Conclusion• Good PARCA-R return rates suggests feasibility of the process.• Possible ways of improving return rate could be more time in clinic, help of interpreter, iPad while waiting etc.• To improve 2 years follow-up documentation and PARCA-R results in Badgernet.• To ensure babies transferred to CDC in early care have PARCA-R/similar assessment by CDC team• Recommendation for questionnaire to be translated into Asian languages commonly used in our population.• Recommend the use of EI SMART leaflet for parents. Actions taken so far • Clerical support with 'safety net check' at 27-28 months to ensure 2 years data and PARCA-R are entered on Badgernet.• Recruitment of Neonatal AHP team to provide support and assessment in 2 years follow-up clinic• 2 years follow-up checklist designed as a guidance for consultant at 2 years follow-up assessment• Discharge Parent Information leaflet is being designed for parents to understand the follow-up procedure 350

Hereditary spherocytosis (HS) is a type of congenital hemolytic anemia, in which heterogeneous alterations in one of the six genes that encode for proteins involved in vertical associations which tie the red blood cell (RBC) membrane skeleton to the lipid bilayer causesdysfunction or deficiency of cell membrane protein resulting in spherical-shaped, hyper- dense, and poorly deformable RBCs with a shortened life span. We report a case of HS in a 2-month-old female who presented with severe anemia, jaundice, and hepatosplenomegaly.The peripheral blood smear showed spherocytosis and reticulocytosis. The osmotic fragility was positive and direct antiglobin test was negative. The osmotic fragility test and direct antiglobulin test were positive. She was managed with packed RBCs (PRBCs) transfusionand folic acid supplementation.

Spurious thrombocytopenia or pseudothrombocytopenia (PTCP) is an important clinical entity, in which the presence of autoantibodies or anticoagulants used during blood sampling causes in vitro clumping of platelet and thereby resulting in a falsely low automated platelet count. The most common cause of platelet clumping is ethylenediaminetetraacetic acid used as an anticoagulant in the blood samples. The other reasons for PTCP include the presence of autoantibodies such as cold agglutinin, giant platelet, and platelet satellitism. There are very few cases of spurious thrombocytopenia in the newborn period published in the literature. We are reporting a case of PTCP due to platelet satellitism in a baby born to a mother with a similar condition.

Background: To study the incidence, severity and risk factors of retinopathy of prematurity (ROP) in neonates delivered in or referred to neonatology and paediatrics department of a tertiary care hospital in Kerala.Methods: Cohort study in the department of neonatology and paediatrics, of a tertiary care hospital in Kerala. There were 56 newborns satisfying the inclusion criteria. Data was collected and entered in the standardized data collection chart, and analysed.Results: Out of the 56 newborns studied, 12 babies developed ROP, and the incidence was found to be 21.4% (12/56). 41.6% (5/12) each developed stage 1 and stage 2 disease, 16.66% (2/12) developed stage 3 disease whereas no one developed stage 4 or stage 5 disease. Multiple maternal risk factors were studied showed no statistical association. Incidence of ROP was found higher in lower gestational age group and low birth. Surfactant administration, longer duration of oxygen therapy, anemia, need for blood transfusion, sepsis and phototherapy were significantly associated with development of ROP.Conclusions: Incidence of ROP was found to be 21.4 % (12/56) with higher proportion of neonates developing early stages of ROP. The incidence of ROP in the present study is comparable to most of the national and international studies, but some studies showed increased incidence of ROP also. Most of the risk factors associated with ROP arise during the stay in neonatal intensive care unit and some of them are avoidable. The incidence of ROP can be decreased by monitoring the risk factors, timely screening, regular follow up and appropriate interventions.

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