Background: There is a large amount of data on the prevalence and risk factors of speech and language delay from the West, but relatively scanty data from India. Objectives: The aim of this study was to assess the prevalence and risk factors of speech and language delay in children less than three years old, using the Langauge Evaluation Scale Trivandrum (LEST 0-3). Materials and Methods: A descriptive, cross sectional study was conducted in the under-five clinic of our institute, on a sample of 200 children, less than three years old. Language was assessed using Language Evaluation Scale Trivandrum (LEST 0-3) and development in other domains was assessed using the Trivandrum Development Screening Chart (TDSC). The Home Screening Questionnaire (HSQ) was used to assess the home environment. Various biological and environmental risk factors were analyzed. Results: The prevalence of speech and language delay was found to be 27%. In univariate analysis, parameters found to be signifi-

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Paracetamol is as effective as ibuprofen for PDA closure in preterm neonates. Ibuprofen used for PDA closure in preterms poses an increased risk for acute kidney injury compared to paracetamol.

In hypoxic ischemic encephalopathy (HIE), oxidative stress markers MDA and protein carbonyl are high at birth and rise further at 48 hours and the values correlate with the morbidity and mortality. Therefore, determining the serum levels of oxidative stress markers MDA and protein carbonyl will be of benefit in predicting the outcome in perinatal asphyxia.

Background:Although the term acute renal failure was replaced by acute kidney injury (AKI) recently, there is a paucity of data on the incidence and profile of AKI in critically ill children from the developing world.Objectives:The objective of this study is to determine the incidence, etiology, short term outcome and predictors of fatality in critically ill children admitted to the pediatric intensive care unit (PICU) with AKI, aged 1 month to 13 years.Materials and Methods:In this prospective observational study, from June 2010 to March 2011, 215 children admitted to the PICU were screened for AKI, defined according to the AKI Network criteria. The patients with AKI were followed-up until discharge/death. Their clinical and biochemical data were recorded.Results:The incidence of AKI among 215 patients screened was 54 (25.1%). The common etiologies were infections, [34 (62.9%)], acute glomerulonephritis (7.6%), snake envenomation (5.7%), hemolytic uremic syndrome (3.8%) and congestive cardiac failures (3.8%). Among infections, pneumonia and septicemia constituted 26.5% each, meningoencephalitis accounted for 23.5%, and dengue, scrub typhus, tuberculosis and malaria constituted 9.3% of children with AKI. 27.8% of patients required dialysis. Overall mortality was 46.3%. On logistic regression analysis, requirement of mechanical ventilation was an independent predictor of fatality in AKI.Conclusions:Besides the high incidence of AKI in critically ill-children admitted to the PICU (25.1%), the condition was associated with adverse outcomes, including high mortality (46.3%) and need for dialysis (27.8%). Infections dominated the etiological profile. Requirement of mechanical ventilation predicted an adverse outcome in our patient population.