Aims and Objectives: To correlate degree of thrombocytopenia and platelet indices with neonatal sepsis in our NICU set up. Materials and Methods: After taking approval from ethical committee of our institute, we studied total 150 cases over a span of 24 months, from August 2013 to August 2015. Peripheral blood was drawn from all the study subjects under aseptic precautions in EDTA bulb. A complete hemogram was performed using Beckman Coulter. Latex agglutination kit was used for CRP estimation. Different organisms were isolated by Bactecblood culture. Results: Out of 150 neonates 40(26%) cases were sepsis proven, 63 (42%) ases had suspected infection and 47(31%) cases were non infected. Male constituted 84(56%) cases and females constituted 66(44%) cases. 35(87.5%) cases out of proven sepsis were preterm neonates. Out of 40 sepsis proven cases CRP was increased in 31 (77.5%) neonates. Gram negative organisms were more common than gram positive organisms. Pseudomonas was most common organism, and was isolated in 16 (40%) cases. Staphylococcus organism isolated in 7 (17.5%) cases. 23 (57.5%) of sepsis proven cases showed severe degree of thrombocytopenia and was seen mainly with Pseudomonas organisms. In platelet indices PDW was significantly increased in newborns with sepsis. Whereas MPV was also increased in sepsis cases but was not significant. Conclusion: Variation in the degree of thrombocytopenia and platelet indices was seen in neonatal sepsis. Severe degree of thrombocytopenia associated with proven sepsis. PDW was significantly increased in newborns with sepsis. Gram negative organisms were common cause of neonatal sepsis.

Background: Neonatal seizures are clinically significant because very few are idiopathic. Further investigation leading to prompt diagnosis of the underlying condition is important because many of the etiologies have specific treatment. Time of onset of seizures has correlation with etiology. Objectives: The objective of the present study is to know the etiology of neonatal seizures, to know the time of onset of neonatal seizures and its relation to etiology and to know the various types of seizures in neonates. Methodology: The present study included 127 neonates presenting with Neonatal seizures admitted to NICU (Neonatal Intensive care Unit) of tertiary care hospital from August 2014 to December 2016. Detailed antenatal, natal and post natal history were taken and examination of baby done and HIE staged according to Modified Sarnat's staging. Then relevant investigations were done and etiology of neonatal seizures was diagnosed. Results: In the present prospective study, out of 127 neonates studied, 118 were full-term, among these 88 (69.3%) were AGA (Average for gestational age) and 30 (23.6%) were SGA (Small for gestational age). 7 babies (5.5%) were preterm. Male: Female ratio in our study was 1.6:1. In our study onset of seizures within first 3 days of life was seen in 101 neonates (79.5%). After 3 days of life, 26 neonates developed seizures (20.5%). Onset of seizures within first 3 days of life of had statistically significant correlation with birth asphyxia as the etiology with p<0.001. Subtle seizures were the commonest type of seizures in our study (49 cases-38.6%), followed by GTS (Generalized tonic seizures-42 cases-33.1%), multifocal clonic (19 cases-15%) and focal clonic seizures (8 cases-6.3%). Birth asphyxia was the commonest cause of neonatal seizures in our study (84 cases-66.1%) followed by hypoglycemia (22 cases-17.3%) and meningitis (11 cases 8.7%). Out of 84 cases of birth asphyxia 66 (78.6%) mothers had prolonged second stage of labour and 28 (33.3%) had MSAF (Meconium Stained Amniotic Fluid). Hypoglycemic seizures were more common in LBW (Low Birth Weight) babies with statistically significant p<0.001. Conclusion: The recognition of etiology of neonatal seizures is often helpful with respect to prognosis and treatment. The most common etiology for neonatal seizure is HIE (Hypoxic ischemic encephalopathy) and is frequently associated with perinatal risk factors. Onset of seizures during first 3 days of life has significant correlation with HIE as etiology. Hypoglycemic seizures are more common in LBW babies. Subtle seizures are commonest type of clinical seizures, which is difficult to identify, therefore careful observation of at risk newborns is necessary.

Background: Electrolyte imbalance is one of the serious complications in hospitalized children with severe pneumonia. Monitoring of changes in electrolytes is very essential to prevent the complications leading to increased morbidity and mortality. Aims and objectives: To study serum electrolytes and calcium disturbances in patients with severe pneumonia. To identify relation of serum electrolytes with outcome of severe pneumonia. Material and Methods: After taking approval of ethics committee of our institute, we studied a total of hundred cases over a span of 24 months- August 2018 to December 2020. Study is carried out among cases of severe pneumonia and community acquired pneumonia (CAP) in age group of 2 months to 5 years admitted in pediatrics department of tertiary care centre in Maharashtra. Laboratory investigations of serum sodium, potassium, chloride and calcium levels were noted at admission and 24 hours after hospitalization. Results: This is observational cross study carried out in 100 children of severe pneumonia admitted in paediatric intensive care unit at Dr. Vasantrao Pawar Medical College, Nashik to observe and study electrolyte changes in them. Most children were in age group of 2 months to 12 months (i.e., 72%) followed by 28% in age group of 13 months to 60 months. At admission most common abnormality was hypocalcemia 49% followed by hyponatremia 27%, hyperchloremia 7%, hyperkalemia 6%, hypernatremia 6%, hypokalemia 4%, hypochloremia 1%. After 24 hours of stabilization hyponatremia was most common 40%, followed by hapocalcemia 43%, hypokalemia 9%, hypernatremia 8%, hyperkalemia 4%, hyperchloremia 4%. Conclusion: Mortality was significantly higher in cases with chloride level abnormality than with normal chloride level. Cases with disturbances in electrolytes showed higher mortality than those without electrolyte disturbances. Hyponatremia and hypokalaemia were associated with adverse outcomes in pneumonia cases. Electrolyte disturbances are commonly seen in pneumonia cases, so we should monitor them properly while treating them to avoid complications. Hyponatremia in pneumonia occurs due to Syndrome of Inappropriate Anti Diuretic Hormone secretion (SIADH). Hyponatremia at admission significantly affect outcome in terms of prolonged duration of hospitalization and two fold increase in mortality.