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International Journal of Contemporary Pediatrics
Number of Followers: 2  

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ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Association of serum vitamin D levels and simple febrile seizures in

    • Authors: Mohammad Ahad Adnan, Mohammad Iqbal Hossain, Wahida Khanam, Jannatul Mawa, Ifthakhar Ahmed, M. Tariqul Islam Mondol
      Pages: 266 - 271
      Abstract: Background: Febrile seizure is one of the commonest childhood neurologic diseases. There is an increasing concern that vitamin D deficiency may play an etiological role. This study was conducted to find out the association between vitamin D levels and febrile seizure. Objective were to determine the association of vitamin D levels in children with simple febrile seizure. Methods: This case control study was conducted in institute of child and mother health, Dhaka from July 2019 to June 2020. Children aged six to sixty months with simple febrile seizure were ‘cases’ and those having fever without seizure were controls. Detailed history regarding breastfeeding, intake of calcium and vitamin D rich diet, sunlight exposure, family history of seizure was taken and physical examinations were done. Data collection was done through a pretested structured questionnaire. Serum vitamin D level was measured. Results: There were 44 cases of simple febrile seizure and 50 controls. Mean age of the study participants was 16.5±8.9 and 14.4±7.1 months in case group and control group respectively, with a majority in the age group 6-12 months. 34.1% of cases and 22% of controls had deficient vitamin D while 50% of cases and 34% of controls had insufficient vitamin D, respectively. Reduced vitamin D level was more common in case group. Mean vitamin D level was also significantly lower in case group. Conclusions: Decreased vitamin D level was found to be significantly associated with simple febrile seizure.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230418
      Issue No: Vol. 10, No. 3 (2023)
  • Correlation between transcutaneous bilirubin levels and total serum
           bilirubin levels in postnatal period in a tertiary care center

    • Authors: Shonit Kantroo, Girish Shakuntal, Vaibhav K. Gode
      Pages: 272 - 274
      Abstract: Background: Neonatal jaundice is generally a benign condition seen during the postnatal period. The non-invasive methods including transcutaneous bilirubinometry have been developed for assessment of neonatal jaundice, transcutaneous bilirubin TcB) meters noninvasively estimate the bilirubin levels by measuring light transmission through the skin of neonates this value is then to be plotted against a chart in order to look for hyperbilirubinemia. Aim was to determine the efficacy of measuring the transcutaneous bilirubin as a screening tool for clinically significant hyperbilirubinemia. Methods: Study was a cross sectional study conducted under pediatric department of SMBT IMS and RC at tertiary care center after taking the approval from the ethical committee. Total of 110 neonates that appear to be clinically suffering from neonatal jaundice were considered for study after consent from respective parent/ guardian. Neonatal TCB levels and serum bilirubin levels were done. If bilirubin levels lie in phototherapy range, then baby was shifted to NICU and phototherapy treatment was given, and once levels came within normal range after the phototherapy treatment, again serum bilirubin levels were measured in order to compare pre-and post-treatment levels. Results: Present study showed male preponderance. 64 were male and 46 were female. Majority 61% were full term normal delivery and 39% were LSCS. Mean TCB level was 8.5±2.8. Statistical significance was seen for TCB and sever hyperbilirubinemia. Conclusions: Present study concluded that hyperbilirubinemia is commonly seen among males. Newborn delivered had hyperbilirubinemia. Statistical significance was seen between TCB level and severity of the disease. Thus, neonatal TCB levels can be used as a screening test for detecting hyperbilirubinemia in neonates. As TCB is a noninvasive and cost effective it can be used widely as predictor of the disease.
      PubDate: 2023-02-01
      DOI: 10.18203/2349-3291.ijcp20230288
      Issue No: Vol. 10, No. 3 (2023)
  • Epidemiological factors and clinical profile of meconium aspiration
           syndrome in newborns admitted in rural tertiary centre

    • Authors: Gokul Ganesh V. R., Sucindar Mullainathan, Chidambaranathan Sivaprakasam
      Pages: 275 - 279
      Abstract: Background: Meconium aspiration syndrome is a severe life-threatening illness in the neonate and is a major cause of perinatal morbidity and mortality. MSAF is reported around 10 to 20% of live births in which MAS seen around 5-10%. Various maternal and neonatal factors have been found associated with MAS which lead to several complications in the neonates and succumb to the disease. Methods: The present study is a observational study was done on 59 babies admitted in NICU of Government medical college, Chidambaram for a period of 1 year and 2 months who fulfilled the clinical criteria for diagnosing MAS. Babies born with MSAF were resuscitated as per NRP guidelines and observed for their immediate outcome. Results: Out of 460 MSAF babies, 59 developed MAS with incidence of (12.8%). MAS was common with thick meconium (55.9%) compared to thin with male preponderance (54.2%) and Primi gravida (74.6%). MAS occurred more in babies having fetal distress and antenatal risk factors like PIH, PROM, and anaemia. MAS was common in babies born through normal vaginal delivery and in term gestation of 37-40weeks with mean birth weight of 2860±394. 1minute APGAR score less than 7 in (57.6%) MAS babies and most common complications were PPHN, seizures and pneumothorax. Mortality in MAS was around (13.5%) with most common cause was hypoxic ischemic encephalopathy. Conclusion: Babies with MAS requires proper diagnosis and careful decisions are made about the timely intervention which reduces morbidity and mortality.
      PubDate: 2023-02-16
      DOI: 10.18203/2349-3291.ijcp20230346
      Issue No: Vol. 10, No. 3 (2023)
  • A prospective study of thyroid profile in children aged 1 month to 12
           years of age with newly diagnosed seizure disorder started on first line
           antiepileptic drugs

    • Authors: Santhosh Kumar M., Supraja Pinnamaneni, Anitha C.
      Pages: 280 - 285
      Abstract: Background: The study's primary aim was to determine the variation in the thyroid profile status in children with newly diagnosed seizure disorders started on first-line antiepileptic drugs. In addition, this study compares the incidence of hypothyroidism secondary to phenytoin, phenobarbitone, valproate and carbamazepine. Methods: A total of 60 children with newly diagnosed seizure disorders belonging to the age group of 1 month to 12 years were enrolled in the study. The children were subjected to a detailed history and neurological examination, and serum levels of T3, T4, and thyroid-stimulating hormone (TSH) were tested. Results: In this study, out of 60 children, the clinical signs and symptoms of hypothyroidism were present only in one subject (1.7%), and the remaining 59 had no signs and symptoms of hypothyroidism. The mean TSH value increased from baseline 1.62±1.17 to 3 months 2.2±1.38 and 6 months 2.78±149 (p value<0.05%). The incidence of subclinical hypothyroidism among the phenytoin group (n=33) was 6.06%. Among the sodium valproate group (n=23), the incidence was 8.6%, and among the carbamazepine group (n=4), the incidence was 25%. Conclusions: Antiepileptic drugs can alter thyroid function tests. In this study, there was no overt hypothyroidism noted. But subclinical hypothyroidism was reported in subjects using phenytoin, valproate and carbamazepine.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230419
      Issue No: Vol. 10, No. 3 (2023)
  • Cranial ultrasound findings in asphyxiated term neonates and their
           correlation clinically with hypoxic ischemic encephalopathy staging

