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To determine the prevalence of short stature, delayed puberty, hypothyroidism, and diabetes mellitus in multiply transfused patients of beta thalassemia major and their correlation with serum ferritin. A descriptive observational study was conducted in a tertiary care center in Indore, Madhya Pradesh from 2014 to 2016. All children with thalassemia major of the age group 8 to 18 y attending outpatient department or admitted in ward were included in the study. Detailed clinical history, demographic data, compliance to transfusion and chelation therapy, and growth parameters were recorded. Blood samples to look for endocrinopathies and serum ferritin were assessed. Tanner staging was done to assess for delayed puberty. Mean age of study participants (n = 50) was 15.98 ± 3.4 y. Short stature (n = 44; 88%), delayed puberty (n = 33; 71.7%), hypothyroidism (n = 6; 16%), and diabetes mellitus (n = 5; 10%) were the endocrinal abnormalities found. Mean serum ferritin level was 3122 ± 2117 ng/mL. Serum ferritin had significant positive correlation with serum TSH (thyroid stimulating hormone), fasting blood sugars, postprandial blood sugar, and delayed puberty. Evaluation of endocrinopatines must be carried out in thalassemia major patients regularly by pediatricians to detect and treat endocrinal complications. Importance of chelation therapy must be emphasized frequently to parents and patients.

In the last few decades, staggeredly increasing human population, indiscriminate use of pesticides, polycyclic aromatic hydrocarbons, and discharge of effluents containing toxic heavy metals, dyes, etc. have negatively impacted the soil fertility and biodiversity to the extent of converting the agricultural land into barren land. These pollutants can be removed or altered by conventional and physical methods. However, these methods are neither cost-effective nor eco-friendly as they generate large amount of toxic intermediates. The most powerful eco-friendly approach is bioremediation. Microorganisms play a pivotal role in the maintenance and sustainability of any ecosystem. They are versatile and capable to adapt to any challenges posed by the environment. The biotic activities of a diverse group of bacterial populations residing in rhizosphere affect the dynamics of soil which in turn affect the crop productivity. They stimulate plant growth by making soil nutrients available to them, stimulating the production of various plant growth hormones, protecting the plants from pathogens by their antagonistic activity and remediation of the pollutants by sequestering toxic heavy metals, and degrading xenobiotic compounds such as pesticides, PAHs, etc. This chapter highlights the role of PGPR in remediation of heavy metal- and xenobiotic-contaminated soil for sustainable crop production.

The work presents microbial community structure of Gumki cave for bioactive compound production. This cave represents a unique atmosphere which is totally different from outer atmosphere. Total 49 isolates were recovered from cave samples. Morphological and biochemical characterization revealed a community that contains nine genera of bacteria: Bacillus (27%), Paenibacillus (21%), Staphylococcus (20%), Streptococcus (16%), Salimicrobium (8%), Lysisnibacillus (2%), Aeromonas (2%), Proteus (2%) and Clostridium (2%). All these microbes were screened for different enzyme production and about 90% isolates displayed positive results for these enzymes. 75.51% recovered isolates were lipase producers, 47% were producing amylase and 24% and 12% bacteria produced protease and cellulase, respectively.

Aim: To identify the common bacterial pathogens associated with neonatal sepsis and to study their systemic, focal, and hematological associates. Design: Retrospective hospital-based observational study. Setting: Level II neonatal intensive care unit. Subjects: Totally, 87 neonates with culture proven sepsis. Materials and Methods: Case records of admitted neonates (from January 2013 to December 2013) with culture-positive sepsis were reviewed. Data were collected in a predesigned proforma and analyzed for type of bacterial isolate, and clinical and hematological manifestations of sepsis. Results: Blood culture was positive in 36.8% (87/236) of the neonates with sepsis. Among the culture-positive cases, 58.62% (51/87) were male, and 51.72% (45/87) were preterm babies. Staphylococcus aureus was the most commonly isolated organism (51, 58.62% cases), followed by Klebsiella in 14 (16.09%), coagulase-negative Staphylococcus in 6 (6.89%), Acinetobacter species in 4 (4.59%), Escherichia coli in 4 (4.59%), Citrobacter freundii in 2 (2.29%), Pseudomonas aeruginosa in 2 (2.29%), and Candida species in 2 (2.29%) babies. Conclusions: S. aureus was the predominant pathogenic organism in both inborn and outborn babies while Klebsiella was the main culprit for causing sepsis in outborn babies. Key words: Clinical, Microbial, Neonate, Sepsis

Background Benign infantile seizures are a common form of idiopathic seizures in infants, but infrequently reported. Case characteristics Four cases identified over a 9-month period. Observation All had a cluster of focal seizures, normal development and no abnormality on hematological and biochemical work-up. Outcome No recurrence of seizures over a follow-up of 5 to 9 months. Message Identification of this syndrome has important therapeutic and prognostic implications.

