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Aims and Objectives: Evaluation of neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding. Introduction: Neonatal hypernatremia is a serious condition in the newborn period. We present infants with hypernatremic dehydration due to breast milk (BM) hypernatremia. Hypernatremic dehydration in breast-fed newborns is usually secondary to insufficient lactation. We present the neonatal hypernatremia and hypernatremic dehydration encountered between January and December, 2012, its causes and treatment. Methodology: This was a retrospective study. We analyzed records of babies admitted to the Neonatal Intensive Care Unit who were investigated and found to have hypernatremia and whose mother′s BM sodium (BM Na) was done. Inclusion Criteria: (1) Babies with serum Na >145 meq/l, (2) euglycemia, (3) normocalcemic, (4) no clinical and lab evidence of sepsis, (5) exclusive breast feeds. Exclusion Criteria: Neonates not satisfying any mentioned criterion. Results: BM Na correlated strongly with neonatal hypernatremia in exclusively breast-fed babies who did not otherwise have any risk factor. Conclusion: Elevated BM Na is an important etiological factor in neonatal hypernatremia.

ABSTRACT INTRODUCTION Sickle Cell Anemia is a rare inherited haematological disorder in which RBCs become sickle-shaped in the abnormal haemoglobin S variant's presence.1 This makes severe sickle-shaped blood difficulty passing through small blood vessels, obstructing the normal blood flow, damaging tissues, and finally leading to Sickle Cell Disorder complications.2 The red blood cells contain haemoglobin S live only about 16 days compared to 120 days for normal RBCs.3 Sickle Cell conditions exist in many types, with the most common being Sickle Cell Trait (HbAS), Sickle Cell Disease (HbSS), Sickle-Hb C Disease (HbSC), and Sickle-Hb C Trait (HbAC). Keywords: Sickle Cell Anemia, Lateral Flow Chromatographic immunoassay test, scan test kit, new-born babies Introduction Sickle Cell Disease is a haematological disorder that causes red blood cells to become sickle-shaped because of the abnormal haemoglobin S variant.1 These rigid sickle-shaped blood cells have difficulty passing in small blood vessels, resulting in obstruction of the normal blood flow and damage to the body's tissues and eventually leading to various Sickle Cell Disorder complications.2 The red blood cells contain mainly Hb-S live only about 16 days compared to 120 days for normal RBCs.3 There are types of Sickle Cell conditions which with the most common, is Sickle Cell Trait (HbAS), Sickle Cell Disease (HbSS), Sickle-Hb C Disease (HbSC), and Sickle-Hb C Trait (HVAC). The diagnosis (preferably as a newborn) of Sickle Cell anaemia becomes necessary at an early stage to initiate early treatment such as penicillin prophylaxis, vaccination against pneumococcus bacteria, folic acid supplementation, pain management, blood transfusions, and hydroxyurea if needed .3,4 Sickle cell trait is milder condition and, harmful complications are possible when there are extreme environmental conditions like high atmospheric pressure, at higher altitudes, decreased oxygen levels, athletic activities, or severe dehydration).5 Caution should be taken in sickle cell disease carriers and situations for individuals' genetic counselling and family planning. MATERIAL AND METHODS Aim: To screen all Newborn babies born in the hospital at N. K. P. Salve institute of medical sciences & research centre and LataMangeshkar Hospital, Nagpur for Sickle cell anemia by Lateral flow chromatographic qualitative immunoassay test.

Background The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. Methods We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT). Because of staff turnover, some birth attendants (BA) were trained as they joined the delivery room staff, after the initial training was completed (catch-up initial training). We compared pass rates for skills and knowledge pre- and post- initial HBB training and following refresher training among active BAs. An Objective Structured Clinical Examination (OSCE) B tested resuscitation skill retention by comparing post-initial training performance with pre-refresher training performance. We identified factors associated with loss of skills in pre-refresher training performance using multivariable logistic regression analysis. Daily bag and mask ventilation practice, equipment checks and supportive supervision were stressed as part of training. Results One hundred five MT (1.6 MT per facility) conducted initial and refresher HBB trainings for 835 BAs; 76% had no prior resuscitation training. Initial training improved knowledge and skills: the pass percentage for knowledge tests improved from 74 to 99% ( p  < 0.001). Only 5% could ventilate a newborn mannequin correctly before initial training but 97% passed the post-initial ventilation training test ( p  < 0.0001) and 99% passed the OSCE B resuscitation evaluation. During pre-refresher training evaluation, a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for the OSCE B resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training). Conclusions HBB training significantly improved neonatal resuscitation knowledge and skills. However, skills declined more than knowledge over time. Ongoing skills practice and monitoring, more frequent retesting, and refresher trainings are needed to maintain neonatal resuscitation skills. Trial registration ClinicalTrials.gov Identifier: NCT01681017 ; 04 September 2012, retrospectively registered.

The Present study to examine the effect of video, mobile games on children's behavior. 160, school going children's, age range from 7 to 10 were recruited based on random sampling. They were administered the Child and Adolescent Inpatient Behavioural Rating Scale, in the sample group. The data were analyzed with the help of compared \"t\" test, an analysis of variance showed a Mean of boy's Child and Adolescent Inpatient Behavioural Rating Scale 102.97 and girls Child and Adolescent Inpatient Behavioural Rating Scale Mean 72.5, and t-value is 13.11, significant at 0.05 levels. In present study show that most of the bad effects of video games are blamed on the violence and other behaviour issues. Children who play more video, and mobile games are more likely to have increased Anxiety, communication problem, psychomotor activity, conduct disorder/disruptive behaviour, social skills, attention and hyperactive behaviour, aggressive thoughts, feelings, and behaviors, and decreased prosocial helping.

Meenakshi Girish and Nilofer Mujawar explain how to manage bites in primary care

Abstract Benign enlargement of the subarachnoid space (BESS) is a common incidental finding on neuroimaging in infants. We report a case of BESS, who developed subdural hematoma and raised intracranial pressure following minor trauma. This case report highlights the fact that BESS may not be so benign after all and protective measures should be taken in all infants found to have BESS.