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International Journal of Contemporary Pediatrics
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Association of high-sensitivity C-reactive protein level with central
           obesity of the children in a tertiary care hospital of Bangladesh

    • Authors: Dhiraj Chandra Biswas, Moshiur Rahman, Farzana Sharmin, Ismat Jahan, Ananya Roy, Suraiya Begum
      Pages: 407 - 413
      Abstract: Background: Obesity is an exaggeration of normal adiposity. Central obesity in children has increased than general adiposity now a days, which is not routinely measured in clinical practice. Adipose tissue contributes to the secretion of a number of inflammatory cytokines which stimulate the production of high-sensitive C-reactive protein (hs–CRP) by the liver. The study was done to see the association of hs-CRP level with central obesity in Bangladeshi children.Methods: A total of 110 obese children aged between 10 to 18 years with BMI≥95th centile and age and sex matched 55 non-obese children with BMI≥5th to <85th centile according to centers for disease control and prevention (CDC) growth chart were selected. A structured questionnaire was prepared taking into account demographic and clinical parameters. The hs-CRP were estimated in study subjects and then correlated to central obesity by waist height ratio (WHtR).Results: The prevalence central obesity was 45.5% by WHtR and raised hs-CRP levels was 46.4% in obese children. About 62% of obese children had central obesity who had raised hs-CRP level ≥2 mg/l (high risk), which showed significant positive correlation with WHtR and was significantly raised in obese children.Conclusions: A high proportion of central obesity was observed in obese children who had raised hs-CRP level, suggesting that it might be useful to assess future metabolic and cardiovascular complication.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210645
      Issue No: Vol. 8, No. 3 (2021)
  • Microalbuminuria among children with congenital heart disease seen in
           Sokoto, North-Western Nigeria

    • Authors: Khadijat O. Isezuo, Usman M. Sani, Usman M. Waziri, Bilkisu G. Ilah, Fatima B. Jiya, Muhammad B. Abdulrahman, Ibrahim J. Hano
      Pages: 414 - 419
      Abstract: Background: Congenital heart disease (CHD) especially cyanotic CHD has been associated with microalbuminuria which is an early marker of glomerular nephropathy but this has hardly been studied in African children. The aim of this study was to compare mean microalbuminuria levels and associations among children with acyanotic CHD, cyanotic CHD and normal controls.Methods: Forty-one (41) children comprising 19 acyanotic CHD, 14 cyanotic CHD and 8 without CHD aged 1 to 15 years were recruited in a cross-sectional study. Quantitative urinary microalbuminuria was measured by ELISA technique. Positive result was microalbuminuria of 30-300 mcg/mgCr. Mean levels were compared by student t-test and analysis of variance (ANOVA). Statistical significance was taken at p<0.05.Results: There were 22 (53.7%) females and 19 (46.3%) males. Mean level of microalbuminuria was highest in those with cyanotic CHD at 147.7±78.8 mcg/mgCr, followed by those with acyanotic CHD at 111.8±61.5 mcg/mgCr and lowest in those without CHD at 67.3±31.6 mcg/mgCr. There was significant difference between the groups with CHD and those without CHD (F=4.1, p=0.03) and microalbuminuria had a significant but weak negative correlation with oxygen saturation implying that microalbuminuria increased with worsening cyanosis.Conclusions: Microalbuminuria was high among the patients with CHD, though higher in cyanotic patients warranting closer follow up of these patients.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210646
      Issue No: Vol. 8, No. 3 (2021)
  • Anthropometric nutrition outcomes of children under 5 years undergoing
           cleft palate repair at CoRSU rehabilitation hospital Uganda; trends,
           patterns and determinants

