Children with severe acute malnutrition, defined as weight for height <70% of reference median or bilateral pedal edema or midarm circumference <11 cm having complications were managed following the WHO guidelines, in the nutrition rehabilitation centre of medical college, Baroda. Total 60 children aged less than five years were admitted during October 2011 to September 2012. Of them majority were aged less than two years, & the predominant age presented was 6-12 months. Severe malnutrition is more among females. 86.65% & 5% study population formed by marasmus & kwashiorkor respectively. Most patients stayed for inpatients treatment between 16-20 days, mean duration of stay was 15.6 days. Reasons for bringing children to the hospital were associated major illnesses & complaint such as fever in 65% of patients, 40% had diarrhea. 96.6% had pallor, and associated co morbidities observed were bronchopneumonia followed by acute gastroenteritis. Observed complications of SAM in our study were hypoglycemia (5%), hypothermia (1.66%) some and severe dehydration were (18.33%) and (13.33%) respectively, hyponatremia (13.33%), hypokalemia (8.33%), hypernatremia (5%), hyperkalemia (1.66%), septic shock (11.6%), severe anemia (58.33%), congestive cardiac failure (28.5%). Majority of patients had weight for height between 61-70% on admission and between 71-80% on discharge. Average weight for height on admission was 68.5% and average weight for height on discharge was 77.2%. 29 % patients reached more than 90% weight for height. Mean weight gain was 9.3 gm/kg/day.78.33% patients who were admitted were discharged, 8.33% absconded, 5% expired. Case fatality rate in our study was 5%.

Background: Dehydration and hypernatremia amongst exclusively breast fed neonates due to inadequate breast feeding or due to less feeding is a potentially devastating condition, and its incidence rate increases during hot environment especially during summer months. We conducted this study to identify possible etiology behind dehydration and hypernatremia among healthy newborn.Methods: Authors retrospectively studied from available records from our Extramural NICU for months of March, April, and May 2017. Inclusion criteria for study were 1) Neonates with signs and symptoms of dehydration, 2) exclusively breast fed newborn. Those with congenital malformations, very low birth weight and perinatal asphyxia were excluded from the study.Results: Total NICU admissions were 434 during these months, and 28 patients we received with dehydration and 21 patients out of 28 had hypernatremia. Incidence rate of dehydration was 6.45%. Almost all the patients had altered renal functions at the time of admission, which became normal before discharge. 4 patients had culture proven sepsis. 2 patients died out of 28 patients. 26 patients out of 28 recovered completely and discharged.Conclusions: Dehydration and hypernatremia is preventable and treatable condition. All the mothers needs to taught correct feeding method like proper position and attachment of feeding. Signs of dehydration must be explained to mother as well as close relatives. Follow up visits should be ensured and check for weight is must. Not to encourage mother to give any other feed apart from exclusive breast feeding for first 6 months and even during summer months.

Background: Community-acquired pneumonia is the leading cause of mortality of under-five children in developing countries, including India. Based on the burden of CAP, India is among the top five countries and has over 23% of the global cases. Accurate, reliable, and rapid determination of etiology in childhood CAP is important because it would influence individual treatment decisions, antibiotic policy in the community, and also rational immunization policy at a national level. Objectives of current study were to study the clinical and bacteriological profile of children admitted with CAP and to determine sensitivity and resistance patterns to various antibiotics to these organisms.Methods: This was a prospective and observational study conducted over one year in the Paediatric ward SSG hospital Vadodara, Gujarat, India. Blood culture and Oropharyngeal swab/endotracheal swab for culture and sensitivity were collected in all study patients. Organisms isolated in blood culture and oropharyngeal/ET swab were analysed in percentage and frequency. Results: Chest retraction (88%) was the commonest sign observed in this study followed by tachypnoea (74%). In blood culture, Acinetobacter was the most common organism isolated and in oropharyngeal and ET swab culture was Klebsiella spp. Major co-morbidity contributing to mortality was severe anemia followed by severe acute malnutrition.Conclusions: Bacterial cultures of blood and oropharyngeal/ ET secretion swab culture have grown predominantly Acinetobacter and Klebsiella pneumoniae in this study. Administration of sensitive antibiotics as per the geographical bacteriological profile of community-acquired pneumonia will help to improve outcomes and prevent antibiotic resistance.