Objective: To describe the observational findings of functional echocardiography (FnEcho) in neonatal intensive care unit of a tertiary care hospital by evaluating its frequency of use, characteristics of patients and distribution of heart diseases. Methodology: This Prospective descriptive observational study was done in a tertiary neonatal intensive care unit (NICU) in Rawalpindi, from July 2017 to June 2018. A total of two hundred and twelve neonates admitted to the NICU undergoing echocardiographic assessment were included in the study. Qualitative variables like gender, mode of delivery, and diagnostic findings were represented in terms of frequency and percentages. Quantitative data like age, birth weight and gestational age were highlighted as mean and standard deviation. Results: Out of a total of 212 neonates, 111 (52.4%) were male. The mode of delivery was noted to be lower segment cesarean section among 126 (60.0%) neonates. The mean gestational age was found to be 36.47+2.3 weeks, ranging from 28 to 41 weeks, whereas the mean birth weight was 2.56+0.68 kg, ranging from 1.1 to 4.2 kg. A total of 75 neonates were found to have functional heart disease in the form of pulmonary hypertension 37 (17.4%), hemodynamically significant patent ductus arteriosus 24(11.3%), hypoxic ischemic cardiomyopathy 4(1.9%), and systemic hypotension 10 (17.4%). Conclusion: FnEcho was found to be an effective tool for identifying different kinds of functional and structural heart defects. VSD was found to be the most common type of congenital heart disease, followed by PDA. Timely intervention in PPHN was also rewarding with good outcome.

Objective: To determine the frequency and pattern of various congenital heart diseases in a tertiary care hospital neonatal unit. Study Design: Prospective longitudinal study. Place and Duration of Study: Neonatal Unit of Pak Emirates Military Hospital, Rawalpindi Pakistan from Jul 2015 to Jun 2018. Methodology: All neonates admitted to the Neonatal Unit of Pak Emirates Military Hospital, Rawalpindi Pakistan, suspected of having congenital heart disease were included in the study. Suspicion for CHD was based on the presence of murmur, cyanosis with or without feeding difficulty, signs of congestive heart failure, and variation in pre and post-ductal SpO2 reading. Echocardiography was performed on all neonates by a Paediatric cardiologist to determine diagnosis and type of lesion. Results: One hundred and thirty-one neonates were found to have congenital heart disease with male predominance, with 79(60.3%) males and 52(39.7%) females. Ventricular Septal Defect (VSD) was the most common lesion occurring in 44(33.6%) neonates, followed by PDA in 28(21.37%) neonates. CHD occurred more frequently in term neonates (62.0%) than preterm neonates (38.0%). Conclusion: Congenital heart disease is the most common congenital malformation, with Asia having the highest prevalence worldwide. Lack of specialized antenatal and neonatal health services and paucity of diagnostic facilities lead to delays in diagnosis, increasing morbidity and mortality of CHD cases. Therefore, drastic measures are required to improve neonatal health and transport facilities in our country to mitigate the impact of this disease.

Objective: To compare the outcome of Salbutamol nebulization with normal saline (placebo) in transient tachypnea of the newborn. Study Design: Comparative prospective study. Place and Duration of Study: Department of Neonatal Medicine, Military Hospital Rawalpindi, from Jan 2017 to Mar 2018. Methodology: Sixty term neonates with respiratory rate >60 breaths/min and transient tachypnea of newborn score of ≥4 were enrolled. They were randomly allocated to two equal groups. Group-1 received Salbutamol nebulization (0.15 mg/kg) while Group-2 received normal Saline (placebo) nebulization. Results: The mean gestational age was 38.31±1.28 weeks, while the average birth weight was 2.97±0.27 kg. The mean change in transient tachypnea of newborn score with Salbutamol nebulization was 5.63±1.22, while 0.63±1.54 with normal Saline nebulization. Likewise, the mean change in respiratory rate with Salbutamol was 9.80±2.05, while -3.73±2.57 with normal saline. Conclusion: This study demonstrated nebulized Salbutamol as an effective tool in reversing transient tachypnea of newborns with decreasing respiratory rate compared to normal saline nebulization (placebo).

Objective: To compare the mean post-treatment bilirubin level with light emitting diode (LED) phototherapy versus compact fluorescent lamp (CFL) phototherapy in neonates presenting with hyperbilirubinemia Study Design: Comparative prospective study Place and Duration of Study: Department of Paediatrics, Pakistan Railway Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: Hundred children fulfilling the inclusion criteria were recuited in the study from Emergency Department. Then neonates were divided into two groups. In Group-A, neonates underwent phototherapy with LED; in Group-B, neonates underwent phototherapy with conventional phototherapy. Then neonates were followed up in the neonatal intensive care unit for 24 hours. Pre and post-treatment reports were assessed, and bilirubin level was noted. Results: In Group-A, the mean age of neonates was 49.12±23.42 hours, while in Group-B was 38.70±15.42 hours. In Group-A, the mean Bilirubin level at baseline was 13.64±5.98 gm/dl and in Group-B was 15.88±5.44 gm/dl. In Group-A, the mean Bilirubin level after 24 hours was 8.47±4.96 gm/dl and in Group-B was 9.538±5.35 gm/dl. In both groups, no significant difference in the mean bilirubin level was observed after 24 hours (p-value=0.30). Conclusion: Light-emitting diode phototherapy and compact fluorescent lamp phototherapy are equally effective in a mean reduction in the total serum bilirubin after 24 hours.