Background: Neonatal sepsis (EOS) is among one of the leading cause of death that usually occurs due to infection in the first month of life and can be the result of various maternal and neonatal contributing factors. Objectives: To determine maternal and neonatal contributing factors for early onset of sepsis in neonates. Study design: cross sectional study Period: From 13th April 2019 to 12th Oct 2019. Settings: Neonatal units of pediatric medicine of central park teaching hospital Lahore and Bhatti international hospital Kasur. Material and methods: After approval from hospital ethical committee total 151 neonates were selected using non-probable consecutive sampling. Neonates of both gender who were having gestational age >30 weeks with early onset sepsis were enrolled. Patients who had received antibiotics before presentation were excluded. 5ml of venous blood after proper sterilization was taken from all patients and sent to hospital laboratory for WBC count, CRP and blood culture. Data was entered in pre-designed Performa and analyzed using SPSS 20. Results: There were total 151 patients in study, minimum and maximum age was 1 day and 7 days respectively with mean age of 3.66±1.88 days. Mean gestational age was 35.5±2.6 weeks and mean birth weight was 2.2±1.4 kg. There was slight increase in female patients 51% and 49% males. Among maternal contributing factors maternal fever was found in 64.9%, premature rupture of membrane was found in 43%, foul smelling liquor in 37.1% and meconium-stained amniotic fluid was found in 33.1% neonates. Among neonatal contributing factors prematurity was found in 66.2% low birth weight was present in 64.2%, and low APGAR score was present in 56.6 % neonates. Data was stratified for gender and contributing risk factors but p value was not statistically significant. Data was stratified for gestational age and p value was significant for prematurity, low birth weight and offensive smelling liquor. Conclusion: Prematurity, low birth weight, low APGAR score and maternal fever were significant contributing factors in EOS. Keywords: EOS, Neonatal contributing factors, Maternal contributing factors

Background and Aim: Down syndrome (DS) is the most prevalent genetic disorder in humans around the globe. Variations in pattern and risk factors for congenital heart diseases significantly contributes to the increasing morbidity and mortality among Down syndrome children. The present study aimed to determine the prevalence of congenital heart diseases among Down syndrome children. Methodology: This prospective study was carried out on 46 Down syndrome children in the Department of Pediatric, Shalamar Hospital Lahore from November 2020 to June 2022. The study protocol was approved by the research and ethical committee. Demographic details, outcomes, and diagnosis on echocardiography were extracted from the proforma and medical record. Data such as date of birth, maternal age, parity, and parental consanguinity were collected. Antenatal history such as obesity, maternal passive smoking, and diabetes confirmed the antenatal infections. Data regarding children including gender, birth weight, maturity, and plurality were considered. For data analysis, SPSS version 25 was used. Results: Of the total 46 Down syndrome children, there were 29 (63%) male and 17 (37%) females. The overall mean age was 3.61±2.3 years with an age range from 0 to 15 years. Majority of the Down syndrome children 32 (69.6%) were under 5 years followed by 9 (19.6%) in 5-10 years and 5 (10.8%) in between 10 and 15 years. The prevalence of congenital heart disease was 26 (56.5%) in Down syndrome children. Of the total 26 Down syndrome children with congenital heart disease, the incidence of cyanotic and acyanotic heart disease were 5 (10.8%) and 21 (45.7%) respectively. Out of 56.5% cases of congenital heart disease, ventricular septal defect (VSD) was the most prevalent congenital heart disease found in 12 (46.2%) cases followed by Atrio-venticular canal defect 7 (26.9%), Tetralogy of fallot 4 (15.4%), and atrial septal defect 3 (11.5%). Conclusion: Our study concluded that the prevalence of congenital heart disease was 56.5% among Down syndrome children. Majority of congenital heart diseases were acyanotic. Male are more susceptible to congenital heart diseases. Ventricular septal defect (VSD) was the most prevalent congenital heart disease. Early diagnosis, referral, and prompt intervention can prevent congenital heart diseases among Down syndrome children. Keywords: Congenital heart diseases, Prevalence, down syndrome children

Objective: To compare the efficacy of 3% hypertonic saline (HS) with normal saline (NS) in children with bronchiolitis, in term of change in clinical severity score and duration of hospital stay. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics, Central, Park Teaching Hospital, Lahore. Period: August 2018-January 2019. Method & Material: Sixty patients as per inclusion criteria, were randomly assigned into two groups. Group-A received nebulization with normal-saline (NS) and Group-B received nebulization with 3% hypertonic-Saline (HS). Data was collected regarding demographics, duration of illness, clinical severity score (CSS) as described by Wang et al., at time of presentation and after 24-hours of management as per assigned group, change in CSS after initial 24 hours of management, and total duration of hospitalization. Data was analyzed through SPSS-version-26. Paired sample t-test was applied to relate outcome of both the groups. Result: The principal outcome parameters studied were change in CSS and duration of hospital stay. Statistically nebulization with NS seems better than with HS with the p-value of 0.001 for both change in CSS after 24 hours and duration of hospital stay. Conclusion: Nebulization with normal saline has better impact on outcome of bronchiolitis, in terms of improving clinical severity score and hospital stay.