Objective To test the hypothesis that oral (PO) feeding at first neonatal intensive care unit (NICU) discharge is associated with less neurodevelopmental impairment and better feeding milestones, as compared with discharge with a gastrostomy tube (g-tube). Study design We studied outcomes for a retrospective cohort of 194 neonates < 37 weeks gestation referred for evaluation and management of feeding difficulties between July 2006–July 2012. Discharge milestones, length of hospitalization, and Bayley Scales of Infant Development scores at 18–24 months were examined. Chi-Square, Mann-Whitney U, or t-tests and multivariable logistic regression models were used. Results 60% (n=117) of infants were discharged on PO feedings; of these, 96% remained PO-fed at 1-year. The remaining 40% (n=77) were discharged on g-tube feedings; of these, 31 (40%) remained g-tube dependent, 17 (22%) became PO-fed, and 29 (38%) were on PO and g-tube feedings at one year. Infants discharged on a g-tube had lower cognitive (p<0.01), communication (p=0.03), and motor (p<0.01) composite scores. The presence of a g-tube, younger gestation, bronchopulmonary dysplasia, or intraventricular hemorrhage was significantly associated with neurodevelopmental delay. Conclusions For infants referred for feeding concerns, g-tube evaluations and feeding management, the majority did not require a g-tube. Full PO feeding at first NICU discharge was associated with superior feeding milestones and less long-term neurodevelopmental impairment, relative to full or partial g-tube feeding. Evaluation and feeding management before and after g-tube placement may improve long-term feeding and neurodevelopmental outcomes.

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Introduction: Melatonin, is a hormone secreted by the pineal gland which activates several elements of the immune system that reduce tissue destruction during the inflammatory response, either directly by scavenging free radical, reactive oxygen species and reactive nitrogen species or indirectly by modulating the action of agents such as cytokines and adhesion molecules, which contribute to the advance of cell damage. Aim: The aim of the present study was to compare and evaluate melatonin levels in saliva in individuals with healthy periodontium, generalized chronic gingivitis and generalized chronic periodontitis. Materials and method: A total of 60 patients were examined and assessed and divided into 3 groups; Group 1: 20 individuals with healthy periodontium, Group 2: 20 individuals with generalised chronic gingivitis and Group 3: 20 individuals with generalised chronic periodontitis. Saliva samples were collected from each sample and melatonin levels were assessed using ELISA, a competitive immunoassay using a capture antibody technique. Results: Melatonin levels in saliva was highest in individuals with healthy periodontium when compared to gingivitis and periodontitis group which was highly significant and inversely proportional correlation was observed between periodontal index and melatonin levels which was statically significant.