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Background: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions.Methods: A retrospective hospital record-based study was conducted at Government Medical College Jammu, Jammu and Kashmir, India from the Department of Pediaterics and comprised data of all the patients presenting to the emergency department between 1st January 2018 to 31st December 2018. Demographic characteristics, length of stay (LOS), revisit frequency and consultation status of the patients were determined.Results: Of the 1,17,035 patients, 25,223 (43.89%) were discharged straight away while 24,113 (41.95%) were admitted to different wards and subspecialties. Besides, 6464 (11.25%) patients left the department against medical advice, 861 (1.5%) expired, 741 (1.29%) were referred to other hospitals and 67 (0.12%) were dead on arrival. Of those who were admitted, 1,4498 (60.13%) patients stayed for more than 10 hours before getting the main hospital bed. Mostly, the delays observed were due to delay in getting lab reports, already preoccupied ventilators and incubators in pediatric and neonatal intensive care units, not using checklist for proper reassessment of patients and early discharge, overburdened by patients coming in just for nebulization and intravenous or intramuscular medications, the admitting residents detain the unstable patient longer in emergency department before admission to wards.Conclusions: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.

Background: Poisoning is a common preventable cause of morbidity and mortality in children. Most of the poisoning in children less than 5 years of age is accidental. Not much of Indian data is available particularly from this part of the country. So, authors conducted a retrospective hospital record-based study to know clinical profile and outcome of children presenting with poisoning in our set up. The objective was to study clinical profile, outcome of childhood poisoning and intoxication in Jammu District (Jammu and Kashmir) IndiaMethods: This was a retrospective hospital record-based study done in patients who were admitted in pediatric wards and pediatric intensive care unit (PICU) of SMGS Hospital Jammu with history of ingestion of poison or intoxication or envenomation from January 2017 to December 2017. The data collected was analyzed with SPSS 12.0 software. Demographic and etiological factors were retrospectively recorded and analyzed.Results: There were 227 children enrolled in study with an incidence of 0.99%. Male: female ratio was 1.2:1. Most of the children were asymptomatic and majority of them arrived to the hospital in less than 2 h. The majority of our patients 115 (50.66%) were in the 13-18 years age group. Organophosphorus poisoning was the commonest poisoning seen in 51 (57.30%) patients followed by snake bite 29 (55.77%), insect bite 17 (32.69%), Phenol 14 (77.78%), kerosene 11 (12.36%) and rat poison 10 (11.23%). Alcohol problem occurred in 9 (24.32%) cases. The most frequent cause of suicide attempt were school problems, followed by conflict in the family. Route of poisoning was ingestion in 173 (76.21%) cases followed by bites 53 (23.35%) and inhalation in 1 (0.44%) case. Vomiting 105 (46.25%) was the predominant clinical feature. Aspiration pneumonia 17 (43.59%) followed by respiratory failure 7 (17.95%) were the most common complications. During treatment 67 (27.91%) received gastric lavage and 28 (12.33%) received antidotes. Overall survival was 210 (92.51%), among remaining cases 2 (0.88%) cases died in hospital and 15 (6.61%) cases left against medical adviceConclusions: Parental health education will decrease the occurrence of childhood poisoning. Along with the parents and teachers, media also should take active steps to educate the rural population about the preventive measures from bite, stings and handling of poisonous agents.

Background: Breast milk is a complete food for growing children until 6 months of age, and mothers play a important role in their growth and development. So, promoting their attitude towards the benefits of breastfeeding ensures guarantee child health in the future. The objective of this study was to assess the knowledge and practice of Breast feeding with their determinants among mothers in Jammu.Methods: In this cross‑sectional study, 200 mothers attending the well‑baby clinics in Jammu from June 2017 to Febuary 2018 were selected, data was collected by face-to-face interviews using a structured questionnaire.Results: Of the 200 women, 70% were 21–30 years of age and 61% of mothers have studied only up to primary school. Majority of deliveries (80%) took place in government run hospitals. 75% of the infants were born out of normal delivery. 47.5% of mothers did not feed colostrum to their babies. Breastfeeding was initiated in only 13% of babies within one hour after birth. 52.5% babies were fed with pre-lacteals. In 7% of babies bathing was done immediately after birth.Conclusions: Maternal knowledge and attitude towards exclusive Breast feeding was moderate. It is essential to plan for mothers by officials in order to promote breast-feeding in the first 6 months of baby's life to enhance positive maternal attitude in this regard.

Background: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. Not much of Indian data is available particularly from this part of the country. So, authors conduct a retrospective study to know the spectrum of congenital heart disease in our set up.Methods: A retrospective hospital based study was carried out in the neonatal intensive care unit of SMGS Hospital, Jammu from January 2017 until December 2017 to see the spectrum of CHD.Results: There were 5552 neonates admitted during the study period out of which 68 were found to have CHD. The prevalence was 12.24 per 1000 admitted neonates. Out of 68 admitted neonates, 41were males (60.3 %) and 27 females (39.7%). Clinically Respiratory distress (51.47%) was the commonest presenting symptom followed by Cyanosis (16.18%), refusal of feed (13.23%) and murmer (10.3%).46 (67.65%) newborn had acyanotic and 22 (32.35%) cyanotic congenital heart lesions. Ventricular septal defect (27.94%) was the commonest acyanotic congenital heart defects whereas Tetrology of Fallot (14.70%) was the commonest cyanotic congenital heart diseases. Cleft lip and Cleft Palate was found in 12.5% followed by Down’s syndrome in 3.57% of cases of newborns with CHD. The mode of delivery was spontaneous in 64.71% followed by Elective LSCS were 23.53% and Emergency LSCS were 11.76%.Conclusions: There is an urgent need for government and non‑government organizations to establish well‑equipped cardiothoracic surgical centers across the country especially in Jammu to cater for children with CHDs.