Knowledge of and Attitude toward Breastfeeding among Medical Staff Workingin the Neonatal Intensive Care Unit and Obstetric Unit

Purpose@#This study aimed to explore the knowledge of and attitude toward breastfeeding among medicalstaff working in the neonatal intensive care unit and obstetric unit. @*Methods@#A cross-sectional survey design was used. The questionnaire focused on participants’ knowledgeof and attitude toward breastfeeding and their characteristics. A total of 123 participants, including nursesand physicians working in the neonatal intensive care unit and obstetric unit, completed the questionnaire.Data were analyzed using descriptive statistics, chi-square test, Fisher exact test, and Spearman correlationcoefficient. @*Results@#One-third the of participants reported that they had obtained formal education related to breastfeedingwithin the last year, 44% of participants obtained information related to breastfeeding from books,while 30.9% of participants learned from coworkers. Over 93% of the participants reported a need forformal breastfeeding education. The rate of correct answers for breastfeeding knowledge was 59.2%, andthere were no significant differences between the nurse and physician groups. Breastfeeding attitude waspositive with a score of 60.0, and nurses working in the obstetric unit scored higher than other nurse orphysician groups (p=0.014). A significant correlation between knowledge of and attitude toward breastfeedingwas found in medical staff attending to preterm infant mothers (p<0.001). @*Conclusion@#Consistent information and positive support regarding breastfeeding need to be provided tomedical staff so that they can help preterm mothers initiate and continue breastfeeding. Further study isneeded to develop an interprofessional education program to increase breastfeeding knowledge and enhancepositive attitude of medical staff attending to preterm mothers.

Association between Alcohol Drinking and the Ratio of Aspartate Aminotransferase to Alanine Aminotransferase in Korean Adult Male

BACKGROUND: The aspartate transaminase (AST)/alanine transferase (ALT) ratio increases with alcohol consumption. This study investigated AST/ALT ratio according to alcohol drinking and predictive power of AST/ALT ratio for heavy drinking in Korean men. METHODS: In 2015, 830 men with no history of disease or medication affecting liver function values were selected. Using 14 g of alcohol as the standard glass, odd ratios (ORs) of AST/ALT ratio over 1 among the drinking group were compared with the non-drinking group by multiple logistic analyses. Screening of heavy drinkers was conducted according to both NIAAA and Korean guidelines. Using AST/ALT ratio >1, sensitivity, specificity, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios and odds ratios were investigated. RESULTS: After correcting for age, body mass index, exercising, and smoking history, ORs (95% confidence interval) of AST/ALT >1 were 1.607 (1.048-2.464) in 14 glasses group. When AST/ALT >1 in the drinking group, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios (LR)+, LR- and OR according to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%, 1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49 (1.05-2.01), respectively. By Korean guidelines, these values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24 (1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89), respectively. CONCLUSIONS: Healthy male adults showed a positive correlation between risk of AST/ALT >1 and drinking amount compared to the non-drinking group. Use of the AST/ALT >1 in combination with other blood markers to predict excessive drinking is advisable.

Effects of Team-Based Learning on Communication Competence for Undergraduate Nursing Students / 정신간호학회지

PURPOSE: In this study an examination was done of the effects of a team-based learning program on enhancement of communication competence for undergraduate nursing students in South Korea. METHODS: quasi-experimental method with a non-equivalent control group pre- and post-test design was used. Participants were 68 undergraduate nursing students recruited from two universities. The experimental group (n=35) received a 5-week team-based learning program on enhancement of communication competence, while the control group (n=33) received traditional lectures. Data were collected using self-report structured questionnaires before and after the intervention, and were analyzed using χ² tests, Fisher's exact tests, and t-tests. RESULTS: Compared to the control group, the experimental group reported significant positive changes in communication efficacy (t=2.58, p=.012), communication ability (t=12.01, p<.001), and learning satisfaction (t=2.11, p=.039). CONCLUSION: The findings indicate that this program is an effective intervention strategy to enhance communication competence for nursing students.

Effect of Abdominal Massage before In Vitro Fertilization Injection on Alleviating Pain among Infertile Women

PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.

