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Objectives: To determine the diagnostic accuracy of C-reactive protein in the diagnosis of neonatal sepsis keeping blood cultures as gold standard. Study Design: Descriptive cross-sectional study. Setting: Pediatric Unit of Lady Reading Hospital Peshawar Pakistan. Duration: Six months from 09-06-2012 to 08-12-2012. Methodology: Total of 196 patients meeting the required inclusion criteria with clinical suspicion of sepsis. Those neonates were subjected to investigations. C.R.P. was tested using the Quantitative method according to the instructions provided with the kit. By keeping blood culture as gold standard, patients with both positive and negative cultures were taken and the results compared to the results of C.R.P. in these subjects being positive or negative. Results: Among the 196, majority of the neonates included were less than a week old having a mean age of 4.5 days. There were 57 (29%) females and 139 (71%) males, with male to female ratio of 2.4:1. Blood cultures were positive in 85 (43%) and negative in 111 (57%) cases, while C.R.P. was positive in 95 (48%) and negative in 101 (52%) cases. Sensitivity, specificity, and positive and predictive values of C-reactive protein were calculated using formulas, and they turned out to be 77.6%, 73.8%, 69.4%, and 81.2% respectively with accuracy being 0.41%. Conclusion: An accurate and timely diagnosis of early onset neonatal sepsis remains challenging to the clinician as well as laboratory. Physicians can prevent unnecessary antibiotic use by performing the qualitative estimation CRP as a single, rapid and inexpensive test with a negative predictive value of 81.2%.

Background: Neonatal jaundice is a common condition in the early days ofinfant’s life. It clinically manifests in a significant number of full term babies and almost allpremature neonates. Increase in the serum bilirubin during early infancy is multi factorial andmay result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei andbasal ganglion results in permanent brain damage. Objective: To determine the frequencyof common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchangetransfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, LadyReading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 fullterm neonates requiring exchange transfusion were included in this study on the basis of serumbilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups,rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: Inthis study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonateswere male and 38% were female. Hemolytic causes were analyzed and ABO incompatibilitywas found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiringexchange transfusion was G6PD deficiency (33%) with hemolysis.

… Background: Neonatal jaundice is a common condition in the early days of infant's life. It clinically manifests in a significant number of full term babies and almost all premature neonates. Increase in the serum bilirubin during early infancy is multi factorial and may result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei and basal ganglion results in permanent brain damage. Objective: To determine the frequency of common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchange transfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Lady Reading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 full term neonates requiring exchange transfusion were included in this study on the basis of serum bilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups, rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: In this study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonates were male and 38% were female. Hemolytic causes were analyzed and ABO incompatibility was found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in 32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiring exchange transfusion was G6PD deficiency (33%) with hemolysis.