We report here the successful use of baclofen administered by nasogastric route in a 3.5-year-old child with tetanus, whose spasms were not controlled even with high dose of midazolam infusion.

Laurey No Inset Face Mount Self-Closing Hinge, Satin Chrome, 2-Pack #28739
Laurey No Inset Face Mount Self-Closing Hinge, Satin Chrome, 2-Pack #28739 - Tai-Chi for health Customer Review: ..disappointed.. Upon inital use of this tape, I felt that it could have gone to a more advanced level. Although it does an adequate job of reviewing basic postures. What is lacking is […]

Strict Guideline Reduces the Need for RBC Transfusions in Premature Infants
The aim of this study was to verify if the adoption of a strict guideline would reduce the need for red blood cell transfusions in the first 28 days of life in very low birth weight preterm infants. Retrospective study of two cohorts of very low birth weight infants transfused according to neonatologist decision (Period 1) or according to a strict guideline for erythrocytes transfusion (Period 2). Clinical and hematological data of 80 premature infants transfused in both periods of the study were obtained by chart review. During the first 28 days of life, 45 (62.5%) of 72 premature infants born in the Period 1, and 44 (55.7%) of 79 newborns born in Period 2 received at least one erythrocyte transfusion; p = 0.40. Among patients transfused, the median number of transfusions was four per infant transfused (range: 1–13; mean: 4.6 3.2) in Period 1 and 3 (range: 1–18; mean: 4.0 3.5) in Period 2; p = 0.26. The median volume of erythrocytes administered per infant transfused in Period 1 was 40 ml kg–1 (range: 10–170; mean: 48.8 38.3) and in Period 2 was 30 ml kg–1 (range: 10–225; mean: 43.4 40.4), p = 0.41. Multiple linear regression analysis, after adjusting for birth weight, clinical risk index for babies, blood loss and days of ventilation, showed that the adoption of the strict guideline reduced the volume of erythrocytes transfused in 15.91 ml kg–1 per infant transfused (95% CI: –24.69–7.14) p < 0.001. The adoption of a strict guideline reduced the need for red blood cells transfusions in very low birth weight infants.

Newborn Care Practices at Home: Effect of a Hospital-based Intervention in Sri Lanka
The aim of the present study was to evaluate the effect of an essential newborn care (ENC) training programme for maternity ward staff in improving newborn care practices after hospital discharge. A before-and-after study was conducted in the community involving mothers who had given birth in two hospitals in the Puttalam district in Sri Lanka. The intervention was a 4-day training programme and primarily aimed at increasing knowledge and skills of ENC among health care providers in the maternity units of these hospitals. Before the intervention, 144 mother–newborn pairs were followed-up and interviewed at their households within 28–35 days of delivery. Three months after the intervention, 150 mother–newborn pairs were interviewed at home. Results revealed that there was a significant improvement in umbilical cord care practices at home following the intervention. Application of ‘surgical spirit’ on umbilical cord has declined from 71.5% in the pre-intervention to 45.3% in the post-intervention samples (p < 0.001). Pre-intervention breastfeeding rates were high, and there wasn't any further improvement in the post-intervention. There was a 35% reduction in the proportion of newborns who developed any undesirable health events at home (p < 0.05). Findings suggest that the implementation of a comprehensive 4-day training programme of ENC for maternity ward health professionals can be followed by a significant improvement in mothers' practices on care of umbilical cord and clinical outcomes of newborns.

Scaling up of Facility-Based Neonatal Care–A District health System Experience
With proportion of neonatal mortality increasing within under-five deaths, innovative approaches and stronger health systems are needed in neonatal care. We present data of a scaled-up neonatal facility in a District Government Headquarters hospital in Southern India. The special care neonatal unit (SCNU) was a community propelled, public private partnership worked out on the principles of private funding of public institutions and effective budgeting of the public health care system. In the first phase the unit was optimized over 3 years with non-governmental organizations (NGO) and government support from a basic nursery to a SCNU. The unit was operational through fixed maintenance budget from government and mobilized funds from NGOs and beneficiaries. Community health workers were motivated for effective utilization. In the second phase the unit’s performance was studied and statistically analyzed in two time frames before and 5 years into the upgradation process. Neonatal admissions from the district increased by 14.65%. Hospital stillbirth, early neonatal and perinatal mortality rates showed significant decline (p < 0.05). There was a 48.59% (CI: 25.46–77.80) increase in antenatal referrals from community health centers. Caesarian sections for neonatal parameters that affect obstetric decisions showed percent changes of 163.25 (CI: 31.18–430.45) and 73.4 (CI: 14.15–164.39) for prematurity and low birth weight (LBW), respectively. Significant decline in case fatality rates for LBW, sepsis and birth asphyxia (p < 0.001) were observed. The district perinatal mortality rate showed a decline. Within the purview of financial constraints of the public health system, private funding, public–private cooperation and effective budgeting may become significant. Motivation of health workers and community to effectively utilize public health care services sets an evolutionary process of referral and vertical linkage of health care system.

Fat Patterning of Santhal Children–a Tribal Population of West Bengal, India
A cross sectional study was undertaken to examine the body composition including fat patterning among 1012 Santal children, aged 5–12 years, in Puruliya district of West Bengal, India. The anthropometric variable measured included height, weight and skinfold thickness of triceps and subscapular. The body mass index (BMI) was also calculated. The measurements were used to estimate body fat percent (%BF) and fat-free mass (FFM) from skinfolds. Fat mass and FFM were each divided by height squared to produce the fat mass index (FMI) and fat-free mass index (FFMI). Maximum gaining of %BF and FFM was found at ages 11–12 years in both sexes. Difference of-FFM between 5 and 12 years of age was found to be highest in girls (18.7 kg) than in boys (14.92 kg). Body fat percentage of girls was significantly (p < 0.05) higher (except in 8 and 9 years old) than that of boys. FMI and FFMI of girls showed different pattern than that of boys. FFM and %BF showed significant (p < 0.01) relationship with all anthropometric variables. Results suggests a clear evidence of sexual dimorphism in fat patterning; girls showing a greater subcutaneous adiposity in comparison with boys. FMI and FFMI, both indices indicate an age-and sex-related variation among Santal children. The data of the present study could be serving as reference data in other studies of Santal children.

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