INTRODUCTIONEach type of malnutrition is the result of a complex interplay of factors involving such diverse elements as household access to food, maternal and child-care, safe water and sanitation and access to basic health services. Children, who fail to get enough medical attention or receive only fragmented care, grow up shattered, both in body and mind. These children are to become our next generation. We will be left with a legacy of damaged ABSTRACT Background: In urban slums, several socio-demographic factors contribute for the occurrence of protein energy malnutrition (PEM) in under-five year children, this study aims at Assessment of prevalence of protein energy malnutrition in under-5 year children in an urban slum of Mumbai and to study associated factors. Methods: A cross-sectional study was conducted in Urban Slum which is a field practice area of institition.Under-5 children were included in the study and information was gathered by interviewing mother/guardian and recording anthropometric measurement of the child. Data was analysed with SPSS v.16 with suitable tests. Result: Prevalence of PEM was found 56%, more per cent of PEM was found in 13-24 month age 64 (66.7%), 120 (54.1%) boys, 122 (55%) non-nuclear family dwellers, in 126 (56.8%) children whose mothers got married<18 years age. About 116 (52.3%) children of illiterate mothers, 158(71.2%) children of birth order >2, 198(89.2%) children who were not given colostrum and 168 (75.7%) who were not given exclusive breast feeding, in 152(68.5%) children with incomplete immunisation, 122 (55%) children with more than 3 episodes of ARI, 142(64%) with >3 episodes of Diarrhoea. 86 (82.7%) children with PEM belonged to Class V, (B.G Prasad classification), statistically significant association of PEM was found with the factors age of child, mother's education, birth order, immunisation status, mother's age at marriage, exclusive breast feeding, history of acute respiratory infection (ARI) and diarrhoea, and socio-economic status. Conclusion: Study has found certain socio-demographic factors like age, gender and birth order of child, type of family, age of mother during marriage and her literacy level, giving colostrum, exclusive breast feeding, immunisation and frequency of ARI and diarrhoea associated with PEM.

Background: About 43% of the under-five child mortality is contributed by neonatal death. According to National Neonatal Perinatal Database (NNPD) in inborn births, Klebsiella pneumonia was the most commonly associated pathogen, followed by Staphylococcus aureus. Hence to know the prevalence and profile of bacterial infection in the inborn unit of an SNCU in Central India,this study was done.Methods: This is a cross sectional study done in the Inborn Unit of SNCU, Department of Paediatrics, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur (M.P.), INDIA done between 1st March 2015 to 31st August 2016 where the blood sample and data collection of the suspected patients was done. Samples were then sent for culture and sensitivity testing. All the details then entered in Microsoft Excel Sheet and data was analysed using SPSS v 20.Results: The prevalence of bacteriologically positive sepsis was found to be 5.06% (in 43patients out of 850 examined cases). It was more prevalent among males that is in 24 among total 43 culture positives (55.8%), low birth weight were 37 (86% of culture positive patients)and preterm were 35(81.4% of culture positive patients). The most common pathogen associated was found to be Klebsiella pneumonia which was detected in 16 patients (37.2% of all bacteriologically positive patients) followed by E. coli and Pseudomonas, each in 7 patients (16.28%).Conclusions: Though we are on the track of minimising morbidities still we have a high prevalence of neonatal sepsis in inborn unit so sepsis related morbidities can be prevented if timely interventions are done.

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Background: Thrombocytopenia is a common haematological problem encountered during neonatal period, particularly in the sick, premature neonates admitted in the NICU, and usually indicate an underlying disease process. Thrombocytopenia may be considered as an important and early tool in diagnosis of septicaemia in neonates.Methods: It is a hospital based cross sectional study. A total 105 neonates with blood and/CSF culture positive sepsis and associated thrombocytopenia admitted in NICU. This study was conducted to find the prevalence of thrombocytopenia in neonates admitted in NICU with culture proven sepsis and to observe the outcome of thrombocytopenia and sepsis.Results: Out of 105 culture positive neonates K. pneumoniae 47/105 (44.8%) was the commonest micro-organism isolated, followed by Pseudomonas 26/105 (24.8%), E. coli 14/105 (13.3%), Staphylococcus 11/105 (10.5%), Candida 2/105 (1.9%) in decreasing order. Thrombocytopenia was present in 100/105 (95.2%). Among thrombocytopenic neonates 38/100 (38%), 36/100 (36%) and 26/100 (26%) having severe, moderate and mild thrombocytopenia respectively. 38 (38%) newborns of severe thrombocytopenia among them K. pneumoniae (50.0%) was commonest organism, followed by Pseudomonas. (23.7%) and Staphylococcus (15.8%) in the decreasing order. 36 (36%) newborns of moderate thrombocytopenia among them K. pneumoniae (47.2%) again commonest organism associated, followed by Pseudomonas. (25.0%), and E- coli (11.1%). In severe thrombocytopenic newborns both GI and pulmonary (60.50%) haemorrhage was the most common bleeding manifestation. Mortality rate (37.1%) was high in newborns having sepsis.Conclusions: Bacterial sepsis is significantly complicated by thrombocytopenia. Severe thrombocytopenia in a suspected case of bacterial sepsis might predict Klebsiella sepsis and hence it may be rational to start empirical antibiotics covering the same.

Introduction: Nutritional status at birth is assessed by using various anthropometric parameters and proportionality indices. Present study aims to assess the utility of CAN score in identifying fetal malnutrition (FM) which would have been missed by using anthropometry alone. We also aim at re-evaluating the cut-off value of CAN score for our population.  Methods: Nutritional status of 411 neonates was assessed using anthropometric parameters, proportionality indices and CAN score. Effectiveness of each parameter in detecting FM was assessed and compared with CAN score cutoff < 25 as well as new found cut-off < 27 using appropriate statistical tools.  Result: Mean (SD) of all anthropometric parameters were significantly less in FM group (p < 0.001). CAN score identified FM in 18.5% (76 / 411) babies whereas weight for GA identified 8.8% (36 / 411) babies as SGA and 91.2% as AGA (375 / 411); 12.3% (46 / 375) babies identified as AGA, were found to be malnourished by CAN score. Similar trend is seen with other parameters too. ROC curves show that AUC for birth weight, mid arm circumference, body mass index, Ponderal index, length and MAC / HC for determining FM was 0.891, 0.855, 0.837, 0.761, 0.749 and 0.714 in decreasing order. Birth weight with cut-off 2300 grams in a term newborn has maximum AUC making it the best marker for predicting FM. Present study identifies more FM by using modified CAN score cut off < 27 instead of < 25, 32.11% (132 / 411) and 18.5% (76 / 411) respectively. Conclusion: CAN score is a simple method to assess FM which does not require any sophisticated equipment or time-consuming calculations.