Background: Although survival of preterm neonates has improved in the surfactant era, necrotizing enterocolitis (NEC) continues to be a major cause of mortality and morbidity. A proposed strategy for the prevention of NEC is the administration of oral synbiotics. We evaluated the role of synbiotics in reducing the incidence and severity of NEC in preterm babies. Methods: A prospective randomized control trial was conducted in preterm neonates <34 weeks of gestation. They were randomized into two groups. The neonates in the test group were fed with synbiotic sachet with breast milk, twice daily till they reach full feeds. The neonates in the control group were fed with breast milk alone. The primary outcome was incidence and severity of NEC. Results: 200 preterm neonates were enrolled, 100 in the test group and 100 in the control group. The demographic and clinical variables were similar in both groups. The incidence of NEC was significantly lower in the test group (2 of 100 vs. 10 of 100). The incidence of stage 2 NEC was nil in the test group but 5 in control group. There were 2 cases of severe NEC (stage 3) in the control group and none in the test group. Incidence of sepsis was also significantly lower in the test group (28 of 100 vs. 42 of 100). Other secondary outcomes like age reached full feeds and duration of hospital stay were similar in both test and control groups. Conclusions: Synbiotics fed enterally with breast milk reduced both the incidence and severity of NEC.

Computed tomography in the diagnosis of pathologies in children is becoming increasingly popular. The aim: to study findings of referrals for CT scans (Computerised Tomography) of the brain in children in the department of Radiology in a developing environment. Materials and methods: retrospective imaging observational study was done in a 1000 bedded tertiary care hospital in South India in the year 2022 from April to August for 5 months under 16 slice CT scan. Cases are referred from the department of Pediatrics to the department of Radiology as part of the routine clinical evaluation and treatment protocol. Results: Our sample includes 100 infants; after exclusion criteria total of 60 infants' brain CTs were taken into account, and analysed their imaging from radiology department records. Of 60 cases, 18 (30 %) showed HIE Pattern, and 42 (70 %) had normal plain CT Brain findings. However, due to clinical signs and symptoms, they are evaluated under сontrast CT imaging (after checking creatinine levels), showing 20 cases (33.3 %) are standard, 10 cases (16.6 %) show meningitis, and 2 cases (3.3 %) show SOL. Out of 18 cases of HIE, 10 cases (16.6 %) are under less than 6 months and they undergone neuro sonogram showing 4 cases (6.6 %) normal NSG, 2 cases (3.3 %) showing grade IV HIE, another 2 cases (3.3 %) showing grade II, III HIE Findings. Conclusions: Our study concluded that plain CT brain showed normal in the majority of the cases which came to the department of Radiology after admission to the hospital. Those cases with strong clinical history are evaluated with contrast CT and evaluated the findings. After contrast imaging, most cases showing their infective, obstructive, and other causes of illness are interpreted. However, its role is minimal for seizures in which CT/CECT shows normal study. Under 6 months, NSG is a suitable method for evaluating and screening the infant's brain.

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