Background: Necrotizing enterocolitis is defined as an inflammatory bowel necrosis in premature infants and is major cause of morbidity and mortality in neonatal intensive care units throughout the world. We aim to study the role of probiotics in reducing incidence and severity of necrotizing enterocolitis in preterm neonates ≤34 weeks and its role on secondary outcomes like mortality, time to reach full feeds, daily weight gain, days of hospitalization and effect on nosocomial infections.Methods: This study was a prospective randomized controlled interventional trial conducted in SGRDIMSAR, Amritsar. A sample size of 150 was selected. 75 were randomized to test group and 75 to control group by simple random sampling.Results: The incidence of NEC was significantly lower in the test group compared with the control group (1 of 75 neonates vs 12 of 75 neonates; p=0.001). The severity of NEC, nosocomial sepsis and mean duration of hospital stay was significantly lower in the test group. Daily weight gain was significantly higher in the test group. There was no significant difference in mean age of onset of NEC, mortality and mean age to reach full feeds in two groups.Conclusions: Incidence and severity of NEC was less in the probiotic group. Daily weight gain was better, nosocomial sepsis and mean duration of hospital stay were less in the probiotic group.

Background: Perinatal asphyxia word derived from the greek word a-spyxos, meaning born without an evident pulse, is one of the most important causes of fetal distress. Inspite of major advances in technology and knowledge of fetal and perinatal medicine, it is one of the significant causes of mortality and long-term morbidity. World health organization (WHO) has defined perinatal asphyxia as a failure to initiate and sustain breathing at birth. HIE is one of the most common complication in an asphyxiated neonate because of its serious longterm neuromotor sequalae among the survivors. A detailed classification of HIE staging in term neonate was proposed by Sarnat and Sarnat.Methods: The present study was prospective case control study conducted in neonatal intensive care unit of Department of Pediatrics at SGRD institute of medical sciences and research over a period of one year from September 2016 to august 2017. Total of 100 newborns among which 50 asphyxiated babies were designated to case group and rest 50 normal term babies to control group. The NRBC count of the case and control groups is compared. The NRBC’s of subjects belonging to different stages of HIE is then compared. The results were analysed statistically chi-square analysis for variance (qualitative analysis), t-test (compare mean NRBC’s in different stages) by SPSS version 20 software for biostatistic and p-value of <0.05 was considered statistically significant.Results: Among total 100 babies included in the study, the male and female distribution was 22 (44%) and 28 (56%) in cases and 23 (46%) and 27 (54%) in controls respectively. In our study, the NRBC /100 WBC count for normal newborn was 0.88±1.35 and in case group it was 21.40±20.Conclusions: In present study, the cord blood NRBC count was shown to be a good predictor of perinatal asphyxia with sensitivity of 86%, specificity of 100%, positive predictive value of 100% and negative predictive value of 87.72%. NRBC’s can be used for early detection of HIE and its grading in asphyxiated neonates.

Background: Immunization is the single most cost effective and efficient intervention to reduce the burden of childhood mortality and morbidity worldwide. Vaccines under universal immunization programme (UIP) are provided free of cost but still the current coverage of fully immunized children is quite low. Main reason identified for poor coverage included illiteracy, lack of knowledge and poverty.Methods: It is a cross sectional study carried out in rural area of Punjab from March 2014-March 2015. Total 500 families with 500 children between age 0-5 years were selected randomly. Study involved one to one, interview according to a pretested structured questionnaire prepared in a vernacular language Punjabi and English too.Results: Total 500 children were included in the study out of which 230 (46%) were female and 270 (54%) were male. Maximum coverage to BCG vaccination (77.2%) and minimum for measles vaccine (56.2%) was observed. 55% of children were completely immunized, 28.8% were partially immunized and 16.2% were not immunized. Most common reason given by families for non\partial immunization was lack of knowledge, family issues and sickness of child.Conclusions: It is concluded from present study that the main reason for partial\non-immunization was lack of knowledge of families about vaccination. Considering incomplete knowledge and inappropriate practices the policy makers and medical profession require to put in much more efforts to sensitise families about importance regarding immunization in preventing diseases and their consequent morbidity and mortality.

Hydrometrocolpos is a rare entity in the newborn period with an incidence of 1 in 16000 female deliveries. We report a rare case of a two days old female child who presented to us with marked abdominal distension at birth due to hydrometrocolpos. DOI: http://dx.doi.org/10.3126/jnps.v33i2.7515   J Nepal Paediatr Soc. 2013; 33(2):136-137

Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis refers to infection occuring within the neonatal period i.e. first 28 days of life for a term baby and up to 4 weeks beyond the expected date of delivery in a preterm baby. Neonatal sepsis is one of the major cause of neonatal morbidity and mortality.Methods: The present study is a prospective observational study conducted in the neonatal intensive care unit (NICU) of Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Sri Amritsar over a period of one year from January 2015 to January 2016. Aim of the study is to know the incidence of neonatal sepsis, to study bacteriology of neonatal septicemia and to evaluate the risk factors associated with mortality in neonatal sepsis in our hospital.Results: During the study period (January 2015 to January 2016), 727 neonates were admitted in NICU of SGRDIMSAR, Sri Amritsar. Out of them, 109 neonates were diagnosed as having septicemia. Incidence of neonatal sepsis in our hospital in this study is 149.9/1000 neonatal admissions. 59 (54.1%) neonates had positive blood culture. Out of 109 septic neonates, 50 died and 59 survived. Mortality observed in the present study is 45.9%.Conclusions: It is concluded from present study that the main factors associated with neonatal mortality are low birth weight, prematurity, positive blood culture, neutropenia and prolonged prothrombin time. Some of the risk factors like low birth weight and prematurity are preventable by proper antenatal check ups and measures can be taken for safe and hygienic delivery. Babies with risk factors should be monitored closely for early detection of sepsis and the neonates with sepsis having abnormal laboratory parameters should be subjected to appropriate therapeutic intervention in order to decrease the mortality.