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Objective: To determine the Diagnostic accuracy of Kramer's visual assessment of jaundice in term neonates by taking total serum bilirubin levels as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, Mar to Sep 2019. Methodology: The study was based on examining and investigating 300 neonates. Kramer scale was used to examine jaundice in all neonates, and results were compared to total serum bilirubin levels. Results: A total of 300 patients were included in this study. The mean bilirubin level was 229.1±74.5mol/L. The sensitivity and specificity of visual assessment of jaundice using the Kramer visual scale were 83.84% and 73.53%, respectively, for neonates who were not jaundiced below the abdomen and thighs included in Kramer zones 1 to 3. Conclusion: Kramer visual assessment can be used as a noninvasive screening method in neonates jaundiced up to the abdomen and thighs, which is included in Kramer zones 1 to 3 but for markedly jaundiced neonates Kramer scale is not a reliable noninvasive method of bilirubin estimation. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To look for the associative factors in avoidance of exclusive and nonexclusive breastfeeding among mothers after lower segment Caesarean section. Study Design: Cross-sectional study. Place and Duration of Study: Paediatrics department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Oct to Mar 2020. Methodology: Mothers bringing their infants for vaccination at six weeks of age with babies born with lower segment caesarean section were included in the study. They were asked simple questions regarding exclusive or nonexclusive breastfeeding. Relevant sociodemographic factors were also recorded and compared among mothers breastfeeding their babies and those avoiding it. Results: A total of 500 mothers were included in the study. The mean age of the study participants was 33.576±9.174 years. 336(67.2%) women were primiparous, while 164(32.8%) were multiparous. 208(41.6%) women were actively breastfeeding their child, while 292(58.4%) avoided breastfeeding their babies. 150(72.1%) women were nonexclusively breastfeeding, while 58(27.9%) showed an exclusive breastfeeding pattern. Pearson chi-square test revealed that low education and working outside the home had a statistically significant association with the avoidance of breastfeeding the babies among our target population (p-value <0.05). Conclusion: Avoidance of breastfeeding was a common finding after six weeks of birth among women who delivered the babies via lower segment caesarean section. Mothers with low education and duties to work outside the home were more at risk of avoiding this highly beneficial practice for the baby. [ABSTRACT FROM AUTHOR]