Breastmilk feeding isthe gold standard. Formula milk is getting easy access due to ignorance of scientific principles, lack of commitment and efforts to promote human milk, besides unavailability of human milk banks. There is a grave need to create awareness for using breastmilk in health care facilities. Risk of unpasteurized donor human milk is probably overrated.Donated raw milk given to newborn infants produces no ill effects including HIV transmission, as observed and practiced in Norway. Bacteriostatic qualities of fresh milk resists bacterial growth. Bacterial counts reduce in fresh breastmilk over initial few hours due to phagocytic activity. Newborns fed MoM with high commensal bacteria count has no untoward effects. Thus pasteurization of MoM is not recommended. Unprocessed mother's milk is choice of feeding pre-terms as often it grows only commensals on preserving. Suchinfants did not show higher late sepsis rates; had better fat absorption & growth; shorter hospital stay as compared to pasteurized donor milk. Refrigerators are there everywhere so MoM feeding can be easily practiced with proper dissipation of scientific information on managing human milk. In resource poor and ethic restricted countries efforts are being put to use unpasteurized raw frozen donor milk after stringent donor screening. These observations and facts opens door to concept of raw human milk banking which has large scope in India. It is suggested that, before starting to donate, documenting two negative tests each for HIV, HBsAg and VDRL are desirable.

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Maternal body dimensions are first determinants of neonate biometrics; predominantly their birth weight and length, which are closely related to perinatal morbidity and mortality(l), it was known that mother's nutritional status is also known to be a key indicator of infant's body dimensions and its early growth features. Birth weight and length are clearly related to mother's nutritional (2) and anthropometric factors(3) Objective: To find out which maternal anthropometric parameter is the best indicator for birth outcome. Study Design: Observational prospective study with correlation. Subject: All booked cases of antenatal mothers in first trimester and their newborn babies delivered at the Hi-Tech Medical College and Hospital during November 2014 to October 2016 were taken as the study population. Result: Occurrence of low birth weight (LBW) was higher(76.8%) in mothers having BMI <18. Only 7.7% LBW babies were seen in mothers having BMI 18-26. Occurrence of LBW was higher(58.1%) in mothers having MUAC (Mid upper Arm Circumference)<23cms. The occurrence of low birth weight was higher in mothers having weight <45kg and more than normal birth weight in mothers having weight ≥ 45kg. Out of 520 mothers 88(16.9%) had height <145cms and 432(83.1%) with height >145cms. LBW babies in mothers with height <145cms is 28.4% and in mothers with height >145cms is 27.3% (p=0.628). Mothers with height ≤ 145cms and BMI >18kg/m2 gave birth to 23 (92%) babies with birth weight < 2500gms and all were NVD and 2 (8%) babies with birth weight 2500gms to 3000 gms with NVD. Out of 63 babies of mothers with height ≤ 145cms and BMI >18kg/m2, 2 (3%) had birth weight <2500 gms, 42(66%) had birth weight 2500-3000, 19 (30%) with birth weight ≥ 3000. Mothers with height ≥145cms and BMI >18kg/m2 had 2 (3%) babies with birth weight < 2500 gms and all had normal vaginal delivery (NVD). 42(66%) babies with birth weight 2500 to 3000gms and 30 (71%) delivered by NVD and 12 (29%) by LSCS, 19 (30%) babies with birth weight ≥ 3000gms among which 6 (31.5%) delivered by NVD and 13 (68.4%) by LSCS. Conclusion: Maternal weight, BMI and MUAC have strong positive association with birth weight of newborns. Interventions during pregnancy should be taken to improve nutritional status of the mother by which it is possible to improve the birth weight of newborn BMI having closest relationship with birth-weight which tends to be inversely proportional to height and directly proportional to weight. Out of the four parameters examined height didn't seems to have any relation with weight.BMI of the mother is the best indicator of the weight of the newborn. As per the reports short height speaks of the obstetrics outcome. Therefore high BMI and low height can be predictive of a cephalopelvic disproportion, which has a direct bearing in the mode of delivery.To save the newborn from distress and reduce neonatal mortality and improve quality of life which could have been the result of hypoxic ischemic encephalopathy, early assisted delivery can be planned in vulnerable segment.

