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Serum lactate level as a predictor of outcome in patients with suspected sepsis admitted in pediatric intensive care unit

2026-08-27T11:41:58Z

Title: Serum lactate level as a predictor of outcome in patients with suspected sepsis admitted in pediatric intensive care unit Authors: Shubham kumar Abstract: Sepsis is the important causes of death among children in globally . Systemic inflammatory response syndrome in the presence of or as a result of a suspected or confirmed infection was considered sepsis; organ malfunction was considered severe sepsis; and cardiovascular dysfunction was considered septic shock. In children, septic shock and severe sepsis are the main causes of death.. A dysregulated host response to infection causes sepsis, a potentially fatal clinical condition marked by immunological dysregulation, systemic inflammation, and microcirculatory abnormalities. The particular clinical characteristics are contingent upon the patient's position on the continuum, which spans from sepsis to multiple organ dysfunction syndrome (MODS) and septic shock.

Serum and urinary uric acid and creatinine ratio as biomarker in perinatal asphyxia

2026-08-27T11:38:05Z

Title: Serum and urinary uric acid and creatinine ratio as biomarker in perinatal asphyxia Authors: Sasidhar Koneru Abstract: Background According to the WHO, the main cause of early neonatal mortality is perinatal asphyxia, which is defined as the inability to establish breathing at birth and is thought to be responsible for 900,000 fatalities annually.1 An estimated 23% of the 4 million neonatal deaths and 26% of the 3.2 million stillbirths that occur each year worldwide are thought to be caused by hypoxia that affects newborns (birth asphyxia) or foetus (fresh stillbirth). Newborns delivered intramurally can be considered asphyxiated if the APGAR score is less than 7 at birth. At 1 minute after birth, moderate birth asphyxia is defined as an APGAR score of four to six, while severe birth asphyxia is defined as an APGAR score of three or lower. Acute kidney injury occurs during moderate to severe Birth Asphyxia. Chronic renal insult may result from hypoxia, hypotension, and the use of nephrotoxic drugs both during pregnancy and after delivery. The most prevalent of the recognized consequences is Acute Renal Failure (ARF), which has a poor prognosis and can cause irreversible renal impairment in as many as 40% of survivors10. Most of the studies on acute kidney injury following perinatal asphyxia focus only on Urinary uric acid and creatinine ratio. The ratio of serum Uric acid to creatinine as a biomarker for prenatal hypoxia has not been the subject of any published research. Ours is the first research of its type. To determine the severity of hypoxia and its result, the study must correlate maternal variables with neonatal resuscitation level, serum creatinine, and uric acid level in resuscitated neonates. Aims & Objectives: 1. To determine serum uric acid and creatinine levels and urinary uric acid and creatinine levels in neonates with perinatal asphyxia and try to correlate them. 2. To compare the extent of Renal injury with the severity of asphyxia and the level of resuscitation done at birth. Results: A total of 68 cases and 61 controls were analyzed. Most of the infants in the case groups were male, comprising 64.7% (n=44). Among the cases, 36.8% (n=25) underwent lower-segment cesarean section (LSCS), while 63.2% (n=43) had a vaginal delivery, out of which 58.1%(n=25) were primigravida and 41.8%(n=18). At an APGAR score of 5 min, 10.2% (n=7) had an APGAR score of 0-3, while 41.1% (n=28) had an APGAR score between 4-6, and later, 48.5% (n=33) had an APGAR score greater than 7. There is an association between renal parameters and APGAR score at 5 min and found that there is a statistical significance between all these after applying the chi-square test (p-value <0.01) Conclusion: This study shows that serum and urinary uric acid and creatinine ratios have potential as biomarkers for perinatal asphyxia. There’s an important link between these biochemical markers and low APGAR scores, which supports their role in early diagnosis.

To study endocrine manifestations in children and adolescents with thalassemia major a prospective cohort study

2026-08-27T11:31:36Z

Title: To study endocrine manifestations in children and adolescents with thalassemia major a prospective cohort study Authors: Manasi Salunkhe Abstract: ABSTRACT Background: Thalassemia major is one of the most common hereditary hemoglobinopathies worldwide, characterized by ineffective erythropoiesis and chronic hemolytic anemia. Regular blood transfusions, though life-saving, result in progressive iron overload affecting various organs including the endocrine glands. Despite advances in iron chelation therapy, endocrinopathies remain a significant cause of morbidity in thalassemia major patients. Objective: To study the endocrine manifestations in children and adolescents with thalassemia major and to identify associated risk factors. Methods: This study included 51 children and adolescents with thalassemia major attending the thalassemia clinic. Detailed history, anthropometric assessment, clinical examination, and laboratory investigations including complete blood count, serum ferritin, glucose parameters (FBS, PPBS, RBS, HbA1c), thyroid function tests (T3, T4, TSH), serum calcium, and gonadotropin levels (LH, FSH) were performed. Results: The study population comprised 58.8% males and 41.2% females, with 62.7% aged 5 10 years. 74.5% had initiated transfusions before one year of age, and 88.2% received monthly transfusions. Growth retardation was evident with 23.5% having weight and 29.4% having height below the 3rd centile. Endocrine abnormalities included diabetes (25.5%), pre-diabetes (33.3%), hypothyroidism (9.8%), hypogonadotropic hypogonadism (25% with low LH and 12.5% with low FSH), and hypocalcemia (21.6%). Serum ferritin was elevated (>1500 ng/mL) in 90.2% of patients. Significant associations were observed between HbA1c levels and chelation therapy (p=0.005). Conclusion: Endocrine complications are common in pediatric thalassemia major patients, with glucose metabolism abnormalities being the most prevalent. Age, transfusion burden, and chelation therapy significantly influence the risk of endocrinopathies. Regular monitoring of endocrine function and appropriate intervention are essential for improving quality of life and reducing morbidity in these patients.

To study the significance of mirna 23 b as a marker for neonatal sepsis.

2026-08-27T11:22:05Z

Title: To study the significance of mirna 23 b as a marker for neonatal sepsis. Authors: Ruchi R Abstract: INTRODUCTION A systemic inflammatory response to infection in newborns, especially those born within the first 28 days of life, is known as neonatal sepsis, a potentially fatal clinical disease. It is a major cause of morbidity and mortality worldwide, particularly in areas with little resources, where healthcare systems struggle to detect it early and treat patients effectively1. Neonatal sepsis is divided into two categories: early onset sepsis (EOS) and late onset sepsis (LOS). Due to their young immune systems' limited capacity to fight infections, newborns are especially vulnerable. Prematurity, low birth weight, prolonged membrane rupture, maternal illnesses, and invasive treatments in the neonatal intensive care unit (NICU) are risk factors for neonatal sepsis. Neonatal sepsis prevalence varies greatly throughout the world, with lower and middle-income nations reporting greater rates because of inadequate prenatal care and restricted access to medical interventions2. Sepsis is still a difficult problem despite improvements in neonatal care because of delayed diagnosis, antibiotic resistance, and the high prevalence of sequelae and long-term impairment such as neurodevelopment delays3. With an emphasis on its epidemiology, classification, pathophysiology, clinical presentation, diagnostic techniques, therapy, and preventative strategies, this paper attempts to offer a thorough overview on neonatal sepsis and effective management and prompt treatment.