الملخص
Objective: To study the correlation of cord blood nucleated red blood cell (NRBC)/100 white blood cell (WBC) count with perinatal asphyxia in terms of severity and short-term outcome. Material and methods: A prospective, comparative case-control study was undertaken in a tertiary care hospital from January 2011 to December 2012, which included a total of 200 neonates with 100 asphyxiated babies (case group) and 100 normal babies (control group). The cord blood was collected immediately after delivery for measurement of NRBC/100 WBC, and pH. Early neonatal outcome of both groups was also evaluated in relation to the NRBC/100 WBC count. Statistical analysis was performed with chi-square and student t-test. Results: The mean NRBC/100 WBC count was 50.82 ± 23.85 (range from 5 to 106) in case group and 1.67 ± 1.005 (range from 0 to 13) in control group (p < 0.001). Also a statistically significant correlation existed between severity of asphyxia (stage of hypoxic-ischemic encephalopathy [HIE]), poor outcome and higher number of NRBC/100 WBC count (p < 0.001). Conclusion: It is an inexpensive and easily available procedure to evaluate perinatal asphyxia, specially in a resource poor country like ours, where blood gas analysis facilities are not available in majority of places. Also, it is a good predictor of short-term outcome of asphyxiated babies.
الملخص
OBJECTIVE: To study the comparative efficacy of the quinine and artesunate in complicated malaria in children. METHODS: All cases admitted to the Pediatrics ward of our hospital with clinical features of complicated malaria (WHO criteria) having asexual forms of P. falciparum in the peripheral smear, were included in the study. Relevant investigations were carried out for confirmation of diagnosis and to assess the prognosis. The patients were sub-grouped into 6 categories as per clinical presentations and each subgroup received alternatively either quinine or artesunate by systematic random sample method. Every odd number received quinine (Group-1) and every even number received artesunate (Group-2). 40 cases in each group were considered for the study and the data obtained were compiled and analyzed by suitable statistical tests. RESULTS: 80 children with complicated malaria enrolled in the present study, of which 48 were boys and 32 were girls. The mean age was 7.93+3.56 years. The most common presentations were fever, splenomegaly and altered sensorium. The CRT, FCT and PCT were significantly less in the artesunate group (50.4 +/- 31.49 hrs; 43.55 +/- 20.12 hrs, and 41.67 +/- 16.78 hrs respectively) as compared to the quinine group (70.15 +/- 17.56 hrs, 62.23 +/- 16.99 hrs, and 52.24 +/- 12.69 hrs respectively) ( p<0.05) No side effects were observed in the artesunate treated group. CONCLUSION: Artesunate is a much better drug than quinine in complicated malaria in terms of rapid coma resolution, fever clearance, parasite clearance and better tolerability.