Background: CPAP has become a useful in management of respiratory distress, especially in preterms. CPAP delivers a continuous distending pressure via the neonates pharynx to the upper and lower airways. The main indication for use of CPAP is RDS. Aim of study: To study the effectiveness of indigenous bubble CPAP in management of respiratory distress in newborn and to determine its outcome. Setting: Department of Pediatrics, MGM Medical College and MY Hospital, Indore during the period February-July 2005. Design: Prospective Observational Study. Method: This study was carried out on inborn neonates in the NICU of MY Hospital over a period of six months. Matched controls were taken from admissions during previous four months. It included the newborns developing respiratory distress with grunting and chest retractions within 6 hours of birth whose severity was measured by Silverman Anderson Score and oxygen saturation.Neonates with increasing Silverman Anderson Score or Oxygen saturation falling below 85%were taken on CPAP and their outcome studied. Result: There were 42 RDS cases in the study group of which 28 survived and 14 died. Indigenous BUBBLE CPAP was beneficial in managing babies with RDS. Conclusion: Indigenous BUBBLE CPAP is an effective and non-invasive way to provide ventilation in a setup with limited resources. It can be used to manage respiratory distress due to RDS, congenital pneumonia & MAS. It resulted in significant reduction in mortality but prognosis was bad in those who required CPAP >8 cm H 2 O.

Background: Stress hyperglycemia is mainly due to increased gluconeogenesis and glycogenolysis & insulin resistance. Longer duration of hyperglycemia during hospital stay is known to have adverse outcome. Aim of Study: To study the prevalence of hyperglycemia and its association with PICU mortality and morbidity in terms of duration of PICU stay. Design: Prospective Observational study. Method: All critically ill children belonging to age group of 1 month to 14 years, admitted in PICU from 1st May 2011 to 15th September 2011 over a period of four and a half months. Children were followed throughout their hospital stay and outcome in terms of mortality and duration of PICU stay were noted. Blood glucose levels weredone every 3 hourly during the first 48 hours of PICU admission. Highest blood glucose level in the first 48 hours was defined as the peak glucose level. The mean of glucose values of first 24 and first 48 hours were calculated. Result: Prevalence of hyperglycemia was 58%. Mortality rate was higher in the hyperglycemic patients (56%) as compared to normoglycemics (14%) and overall mortality (36%). The p value for difference in the mean of peak RBS and 24 hours mean RBS of the non-survivors and survivors was <0.005 and hence significant. Statistical Analysis: Independent student t test used for analysis. Conclusion: Hyperglycemia during first 24 hours of PICU admission was associated with higher mortality rate and longer duration of PICU stay.

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