BACKGROUND Auricular lobuloplasty is one of the commonly done day care surgical procedure. Though surgery seems simple and lobule is small, its impact on the individual is very high because ear is one of the aesthetic parts of face. Both males and females wear attractive ornaments on their ears, for which they undergo different kinds of ear-piercing techniques. In this process, due to various reasons, ear lobule gets distorted in shape and form for which most of them seek medical advice and undergo surgical procedures to regain near normal structure of lobule. Auricular lobuloplasty is done by general surgeons, ENT surgeons and general practitioners apart from plastic surgeons. But good aesthetic results are obtained by surgeries done by plastic surgeons for the reasons of meticulous tissue handling, use of finer suture materials and post-operative follow up and care. METHODS 50 patients who underwent auricular lobuloplasty were included in this study. Demographic characteristics, cause of surgery, presence of complications, patient satisfaction were evaluated. Surgeries were performed under local anaesthesia in 49 cases and one under general anaesthesia. Lobuloplasty was performed in 49 female patients and one male patient. Of the 50 cases of lobuloplasty, 37 were with enlarged holes, 5 tear ear, one lobule tissue loss, and 4 cases with keloid of ear lobule. There were no post-operative complications and in no case revision surgery was done. RESULTS Mean age was 47 years; smallest is a girl of 6 years, and oldest was 89 years old. The commonest cause for auricular lobuloplasty was enlarged ear holes, followed by ear keloids. Commonest procedure done was simple bilayer closure. It gave good aesthetic results. Patient satisfaction was evaluated by visual analogue scale. CONCLUSIONS Multiple surgical techniques exist for repairing ear lobule deformities. Auricular lobuloplasty is a surgical procedure that has several advantages including safety, it being a day care procedure, effectiveness and good patient satisfaction, and very minimal complications. It has great impact on feelings and beauty of a woman.

BACKGROUND Optimum nutrition is essential for child survival and quality of survival. As per global public health recommendations, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond 4. Infant feeding and rearing practices have a major effect on short term and long-term nutritional status of infants. Present study is undertaken to assess the current feeding practices in infants attending paediatrics department in a tertiary care hospital. METHODS Present study is a cross sectional study in which about 500 Mothers and their infants attending paediatric OPD, postnatal ward, paediatric ward of KGH for various reasons of health care, were selected for study. Statistical analysis was done using Epi Info 7.1.2.0 of Centre for Disease Control, USA and MedCalc 12.7.5 Belgium. RESULTS The median age of mothers in the study is 22 years in which about 54.4% were illiterate and 81% were house wives. Breast feeding suggestion during ANC to mothers by doctors is 79%. 11.2% children were given prelacteal feeds. Exclusive breast feeding was done by mothers in 88%. When the mothers knowledge regarding the age of initiation of complimentary feeding is obtained, 2.2% of mothers thought complimentary feeding can be started when the child was between 2 to 3 months age, 9.8% felt that it can be started between 3 to 4 months of age; 15% felt 4-5 months, about 23% felt 5 to 6 months, 29.4% felt 6 to 7 months, 21% felt that it can be started > 7 months of age. CONCLUSIONS There is a need to improve health education regarding infant feeding practices like exclusive breast feeding and weaning. Problems during breast feeding should be taught during pregnancy. Counselling should be started antenatally to improve confidence in mothers and to identify problems like inverted nipple. Breast feeding and weaning are two major pillars in infant feeding which should be done appropriately to reduce infant morbidity and mortality.

BACKGROUND Jaundice is yellowish discolouration of the skin, the mucous membranes or the eyes. It is caused by high levels of the chemical bilirubin in blood, a by-product of destruction of old red blood cells. A newborn baby's liver is not fully matured, so jaundice is common during a baby's first few days of life 1 Since bilirubin is potentially toxic to the central nervous system, early detection and appropriate management of neonatal jaundice (NNJ) is of paramount importance 2. Hence early detection of neonatal jaundice is an important issue. The present study was conducted to find out the critical value of serum bilirubin in the cord blood and at 24 hrs. in predicting the subsequent development of hyperbilirubinemia in healthy newborn babies. METHODS Cord blood sample and blood sample at 24 hours were collected from all 200 babies. After 24 hours and up to 5 th post-natal day, blood samples for serum bilirubin estimation were taken from those babies who were clinically suspected to be having jaundice. RESULTS Total serum bilirubin > 2.3 mg/dl has sensitivity of 75.3% (95% CL 65.2% to 83.6%), specificity of 81.3% (95% CL 72.6% to 88.2%), positive predictive value of 77.8 (67.8 to 85.9), negative predictive value of 79.1% (70.3% to 86.3). The diagnostic ability of TSB at 24 hrs. to predict the need for phototherapy shows that TSB > 5.3 mg/dl, has sensitivity of 87% (95% CL 78.5% to 93.2%), specificity of 67.3% (95% CL 57.5% to 76%), positive predictive value of 69.8 (60.6 to 78.0), negative predictive value of 85.7 (87.5 to 85.4). CONCLUSIONS The time to reach maximum total serum bilirubin level after birth is 3 rd postnatal day in our study. So, the baby in need of phototherapy has to be identified earlier to 3 rd postnatal day. A total serum bilirubin level prior to 3 rd day which can predict the later need of photo-therapy in a given baby will have clinical utility. The optimum cut off value of total serum bilirubin in cord blood which can predict the need for phototherapy is > 2.3 mg/dl and value of total serum bilirubin at 24 hrs which can predict the need for phototherapy is > 5.3 mg/dl. So, these at-risk babies should be observed carefully for the need of phototherapy.