Comparison of the frequency and complications of inappropriate antidiuretic hormone secretion in patients with septic and aseptic meningitis

Objective Due to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic memingitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006. Materials & Methods This descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information (age, gender, type of meningitis, serum sodium and potassium, urine specific gravity (USG), blood sugar, blood urea nitrogen, serum creatinin, hydration condition) was collected from patients' records. Datawas analyzed using Mann-Whitney and K2 tests. Results Out of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases (34.5) suffered from SIADH. It was more frequent among 1-2 year old children. According to this research, SIADH was diagnosed in 57 of the 121 patients with hyponatremia, 58.7 of the 167 patients with USG > 1.004, 74 of the 93 patients with serum osmolity < 280 mOs/L and 100 of the patients with BUN < 10 mg. Conclusion Due to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH

Predictive value of interleukin-6 (IL6) in term neonates with early sepsis during 2010-2011

Background: Neonatal sepsis is one of the main causes of neonatal mortality and morbidity. It breaks out in one to ten cases per 1000 live births with a mortality rate of 10 to 50 percent. However, the rate of hospital admission for neonates suspicious to systemic infections is more than that for neonates with sepsis which is due to the nonspecific signs and symptoms in the neonatal sepsis. Objectives: This study was conducted to measure interleukin 6 (IL-6) plasma level as a sign for early detection of neonatal infection. Materials and Methods: The level of plasma IL-6 and blood culture were checked in all the term neonates suspicious to sepsis admitted to the neonatal intensive care unit of Shahid Beheshti hospital of Kashan during 2010-2011. Positive blood culture was considered as definite sepsis and negative blood culture as suspicious sepsis. Then, the level of IL-6 was compared with the state of blood culture. Premature neonates with low APGAR score, ages more than seven days old, and history of previous admission were excluded from the study due to the probable effect on plasma IL-6 level. Results: Seventy four cases were male and 68 were female. The prevalence of early neonatal sepsis was reported to be 7. The etiologic bacterial agents were streptococcus in Group B (GBS) and staphylococcus Epidermis (SE). The most common symptom observable in the patients was respiratory distress (38.6). The average level of IL-6 was 1545.65 pg/mL for the first group (admitted with sepsis signs and symptoms and positive blood culture) and 14.79 pg/mL for the second one (admitted with sepsis signs and symptoms and negative blood culture), while in the control group, it was 11.04 pg/mL. Conclusions: A comparative test indicates that there is a significant difference between the levels of interleukin-6 in three groups (P value = 0.001). This result, not only omits all the probable confounding factors in plasma level of IL-6, but also emphasizes the role of this useful inflammatory marker in detection of neonatal sepsis. © 2013, Ahvaz Jundishapur University of Medical Sciences