Cerebral perfusion pressure-targeted therapy, which relied on more frequent use of vasopressors and lesser use of hyperventilation and osmotherapy, was superior to intracranial pressure-targeted therapy for management of raised intracranial pressure in children with acute CNS infection in reducing mortality and morbidity.

In preterm infants with respiratory distress starting within 6 h of life, CPAP failure rates were similar with Jet CPAP and Bubble CPAP.

Bubble CPAP device with its nasal interface had higher and more serious incidence of nasal injuries in comparison to Jet CPAP device. What is known: • Nasal injuries are becoming increasingly common with use of nasal CPAP low gestational age, low birth weight, longer use of CPAP and longer NICU stay are risk factors for such injuries • Validated nasal injury scores have been created for assessment of nasal trauma in neonates What is new: • Bubble device with its interface had higher and more serious incidence of nasal injuries in comparison to Jet device • Even though pain assessed by N-PASS was less with Jet device, prong displacements were more frequent with its system.

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Ten-year-old boy with acute lymphoblastic leukemia (ALL)-T cell subtype was on MRC UKALL 2003-based chemotherapy. Bone marrow attained remission after induction. After 8 months into maintenance, he presented with chronic diarrhea and weight loss. Search for infective and malabsorptive etiology was unrewarding. Infiltration with leukemic cells was seen in the lamina propria on mucosal biopsies of duodenum and colon. Marrow was in remission. Isolated gut relapse is exceedingly rare. It should be considered in the etiology of chronic diarrhea in patients with ALL, after common causes are excluded.

ObjectiveTo describe early neurodevelopment outcomes of neonates with severe hyperbilirubinemia without acute bilirubin encephalopathy (ABE).MethodsNeonates born at gestation ≥35 weeks, admitted to NICU with total serum bilirubin (TSB) in exchange range with no features of ABE, were followed up until the age of 6 months. Infants were assessed for impaired hearing and neurodevelopment at 3 months and 6 months of age.ResultsA total of 59 neonates were enrolled in the study. At 3 months of age, 7.6 percent of neonates were found to have hypotonia and motor delay, whereas 42.3 percent had abnormal brainstem evoked response audiometery. At 6 months, 6.4 percent of neonates were found to have persistent neurodevelopmental impairment.ConclusionSevere hyperbilirubinemia is associated with impaired neurodevelopment and hearing even in infants without ABE. Peak TSB level strongly correlates with abnormal outcomes.

Introduction: Asthenopia is a common complaint in school going children. The magnitude of the problem in our region is not known. Methodology: Children (5-18 years) presenting in pediatric and ophthalmology outpatient department with symptoms (defined a proiri) were included in study. Exclusion criteria included BCVA of less than 6/9 in either eye, strabismus, ocular or systemic diseases affecting binocular vision, and using any medication that can impact accommodation or convergence. Previous day 24 hour recall method was used to assess the time spent on various activities. Subsequently, detailed refractive assessment was done. Results: A total of 24200 children with age group 5-18 years visited outpatient department. Out of them 520 (2.1%) children had symptoms of asthenopia. The proportion of males (66.6%) was higher than female (33.4%). The proportion of children with asthenopia increased from 21% in 5-9 year group to 45% in 13-18 year group. Tearing and eye pain were the commonest presenting complaints The presence of four or more symptoms was not observed in 5-9 age group. Asthenopic children spend a mean of 4.2 hours/day on screen. Conclusion: Asthenopia is common eye complaint in school children. It can interfare in near work, so warrants prompt treatment.

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