing the importance of differentiation between NEC and SIP, as each condition has variable treatment options and outcome considerations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Harsha et al.)