Toxicity of Salvia officinalis in a newborn and a child: an alarming report.

Although it is widely believed that herbal products are beneficial to the health, some herbal products can result in serious adverse effects, such as epileptic seizures, especially in children who are particularly susceptible. Sage oil contains well-known convulsant substances such as thujone, camphor, and cineole in different proportions. We report 2 cases, those of a newborn and a toddler, who experienced generalized tonic-clonic seizures after accidental exposure to sage oil. No other causes of seizure were detected by our clinical inquiries in either of the patients. The seizures occurred as an isolated event in the toddler, but in a repeated manner in the newborn; both patients experienced good outcomes. In any case of a first seizure of unexplained origin, the possibility of exposure to a herbal product should be kept in mind. Parents should be informed about the pros and cons of these untested remedies, which are presented as an alternative to conventional medicine.

Bilateral clavicle fracture in two newborn infants.

BACKGROUND: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns. CASE PRESENTATION: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel. CONCLUSION: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

Assessment of myocardial dysfunction in neonates with hypoxic-ischemic encephalopathy: is it a significant predictor of mortality?

OBJECTIVES: Hypoxic-ischemic cerebral injury due to perinatal asphyxia is an important cause of neonatal mortality and morbidity. To predict who will survive or die due to this disorder still remains obscure. The aim of this study is to evaluate the predictive value of myocardial involvement in the assessment of mortality for the neonates with hypoxic-ischemic encephalopathy (HIE). PATIENTS AND METHODS: The study included 34 term newborns fulfilling the diagnostic criteria for HIE and staged according to Sarnat and Sarnat classification. To assess the myocardial involvement, electrocardiogram (ECG) and echocardiogram (Echo) were performed in the first 24-48 h of life. In addition, serum Troponin I and creatine kinase-myocardial band (CK-MB) were measured at delivery and postnatal day 3. RESULTS: Of the 34 cases, 19 (55.9%) were stage in 1, 9 were in (26.4%) stage 2 and 6 (17.6%) were in stage 3 HIE. Nine (26.4%) patients died of the disease. Thirteen patients (38.2%) showed ECG findings related to perinatal asphyxia. Only one patient had mild Echo changes. Higher Troponin I level was a significant predictor of mortality, whereas CK-MB did not show any significant predicting value. Troponin I test showed 33% sensitivity and 80% specificity in predicting mortality. In addition, the sensitivity and specificity of ECG as a predictor of mortality were 77 and 76%, respectively. CONCLUSION: This study highlights the significance of monitoring cardiac functions in newborns with HIE. ECG changes and serum Troponin I level at 72 h after birth are likely to have significant predictive value in the assessment of mortality in HIE. Further studies will provide additional data for the long-term prognostic value of cardiac functions in this disorder.

A novel DAX1 gene mutation in a Turkish infant with X-linked adrenal hypoplasia congenita.

Adrenal hypoplasia congenita (AHC) is a rare inherited disorder of the adrenal cortex commonly manifested as an early onset adrenal insufficiency syndrome. A novel DAX1 (NR0B1) gene mutation was detected in a Turkish newborn boy presenting with primary adrenal insufficiency. He was from a family with a history of unexplained death of three male siblings in the neonatal period. This report highlights the value of mutational analysis of the DAX1 gene for definitive diagnosis of AHC as well as for genetic counselling because this disorder shows an X-linked genetic pattern of transmission, providing the possibility of finding new cases even in presymptomatic individuals.