Effects of Empathy, Communication Ability and Attitudes toward Mental Illness on Psychiatric Nurses' Image for Nursing Students / 정신간호학회지

PURPOSE: This study was conducted to identify the effects of empathy, communication ability and attitude toward mental illness on psychiatric nurses' image for nursing students. METHODS: Participants were 349 nursing students from two universities in G metropolitan city. A survey was conducted from June 10 to 30, 2016, using a self-report questionnaire. Data were analyzed using t-test, one way ANOVA, Pearson correlation coefficients and multiple regression with SPSS/WIN 20.0. RESULTS: The level of psychiatric nurses' image for nursing students was 4.03±0.46. Models including the variables, empathy, communication ability and attitude toward mental illness explained 30.0% of the variance in the image of psychiatric nurses. Attitude toward mental illness was the most influential factor (β=.28, p<.001). CONCLUSION: Based on the outcomes of this study, steps should be taken to design intervention programs that emphasize a positive image of psychiatric nurses for nursing students.

The Validity and Reliability of a Psychiatric Nurses' Image Scale (PSYNIS) / 정신간호학회지

PURPOSE: This study was done to verify the validity and reliability of a Psychiatric Nurses' Image Scale (PSYNIS) for Korean psychiatric and mental health nurses. METHODS: A methodological study design was used with an exploratory factor analysis, Pearson's correlation, and a fitness of the modified mode for validity. Cronbach's alpha coefficients and an alternative-form method for reliability were used. Psychiatric Nurses' Image Scale (PSYNIS) was tested with 345 psychiatric and mental health nurses, residing in G city, J city, and J province. Data were collected from Jun. 1 to Aug. 2, 2012. Responses were obtained from respondents through self reports method and each item had a possible score of 5. Collected data were analyzed using the SPSS 20.0 and LISREL 8.54 programs. RESULTS: The 28 items making up the instrument were classified into the following 4 factors: 'Professionalism', 'Activism', 'Coordination competence', and 'Personalism'. These factors explained 63.2% of the total variance. Fitness of the modified mode was good (chi2= 1052.30, RMSEA=.05, GFI=.90, AGFI=.86, NFI=.97, and CFI=.98). The reliability of the PSYNIS was .95 (Cronbach's alpha). CONCLUSION: Results of the present study suggest that the PSYNIS is useful for efficiently evaluation of the image of psychiatric nurses.

Relationship of Psychiatric Nurse Image, Job Satisfaction and Assertiveness of Psychiatric Mental Health Nurses / 정신간호학회지

PURPOSE: This study was done to investigate the relation between psychiatric nurse image, job satisfaction and assertiveness of psychiatric mental health nurses. METHODS: The participants for this study were 159 psychiatric nurses in G-city and J-province. The instruments were the Psychiatric Nurses Image Scale, Job Satisfaction Scale, and Assertiveness Scale. Collected data were analyzed using mean, t-test, ANOVA, and Pearson' correlation coefficients with the SPSS/WIN 20.0 program. RESULTS: Mean scores for psychiatric nurse image, job satisfaction, and assertiveness, were 3.9+/-0.5 and 3.3+/-0.4 and 93.5+/-12.0 respectively. Significant positive correlations were found between psychiatric nurse image and job satisfaction (r=.51, p<.001), and assertiveness (r=.25, p=.002). CONCLUSION: The result indicate that nurses with higher levels of psychiatric nurses image disposition exhibit positive job satisfaction, and assertiveness. Therefore it would be helpful to provide intervention programs to improve the psychiatric nurse image, job satisfaction, and assertiveness of psychiatric nurses.

An Analysis of Blood Usage and Blood Wastage in Korea Hospitals in 2008 / 대한수혈학회지

BACKGROUND: Investigating the blood usage and blood wastage in Korea hospitals national wide, and including all types of medical institutes, has not been sufficient with the only study having been carried out by the KCDC thorough an Academic Research Contract in 2007. Yet that study was limited due to lack of participation from hospitals. Our study tried to establish a fundamental database for blood transfusion management by investigating the current status of blood products usage, under the KCDC's supervision, to improve participation from medical institutes. METHODS: From January to December in 2008, the Blood Bank, Red Cross of the Republic of Korea looked into the blood product supply of all the medical institutes and we conducted a national survey using questionnaires distributed via the local public health centers on the blood use, blood waste, the reasons for waste and the inventory of the remaining blood. The supply, as compared to the actual use of blood products in the same period, was analyzed by the Korean Red Cross. RESULTS: The total amount of blood products distributed by the Korean Red Cross to medical institutes in 2008 increased by 13.8% for platelets, 11.5% for RBC products, 8.4% for apheresis products and 2% for FFPs, as compared with that of 2006. A total of 2,500 institutions participated in the questionnaire and 60.7% (1,517 out of 2,500 institutes) of the institutes sent feed-back. The total amount of blood use was 3,483,636 units and 52% of the consumption was focused in metropolitan areas like Seoul, Geong-Ki and Busan. The total wastage rate for blood was 1.2% and it was 4.8% for institutes with admitting capacities of 100 beds or less, with expiration of the storage date being the main reason for wastage, while the wastage rate was 1.1% for general hospitals with admitting capacities of 500 beds or more, with an improving patient status or death being the main reason. CONCLUSION: The results of this study were similar to those of 2007, but the participation rate from medical institutes was much increased. Establishment of an investigational system for the use of blood products in medical institutes on a national level is needed to secure data for dealing with the increased projected demand of blood/blood products in the future.

