Hypernatremia and excessive weight loss in exclusively breastfed term infants in early neonatal period

Introduction: Newborn infants lose weight in the first week of life. There is an increasing recognition of hypernatremia and it’s complications in exclusively breastfed newborns. Early recognition of critical weight loss, signs, and symptoms of dehydration and hypernatremia are keys to prevent morbidity and mortality in these neonates. Objectives: To identify term neonates with excessive weight loss >10% of birth weight and to compare their serum sodium levels with levels in babies with weight loss <10% of birth weight. Materials and Methods: A prospective observational study was conducted on healthy full-term exclusively breastfed newborns delivered in a rural tertiary hospital. The primary outcome was the proportion of newborn infants with loss >10% of birth weight at day 5 and serum sodium levels in these babies. Results: Weight loss >10% of the birth weight was seen in 6.22% of term babies. The mean weight loss in this group was 360.14±81.82 g in comparison to 141.32±67.78 g in rest of the babies. Serum sodium >149 meq/L was seen in three neonates in excess weight loss group, i.e., 1.33% of neonates in the study. The mean serum sodium was higher in babies with excess weight loss (141.71±4.39 vs. 139.74±2.32 mEq/L, p=0.0045). Conclusion: About 6.22% of exclusively breastfed term neonates had excessive weight loss and serum sodium levels were higher in these babies with than those with weight loss <10% of birth weight. Neonates with excessive weight loss need more cautious follow-up for early recognition of potential hypernatremia and its complications

Chemical and structural changes of pretreated empty fruit bunch (EFB) in ionic liquid-cellulase compatible system for fermentability to bioethanol

The pretreatment of empty fruit bunch (EFB) was conducted using an integrated system of IL and cellulases (IL-E), with simultaneous fermentation in one vessel. The cellulase mixture (PKC-Cel) was derived from Trichoderma reesei by solid-state fermentation. Choline acetate [Cho]OAc was utilized for the pretreatment due to its biocompatibility and biodegradability. The treated EFB and its hydrolysate were characterized by the Fourier transform infrared spectroscopy, scanning electron microscopy, and chemical analysis. The results showed that there were significant structural changes in EFB after the treatment in IL-E system. The sugar yield after enzymatic hydrolysis by the PKC-Cel was increased from 0.058 g/g of EFB in the crude sample (untreated) to 0.283 and 0.62 ± 06 g/g in IL-E system after 24 and 48 h of treatment, respectively. The EFB hydrolysate showed the eligibility for ethanol production without any supplements where ethanol yield was 0.275 g ethanol/g EFB in the presence of the IL, while lower yield obtained without IL-pretreatment. Moreover, it was demonstrated that furfural and phenolic compounds were not at the level of suppressing the fermentation process

Clinical features and bacteriological profile of late onset sepsis

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is associated with community environment or postnatal exposure to hospital environment. It's incidence is rising due to greater survival of preterm neonates and very low birth weight babies. The bacterial isolates of neonatal sepsis especially that in LOS are changing. An understanding of the changing epidemiology of neonatal LOS will help to reduce the associated mortality and morbidity. The objective was to study the clinical symptoms and signs of late onset sepsis, to study the bacteriological profile of LOS.Methods: A prospective observational study. All neonates presenting with signs and symptoms of sepsis after 72 hours of life up to day 28 were included. Babies with birth asphyxia and congenital anomalies were excluded from the study.Results: A total of 120 newborns with LOS were included in the study. Of this 42.5% had blood culture positive sepsis. Lethargy, refusal of feeds and apnoea were seen in 61.66%, 55.0% and 34.17% of babies respectively. Klebsiella (25.49%), Staphylococcus aureus (23.53%) and coagulase negative Staphylococcus (21.57%) were the predominant organisms isolated in LOS.Conclusions: Prompt diagnosis of neonatal sepsis is a challenge. The incidence of LOS in neonates is rising. Klebsiella is the most common gram negative organism; Staphylococcus aureus and CONS are the predominant gram positive organisms. CONS is emerging as an important causative organism in LOS.</jats:p