    • Authors: Dhanushuya Ganesan, Saravanan S.
      Pages: 286 - 289
      Abstract: Background: The survival of asphyxiated neonates has significantly increased in recent years because of numerous advancements in contemporary neonatal intensive care. The most popular and easily repeatable imaging method for the neonatal brain, the neurosonogram can demonstrate the most common types of cerebral injury in preterms and term infants. This study aims to analyse the value of cranial ultrasonography as an investigative tool for birth asphyxia babies (>34 weeks) will be evaluated to learn the morphology of various cerebral lesions and to compare clinical findings with neurosonogram results. Methods: An observational study was conducted in 75 neonates (>34 weeks) admitted in Government Cuddalore medical college with birth asphyxia. A detailed history and clinical examination was carried out according to the designed proforma. All the babies in the study group were subjected to cranial ultrasound and the morphology of findings studied. CUS findings were correlated clinically. Results: Among babies with HIE stage I, 89.7% had normal Cranial Ultrasound Findings, and 10.3% had abnormal findings. 43.3% babies had abnormal Cranial ultrasound findings in HIE stage II, and 70% had abnormal findings in HIE stage 3. Conclusions: Cerebral oedema was the commonest neurosonogram finding in Asphyxiated babies and HIE 3 had the maximum abnormal findings in our study. Since there is a positive correlation between the severity of hypoxic ischemic encephalopathy and cranial ultrasound findings, USG cranium can be performed as a screening tool in all neonates with birth asphyxia in whom additional investigations could not be performed.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230420
      Issue No: Vol. 10, No. 3 (2023)
  • Clinical profile of mumps in children in a tertiary care hospital in

    • Authors: Ummer M. Bhat, Naseer Yousuf Mir, Wamiq Farooq, Bashir U. Zaman, Mohammad Imran Malik
      Pages: 290 - 294
      Abstract: Background Mumps is one of the oldest human illnesses known to humans. Mumps is caused by a paramyxovirus, which is a single-strand RNA virus. Mumps is characterized by painful, unilateral, or bilateral swelling of the salivary glands, in particular, the parotid glands. Methods: This is a hospital-based prospective observational study. All children of age ≤18 years, both males and females with acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland without other apparent cause. Results: Of the 150 clinically diagnosed mumps cases, 87 (58%) were male and 63 (42%) were female (male-to-female ratio of 1.4:1). There was no case below 1 year but there were 40 cases between 1 and 5 years. The 40% belonged to the lower middle class of socioeconomic status as per Kuppuswamy’s scale, followed by the upper-middle and lower-middle class. Only 15 patients (10%) were completely immunized whereas the immunization status of 8% patients was not known, and the rest of the patients were non immunized (82%). Fever was the most common presentation (150 patients;100%), followed by parotid involvement. Parotitis was present in 146 (97.3%) cases at some point during the illness, 36 patients (24%) had unilateral and 110 patients (73.3%) had bilateral involvement. 16% of patients had multiple salivary gland involvement. Mean duration of illness was 9.0±2 days. Conclusions: Mumps is a significant public health problem to warrant investment in prevention through vaccination.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230421
      Issue No: Vol. 10, No. 3 (2023)
  • A randomised controlled trial on effect of topical anaesthetics on
           injection pain during immunization in infants of 6 weeks to 6 months of
           age with pentavac vaccine

    • Authors: Sowmiya D. K., Ramanathan R., Ramamoorthy R.
      Pages: 295 - 299
      Abstract: Background: Pain is a both a sensory and an emotional experience when untreated and unrecognized, it extracts a significant physiological, biochemical and psychological toll on both the children and family members. Vaccine injections are considered to be the most common cause of iatrogenic pain in childhood. Positive experience during vaccine injection like reducing injection pain with local anaesthetics can avoid pre procedural anxiety in future, needle phobias, healthcare avoidance behaviors and maintain trust in healthcare providers. Methods: This randomized controlled trial was done at immunization clinic of Rajah Muthiah Medical College Hospital over a period of 2 years.100 infants of age group 6 weeks to 6 months brought for Pentavac (DPT-Hib-Hepatitis B) combination vaccine were taken for study and allocated into control, intervention group (receiving local anaesthetic cream/lidocaine spray) and pain score was compared using modified behavioral pain score (MBPS). Results: Among the three groups studied, the mean pain scores after vaccine injection were minimum in group A (infants with topical occlusive EMLA cream), followed by group B (infants with topical LA spray), whereas control group of infants who did not receive any local anaesthesia exhibited higher pain scores values. Conclusions: Our study showing that topical occlusive EMLA cream significantly decreases injection pain in infants has applicability in clinical practice, where it can be routinely used in infants before administering intramuscular vaccine injections in settings where resources are not a constraint.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230422
      Issue No: Vol. 10, No. 3 (2023)
  • Clinico-demographic profile of children with neurocysticercosis and risk
           factors for persistent seizures

    • Authors: Deepali Sangale, Arpita Adhikari, Mona Gajre
      Pages: 300 - 304
      Abstract: Background: Neurocysticercosis is one of the common cause of acquired epilepsy in childhood. The objective of this study was to study the clinic-demographic profile of children having Neurocysticercosis and to evaluate the potential risk factors for persistent seizures. Methods: A prospective observational study was conducted after recruiting 30 children with neurocysticercosis. After detailed history and clinical examination, the neuroimaging findings were studied. Patients were started on standard anti-helmenthic and antiepileptic therapy. A regular follow up was taken with regard seizure recurrence. A neuroimaging was repeated at 6 moths follow up. Results: Among 30 children with neurocysticercosis who presented with first seizure due to neurocysticercosis, focal seizure was the commonest (63.3%) presentation and 23.3% of these presented with status epilepticus. Out of 30 cases, 7 (23.3%) patients had seizure recurrence on follow up. Patients presenting with status epilepticus, neuroimaging showing larger lesions (size more than 10 mm), multiple number of lesions and persistent presence of lesion on the CT scan at a follow up of 6 months were the factors found to have significant positive association with recurrence of seizures on follow up. Conclusions: There are potential clinical and radiological risk factors which are associated with the recurrence or persistence of seizures in patients with neurocysticercosis.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230423
      Issue No: Vol. 10, No. 3 (2023)
  • Role of magnetic resonance imaging brain in children with developmental