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Objective: Respiratory infections in children are associated with significant economic burden,as well as significant morbidity and mortality. Immunomodulation with pidotimod, a synthetic dipeptide, has been shown to reduce incidence of recurrent respiratory infections (RRIs) in children. This study was conductedto assess efficacy and safety of pidotimod in Indian children with RRIs. Materials and Methods: In an OPD based study, children aged 2 to 10 years were randomized to pidotimod or control group in a 2:lratio. Patients included had RRIs defined as six or more acute respiratory infection episodes in one year. Pidotimod was administered in dose of400 mg as 7 ml of oral suspension twice daily for 15 days followed by once daily to complete 2 months. Treatments were started on day 1 of infection in addition to standard treatments. Patients were followed for 6 months after completion of treatment. Incidence of respiratory infection episodes were compared to previous rate in either treatment groups as well as between the groups. Results: In 63 patients, 43 received pidotimod and 20 were controls. Mean age did not differ in two groups. 44.2% patients in pidotimod and 25% patients in control group had known asthma. In 6-month period, compared to control pidotimod resulted in significantly lower RRI episodes in both overall (mean number of episodes: 0.09±0.29Vs 2.90±0.64 respectively, p<0.001) and asthmatic (0.05±0.23 Vs 3.40±0.55 respectively, p<0.001) populations. Compared to previous year's mean number of RRI episodes, pidotimod significantly reduced incidence of RRIs episodes in 6-months period (mean difference: -7.31±0.96Vs- 4.48±1.09, p<0.001 in overall population and - 7.31±0.96Vs-4.48±1.09, p<0.001 in asthmatic population). No adverse effects were reported and treatment was well tolerated. Conclusion: Pidotimod is effective and safe addition to lower the recurrence of respiratory infections in children including those having asthma and may be recommended in Indian children with RRIs.

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Congenital Cystic Adenomatoid malfor-mation consists of hamartomatosis or Dysplastic lung tissue mixed with more normal lung, generally confined to one lobe. This congenital pulmonary disorder occurs in 1:25,000-1:35,000 births. These lesions arise from excessive disorganised proliferation of Bronchial structures and probably results from an embryologic insult before 35thday of gestation. CCAM can be diagnosed in Utero by Ultrasonography; the median age for the diagnosis is usually 21 weeks of gestation. Patient can present in the neonatal period with significant respiratory distress, recurrent respiratory infections and pneumothorax. Patient with smaller lesions are usually asymptomatic until mid-childhood, when it can present with episodes of Recurrent or persistent pulmonary infections or chest pain.

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Bronchiectasis in childhood is still one of the most common causes of childhood morbidity in developing countries. Diagnosis and management of these patients remain problematic. Bronchiectasis can be focal or diffuse. When occurs locally, often present with recurrent cough and infectious exacerbations. When diffuse, the patients often have additional signs and symptoms of generalized airway obstruction, reduced lung function and may ultimately progress to respiratory failure. Bronchiectasis develops as a result of acute or chronic infection or inflammation; which may also be associated with an underlying anatomic airway obstruction, a congenital disease. Here we report two cases having unusual presentations whichhad led to diagnostic dilemma.