Factors Associated with Success of Smoking Cessation during 6 Months / 간호학회지

PURPOSE: This study was to identify which factors are likely to influence the effectiveness of smoking cessation on adults who smoke in Metropolitan Incheon. METHOD: Data from 9,083 smokers, who visited a smoking cessation clinic of a public health center from Jan. to Oct. 2005, were provided by the Korean Health Research Society. Among 9,083 smokers, 1,495 people were selected for follow up care at 6 months in order to analyze the differences between two groups one is a successful group and the other is a failure group. RESULTS: The successful group included 639 people and the failure group 856 people. In the demographic profiles such as sex, age and motive registration, there was a significant difference between the two groups. In the view of smoking pattern and factors such as the expiratory CO level, the age of starting to smoke, the duration of smoking, alcohol, and dependence on alcohol use and nicotine, there were significant differences between the two groups. The smoking cessation method, results of uni variate analysis, the total number of visits to the smoking cessation clinics, and the use of nicotine gum or a patch(stage 1, stage 2) were significantly different in the two groups. CONCLUSION: The results of multi variate analysis have shown that the factors associated with the success for smoking cessation is the total number of visits to the smoking cessation clinic, and the dependence on alcohol.

Transfusion-Transmitted Malaria in Korea - 10 cases during 1997~2001 - / 대한수혈학회지

Since the reemergence of tertian malaria in Korea in 1993, we have confirmed 10 cases of Plasmodium vivax malaria associated with blood transfusion from 1997 to 2001. Age of patients ranged from 4 months to 68 years; three cases were younger than 1 year old. Because 2 of 10 patients received different components of the same donor, 9 presumably infected donors were identified for the 10 cases. Four of them were identified by polymerase chain reaction, 2 by indirect fluorescent antibody test, and 1 donor was identified by peripheral blood film examination. Geographically the cases were distributed over the whole Nation; 3 cases in Seoul, 2 in Kyunggi and Ulsan, and 1 case each in Pusan, KyungNam and Taegu. The infective components were 1 unit of whole blood, 5 units of packed red cells and 4 units of packed platelets. The incubation periods ranged from 9 days to 78 days(mean : 30.5 days, median : 21.5 days). The incidence rate of transfusion-transmitted malaria From 1997 to 2001 calculated as number of cases/number of units of whole blood and packed red cells transfused during each year ranged from 0 to 2.85 cases per million units transfused. Enforced predonation counseling might have prevented some of the above cases. Although test for malaria antibody has been implemented for donor screening this method does not reflect the present infective status of donor. Therefore careful screening of donors according to the exclusion guidelines of the Korean Red Cross remains as the best way to prevent transfusion-transmitted malaria.

A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA) / 기본간호학회지

The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47), 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), patient's relationship to caregivers (P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering (P=0.03). 5. There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient (r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

Analysis of Blood Donation History of Korean Malaria Patients / 대한임상병리학회지

BACKGROUND: After the resurgence of endemic malaria case in 1993, the number of malaria cases is increasing in succeeding years and most of patients were soldiers who served in the northern parts of Kyeonggi-do and Kangwon-do. Because group donations of blood from soldiers are frequent in these area, it is possible that donated blood from these area cause malaria. So we examined blood donation history of malaria patients to know their donation behavior. METHODS: The subject was 1,671 malaria patients who were diagnosed in 1997 and referred to blood transfusion research institute and their past donation history, time and frequency of donation were examined. The database consisted of malaria patients and blood donors who are known to be related with transfusion-transmitted malaria has been retrieved at each red cross blood center for every blood donors. The results were analyzed from January to December, 1998. RESULTS: About 60% (1,017) of 1,691 malaria patients in 1997 had donated their blood before diagnosis. The number of one time donation was 268; two time 289; more than three time was 460. Two hundred thirty six donors were checked by malaria registry file. In 236 donors, 92 cases were diagnosed with malaria, 96 cases were suspected to have malaria, 48 cases were namesakes. Conclusion: Because some malaria patients donate their blood after their diagnosis, it would be necessary to operate 'the computerized retrieving programme'to detect their donation after the diagnosis. Also, an education for malaria patients for their risk of transmitting malaria and strict history taking from donors for malaria will be required.