    • Authors: Joseph Mbuga, George William Galiwango, Martin Tungotyo
      Pages: 420 - 429
      Abstract: Background: Objective of the study was to assess the prevalence and determinants of postoperative malnutrition and compare the preoperative and postoperative trends and patterns of malnutrition among children under 5 years undergoing cleft palate repair at CoRSU rehabilitation hospital in Uganda.Methods: A cross-sectional analytical study done between March 2018 and March 2019 at CoRSU rehabilitation hospital; a tertiary rehabilitation hospital offering free comprehensive cleft care to patients from Uganda and beyond. We consecutively enrolled 115 non-syndromic children under 5 years who had undergone complete cleft palate repair at CoRSU hospital at least 3 months previously. Children’s anthropometric parameters; weight for age Z score, height for age Z score and weight for height Z score were obtained and compared at initial, preoperative and postoperative visits.Results: The prevalence of wasting was 53.0% versus 12.7% versus 4.4% that of stunting was 44.4% versus 41.7% versus 48.7% that of underweight was 57.4% versus 34.8% versus 15.7% while that of overweight was 0.0% versus 5.2% versus 9.6% at initial, preoperative and postoperative visits respectively. Postoperative stunting was independently associated with age groups 12-23 months (p=0.013) and 24-59 months (p=0.006), residing in Eastern (p=0.021) and Western (p=0.033) regions and being stunted (p=0.000) or wasted (p=0.028) preoperatively.Conclusions: Postoperatively, the prevalence of both wasting and underweight reduced by 10- and 3- fold respectively; prevalence of stunting remained critically high while that of overweight increased nearly 10-fold. Surgery improves the nutrition status of children with cleft palate. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210647
      Issue No: Vol. 8, No. 3 (2021)
  • Prevalence of infectious abortion and its complications in pregnant women
           hospitalized in Ardabil city hospital during 2011-2018

    • Authors: Faranak Jalilvand, Shahla Farzipour, Jafar Mohammadshahi, Amir Kabood Mehri
      Pages: 430 - 433
      Abstract: Background: Infectious abortion and its mortality is one of the most serious health threats to women. Infectious abortion with high prevalence rate is more accessible in many of developing countries. The aim of current study, was to investigate the prevalence of infectious abortion and its complications in pregnant women hospitalized in Ardabil city hospital during 2011-8.Methods: In this retrospective cross-sectional study which done on pregnant women with symptom of infectious abortion who admitted to Alavi hospital in Ardabil city during the years 2011-2018. Data collected by a checklist including demographic and clinical information and then analyzed by statistical methods in SPSS version 20. Results: The rate of infectious abortion in this study was 40 people per 50,000 live births. The mean age of the studied women was 32.58±5.35 years. The highest number of infectious abortion was related to the women in the gestational age group over 13 weeks (50%). Most of women with 80% had fever and 52.5% of women had an open cervix at the time of referral. Complications of infectious abortion included peritonitis, uterine rupture, septic shock, and DIC.Conclusions: Results showed that the rate of infectious abortion in this study was 22.5% that generally due to manipulation by methods such as curettage, drug use and its side-effects. By considering the average age of women about 32 years and problems related about pregnancy, so programing and training in this themes could prevent many of these problems in pregnant women in future.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210648
      Issue No: Vol. 8, No. 3 (2021)
  • Study of fetal hemoglobin with different gestational age and birth weight
           of the newborn

    • Authors: Santosh Kumar Roy, Ajit Kumar Shrivastava, Prema Ram Choudhary
      Pages: 434 - 439
      Abstract: Background: In many parts of the developing country estimation of antenatal gestational age is still not possible and challenging condition of proper perinatal care. This study aimed to find out relationship between the gestational age and birth weight of the newborn with fetal hemoglobin concentration.Methods: In this comparative study, we included 90 pregnant women who delivered their babies by normal vaginal delivery. Out of these 90 babies, 27 were preterm with gestational age 28-36 weeks, 55 were term with gestational age 37-41 weeks and remaining 8 were post term with gestational age of more than 41 weeks. All these 90 newborn infants were also divided into two groups: low birth weight (birth weight <2.5 kg) and birth weight ≥2.5 kg. Fetal hemoglobin was estimated by using alkali denaturation technique of Chernoff and Singer on appropriate spectrophotometer. Statistical analysis was performed using SPSS windows version 20.0 software.Results: The total number of newborns were significantly (p<0.001) higher in term group and with normal birth weight group. Fetal hemoglobin level was significantly (p<0.0001) lower in term, post term and normal birth weight groups. Study showed a definite negative correlation between gestational age and the fetal hemoglobin concentration. Fetal hemoglobin level was gradually declining with increasing gestational age and birth weight.Conclusions:  It is concluded from this study that the concentration of fetal hemoglobin decreases at the rate of 2.4% per week with considerable variation of values at every week of advancing gestational age. Hence level of fetal hemoglobin estimation can be taken as an important criterion for evaluation of gestational age. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210522
      Issue No: Vol. 8, No. 3 (2021)
  • Seroprevalence of hepatitis a virus antibody in 11-15 years old children
           in Vijayawada and age-related incidence of hepatitis a virus in GGH,

