ObjectiveBears are strong and agile wild animals that defend themselves, their young ones and their territory, if they feel threatened. Conflicts between humans and bears are common in bear-prevalent areas of the world. Our valley, which is surrounded all around by forests, is a habitat for black bears (U. thiabetanus) only. Maulings inflicted by these black bears are catastrophic events and such attacks have increased considerably in the recent past due to merciless deforestation. The rising incidences of such attacks, especially in maxillofacial region, have urged our department to undertake a study of such attacks and injuries.Materials and Methods:The present study is both a retrospective and prospective study of 200 patients of bear maulings who were admitted and treated in the Department of OMFS, Govt. Dental College, Srinagar, from January 2005 to October 2009.Results:Majority of the patients were from villages. Most of them belonged to fourth decade and majority was males. Black bears only were involved in all the encounters. Claws, paws and combination of both, were the used for attack. In majority of cases, no defense was used for the termination of attack. All the patients had soft tissue injury, deep lacerations, facial viscera, eyes, salivary glands and facial nerve commonly involved.
Thrombocytopenia is one of the common hematological problems encountered in the neonatal period particularly in the sick newborns, premature babies and neonates admitted in neonatal intensive care units and usually indicate an underlying pathologic process. Thrombocytopenia is reported in neonates with bacterial, fungal, rickettsial, protozoal and viral infection. Some patients with bacterial septicemia may develop coagulopathy associated with DIC. The presence of thrombocytopenia is seen frequently in early sepsis with or without laboratory evidence of overt DIC. This study was conducted on 85 neonates admitted in NICU with clinical diagnosis of septicemia and 50 age and weight matched neonates served as control. Thrombocytopenia was seen in 83.5% cases where as bacterial culture was positive in only 41.1% cases. Further it was noted that, in gram negative (Gm -ve) septicemia, thrombocytopenia was more severe as compared to gram positive (Gm ?ve) septicemia. It is concluded that thrombocytopenia is early predictor of septicemia but other causes of neonatal thrombocytopenia should also be ruled out.
Background and Aims:Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identification of risk factors is important. This study was undertaken to find out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome.Subjects:Age <1-month; mechanically ventilated; not having suspected metabolic disorders or congenital anomalies; excluding postoperative patients.Methods:Neonates consecutively put on mechanical ventilation during the study period (October 2011 to November 2013) enrolled. Primary disease of the neonates along with complications present listed. Clinical and laboratory parameters analyzed to find the predictors of mortality.Results:Total 300 neonates were ventilated. 52% were male. Mean age, weight, and gestational age were 21 ± 62 h, 2320 ± 846.2 g, and 35.2 ± 4.9 weeks, respectively. 130 (43%) neonates died. Respiratory distress syndrome (RDS) (31.1%), sepsis (22.7%), and birth asphyxia (18%) were the most common indications for ventilation. Mortality in ventilated patients with sepsis, pneumonia, RDS or birth asphyxia was 64.7%, 60%, 44.6%, and 33.3%, respectively. Weight <2500 g, gestation <34 weeks, initial pH <7.1, presence of sepsis, apnea, shock, pulmonary hemorrhage, hypoglycemia, neutropenia, and thrombocytopenia were significantly associated with mortality (P < 0.05). Resuscitation at birth, seizures, intra ventricular hemorrhage, pneumothorax, ventilator-associated pneumonia, PO2, or PCO2 did not have a significant association with mortality. On logistic regression, gestation <34 weeks, initial pH <7.1, pulmonary hemorrhage, or shock were independently significant predictors of mortality.Conclusions:Weight <2500 g, gestation <34 weeks, initial arterial pH <7.1, shock, pulmonary hemorrhage, apnea, hypoglycemia, neutropenia, and thrombocytopenia were significant predictors of mortality in ventilated neonates.
Cerebrospinal fluid levels of procalcitonin, lactate, and lactate-ratio are reliable markers to diagnose bacterial meningitis in blood-contaminated cerebrospinal fluid.
Hereditary folate malabsorption should be suspected in any child having megaloblastic anemia and neuro degeneration disorder.
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