Background: Shock is a state of impaired tissue perfusion resulting in an imbalance between oxygen demand and supply. This widespread reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients, the end result of which is an altered cellular and sub cellular function leading to anaerobic metabolism and accumulation of lactic acid, and consequently cellular damage, multiple organ dysfunction and finally cardiovascular collapse.Methods: The present study was conducted in the department of Pediatrics at Alluri Sitarama Raju Academy of Medical Sciences hospital, Eluru, between December 2014 and June 2016. It is a prospective study. Children aged 1 month to 12 years with a clinical diagnosis of shock were included after written consent from parents.Results: Out of 75 children admitted with shock, 69.33% had septic shock, 25.33% had hypovolemic shock, 2.66% had distributive shock, 2.66% cardiogenic shock. Most common age group admitted with shock was 1 month-1 year 38.666%. Among 75 children with shock, 74.66% children survived and 25.33% children died. Mortality rate in cardiogenic shock was 100%, in septic shock 28.84%, in hypovolemic shock 10.52%.Conclusions: Septic shock was the most common type of shock. Most common cause for septic shock was pneumonia. Septic shock has got highest mortality in the present study.Need for inotropes and mechanical ventilaton indicates poor prognosis in shock.

First breath is the most vital parameter in the beginning of a new life. Respiratory distress (RD) is among the most common symptom complexes seen in newborn infants. A variety of respiratory and non-respiratory disorders manifest clinically as respiratory distress. This study was undertaken with the aim to know the most common etiological factors responsible for neonatal respiratory distress and effect of modern advancements like bubble CPAP and mechanical ventilation on the outcome of newborns with severe distress because the information available in our area till date is insufficient to prognosticate the outcome of severe respiratory distress. Aims and objective The objectives of the study were as follows.

Introduction: Neonatal hyperbilirubinemia is one of the most common problems in term and preterm babies. Development of hyperbilirubinemia in neonates is fretful for the parents and a concern for the pediatrician too. Healthy babies born through normal vaginal delivery who are getting discharged early are being readmitted for the treatment of hyperbilirubinemia. Aimsand Objectives: The present study is done to determine the correlation of cord blood bilirubin, albumin and neonatal hyperbilirubinemia in identifying newborn babies at risk of developing significant hyperbilirubinemia and to establish the cutoff values of cord blood bilirubin and cord blood albumin levels to identify such high-risk neonates. Materials and Methods: In present study, 303 term neonates who are delivered in ASRAM, Eluru from January 2012-January 2013, were included after parental consent. Cord blood bilirubin, Blood grouping and typing, Cord blood albumin and serum bilirubin levels were done in all babies. Results: The incidence of significant hyperbilirubinemia in this study was 23.7%. Cord serum unconjugated bilirubin level ≥2.0 mg/dl and total cordserum bilirubin level ≥ 2.5mg/dl as high risk indicator towards predicting neonatal hyperbilirubinemia in first week of life. 58.53% babies had cord serum albumin level < 2.8gm/dl. Conclusion: Cord serum unconjugated bilirubin level ≥2mg/dl and total cord serum bilirubin level ≥2.5mg/dl, cord blood albumin <2.8g/dl is a high-risk indicator towards predicting neonatal hyperbilirubinemia in the first week of life.

Background: Hutchinson-Gilford progeria syndrome is a rare genetic disorder characterized by dramatic premature senescence. Progeria is almost always caused by de novo point mutations in the LMNA gene that activates a cryptic splice donor site, producing a truncated mutant protein termed ''progerin.'' A previous study has also reported an association of 594 C>T mutation in B4GALT1 gene with HGPS. In this study we investigated two HGPS siblings originating from South Indian region of Andhra Pradesh. Methods: 50 healthy controls from the same ethnic group were also included in the study. Clinical characteristics of the affected children were noted down. All the exons of LMNA gene were amplified by PCR and the mutations detected by sequencing the PCR products. The 594 C>T mutation in B4GALT1 gene was also evaluated by sequencing the PCR products. Results: A novel de novo point mutation C1699T was observed in exon 10 of LMNA gene in proband as well as the affected younger sibling. However, neither the parents nor the controls had this mutation. Conclusions: The observation of heterozygous de novo LMNA mutation C1699T in HGPS patients in exon 10, supports the prevailing hypothesis that HGPS essentially represents a sporadic autosomal dominant disorder.

Hemorrhage both localized and generalized is a significant cause of morbidity and mortality in the neonatal period. Significant haemorrhagic complication accounts to about 1-2% of all NICU admissions and accounts to 40% of deaths associated with hemorrhage.