Background: Kangaroo mother care (KMC) involves skin-to-skin positioning of the infant in an upright position against the mother’s chest. The two other components of KMC are frequent and exclusive breastfeeding (where possible) and early discharge from hospital. Aim of present study was to asses effect of kangaroo mother care on heart rate, respiration rate and temperature of low-birth weight preterm newborns admitted in a tertiary care centre of central India. Methods: Low birth weight babies (weighing 0.05) where as kangaroo care is highly effective in maintaining skin temperature (p

Background: Hyperbilirubinemia is a common problem and, in most cases, a benign problem in neonates. Jaundice is observed during the 1st week of life in approximately 60% of term infants and 80% of preterm infants.Methods: In present study, total 187 newborns were enrolled prospectively over one and half year of study period from November 2015 to April 2017. Detailed patient information was taken at the time of admission in NICU. In this study all the newborns with age less than 28 days were included who had clinical jaundice, ascertained by Kramer’s criteria and confirmed by biochemical methods. The investigations done were Serum bilirubin (total, direct and indirect) complete blood picture, reticulocyte count, G6-PD estimation (qualitative), Coombs' test, peripheral smear examination, blood group (ABO,Rh) of the mother and baby, CBC,CRP, thyroid function test.Results: Total 187 newborns were enrolled for study. Maximum number of the babies have a pathological jaundice 108 (57.7%) whereas 79 (42.24%) were found to have exaggerated physiological jaundice. The commonest causes of pathological jaundice were found to be septicemia 63 (33.68%) followed by ABO incompatibility 25 (13.36%). Most of the babies had onset of jaundice between 24-72 hours (86.6%).Conclusions: Health care providers working with neonates play a key role in identifying and assessing neonates at risk for pathologic jaundice. Parents counseling is required for bringing their babies early to healthcare centre preventing acute bilirubin encephalopathy and subsequent kernicterus.

Background: Worldwide approximately one million babies die per year due to asphyxia out of which about one third (approximately 3 lakhs) is contributed by our country. The objective of this study was to determine the requirement of respiratory support in newborn babies and their short-term outcomes. Methods: This retrospective observational study was conducted over one year at PCMS and RC Bhopal. Babies who were delivered in PCMS and required respiratory support at birth were enrolled in the study. The medical records of all these babies for resuscitation measures, requirement of respiratory support after hospitalization to the neonatal intensive care unit and their short-term outcome were recorded on a pre-designed study proforma . Results: During post-resuscitation care in neonatal intensive care unit, 55.5% (30/54) babies required respiratory support. Among them 7.4% (4/54) were supplemented with oxygen for a few hrs, 22.2% (12/54) required positive end expiratory pressure and put on high flow oxygen and air mixture for 24-48 hours. While 25.9% (14/54) newborns required mechanical ventilation for 3-7 days and then switched over to CPAP for the next 24-48 hrs. Out of 54 babies eight babies expired while ten babies went against medical advice. Remaining 36 babies were discharged, of which five babies developed hypoxic ishchaemic encephalopathy. Conclusions: It is evident from the present study that half of the resuscitated babies further required respiratory support in the NICU. We also concluded that three fourth of the newborns were discharged and had normal short term outcome.

Objective: To identify predictors of fatal outcome of severe malaria in children admitted to a tertiary care centre. Method: This retrospective study was performed at a tertiary health care institution which is a low transmission area of malaria. Confirmed malaria patients (P. falciparum, P. vivax or mixed infection) satisfying one or more of the 2010 WHO criteria for severe malaria were included in the study. Prevalence of fatal outcome due to major symptoms was calculated followed by univariate regression analysis to identify major predictors of fatal outcome. Results: A total of 102 children satisfied WHO criteria of severe malaria and were included in the study. Fatal outcome was seen in 14 children and girls (71.4%; 10/14) were more affected as compared to boys (p 7years) but this was not a predicting factor for fatal outcome (p>0.05). Fatal outcome was seen more in children with falciparum infestation (78.5%; 11/14) but this was insignificant (p>0.05). Univariate regression analysis identified impaired consciousness (p Conclusions: Impaired consciousness, shock, spontaneous bleeding, multisystem involvement, gastrointestinal dysfunction, renal failure and respiratory distress were predictors of fatal outcome of severe malaria in children admitted to the tertiary care centre. Sri Lanka Journal of Child Health , 2015; 44 (1): 17-23 DOI: http://dx.doi.org/10.4038/sljch.v44i1.7958