Effect of Regular Physical Exercise on Physical Fitness Level in Nursing Students / 기본간호학회지

This study was to test the relationship between regular physical exercise and physical fitness in nursing students. These subjects were 54 volunteers who agreed with intention of this study and were composed of 24 active group and 30 non-active group. The selected physical fitness tests were grip strength and back strength for measuring muscular strength, sargent jump and standing broad jump for measuring power, push-up, sit-up, and heart rate for measuring total for measuring agility, stick test and stork stand for measuring balance, and trunk flexion and trunk extension for measuring flexibility. The conclusion acquired was as follows : 1) Grip strength had significant difference between active group of 29.5+/-5.9kg and non-active group 25.4+/-7.2kg(t=2.283, p=.027), and back strength between active group of 54.1+/-13.7kg and non-active group of 44.7+/-15.7kg(t=2.310, p=.025). 2) Sargent jump was lower with non-active group(44.9+/-8.6cm) than with active group(45.3+/-8.8cm), however, was not significant(t=.182, p=.856). Standing broad jump was significantly lower with non-active group of 161.3+/-28.7cm than with active group of 191.4+/-27.0cm(t=3.939, p=.000). 3) Push-up showed significant difference between active group of 25.3+/-12.3times and non-active group of 11.5+/-5.1 times(t=5.572, p=.000), and sit-up between active group of 21.8+/-7.4times and non-active group of 17.1+/-5.8times(t=2.631, p=.011), and heart rate between active group of 110.5+/-12.8beats/min and non-active group of 121.5+/-9.5beats/min(t=-3.648, p=.001). 4) Reaction time was significantly higher with non-active group of .300+/-.051sec than with active group of .341+/-.041sec(t=-3.285, p=.002). Side step test was lower with non-active group(8.8+/-1.1times) than with active group(9.2+/-1.2times), however, was not significant(t=1.309, p=.196). 5) Stick test showed not significant difference between active group of 25.8+/-14.8sec and non-active of 30.7+/-17.9sec(t=-1.058, p=.295), and stork stand between active group of 4.5+/-3.2sec and non-active group of 3.7+/-3.5sec(t=.918, p=.363). 6) Trunk flexion came out not significant difference between active group of 14.2+/-5.0cm and non-active group of 15.8+/-7.3cm(t=-.927, p=.358), and trunk extension between active group of 67.1+/-6.5cm and non-active group of 67.3+/-6.6cm(t=-.140, p=.889). 7) Power was shown to be significantly related to total endurance(r=.717, p=.000; r-.739, p=.000). 8) Total endurance was shown to be significantly related to agility(r=-.752, p=.000; r=.684, p=.000; r=-.664, p=.000; r=.598, p=.002; r=.864, p=.000; r=-.536, p=.007). These results suggest that regular physical exercise is effective in promoting and maintaining physical fitness. As the further study, it is necessary to reinvestigate the effect with more refined design.

Effectiveness of Supplemental Enzyme Immunoassay Using Abbott IMx HCV Kit for the Anti-HCV Positive Donors / 대한수혈학회지

BACKGROUND: Only 39% was the positive predictive value of anti-hepatitis C virus (HCV) antibody test done by Korean Red Cross. Supplemental enzyme immunoassay (EIA) by another EIA kit may be also effective for reporting the more correct result to donors, instead of expensive supplemental immunoblot test. METHODS: All repeatedly reactive blood samples by EIA from 16 regional blood centers were retested for anti-HCV antibody by Abbott IMx HCV kit and LG HCD CONFIRM immunoblot kit. Presence of viral RNA was also confirmed using Amplicor HCV TEST kit from 180 samples, which were proportionately selected according to supplemental EIA and Immunoblot results. RESULTS: Of 2,211 repeatedly reactive samples, 909 samples (41%) were reactive and 1,302 (59%) samples were non-reactive with IMx HCV kit. 81% of reactive samples also showed positive pattern on the LG HCD CONFIRM strips and 79% of 1,302 samples showed negative pattern. RNA positivity was estimated 66% and 17% in Abbott IMx HCV positive and negative samples respectively, and 72%, 6%, 20% in LG HCD CONFIRM positive, indeterminate and negative samples respectively. CONCLUSION: HCV RNA positivity in positive samples by Abbott IMx HCV or LG HCD CONFIRM was not statistically significant (z=0.57 < 1.96, alpha=0.05). RNA detection rate by Abbott IMx HCV or LG HCD CONFIRM among HCV RNA positive samples, which was estimated as 73%, 70% respectively, was also statistically insignificant (z=0.375 < 1.96, alpha=0.05). So, it seems to be a good and economical practice that donors are notified of anti-HCV antibody results after supplemental EIA test using Abbott IMx HCV kit.

