Introduction: Dengue fever is the most rapidly spreading arboviral infection with major public health consequences. Leucopenia, thrombocytopenia, hematocrit, elevated aminotransferases, low CRP and prolonged APTT, are useful predictive markers for early diagnosis of dengue infection. Objectives of the study: To study the clinical presentation and laboratory predictive markers of dengue fever, dengue with warning signs and severe dengue. Materials and Methods: Prospective hospital based study of 100 patients who were classified as dengue (DF), dengue fever with warning signs (DWS) and severe dengue (SD). Lab investigations included WBC count, Platelet count, Hematocrit, SGOT, SGPT, PT, APTT, INR, CRP. Clinical and laboratory parameters in the 3 groups of dengue fever were compared in the study. Results: Study group included 100 cases of which DF was 36%, DWS 52% and SD 12%. Commonest presenting symptom was fever, nausea and vomiting. Pain abdomen, hepatomegaly, splenomegaly, bleeding, jaundice were seen in DWS and SD group. Lab parameters: Mean WBC count was low to normal in all 3 groups. Platelet count was low in all groups. Hematocrit, SGOT/SGPT, PT /APTT/INR was progressively found to be increased in the 3 groups. Low CRP was found in all 3 groups. Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Ascites, pleural effusion, shock, liver dysfunction and hemorrhage are the markers for severe dengue. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases.

Introduction: This study was done to estimate the nucleated red blood cell count (NRBCs) in normal and asphyxiated babies and find their correlation with severity of birth asphyxia. Materials and Methods: About 50 normal newborns as control and 50 newborns with perinatal asphyxia as cases were considered. At birth 2 mL of venous blood was collected in both cases and control groups. nRBC count per 100 white blood cells (WBC) was done at admission. Clinical assessments in terms of neurologic status at birth, 24 hours after birth and every day thereafter till discharge/death was done. Cord blood nRBC/100 WBC was correlated with stages of HIE during hospital stay. Neonates were monitored for adverse outcome such as tone abnormalities, feeding difficulty, refractory seizures and death. Controls were followed up in the same manner. Results: Among 50 cases, 24 had no hypoxic ischaemic encephalopathy (HIE),17 had stage 1 HIE, 6 had stage 2 and 3 newborns had stage 3 HIE. The mean APGAR score in cases was 5.34 ± 1.19 whereas for the control group it was 8.12 ± 0.77 with p value of 0.001 which is statistically significant. The mean nRBC in newborns with APGAR score of 3, 4,5, 6 were 35.5, 19.9, 20.6 and 12 respectively. The low APGAR scores showed high nRBCs. Mean nRBCs for HIE stage 1, 2, 3 was 19.1, 31.0, and 54.3 respectively. High nRBC count correlated with increasing severity of birth asphyxia. Conclusion: nRBC count is an easy, simple and a reliable test to assess the severity of birth asphyxia in resource poor settings.

Background: Vaccination is an integral aspect of a pediatrician's practice. The fear associated withpain is a common problem. Alleviating this pain, not only puts the child at ease but also reduces theapprehension some parents have. Our objective was to evaluate local analgesic use during childhoodimmunization, its efficacy, and assessing how it serves as an advantage to the patient, theparents/guardian, and the medical personnel. Methodology: It was a randomized study. Data wascollected for a period of 1 year, from August 2018 to August 2019. Children from birth to 18 yearswere divided into 2 groups: case (local anesthetic i.e Lidocaine aerosol applied) and control (no localanesthetics applied). They were immunized as per NIS/IAP. The pain was assessed by a standardpain chart (Modified Behavioural Pain Scale (BPS). Result: Totally (including IM, SC, and IDinjections), the Local anesthesia group Median pain score was 6 and the No Local anesthesia groupMedian pain score was 8. There was a significant difference in pain scores between the two groups.Conclusion: The present study showed that local anesthetics could be applied quickly and withease. There was a significant difference in pain scores between the two groups (higher score beingin the group in which local anesthetics weren’t used). The reduction in the pain score, in turn,showed a significant difference in the attitude of the child, parent, as well as medical personnel.