Gene/Protein Disease Symptom Drug Enzyme Compound
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A study of 200 pregnant women at the State Zenana Hospital, Jaipur, was conducted to analyse the effects of various maternal diseases on neonates. The maternal diseases were anemia, hypertension, urinary tract infection, heart disease, and tuberculosis. 200 healthy pregnant women were studied as controls. A high incidence (64.3%) of low birth weight babies were born to the unhealthy mothers. 80% of the tubercular mothered babies weighed less than 2.5 kg; 70% of the heart disease; 65% urinary tract infections; 60% hypertensive; and 64.3% anemia. The abnormal newborns showed a smaller average length and smaller head circumference (less than 33 cm.) than the normal group. There was also higher incidence of prematurity and poor neurological status among the abnormal group. Congenital malformations accounted for 2.15% in the abnormal cases, compared to .5% in the control group. The morbidity rate was 85%, compared to 46% in the controls. The causes were conjunctivitis, diarrhea, and cord sepsis.
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PMID:Effects of maternal medical diseases on the newborn. 72 Dec 25

The study was conducted on 785 neonates aged up to 28 days to evaluate the influence of admission weight on mortality. It was observed that there were 200 (25.5%) cases of septicaemia, 134(17.1%) of diarrhoea, 120(15.3%) each of prematurity related conditions and neonatal jaundice, 117(14.9%) of respiratory diseases and 94 (11.9%) cases of convulsion. There were total 182(23.18%) deaths comprising 70(38.5%) from prematurity related conditions, 40(22%) from diarrhoea, 35(19.2%) from respiratory diseases, 26(14.3%) from septicaemia, 8(4.4%) from neonatal jaundice and 3(1.6%) deaths from convulsion. The incidence of deaths among neonates weighing less than 2500 g on admission was 59.2% in diarrhoeal diseases, 53.4% in respiratory diseases and 44.6% in other conditions compared to those of 10%, 8.2% and 7.1% respectively in neonates having admission weight more than 2500 g. The findings are statistically significant. The results of the study indicate that low admission weight should be considered as a predictor of mortality among neonates.
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PMID:Influence of admission weight on neonatal mortality amongst hospitalised neonates in Calcutta. 130 13

Diarrhea and pneumonia are common diseases in children aged under one year, for which there are simple therapeutic measures. However, infant mortality due to these diseases is still very high, varying markedly according to socio-economic status. The characteristics of children who died (cases) and of those who were hospitalized with diarrhea or pneumonia, but survived (controls), were studied. The following groups of variables were studied: socio-economic, environmental and biological conditions, nutritional status and breast-feeding. Information on cases and controls was collected from hospital records and through home interviews. Important losses occurred in the latter: 40% of cases and 50% of controls were not interviewed. There were no significant differences between cases who were included and those who were not, in terms of age, sex or place of residence. To estimate relative risks of prognostic factors unconditional Logistic Regression was used to calculate the odds ratios and their 95% confidence intervals. Prematurity, low birth weight, weight/age deficit, presence of edema and poor general status at hospital admission were prognostic factors for hospital case-fatality. In relation to the anthropometric variables, it was not possible to conclude for certain whether the increased case-fatality was linearly or non-linearly (threshold) associated with nutritional deficit. The duration of breast-feeding was only associated with case-fatality for pneumonia. Socio-economic factors were not important for the prognosis of children admitted to hospital with diarrhea or pneumonia. Some of the expected risk factor associations were not detected, maybe due to the small sample size (resulting from the high losses) which was insufficient to show small differences. In this study the biological conditions of children with diarrhea or pneumonia appeared to be the important prognostic factors for hospital case-fatality.
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PMID:[Prognostic factors of hospital mortality from diarrhea or pneumonia in infants younger than 1 year old. A case-control study]. 134 27

A prospective case series study was conducted Jan 1991-Oct 1991 on 108 neonates admitted to NICU, Lusaka. 90 patients satisfied inclusion criteria, 45 cases and 45 controls. Symptomatic seropositive babies born to seropositive mothers presented with failure to thrive, fever, persistent or recurrent thrush, severe Sepsis and large liver. Tendency to prematurity among cases was high. Diarrhoea, Sepsis and Haemolytic Anaemia appear to be terminal signs. Neonates suffer the most aggressive form of HIV/AIDS, with symptomatic cases dying 3-4/52 of onset of symptoms. Over one quarter of the mothers were symptomatic. Congenital malformations and Lymphadenopathy were not significantly associated. Microcephaly occurred in association with failure to thrive and was not an isolated finding.
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PMID:Clinical presentation of HIV/AIDS in the high risk neonate in Zambia. 139 42

