Background: Neonatal transport system in our country is a major gap in holistic newborn care and acute neonatal physiology deranged during neonatal transport which adversely affects the mortality and morbidity of sick newborns. To determine the effect of mode of transport on outcome of extramural newborns. To determine the effect of mode of transport on extramural newborns outcome at the level of tertiary care center.Methods: This is a prospective cohort study carried out in chengalpattu medical college and hospital, NICU over a period of 6 months. Inclusion criteria were all admitted extramural babies, readmitted intramural babies and those babies died while transport. Exclusion criteria were those babies born in the institution of study. A predesigned and tested proforma was used to record the required information for the study at the time of admission. Data was analysed and tabulated, for analysis of data software STATISTIX was used.Results: Out of 490 newborns 11% were died, 84% were discharged and 2.45% were gone against medical advice. About the mode of transport was 60% by Ambulances, 10.6% by Auto, 22% by Bus and 6.8% by Car.Conclusions: The study concludes that even though the mode of transport accompanied by a health personnel no difference in the outcome of babies. So, we suggest well trained and equipped transport system to improve the outcome.

Background COVID-19 infection during pregnancy was reported to cause adverse outcomes. Such knowledge stands low quality evidence due to lack of internal controls and inferential statistics. Objectives To assess impact of COVID-19 in pregnancy on fetal and neonatal outcomes. Study Design Prospective analytical cohort study (July 2020 to March 2021). Setting Level III NICU of teaching hospital in India. Participants COVID positive mothers (exposed = 239) each matched with 2 women delivered consecutively by same mode without COVID (unexposed = 478) and enrolled at admission during delivery. Procedure Maternal demographic, comorbidities, and obstetric characteristics; fetal growth, pregnancy complications, and neonatal details of 242 and 482 neonates born to exposed and unexposed mothers respectively were analyzed. Infants were followed until neonatal period. Outcomes Incidence of prematurity was primary outcome. Secondary outcomes were incidence of abortions, IUD, stillbirth, neonatal mortality, neonatal resuscitation at birth, SFD, NICU admission, neonatal morbidities, length of hospitalization, in-hospital mortality, infant positivity rate for SARS COV-2. Results Incidence of prematurity was not significantly different between mothers with and without COVID-19 infection [42(17.3%) vs 94(19.3%), IRR (95%CI) 1.04(0.83,1.31), P = .833]. Neonatal mortality, adverse fetal outcomes, PROM, fetal distress, SGA, neonatal resuscitation, NICU admission did not differ significantly between groups. Gestational hypertension was associated with COVID-19 infection [14(5.9%) vs 11(2.3%), (p=0.014)]. Infant swab positivity was 7%. Swab positivity and neonatal symptoms were associated significantly (10/17(58.8%) vs 7/17(41.1%), P = .0001). Conclusion Asymptomatic COVID-19 infection during pregnancy does not increase adverse fetal and neonatal outcomes. COVID positive neonates become symptomatic and hence need monitoring in health-care facility.

Introduction: Prognostic scores play a vital role in predicting the outcome of children admitted in Paediatric Intensive Care Unit (PICU) thereby reducing the mortality. For paediatric populations Paediatric Risk of Mortality (PRISM) and Paediatric Index of Mortality (PIM) are the principal scores. As limited PICU beds are available in many tertiary care centres, PRISM score helps in predicting mortality risk and admission to PICU. Aim: To compare PRISM III and PIM II in predicting the mortality in sick children in a PICU and their relation between observed and predicted mortality. Materials and Methods: This was a prospective observational study, conducted in Chengalpattu Medical College Hospital, Chennai, Tamil Nadu, India, from July 2018 to June 2019 that enrolled 102 children who were admitted to PICU. At first hour of admission, PIM score was assessed and at 24 hours of admission PRISM score was assessed and the mortality was predicted. Children were followed-up until discharge or death, and the predicted mortality was compared with actual mortality and validation of scores was done using Statistical Package for the Social Sciences (SPSS) version 16. Results: Mean age of the population was 37.6 months, and majority of the children were aged less than 12 months. Male children were predominant (52%). Major system involvement was respiratory system 38 (37.3%) and mortality was 18 (17.6%). The mean score for death in PRISM and PIM were 11.8 and 19.9, respectively. The mean score for survival in PRISM and PIM were 4.4 and 9, respectively. Total PRISM and PIM score was lower in children who survived and mortality has been observed with higher scores. On comparison PRISM score was better to predict the mortality than PIM. The Area Under Curve (AUC) and sensitivity for PRISM score were 0.881 with 95% CI (0.769 to 0.992) and 94.44% respectively versus the AUC and sensitivity for PIM score were 0.768 with CI (0.628 to 0.908) and 61.11%, respectively. Using logistic regression, risk of mortality was analysed and found that increase in one score has 0.62 times the increased risk of death in PRISM score and thus it predicts the mortality better. Conclusion: The PRISM score was better than PIM score for risk stratification and to optimise available limited resources. Both scores underestimate the predicted mortality in comparison to observed mortality