    • Authors: Srimukhi Anumolu, Kireeti Jarjapu, M. A. Rahman
      Pages: 440 - 444
      Abstract: Background: To estimate seropositivity of hepatitis A virus Ig G antibody (HAV Ig G antibody) in 11 to 15 years aged children in Vijayawada.Methods: The study group includes 265 consecutive children aged 11 to 15 years attending GGH, Vijayawada and had a blood sample taken for any reason. The serum samples collected were screened for Anti HAV IgG antibody using commercially available Elisa kit (WANTAI). Information related to various socio demographic factors also were elicited by interview method. All the Anti-Hepatitis A virus IgM antibody positive individuals list are collected from 1stJuly 2015 to 1st august 2017 and were categorized based on age and analysed.Results: The total seropositivity against Hepatitis A virus is 71%. The number of children in the urban population showing IgG antibodies is lower compared to that of rural population (p value-0.028). The highest number of Hepatitis A virus infected population (positive IgM) is between 10-14 years (50), followed by 15-19 years (45) and 5-9 years (43). This shows that there is increased risk of infection in the older age group and there is a shift to 2nd and 3rd decade (p value – 0.045).Conclusions: The seropositivity of HAV IgG antibody in children aged 11-15 years is 71% in Vijayawada. Seroprevalence in the nearby area, Chennai, ten years back was found to be 95% by 12 years of age. This indicates there is a shift from high to intermediate endemicity in Vijayawada. There is need for vaccination in the susceptible individuals. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210649
      Issue No: Vol. 8, No. 3 (2021)
  • 100% human milk diet: an integral part of nutrition management in NICU:
           PAN India neonatologist’s survey

    • Authors: Sanjay Wazir, Syed Ershad Mustafa, Vikram K. Reddy
      Pages: 445 - 450
      Abstract: Background: Exclusive human milk diet (EHMD) benefits preterm infants the most, particularly in neonatal intensive care unit. EHMD is dependent on multiple factors consisting of breastfeeding awareness, availability of pasteurized donor human milk, functioning human milk banks and infrastructure. Neonatal nutritional practice varies considerably in India. The aim of this survey was to understand the implementation and benefits of 100% human milk diet through human milk derived nutritional products in preterm infants from NICU experts’ perspective.Methods: The online survey questionnaire formulated and reviewed by the expert neonatologists was shared with the NICU experts pan India through multiple communication channels and referrals. The survey was constructed on the Google Forms platform, the responses was collected between May 2020 to July 2020.Results: A total of 100 neonatologists responded to the survey from 79 hospitals and 31 cities across India. All the respondents (100%) opined that EHMD is important for preterm infants, 15% opined that EHMD was ensured to all preterm infants, 80% opined that human milk-based fortifier (HMBF) was safe and well tolerated by premature infants, 17% reported that 51-80% of preterm infants experience feed intolerance issues with bovine milk based fortifiers (BMBF), blood urea nitrogen (49%) was chosen as an optimal biochemical parameter for assessing protein utilization in NICU, 93% opined that post discharge nutritional supplementation is required for preterm infants among which 49% respondents opined that HMBF and human milk 70 calorie sachet would be preferable as post discharge nutritional supplementation.Conclusions: EHMD unequivocally offers multiple benefits to preterm infants and hence needs to be included in the NICU protocol, availability of human milk derived nutritional products such as HMBF are termed safe and well tolerated and would aid in implementing EHMD in NICUs. Pasteurized donor human milk is vital for ensuring EHMD, thus access to the same needs to be empowered by strengthening the human milk donation and awareness measures.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210482
      Issue No: Vol. 8, No. 3 (2021)
  • Clinical and genetic profile of patients with primary hyperoxaluria:
           observation from a single centre from West India

