Background: Congenital Heart Diseases (CHD) are often associated with malnutrition with prevalence of 64%. Malnutrition in CHD increases morbidity and mortality in these children and hence it is essential to assess the nutritional status of the children with CHD so that proper nutritional therapy and rehabilitation can be done.Methods: In this case control study 126 cases of un operated CHD in the age group of >28 days to 10 years and 126 age and gender matched controls without CHD were studied during a period of 2 year. Informed consent from the parents was obtained and they were interviewed using pre-validated proforma and relevant clinical examination, detailed anthropometric assessment was done of all cases and control.Results: Male to female ratio was 0.9:1. Maximum cases were in age group of 1 to 5 years. Acyanotic CHD was seen in 80.16% and cyanotic CHD was seen in 19.84%. Stunting was seen in 58.72% cases and in 41.26% of controls. 82.53% of cases and 24.6% of controls were underweight. Conclusions: The prevalence of acyanotic CHD was more common than cyanotic CHD. In acyanotic CHD cases VSD was commonest and in cyanotic CHD cases TOF was the commonest lesion. The overall prevalence of underweight and stunting was high in cases than controls. In acyanotic CHD underweight and stunting was high than cyanotic CHD. In this study malnutrition correlated significantly with congestive heart failure, low hemoglobin level, poor dietary history and pulmonary hypertension and this was statistically highly significant.

Background: The mortality in pediatric and neonatal critical care units can be predicted using scores. Prediction of mortality using (PRISM III) score in first 24 hours of admission in pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU).Methods: Pediatric cases below 14 years with necessary investigations admitted in PICU and neonates in NICU during the period 1st August 2009 to 31 July 2011. Post-operative and patients with malformations or malignancy were excluded. A prospective observational study carried out at tertiary care rural hospital having 10 bedded well equipped PICU and NICU each. In subjects fulfilling inclusion criteria, PRISM III score which includes 17 variables was calculated within 24 hours of admission. The outcome at discharge was determined as non-survival or survival.Results: With increasing PRISM III score there was increase in mortality. PRISM III score offered a good discriminative power with the areas under the ROC curve > 0.86 (95% CI). Among different variables minimum systolic blood pressure, pupillary reflex, mental status (GCS), acidic pH, total co2, BUN, platelet count and PTT showed very high significant association with the mortality and Pco2, PaO2, temperature, potassium and creatinine showed significant association with mortality. Variables like Heart rate, Glucose, Alkaline pH and WBC count showed no significant association with the mortality.Conclusions: PRISM III score can be effectively used as a reflector of severity of illness.

Background: In high risk neonates’ incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycemia. This study was undertaken to know the incidence, clinical profile, sequential blood glucose level upto 72 hours and short-term outcome of neonatal hypoglycemia.Methods: Blood sugar was screened at admission, after feed or D10 bolus, 6, 12, 24, 48 and 72 hours of age. Detailed maternal history and neonatal history, clinical manifestation, management and short-term outcome of hypoglycemic neonates were noted. Statistical analysis of data was done by SPSS 22.0 software.Results: 200 neonates with blood glucose less than 40mg/dl at admission to NICU in which 47 had repeat episode of hypoglycemia. Incidence of hypoglycemia at admission was 22.49% and 5.29% was incidence of repeat episode of hypoglycemia. Pre-term (p=0.005), low birth weight (p=0.020) and SGA (p=0.012) had repeat episode of hypoglycemia. GDM (p=0.040), birth asphyxia (p=0.046) and early septicaemia (p=0.0001) were common risk factors for hypoglycemia. Poor feeding, jitteriness and respiratory abnormality were common presentation of hypoglycemic neonates. The blood glucose levels at admission were less than 30 mg/dl in neonates who later had repeat episode of hypoglycemia. Most hypoglycemic episode after admission occurred within 24 hours of life.Conclusions: LBW especially Preterm SGA neonates are at increased risk of hypoglycemia. Maternal and neonatal risk factors are GDM and birth asphyxia, early septicaemia. Screening for hypoglycemia is essential for high-risk neonates.

Introduction: Premature rupture of membranes (PROM) refers to rupture of fetal membranes prior to the onset of labour regardless of the gestation.

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