There was no difference in the overall mortality, rapidity of shock resolution, or incidence of complications between the groups. The occurrence of hepatomegaly at 20 minutes following 40 mL/kg is of concern in settings with limited access to post-resuscitation ventilator care.

Background and Aims:Pediatric index of mortality (PIM) 2 score is one of the severity scoring systems being used for predicting outcome of patients admitted to intensive care units (ICUs). The aim of the present study was to evaluate the usefulness of PIM2 score in predicting mortality in a tertiary care pediatric ICU (PICU) and to assess the associated factors in predicting mortality such as presence of shock, need for assisted ventilation and Glasgow coma scale <8.Materials and Methods:This was a prospective observation study done at tertiary care PICU from May 2011 to July 2011. Consecutive 119 patients admitted to PICU (aged 1 month to 12 years) were enrolled in the study. PIM2 scoring was done for all patients. The outcome was recorded as death or discharge. The associated factors for mortality were analyzed with SPSS 17.Results:PIM2 score discriminated between death and survival at a 99.8 cut-off, with area under receiver operating characteristic curve 0.843 with 95% confidence interval (CI) (0.765, 0.903). Most patients were referred late to this hospital, which explains higher death rate (46.2%), lesser length of hospital stay (mean 2.98 days) in the mortality group, and increased rate of mechanical ventilation (68.1%). Presence of shock was independently associated with mortality, as evidenced by binary logistic regression.Conclusion:PIM2 score discriminated well between survivors and death at PICU. Presence of shock was significantly associated with mortality.

Background and Aims:Noninvasive ventilation (NIV) is an emerging popular concept, which includes bi-level positive airway pressure or continuous positive airway pressure (CPAP). In settings with scarce resources for NIV machines, CPAP can be provided through various indigenous means and one such mode is flow inflating device - Jackson-Rees circuit (JR)/Bain circuit. The study analyses the epidemiology, various clinical indications, predictors of CPAP failure, and stresses the usefulness of flow inflating device as an indigenous way of providing CPAP.Methods:A prospective observational study was undertaken in the critical care unit of a Government Tertiary Care Hospital, from November 2013 to September 2014. All children who required CPAP in the age group 1 month to 12 years of both sexes were included in this study. They were started on indigenous CPAP through flow inflating device on clinical grounds based on the pediatric assessment triangle, and the duration and outcome were analyzed.Results:This study population included 214 children. CPAP through flow inflating device was successful in 89.7% of cases, of which bronchiolitis accounted for 98.3%. A prolonged duration of CPAP support of >96 h was required in pneumonia. CPAP failure was noted in 10.3% of cases, the major risk factors being children <1 year and pneumonia with septic shock.Conclusion:We conclude that flow inflating devices - JR/Bain circuit are effective as an indigenous CPAP in limited resource settings. Despite its benefits, CPAP is not a substitute for invasive ventilation, as when the need for intubation arises timely intervention is needed.

Children decide the future of a country and hence a lot of importance is given to childhood nutrition. School age is the vital period during which body's nutritional status is built. Adolescence is a critical phase in the life cycle of human beings. Rapid rate of growth occurs in this phase and it is a transition from childhood to adulthood. 1 Hence adequate nutrition is essential for this spurt of growth. 2 Adolescence is also considered as a second chance for growth or catch up growth for those children who had undergone deficits in nutrition in their early life. 3 Adolescents contribute to approximately 21.4% of Indian population (National Youth Policy 2002). 4 A lot of studies have been done on the nutritional status of children in the under-five age group. Hence we had proposed a study to focus on the adolescent nutritional status based on anthropometry. METHODS This cross-sectional study was done in a semi urban area of Southern part of India during November 2012-November 2013, after obtaining clearance from the ABSTRACT Background: Adolescent nutrition is generally given less importance when compared to the under-five nutrition in developing countries like India. Studies throwing light on the nutritional status of adolescent children are needed. Aims and objectives of the study were to know the prevalence of obesity, overweight, thinness, severe thinness and stunting in adolescent schoolchildren based on anthropometry and its association with various factors. Methods: A cross sectional study was done in six schools in a semi urban area of Southern part of India during November 2012-November 2013.Obesity,overweight,thinness, severe thinness and stunting were determined in the children of the age group of 9-17 years based on WHO Z scores. A predesigned questionnaire and clinical examination were used to find out the factors associated with malnutrition and their implications. Results: Out of the 2100 children studied, the prevalence of obesity was 6%; overweight 10.9%, thinness 13%; severe thinness 5% and stunting 19.8%. Mother's education, occupation and socioeconomic status have significant associations with both over nutrition and under nutrition. Skipping breakfast is associated with thinness. Conclusions: Even though obesity and overweight are increasing in recent times; under nutrition is still prevalent in adolescent school children. Routine school health visits, improving female literacy, dietary modifications, imparting health as well as physical education are the need of the hour to avoid malnutrition in adolescent school children.

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