Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome (MAS) can still occur and considerable morbidity and mortality may result in the newborn. Amino infusion is being considered as useful in decreasing MAS and its sequelae. Before resorting to amino infusion, we decided to analyse the perinatal outcome in meconium stained liquor to compare whether early caesarean section offered any advantage. This is a retrospective study of 150 labours complicated by thick meconium stained liquor, during a 12 month period (1992-93).

A serological survey was carried out to determine the frequency of distribution of hydatid antibodies in Pondicherry during 1981 to 1984. 1325 apparently normal sera and 109 sera from clinically suspected hydatid disease cases were screened by the indirect haemagglutination (IHA) test. Results showed a diagnostic titre of 1:128 or higher in 6 normal sera and 27 sera of suspected hydatid cases. An antibody titre of 1:64 was observed in 8.17 per cent of the sera screened by this test.

BACKGROUNDABO incompatibility can cause neonatal jaundice and haemolytic disease of foetus and newborn (HDFN). The aim of this study is to describe the clinical profile of ABO HDFN in a tertiary care centre. Settings and Design-This was a descriptive study conducted in neonates suffering from ABO HDFN. Setting for the research was

BACKGROUND Haemolytic Disease of Fetus and Newborn (HDFN) is characterised by lysis of red blood cells resulting in anaemia and its hypoxic effects thereafter. Following anaemia, the production of fetal red blood cells is drastically increased. This is followed by extramedullary haematopoiesis in a widespread manner and erythroblastosis characterized by nucleated red cells in the circulation. Since this is an illness affecting many a newborn, assessing the patterns of anaemia in both ABO and Rh-D HDFN may help in effective planning and implementation of better management protocols. METHODS This is a cross sectional study with comparative analysis. The study was performed among 154 neonates who were diagnosed to have HDFN. Setting for this study was Department of Transfusion Medicine and Pediatrics of Government Medical College, Trivandrum. During the time of delivery, 5 mL umbilical cord blood was collected. That sample was used for analyzing haemoglobin levels of the neonate. Duration of treatment of the neonate was noted down during follow up. Statistical analysis was done using SPSS software version 16. RESULTS The mean cord blood haemoglobin value in ABO haemolytic disease was 17.1 ± 2.7 g %. The mean cord blood haemoglobin value in Rh-D haemolytic disease was 14.5 ± 1.9 g %. In infants with ABO haemolytic disease, 53 (48.2 %) had undergone no treatment in ICU. Remaining 51.8 % had undergone 3 - 10 days of treatment in neonatal ICU. Infants with Rh-D HDFN 20 (45.5 %), had undergone no treatment in ICU. Remaining 54.5 % has got 3 - 9 days of treatment in neonatal ICU. Mean treatment duration in infants with ABO haemolytic disease was 3.1 ± 3.3 days. Mean treatment duration in infants with Rh-D haemolytic disease was 2.9 ± 2.9 days. A comparison of mean values of cord blood haemoglobin in neonates with both categories of haemolytic disease was performed. The p value was 0.00 and it was significant. Mean values of duration of treatment of neonates with ABO and Rh-D haemolytic anaemias were compared statistically. No significant difference was observed. CONCLUSIONS Mean haemoglobin levels in Rh-D HDFN showed a significant decrease as compared to ABO-HDFN. Duration of treatment in ABO HDFN and Rh-D HDFN presented no significant difference. KEYWORDS Haemolytic Disease of Fetus and Newborn, Umbilical Cord Haemoglobin, Anaemia, ICU Stay, ABO HDFN, Rh-D HDFN

BACKGROUNDThe potency of anti-A and anti-B was determined by racial and environmental factors. With respect to ethnic groups, the prevalence and intensity of maternal-newborn ABO incompatibility varied in different populations. The aim of this study is to describe the immunological profile of ABO HDFN. Settings and Design-This was a descriptive study conducted in neonates with ABO HDFN. Research was conducted in Depts. of Transfusion Medicine and Neonatology division of Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODSThose neonates who fulfilled the inclusion criteria were enrolled in this study. Demographic details, maternal details, bilirubin and haemoglobin levels were recorded. Investigations such as maternal blood grouping and antibody titration were done. In infant's blood sample direct antiglobulin test, blood grouping and elution was performed.Statistical Analysis-All statistical data were analysed using SPSS software version 16. RESULTSAmong mothers of infants with ABO HDFN 25 (22.7%) had a titre of 128, 34 (30.9%) had 256, 35 (31.8%) had 512 and 16 (14.6%) had 1024. Among 110 infants 34 (30.9%) were DAT positive, while the rest 76 (69.1%) were DAT negative. While DAT positive was graded 13 (11.8%) fell in grade 1, 16 (14.6%) in grade 2, 3 (2.7%) in grade 3 and 2 (1.8%) in grade 4 categories. Eluate from 59 (53.6%) of infants with ABO HDFN gave a positive result, while the rest 51 (46.4%) gave a negative result. Out of that 59 (53.6%) elution positive infants, 34 (30.9%) had a positive DAT and 25 (22.7%) had a negative DAT; 51 (46.4%) of infants were negative for both elution and DAT. CONCLUSIONMothers of infants with ABO HDFN had an antibody titre of 128 -1024. Almost one-third of infants were DAT positive and majority fell in grade 1 or 2. Eluate from half of infants gave a positive result.

