Background: Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. Every hour, 104 children die as a result of asphyxia. In India; between 250,000 to 350,000 infants die each year secondary to birth asphyxia and mostly within the first three days of life. The present study was performed to determine the Urinary Uric Acid to Creatinine Ratio in perinatal asphyxia and its correlation between APGAR score and urinary uric acid to creatinine ratio in perinatal asphyxia.Methods: A randomized case control hospital-based study was conducted on 50 asphyxiated and 50 normal newborn. Urinary uric acid and creatinine were estimated in spot urine within 24 hours after birth in both cases and controls. A ratio between the concentrations of uric acid to creatinine was estimated and comparison done between cases and controls.Results: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.Conclusions: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.

Background: Millions are infected with dengue every year.  Early diagnosis of dengue infection is important for proper treatment of DHF and DSS to avoid fatal outcome. Thrombocytopenia is a common hematological abnormality in dengue, which demands platelet transfusion in most of the severe dengue cases. Platelet transfusion though life-saving has its own hazards. Hence, we can use some new parameter like immature platelet fraction (IPF) which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. The risk of platelet transfusion may be decreased by rapid identification of immature platelet fraction. This study was performed to establish reference of IPF values for the assessment of thrombopoiesis.Methods: Blood samples from 150 children were obtained on day of illness 3, 5 and 7. The IPF is identified by sysmex XE2100 hematology analyser in the reticulocyte channel using a fluorescent dye and a carefully designed gating system and counted by a special software termed IPF master7. IPF values against platelet count were assessed separately on day 3, 5 and 7.Results: The reference intervals of IPF > 8 % and IPF < 8 % were assessed against platelet count. Increase in IPF favored increase in platelet count on day 5 which was statistically significant with the p value <0.001.Conclusions: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study it can be concluded that IPF is an important predictor of increase in platelet count.  Increase in IPF>8 % suggests that platelet count will be increased in next 24 to 48hrs indicating that further blood transfusion will not be required.

Background: Pediatric index of mortality 2 (PIM 2) score is an illness severity and scoring systems used for predicting outcome of children admitted to PICU. The objective was to evaluate the usefulness of PIM 2 score in predicting mortality in our PICU, assess whether the model is calibrated to our case mix and to compare the observed and expected death rates by calculating standardised mortality ratio. Methods: It was a prospective observational study done in a tertiary care center from January 2019 to June 2020. Consecutive 120 patients admitted to PICU aged from 1 month to 18 years were enrolled in study. PIM 2 scoring was calculated for the data obtained within 1 hour of admission to PICU. The outcome was recorded as death or discharge. PIM 2 logit score is calculated using software.Results: PIM2 can discriminate between death and survival with area under curve (AUC) of 0.867 with 95% CI (0.729,0.980). PIM 2 predicted death rate was significant (p<0.001). The model is well calibrated with Hosmer- Lemeshow Goodness-of-fit test p=0.961 (p>0.05). The observed death rates are equal to predicted death rates and standardized mortality ratio (SMR) is equal to 1. Conclusions: PIM 2 score predicted mortality correlated well with observed mortality in PICU patients. The model is well calibrated for use in our set up and discriminate well between survivors and   non-survivors.