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To study the utility, safety, and effects of flexible fiberoptic bronchoscopy (FFB) on oxygenation status, ventilation parameters, and hemodynamics in mechanically ventilated children.Retrospective study.Children aged1 month to 18 years suffering from critical medical and surgical diseases.First bronchoscopy data of 131 patients were analyzed. Indication, FFB findings, the microbiological yield from bronchoalveolar lavage, and medical and surgical interventions based on FFB results were recorded. Hemodynamic and ventilation parameters before, during, and 3 h after FFB were also captured. The majority of bronchoscopies were done for diagnostic purposes with a positivity rate of 90.8%. Retained mucopurulent secretion in the airways was the commonest finding in 60 patients. A cause for weaning or extubation failure could be identified in 83.3%. Post-FFB radiological resolution of atelectasis was seen in 34/59 (57.6%; p-value: 0.001) chest radiographs. Forty-seven medical and 25 surgical interventions were done depending on FFB and BAL findings. There was a significant drop in oxygenation parameters and a rise in heart rate during FFB (p-value: 0.0001). The peak inspiratory pressure, positive end-expiratory pressure, and mean airway pressure increased significantly during bronchoscopy (p value: .0001) while patients were on pressure-regulated volume-controlled ventilation. All these changes reversed to pre-FFB levels. There were minor procedure-related complications.FFB was an important diagnostic and therapeutic tool for mechanically ventilated children and the results helped plan interventions. It was a safe procedure with transient reversible cardiopulmonary alterations.

Present study was a Hospital based observational study of 100 newborns admitted in level II NICU. The study was done to assess the development of severe distress against onset, duration, oxygen requirement & outcome in terms of final diagnosis, mortality & treatment intervention. Among the 100 cases, 90% cases were of respiratory in origin. Commonest cause of respiratory distress was transient tachypnoea of newborn followed by Meconium aspiration syndrome & Respiratory distress syndrome of newborn. The onset of respiratory distress in newborn developing after 6 hours of birth & respiratory distress > 24 hours duration had severe respiratory distress. Newborn with risk factors like high maternal age, primigravida, >4 PV examinations, Meconium stained liquor and lower socioeconomic strata developed severe respiratory distress. Statistically significant correlation of severity of respiratory distress was not found with the mode of the delivery, Apgar score

Background: Immunisations is one of commonest cause of iatrogenic pain among healthy infants though several authorities have recommended that no aspiration is required before injecting into the anterolateral thigh, it is still a commonly followed procedure. Method: 202 healthy infants of either sex of age group 6 weeks to 6 months receiving routine intramuscular pentavalent vaccine were selected randomly by computer generated numbers and divided into two groups “standard” group and “pragmatic” group with 101 infants in each group. Two methods of vaccination conventional and pragmatic are used. In both cases pre vaccination and post vaccination pain was accessed by using FLACC scale and modified behavioural pain scale as well as cry time was noted. Results: The pre vaccination mean FLACC score in standard group is 2.07 (±1.17) while that in pragmatic group is 1.79 (±1.28). Post vaccination mean FLACC score in standard group is 8.5 (±0.82) while that in pragmatic group is 7.79 (±1.25). The pre vaccination mean MBPS in both standard & pragmatic group is 2.16 (±1.07). The post vaccination mean MBPS in standard group is 8.13 while that in pragmatic group is 8.16. Conclusions: Our study revealed that there was significant difference in perception of pain among the two groups. The Pragmatic group being a better technique for vaccination.