    • Authors: Shahenaz Kapadia, Kinnari Vala, Anshuman Saha, Subho Banergy, Divyesh Engineer, Himanshu Patel, Vivek Kute, Dinesh Gera, Vineet Mishra
      Pages: 451 - 459
      Abstract: Background: Primary hyperoxaluria (PH) is characterized by oxalate overproduction due to glyoxylate pathway enzyme defects in the liver. Apart from heterogeneous clinical manifestations of PH, diagnosis by urinary and plasma oxalate levels or stone analysis is not always confirmatory. Mutational analysis is required for definite diagnosis. There is heterogeneity between genotype of PH patients between Western and Indian population. The aim of this study is to describe clinical and genetic profile of Indian patients, diagnosed with PH in Western India.Methods: All clinical PH suspects in Nephrology and Paediatric Nephrology units from October 2016-September 2020, were counselled for genetic analysis for diagnostic confirmation. Cases, genetically confirmed to have PH, were included and retrospectively analysed for their clinical profile, modality of renal replacement therapy, survival/death. The mutations identified in our patients were compared with commonly prevalent mutations in world PH databases.Results: 13 of 15 patients were identified to have genetically confirmed PH. Median age at diagnosis was 1 year (range, 4 months to 46 years) and six (46.15%) were male. Six (46.15%) infants, two (15.38%) adolescents and five (38.46%) presented in adulthood. Nine presented as ESKD, while three patients progressed to ESKD during study. Eight (61.54%) with AGXT mutation were diagnosed as PH type1, four (30.76%) GRHPR mutation while one (7.69%) female infant had PH type 3 with HOGA mutation. Out of thirteen, five (38.46%) patients expired, five (38.46%) are ESKD requiring dialysis. Two (15.38%) post-transplant patients, graft loss for one and another requiring supportive medical management for deteriorating eGFR.Conclusions: ESKD being commonest presentation, high index of suspicion in all cases with renal stone and complete work up should be done for early diagnosis and timely intervention. National registry is required for detection of novel PH mutations in Indian population.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210475
      Issue No: Vol. 8, No. 3 (2021)
  • Bacteriological profile of neonatal and pediatrics sepsis in intensive
           care unit at a tertiary care hospital in western India

    • Authors: Ajit Kumar Shrivastava, Prema Ram Choudhary, Santosh Kumar Roy
      Pages: 460 - 466
      Abstract: Background: Neonatal and pediatrics sepsis are one of the main causes of mortality in neonatal and pediatric intensive care units of developing countries. This study was conducted to determine bacteriological profile of neonatal and pediatrics sepsis in the intensive care unit. Methods: A prospective cross-sectional study was conducted in the neonatal and pediatric intensive care unit, for the period of two years. All 400 neonates and pediatrics patients admitted with suspected clinical sepsis were included. Sepsis screens and cultures were sent under aseptic conditions. Isolation of microorganisms and their identification was done according to standard microbiological techniques bacteriological profile was analyzed with descriptive statistics.Results: Incidence of septicemia is 35.34% in neonates, 9.83% in post neonates and 22.95% in older children. Most common associated factor in neonates were preterm 41.46% in neonates, fever of unknown origin 50% and 78.57% in post neonates and children respectively. Out of 232 suspected cases on neonates in 36.07% cases bacterial pathogen were isolated, 62 suspected cases on post neonates in 9.83% cases bacterial were isolated and 106 suspected cases of older children in 22.95% cases bacterial pathogen were isolated. Common bacterial species isolated were Klebsiella sp. 39.02% in neonates, S. aureus 50% and 35.71% in post neonates and older children respectively.Conclusions: There is entail prevention of infection control measures and rational antibiotic strategy to decrease the economic burden of hospital and community. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210521
      Issue No: Vol. 8, No. 3 (2021)
  • Impact of cesarean section on transient tachypnea of the newborn: a
           longitudinal study

    • Authors: Keziah Joseph, Bhargavi B., C. S. Jain, Dasaradha Rami Reddy
      Pages: 467 - 473
      Abstract: Background: Transient tachypnea of the new born is a benign condition. The aim of the study is to find any correlation between the mode of delivery and occurrence of transient tachypnea of newborn.Methods: Study is proposed to assess the risk factor like caesarean section and its relationship with occurrence of TTN in term neonates and the clinical course of TTN cases admitted in Neonatal intensive care unit (NICU), Department of Pediatrics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana.Results: During the study period, total number of deliveries in our hospital was 4576. Of 356 term neonates with respiratory distress admitted in NICU, the most common cause was found to be early onset sepsis i.e 168 of 356 cases accounting for 47.19%, followed by transient tachypnea of newborn i.e., 68 of 356 cases accounting for 19.10%.Conclusions: The mode of delivery i.e caesarean section has a significant impact on transient tachypnea of newborn (TTN) with a relative risk of 3.78 compared to normal vaginal delivery. The majority of cases had mild respiratory distress and were relieved of symptoms within 3 days of hospital stay.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210505
      Issue No: Vol. 8, No. 3 (2021)
  • Urinary tract infections in children aged 6 months to 5 years presenting
           with severe acute malnutrition in a tertiary care hospital