    • Authors: L. V Padma Priyanka Dittakavi, Shreya Tanneru, Prasad Thanda, Suresh R. J. Thomas
      Pages: 305 - 310
      Abstract: Background: Developmental delay is one of the most common conditions encountered by paediatricians. It is defined as significant delay in one or more of the developmental domains. Evaluation of such children with neuroimaging is important to come to a specific diagnosis. Early identification and diagnosis have implications for better treatment and parental counselling regarding the outcome. This study aims to observe the various findings in magnetic resonance imaging (MRI) brain and to depict the aetiology in children with developmental delay. Methods: A hospital based retrospective observational study, was carried out in Kamineni institute of medical sciences, Narketpally among 40 children aged between 6 months to 12 years, with features of developmental delay. MRI brain was done and findings were later classified into various etiological subgroups. Results: Normal morphological MRI findings were seen in only 12.5% of children with developmental delay. Abnormal morphological findings in MRI were seen in 87.5%, out of which 40% showed metabolic and degenerative disorders, 37.5% of the findings depicted congenital malformations, 10% of them were of infectious aetiology. The white matter was the most commonly involved anatomical structures i.e., (52.5%), followed by ventricles (20%). Conclusions: MRI can easily detect many specific etiological and pathophysiological conditions thus; clinical diagnosis of developmental delay must be aided with neuroimaging for better understanding of the aetiology.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230424
      Issue No: Vol. 10, No. 3 (2023)
  • Predictors of morbidity and mortality of extramural neonates with respect
           to TOPS score: prospective experience from a tertiary care centre of
           western India

    • Authors: Charul R. Mehta, Diwakar K. Singh, Aashna Verma, Mehul Patel
      Pages: 311 - 315
      Abstract: Background: The transport of sick newborns in India is still at a premature stage. Many of these newborns thus transported are cold, blue, and hypoglycaemic, and 75% of the babies transferred this way have serious clinical implications. The aim of this study was to study the clinical status of neonates transported to our hospital and predict the outcome in terms of morbidity and mortality, based on the TOPS score. Methods: This prospective, observational, longitudinal, simple randomized study was carried out over 12 months in the Department of Paediatrics, Civil Hospital Ahmedabad, Gujarat, and a total of 750 patients were enrolled. A detailed history and clinical examination were carried out through a preformed proforma. Results: The parameter that was found to be most altered was temperature (70.6%), 52% had hypoxia, 48.6% had poor perfusion and 20% patients had hypoglycemia. Hypoxia was the strongest predictor of mortality. 74.8% of the neonates referred to our hospital had TOPS score of 4-6, and had the highest mortality (41.3%). 25.2% of the newborns were having a TOPS score of 7-8. Conclusions: TOPS is a simple, reliable score which can help in the quick assessment of neonates on arrival. Hypothermia was the most common altered parameter at the time of presentation followed by hypoxia and hypoperfusion. Mortality was found to be statistically significant in those sick newborns, who presented with more than one altered parameter of TOPS.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230425
      Issue No: Vol. 10, No. 3 (2023)
  • A retrospective study on acquired demyelinating diseases in children

    • Authors: Mona P. Gajre, Akash D. Sarkate, Swarali S. Joshi, Arpita D. Adhikari, Ankur Garg
      Pages: 316 - 321
      Abstract: Background: Acquired demyelinating diseases (ADS) соnstitute а heterogeneous grоuр of central nervous system disorders of autoimmune origin that causes significant physical and cognitive disabilities. Early recognition and prompt management causes significant improvement in acute episodes of demyelinating disorders. Methods: 33 children diagnosed with demyelinating disorders at Lokmanya Tilal municipal medical college and hospital in Mumbai were enrolled. The study was conducted between January 2013 and November 2022. Demographic data, clinical profile, CSF study, serum antibody, radiological findings were collected and results were analyzed. Statistical Data was analysed using statistical software GraphPad in Stat.V3.0. Data were presented in tables and figures whenever needed. P value <0.05 considered as significant. Results: Of 33 patients, 21 (63%) were cases of acute disseminated encephalomyelitis (ADEM), 6 (18.1%) of transverse myelitis (TM), 1 case of ADEM + TM (3%), 3 (9%) of neuromyelitis optica, 1 (3%) of Optic neuritis and 1 (3%) of multiple sclerosis. ADEM patients presented with encephalopathy and multifocal neurological deficits, 40% were MOG positive. Two patients were of multiphasic ADEM. Patients of transverse myelitis had paraparesis or quadriparesis and sensory + bladder involvement. Patients with NMO presented with bilateral visual impairment with limb weakness and bladder involvement. Steroids were the primary treatment, 3 patients (9%) required intravenous immunoglobulin (IVIG) and 1 (3%) patient received plasma exchange therapy. Conclusions: ADEM is the most common ADS. Early diagnosis and management with steroids therapy improves outcome in most of the patients. Non response to steroids warrants second line treatment options like IV Immunoglobulin (IVIG) or Therapeutic plasma exchange.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230426
      Issue No: Vol. 10, No. 3 (2023)
  • Evaluation of peak expiratory flow rate with severity of lower respiratory
           tract infection in children of Hadoti region

    • Authors: Shobhit Kumar Tripathi, Yatendra Sahu, Neelam Meena, Anjali Rathore
      Pages: 322 - 325
      Abstract: Background: Correlation of peak expiratory flow rate (PEFR) with severity of lower respiratory tract infection (LRTI) and comparison of PEFR with same age, sex, height and nutritional status of children of age group 7 to 18 years. Methods: This is a case control study in children in the age group of 7 to 18 years of both sexes suffering from LRTI admitted in department of paediatrics of a tertiary care government hospital of Hadoti region. The duration of study was October 2019 to September 2020. Group 1 (case group) comprised of children having LRTI, whereas group 2 (control group) comprised of healthy and asymptomatic children There were 250 children in each group and they were further categorized into 3 age groups of 7-10 years, 11-13 years and 14-18 years. The PEFR of LRTI group children was compared with control group children with the similar age, sex as well as the anthropometric measurements. Results: In LRTI group, the PEFR had significant difference from control group, in all three age groups (p<0.0001). The study showed positive co-linear relationship between age, height, weight and BMI with PEFR in both males and females in LTRI and control groups. Conclusions: Effect of PEFR depends upon anthropometric measurements of children of different age group in both LRTI population and control population. In control group PEFR showed significant difference between boys and girls, but in LRTI group PEFR showed non-significant difference between boys and girl in their respective age groups.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230427
      Issue No: Vol. 10, No. 3 (2023)
  • Serum zinc levels in children aged two months to five years in
           hospitalized children with pneumonia

