Background: Perinatal asphyxia, neonatal asphyxia or birth asphyxia is the medical condition resulting from deprivation of oxygen to a new born infant that lasts long enough during the birth process to cause physical harm, usually to the brain. This study was performed to evaluate study population who were 6 to 8 years of age to determine whether the application of moderate hypothermia after perinatal asphyxia is associated with long term benefits.Methods: This study was a randomised, controlled trials which consisted of infants who were admitted with moderate and severe encephalopathy within 6 hours after birth after an acute perinatal event, with acidosis or resuscitation. Infants were assigned to undergo whole body hypothermia at 33ºC for 72 hours or to undergo usual care randomly.Results: All maternal baseline characteristics and Neonatal characteristics are non significant in both groups. APGAR score ≤5 is significant at 10mins in comparison. cerebral palsy were 18% and 25%, respectively, the rates of blindness were 1% and 4% the rates of hearing impairment (requiring aids) were 5.4% and 12.8%. There were no significant between-group differences in the level of disability among all survivors or in motor function among the 45 nondisabled children. Among children who had moderate or severe disability at 18 months, the corresponding rates at 6 to 7 years of age were 88% in the hypothermia group and 95% in the control group. All the children who had moderate-to-severe cerebral palsy at 18 months continued to be affected at 6 to 7 years in both groups. There was no significant between-group difference with respect to IQ scores that were measured on a continuous scale and other scores, with the exception of 1 of the 11 scores compared (attention and executive function, P=0.03). There were also no significant differences between groups in mean scores on the index of health care status derived from parental assessments or in parental scores for children’s strengths and difficulties and ADHD The mean difference in the academic achievement score favored the hypothermia group but was not significant.Conclusions: Moderate hypothermia after perinatal asphyxia resulted in improved neurocognitive outcomes in middle childhood.

Background: Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools. This is a randomized controlled trial to find the relationship between probiotics and constipation in children. Methods: This study was a randomized, controlled blinded trial conducted in Department of Paediatric. This was done during a period of January 2014 to January 2016 conducted in 50 patients. The patients were divided into two groups randomly namely group A who received lactulose plus protexin daily and group B who received lactulose plus placebo alone. Results: Males were 15 (60%) and females were 10 (40%) in group A and in group B, males were 10 (40%) and females were 15 (60%). Faecal incontinence was in 13 (52%) in group A and in 10 (40%) in group B. Abdominal pain was in 16 (64%) in group A and was in 14 (56%) in group B. The stool frequency and consistency improved significantly. There was a significant improvement in fecal incontinence and abdominal pain in the Group A, and at the end of the fourth week, this difference was not significant and there was improvement significantly in weight gain. Side effects were not seen in the during the treatment. Conclusions: This study shows that there was a positive effect of probiotics on constipation in children.

Background: Bronchiolitis is one of the commonest causes of hospitalization of infants and young children in India. Parental smoking is an important risk factor for both susceptibility and severity of bronchiolitis. Paternal smoking alone causes a 1.3-fold (95% CI = 1.2-1.4) increase in risk. The aim of this study was to find out the role of parental smoking in severe bronchiolitis.Methods: This is a case control study conducted in the Department of Pediatrics from July 2013 to December 2015. Sixty-four patients admitted into the ward with severe bronchiolitis were enrolled as cases and sixty-four suitably matched apparently healthy children attending EPI centre and outpatient department presenting with non-respiratory illness were enrolled as controls. Every second case satisfying the inclusion and exclusion criteria was enrolled in the study.Results: The mean age of the patients was 8.53 (SD±4.75) months. Forty-two (65%) patients were male and twenty-two (34.3%) patients were female. Male-to-female ratio was 1.9:1. Most of the cases (62.5%) came from low socioeconomic background. More than half of the cases (53.13%) were not exclusively breastfed babies. Mean length of hospital stay was SD (5.41±2.82) days. Thirty-nine (60%) cases and twenty-three (35%) controls were exposed to parental smoking. Result was highly significant (p = 0.005). Odds ratio was 2.8 (95% CI from 1.36 to 5.68).Conclusion: Exposure to parental smoking causes a statistically significant (p = 0.005, odds ratio = 2.8) increase in the risk of developing severe bronchiolitis in the first year of life

BACKGROUND: Rheumatic fever and rheumatic heart disease continue to be an important public health problem in developing countries. Doppler echocardiography is now widely used for early detection and recurrence of clinical evident carditis (CC) and silent (subclinical) carditis (SC). In this present study, we performed Doppler echocardiography in ARF children clinically diagnosed by the Jones criteria in order to compare its effectiveness in detecting single/multi-valvular lesions over clinical evaluation alone and they were followed with repeat examinations over a period of 6 months. METHODS: A total of 57 consecutive patients diagnosed with acute rheumatic fever were included in the study. The patients without clinical evidence but with echocardiographic findings of carditis were diagnosed as having subclinical carditis. RESULTS: Acute rheumatic fever was diagnosed in 57 patients, and 38 of these had carditis. Among the 38 clinically 25(65.8%) patients were detected to have cardiac lesion. Echocardiography showed thirteen (34.2%) more patients were affected with carditis. The prevalence of SC was 13(22.8%) among these 57 patients. 51patients were followed up for 6months, and 11 of those had SC. CONCLUSION: It is suggested that Doppler echocardiography be performed in all patients with suspected acute rheumatic fever for early detection of SC. Echocardiography should be used as a diagnostic criterion in order not to miss a diagnosis of SC.

Background: Low birth weight (LBW) is defined by the World Health Organization as a birth weight of an infant of 2,499 g or less, regardless of gestational age. Low birth is caused mainly due to diabetes and cardiovascular diseases in adults This study compared breast feeding with or without supplemental feeding on short term growth patterns and fasting insulin levels in low birth weight neonates. Methods: This study was conducted in Department of Paediatric and it was approved by institutional review board. 100 low birth weight neonates who were less than 2.5 Kg who were born at >38 weeks of gestation, less than 10 days of age, were enrolled in the study. 50 children’s parents provided informed consent (50%) and assured follow-up were included in the study. Children born after 38 weeks of gestation, low birth weight, having no intercurrent illnesses such as acute infections or congenital malfunctions were included in the study. These children were randomly divided into two groups, Group I consisted of 25 were made to receive breast feeding, Group II consisted of 25, received fortified meal along with breast feeding. Results: In the present study, birthweight was 2.00±0.58 in group I, and it was 1.88±0.35 kg in group II; birth length was 43.5±2.5 in group I and it was 43.8±2.8 cm in group II; head circumference was 31.2±1.4 in group I and it was 30.25±8.7 cm in group II; chest circumference was 29.1±2.8 in group I and it was 28.7±5.8 in group II. Haemoglobin levels, glucose fasting levels were lesser in group II compared to group I and insulin levels and IQR levels were more in group II compared to group I. Conclusions: Those low birth weight neonates who had exclusive breast feeding had lesser fasting insulin levels when compared to those who were fed with fortified breast milk.