Study of risk factors, clinical profile, and outcome in meconium-stained deliveries

Background: The presence of meconium in amniotic fluid is a serious sign of fetal distress which leads to an increase in neonatal mortality. Objective: The objective of this study was to study the risk factors, clinical profile, and outcome of babies born through meconium-stained fluid. Materials and Methods: This prospective observational study was conducted during the period from February 2018 to October 2018 at neonatal unit of a tertiary care hospital. All live babies delivered through meconium-stained liquor were included in this study. Routine investigations such as complete blood count and C-reactive protein were done in all the patients. All the variables were analyzed with the help of the Chi-square test and Fisher’s exact test. Results: A total of 606 meconium-stained amniotic fluid (MSAF) babies were included in the study. Most of the MSAF babies were term, appropriate for gestational age babies. The number of babies delivered through the lower segment cesarean section was 61.7%. Fetal distress was present in 23.2% of the cases. Otherwise, the most common risk factor associated with MSAF was pre-eclampsia (5.9%). A total of 58.2% of babies developed respiratory distress after birth; other morbidities associated were convulsion, hypoxic-ischemic encephalopathy, sepsis, shock, hypoglycemia, and hyperbilirubinemia. In the present study, total mortality in MSAF babies was 12%. Babies who expired had severe meconium aspiration syndrome. Duration of hospital stay was <7 days in 83.9% of the neonates, of which 14% expired and 85% were discharged. All the mortalities in our study except one occurred within 7 days of life. Conclusion: MSAF is associated with significant morbidity and mortality in neonates. Mortality was more in non-vigorous babies and in those who developed severe meconium aspiration syndrome and pulmonary hypertension of the newborn. Other morbidities did not have a strong association with MSAF

Study of clinical profile of childhood extra pulmonary tuberculosis

Background: Tuberculosis is the second most common cause of death from infectious disease at the global level, being second only to AIDS. Good data on the burden of all forms of TB amongst children in India is not available; most surveys conducted have focused on pulmonary TB. The present study was designed to study clinical profile of various forms of childhood EPTB. Objective of current study was to study clinico-epidemiological profile of various forms of childhood EPTB.Methods: Retrospective analysis of clinical profile of 100 patients of childhood EPTB in the age group of 6 months to 12 years.Results: Age distribution in our study showed that 62% cases falling in the age 0-5 years and 38% cases in 5-12 years (P = 0.041) with male to female ratio of 1.9:1. 96% (P = 0.016) of the patients belonged to the lower socio-economic class (P = 0.01). The distribution of EPTB was - TBME (46%), disseminated TB (21%), pleural effusion (12%), abdominal TB (10%), TB lymphadenitis (7%), Osteoarticular (4%). 28% of the patients had mild to moderate malnutrition (PEM Grade-I,II)  and 46% (PEM Grade-III,IV) were severely malnourished. 66% of the patient were BCG vaccinated & history of  Koch’s contact were present in 28% of the all cases. In CNS tuberculosis, fever was present in 97% followed by altered sensorium & convulsion in 80%, tonic posturing in 60% & abnormal movements in 4% and in most common sign was tonic posturing in 60%, crack pot sign positive in 41%. In abdominal tuberculosis - fever (100%), anorexia (90%), weight loss (80%) abdominal pain (50%) & hepatomegaly was common finding seen in 100% of abdominal tuberculosis.Conclusion: Childhood EPTB is commonly seen in children age more than 1 year, lower socioeconomic class & in severely malnourished. CNS tuberculosis commonly present with fever, altered sensorium, convulsion, abnormal movements while abdominal TB present with fever, anorexia, weight loss & abdominal pain

Unique features of a global human ectoparasite identified through sequencing of the bed bug genome

The bed bug, Cimex lectularius, has re-established itself as a ubiquitous human ectoparasite throughout much of the world during the past two decades. This global resurgence is likely linked to increased international travel and commerce in addition to widespread insecticide resistance. Analyses of the C. lectularius sequenced genome (650 Mb) and 14,220 predicted protein-coding genes provide a comprehensive representation of genes that are linked to traumatic insemination, a reduced chemosensory repertoire of genes related to obligate hematophagy, host-symbiont interactions, and several mechanisms of insecticide resistance. In addition, we document the presence of multiple putative lateral gene transfer events. Genome sequencing and annotation establish a solid foundation for future research on mechanisms of insecticide resistance, human-bed bug and symbiont-bed bug associations, and unique features of bed bug biology that contribute to the unprecedented success of C. lectularius as a human ectoparasite