Objective:To study acid–base imbalance in common pediatric diseases (such as sepsis, bronchopneumonia, diarrhea, birth-asphyxia etc.) in neonates.Design and Setting:An observational study was conducted in an emergency room of a tertiary teaching care hospital in Haryana, India.Patients and Methods:Fifty neonates (from first hour to one month) attending pediatric emergency services with various ailments. Blood gas analysis, electrolytes, plasma lactate, and plasma albumin were estimated in neonates.Results:Metabolic acidosis was the most common acid–base disorder. Hyperlactatemia was observed in more than half of such cases. Birth asphyxia was another common disorder with the highest mortality in neonates followed by bronchopneumonia and sepsis. Significant correlation between mortality and critical values of lactate was observed.Conclusion:Birth asphyxia with high-lactate levels in neonates constituted major alterations in acid–base disorders seen in an emergency room of a tertiary teaching care hospital. Plasma lactate concentration measurement provides an invaluable tool to assess type of metabolic acidosis in addition to predicting mortality in these neonates.

ChildHealth Insights from Linked Data (ECHILD) Database) 2. Assess linkage quality in the ECHILD Database Methods To create the ECHILD Database, NHS Digital applied multi-step rules-based algorithms to longitudinal records of names, date of birth, gender and postcodes extracted from HES and NPD (to separate them from healthand education-related information). This produced a bridging file of pseudonymised IDs to link extracts of de-identified NPD and HES data (the ECHILD Database). If data linkage is biased (for example, less accurate for ethnic minority groups), then subsequent analyses could underestimate health needs and further entrench disadvantage. We evaluated linkage quality for three academic cohorts born 1st September to 31st August in 1996/7, 1999/00 and 2004/5. Permissions to create the ECHILD Database are described at: https://www.ucl.ac.uk/ child-health/echild Results In total, the newly-created ECHILD Database includes de-identified, linked HES-NPD records for approximately 14.7 million individuals. It currently covers a 25-year period (01/ 09/1995 to 31/03/2020) and will be updated with more recent data as it is available. Our initial assessments indicate high linkage rates, particularly for more recent cohorts. Of pupils born in 2004/05, 99% linked to a HES record and, overall, 96% of pupils linked (1,609,670/1,674,899). Ethnic minority pupils and those living in more deprived areas were less likely to link; however, differences in linked and unlinked pupil characteristics were moderate to small. Throughout childhood, two-thirds of children had at least one admission to hospital (excluding being born in hospital). Conclusions The ECHILD Database enables large-scale, longitudinal research exploring interrelationships between health and education. For example, we are exploring how gestational age at birth relates to attainment and SEN. These results will be useful for policymakers and service providers for estimating future need for SEN support in schools based on the population's birth characteristics. As more recent data becomes available, the ECHILD Database represents a unique opportunity to explore the impact of recent disruptions to health services on health and educational outcomes for children and young people during and after the COVID-19 pandemic.

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