    • Authors: Sivasankari Velladurai, Saravanan S.
      Pages: 326 - 329
      Abstract: Background: Pneumonia is the infection of the lung parenchyma which is one the leading cause of morbidity and mortality among under five age group. The prime aim of this study is to identify the severity and to supplement the children with factors that reduce the mortality caused by pneumonia, zinc being one of the major factors in the immune defense mechanism in reducing the severity and mortality. Our study estimates the amount of zinc in severe pneumonia child thereby to arrive at a rationale to supplement zinc among Pneumonia children to reduce the course of illness. The core objective of this study is to compare serum zinc level in children with severe pneumonia among different age and sex. Methods: A prospective case-control study was carried out with 50 cases and 50 controls in age group of 2 months to 5 years admitted in Government Cuddalore Medical College, Chidambaram. The study period ranges from December 2020 to December 2022. The cases are identified as per history thorough clinical examination and radiological evidence based on IMNCI criteria. All the children in both case and control group were subjected to serum-zinc level analysis after obtaining informed consent from the Parents. Zinc level in both groups were compared and analyzed. Statistical package for the social sciences (SPSS) version-16 was used as a statistical tool. Ethical clearance has been obtained. Results: The mean serum zinc level in children admitted with pneumonia is 55.126 and the mean serum zinc level in controlled growth is 78.803. Zinc level is significantly lower in children with pneumonia. Conclusions: The estimated mean serum zinc levels in pneumonia group children confirms that there is a relative zinc deficiency in children with pneumonia and may play a role in the severity progression. Our study supports the need for zinc supplementation in pneumonia children to boost their immune defense mechanism which in turn reduces the severity and the progression of pneumonia. It tends to curtail the case fatality rate of pneumonia.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230428
      Issue No: Vol. 10, No. 3 (2023)
  • Correlation of serum ferritin level in transfusion-dependant thalassemia
           major patients: a study at a medical college affiliated hospital in
           Gujarat region

    • Authors: Vijay R. Bhalodiya, Lalji G. Valiya, Niyati A. Mehta, Bhavin B. Padhariya
      Pages: 330 - 333
      Abstract: Background: Beta thalassemia is one of the most common causes of inherited disorder in the world. In India, around 65000-70000 cases of thalassemia are present currently and every years around 9000-10000 new cases are added. Measurement of serum ferritin level gives an idea about when to start iron chelation therapy, which will reduce the concentration of iron in the serum and thereby prevents the multiple organ damages. Methods: A prospective hospital based study was conducted on 100 children having beta thalassemia major. These children were regularly transfused at our hospital and their serum ferritin level were measured by ELISA based assay. Detailed transfusion history and demographic profile were recorded and compared with serum ferritin level. Results were analyzed with SPSS software and Microsoft Excels. Results: In present study, mean serum ferritin level in 0-5 year age group was1262 µg/l, in 6-10 years age group was 1963.44µg/l and in 11-18 years age group was 2387.43µg/l. On applying ANOVA test, it was evident that there was a statistically significant correlation between increased serum ferritin level with increasing age of the patient as well as with increasing number of a total blood transfusion. Conclusions: High serum ferritin level in beta thalassemia is associated with increasing age of children as well as with increasing transfusion dependency. Serum ferritin measurement at regular interval helps in determining the ideal timing to start iron chelation therapy in transfusion dependant thalassemic patients.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230429
      Issue No: Vol. 10, No. 3 (2023)
  • Developmental outcome of neonatal intensive care unit graduates born in
           tertiary care hospital in South India

    • Authors: Hrishikesh S. Pai
      Pages: 334 - 337
      Abstract: Background: With the advancement in technology and advances in perinatal care, survival rates of high risk newborns have improve. Despite the reduction in neonatal mortality, chronic morbidities and adverse outcomes have not declined. These include cerebral palsy, cognitive delay, visual and auditory deficits signifying the need for regular monitoring of growth and development. Methods: Retrospective and prospective cohort study in a tertiary care centre in South India. Study duration of one year. Retrospective analysis of data of 190 high risk newborns admitted in NICU for more than 48 hours during the period 2012-2014. Neurodevelopmental outcome of these high-risk newborns at the age of 8-10 years. These were contacted and followed up for clinical assessment including motor and neurological function, visiomotor integrative skills, academic achievement, language, executive function, behavioral issues and child behavioral checklist applied. Findings described in simple descriptive manner. Results: In this study of 190 babies,139 babies were followed up for clinical assessment at the age of 8-10 years. From the follow up, 7.2% were diagnosed to have seizure disorder during childhood. 18.7% had hyperactive airway disease during childhood. 9.8% had academic problems, 5.8% had motor abnormalities, 2.9% had vision abnormalities requiring glasses from early childhood, 4.3% had gait abnormalities, 4.9% had speech related difficulties,17.3% had behavioral issues including excessive anxiety, withdrawal, aggressiveness. 1.2% had sleep problems, 21.6% babies had features of attention deficit hyperactivity disorder, 2.9% had features related to autism. Conclusions: Neonatal period is a critical period for proper neurodevelopment, having impact on child development. Babies with difficulties during transition period had higher immediate as well as long term morbidities. Long term morbidities included hyperactive airway disease/asthma, seizure disorder, academic problems, motor and gait abnormalities, behavioural abnormalities in childhood.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230430
      Issue No: Vol. 10, No. 3 (2023)
  • Predictive value of CRP and albumin ratio in neonatal sepsis

    • Authors: Chandana Athmananda, Mahendrappa K. B., Praveen Unki, Hemanth Kumar, Madhu P. Kerudi, Keerthana T. Babu
      Pages: 338 - 343
      Abstract: Background: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The study was conducted to assess the predictive value of the CRP vs Serum albumin in earlier identification and as a prognostic indicator of neonatal sepsis. Methods: In this research, from July 2021 to February 2022 a total of 150 studies were enrolled at Adichunchanagiri Institue of medical sciences. Complete clinical and laboratory data were collected. To identify the potential independent risk factor for neonatal sepsis, multivariate logistic regression analysis was performed. Receiver operating characteristic curve analysis was used to evaluate the prediction accuracy of CAR in identifying neonatal sepsis. Results: A total of 150 neonates were included in the study out of which 78 neonates were preterm, 32 neonates were late preterm and 40 neonates were term neonates. CAR levels were higher in neonates with sepsis and showed a gradual increase among the control group, mild sepsis group, and severe sepsis group. The prevalence of neonates with overall sepsis, mild sepsis, and severe sepsis increased significantly from CAR tertile 1 to tertile 3. Multiple logistic regression analysis showed that CAR was an independent risk factor for the presence of sepsis (OR = 11.123, 95% CI 6.74–14.5, p<0.001) and severe sepsis (OR=1.568, 95% CI 1.3-2.4, p<0.001). ROC curve analysis showed that CAR had a well-discriminatory power in predicting sepsis (area under the curve= 0.74, 95% CI, 0.71-0.77, p<0.001) and severe sepsis (AUC=0.70, 95% CI, 0.67-0.74, p<0.001). Conclusions: CAR was an independent predictor for the presence and severity of neonatal sepsis.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230431
      Issue No: Vol. 10, No. 3 (2023)
  • Etiological profile of febrile thrombocytopenia in children aged <12 years
           in a tertiary care centre