Gram-negative bacterial infections were documented in 6 neonatal New World camelids (5 Ilamas and 1 alpaca). The organisms isolated from blood before death or from multiple organs after death were Escherichia coli (n = 3), Actinobacillus sp (n = 1), and Klebsiella pneumoniae (n = 1). Only 2 crias survived, and 1 became blind secondary to retinal detachment and ocular inflammation, which developed after treatment for bacterial infection. Abnormal events during the perinatal period (prematurity, dystocia, cesarean section, weak at birth) were reported in all 6 crias. Signs of depression, convulsions, and/or coma were observed in all animals. Diarrhea and respiratory distress were also noticed in the 3 crias that died shortly after admission. Serum immunoglobulins were assessed, but without the benefit of a stall-side test specific for Ilama immunoglobulins. All crias were suspected to have poor transfer of maternal immunoglobulins. Hemograms and serum biochemical values prior to the initiation of treatment were obtained on 5 of the 6 crias. Total nucleated cells ranged from 1,400 to 23,100 cells/microliter. Four of the 5 crias has a left shift, and 2 crias had toxic neutrophils. Serum glucose concentrations, measured in 5 of 6 crias, ranged from 83 to 293 mg/dl. Serum creatinine values were high in 2 of 5 crias, 1 of which had acute tubular necrosis. Three crias with high serum electrolyte (sodium, chloride, or potassium) values subsequently died. Arterial blood gas values were assessed in 3 crias, 1 of which had respiratory alkalosis and mild hypoxemia.
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PMID:Gram-negative bacterial infection in neonatal New World camelids: six cases (1985-1991). 142 94

Congenital chloride-losing diarrhea is a recessively inherited disorder due to the absence of chloride-bicarbonate exchange in the small bowel. Malabsorption of chloride leads to osmotic diarrhea, electrolyte abnormalities, and dehydration. If left untreated, the infants fail to thrive and have a very high mortality. Clinically, affected patients develop secretory diarrhea in utero resulting in distended bowel loops and polyhydramnios. At birth these infants have profuse watery diarrhea that may be confused with urine. Thus, the correct diagnosis is often missed, and they may be subjected to unnecessary interventions. If diagnosed early, the electrolyte abnormalities are easily corrected and the prognosis is good. We report two patients who were initially evaluated for other conditions but later proved to have congenital chloride-losing diarrhea. The cases emphasize the importance of having a high index of suspicion in patients with a history of polyhydramnios, prematurity, and watery stools.
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PMID:Misdiagnosis of congenital chloride-losing diarrhea. 152 26

Babies, on admission into a neonatal ward at the Lagos University Teaching Hospital, had their rectal swab specimens examined bacteriologically and screened for enteric bacterial pathogens over a one-year-period at two-week intervals. It was found that on the average there were 3 (9.68%) enteric bacterial pathogens out of an average of 31 admissions at each screening period. The enteric bacterial pathogens isolated included: non-typhoid salmonellae, which accounted for 55 (80.88%) isolates out of the 68 enteric bacterial pathogens, Salmonella typhi 2.94%, Shigella dysenteriae 2.94%, Shigella flexneri 4.41%, S. boydii 1.47%, S. sonnei 1.47%, Campylobacter jejuni 1.47% and Enteropathogenic Escherichia coli (EPEC) 2.94%. The main clinical conditions associated with those babies in whom the enteric pathogens were isolated included sepsis, prematurity, neonatal jaundice and tetanus. It is concluded that the enteric bacterial pathogens, even though they were not directly associated with diarrhoeal disease in the newborns in this study, might have contributed to other illnesses like sepsis and meningitis. It is also noteworthy that the enteric bacterial pathogens isolated sporadically from the babies could have been over-looked in view of the fact that it is not conventional to search for enteric bacterial pathogens in babies without diarrhoea on admission. Rectal swab investigations could provide additional information which might be of epidemiological importance in ill neonates in the clinical settings that prevail in developing countries.
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PMID:Screening of children for enteric bacterial pathogens in the outborn neonatal ward in Lagos, Nigeria. 191 94

