The objective of this study was to compare the transcutaneous bilirubin (TcB) with total serum bilirubin (TSB) and to find out the effect of phototherapy on correlation of TcB and TSB during and after phototherapy in Indian neonates. Prospective observational study was performed at neonatal intensive care unit of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, India. Blood samples for TSB estimation of 276 jaundiced neonates were sent, and simultaneously, TcB was measured at forehead and sternum on admission and 12 hourly till discontinuation of phototherapy as per the American Academy of Pediatrics nomogram chart and their correlation was assessed. The effect of phototherapy on correlation of TcB and TSB during and after phototherapy was also observed. The correlation between TSB and TcB was linear and significant for the entire study population over forehead (Pearson's r = 0.802, R 2 = 0.644, p < 0.001) as well as over sternum (Pearson's r = 0.825, R 2 = 0.681, p < 0.001) before starting the phototherapy. This correlation becomes slightly lower for TSB versus TcB forehead (Pearson's r = 0.753, R 2 = 0.568, p < 0.001) and for TSB versus TcB sternum (Pearson's r = 0.754, R 2 = 0.569, p < 0.001) after giving phototherapy for at least 24 hours. The correlation coefficients for TSB versus TcB measurements over forehead and sternum were 0.758 and 0.806, respectively, after 36 hours of phototherapy. TcB measurements using the transcutaneous bilirubinometer correlate closely with TSB levels, so it can be used as an easy and rapid noninvasive method of bilirubin measurement in jaundiced neonates.

Background: Tuberculosis remains a worldwide public health problem despite the fact that highly effective drugs are available making TB a curable disease. DOTS chemotherapy remains central to the public health approach to tuberculosis control under RNTCP. The present study is conducted to know the clinical profile and treatment outcome of TB patients registered under RNTCP in Mukkam CHC, Calicut. The study was conducted with the following objectives: 1) to study the treatment outcome of TB patients receiving DOTS, 2) to find the occurrence of pulmonary, extra-pulmonary and MDR TB and 3) to find out factors responsible for poor treatment outcome.Methods: This record based study was conducted in Mukkam CHC. Details of patients who were enrolled under RNTCP in the year 2013 were collected from RNTCP records. Data was analyzed using SPSS version 16. Results are expressed in percentage. Statistical analysis used was Chi square test.Results: Out of 289 patients studied, 66.78% were males and 33.22% were females. 69.5% of the patients were having pulmonary TB and 30.5% extrapulmonary TB. There were two cases of MDR TB. 58% of the patients with pulmonary TB were sputum positive and 42% were sputum negative. 87.8% were given Cat I treatment and 11.7% were given Cat II treatment. Only one patient was on Non DOTS regimen. 96.6% of the patients had completed DOTS. When treatment outcome was analyzed, the patients with treatment completed was 54%, cured 35%, defaults 4%, treatment failure 2% and transfer out 2% and 3% of patients died during the course of the treatment. 7.61% of patients had diabetes mellitus and only one case was reported HIV positive. Treatment outcome was significantly associated with type of patient and pulmonary TB sputum positivity.Conclusions:The treatment success rate was 100% in 0-5 years and least in > 65years of age group. Further studies are required to find out the reasons for comparatively high proportion of sputum smear negative cases.

