Background: Vitamin D deficiency is a significant health problem throughout India irrespective of gender, age, race and geography. It plays important role in neonatal period in fetal skeletal growth, prevention of rickets, sepsis, respiratory tract infections, cancer, cardiovascular diseases, diabetes and other endocrine disorders. Thus, we aim to study vitamin D levels in neonates at birth and its relationship with gestational age. Methods: This was a hospital based prospective observational study. Total 300 neonates born at SGRDIMSR, Amritsar were enrolled out of which 150 were term and 150 preterm. Results: Overall 85.67% neonates were found to be deficient in vitamin D. Mean 25 (OH) levels in <32, 32≤37, ≥37 weeks gestation was 12.46, 17.96, 19.36 ng/dl respectively. Deficiency was present in 94.74%, 87.78%, 82.67% and neonates born <32 weeks, 32≤37 weeks, ≥37 weeks gestation respectively. No significant relationship was found between vitamin D and gestational age. Vitamin D levels were higher in neonates born by LSCS and mothers without vitamin D supplementation. Conclusions: Vitamin D deficiency was prevalent in neonates. Premature neonates had low levels as compared to the mature ones however the association between two was found to be insignificant.

Background: According to World Health Organization WHO (2009), 'Exclusive breastfeeding means that an infant receives only breast milk from his or her mother, or expressed breast milk and no other liquids or solids, not even water, with exception of oral rehydration solutions, drops consisting of vitamins, minerals supplements or medicines if required'. In India, breastfeeding appears to be influenced by social, cultural and economic factors. In 1991, Breastfeeding Promotion Network of India (BPNI) was formed to protect, promote and support breastfeeding. Further, the government of India has undertaken National Rural Health Mission, which intends to implement Integrated Management of Neonatal and Childhood Illness (IMNCI) through the existing healthcare delivery system. Poor practices and attitudes towards breastfeeding have been reported as major reason for poor health outcomes in developing nations. Methods: Present study is a prospective study carried out among postnatal mothers, attending OPD's and immunization clinic, Department of Paediatrics at Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar from February 2016 till March 2017 over period of 13 months. Total of 1000 mothers were included who met with the inclusion criteria. Inclusion criteria of study were mother of healthy baby (baby weight more than 2.5 kgs), baby without any congenital defect and baby born between 37 to 42 weeks of gestation. Results: The sample of the present study comprised of postpartum mothers (N=1000), among whom 35% (n=350) belonged to 22-25-year age group and only 12.8% (128) were above age group of 31 years. Among total 1000 subjects 28% (n=28) were illiterate. 65.3% (n=653) of the mother were living in the joint family in contrast to 34.5% were having nuclear family. Among total subjects (n=1000) 18.2% were working mothers and rest 81.8% were housewives. 76.4% belonged to rural area and 23.6% to urban area. 60.4% were primigravida and 39.6% were multigravida. Among total subjects 56% delivered normally and 44% by LSCS. In present study, majority of the mothers had prior knowledge regarding importance of colostrum, the first breast milk to baby, i.e 71.8% where as 28.2% were not aware of it. 82% mothers in current study had knowledge about importance of breastfeeding while rest 18 said breastfeeding was not important. Conclusions:The present study concludes that mothers have an average knowledge about breastfeeding and poor breastfeeding practices were followed, thus, it is important to educate mother and families regarding breastfeeding and its importance, we need to strengthen public health education system to promote breastfeeding. Further focus on various factors which play important role in promotion and practices of early initiation and exclusive breastfeeding can lead to successful implementation of policies and programmes and in turn help in raising and nurturing a healthy child, a healthy youth for the nation.

Background: Perinatal asphyxia word derived from the greek word a-spyxos, meaning born without an evident pulse, is one of the most important causes of fetal distress. Inspite of major advances in technology and knowledge of fetal and perinatal medicine, it is one of the significant causes of mortality and long-term morbidity. World health organization (WHO) has defined perinatal asphyxia as a failure to initiate and sustain breathing at birth. HIE is one of the most common complication in an asphyxiated neonate because of its serious longterm neuromotor sequalae among the survivors. A detailed classification of HIE staging in term neonate was proposed by Sarnat and Sarnat.Methods: The present study was prospective case control study conducted in neonatal intensive care unit of Department of Pediatrics at SGRD institute of medical sciences and research over a period of one year from September 2016 to august 2017. Total of 100 newborns among which 50 asphyxiated babies were designated to case group and rest 50 normal term babies to control group. The NRBC count of the case and control groups is compared. The NRBC’s of subjects belonging to different stages of HIE is then compared. The results were analysed statistically chi-square analysis for variance (qualitative analysis), t-test (compare mean NRBC’s in different stages) by SPSS version 20 software for biostatistic and p-value of <0.05 was considered statistically significant.Results: Among total 100 babies included in the study, the male and female distribution was 22 (44%) and 28 (56%) in cases and 23 (46%) and 27 (54%) in controls respectively. In our study, the NRBC /100 WBC count for normal newborn was 0.88±1.35 and in case group it was 21.40±20.Conclusions: In present study, the cord blood NRBC count was shown to be a good predictor of perinatal asphyxia with sensitivity of 86%, specificity of 100%, positive predictive value of 100% and negative predictive value of 87.72%. NRBC’s can be used for early detection of HIE and its grading in asphyxiated neonates.

Crouzon syndrome is an example of syndromes caused by premature obliteration and ossification of two or more sutures, most commonly coronal and sagittal. Described by a French neurosurgeon in 1912, it is a rare genetic disorder. Crouzon syndrome is caused by mutation in the Fibroblast Growth Factor Receptor 2 (FGFR2) gene. This disorder is characterized by distinctive malformations of skull and face (craniofacial region). Premature cranial suture closure is the most common skull abnormality. The case of an 8-month-old boy with Crouzon syndrome which is one of syndromes associated with synostosis, is presented. He presented in OPD with a cranial deformity, maxillary hypoplasia and exophthalmos. The clinical, characteristic radiological features and investigations carried out, along with treatment of this patient are discussed as part of multidisciplinary management.

Clinical manifestations of the different types of mucopolysaccharidosis vary from one type to another.MPS typeI show a chronic, progressive and multisystemicevolutionand Hurler syndrome remain the most severe form of mucopolysaccharidosis type I.The involvement of the central nervous system is characteristic and MRI remains the imaging of choice to assess cerebral and spinal cord abnormalities. [8]Certain diagnosisis only retained after biochemical proof of the enzyme deficiency.Some neuroimaging features are characteristic of Mucopolysaccharidosis. However, the correlation between them and disease severity remains controversial, without well-established imaging biomarkers at this time. The role of imaging is to evaluate disease progression and detect some complications particularly cord compression or massive hydrocephalus, so that the patient can benefit from early intervention before the installation of irreversible damage[8].Early diagnosis remains a key success factor essential to prevent the appearance of irreversible lesions and increase the benefits of treatment.