Introduction: Ascites is a common clinical problem in children with liver and renal disease. The peripheral arterial vasodilation hypothesis is mostly accepted as the patho-physiological basis of ascites. The most important complication is spontaneous ascitic fluid infection in the form of spontaneous bacterial peritonitis (SBP) and its variants. Objective: To know the incidence, etiology, associated clinical co-morbidities & the outcome (morbidity & mortality) of the hospitalized children with ascites. Materials and Methods: After informed written consent from parents/ guardian, 102 children admitted with ascites irrespective of primary diagnosis were studied at department of Pediatrics, S. Nijalingappa Medical College, Bagalkot. The study was a prospective study and subjects were enrolled consecutively. Detailed history, complete physical examination & routine investigations were done in all patients and were recorded in predesigned proforma. A detailed etiological workup was done. Results: The most common symptoms were abdominal distension (100%), facial puffiness (62.74%), pedal edema (46.08%), & generalized swelling (35.29%). The most common signs were facial puffiness in 62.74%, pedal edema in 46.07% & anasarca in 35.29% the most common etiology of ascites was dengue fever, followed by nephrotic syndrome. Of the 102 children with ascites, 2 expired (Gaucher's disease & Wilson's disease). Conclusion: Prompt and early diagnosis and appropriate management of ascites is warranted to prevent related morbidity and mortality in children.

Background: Respiratory distress in newborn due to varied aetiology is one of the common causes for new born admission to NICU, new born morbidity and mortality. Bubble CPAP is a simple, cost effective and gentle mode of respiratory support in newborns with respiratory distress. It reduces the need for mechanical ventilation in appropriately selected cases. In this paper we review our institute experience of using very low cost indigenous CPAP as primary way of respiratory support and its outcome. Objectives: Effectiveness of indigenous CPAP as a low cost measure in treatment of respiratory distress in newborn period and its outcome. Design: Prospective observational study. Subjects and Methods: This study included 100 consecutive both term and preterm newborns admitted for respiratory distress due to varied aetiologies like respiratory distress syndrome, transient tachypnea of newborn, apnea of prematurity, birth asphyxia, meconium aspiration syndrome, etc in our NICU over a period of 1 year. Exclusion criteria being babies put on CPAP for post-extubation respiratory distress and babies with severe life threatening surgical conditions. Downe's scoring for term and Silvermann's scoring for preterm babies were used to assess the severity of respiratory distress and also to assess the response to indigenous CPAP. Results: Out of 100 newborns with respiratory distress treated with indigenous CPAP, 73% improved, 21% were further put on mechanical ventilation and 6% were discharged against medical advise. Failure of CPAP was associated with co morbidities like sepsis, congenital heart diseases, PPHN and IVH. Conclusion: Indigenous bubble CPAP is low cost equipment (Total cost Rs.301) effective in treatment of respiratory distress in newborn at resource limited neonatal intensive care units where newborn admissions are in excess.

Background:The most important consideration in a patient with a new onset of ascites is to perform a peritoneal tap and to ascertain the cause. A peritoneal tap is also indicated in a patient with known liver disease who presents with sudden clinical deterioration, worsening encephalopathy, or unexplained fever. A missed or delayed diagnosis of spontaneous bacterial peritonitis could potentially lead to sepsis and significant morbidity & mortality. Prophylactic antibiotic therapy with a quinolone is often recommended. Subjects and Methods: All children with ascites were included in study irrespective of their primary diagnosis. Detailed history, complete physical examination & routine investigations were done in all patients. Ascitic tap was done after taking written consent from the guardian with full aseptic precaution. Results: Diagnostic ascitic tap was done in 48 patients, off which it was clear in 70.83%. In 8 patients the fluid was hazy in appearance suggestive of possibly infective origin either due to elevated protein or cells. One patient had milky appearance of ascetic fluid that suggests chylous nature of it. Conclusion: Proteinuria (33.3%), Hypoalbuminemia (42.16%), reversed AG ratio (34.3%) & hypercholesterolemia (37.2%) were present all together in 33.3% (34) patients suggestive of Nephrotic syndrome.