Background: The study was planned to evaluate awareness of breast feeding among mother, institutional quality indicators of early breast feeding. The objective was to know factors causing delay in breast feeding initiation, to assess knowledge, cultural practices, and quality indicators of hospital regarding breast feeding initiative.Methods: The observational study was conducted over a period of 3months from July 2017-Sept 2017 in a tertiary care centre of India. 118 postnatal mothers were interviewed for time of first breast feeding (dependent variable or outcome), and independent variables age, education , religion, parity, occupation of mother, antenatal visits, prelacteal feeds, customs of not breast feeding, duration of labour, mode of delivery, sedation, pain after delivery, baby over mother abdomen after birth, institutional quality indicators-knowledge of breast feeding given by doctor /nurses, relatives, self reading, mothers with correct attachment and position of baby during breast feeding and separation of mother and baby post delivery.Results: Mean time of initiation of breast feeding was 1340.262min after birth. Prelacteal feeds, lack of education, cesarean deliveries, parity of mother, sedation, anesthesia during cesarean and lack of counselling by staff nurses were found to have early increased time of initiation of breast feeding.Conclusions: Great lacuna in knowledge, attitude and practice of early breast feeding of mother.

Background: Iron deficiency anemia is common problem in children, though the oral iron therapy is the main stay of treatment, but most of children not responding to it due to non-compliance. So the parental iron therapy is the treatment of choice for it. Methods: Fifty children between the age group of 1-17 years of age were selected for this study diagnosed as iron deficiency anemia. Iron sucrose given by IV according to their weight and age. CBC performed before starting of study and after receiving Iron sucrose intravenously i.e. after 4, 10 and 30 days of iron sucrose. Results: Among the red cell indices, mean corpuscular volume and mean corpuscular haemoglobin in this study we got mark improvement in both the parameters along with improvement in PCV and finally increase in haemoglobin level. All the parameters having P value highly significant i.e. <0.001 along with minimal side effects. Conclusions: Iron sucrose can be safely used in children.

The cause of this unusually massive degree of dilatation of the upper-pole moiety of the duplicated collecting system is uncertain, but may have resulted from an error in the development or because of VUR. We suggest mandatory intraabdominal examination after delivering uterus while conducting a cesarean section.

INTRODUCTIONHyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The sheer prevalence of neonatal jaundice and periodic occurrence of bilirubin associated encephalopathy ensures sustained interest in this subject. The fear for the level of 20 mg/dl has given anxious moments to doctors and the relatives of the "jaundiced infant". To the pediatrician jaundice remains ABSTRACT Background: Hyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The aim was to determine the risk factors and treatment modalities of newborns with significant hyperbilirubinemia admitted from September 2011 to August 2013. Methods: One hundred and fifty newborns with significant hyperbilirubinemia, both inborn and outborn were included in the study. Relevent information during hospitalisation was taken. American Academy of Pediatrics (AAP) guidelines were followed to determine the treatment modality. Treatment in the form of either phototherapy or exchange transfusion was given. Results: Out of 150 patients 90 were males and 60 females. Higher values of serum bilirubin were found in the female babies and this difference was statistically significant. One hundred and thirty four babies had a birth weight of more than 2 kgs and 16 less than 2 kgs. The serum bilirubin levels were more in babies more than 2 kgs and this was statistically significant. Ninety one babies were delivered vaginally and 59 by LSCS. Higher serum bilirubin levels were found in those delivered vaginally with the difference being statistically significant .ABO blood group incompatibility was seen in 70 babies, 6 babies with Rh incompatibility. ABO incompatibility resulted in higher serum bilirubin levels with the difference being statistically significant. Ninety six babies had a gestation of more than 37weeks and higher bilirubin levels were found in this group as compared to lesser gestational age baby, the difference was statistically significant. Eighty five patients were admitted before 72 hours of life and 65 after that. Higher serum bilirubin levels were found in those admitted later with a statistically significant difference. The presence of antenatal risk factors (P = 0.4), parity of the mother (P = 0.178) were not found to play a major role in development of significant hyperbilirubinemia. Phototherapy was used as treatment modality in 137 patients, whereas 13 required exchange transfusion. Conclusions: Significant hyperbilirubinemia was found to be more common in female babies, more than 37weeks of gestation, delivered vaginally, with birth weight of more than 2kgs, with ABO blood group incompatibility, admitted after 72hrs of life and with no identified antenatal risk factors. Most commonly used treatment modality found in these cases was phototherapy.

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