    • Authors: Sony Moluguri, Shreya Tanneru, Prasad Thanda, Suresh R. J. Thomas
      Pages: 344 - 348
      Abstract: Background: Febrile thrombocytopenia is platelet count <1,50,000/mm3 associated with fever irrespective of age and gender. There is an increasing trend in the incidence of febrile thrombocytopenia with varied etiology. Though infections are the most common cause in tropical countries like India, sometimes non-infectious conditions like primary haematological disorders and malignancies can also present as febrile thrombocytopenia. Hence it is essential for the treating physicians to be fully aware of etiological factors for febrile thrombocytopenia and how to approach to the condition. Methods: A hospital based observational study done at Kamineni Institute of Medical Sciences during the study period October 2020 to December 2021 by collecting and analysing details of 100 patients between 1 month-12 years of age who presented with fever and thrombocytopenia at admission. Patients on drugs causing thrombocytopenia were excluded from the study. Results: Majority of the cases (51%) belonged to the age group of 1-6 years. Out of 100 subjects, 60% of them had dengue fever, 12% of cases had malaria and 10% of cases had enteric fever. Bleeding manifestations were seen in 12% of cases and blood product transfusion was done in 30% of the cases. 98% of cases had recovered and 2 deaths were reported. Conclusions: Febrile thrombocytopenia is a common clinical presentation in children. Majority of the dengue cases responded well to treatment given as per WHO guidelines. In most of the other infections, thrombocytopenia was transient and asymptomatic with lesser severity and resolved with the treatment of underlying condition.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230432
      Issue No: Vol. 10, No. 3 (2023)
  • Clinical and demographic profile of nephrotic syndrome in a rural tertiary
           care center

    • Authors: Sreevarsha Tipparthy, Shreya Tanneru, Suresh R. J. Thomas, Prasad Thanda
      Pages: 349 - 352
      Abstract: Background: Nephrotic syndrome is a common renal disease in children, associated with high risk of death, most commonly from infections, if not identified and treated promptly. It is a disease that not only affects the physical health but also psychology of the child and that of the family and there is lack of information on nephrotic syndrome in children in a rural setup. Methods: This hospital based observational study was conducted from September 2020 to December 2021, in department of pediatrics in KIMS, Narketpally. A total of 40 eligible children diagnosed with nephrotic syndrome between 3 months to 12 years were taken up for this study. Detailed information of the patient, including thorough history, clinical examination, investigations, response to treatment and complications of the disease were recorded in a pre-designed proforma and the data was analyzed. Results: It was observed that out of 40 subjects, the most common age group affected was 6-9 years (42.5%), majority of which were male children (72.5%). Most common presenting symptom was edema seen in 100% patients, followed by oliguria in 50%. Most common complication noted was ascites (62.5%) followed by hypertension (42.5%). UTI was observed in 52.5% of cases. 75% of the patients were newly diagnosed and 25% were relapses. Conclusions: In the present study, clinical and demographic profile of nephrotic syndrome was congruent with nephrotic syndrome in children in other studies. The response to treatment and associated complications did not differ significantly in a rural center when compared to other studies.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230433
      Issue No: Vol. 10, No. 3 (2023)
  • Incidence of nasal trauma in nasal continuous positive airway pressure
           versus heated humidified high flow nasal cannula in neonates, our
           experience in Government Medical College Srinagar

    • Authors: Naseer Yousuf Mir, Mohammad Imran Malik
      Pages: 353 - 356
      Abstract: Background: The nCPAP (nasal continuous positive airway pressure) is noninvasive mode of ventilation that decreases the need for mechanical ventilation in neonates. The newer device heated humidified high flow nasal cannula (HHHFNC) delivers heated (to body temperature, 37 °C) and humidified (near 100% relative humidity) gas at flow rates of more than 1 liter/min through small bi-nasal prongs, that is more physiological. Methods: This was a retrospective study conducted in neonatal intensive care unit. The eligible neonates who were put on HHHFNC or nCPAP depending upon the availability of any of these devices at the time of admission. The details regarding complications were recorded from the admission files of these patients from medical record section of the hospital. Results: There was no statistically significant difference in complications like shock, NEC, pulmonary air leak, apnea, PDA, ROP, IVH or PVL for nCPAP or HHHFNC. However, nasal trauma was present in 18 (18%) patients in nCPAP group but in no patient in HHHFNC. Conclusions: There is no significant differences in complication in nCPAP vs HHHFNC except nasal trauma which is more common in nCPAP.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230434
      Issue No: Vol. 10, No. 3 (2023)
  • Study on the effect of severe acute malnutrition on various
           echocardiographic parameters of the heart

    • Authors: Hari Pradhaa M. V., Ramanathan R.
      Pages: 357 - 360
      Abstract: Background: Malnutrition is a major cause for morbidity and mortality in children below 5 years of age in developing countries. According to National family health survey-5 (NFHS-5), stunting has reduced from 38.4% to 35.5%. Wasting has reduced from 21.0% to 19.3% and underweight prevalence has reduced from 35.8% to 32.1%. Acute malnutrition can lead to biochemical changes based on metabolic, hormonal and glucoregulatory mechanisms and can affect various organ systems. This study aims to determine the effect of malnutrition on various cardiac parameters by M mode echocardiography. Methods: A cross sectional observational study was conducted in 50 severe acute malnutrition children selected by convenient sampling between 6 months and 5 years of age of Government Cuddalore medical college for a period of 2 years and M mode echocardiography was done to assess various parameters of cardiac wall dimensions and cardiac mass and compared with age/body surface area specific values. Results: Among SAM children, 74% had decreased end diastolic diameter, 80% had decreased end systolic diameter and 88% had decreased posterior wall dimension. Ejection fraction and fractional shortening was in normal range for all children. 64% had decreased left ventricular mass and 56% had decreased left ventricular mass index. Conclusions: Dimensions of the heart and cardiac mass was reduced in majority of malnourished children. Systolic function of the heart was relatively preserved as demonstrated by normal ejection fraction and fractional shortening. Thus, echocardiography can serve as a valuable tool in detecting changes in cardiac structure and function in malnourished children.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230435
      Issue No: Vol. 10, No. 3 (2023)
  • Electrolyte abnormalities and type of feeding in acute diarrhoea in
           children upto five years

    • Authors: Prakash S. , Saravanan S.
      Pages: 361 - 364
      Abstract: Background: Children in infancy are protected against diarrhoea by breastfeeding as suggested by many studies. Failure to exclusively breastfeed and early introduction of complementary feeds in children predispose to several diseases especially diarrhoea. This study was mainly aimed at analysing electrolyte abnormalities in children with diarrhoea in relation to their type of feeding. Methods: Around 100 children under five years of age with acute diarrhoea presenting to paediatrics department were enrolled in the study after meeting the inclusion criteria. The electrolyte abnormalities, glucose level, renal parameters, severity of dehydration and type of feeding of the children were recorded. The incidence of electrolyte abnormalities in diarrhoea in the children and their type of feeding were analysed. Results: Participants had hyperkalaemia which was 30%, followed by 19% had hyponatremia, 13% had hypokalaemia, 12% had hypernatremia and 1% had hyperchloremia. 38% had no dehydration, 8% had severe dehydration and 54% had some dehydration. 49% of the children followed breast feeding, 16% followed formula feeding, 14% were taken cow’s milk and 21% were followed mixed feeding. There was no statistically significant relationship between electrolyte abnormalities and type of feeding except for hypokalemia. Conclusions: Except with hypokalaemia, our study did not find a statistically significant relationship between electrolyte abnormalities in diarrhoea in children with type of feeding. But still, need for exclusive breastfeeding, continuation breast feeding more than two years remains protective against acute diarrhoea in children.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230436
      Issue No: Vol. 10, No. 3 (2023)
  • Acute lymphoblastic leukemia after COVID-19 infection: a coincidence or a
           second hit

