Altered resistin and IL6 in Neonatal sepsis in patients admitted in a tertiary care teaching hospital at Eastern India

Background: Neonatal sepsis is a clinical syndrome followed by bacteraemia in the first month of life and appears to be one of the primary causes of mortality and morbidity worldwide. The study aim was to detect the levels of resistin, IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease. Materials & Methods: The case control study consists of 78 neonates of whom 42 were clinically suspected case of sepsis admitted in NICU of Paediatric department and were taken as cases and 36 were normal healthy neonates taken as control subjects in a tertiary care teaching hospital, Durgapur, West Bengal. The cases as well as controls were within 28 days of age. Preterm and term neonates (< 28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. Two ml of blood was collected without anticoagulant and serum was separated by centrifugation at 3500 rpm for 15-20 mins and was used for measurement of hs-CRP, resistin and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL-6 and Resistin were measured by immunoassay Kits (Raybiotech, USA). Results: Serum resistin levels were increased in sepsis cases as compared to controls and were statistically significant (38.96 ± 17.15 vs 15.49 ± 8.54 ng/ml; p < 0.0001). It was also observed that serum IL 6 levels were higher in sepsis cases as compared to controls which was statistically significant (58.19 ± 39.97 versus 8.48 ± 3.90 pg/ml; P < 0.0001). However, a weak positive correlation was observed between serum resistin with serum IL 6 level (r = 0.343; P = 0.025) among neonatal sepsis subjects while no correlation was seen in controls (r = 0.141; P = 0.411). Conclusion: The measurement of these sepsis markers is extremely important only in case of neonates with unclear infectious status. We have observed a significant rise in Resistin or IL 6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis.  The combination of Resistin or IL 6 or CRP or hs-CRP could therefore be crucial for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease. Keywords: Preterm neonates, neonatal sepsis, mortality and morbidity, serum resistin, interleukin-6 (IL-6), hs-CR

Resilient flood loss response systems for vulnerable populations in Mumbai: a neglected alternative

This dissertation examines different methods of sharing and redistributing flood losses borne by poor populations in Mumbai, India. It focuses on practices that are adopted to shift losses between economic classes and within specific populations at risk. It also develops a basis of knowledge about the impact of globalization on the vulnerability of poor communities in cities and calls for the development of hazard mitigation and economic assistance devices that can be applied at the micro level with a view to becoming sustainable means of reducing the burden of risks. Multiple levels of analysis are employed. Information from interviews and discussions with government officials, and other influential informants in community development and planning organizations is combined with documentary evidence, to explain the nature of socio-economic and environmental challenges experienced by different groups. This sets the context for two in-depth surveys of fifty households each in slum settlements that are severely affected by flooding. Data collected include the extent and impacts of flooding, formal (official) mitigation methods employed and the range of informal support systems used by individual families to recover from the consequence s of floods. Results show that local loss redistribution systems are extremely diverse but significantly effective in addressing important concerns about survival that are overlooked in public policy measures. Most are not integrated into the systems of flood hazard mitigation employed by public agencies and other institutions. Household vulnerability fluctuates over time and with different stages of the hazard cycle (preparedness-recovery-reconstruction). The loss redistribution systems are strongly shaped by inherent social characteristics of local communities and changing economic factors of affected households. In conclusion the results argue that though marginalized informal population in third world cities are affected by downward pressures of ongoing socio-economic and environmental processes at different levels of society, using the same processes they sometimes develop the capability to acquire networks of support that increase the range of their alternatives of environment risk reduction. Suggestions for improving public policy in light of these findings are included.Ph.D.Includes bibliographical referencesIncludes vitaby Monalisa Chatterje