Pediatric Education and Research

Background: Neonatal morbidity and mortality remain significant concerns in developing countries, especially among home deliveries lacking skilled birth attendance. Objective: To compare clinical profiles, morbidity, and outcomes of neonates admitted to NICU from inborn deliveries versus home deliveries. Methods: A prospective observational study conducted over one year in a tertiary care hospital NICU. A total of 80 neonates were included - 40 inborn and 40 homedelivered neonates. Data regarding demographic profile, clinical conditions, interventions, and outcomes were analyzed. Results: Home-delivered neonates had significantly higher rates of sepsis (45% vs 20%), birth asphyxia (35% vs 15%), and mortality (25% vs 10%) compared to inborn neonates. Early initiation of treatment and institutional delivery were associated with improved survival. Conclusion: Home deliveries are associated with increased neonatal morbidity and mortality. Strengthening institutional deliveries and neonatal referral systems is crucial.

The Moro reflex is one of the most recognizable primitive reflexes in early neonatal life and provides important information about the functional status of the central and peripheral nervous systems. It is routinely assessed in newborns and reflects brainstem activity, motor pathway integrity, and developmental maturity. This review summarizes the physiological basis, method of elicitation, normal and abnormal patterns, and differences between preterm and term infants. Literature from standard neonatal references and indexed medical databases was reviewed. The reflex consists of a two‑phase sequence initial abduction and extension of the upper limbs followed by adduction and flexion mediated mainly through brainstem circuits. Abnormalities such as absence, asymmetry, or sluggishness may indicate neurological dysfunction, peripheral nerve injury, or systemic illness. The reflex appears during late gestation, is well developed at term, and typically disappears by 4–6 months of age. Accurate assessment of the Moro reflex aids in early identification of neurological abnormalities and guides further evaluation.

Multidisciplinary team has effectively adapted advanced reconstructive techniques merged with regenerative medicine modalities to improve outcomes. These treatments combine traditional reconstruction measures with regenerative medicine applications and has been termed ‘hybrid reconstructions’. The hybrid reconstruction model aids in maximizing the function while minimizing the disability and morbidity associated with traditional reconstruction.

Pericardial effusion is an uncommon but clinically important complication of upper / lower respiratory tract infections (URTIs) in children. Although most URTIs are benign and self-limiting, certain viral pathogens can extend beyond the respiratory tract and cause pericardial inflammation, leading to fluid accumulation. Early recognition is essential to prevent life-threatening complications such as cardiac tamponade. This review summarizes current knowledge on epidemiology, etiological agents, pathophysiology, clinical manifestations, diagnostic evaluation, and management strategies for pericardial effusion following URTIs in pediatric populations.

Congenital granular cell epulis (CGCE) is a rare benign tumor of the newborn arising from the alveolar ridge and occasionally causing feeding or airway difficulties. We report a case of a 19-day-old neonate who presented with a rapidly enlarging swelling arising from the upper jaw. Complete surgical excision was performed. Histopathological examination revealed characteristic granular cells, and immunohistochemistry showed positivity for CD68 and S-100 protein, confirming the diagnosis of CGCE. Although the management of CGCE is simple and the lesion is benign, it can cause severe feeding difficulties and anesthetic concerns during airway management. The case highlights diagnostic features, surgical management, and anesthetic challenges associated with neonatal oral tumors.