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Background: Hearing impairment in children constitutes a particularly serious obstacle to their optimal development. Early detection of hearing impairment is vital since early intervention including hearing aids and speech therapy can be initiated at the earliest and will help them to enjoy equal opportunities in society alongside all other children. The aim of the study was to determine the prevalence and risk factors associated with hearing impairment among newborns delivered in a tertiary care centre using a two staged OAE test.Methods: This study was a prospective descriptive study done in Govt. T.D. medical college, Alappuzha over a period of 12 months. All newborns (4359) were included in the study. They were carefully evaluated for presence of risk factors and OAE was done before discharge from the hospital. If found abnormal OAE was repeated at 6 weeks, failing which BERA was performed.Results: Out of 4268 newborns screened, 275 failed OAE (6.4%) and 44 failed second OAE (1.03%) also. BERA was done in 40 newborns out of whom 6 failed (prevalence of 1.3 per 1000 population). Risk factors studied were prematurity, perinatal asphyxia, hyperbilirubinemea requiring phototherapy, congenital infection, family history of deafness, NICU admission more than 5 days, culture positive sepsis and newborns receiving ototoxic medications.Conclusions: Hearing impairment was more among those with risk factors. But hearing evaluation is important in all newborns irrespective of presence of risk factors to avoid missing hearing impairment in otherwise normal newborn.

Background: Candidiasis refers to infection with fungi of the genus candida. Candida infections are frequent and major causes of septicemia in neonatal intensive care units and are associated with high morbidity and mortality. Low birth weight preterm infants are especially vulnerable to these devastating infections. Candida infections are a major cause of septicemia in neonatal ICUs and may affect 1.6% to 12.9% of very low birth weight infants. The smaller the infant is, the greater is the likelihood for systemic fungal infection to develop.Methods: 40 Newborns with culture proven candidiasis admitted in new-born nursery of Government T. D Medical College, Alappuzha, were selected for the study. The significance of different parameters such as gender, gestational age, birth weight, Apgar score, duration of hospital stays, central venous catheter and use of third generation cephalosporins were analysed. Clinical profile like apnoea, feed intolerance, requirement of ventilator support, temperature instability, thrombocytopenia, hyperglycemia etc. were analyzed.Results: Out of 40 newborns 39 were preterms, 42% of study population were having a birth weight of 1-1.5 kg, 33% with a birth weight of 1.5-2 kg and 20% with a birth weight of <1 kg.75% of the study population were hospitalized for >1 week. In the study group 58% had feed intolerance, 52.5% needed ventilator support, 52.5% had temperature instability, 70% had thrombocytopenia 50% had apnea and 4% had hyperglycemia. The overall survival was 60%.Conclusions: Prematurity, low birth weight and prolonged hospital stay were associated with increased risk of candidiasis. Feed intolerance, increased need for ventilator support, apnea, temperature instability and thrombocytopenia were significant clinical parameters.

Background: Pediatricians often encounter children with heart murmurs during routine follow up visits or while assessment of intercurrent illness. Clinical differentiation between pathologic and innocent murmurs would be important. It is important to identify those children who need further evaluation. The aim of the study was to evaluate whether Nadas criteria can be applied as a screening test to decide on further workup.Methods: This was a prospective descriptive study done in Government T. D. Medical College, Alappuzha over a period of 12 months from July 2013 to June 2014. All children in the age group one month to 12 years, attending the outpatient department were screened for presence of murmur of grade 2 and more. They were further evaluated carefully. They were also studied for association of variables like maternal age, birthweight, dysmorphism and family history of heart disease. Nadas criteria was then applied to the study population. A score of 2 and 1 were given to major and minor criteria respectively.Results: 3070 children were screened. 150 children were detected to have murmur of grade2 and more.66 children were detected to have a structural heart disease by an echo study.74% of the study population in the age group <1 year had a heart disease.8 out of 78 children with a Nadas score of 1 and 10 out of 24 with a score of 2 had a heart disease. All with a score 3 and more had congenital heart disease (CHD).Conclusions: Nadas criteria can be used as screening test with a sensitivity of 87% and specificity of 83%.

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GFR (Glomerular filtration rate) is the amount of blood filtered by the kidney’s glomerulus into the Bowman ’s capsule per unit of time. Schwartz equation is the length based calculation of estimated GFR (e GFR). Pottel’s equation is length independent one. The aim of the study is to find out the mean eGFR values in different age groups using the height dependent Schwartz formula in children 2-12 years. Secondary objective is to find out the relationship between eGFR and birth weight, gestational age, family history of renal disease and past history of urinary tract infection and to compare eGFR calculated by height dependent Schwartz formula and height independent Pottel’s equation700 children in the age group 2 to 12 years were included in the study. After obtaining written informed consent from the child’s guardian, pessronal details and serum creatinine values were collected. Height was measured using a stadiometer. Estimated GFR values were calculated using Schwartz formula and results were statistically analysed.Where GFR values by Schwartz formula were compared with inulin based GFR as in referenced study, it was found out that in certain ages there was statistically significant difference. Among the determinants studied, there was a weak positive correlation between gestational age and eGFR. eGFR by Schwartz formula was also compared with eGFR based on height independent Pottel’s equation and was found that there was statistically significant difference between absolute values, but they show a positive correlation1: There was no statistically significant correlation between birth weight, family history of renal disease and past history of urinary tract infection with eGFR; 2: There was a weak positive correlation between gestational age at birth and eGFR; 3: When eGFR by Schwartz formula was compared with eGFR by Pottel’s equation, there was a positive correlation between the two, though the absolute values differed significantly; 4: Normative data of this study can be used for predicting eGFR in children 2-12 years.