Long distance neonatal transport on road is feasible and with a qualified team results can be comparable to those transported from shorter distances.

Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of high pulmonary vascular resistance (PVR) commonly seen all over the world in the immediate newborn period. Several case reports from India have recently described severe pulmonary hypertension among infants in the postneonatal period. These cases typically present with respiratory distress in 1–6-month-old infants, breastfed by mothers on a polished rice-based diet. Predisposing factors include respiratory tract infection such as acute laryngotracheobronchitis with change in voice, leading to pulmonary hypertension, right atrial and ventricular dilation, pulmonary edema and hepatomegaly. Mortality is high without specific therapy. Respiratory support, pulmonary vasodilator therapy, inotropes, diuretics and thiamine infusion have improved the outcome of these infants. This review outlines four typical patients with thiamine-responsive acute pulmonary hypertension of early infancy (TRAPHEI) due to thiamine deficiency and discusses pathophysiology, clinical features, diagnostic criteria and therapeutic options.

The study was designed to compare the biochemical characteristics of neonates transported by qualified transport team, before and after stabilization, interventions required and setbacks during these transports. Prospective cohort study of all neonatal transports during a period of 13 months from various maternity and pediatric centers was conducted; 151 babies who fulfilled the criteria were included in the study. 58% of babies < 32 wks were hypothermic, 21% of the total babies were hypotensive and a total of 25% of the babies were hypoxic at the referral hospital. Intubation was done by the transport team in 23% of babies and 25 % of the babies were transported on a ventilator. There was a significant improvement in the clinical condition of all these babies in relation to temperature control, sugar control, oxygenation and blood pressure after stabilization.

Severe malaria causes multiorgan dysfunction, which is the predominant reason for mortality in these children. Cardiac enzymes have been elevated and cardiac involvement has been suspected in some of these children, however, clear cut echocardiographic evidence for it was not possible. There were isolated reports of myocardial dysfunction in malaria in adults but none in children. We present two such children with cardiac involvement and myocardial dysfunction.

Colistimethate sodium is effective against carbapenem-resistant Gram-negative bacteria, and is safe in children.