Mortality of infants aged 0-30 months was studied in a subdistrict of the eastern Ivory Coast with a population of 240,000 inhabitants. A cluster sample of the type recommended by the World Health Organization for evaluating progress of the expanded program of immunizations consisted of 2 samples with 30 clusters of 70 children each, 1 taken in urban Abengourou and the other in rural cantons of the subprefecture of Abengourou. A standardized questionnaire was administered to all the mothers about their births within the last 3 years. Supplementary questionnaires concerning all deaths of children of the sample mothers were interpreted by 3 physicians who agreed on a probably diagnosis in each case. The survey covered 2375 infants under 1 year and 1825 aged 12-30 months. The total mortality was 103 deaths in the total sample and 70 for infants aged 0-11 months, for a rate of 29.4%. The difference between the urban rate (31.7%) and the rural rate (26.8%) was not significant. The rate varied significantly by sex for deaths due to malnutrition (11 boys, 1 girl), and pneumopathies (6 girls, 1 boy). Mortality varied significantly according to treatment received and place of death. 55% received traditional treatment and 45% modern treatment. 53% died at home, 36% at a health center, and 9% at the home of a healer. Among infants aged 0-27 days, the cause of death was tetanus for 8, prematurity for 12, neonatal distress for 5, neonatal jaundice for 5, and infection for 2. Among infants aged 1-11 months the cause of death was malaria for 10, meningitis for 7, tetanus for 2, diarrhea for 9, pneumopathy for 3, measles for 4, whooping cough for 2, and unknown for 1. Among infants aged 12-30 months the cause of death was malaria for 11, malnutrition for 12, meningitis for 3, pneumopathy for 4, measles for 1, and sickle cell anemia for 2. Malaria was the single most important cause of death followed by malnutrition for the overall sample. In urban and rural areas respectively, the proportions of infants correctly vaccinated for their age groups were 78.1% and 76.0% for those under 11 months; 92.3% and 80.6% for those 12-17 months; 78.3% and 76.6% for those 18-23 months; and 66.5% and 71.4% for those 24 months and over. Mortality rates varied very significantly by vaccination status. 70 of the children dying had not been vaccinated. Their mortality rate was 19.6%, compared to .5% for children in process of vaccination, 1.1% for children incompletely vaccinated, and .9% for children correctly vaccinated.
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PMID:[Infant mortality and its causes in a sub-district of the Ivory Coast]. 196 15

In a prospective study of 257 children in Lusaka during their first year of life the infant mortality rate was 118 per thousand live births. Deaths were due to prematurity and respiratory problems during the first few months of life, and diarrhoea, measles, and malnutrition during the later months. The low birth weight rate was 11 per cent. Growth was good during the first 6 months, but thereafter there was faltering in weight gain and gain in length faltered after 8 months. By age year 1 only 12 per cent attained the average weight-for-age and 8 per cent the average height-for-age. Breast feeding decreased in frequency very gradually over the first year with 66 per cent of children still being breast-fed more than six times a day at a year. Meals were usually given only three times a day and consisted mainly of maize porridge with vegetables, beans, or meat when it could be afforded. Over 70 per cent of children were fully immunized. Milestones were generally achieved at expected ages or even earlier. Where they were delayed most of the children affected died within a couple of months. Recommendations are made on the surveillance of infants in urban areas and the provision of a precooked fortified appropriate weaning food obtained at Health Centres.
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PMID:Children in an urban township in Zambia. A prospective study of children during their first year of life. 228 Apr 35

Copper deficiency developed in a five-month-old prematurely born infant with an abdominal wall closure defect and a small bowel fistula under long-term parenteral nutrition. The first manifestations were typical bone changes including diffuse osteoporosis, delayed bone age, widened cupped metaphyses with beaks and a fracture, subperiosteal hematomas and ossifications in the shafts of long bones, and a diaphyseal fracture. Other findings that confirmed the diagnosis included edema of the limbs with pseudoparalysis, neurologic abnormalities, anemia, leukoneutropenia, and very low serum levels of copper and ceruloplasmin. Following initiation of copper supplementation, clinical, hematological and biological disorders resolved within a few days and roentgenologic bone abnormalities within four months. Copper deficiency develops only in the presence of specific risk factors, that are often combined in a single patient: inadequate stores due to prematurity, excessive loss due to chronic diarrhea, exudative enteropathy, a proximal stoma, or a biliodigestive fistula; and inadequate intake due to malabsorption or long-term exclusive parenteral nutrition (EPN). Appropriate copper supplementation is needed in all these high risk situations. Early, continuous copper supplementation is required for young children under EPN. Serum copper assays should be included among the periodically monitored biochemical parameters.
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PMID:[Nutritional copper deficiency. Apropos of a case]. 250 Aug 84


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