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BACKGROUNDIn Rh-D haemolytic disease of foetus and newborn (HDFN), newborns can be severely affected, thereby associated with extensive morbidity and mortality. Aim-The aim of this study is to describe the clinical profile of Rh-D HDFN. Settings and Design-This was a descriptive study conducted in newborn, who had Rh-D HDFN. Setting was Depts. of Transfusion Medicine and Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODSEnrolment of newborn was done according to inclusion criteria. Maternal and neonatal details were noted and risk of jaundice, severity of disease and intensity of treatment was assessed. Statistical Analysis-All statistical data were analysed using SPSS software version 16. RESULTS 29 (65.9%) belonged to male gender and 15 (34.1%) to female gender. The mean bilirubin levels in neonates on Day 1, 2, 3, 4 and 5 were 4.15, 6.66, 9.44, 11.1 and 11.14 mg% respectively; 20 (45.5%) belonged to low risk, 13 (29.5%) to low intermediate risk, 7 (15.9%) to high intermediate risk and 4 (9.1%) to high risk categories; 4 (9.1%) belonged to no anaemia category, 17 (38.6%) belonged to mild anaemia category, 19 (43.2%) to moderate category and 4 (9.1%) to severe category; 35 (79.5%) of infants showed signs of haemolysis; 33 (75%), 7 (15.9%), 3 (6.8%) and 1 (2.3%) infants had mild, moderate, severe and very severe disease respectively; 20 (45.5%) infants required no treatment; 13 (29.5%) infants were treated only with phototherapy. IVIG was given along with phototherapy in 7 (15.9%) infants; 4 (9.1%) infants were treated with exchange transfusion along with IVIG and phototherapy. Neonates were transfused with 9 (20.5%) packed red blood cells, 3 (6.8%) platelets and 2 (4.5%) fresh frozen plasma. Results of intensity of treatment was 20 (45.5%) belonged to grade 0, 13 (29.5%) to grade 1 category; 7 (15.9%) fell into grade 2, 3 (6.8%) into grade 3 and 1 (2.3%) into grade 4 category of treatment. CONCLUSIONMale infants had higher risk of developing Rh-D HDFN. Majority of infants had mild hyperbilirubinaemia and anaemia only. Disease was mild among 3/4 th of infants and almost half of the infants required no treatment.

Background: Typhoid fever, caused by the bacterium Salmonella typhi, remains an important health problem in developing countries including India. Human beings are the only reservoir and host for typhoid fever, which is transmitted by faeco-oral route. The Widal agglutination test is the diagnostic test, commonly used to diagnose typhoid fever. The interpretation of the Widal test depends upon the baseline titre of that area. Aims and objectives: 1.T o know the positivity rate of widal test, 2. To know the titres for both 'O' & 'H' antibodies in typhoid fever. Methods: Widal test was done for 1525 serum samples for detection of antibodies of S. typhi. A titre of more than 1 in 80 for 'O' antibody and 1 in 160 for 'H' antibody was taken as positive in the diagnosis of typhoid fever. Results: 44.78% of samples (683/1525) were from 11-30 years age group. The rate of positivity was increased as the age increases except in the age group of 21-30 yrs. Widal test was positive in 43.01% of samples. Positivity rate was high among females (50.73%) when compared to males (32.34%). Conclusion: 1. The percentage of positivity was 43.01% .2. The rate of positivity was increased as the age increases except in the age group of 21-30 yrs. 3. Positivity rate was high among females (50.73%) when compared to males (32.34%). 4. Highest positivity rate was seen in males in the age group of 51-60 yrs (80.39%) and in females in the age group of above 60 yrs (72.85%).