Objective: To evaluate the effect of early total enteral feeding (ETEF) when compared with conventional enteral feeding (CEF) in stable very-low-birth-weight (VLBW; 1,000–1,499 g) infants on the postnatal age (in days) at attaining full enteral feeds. Methods: In this unblinded randomised controlled trial, 180 infants were allocated to an ETEF (n = 91) or a CEF group (n = 89). Feeds were initiated as total enteral feeds in the ETEF group and as minimal enteral nutrition (20 mL/kg) in the CEF group. The rest of the day’s requirement in the CEF group was provided as parenteral fluids. The primary outcome was postnatal age at attaining full enteral feeds. The secondary outcomes included episodes of feed intolerance, incidence of sepsis and necrotising enterocolitis (NEC), and duration of hospital stay. Results: The baseline variables including birth weight and gestational age were similar in the two groups. The infants of the ETEF group attained full enteral feeds earlier than those of the CEF group (6.5 ± 1.5 vs. 10.1 ± 4.1 days postnatal age; mean difference –3.6 [–4.5 to –2.7]; p < 0.001). Total episodes of feed intolerance and clinical sepsis were fewer, with a shorter duration of hospital stay, in the ETEF group (15.5 vs. 19.6 days) (p = 0.01). The incidence of NEC was similar in the two groups. Conclusion: ETEF in stable VLBW infants results in earlier attainment of full feeds and decreases the duration of hospital stay without any increased risk of feed intolerance or NEC.

Objectives: (1) To determine the antimicrobial susceptibility pattern in pediatrics, (2) to identify the pattern of empirical antibiotic usage, (3) to determine the cost analysis of generic antibiotic usage pattern, (4) to assess the different dosage forms of antibiotics.Methods: A retrospective observational study was carried out. The study population included the medical records of children aged day 1-15 years with bacterial infection who got admitted in the pediatric department of the hospital. The average cost for each generic dosage form of antibiotic was calculated.Result: Among the 176 cases taken for the study, sepsis (35.8%) was found to be the most common disease. Bacterial infection showed gender predominance in males (62.5%) and occurrence of sepsis was highly found in age groups of 0-1 years (55.68%). Among the 14 causative organisms, methicillin-resistant coagulase negative staphylococci (61.93%) was predominant in Gram-positive and Escherichia coli (38.06%) for Gram-negative. Highly prescribed drug for empirical therapy was considered to be amikacin (39.20%). Widely prescribed antibiotics were amikacin (21%), ceftriaxone (15.1%), ampicillin (12.34%) and meropenem (9.57%), among which meropenem was found to be of high cost. Conclusion:It should be taken care that the drug should be given not only based on the sensitivity pattern but can also consider the economic affordability of the patient, with reference to existing brands from the formulary. This would help in reducing the burden of health-care cost for the patients.

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Background: The prevalence and magnitude of childhood obesity is increasing in pediatric age group. Incidence of metabolic syndrome is high among obese children and adolescents leading to increased risk of cardiovascular morbidity in long term. For this reason, recognition of metabolic syndrome in obese children is of great importance.Methods: This study was a cross-sectional study carried out among children aged 10-18 years from both urban and rural schools in Coimbatore. Children were screened, sample for metabolic studies collected after consent and analyzed.Results: Total 1582 children in the age group of 10-18 years were screened. 300 children were recruited. Among the studied group, 19.3% were overweight, 30.7% were obese. Metabolic syndrome was present in 55.1% of obese and overweight children. Hyperinsulinemia was present in 30% of obese children.Conclusions: This study done in adolescent school children showed a strong association between obesity and early onset of metabolic syndrome. Early intervention with lifestyle modifications is strongly recommended to prevent long term cardiovascular morbidity.