Genotyping of ABO and D Antigens / 대한수혈학회지

BACKGROUND: Genes for ABO and Rh phenotypes were recently identified. Although ABO genotyping don't find wide application in hospital transfusion services, it can play an important role in paternity and forensic investigation. In case of Rh system, however, DNA typing may find several practical applications such as prenatal determination of fetal Rho(D) genotype. METHODS: 64 blood samples for ABO genotyping were collected from blood donors (34 A, 30 B) and 18 samples for D genotyping (10 D+, 8 D-). To distinguish A, B and O alleles, we analyzed nucleotide positions 261 and 803 using polymerase chain reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP). PCR products containing nucleotide position 261 were restricted with KpnI and BstEII. Rh genotyping was done by two sets of primers, one set for both RhD and RhCcEe gene amplification, and the other set for RhD only. RESULTS: The frequencies of ABO genotypes found in Korean blood donors were as follows: in the phenotype A group, AO=79% and AA= 21%; and in the phenotype B group, BO=93% and BB=7%. Of 18 blood samples for D genotytping, 10 were typed as RhD positive and 8 as RhD negative, showing full agreement with serological typing. CONCLUSION: ABO and D genotyping can be used when RBCs suitable for serological phenotyping are not available. Futhermore, these will be useful as a supplemental test to solve the problem of blood group typing caused by weak ABO and Rh phenotype.

Radiological evaluation congenital gastrointestinal tract anomalies

With the improvements, during recent years, in the control of the infections and nutritional diseases thesubject of congenital malformation becomes of increasing importance. The radiologic signs are crucial for promptdiagnosis of anomalies of alimentary tract and with early identification of resulting complication, surgicaltherapy is usually life-saving. 30 cases of congenital anomalies of alimentary tract in infants were reviewed inrespect of age, sex, incidence and radiological findings. 1. The most common lesion was hypertrophic pyloricstenosis, followed by congenital megacolon and anorectal anomaly, tracheoesophageal fistula, intestinal atresia.2. Male outnumbered female in most congenital anomalies of alimentary tract. 25 cases were under the age of 1month. 3. Common symptoms of upper gastrointestinal tract obstruction are vomiting and abdominal distention. Inthe obstruction of lower gastrointestinal tract, abdominal distention and failure of meconium passage were noted.4. Roentgenologic finding were as follows, a. Chest A-P and lateral view; In tracheoesophageal fistula, sacculardilatation of upper esphagus and displacement of trachea anterolaterally were the most common finding. b. Simpleabdomen: Obstructive pattern of proximal portion of duodenum shows in 11 cases, of distal bowel shows in 16 cases.Duodenal atresia showed “double bubble” sing, hypertrophic pyloric stenosis showed marked gastric distention,paucity of air in small bowel and increased gastric peristalsis were the most common finding. Hirschsprung'sdisease showed absence of rectal gas almostly. The variable length between blind hindgut to anus was seen inanorectal anomalies. c. Esophagogram: Blind sac of upper esophagus was seen at the 4th thoracic spinal level anddisplacement of trachea anteriolaterally. 1 case of tracheoesophageal fistula had an intact esophageal lumen. d.Upper G-I series; In hypertrophic pyloric stenosis, delayed gastric emptying, string or double tract sign were themost common finding and catapiller sign, tit sign, shoulder sing or open umbrella sign were noted. e. Bariumenema; In congenital megacolon, transitional zone and irregular bizzar contraction, “choppywave” were noted.Radiograph made 24 hours after barium enema showed retained barium in the colon. f. Selective retrogradefistulogram, distal loopgram & voiding cystogram: In anorectal anomalies, 3 cases showed rectourethral fistula and2 cases showed rectovaginal fistula and 1 case showed rectovesical fistula. And membranous imperforate anus is in1 case.