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Background: Immunisations is one of commonest cause of iatrogenic pain among healthy infants though several authorities have recommended that no aspiration is required before injecting into the anterolateral thigh, it is still a commonly followed procedure. Method: 202 healthy infants of either sex of age group 6 weeks to 6 months receiving routine intramuscular pentavalent vaccine were selected randomly by computer generated numbers and divided into two groups "standard" group and "pragmatic" group with 101 infants in each group. Two methods of vaccination conventional and pragmatic are used. In both cases pre vaccination and post vaccination pain was accessed by using FLACC scale and modified behavioural pain scale as well as cry time was noted. Results: The pre vaccination mean FLACC score in standard group is 2.07 (±1.17) while that in pragmatic group is 1.79 (±1.28). Post vaccination mean FLACC score in standard group is 8.5 (±0.82) while that in pragmatic group is 7.79 (±1.25). The pre vaccination mean MBPS in both standard & pragmatic group is 2.16 (±1.07). The post vaccination mean MBPS in standard group is 8.13 while that in pragmatic group is 8.16. Conclusions: Our study revealed that there was significant difference in perception of pain among the two groups. The Pragmatic group being a better technique for vaccination.

Present study was a Hospital based observational study of 100 newborns admitted in level II NICU. The study was done to assess the development of severe distress against onset, duration, oxygen requirement & outcome in terms of final diagnosis, mortality & treatment intervention. Among the 100 cases, 90% cases were of respiratory in origin. Commonest cause of respiratory distress was transient tachypnoea of newborn followed by Meconium aspiration syndrome & Respiratory distress syndrome of newborn. The onset of respiratory distress in newborn developing after 6 hours of birth & respiratory distress > 24 hours duration had severe respiratory distress. Newborn with risk factors like high maternal age, primigravida, >4 PV examinations, Meconium stained liquor and lower socioeconomic strata developed severe respiratory distress. Statistically significant correlation of severity of respiratory distress was not found with the mode of the delivery, Apgar score <7 at 1 min, gestational age of the baby, birth weight and sex of the newborn. Only neonates with RDS & MAS required ventilator care. Two of the patients of RDS required only surfactant therapy, while other two required surfactant with ventilator support. Amongst the 100 newborns with respiratory distress, mortality was in 5 newborn (5%) which includes 2 of Respiratory Distress Syndrome & 3 of Meconium Aspiration Syndrome.

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