Survival of premature and low birth weight infants has markedly improved during the last few decades. Nutrition is believed to play a fundamental role in optimizing the growth and development of these infants both during their period of hospital stay and post discharge. Feeding of low birth weight babies is a very challenging issue as trials dealing with various aspects are lacking. There is need for information on the choice of milk for a preterm in hospital and post discharge, fortification, dilemmas regarding when to initiate feeds, progression and frequency of feeds and lastly management of feed intolerance. The purpose of this review is to highlight the paucity of evidence in certain areas of LBW feeding and suggest important areas of future research.

Objective: To evaluate whether preterm neonates less than 34 weeks at birth receiving rapid enteral feeding advancement at 25-30 ml/kg/day and those receiving slow enteral feeding advancement at 15-20 mL⁄kg⁄day to attain full feeding (180 ml/kg/day) are atincrease in the incidence of necrotizing enterocolitis or feed intolerance.Study design: Retrospective cohort study.Setting: Level III Neonatal Unit in Southern India Subjects: Neonates born at <34 weeks of gestational age and admitted to the NICU during study period were enrolled.Outcome: Mortality and major morbidity -NEC as per Bell staging, incidence of feedintolerance. Results:Both groups had similar baseline characteristics. The average gain in weight, length and head circumference were significantly lower in the slow feeding group as compared rapid feeding group. The mean days to reach birth weight was less in rapid feeding group; 12.43 vs. 15.46 in slow feeding group (p=0.04). It was inferred that duration of hospital stay (22.58 vs. 31.34 days) and parenteral nutrition( 8.69 vs. 11.18 days) was less in rapid feeding group as compared to slow feeding group (p= 0.04). Powered by Editorial Manager ® and ProduXion Manager® from Aries Systems Corporation Rapid feeding group does not have increased episodes of feed intolerance or NEC (5 vs. 6 cases) compared to slow feeding group.Conclusions: Our study support enteral nutrition by rapid enteral feeding regimen (increments of 25-30 ml⁄ kg ⁄day) in stable preterm neonates less than 34 weeks of gestation.

Mid aortic syndrome is rare cause of hypertensive urgency in children with poor outcome if left untreated, high index of suspicion with prompt management is the key to survival with good outcome. A 12-year-old boy was presented with fever, puffiness of face, and breathing difficulty. Clinically, he had hypertension with differential pulsation and BP in upper and lower limbs. He had peak systolic gradient of 80 mm Hg between upper and lower limb. His echocardiography and CT angiography was suggestive of significant isolated 80% narrowing of abdominal aorta without involvement any other large vessels. Percutaneous balloon dilatation of aorta was done considering multiple parameters. Post procedure, there was significant improvement in BP and we could wean his multiple anti-hypertensive drugs to keep his blood pressures below 95 th centile. His BP remained control with minimum upper and lower limb gradient on follow up of almost 1 year. How to cite this article Dekate PS, Reddy S, Prasad VSV, Boda S, Saini L, Patil P. An Uncommon Cause of Hypertensive Urgency in Young Adolescent: Case Report. Indian J Crit Care Med 2019;23(7):339–341. Key message Mid aortic syndrome is most uncommon amongst them. With prompt diagnosis and proper selection of therapeutic options like balloon dilatation or surgical correction, it has good prognosis. Aortic narrowing because of different diseases is an uncommon cause of HT urgency in children.

Introduction: Breath holding spells are a common disease entity in children and mostly occur between 6-18 months of age and terminate by 3-4 years. Case Report: We present a case of a neonate with cyanotic breath holding spells which presented as recurrent apparent life threatening events. Infant was evaluated for possible causes of recurrent life threatening events and diagnosed as cyanotic breath holding spells. Conclusion: We have reported this case to highlight that breath holding spells can present early in the life and needs to be considered in the differential diagnosis of any neonate presenting with cyanotic spells. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Conflict of interest: None declared | Source of funding: Nil | DOI: http://dx.

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