Background: Ventilator induced lung injury prevention may begin from birth, and respiratory support without endotracheal intubation is an attractive option in preterm baby with Respiratory distress syndrome (RDS). The objective of the study was to evaluate the clinical course and respiratory outcomes in preterm infants with moderate RDS assigned from birth to Nasal Continuous Positive Airway Pressure (NCPAP) or Bi-level Nasal Continuous Positive Airway Pressure (Bi-level NCPAP).Methods: 60 infants of 28-34 weeks GA (<35 wks GA), affected by moderate RDS, were considered eligible and were randomized to NCPAP (CPAP level=6cm H2O, Group A n=30) or to Bi-level NCPAP (lower CPAP level=4.5 cmH2O; higher CPAP level=8 cmH2O, Group B n=30), provided with the variable flow devices (Infant Flow CPAP vs Infant Flow SiPAP™, Viasys Healthcare, Yorba Linda, CA).Results: Length of ventilation, oxygen dependency, need for intubation and occurrence of air leaks were considered as outcomes. Infants showed similar characteristics at birth (Group A versus Group B: GA 30.4±2 wks versus 30.3±2wks, BW 1433±545g versus 1415±560g. Group A underwent longer respiratory support (6,2±2 days versus 3,8±1 days, p=0.025), longer O2 dependency (13,8±8 days versus 6,5±4 days, p=0.027) and was discharged later (GA at discharge 36,7±2,5 weeks versus 35,6±1,2 weeks, p=0.02). All infants survived. No BPD or neurological disorders occurred.Conclusions: Bi-level NCPAP was associated with better respiratory outcomes versus NCPAP, and allowed earlier discharge, inducing the same changes in the cytokine levels. In our population, it was well tolerated and safe

Background: This study describe the breastfeeding practices. This study was describe the breastfeeding practices and factors affected initiation and duration of breastfeeding  Methods: The cross sectional study was conducted on mothers with infants less than 1 year who came to immunization center for vaccination was included in the study. Total 500 mothers include in this study. Results: Only 35.20% of the mothers did the exclusive breastfeeding until 6 months and started weaning after 6 months. A total 56.00% of mothers in our study prematurely started weaning. Conclusions: The study emphasizes the need for breastfeeding intervention programs especially for the mothers during antenatal and postnatal check-ups. The information regarding the advantage and duration of breastfeeding need to be provided for the community as a whole. Keywords: Breastfeeding, Immunization, Infants.

Background: To study outcome of preterm babies with RDS in babies admitted in NICU. Methods: This study was hospital based prospective study of preterm neonates with respiratory distress syndrome admitted in NICU of MBGH RNT medical college Udaipur, from February 2017 to January 2018. Results: Among 200 preterm neonates included in the study 31 neonates expired. Mortality was 15.5%. The mortality was 10.17% among the preterm neonates with RDS and hospitalized within 6 hrs. It was 31.81% among neonates hospitalized between 6-12 hrs and 62.5% and 66.66% among neonates hospitalized between 12-24 hrs and after 24 hrs of birth respectively. Conclusion: Mortality rate is inversely related to birth weight and gestational age and directly related to age at admission and severity of respiratory distress (Silverman-Anderson score). Keywords: Preterm, Neonates, Birth weight.

Background: Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. While most patients recover following a self-limiting nonsevere clinical course, small proportion progress to severe disease. Early recognition of dengue is challenging because the initial symptoms are often non-specific.  Methods: The hospital based study was conducted on patients presenting to paediatric hospital, who fulfilled inclusion and exclusion criteria. Results: According to complications, in dengue positive cases, bleeding was the most common complication seen in 51.00% cases while shock, myocarditis, and convulsion were present in 34.00%, 3.00% and 1.00% of cases respectively. Among the dengue negative cases, 63.00% had no complication while shock and bleeding were present in 23.00% and 14.00% cases respectively. Conclusion: It concluded that shock was most common complication. Keywords: Complication, Fever, Dengue Like Illness

Background: To study the maternal risk factors, morbidity, mortality of moderate preterm in comparison to term neonates.Methods: This Cohort study involved two hundred fifty consecutively born moderate preterm and equal number of term newborns delivered in a tertiary care hospital. They were followed till discharge for morbidities and mortality. Detailed maternal and neonatal factors were studied and compared between the two groups.Results: Moderate preterm babies constituted 55% of all live preterm births during the study period. The odds of babies developing major morbidity was significantly more in those whose mothers had hypertension and infections (OR 2.69 95% CI: 1.55, 4.68 and 2.08, 95% CI: 1.6, 2.71 respectively). In the study group, 42.4% and 20.8% babies suffered major and minor morbidity compared to 8.4% and 6.8% of term controls respectively. moderate preterm neonates had significantly higher odds of developing morbidity like respiratory distress (12.4% vs. 5.6%, OR 2.21, 95%CI 1.21,4.11), need for non-invasive(17.3% vs. 5.7%, OR 3.05 95% CI 1.69, 5.47) and invasive ventilation (14.6% vs. 1.7%, OR 8.62, 95% CI 3.09, 24.04), sepsis (20.8% vs. 5.2%, OR 5.20, 95% CI 2.71, 9.99), seizures (22.8% vs. 4.8%, OR 4.75 95%CI 2.61, 8.63), shock (17.6% vs. 4.4%, OR 4.00 95% CI 2.12,7.56), and jaundice (26% vs. 6%, OR 4.33 95%CI 2.54, 7.39). By logistic regression, the odds of developing major morbidity decreased with increasing gestational age (aOR 0.28 95% CI 0.18, 0.45; p<0.001) and increased with hypertensive disease of pregnancy (aOR 2.16 95% CI 1.09, 4.260; p00.026).Conclusions: Moderate preterm neonates have significantly more mortality and morbidity compared to term controls. Maternal hypertension and lower gestational age are the strongest predictors of morbidity.