Background: Hypoglycemia is the commonest metabolic disorder of neonates. If not detected in time, it can lead to considerable morbidity and mortality. Hypoglycemia both symptomatic and asymptomatic can lead to long term neurological sequelae. Therefore, it needs early management to prevent brain damage in a developing neonate. The objective to study the frequency and pattern of hypoglycemia in low birth weight neonates (LBW) and the factors associated with hypoglycemia.Methods: All neonates less than 2500 gm were carefully examined, and a detailed antenatal, natal and postnatal history was obtained. The measurement of blood glucose was estimated by glucometer by taking blood sample by prewarmed heel prick and the same time venous blood sample was sent for laboratory confirmation by glucose oxidase method. Blood glucose was estimated by glucometer at 0, 1, 2, 3, 6 and every 6 hours till 72 hours and the clinical profile of these neonates was recorded.Results: Out of 50 neonates, 12 (24%) had one or more episode of hypoglycemia overall 20 episodes were recorded 15(75%) in first 24 hours and 5(25%) between 49-72 hours all the episodes were asymptomatic. Out of 12 hypoglycemic neonates 7 (58.3%) were small for gestational age (SGA) and 5 (41.7%) were AGA (P = ns). Sepsis was significantly noticed after hypoglycemia (p = 0.00). The pattern of blood glucose levels was significantly different among hypoglycemic babies and normoglycemic babies over first72 hours.Conclusions: Hypoglycemia was frequent among low birth weight babies more so in SGA babies in first 24 hours.

Background: Thalassemiais one of the most common inherited single-gene disorder in the world. Every year approximately 100,000 thalassemia major children are born all over the world, and there are about 65,000-67,000 β thalassemia major patients in India, with around 9,000-10,000 cases being added every year. Measurement of serum ferritin level can give idea regarding starting of Iron chelation therapy, which will reduce the concentration of serum ferritin and effective in preventing iron induced tissue injury and prolonging life expectancy. Method: This study was conducted on 60 children between 3 to 17 years, being regularly transfused at department of Pediatrics, Kamala Raja Hospital, Gajra Raja Medical College, Gwalior, for period of 1 year from 2011 to 2012, after taking the informed consent from the parents and explaining them the purpose of study. Detailed history weretaken and serum ferritin level weremeasured by ELISA based serum ferritin assay kit. Results: Serum ferritin level was found to be elevated in all the patients of beta thalassemia major with range from 1050 to 5029 µg/l and with a mean value of 3879µg/l. Out of 60 patients, 30 (50%) patients had serum ferritin level below 2000μg/l,20 (33.3%) patients had serum ferritin value between 2001 to 4000 μg/l and rest 10 (17.7%) patients had values above 4000 μg/l. Mean value of serum ferritin was found to be higher in patients who received frequent blood transfusion. Conclusion: Majority of the patients had very high ferritin levels, with a mean value of 3879 µg/l. 50% patients had serum ferritin levels more than 2000μg/l. This cut off value reflect either inadequate chelation therapy or non-affordability of parents to purchase oral chelation therapy.

Gitelman's syndrome is an autosomal recessive disorder characterized by hypokalemic metabolic alkalosis, hypokalemia, hypomagnesaemia, hypocalciuria, hyperreninemia and without hypertension. Gitelman's syndrome is caused by mutations of the SLC12A3 gene, which encodes the Na/Cl co-transporter (NCCT) in the distal convoluted tubule. Majority of cases manifest during adolescence or adulthood and growth retardation is not the common feature. We report a rare presentation of Gitelman's syndrome in a four-year-old boy with growth retardation.