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Objectives: To compare change in oxygen saturation (SPO2) and other parameters during endotracheal intubation (ETI) in newborns on nasal intermittent positive pressure ventilation (NIPPV) versus free flow oxygen (FFO).Method: In this randomized controlled trial, FFO at 10 L/min was delivered during ETI in FFO group and in NIPPV group, newborns received NIPPV during ETI. Procedure was video recorded.Results: A total of 50 newborns was enrolled, 25 in each group. Reduction in mean SPO2 from baseline to during ETI (0.56 vs 4.4) in NIPPV vs FFO, p=0.009] and from baseline to after intubation (-0.32 vs 3.8) in NIPPV vs FFO, p=0.01] were significantly higher in FFO group compared to NIPPV group. Reduction in mean heart rate from baseline to during intubation (16.48 vs 17.16) for NIPPV vs FFO group (p=0.92)] and from baseline to post intubation (9.08 vs 13.56) for NIPPV vs FFO group (p=0.41) were non-significant. Successful first-attempt intubation (68% vs 60% in NIPPV vs FFO group, (p=0.556)], total intubations within 30 seconds (88.2% vs 80%) in NIPPV FFO group, (p=0.645)] and mean time for intubation (27.80 vs 32.28 seconds for NIPPV vs FFO group, p=0.306) were non-significant.Conclusions: NIPPV prevented reduction in SPO2 in newborns during and after intubation compared to FFO.

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Introduction: Breastfeeding confidence affects how long exclusive breastfeeding lasts. Furthermore, support from close ones is important. Objectives: To establish a model and explore the relationship among support from husbands, family, healthcare providers, breastfeeding self-efficacy, and the duration of exclusive breastfeeding. Method: The study employed a cross-sectional design involving 117 mothers with children aged 6-24 months in the Pengasinan Health Centre area, Depok City, Indonesia. Participants were chosen randomly. The endogenous variables of the study were the duration of exclusive breastfeeding and breastfeeding self-efficacy, while the exogenous variables included support from husbands, family, and healthcare providers. Data analysis utilized partial least square-structural equation modeling to establish a suitable model and examine the relationships between the constructs. Results: The model was found to be a good fit for Indonesian mothers [standardized root mean square residual (SRMR) = 0.072] and demonstrated good predictive relevance (Q square = 0.299). All indicators comprising the constructs were deemed valid and reliable. There was a relationship between husband's support (p=0.004) and healthcare provider (p=0.015) with breastfeeding self-efficacy. Breastfeeding self-efficacy directly correlated with the duration of exclusive breastfeeding (p=0.000). Indirectly, there was a relationship between husband's support (p=0.027) and healthcare provider (p=0.028) with the duration of exclusive breastfeeding through breastfeeding self-efficacy. Conclusions: The duration of exclusive breastfeeding was indirectly influenced by husband's support and healthcare provider support through breastfeeding self-efficacy.

Background: Acute febrile encephalopathy (AFE) is characterized by fever, altered mental state, and/or seizures due to infections agents, metabolites and toxins. Objectives: To determine the clinical profile and risk factors of mortality in children with AFE. Method: A two-year retrospective observational study was done on paediatric intensive care unit admitted children, aged 1 month to 12 years, with a history of recent onset fever and altered sensorium with or without seizures. Children with space occupying lesion, cerebrovascular accident, traumatic brain injury, and seizure disorder were excluded. Demographic, clinical and relevant laboratory data were extracted from medical records. Student’s t-test, Chi-square test and univariate / multi-variate regression model were used for statistical analysis. Results: Males outnumbered females and 63.8% were less than 5 years old. Two-third were from lower-socio-economic class of rural residences. Almost two-third presented during winter and summer. All cases presented with fever and altered sensorium and 81.9% had seizures. Glasgow coma scale (GCS) score <8 was noted in 46.8% cases, with mean score 7.65±2.87. Signs included raised intracranial pressure (82.7%), meningeal irritation (59.6%), abnormal pupillary size (42.6%) and abnormal tone (87.2%). Pyogenic meningitis and viral encephalitis were the common causes. Mortality was 40.4%; 60.7% survivors had neurological sequelae. GCS score <8, hypotension, respiratory distress/cyanosis, need for mechanical ventilation, low serum albumin, low sugar and high protein in cerebrospinal fluid (CSF) were the risk factors for mortality. Conclusions: Hypotension, respiratory distress, need for mechanical ventilation and presence of high protein in CSF were the independent predictors of mortality.

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Background: The expanded programme of immunisation (EPI) has been a major success in Sri Lanka. However, despite its success, vaccine hesitancy remains a concern. Timely vaccination is crucial, as delays and missed doses reduce herd immunity and increase susceptibility to vaccine-preventable diseases. Objectives: To evaluate vaccine compliance, parental attitudes toward childhood immunization, and the factors influencing vaccination compliance among parents in the Doluwa Medical Officer of Health (MOH) area. Method: A community-based cross-sectional descriptive study was conducted with 176 participants attending vaccination and well-baby clinics in conveniently selected Public Health Midwife (PHM) areas within the Doluwa MOH area in Kandy district. Data were collected using a structured interviewer-administered questionnaire and Child Health Development Records. Results: Study involved 176 parents, with mean participant age of 31 years. All participants had appropriately vaccinated their children for their age, except for 47 (26.7%) who reported vaccination delays, primarily due to child illness (23.4%). There were no non-vaccinated participants. A significant association was found between child’s age and vaccination delay (OR= 1.045, 95% CI=1.02–1.07). All participants obtained vaccines from government sector. A majority (96.6%) had positive attitudes towards EPI, citing the high responsibility of the government sector (76.7%). Conclusions: Despite excellent vaccination coverage, vaccination delays persist, indicating areas for improvement in the implementation of EPI.