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Introduction: Hypernatremic dehydration is commonly found in the first week of neonatal life. Hypernatremia develops when water loss exceeds sodium loss, as in lactational failure with inadequate breastfeeding, or when sodium intake exceeds water intake disproportionately (salt poisoning), such as when neonates receive concentrated formula or top milk. The common presentations include lethargy, irritability, poor feeding, dehydration, reduced urinary frequency, significant weight loss, and fever. Aim: The aim of this study was to investigate the clinico-etiological profile and outcome of hypernatremic dehydration in term neonates admitted to the Neonatal Intensive Care Unit (NICU) at a tertiary care centre. Additionally, the study aimed to examine the factors contributing to hypernatremic dehydration. Materials and Methods: This prospective cohort study was conducted at the NICU, Department of Paediatrics, of Geetanjali Medical College, Udaipur, Rajasthan, India from February 2021 to July 2022. A total of 51 term neonates with a history of inadequate breastfeeding, maternal history of lactational failure, significant weight loss (>10% weight loss within a short period of time), or dehydration fever, along with hypernatremia (serum sodium > 145 mEq/L), were enrolled in the study. Data regarding serum sodium level, serum bilirubin level, Kidney Function Test (KFT), Ultrasonography of Kidney, Ureters and Bladder (USG KUB), and neuroimaging were collected for all study subjects and statistically analysed using the Chi-square test. Results: A total of 51 neonates were admitted to the NICU during the study period, with a mean age of 6.05±2.2 days (range 0-15 days) and a mean birth weight of 2810 grams. The study showed that the mean weight (in %) loss was 13.75±4.1 (range 10.1-21%). The study also revealed that 64.7% of the mothers of neonates experienced lactational failure, with a p-value

Background: Increased clustering of metabolic risk factors has been demonstrated in patients with hypopituitarism on standard replacement therapy. This usually has been attributed to persistent growth hormone deficiency, though contribution from underlying etiology of hypopituitarism cannot be underestimated. We, therefore, studied conventional metabolic risk factors and pro inflammatory markers in a cohort of hypopituitary patients in whom the etiology was Sheehan's syndrome. Material & Methods: We studied 30 GH naive patients with Sheehan's syndrome (SS) on standard replacement therapy and compared with healthy age, BMI and parity matched controls. All subjects were normotensive, non-diabetic, non-smokers and none had history of any acute or chronic illness. We recorded height, weight, BMI, waist circumference and waist hip ratio, besides measuring biochemical parameters like lipid profile, fasting plasma glucose and insulin, sVCAM-1, ICAM-1 and hsCRP. Results: Metabolic syndrome and impaired glucose tolerance were more common with SS patients. Similarly total cholesterol (mean ± SD, 5.21 ± 0.98 vs 4.57 ± 0.88, P = 0.00), LDL-cholesterol (3.15 ± 0.90 vs 2.67 ± 0.75, P = 0.02), triglycerides (2.14 ± 1.00 vs 1.43 ± 0.45, P = 0.00) and pro-inflammatory markers i.e. hsCRP (3.95 ± 2.58 vs 1.45 ± 2.77, P = 0.00) were significantly higher in patients with SS. hsCRP positively correlated with fasting insulin ( r = 0.40, P = 0.02), HOMA-IR ( r = 0.38, P = 0.03) and negatively with HDL ( r = − 0.33, P = 0.05). Conclusions: GH naïve SS patients on standard replacement therapy have increased clustering of metabolic and pro-inflammatory risk factors. [ABSTRACT FROM AUTHOR]

Natural processes do not always function perfectly. In breastfeeding, problems are encountered in up to 80% of mother-infant dyads. Altogether, in Western societies, the difficulties reduce the breastfeeding rate within the first months drastically. To deal with the problems of breastfeeding efficiently requires a profound understanding of its physiology, as well as of its psychological and social determinants. This review focuses on the current knowledge of breastfeeding physiology, only touching the psychosocial factors, which are included in the promotion strategies. Subsequently, it scrutinizes definitions, incidences, prevention, and treatment of breastfeeding problems faced most frequently by nursing mothers and their consultants. Not all measures used in counseling mothers and not all treatments for the most common medical problems withstand a careful evaluation on the basis of current scientific data. However, applying proven prevention strategies will significantly improve the well being of mothers and their infants, and may contribute to an affective attitude that increases the success, frequency, and duration of breastfeeding. [ABSTRACT FROM AUTHOR]

Risk factors for lactational failure in puerperium were investigated. Sixty mothers with inadequate daily milk supply for their babies were the lactational failure group, and 60 mothers with similar age having babies with similar age and weight were chosen as the control group. Low prolactin levels, low serum iron and low serum ferritin levels and low aldosterone values and birth in community hospitals were associated with significantly increased risk of deficient lactation. High income of the family, increase osmolality of breastmilk, high systolic blood pressure of the mother, birth by cesarean section were some of the variables that increased the risk that could not reach the level of significance. Prematurity of the baby was not among the risk factors if the gestational ages were more than 30 weeks. It is concluded that physicians awareness of the factors that may adversely effect the initiation and continuation of lactation is vital. Correcting iron deficiency even if it is not overt, sparing more time for the mothers discussing the benefits of breastmilk to their babies, and avoiding cesarean section if possible may help increase the incidence of breastmilk feeding. [ABSTRACT FROM AUTHOR]