    • Authors: Pallavi Agarwal, Pauline Balkaransingh, Chandra Krishnan, Erlyn Smith
      Pages: 365 - 368
      Abstract: Since the advent of COVID-19 in 2019, the virus has affected all age groups and has a very wide clinical spectrum, ranging from asymptomatic infection to serious life-threatening complications including multi-organ dysfunction syndrome in children. The virus tends to affect all organ systems including the hematological system. There are many contradictory views on the effect of the COVID-19 pandemic on the incidence of hematological malignancies. Some studies have shown an increased incidence of acute lymphoblastic leukemia (ALL) after COVID-19 infection supporting the Greaves two-hit hypothesis of leukemogenesis, while others have shown a decline in the incidence of ALL postulated to be due to widespread lockdown and decreased exposure to environmental pathogens. We report the cases of three children who were diagnosed with acute lymphoblastic leukemia shortly after the initial diagnosis of multisystem inflammatory syndrome in children (MIS-C) or COVID related transient erythroblastopenia of childhood.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230438
      Issue No: Vol. 10, No. 3 (2023)
  • Brain abscess in older children with uncorrected tetralogy of Fallot

    • Authors: Arun Prasad, Abhiranjan Prasad, Pulak Azad
      Pages: 369 - 371
      Abstract: Tetralogy of Fallot is the most common cyanotic congenital heart disease. Corrective surgery is indicated during infancy for the best outcome, however, due to poor availability and affordability of surgery, many children of resource-poor settings live with uncorrected tetralogy of Fallot. They suffer from dreaded complications like brain abscess, in later years of life. We report 3 cases of tetralogy of Fallot who developed brain abscess during their childhood.
      PubDate: 2023-02-18
      DOI: 10.18203/2349-3291.ijcp20230349
      Issue No: Vol. 10, No. 3 (2023)
  • Neurological manifestations of multisystem inflammatory syndrome in
           children associated with COVID-19 in a tertiary care centre

    • Authors: Lakshman Chintha, Suvarna Magar, Varsha Vaidya, Shirish Bhartiya, Krishna Mehta
      Pages: 372 - 375
      Abstract: Multisystem inflammatory syndrome in children (MIS-C) and adolescents temporally related to COVID-19” is a new entity characterized by fever, multisystem organ involvement, laboratory evidence of inflammation, and laboratory or epidemiological evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in individuals aged 0–19 years with no alternative diagnosis. Neurological manifestations are not part of the diagnostic criteria of MISC and hence remain poorly described. So, we wanted to note down the neurological involvement in multisystem inflammatory syndrome in children (MIS-C) related to severe acute respiratory syndrome with coronavirus infection. Here we describe 6 cases of COVID MISC who presented as acute febrile illness with drowsiness, irritability, convulsions and serious ones with encephalopathy. Focal neurological signs, abnormal brain magnetic resonance imaging (MRI) was present in four patients. MRI brain was normal in 2 cases CSF study was normal in all cases. These patients received intravenous methylprednisolone at 30 mg/kg/day for 3 days. Cases 3 to 6 were given intravenous immunoglobulin (IVIG), the clinical picture rapidly improved in the first three days, and all neurological symptoms disappeared within 10 and 30 days with some sequel in cases 4 to 6. In conclusion we describe clinical and laboratory parameters in these patients with neurological manifestations and we documented an increase in pro inflammatory markers correlating with severity of neurological presentation in children with MISC. High index of suspicion is needed to diagnose neurological manifestations of MISC following COVID-19 pandemic. Neurological spectrum can be broad range of manifestations though outcome was favorable with early treatment.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230439
      Issue No: Vol. 10, No. 3 (2023)
  • Role of nutrition in curing dysphagia: a case series of five rare cases of
           severe acute malnutrition with severe megaloblastic anaemia

    • Authors: Rujuta Parikh, Sangeeta Mudaliar, Sanjay Prabhu, Minnie Bodhanwala
      Pages: 376 - 379
      Abstract: Severe acute malnutrition (SAM) is associated with multiple vitamin deficiencies, including vitamin B12. Vitamin B12 deficiency is commonly found in the Indian subcontinent, and has devastating clinical consequences. It leads to megaloblastic anaemia and several other complications. Dysphagia is an unusual symptom of the same. The present study was undertaken to evaluate the reversal of dysphagia with vitamin B12 supplements. A hospital-based retrospective case series was conducted at the B. J. Wadia Hospital for Children. Cases were collected from 19 November 2021, to 25 August 2022. Five children less than two years of age, who presented with complaint of dysphagia, presence of megaloblastic anaemia and concurrent nutritional compromise were evaluated for their clinical profiles, and the outcomes were analysed. We found that dysphagia was a reversible symptom with medical nutrition therapy and injectable B12 therapy in children with SAM who had severe megaloblastic anaemia. The present study has identified the prevalence of dysphagia in cases of SAM with megaloblastic anaemia. This dysphagia is reversible and curable with nutritional rehabilitation and injectable B12 therapy without any further invasive intervention.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230440
      Issue No: Vol. 10, No. 3 (2023)
  • Clinical spectrum of infants with thiamine responsive pulmonary arterial

    • Authors: Tanmayi Uppalapati, Yathirajam S. Krishna, Adarsh Eregowda
      Pages: 380 - 386
      Abstract: Pulmonary arterial hypertension (PAH) is a progressive disorder caused by hypertension in blood vessels from heart to lungs. Exclusively breastfed infants are at the highest risk due to their high metabolic demand and low thiamine level in mothers. Symptoms are observed to be sometimes precipitated with the presence of co morbidity such as sepsis and lower respiratory tract infections. This study explains 10 cases with varied clinical presentation and response to management of different grades of infantile pulmonary arterial hypertension.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230441
      Issue No: Vol. 10, No. 3 (2023)
  • Pigtail chest drain-related organ injuries in preterm neonates

    • Authors: Laëtitia Bessalah
      Pages: 387 - 389
      Abstract: Pigtail catheters are increasingly used in Neonatal Intensive Care Units. Despite being easier to position, presumably less invasive, and non-inferior to classic trocar drains, complications related to placement have been sporadically reported. We describe 3 cases of traumatic injury to neighboring organs and structures related to pigtail catheter positioning in small preterm infants. In the absence of formal neonatal guidelines, accurate estimation of needle and guidewire depth and ultrasonography guidance may contribute to prevent such dreadful complications.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230437
      Issue No: Vol. 10, No. 3 (2023)
  • Lemierre's syndrome: an evolving disease