Background: Probiotics have been used for long in the treatment of acute diarrhea although their efficacy has always remains the subject of discussion. Objective: To determine the effect of probiotics in acute diarrhea among the children in rural population. Method: Double-blinded randomized control trial. We included children of age group 6 months - 5 years suffering from acute diarrhea of <48 h and fulfilling the inclusion criteria. All children were given oral rehydration salts (ORS) ad-lib till the resolution of diarrhea and zinc 20 mg/day for 14 days while intervention arm (n=101) were given probiotic sachet twice a day for 7 days containing Streptococcus faecalis 30 million, Clostridium butyricum 2 million, Bacillus mesentericus 1 million, Lactobacillus sporogenes 50 million, control group were given identical placebo apart from ORS and zinc. Duration of diarrhea in both the groups was measured as primary outcome while secondary outcome was to know the days of maximum recovery from diarrhea in both groups. Results: Totally, 207 patients were randomized to control and study group, out of which, 195 completed the study. Out of total 195 patients, 94 (48.2%) patients were treatedwith standard treatment of diarrhea without probiotics while 101 (51.8%) patients were given probiotics apart from standard treatment of diarrhea. The mean duration of diarrhea was found to be reduced in the study group (4.6 days [2.84-4.776 days]) as compared to control group (5.31 days [5.108-5.512 days]), p<0.001. Conclusion: Probiotics significantly reduced the duration of acute diarrhea in children.

Background There is inconclusive evidence on the role of nebulized magnesium sulphate (MgSO4) in the management of acute asthma in paediatric population. Objectives Whether the use of nebulized salbutamol with or without MgSO4 in the management of acute asthma results in clinically significant improvement in lung function in Indian children? The primary outcome measure was to assess improvements in peak expiratory flow rate (PEFR), heart rate, respiratory rate and SpO2. Methods This was a single centre; prospective double-blind randomized control trial conducted in paediatric intensive care unit of a tertiary care centre. Ninety children of 6–14 years with acute exacerbations of bronchial asthma were enrolled to receive either inhaled magnesium sulphate (95 mg) with salbutamol (5 mg) or inhaled salbutamol (5 mg) alone. All patients got three nebulizations done during the first hour at 20 min intervals, two nebulizations during the second hour at 30 min intervals, hourly for the next 2 h and then at 24 and 48 h. Results Eighty-five patients were finally analysed as per protocol analysis. The trial showed that PEFR increased gradually in both groups over the study duration, but it was statistically not significant. Heart rate decreased significantly in both groups over the study duration. Respiratory rate decreased significantly between the groups at 24 and 48 h only. SpO2 improved too in both groups but was not significant statistically. Conclusion The addition of nebulized MgSO4 to salbutamol does not seem to result in improvement in lung function in the management of acute asthma in Indian children.

Background: An average 8 million Indian children younger than 5 years (under-fives) are severely wasted. Each year approximately 2.3 million deaths among 6–60 months aged children in developing countries are associated with malnutrition, which is about 41% of the total deaths in this age group. Objective: The objective of the study was to compare the efficacy of cereal-based the World Health Organization (WHO) F-75 diet and homogenized toned milk with added sugar in the recovery of presenting complaints and weight gain in severe acute malnutrition (SAM) children in the stabilization phase. Materials and Methods: This clinical effectiveness trial was conducted between March 2016 and August 2017 in the Department of Pediatrics, in a MedicalUniversity, Saifai, Uttar Pradesh. A total of 77 children aged 6–59 months with SAM who were admitted in the pediatric ward for various reasons were included in the study. Patients were randomly allocated to receive either cereal-based F-75 diet (Group I) or homogenized toned milk (Group II). Each child was monitored during the early stabilization phase for improvement in terms of the return of appetite, the start of edema reduction as well as the complete disappearance of edema, vomiting, loose stool, weight gain, clinical duration of hospital stay, and mortality. Data collected from each group were analyzed. Results: No statistically significantdifference was found in the onset of edema reduction, complete disappearance of edema and return of appetite in both groups. Number of vomiting and loose stools per day, on day 4 and day 10, was significantly lower in children fed with homogenized toned milk (Group II). Mean weight gain among patients fed with the WHO F-75 diet (Group I) was higher (8.29±2.77 g/kg/day) as compared to that of Group II (7.31±2.87 g/kg/day) but difference in weight gain among patients of Group I and Group II on day 10 was not statistically significant (p=0.133). Conclusions: As homogenized toned milk avoids problems of quality control and microbial contamination, it may be considered for evaluation in difficult circumstances where standard protocols are not feasible for management of severe malnutrition, especially in developing countries.