Background: Diarrhea is the major cause of morbidity and mortality among children worldwide.Various studies were done on the role of zinc therapy and probiotic therapy in reducing the durationand severity of acute watery diarrhea. This study aimed to compare the effect of Zinc –probioticcombination versus Zinc only therapy in acute watery diarrhea in pediatric patients. Material andMethods: This was an open, randomized control trial in the pediatric outpatient department of Sub-District Female Hospital, Haldwani (Uttarakhand), from June 2020 till August 2020 for three months.Total 104 children aged six months to 5 years with acute diarrhea who met the inclusion criteriawere enrolled and divided into 52 patients each. 1stGroup A (n=52) received Zinc-Probioticscombination therapy, and 2ndGroup B (n=52) received Zinc only. Measurement of disease severitywas based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initialdrug consumption. The resolution was assessed in mean remission time (time required to form solidstool from watery stool).Result: Among the study population in group A, 62% were male, 38%were female, and in group B, 65% were male & 35% were female. Male predominance was observedin both groups. The mean frequency of diarrhea before treatment in Group A was 7.46 ± 4.1times/day as compared to 6.69 ± 3.6 times/day in Group B. Mean duration of diarrhea in Group Awas 53.5 ± 30.5 hours as compared to 57.6 ± 34.3 hours in Group B. Conclusion: Combinationtherapy was more effective than Zinc only therapy in early remission and resolution of acute waterydiarrhea in children.

Background: Congenital malformations are major cause of neonatal morbidity and mortality and account for 8-10% of all peri-natal deaths especially in developing countries. Incidence of congenital malformation is increasing owing to reduction in other causes of neonatal deaths due to improvement in perinatal care worldwide. This study was aimed to evaluate the incidence, perinatal variables and contributing risk factors associated with birth defects that will help to plan future strategies for prevention, early diagnosis and timely management.  Methods: This is a hospital-based prospective observational study conducted in department of pediatrics of a tertiary care centre of western India over period of two year. All new-borns with anatomical congenital malformations detected antenatal or postnatal (prior to discharge) period were included in this study. Detailed and careful clinical examination was carried out for all new-born.Results: The incidence of congenital malformation in the present study is 1.27%. Prematurity (76.1%), low birth weight (68%) and male neonates (67%) were associated with increased risk of congenital malformation. Most common system involved in this study was cranio-spinal system (47.3%). Overall, most common congenital anomaly was Hydrocephalus with meningomyelocele (8%). Among maternal variables, malnutrition (90%), consanguinity (40%) and abortions (40%) are strongly associated with malformations.  Conclusions: Congenital malformations are important cause of neonatal death. Strategies to diagnose, prevent, treat and rehabilitate the neonate are utmost necessary. Early screening to identify high risk pregnancies and timely management is strongly recommended.

Introduction: Fetal malnutrition is an important contributor to perinatal mortality and morbidity.This study was aimed to assess the nutritional status of the newborn at birth using ClinicalAssessment of Nutrition (CAN score) and compare it with other conventional anthropometric indices.In addition to studying maternal variables associated with fetal malnutrition. Material andMethods: This prospective study was conducted at Sub-District hospital, Uttarakhand for a 3-monthduration from June 2020 to August 2020. Total 765 term, singleton newborn without majorcongenital malformation or comorbidities were included in the study. Anthropometric indices andCAN score were assessed and compared. Results: The incidence of fetal malnutrition was 17.39%using the CAN score. Fetal malnutrition was detected in 133(17.3%), 65(8.5%), 141(18.4%),91(11.8%), 85(11.1%) of newborn using CAN score, PI, Gestational age, BMI, and MAC/HCrespectively. Out of clinically malnourished babies identified by CAN score, PI, gestational age, BMIand MAC/HC identified 49.23% (32), 76.6% (108), 56.04%(51), 49.41%(42) as fetal malnutrition.BMI has the highest sensitivity and diagnostic accuracy for detecting fetal malnutrition. Maternalvariables associated with FM include early maternal age during conception 81.4% (623),primigravida 33.1% (112), anemia (21%), irregular antenatal checkups (40%) and concurrentillnesses (PIH, urinary tract infection, heart disease, renal disease, vascular disease) (50.9%).Conclusion: CAN score is a simple, handy and cost-effective tool to identify FM. Using BMI with CANscore can serve for screening FM. Among maternal variables, primigravida (33.1), anemia (21.5%),irregular antenatal checkup (40.25%), Concurrent medical illnesses (50.96%) is strongly associatedwith FM. Maternal age is not statistically significant.

Background: 60–80% of neonatal deaths are due to low birth weight (LBW <2500 g) in developing countries.Aim & Objective:The objectives of this study was to identify a suitable anthropometric surrogate and to identify LBW babies in the resource limited settings like rural areas where 80–90% deliveries take place to screen the LBW babies.Subject and Method:This is a prospective observational study conducted in department of pediatrics of tertiary care hospital and medical college of western India. A total of 519 newborns were studied by random sampling method. BW and other anthropometric measurements were taken within 24 h of birth. Result:Mean birth weight significantlyincreases with increasing value of anthropometric measurement, all key anthropometric parameters were significantly correlated to each other. The correlation with birth weight is more for chest circumference (0.58)than mid upper arm circumference (0.54). Conclusion:CC is the better measurement to identify low birth-weight babies. Measurement of both MUAC and CC is of little additional value in predicting LBW babies. Chest circumference is a simple, quick, and valid screening tool for identifying LBW neonates in a community setting where there are problems of nonavailability of weighing scales.

Mushrooms have been dietary source in hilly and ethnic tribes of India. More than 5000 mushroom species are known worldwide and nearly 100 species are known to be poisonous for humans. Mushroom poisoning occurs due to unintentional and accidental ingestion of poisonous mushroom due to misidentification of poisonous variety as edible one. There has been increasingly incidence of reporting of mushroom poisoning cases nowadays. Here we are reporting case series of 4 patients admitted hailing from same village with accidental ingestion of poisonous mushrooms with clinical-laboratory profile and outcome at our institution. Mushroom Poisoning is an emerging healthcare concern nowadays. Education and mass awareness for identification of poisonous mushrooms is an important preventive measure. Early hospitalization, proper hydration, gastric decontamination, silibinin and N- acetyl cysteine therapy with hepato-renal support constitutes mainstay of treatment. Delay in treatment and complications results in poor prognosis and mortality.