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Background: Breastfeeding gives children the best start in life. It is estimated that over one million children die each year from diarrhoea, respiratory and other infections because they are not adequately breastfed.Lactation is influenced by a complex hormonal milieu, including reproductive hormones and metabolic hormones. Lactation failure can have dire consequences on nutritional status of young infants. The present study was carried out to find the demographic and clinical profile of infants whose mothers had lactation failure. Methods: This was a descriptive study conducted in a tertiary hospital in a metropolitan city.After the clearance from Institutional Review Board, all infants whose mothers had lactation failure were enrolled in this study. All infants underwent clinical examination to evaluate for organic illnesses if any. Detailed anthropometry i.e. weight, length and head circumference of the infants were recorded. Demographic, socioeconomic, antenatal, perinatal and postnatal history was obtained from the mother. Mother's milk output and feeding habits of baby were also taken into account.Mother's nutritional status in the form of present weight was recorded on a digital balance.Data was analysed using student unpaired t test and chi square test. Results: The mean age of presentation was 1.78 months.Majority (58.3%) of the infants were first by birth order. There were 61.7% pre-terms and 35% were SGA at birth.Fifty five percent infants had a history of NICU stay.Majority (76.7%) of mothers were in the age group of 20-30 years. 56.6% of the mothers had a weight less than 55 kg. There were 43.3% babies born of cesarean section. There was a history of breast feeding having been initiated after 24 hrs in 56.7% infants. At enrollment, 65% babies were already receiving supplementary feeds while only 35% were being exclusively breastfed.

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Introduction: Meningitis is a major cause of morbidity and mortality in infants and children below 5 years of age. Early detection and prompt therapy are the most important factors in prognosis of meningitis. LAT provides rapid microbiological diagnosis of acute bacterial meningitis earlier than culture so as to guide the clinicians for administration of appropriate antibiotics. Aim: To study the clinical profile of meningitis in children and to evaluate the efficacy of CSF Latex Agglutination Test to diagnose the type of organism causing bacterial meningitis in children. Material & Methods: A hospital based prospective observational and analytical. A total of 60 children were enrolled in our study on basis of inclusion criteria i.e. 1 month to 12 years of age and clinical history and examination suggestive of meningitis. Results: Predominance of patients were between 1 to 5 years of age in 50% with male predominance. Based on CSF picture, incidence of viral meningitis was seen in 38.3% patients, bacterial meningitis in 30% patients, and aseptic meningitis in 16.7% patients and TBM in 15% patients. Out of 18 ABM patients, sensitivity of CSF gram stain was 22.7%. Sensitivity of CSF Culture was 22.2%. In our study, 14 out of 18 patients had CSF LAT positive. Sensitivity of CSF LAT was 77.8%. Haemophilus influenzae was the most common organism positive in CSF LAT followed by Streptococcus pneumonia and Escherichia coli. Neurological deficit was seen in 41.9%, 55.5% and 11.1% cases of viral meningitis, TBM and ABM cases respectively. Overall case fatality rate in meningitis is 21.7%. Conclusion: Bacterial meningitis is the commonest cause of morbidity and mortality.Haemophilus influenza type b being the commonest organism.CSF LAT is a good sensitive test to detect bacterial meningitis early with sensitivity of 77.8%.

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Background & Objectives: Informations regarding predictors for development of chemical pneumonitis among children who ingested hydrocarbon are scarce in Indian context. Hence this study was undertaken to find out the factors responsible for development of chemical pneumonitis among children admitted with ingestion of liquid hydrocarbon in pediatric emergency ward of Burdwan Medical College, Bengal. Mehodology: A hospital-based study was conducted among 173 children selected by complete enumeration method with a mean age of 4.81±2.48 years. Chi-square test and binary logistic regression method was used to find significance of association between different variables and chemical pneumonitis. Result: 38.15 of the study population developed chemical pneumonitis. Majority of them were from to rural area (68.2%),ingested more than 30 ml of hydrocarbon (80.3%), hospitalized more than 2 hours after ingestion (69.7%), not treated with hydrocortisone (75.8% & 71.2%, respectively) and developed fever within 1st 2days after ingestion(84.8%).Our model predicted 96% of dependent variable correctly. Conclusion: Proper treatment protocol should be developed for treatment of hydrocarbon ingestion. Appropriate preventive measures should be taken to prevent ingestion of hydrocarbon.

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