    • Authors: Naveen Dangayach, Hemant Jain
      Pages: 474 - 480
      Abstract: Background: Urinary tract infections (UTI) is more common in malnourished children than in well-nourished children. Malnutrition is associated with immune deficiency which makes affected children more vulnerable to various severe infections. World Health Organization (WHO) defined severe acute malnutrition (SAM) as weight-for-height below -3 standard deviations (or Z-scores) or mid upper arm circumference <11.5 cm or visible severe wasting or bilateral pedal edema.Methods: All eligible children were consecutively enrolled in the study. Detailed anthropometry measurements were taken and physical examination was done. Two urine specimens for routine microscopy and culture and sensitivity were sent. Antibiotic therapy was given as per standard protocol/sensitivity pattern. Statistical analysis was performed using the statistical packages for social sciences (SPSS) version 20 IBM Corporation.Results: Prevalence of UTI in our study was 21.54% in children with SAM. UTI was more common in females than males in SAM children with maximum prevalence in less than 24 months of age. MUAC was the most prevalent diagnostic criteria. Fever was the most common presenting symptom, but 36.84% asymptomatic children with SAM had UTI. Increased frequency of micturition had 100% association with UTI. E. coli was the most common isolated bacteria. Most sensitive antibiotic was imipenem. Routinely used antibiotic like ceftriaxone showed significant percentage of resistance.Conclusions: Given the high prevalence of UTI among children with SAM, it is suggested that urine culture should be performed in all children with SAM to diagnose UTI and to treat it on basis of antibiotic sensitivity pattern. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210650
      Issue No: Vol. 8, No. 3 (2021)
  • Study of screen-time and sleep in children aged 3-15 years in Kanchipuram,
           Tamil Nadu, India

    • Authors: Prahlad Kadambi, L Sushanth Prabhath Reddy, S. Mohammed Aashiq, Suresh P.
      Pages: 481 - 487
      Abstract: Background: Sleep plays a vital role in good health, growth and well-being. Sleep disorders manifest with disturbance in both quantity and quality of sleep. The current generation of children is growing up surrounded by a world of electronic media through the smartphones and tablets of their parents. Previous studies have shown that sleep disorders are increasing in pediatric age group. This study aimed to assess screen-time, quality and quantity of sleep in children aged 3-15 years.Methods: Total 104 children were recruited for our cross-sectional study from Meenakshi Medical College Hospital and Research Centre, Kanchipuram. After obtaining consent, Pediatric Sleep Questionnaire (PSQ) was administered after collecting clinical history. Anthropometry and clinical examination was performed.Results: Total 8 out of 104 children (7.69%) in the study had poor quality sleep (PSQ Score≥5). 48 out of 104 children (46.1%) had deficient quantity of sleep as per American Academy for Sleep Medicine (AASM) recommendations. Children born with low birth weight had comparatively poorer quality of sleep (r=0.331 p=0.015). All 104 children had spent more screen time than permitted for their age.Conclusions: Quality and quantity of sleep were affected in children aged 3-15 years. This may be attributed to increased screen time but needs to be confirmed in larger studies.   
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210651
      Issue No: Vol. 8, No. 3 (2021)
  • Use of early nasal continuous positive airway pressure in preterm neonates
           with hyaline membrane disease (neonatal respiratory distress syndrome)

    • Authors: R. D. M. Suresh Reddy, Seshagiri Koripadu, Harischandra Venkata Yanamandala
      Pages: 488 - 494
      Abstract: Background: In developing countries like ours, there is high burden of prematurity and sub-optimal use of antenatal steroid administration resulting infrequent hyaline membrane disease (HMD).Methods: A total 50 cases of clinically diagnosed HMD with gestational age between 28-34 weeks admitted to neonatal intensive care unit (ICU). 50 babies were treated with early nasal continuous positive airway pressure (CPAP) (within 6 hours of onset of respiratory distress).Results: Incidence of prematurity was 12.42%. Incidence of HMD observed between gestational ages of 28-34 weeks is 3.2%. Out of total 50 babies who were managed with early nasal CPAP, it proved effective in 40 babies (80%), remaining 10 babies (20%) had to be intubated and required ventilation. Out of 10 babies who required ventilation 90% of the babies were less than 32 weeks gestation age; remaining 10% were between 33-34 weeks. Analysis of these results showed that outcome is better with increased gestational age (p<0.005). Out of 10 babies who failed 80% were <1500 g and remaining 20% above 1500 g. We found significant improvement (p<0.005) in SA score after application of nasal CPAP. Babies on CPAP had significant improvement in oxygenation (p<0.05). A success rate of 93.1% observed in moderate grade HMD (p<0.005). Out of 10 babies who failed on nasal CPAP, 80% of them had severe grade HMD and 20% showed moderate HMD. A success rate of 92.86% was found in babies of mothers who had received antenatal steroids and 63.63% of babies whose mothers had not received antenatal steroids improved with early nasal CPAP (p<0.05).Conclusions: Nasal CPAP is found to be effective in babies of mothers who had received antenatal steroids. Nasal CPAP is safe, inexpensive and effective means of respiratory support in HMD. Use of early nasal CPAP which is simple, non-invasive, has low capital outlay and does not require expertise, is the option for us where most places cannot provide invasive ventilation.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210652
      Issue No: Vol. 8, No. 3 (2021)
  • A comparative study of surgical procedures in neonatal intestinal atresia

