Background: the study was aimed to determine the predictive value of cord bilirubin and 24th hour serum bilirubin levels in identifying newborn babies at risk of developing significant hyperbilirubinemia.Methods: A total 300 term neonates with a mean birth weight of 2.58±0.23 kg ranging from 1.92 kg-4.1kg were included in this study. Under strict aseptic precautions cord blood sample were collected from all newborns for analysis of serum bilirubin levels, and haemoglobin levels.Results: The incidence of significant hyperbilirubinemia in this study was 14%. Among jaundiced newborns sex ratio M/F:1.6:1(male female ratio 1.1:1). Mean Cord bilirubin levels in babies who subsequently developed hyperbilirubinemia was 2.798±0.5559 mg/dl and in others were 1.511±0.3260 mg/dl and the difference was statistically significant. There was a statistically significant correlation between cord bilirubin and neonatal jaundice. Cord bilirubin ≥2 mg/dl had good predictive value in identifying newborns who are likely to develop significant hyperbilirubinemia later.Conclusions: Babies with cord blood bilirubin ≥2 mg/dl can be followed up in the hospital for 5 days, the time of peak neonatal hyperbilirubinemia to prevent the babies discharged early and later readmission for neonatal hyperbilirubinemia.

Background: Respiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm infants. An effective way to reduce the incidence of chronic lung injury is to use continuous positive airway pressure (CPAP) and avoid mechanical ventilation. Objective:To assess the effectiveness of bubble CPAP (BCPAP) on immediate outcome of preterm infants with mild to moderate RDS in a level 2 neonatal intensive care unit (NICU) in Bangalore, India.Method: A prospective analytical study was carried out on preterm neonates of gestational age 28 to 36 weeks with mild to moderate RDS admitted to a level 2 NICU in Bangalore, India, from November 2011 to May 2013. Downe score (DS) was used to assess the severity of RDS. Effectiveness of CPAP was judged using DS and fraction of inspired oxygen (FiO2) requirement.Results: BCPAP was effective in 91% of the studied babies. At the start of CPAP 11%, 48% and 41% of babies had DS of 4, 5 and 6 respectively. At 6 hours of CPAP therapy, 56% of the babies had a score of less than 4. At 12 hours of CPAP therapy 89% of babies had a score of 4 or less, only 3% and 8% of the babies having DS of 5 and 6 respectively. Nine percent of the babies persisted in having a FiO2 requirement of 50% or more at 6 and 12 hours of CPAP therapy. BackgroundRespiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm infants 1 . Diagnosis of RDS is based on a chest x-ray consistent with RDS, and response to surfactant therapy 2 . Mechanical ventilation is invasive and can injure the airway and lung parenchyma. An effective way to reduce the incidence of chronic lung injury is the use of continuous positive airway pressure (CPAP) and avoidance of mechanical ventilation 1,3 . Bubble CPAP (BCPAP) prevents alveolar collapse, ensures gas exchange throughout the respiratory cycle and allows lung inflation to be maintained. It can be effectively given through the silastic nasal tubes or nasal prongs which eliminate the need for the endotracheal intubation 4 . CPAP preserves spontaneous breathing, does not require endotracheal intubation and may result in less lung injury than mechanical ventilation 5 . However, not all preterm infants with RDS respond to BCPAP and not all preterm infants with RDS are candidates for initial treatment with CPAP 4,6 .

VACTERL association is a non-random association of birth (congenital) defects that affects multiple median and para-median structures. VACTERL association is a useful acronym to denote vertebral abnormalities (V), anal atresia (A), cardiac defects (C), tracheo-esophageal fistula (TE), renal or radial abnormalities (R), and limb abnormalities (L). Atleast 3 or more defects must be present to make a diagnosis of this condition. Most of these cases occur sporadically, although few cases with chromosomal abnormalities have been reported. Herein, we report a newborn who had most of the defects seen in VACTERL association.

Background: Acute encephalitis is the clinical diagnosis of children with acute onset of symptoms and signs of inflammatory lesions in the brain. It must be diagnosed promptly for saving life and preserving brain functions.Authors objectives was to determine the profile and outcome of children admitted with Acute Encephalitis Syndrome (AES) and to identify etiological factors.Methods: Study consist of a retrospective analysis of hospital records of children up to 15 years of age admitted with a diagnosis of AES in the pediatric ward, Narayana medical college, Nellore from January 2018 to June 2019.Results: In a total of 30 patients of AES, clinical features like fever (100%), altered sensorium (100%), convulsion (40%), headache (45%) and neuro deficit (40%) and vomiting (50%). The average Glasgow coma scale at admission was 8. There are 55% of cases in the 5 to15 yr age group (p>0.05). Both Encephalitis (56.6%) and meningitis (43.3%) were documented significantly more in males as compared to females (p<0.01). Twenty-one cases are discharged, eight expired, and 1 case was referred (p<0.001). JE IgM positive cases contributed to 36.6%, of which eight males and three females recorded between 5-15 years. Male children are more likely to play outdoors where the mosquito vector of the disease is abundant.Conclusions: JE has significant morbidity and mortality, can be prevented by immunization, and reduced if supportive interventions are provided in time. Preventive measures must be taken for 5-15 years of age group those playing outdoors, going to school or agriculture fields predisposing them to vector mosquito bite.

Background: Chronic cough is a common complaint in children which causes distress and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity. Aims and objectives of the study was to evaluate the specific diagnosis and prognosis of chronic cough in children aged 2 to 12 years.Methods: A prospective study was done in 100 children with chronic cough (history of cough >4 weeks) at Narayana Hospital, Nellore. Routine investigations like complete blood count with differential count, Mantoux test, sputum examination, and X ray chest and other investigations like bronchoscopy, HIV, CT scan chest and paranasal sinuses, barium swallow, endoscopy and biopsy whenever needed. Pearson Chi square test carried out to quantify significance difference, p value <0.05, considered significant.Results: The mean duration of chronic cough was 56.27 days (1-5 months). Most of the children belonged to <6 years age with higher boys’ prevalence. Breathlessness and fever noticed in 79% cases; it was found mostly in pneumonia cases as compared to other diagnosis (p=0.001). Sputum production noticed in 4, which found to be bronchiectasis. 1 case noticed with regurgitation, which is gastro oesphageal reflux disease. History of triggers for the symptoms of cough, wheeze and breathlessness is found to have a significant correlation with asthma (p=0.000). Asthma in 14% of cases, of which 12 were mild persistent and 2 were moderate persistent. Tuberculosis was diagnosed in 14% cases, Pneumonia in 12% cases, and Bronchiectasis in 12 cases. Undernourished children noticed in 56%, maximum number in tuberculosis group. Asthma was associated with pneumonia, mucous plug obstruction and collapse lung. Recurrent pneumonia was associated with airway anomaly, gastro esophageal reflux disease.Conclusions: It should be remembered that a prolonged cough can be indicative of a more serious underlying condition, and always warrants thorough investigation.