Study of urinary uric acid and creatinine ratio as a marker of neonatal asphyxia for babies born in a tertiary care hospital

Background: Perinatal asphyxia is a common neonatal problem and there is significant contribution to neonatal morbidity and mortality. It is regarded as an important and common cause of preventable cerebral injury. The prediction of perinatal asphyxial outcome is important but formidable. There is only a limited role for the Apgar score for predicting the immediate outcome, such as HIE and the long-term neurological sequelae observational error can happen in APGAR. But biochemical parameters can be truly relied upon. This study was to evaluate the utility of urinary uric acid to creatinine ratio (UA/CR ratio) as non-invasive, easy, cheap and at the same time early biochemical means of asphyxia diagnosis.Methods: In this prospective case control study conducted in KAPV Government medical college between Feb 2017 to Sept 2017, 100 asphyxiated and 100 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for uric acid and creatinine estimation. Results were recorded, and statistical analysis was done.Results: The mean Uric acid/Creatinine ratio in the cases and controls groups were 2.58±1.09 and 0.86±0.17 respectively. The ratio also correlated well with the stage of HIE.Conclusions: The ratio of UA/Cr enables early and rapid recognition of asphyxial injury and also the assessment of its severity and the potential for short term morbidity or death

Trial of vitamin D supplementation to prevent asthma exacerbation in children

Background: To assess the level of vitamin D in children with bronchial asthma and to study the effects of vitamin D supplementation in asthmatic children who had vitamin D deficiency in terms of asthma control test score and Number of exacerbations.Methods: This interventional study was conducted in Department of Paediatrics, KAPV Government medical college, Trichy, Tamil Nadu, India from September 2016 to February 2017. 96 asthmatic children of age group 5-12 years who attended outpatient department and admitted in ward for asthma exacerbation were selected. After assessing their Vitamin D level, Vitamin D supplementation given along with standard treatment for asthma. Outcomes measured were ACTS (Asthma control test score), number of emergency room visits, number of hospital admissions and reliever medication use.Results: Out of 96 children, 83 (86.4%) children had vitamin D deficiency. There was significant correlation between vitamin D level and absolute eosinophil count (p-value-0.037), asthma severity (p-value<0.001) and asthma control (p-value<0.001). Significant reduction in emergency room visits, (p-value<0.001) reliever medication use (p-value<0.001) and improvement in asthma control test score (p-value-0.008) occurs after vitamin D supplementation.Conclusions: There is a significant correlation between vitamin D level, asthma severity and its control. Asthma exacerbation in terms of emergency room visits and reliever medication use were further reduced by vitamin D supplementation

Evaluation of cord bilirubin and hemoglobin analysis in predicting pathological jaundice in term babies at risk of ABO incompatibility

Background: Cord bilirubin and hemoglobin analysis helps not only in predicting the pathological jaundice in ABO incompatibility but also useful for early referral and intervention for better outcome. Aim of this study is to evaluate the cord blood bilirubin and hemoglobin analysis in predicting pathological hyperbilirubinemia in newborn at risk of ABO incompatibility.Methods: In this descriptive study conducted in Government Stanley medical college between January 2016-June 2016, A positive or B positive babies born to O positive mothers with birth weight >2.5 kgs and gestational age >37 weeks were included. A total of 191 babies were studied. Cord bilirubin, reticulocyte count, hemoglobin and fourth day bilirubin were evaluated and data was analysed using Pearson’s Chi square and ANOVA.Results: Out of 191 babies, 25 (13%) did not develop any jaundice, 122 (64%) developed physiological jaundice and 44 (23%) had pathological jaundice. The mean cord bilirubin and cord hemoglobin values of newborn who did not develop jaundice were 1.35mg/dl and 15.3g/dl while the values among pathological jaundice were 3.15mg/dl and 14.97g/dl. Conclusions: Babies with cord bilirubin >1.8mg/dl and hemoglobin <15.1gm/dl are more prone for pathological hyperbilirubinemia