Indian pediatrics
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Historical Article
50 years of neonatology in India, progress and future.
India has made impressive gains in its child survival indices during the past half a century with infant mortality rates declining from 159.3 in 1960 to 44 in 2011 and neonatal mortality rate declining from 47 (1990) to 32 (2010). Neonatal health is now an integral part of the countrys flagship program; National Rural Health Mission. Facility based newborn care is not only available in large public and private sectors hospitals, but also in about 300 of Indias district hospitals. ⋯ The last two decades has also witnessed an increase in newborn research and its incorporation into medical and paramedical education as a major course component. Neonatology now is an independent super-specialty in India. The National Neonatology Forum has had a major role in spearheading reforms in neonatal care in India.
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To assess Indias recent trends in child mortality rates and disparities and identify ways to reduce child mortality and wealth-related health disparities, we analyzed three years of data from Indias National Family Health Survey related to child mortality. Nationally, declines in average child mortality were statistically significant, but declines in inequality were not. ⋯ Interstate differences in child mortality rates were significant, with rates in the highest-mortality states four to six times higher than in the lowest-mortality states. However, child mortality in most states declined.
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Randomized Controlled Trial
Ringers lactate vs Normal saline for children with acute diarrhea and severe dehydration- a double blind randomized controlled trial.
WHO recommends Ringers lactate (RL) and Normal Saline (NS) for rapid intravenous rehydration in childhood diarrhea and severe dehydration. We compared these two fluids for improvement in pH over baseline during rapid intravenous rehydration in children with acute diarrhea. ⋯ There was no difference in improvement in pH over baseline between RL and NS among children with acute diarrhea and severe dehydration.
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During the past decade, guidelines for cardiopulmonary resuscitation have focused on the importance of high quality CPR. The purpose is to temporarily maintain a circulation to vital organs until specialized treatment is available. ⋯ A fifth component to the pediatric chain of survival has been added with emphasis on integrated post cardiac arrest care. With mounting scientific evidences, American Heart Association published new Pediatric Advanced life support 2010 guidelines in accordance with the established five yearly cycle of guideline changes.