Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and ASD (atrial septal defect) in 20.2%. Tetralogy of Fallot was the commonest cyanotic heart disease (8.0%). Maximum numbers of children with heart disease were diagnosed in the age group 6 weeks to 6 years.Conclusions: For better estimation of prevalence of congenital heart diseases, more elaborate community-based studies are needed. Such community based studies can be easily done by collecting and analyzing data collected from screening programs like RBSK. Such community based screening programs helps in detecting silent cardiac ailments, their prevalence and pattern, and early therapeutic intervention. A few prevalence studies have been carried out piecemeal in different locations of India; and more such studies can be easily done by collecting and analyzing data collected under RBSK screening program.

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Background: Breastfeeding is a well-established and recommended intervention for the improvement of child nutrition. Formula feeding is a major public health problem. Objective of the current study was to know the significance of demography, socioeconomic, parental education and employment and mode of delivery on exclusive breast-feeding Kashmir, North India.Methods: A prospective hospital-based study, carried out in the Department of Pediatrics, G.B Pant Hospital Srinagar Kashmir India over the period from 2014 July to June 2015. A teaching, research and tertiary care hospital at Srinagar Kashmir North India. All the mothers who were having infants in the age group 0 to 6 months were included in study. Procedure of this variables recorded were modes of feeding, demographics, socioeconomic status, literacy level, mode of delivery, place of delivery etc.Results: A total of 600 mothers were included in study. Less than 35% of mothers were exclusively breast feeding their infants. Exclusive breast feeding was significantly high in babies born by normal vaginal delivery, more than 3 antenatal visits, mother knowing advantages of breast feeding and higher parental education.Conclusions: Exclusive breast feeding is very low (less than 35%) in this part of world and formula feeding is a major public health problem.

BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. It is one of the four leading causes of morbidity and mortality in India among the neonates due to delivery and postnatal follow up in an unhealthy environment and low socioeconomic state leading to maternal infection and premature delivery. It is absolutely necessary to diagnose early neonatal sepsis and its cause using clinical signs and rapid diagnostic method so that no time is wasted in starting appropriate treatment. MATERIALS AND METHODS A hospital-based study carried out in the Department of Neonatology over the period from 15 June 2013 to 15 May 2014. Setting-A teaching, research and tertiary care hospital at Srinagar, Kashmir, North India. Participants-All the neonates, inborn or out-born with at least one of the following anamnestic or clinical criteria as developed by the French National Agency for Accreditation and Health, were included in study. Procedure: Variables recorded were-presenting risk factors, symptoms, clinical signs, baseline laboratory tests, blood, urine and CSF cultures and sensitivities. RESULTS 100 neonates were included in the study. The most common symptoms of neonatal sepsis were general (62%) followed by respiratory (54%). 32% neonates were having fever and 34% hypothermia. Klebsiella was most common gram-negative organism (36.84) grown and CONS most common gram-positive organism (13.5%) among culture positive sepsis. CONCLUSION Neonatal sepsis is a major cause of morbidity and mortality in neonates in Kashmir India despite recent improvements in the health care system. Clinical manifestations are nonspecific and varied and early diagnosis is must to prevent morbidity and mortality. Gram negative neonatal sepsis is most common.

Background: The measurement of severity of illness using scoring systems is an important aspect in predicting mortality and morbidity in intensive care units which in turn can help in optimizing the limited healthcare resources in developing countries. The primary objective was to determine the correlation between clinical risk index of babies-II (CRIB-II) and score for neonatal acute physiology-II (SNAP-II) scores while the secondary objective was to identify which among them is superior in predicting mortality and morbidity in preterm neonates.Methods: The components of CRIB-II and SNAP-II scores were recorded prospectively over a period of 1 year in preterm very low birth weight (VLBW) babies and receiver-operating-characteristics (ROCs) were plotted for comparison. Correlation between CRIB-II and SNAP-II was examined by Pearson technique. The ability of CRIB-II and SNAP-II scores to correctly predict mortality, was assessed by calculating ROCs and their associated area under the curve (AUC).Results: Thirty nine neonates with a mean birth weight of 994.10 grams (SD±273.45 grams) and mean gestational age of 28.07 weeks (SD±2.29 weeks) were included in this study. The mean value of CRIB-II score and SNAP-II score was 8.54 (SD±4.67) and 9.82 (SD±8.93) respectively with a Pearson coefficient of 0.483 showing a modest correlation. CRIB-II (AUC 0.909) showed greater discrimination than SNAP-II (0.869) as a predictor of mortality. However, both the scores have poor discrimination when it comes to predicting neonatal morbidity.Conclusions: CRIB-II with its simplicity, need for uncomplicated variables and minimal time to generate a score for prediction of mortality and morbidity could be a useful tool in a busy neonatal intensive care unit (NICU).

Background: Objective of the study was to determine the incidence and risk factors for extrauterine growth restriction (EUGR) at discharge in preterm neonates.Methods: This prospective analytical cohort study included 107 preterm neonates between 30-35 weeks of gestational age who were admitted to a tertiary neonatal intensive care unit from January 2016 to December 2016. These preterm neonates were classified into EUGR group (n=93) and non-EUGR group (n=14) based on the body weight at discharge. The risk factors for EUGR were analyzed statistically.Results: The incidence of EUGR at discharge was 87.4% in the cohort. Delay in initiation of parenteral nutrition (p=0.04), longer time to reach full enteral feeds (p=0.03), very low birth weight (p=0.01), small for gestational age (p=0.01), intrauterine growth restriction (p=0.01), necrotizing enterocolitis (p=0.03), late-onset sepsis (p=0.03) and bronchopulmonary dysplasia (p=0.04) were significant risk factors for extra-uterine growth restriction at discharge in preterm neonates.Conclusions: The incidence of EUGR can be decreased by improving perinatal care, minimizing preterm deliveries, early initiation of parenteral nutrition and enteral feeding and reducing immediate postnatal complications.