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Letter to the Editor

Amrinone was used in the study. Thus, it is important to keep in mind a possibility of

PPHN in newborns with respiratory distress in the settings of sepsis and treat them appropriately.

Bela Verma, S.R. Daga and Abhi j i t Mahapankar Department of Pediatrics,

Cama and Albless Hospital, Grant Medical College, Mumbai.

E-mail : belaverma555~hotmail.com

REFERENCES

1. Manroe BL et al. The neonatal blood count in health and diseases : reference values for neutrophilic cells. J Pediatr 1979; 95 : 89-93.

2. Versmold HT, Kitterman JA, Phibbs RH et al. Aortic blood pressure during the first 12 hours of life in infants with birth weight 610 to 4220 grams. Pediatrics 1981; 67(5) : 611.

3. Linda J Van Mater. In John P. Cloherty, Eric C Eichenwald, Ann R Stark, eds. Persistent Pulmonary Hypertension of the Newborn. Manual of Neonatal Care. Philadelphia; Lippincott Williams & Wilkins, 2004; 377-383.

4. Abu - Osba YK, Galal O, Mansara IG Rejjal A. Treatment of severe persis- tent pulmonary hypertension of the newborn with magnesium sulphate. Arch Dis Child 1992 ; 67 : 31 - 35.

5. SR Daga, B Verma, RG Lotlikar. Magnesium Sulphate for Persistent Pulmonary Hypertension in Newborns (Letter). Indian Pediatr 2000; 37 : 449-450.

6. Lindsay CA, Barton P, Lsawless S, Kitchen L, Zorka A, Garcia Jet al. Pharmacokinetics and pharmacodynamics of milrinone lactate in pediatric patients with septic shock. J Pediatr 1998; 132; 329-334.

Early Onset Neonatal Sepsis Sir, The article "Early Onset Neonatal Sepsis "1 (EOS) is a study of 1743 live births in 15 months, from October 2000 to December 2_,001, that includes the colder post-monsoon months of Oct-Dec, twice which are likely to have low sepsis rates. There is an average of 3.8 births per day and a 12 month figure of 1394.

During this period, 136 babies who had potential maternal risk factors (MRF) and infants with features of altered body temperature, tachypnea/apnea, lethargy, poor feeding, shock and metabolic acidosis, were selected, in whom blood cultures were obtained soon after birth. The infant risk factors considered in the study are not exclusive for sepsis; they can be features of several morbidities like hypothermia, hyaline membrane disease, prematurity, and birth asphyxia. Other investigations like neutrophil counts etc. haye not been mentioned. Of the 36 EOS only 15 were culture positive. How many of these were in the MRF positive versus negative category? The incidence of sepsis in MRF negative group was 8 (22 %) vs 28 (78 %) in the positive group, so it is not negligible. Out of 8 babies in MRF negative group, 4 had 1-min Apgar score of