Gastric dysmotility is common in critically ill children. It is defined as the functional impairment of the stomach's capacity to move content forward by abnormally slow and/or uncoordinated activity of the gastric and antroduodenal musculature. The most common manifestation of gastric dysmotility in this cohort is delayed gastric emptying (GE), which is defined as prolongation in the time required to empty the stomach's contents. Gastric dysmotility may be a consequence of critical illness and the therapies provided in this setting. In critically ill children the prevalence of delayed GE has been estimated to be 50%. However, current methods of identifying delayed GE in this population are inaccurate, therefore the true rate of delayed GE in the pediatric intensive care unit (PICU) is unknown. Enteral nutrition (EN) intolerance is a common manifestation of delayed GE and is diagnosed by a variety of nonstandard clinical assessments that are not evidence-based. EN intolerance is the most common barrier to delivering optimal EN, and it is reported to be present in 43% to 57% of critically ill children. In addition, delayed GE has other clinical implications in the PICU, including increased risk for gastroesophageal reflux, potential for aspiration of gastric contents, and reduced efficacy of enteral medications. A basic understanding of the physiology of gastric motility and its alteration during critical illness is essential for optimal bedside care in the PICU. Will present the pathophysiology, diagnosis , management and feeding protocol of gastric dysmotility with a focus on GE in critically ill children.

Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, about 260 million live with chronic hepatitis B. Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States. Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a minute amount, such as on a shared toothbrush can cause infection. Hepatitis B is sometimes referred to as the “silent epidemic” because most people who are infected do not experience any symptoms. Liver cancer is the fourth leading cause of cancer deaths throughout the world, behind lung, colorectal and stomach cancers. Almost half of liver cancers are caused by chronic infection with hepatitis B. The World Health Organization (WHO) recommends the inclusion of hepatitis B vaccine in immunization programs of all countries; in 2017, about 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.

The gap between medical and dental world is the reason why nobody has never published about this multifactorial topic. We are now able to explain how dental malocclusions and oro-facial dysfunctions are linked to imbalances during the perinatal sensorimotor coordinations, often leading in adulthood  to general posture (lumbo-sciatic) and/or respiratory disorders (OSA). If, since the first neurodevelopmental steps, the determination of the primary oro-facial balance is the witness as well as a relay of an accurate implementation of the child’s posture balance (both being under the required control of the respiratory balance between nasal ventilation and mouth breathing), this means that we are heading towards a new daily concern and an additional responsibility for paediatricians in monitoring children’s growth

Technological improvement remains a constant need in neonatal transport. ANTS is responsible for a large geographical area (6 counties, 15% of UK) with a large population density (>68,000 deliveries/yr, > 6.168 million people). 13 transfer services out of 14 in UK are unable to meet nationally agreed key performance indicator (KPI) of mobilisation (60 min) for time critical transfers. Time taken to complete the clinical referral, collating and checking all resources (drugs, vehicle etc.), availability of teams are the main contributory factors for this delay. To improve the efficiency of transport service we are developing a tool, LocANTS ; to validate this tool we introduced a small part of this as a manual version (paper / screen) which is updated daily at 08:00 to localise available resources from January,2019. The paper copy includes on-call team/shift, pending transfers, vehicle, equipment, stock medication related updates, road and weather conditions, regional cot status, review of transfers (for shared learning) and in-utero transfers in the previous 24 hrs

There there has been an explosive growth on internet users worldwide. Excessive internet use can lead to internet addiction so this study was designed to find out prevalence of internet addiction in adolescent 12 to 18 year age  group and to determine the association between internet addiction and depressive symptomatology and effect on school performance.This was a a cross-sectional observational study performed in two schools of Bikaner City, India . About 2000 students of 12 to 18 years age group were  screened for internet addiction by using young's internet addiction scale. Symptoms of depression and anxiety were assessed by using PHQ -9 and GAD-7 scale respectively.In the study 34.2 % subject  were found to be internet addicts. Among 34.2 % net addicts 31.5 % subjects were found positive on PHQ - 9 ; depression and 18.7 % subjects were found positive on GAD - 7 scale ; anxiety. School performance was decreased in 59.6% of  internet addicts . The addiction was found to be more common among male older adolescent 16 to 18 year age group with higher economic status families , long duration of internet use and with early years of internet contact. 12.2% net addicts were found   doing pornography on internet. Majority were male adolescent of 14 to 18 year age group . To conclude internet addiction affects various facets of life ; like interpersonal relations, academic performance, social isolation, depression, anxiety , and sexual behaviour

Constipation is described as having fewer than three bowel movements a week. In traditional Chinese medicine (TCM), constipation is Blood deficiency with Heat retention.To demonstrate that constipation has energies alterations as the root and correcting it is the goal in the patient’s recovery. One case report of an eight-years-old girl complaining of not having bowel movement for more than a week for three years. She was being seen by a surgical pediatrician and a colostomy was in thoughts of being done. The mother sought for a TCM treatment, where the patient was diagnosed with Blood, yin and yang deficiencies. The patient received Chinese dietary counselling, auricular acupuncture/apex-ear bloodletting, systemic acupuncture and chakra energy measurement by radiesthesia. The patient result was 1 out of 8, except for the seventh chakra (normal). The patient had great improvement of the bowel movement (once a day), as well as an overall improvement of all symptoms, after TCM prescribed treatment.  Constipation has an energy alteration as root and treating these energy imbalances and chakra’s energy deficiencies is essential for recover of all symptoms altogether.

Optimizing the social, emotional, moral and cognitive development of children will support prosocial behavior and peaceful societies. To accomplish these goals, efforts need to start from birth with authoritative parenting to achieve secure attuned attachment between caregiver and child.  Such parenting should eliminate the toxic stress associated with the authoritarian approach and the lack of direction seen with permissive or uninvolved parenting. Early literacy is the key to building character using the vehicles of modeled behaviors, reading stories with a moral and that teach a lesson and Human Relations Programs for Children.  Benevolent mindfulness characterized by emotional empathy, compassion and helping behaviors will result from proper parenting and successful character education.  The resultant ability to think in a complex fashion where virtues are pursued and vices avoided should facilitate resistance to false narratives and non-violent conflict resolution. Avoiding Adverse Child Experiences has been shown to minimize depression, violence perpetration and other problem behaviors and disorders.  When there are educational and professional resources in play to support the development of children in communities, a responsible, caring citizenry can be anticipated.

The quality of care services provided to extremely premature neonatal patients has key bearing on parental satisfaction and therefore the improvement of knowledge of best practices for care beyond hospitalization. There exists a gap in current research on neonatology when it comes to parental satisfaction of the services provided. It is therefore necessary to undertake regular Neonatal Satisfaction Survey at the national level, compare results and finally provide recommendations for improvement. Having a large sample size of about 50 women in every state and therefore 2,500 total participant ensured diversity and wide range in highly valid data. Both logistic regression and nonparametric analysis were used to analyze the resulting data and produced the following findings. According to the data, the biggest source of parental satisfaction was the involving parents in decision making procedures for the infant. Medical professionals are to understand the emotional element of the issue and consider the parents as a team member. Another source is being shown empathy and respect from medical practitioners as well as showing interest to continue with care and treatment until the point of discharge. Another source of support was being received from close friends and family. The level of support from these sources developed from the level of awareness regarding issues related to neonatal hospitalization. Extensive public awareness campaign is necessary to ensure people come to understand various issues surrounding extremely premature neonatal hospitalization and the need to support parents. Parents too also need more education and training on best practices for child care.