Background: Neonatal sepsis is an important cause of neonatal mortality and morbidity. Early diagnosis of sepsis is difficult due to its non- specific clinical presentation. The gold standard for diagnosis is blood culture, which is obtained in only 25%-40% of cases and requires 48-72 hours. There is a need for a sepsis screen for early diagnosis of septicemia and identification of culture negative cases. The objective of the study was to study the role of sepsis for early diagnosis of septicaemia and identification of culture negative cases and to compare the rapid diagnostic tests with blood culture singly and in combinations for specificity and sensitivity.Methods: 60 cases of suspected septicemia were studied. Total leucocyte count, bandforms peripheral smear examination, C-reactive protein assay, micro-ESR, and blood culture study was investigated. Results: Study revealed that CRP had maximum sensitivity while band neutrophil ratio had balanced sensitivity and specificity. In the two tests, CRP with PS/BF had balanced sensitivity and specificity. In the three tests combination, CRP with TC with micro-ESR had balanced sensitivity and specificity in proven sepsis, While CRP with BF with micro-ESR had balanced sensitivity and specificity in most probable sepsis cases.Conclusions: Neonatal sepsis has vague signs and symptoms, so high index of suspicion helps in arriving early diagnosis and management. CRP had maximum sensitivity in the individual tests. Using either two tests (CRP + PS/BF) or three tests (CRP + Micro ESR + BF/TC) most of the sepsis cases could be identified and sepsis negative cases can be ruled out. Sepsis screen is helpful in avoiding overuse of antibiotics.

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Background: The optimal timing of cord clamping has been a controversial issue for decades. Most practitioners in developing countries clamp and cut the cord immediately after birth and this takes place during the third stage of labour. World Health Organization advises late cord clamping, however there is a debate on the optimal time for cord clamping. Delayed umbilical cord clamping appears to be beneficial for term and preterm infants.Methods: This observational study was undertaken at Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India from June 2018 to January 2019.Results: Total 100 neonates were studied of which 48 were females (48%) and 52 were males (52%). 76 babies (76%) were 3 day old in this study and 24 babies were (24%) 4 day old during the study period. 92 babies (92%) didn’t receive phototherapy in this study and 8 babies (8%) required phototherapy during the study period. No babies were polycythemic during this study period. Mean TB was 11.832 whereas mean DB was 0.5. Mean HCT was 56.332 and mean HB was 18.3002.Conclusions: Present study concluded that there are various advantages if authors practiced delayed cord clamping including higher levels of haemoglobin and haematocrit levels.

Background: It is well established that maternal body mass index (BMI) and haemoglobin (Hb) level has an impact on foetal growth. Various studies have concluded that intrauterine growth as reflected by the Ponderal index (PI) is strongly influenced by various maternal factors. Therefore, we undertake this study to address the evidence gap to establish the strength of association between maternal nutritional status as indicated by her pre-pregnancy BMI and haemoglobin levels and neonatal PI.Methods: A hospital based cross-sectional, observational study was conducted that included 236 normal newborns and their mothers. A predesigned questionnaire was used to collect relevant socio-demographic data and obstetric history. Details regarding the maternal pre-pregnancy weight were collected from antenatal records, maternal height was measured and BMI was calculated. Neonatal birth weight and recumbent length was measured. PI was calculated and co-related with the maternal BMI and haemoglobin values.Results: 11.9% of the mothers were underweight and 51.3% had normal BMI. Majority of the mothers (62.7%) had normal Hb levels and 0.4% were found to have severe anemia (Hb <7 mg/dl). We saw a significant positive correlation (p<0.05) between BMI and birth weight, BMI and PI that is, with decrease in BMI there was a significant decrease in the birth weight and PI of the newborn. There was no significant correlation between haemoglobin level and PI.Conclusions: Our study showed a positive association between maternal pre-pregnancy BMI and birth weight, BMI and PI. Therefore, interventions aimed at improving the nutritional status of the mother have a direct impact on the foetal growth outcomes.