    • Authors: Chaitra Manjunath, Amanda Atkins, Chibuzo Ilonze
      Pages: 390 - 393
      Abstract: Lemierre’s syndrome is characterized by thrombophlebitis of the internal jugular vein with resulting systemic septic emboli. Most cases occur following an oropharyngeal infection and have been historically caused by the bacterial pathogen Fusobacterium necrophorum. However, infection from other pathogens is becoming more common in recent years. Our case is special in the sense that Lemierre’s syndrome was caused by staphylococcus aureus after influenza infection. A 23-month-old male presented with complaints of left neck swelling and recurrent fever for one week, following influenza A infection. The child was ill-appearing with fever, tachycardia, tachypnea, and erythematous swelling on the left cheek. Laboratory results revealed elevated inflammatory markers. Computed tomography (CT) scan of the neck showed loculated fluid collection suggesting an intra parotid abscess with poor visualization of the internal jugular vein (IJV). Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Due to high clinical suspicion of Lemierre’s syndrome, a doppler ultrasound was obtained which showed a left IJV thrombus. CT scan of the chest after the clinical suspicion showed multiple bilateral pulmonary nodules suggesting septic emboli. He was treated with antibiotics and a six-week course of the anticoagulant with a resolution of his thrombus. Though historically, Lemierre’s disease is caused by Fusobacterium necrophorum, other causative organisms such as methicillin-sensitive Staphylococcus aureus are increasingly being recognized. Lemierre’s disease can present as a complication of influenza. A high index of clinical suspicion based on the location of the abscess helped us delineate diagnostic tests and treatment.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230442
      Issue No: Vol. 10, No. 3 (2023)
  • Multiple congenital anomalies-hypotonia-seizures syndrome 3 secondary to
           phosphatidylinositol glycan class T mutation: a neonatal case report

    • Authors: Ankit Ranjan, M. Shahbaz Alam, Vinod Kumar, Snigdha Samanta, Rajesh Kumar, Khalid M. Saifullah
      Pages: 394 - 397
      Abstract: Multiple congenital anomalies-hypotonia-seizures syndrome 3 (MCAHS3) is caused by genetic defects in glycosyl-phosphatidylinositol transamidase complex synthesis due to mutations in the PIGT gene. The disease encompasses dysmorphism, cardiac, genito-urinary and skeletal anomalies, developmental delay and epilepsy in variable severity. Only 39 such cases have been reported till date in literature. We reported the first Indian case with neonatal presentation and overall the sixth case of MCAHS3 to present in neonatal age. The pro-band was a male baby born to non-consanguineous parents. He had perinatal depression, craniofacial dysmorphism, epileptic encephalopathy, left radio-ulnar congenital fractures and respiratory failure managed with multiple anti-epileptics, invasive ventilation and limb splinting. Clinical exome sequencing revealed an autosomal recessive homozygous PIGT gene mutation on exon 6 of chromosome 20 with a variant nomenclature of C.709G>C with heterozygous parents confirming MCAHS3. This report expands the range of information available on MCAHS3. It highlights the need to elaborately investigate dysmorphic newborns with severe hypotonia along with the described neurological symptoms, so as to pin point this potentially diagnosable entity.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230443
      Issue No: Vol. 10, No. 3 (2023)
  • A case of diazoxide unresponsive congenital hyperinsulinemic hypoglycemia
           with missense mutation in ABCC8 gene

    • Authors: Nirmala B. S., Kanika Handu, Lavanya S. , Pushpalatha Kariyappa
      Pages: 398 - 400
      Abstract: Hypersecretion of insulin by pancreatic ß-cells causes hypoglycemia called congenital hyperinsulinism (CHI). It can inhibit brain development in infants. It is associated with mutations in the ABCC8 or KCNJ11 genes encoding for the SUR1 and KIR 6 (subunits of the ATP-sensitive potassium (KATP channel) a rare genetic disorder. It has an incidence rate of 1 in 50,000 in general populations and 1 in 2000 in areas with a higher rate of consanguinity. Here, we report a case of hyperinsulinemic hypoglycemia with ABCC8 gene mutation in a late preterm female infant who developed late-onset hypoglycemia. The infant developed hypoglycemic seizures on day 3 of life and her metabolic workup revealed hyperinsulinemia. A high glucose infusion rate and enteral feeding could not maintain the infant's serum glucose level. PET scan showed no abnormal somatostatin receptor avid lesion in pancreatic parenchyma. Hence genetic workup was done which showed a missense mutation in the ABCC8 gene which was c.4154C>G/p.Ser1385Cys. Over 9 months of follow-up, the infant is treated with octreotide and diazoxide, hasn't had any hypoglycemic events and has normal growth and psychomotor development for her age.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230444
      Issue No: Vol. 10, No. 3 (2023)
  • Look into their eyes and save their vision: role of primary health care
           provider in early diagnosis of retinoblastoma

    • Authors: Soundharyaa Gunaseelan, Pujitha, Latha M. Sneha, Julius Scott, Vikas Khetan
      Pages: 401 - 403
      Abstract: Childhood cancer is not amenable to preventive or screening strategies. The most effective strategy to reduce the cancer burden and improve outcomes, is to focus on early, correct diagnosis followed by evidence-based therapy. When diagnosed early, they are responsive to appropriate therapy and increases survival rates, thereby reducing the need for intensive treatment and reduces the expenditure per child. Retinoblastoma is the most common intra ocular malignancy and is one of the most curable cancers in children. If diagnosed early and treated optimally, not only they are completely cured but a vast majority can have ocular salvage and retain vision. Lack of awareness among general population, diagnostic delays, delays in referral to proper treatment centre, compounded by socio economic factors attributes to the poor outcome in such children. We report a case of 2 years 10 months old girl child whose initial presentation of leukocoria was missed and later presented with advanced retinoblastoma with CNS metastasis.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230445
      Issue No: Vol. 10, No. 3 (2023)
  • An unusual presentation of scrub typhus with lateral rectus palsy in a

    • Authors: Jeslin Joshy Chiramel, Parimala V. Thirumalesh
      Pages: 404 - 405
      Abstract: Scrub typhus, an acute febrile infectious disease prevalent in the “Tsutsugamushi triangle”, is a mite-born rickettsial zoonosis, caused by Orientia tsutsugamushi. Although the clinical presentation is protean, it rarely causes abducens nerve palsy. We report a 13-year-old previously healthy Indian boy who presented with a recent onset right abducens nerve palsy, headache and fever but without the classic dermatological manifestation (“eschar”) of the disease. After exclusion of common infectious and other causes, he was finally diagnosed with scrub typhus associated with an abducens nerve palsy, which responded to doxycycline therapy.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230446
      Issue No: Vol. 10, No. 3 (2023)
  • Case report of ataxia telangiectasia

    • Authors: Raksha R. Kamat
      Pages: 406 - 408
      Abstract: Ataxia telangiectasia is rare inherited disorder characterized by progressive, neurodegenerative, variable immunodeficiency, celebral ataxia, ocular and cutaneous telangiectasia. They are prone for sinopulmonary infection also at risk of cancer development. Hallmark of disease is ataxia and telangiectasia. Incidence is 1 in 1,00,000 live births. 10-year-old presented to us with chief complaint of not able to Maintain balance and walk steady since 5 years of age. on examination bulbar telangiectasia was present. Also, dysdiadokinesia, past pointing, intention tremor was present. Magnetic resonance imaging (MRI) of the brain was done. Alpha fetoprotein was more than 1000. Vitamin E with balance exercise as supportive treatment starred. Ataxia begin during infancy when child start to walk, 2nd most hallmark of disease. In bulbar telangiectasia, average life span is 25-year-old. It is a multisystem genetic disorder. Death occurs due to cancer and infection. Counseling plays an important role as there is no cure for disease.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230447
      Issue No: Vol. 10, No. 3 (2023)
  • Association of hypodontia to skeletal, dental and soft tissue anomalies- a
           rare case report

