Objective: To develop and validate a simple screening tool for identifying developmental delay among children of 0-3years of age in the community. Methods: The 27-items of Trivandrum Development Screening Chart for children of 0- 3years [TDSC (0-3y)], were carefully prepared from the norms in various existing developmental charts/scales, by experts keeping in mind the face validity. The criterion validity was assessed in a community sample of 400 children of 0-3y with a mean age of 14months (SD of 10.33), including 203(50.75%) boys and 197 (49.25%) girls. TDSC (0-3y) was validated against Denver Developmental Screening Test (DDST) as the ‘Reference Standard’. Result: When one item delay in TDSC (0-3y) was considered as ‘TDSC delay’ (Test positive), the sensitivity and specificity of TDSC (0-3y) was found to be 86.7% (95% CI: 58.4%-97.7%) and 100% (95%CI 98.8%-100%) respectively with a Negative Predictive Value of 99.5% (95% CI 97.9%-99.9%). Conclusions: TDSC (0-3y) is a simple, reliable and valid screening tool for use in the community to identify children between 0 and 3 years with developmental delay, enabling early intervention practices.

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Objectives: (1) To determine the critical value of cord serum albumin in predicting subsequent development of neonatal hyperbilirubinemia and need of photo therapy or exchange transfusion. (2) To predict proportion of newborn requiring intervention for hyperbilirubinemia, depending upon cord serum albumin. Design: Prospective cohort study, Setting: Pediatrics department of a Medical College Hospital. Study Population: 174 neonates from delivery room, operation Theatre, maternity ward and paediatric intensive care unit from October 2013 to September 2015. Methods: Serum albumin was estimated from cord blood at birth. Followed- up for 5 days for development of Jaundice and estimation of bilirubin from blood. Data entered in Microsoft excel sheet, registered and analysed in registered version of Stata SE v 12.0 Results: Neonates were divided in three groups with cord Albumin <2.8 grp I) 2.9 - 33 gm/dl (grp II) and >3.4 gm/dl (grp3) with 77, 57 and 40 in three respective groups. 20 out of 174 developed hyperbilirubinemia requiring intervention. 19 in group I, 1 in group II and non in group III developed hyperbilirubinemia. Conclusion: Neonates with hyperbilirubinemia had significantly low levels (<2.8 gm/dl) of cord albumin level and this group need to have meticulous follow up and early intervention.

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Hepatitis A is common infection in pediatric age group especially in developing country due to poor hygiene and sanitation practices. It is endemic in India. Here we report a case of hepatitis a with unusual presentation in 6 year old girl.

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Introduction: HIV infection has been recognized as pandemic by World health organization (WHO). Management of HIV includes a combination of antiretroviral drugs (ARV). It effectively suppress viral replication and improves quality of life if adherence is good. Maintenance of good adherence in children is difficult as they depend on their caregiver. So it is very important to assess the level of adherence and different factors influencing it. Setting: Pediatric ART centre of a tertiary care teaching hospital of West Bengal. Study Design: This was a prospective observational study. Methods: All children started on ARVs within first three months of study period with an identifiable caregiver were included in the study and followed up for next 9 months. Level of adherence was assessed by medicine return technique. Objective of the study was to assess the relationship between level of adherence to Antiretroviral therapy (ART) with different socioeconomic, socio-demographic and therapy related factors and clinical, immunological staging of the disease. Result: 76.78% of the children were showing adherence to ART >=95%. Nutritional status of the child at the initiation of ART, socioeconomic factors and disease severity were strongly related to level of adherence. Most common barrier of adherence was simple forgetting (35.71%). Conclusion: Level of adherence to ART should be assessed with every visit to the ART centre. Medicines return technique is quite good in this resource limited setting. By assessing the factors that can influence adherence we can identify the vulnerable population and we can give our extra attention to this group of children.

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Globally, preterm birth is a serious public health problem and is a leading cause of perinatal death and disability. Care provided to mother during antenatal period has a significant bearing on the new born survival.Antenatal corticosteroids are usedfor accelerating foetal lung maturation for women at risk of pre-term birthwhich results in decrease of neonatal morbidity and mortality. Antenatal corticosteroids are effective in reducing respiratory distress syndrome (RDS) and other complications of premature deliveries. Govt, of India is placing it's efforts to bring this intervention into focus and also to empower ANMs to give apre- referral dose of Antenatal Corticosteroid to a pregnant women going in to preterm labour to improve its access.

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Clinical markers of tuberculosis are varied and involve all systems with classical and non- classical features; presence of its hallmarks makes the suspicion strong. It is erroneous to give antibiotic therapy for confirming TB. It is very simple with good history taking and the clinical markers with the supportive evidences to arrive at a diagnosis of childhood TB. This situation is especially applicable to India, the rural setup and the urban slums to have high index of suspicion and thereby reduce the spread, morbidities and mortality.

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Hemophilia A is a X-linked recessive hereditary clotting factor deficiency condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased level of factor VIII activity leads to increased risk of bleeding. During newborn period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Severe cephalhaematoma at birth is a rare, nd can lead to high mortality in neonates. We present a neonate with unremarkable third degree consanguous marriage and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe cephalhaematoma bleeding at 4 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

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