Introduction: Respiratory distress is a common problem in neonates necessitating admission. Transient tachypnea of newborn (TTNB) is most common after term cesarean delivery. It is characterized by the early onset of tachypnea with retractions, or expiratory grunting and, occasionally, cyanosis. Distinguishing the disease from respiratory distress syndrome (RDS) andother respiratory disorders may be difficult, and TTNB is frequently a diagnosis of exclusion; the distinctive features of TTNB are rapid recovery of the infant and the absence of radiographic findings for RDS (hypoaeration, diffusereticulogranular pattern, air bronchograms) and other lung disorders. Objective: To study incidence, clinical profile of TTNB and to identify clinical clues that may help inprediction of severity of disease and need for early intervention for better outcome in patients with TTNB. Study design: This is a prospective study conducted at a tertiary care institute in late preterm and term babies admitted in neonatal intensive care unit (NICU) with respiratory distress during the study period. Results: Total admissions during study period were 510 of which 22 Newborns had TTNB. The average gestational age of 36+ 1.2 weeks and birth weight of 2924 + 404 gm. Neonates were included in the study following inclusion criteria. Risk factors identified for TTNB includes caesarean section (most common), male sex, infant of diabetic mother. Outcome can be predicted based, on Downe's score at presentation and time of development of respiratory distress after birth. Conclusion: According to this study all late preterm and term newborn delivered through LSCS are at greater risk for developing TTNB and early development of respiratory distress and higher Downe's score at presentation are associated with longer hospital stay.

Background: Cardiac failure is one of the common complications of Acute Myocardial Infarction. As CAD is the leading cause of death and post MI Cardiac failure also causing increase in rate of Mortality. It directs us to assess the complications of MI and to evaluate the precautionary & preventive steps of cardiac failure.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. We excluded the patients who presented with Cardiac failure without Prior history of MI. This hospital based cross sectional study was conducted at Rajiv Gandhi Institute of Medical Sciences (RIMS), Ongole, Prakasam District, Andhra Pradesh. The study was carried out for a period of 1 year with informed consent.Results: In present study majority number of patients (33) show hypokinesia and 10 are found to have dyskinesia and only 4 are akinesia. In this study More than 50% patients are with history of anterior wall involvement. 36(72%) patients have elevated JVP, 34(68%) have cardiomegaly, 38 patients presented with PND. 29(58%) patients are DM and 35(70%) are HTN and only 6(12%) patients are neither DM, nor HTN.Conclusions: Cardiac failure is a common complication after MI. Most common presentations are breathlessness, chest pain, PND, JVP etc. Anterior wall MI on ECG either isolated or associated with other walls is the leading cause of post MI cardiac failure.

Background: Dengue Fever is an Infectious condition caused by flavo virus. It is an epidemic since 4 years and its prevalence is increased in the recent years in India. The increase in India is due to rapid urbanization, population growth, increased international travel and global warming. But dengue fever is now being reported from rural backgrounds due to poor sanitation and stagnant water sources.Methods: This is an institutional cross sectional study in which we took patients presenting with fever and various other complaints related to viral fevers for 9months from 2016 June to March 2017 at Rajiv Gandhi Institute of Medical Sciences, Ongole. In this study we included patients who are NS1 Ag positive and dengue ELISA positive only. We excluded whose NS1 Ag test positive but their dengue IgM ELISA report is negative.Results: In this study we have included 94 patients of all age groups who are diagnosed with dengue fever. Next in the list are nausea/vomiting (43.6%) and diarrhea (40.4%) respectively. We highlighted this in conclusion to consider abdominal manifestations association while evaluating pyrexia patients.Conclusions: As usually fluid management and regular monitoring is the main role in the management of dengue cases than platelet or blood transfusions and antibiotics. We concluded that there is significant association between abdominal manifestations and dengue fever. So abdominal manifestations should be considered while evaluating pyrexia patients to rule out dengue association in those patients and prognosis of dengue fever.

Background: Intensive care Unit is the one place where we come across various medical critical cases and high number of deaths is also recorded here. In spite of so many deaths occurring at this unit, cause of death is poorly reported. We studied the different causes for deaths in ICU which includes single and multiple factors for cause of death.Methods: A retrospective study performed between January 2017 to January 2018 at Rajiv Gandhi Institute of Medical sciences, Kadapa, Ongole, A.P. This study includes 260 deaths among patients admitted in ICU of our institute during this duration. We gathered data at various levels like clinical evaluation and investigations.Results: A total of 260 deaths were recorded during this study. Among these 215 (82.69%) are female and 45 (17.30%) are male. At the time of death 174 (66.92%) patients has single systemic cause 86 (33.06%) had more than one systemic cause. Cardiovascular death 50 (19.23%) is the most common cause of death among all in which CAD 28 (10.76%) are major portion and congestive cardiac failure 20 (7.6%) are the remaining portion of the cardiac deaths. Chronic kidney disease 37 (14.2%) is the next highest deaths recorded and cerebro vascular 35 (13.46%) deaths follows the next in line.Conclusions: Majority of ICU patients were present with at least one organ failure at the time of death. What we have concluded in this study is that there are more number of deaths with single systemic cause than multiple systemic causes.