    • Authors: Shradha Jain, Nikhil Marwah, Anant Gopal Nigam, Divya Gera, Mamta Bishnoi
      Pages: 409 - 412
      Abstract: Hypodontia is commonly found dental anomaly but its corelation with skeletal and soft tissue anomaly is rare. The aim of the present paper is to highlight the rare finding of mild case of hypodontia associated with skeletal, dental and soft anomalies.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230448
      Issue No: Vol. 10, No. 3 (2023)
  • An unusual case of familial hypophosphatemic rickets

    • Authors: Leny E. Bhadke, Suryakant Y. Ingale, Prathamesh S. Shinde
      Pages: 413 - 416
      Abstract: Rickets is the failure of mineralisation of osteoid and newly formed bones in a child skeleton. It is commonly associated with vitamin D deficiency; however, it can be because of a decrease in serum phosphate level leading to inadequate mineralization of cartilage and bone, consequent skeletal deformities and growth retardation. In hypophosphatemic rickets, there are both inherited and acquired forms, where X-linked hypophosphatemic rickets (XLH) is the most prevalent genetic form and caused by mutations in the phosphate-regulating endopeptidase (PHEX) gene. XLH is associated with growth retardation and bone deformities. This rare variety was diagnosed in a 2 year 4 month old child who had brought by parents with complaint of abnormal gait. In the present case, clinical and radiographic aspects of manifestation of familial hypophosphatemic rickets are discussed.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230449
      Issue No: Vol. 10, No. 3 (2023)
  • Early presentation of complete branchial fistula with review of literature

    • Authors: Shilpi Arora
      Pages: 417 - 421
      Abstract: Branchial anomalies are rarely seen in clinical practice. They arise as a result of aberrations of the branchial apparatus during fetal development. Though present since birth, they are usually diagnosed in the first or second decade of life. Second arch anomalies are by far the most common and present as a neck mass or discharging sinus that may be complicated by infection. Clinical examination often reveals the lesion to be related to the junction of the upper two thirds and the lower one third of the sternocleidomastoid muscle. Branchial fistulas often present as a discharging sinus in the neck. The fistulous tract may extend for a variable distance within the neck. However complete branchial fistula of the second cleft with an internal opening in the tonsillar area and an external opening in the skin is rare. Surgical excision using the step ladder approach was used. No recurrence was seen at one year follow up. The incidence of such lesions presenting within first two years of age is extremely rare. Surgical excision is the treatment of choice for branchial anomalies. We present the case of a two-year-old female patient with complete branchial fistula and discuss the clinical presentation and surgical management of such lesions, while reviewing the relevant literature.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230450
      Issue No: Vol. 10, No. 3 (2023)
  • Intravenous acyclovir causing vesicular eruptions at and away from
           infusion site in a child

    • Authors: Deepty Nauriyal, Anand Shukla
      Pages: 422 - 424
      Abstract: Acyclovir is an antiviral drug used to treat infections caused by Herpes virus. Acyclovir is known to cause systemic and local adverse reactions. Local adverse reactions include inflammatory reactions at infusion site. We case report a child with vesicular eruptions at and away from infusion site due to IV acyclovir. It is quite a rare finding, as only few such cases have been reported till now in literature.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230451
      Issue No: Vol. 10, No. 3 (2023)
  • Longitudinally extensive transverse myelitis after COVID-19 vaccination in
           a teenage girl

    • Authors: Arun Prasad, Pradeep Kumar, Amrita Banerjee, Dipyaman Ghosh
      Pages: 425 - 428
      Abstract: COVID-19 pandemic has led to the development of a variety of vaccines for protection against SARS-CoV-2 infection, with varying safety profiles and protective efficacy. As with other vaccination, vaccination against COVID-19 has also been found to be associated with various kinds of adverse events following immunization. While most adverse effects are mild, some serious side effects like transverse myelitis and acute disseminated encephalomyelitis have also been reported. However, these serious side effects have been reported in adults. To the best of our knowledge, there is no report of longitudinally extensive transverse myelitis (LETM) in the paediatric population, associated with this vaccination. We report here a case of a teenage girl, who was admitted to our hospital with the symptoms of LETM after receiving COVID-19 vaccination. Her diagnosis was based on history and, laboratory and imaging findings. She was discharged after a full recovery.
      PubDate: 2023-02-14
      DOI: 10.18203/2349-3291.ijcp20230336
      Issue No: Vol. 10, No. 3 (2023)
  • Role of oral fluid, electrolytes and energy in various pediatric illnesses
           beyond diarrhea: an Indian expert panel consensus recommendation

    • Authors: Apurba Ghosh, Ashish Ramesh Bavdekar, Nishant Wadhwa, Pavitra Chakravarty, Rahul Nagpal, Somashekar A. R., Janani Shankar, Eileen Canday, Haritha Bathina, Christian Tesado, Priti Thakor, Harshad Malve
      Pages: 429 - 438
      Abstract: Dehydration in non-diarrheal illnesses often goes unnoticed and there are no consensus treatment recommendations for management of dehydration in non-diarrheal illnesses. A multi-disciplinary committee of 10 experts from India gathered on virtual platform in September 2020 to develop consensus recommendation on current treatment strategies for managing oral fluid electrolyte and energy in pediatric patients during non-diarrheal illnesses and to identify unmet needs and gaps. A pre-meeting questionnaire-based voting system was adopted to reach consensus followed by a discussion between panel members. In absence of consensus, the topic was opened for debate to arrive at an aligned recommendation. Key clinical challenges include identifying dehydration in acute illnesses and recommending appropriate quantity and type of oral fluids based on symptom severity. This consensus statement provides guidance on management of dehydration in non-diarrheal illnesses including recommendation on oral fluid, electrolytes, and appropriate energy management in pediatric population. Oral fluid, electrolyte and energy supplementation were recommended based on symptoms in acute non-diarrheal illness increased insensible losses and/or decreased intake. Oral rehydration fluids should be prescribed accurately and at the right-time for countering dehydration, ideally early in the course of illness. Prescribing pattern should be precise and like intravenous fluids. Carbonated drinks and canned juices should not be recommended. Plain water may not be optimal in replacing electrolytes especially for anorexic patients who can only tolerate fluids. These clinical practice statements provide guidance for oral fluid, electrolytes, and energy recommendations for pediatric patients with various acute illnesses beyond diarrhea.
      PubDate: 2023-02-23
      DOI: 10.18203/2349-3291.ijcp20230452
      Issue No: Vol. 10, No. 3 (2023)
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