    • Authors: Aniruddha Basak
      Pages: 495 - 500
      Abstract: Background: The aim of this work was to assess the outcome for patients with jejunoileal atresia who underwent primary anastomosis, Bishop–Koop, Santulli procedure and Mikulicz procedure. Intestinal atresia is one of the most common causes of intestinal obstruction in neonates. But ideal surgical management of this condition remains controversial.Methods: During the period from January 2017 to January 2019, 112 neonates (62 males and 50 females) suspected to have intestinal atresia were operated in NRSMCH, Kolkata. 30 patients were treated with primary resection/ anastomosis, 30 patients underwent Bishop-koop (BK) technique, 27 patients who were treated with Santulli technique and 25 patients who were treated with Mikulicz procedure. Demographics, treatment and outcomes including mortality, morbidity and nutrition status were reviewed and were compared among the four groups.Results: 20 patients (17.86%) died during the perioperative period. Among them, 10 died due to uncontrolled sepsis and 10 due to malnutrition. Mortality was highest in Primary anastomosis group (33.33%) followed by BK group (13.3%), Santulli group (11.1%) and lowest in Mikulicz group (4%). The Mikulicz group experienced the lowest re-operation rate (4%) and Primary anastomosis group experienced highest re-operation (26.7%). This difference was statistically significant (P<0.003).Conclusions: Using Mikulicz procedure in the current study has improved the survival of these patients and minimized the post-operative complications.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210653
      Issue No: Vol. 8, No. 3 (2021)
  • Active versus expectant management of preterm premature rupture of
           membrane before 34 weeks and neonatal outcome

    • Authors: Gouda A. P. Kartikeswar, Dhyey I. Pandya, Siddharth Madabhushi, Vivek M. Joshi, Sandeep Kadam
      Pages: 501 - 506
      Abstract: Background: Preterm premature rupture of membranes (PPROM) predisposes the mother for chorioamnionitis, endometritis, bacteremia and neonate to preterm delivery related complication. There is often dilemma regarding the management of PPROM in mothers with gestational age (GA) <34 weeks.Methods: A retrospective cohort study conducted in a tertiary care hospital over two year period. Neonates delivered before 34 weeks were enrolled and categorized into active management (AM) and expectant management (EM) group. Associated risk factors, duration of PPROM and latency period, Neonatal outcomes like sepsis, morbidity, duration of respiratory support, duration of NICU stay compared between groups.Results: Out of total 197 cases, AM group had 91 babies. Active management resulted in earlier delivery [mean GA (SD): 30.88(1.8) VS 31(2.1) weeks], higher number of caesarian section (76.9% versus 53.8%), lesser birth weight {1233.6 (±282.9) versus 1453.39 (±380.6) gm} and more ELBW babies (23.1% versus 7.5%). EM resulted in significantly higher antenatal steroid cover (73.6% in AM versus 89.6% in EM) and lesser need of surfactant for RDS [42.9% versus 28.3%]. Significant difference was found for NICU stay days {mean (SD): 25.46 (16.8) versus 20.94 (17.5)}. No difference found between respiratory support days [median (IQR) 2 (0, 6) versus 2 (0, 7)]. No significant differences found in incidence of maternal chorioamnionitis, NEC, sepsis, BPD and ROP. Early delivery resulted in higher mortality though that was statistically not significant.Conclusions: Gestational age at delivery is more important predictor of neonatal outcome then PPROM in early preterm. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210654
      Issue No: Vol. 8, No. 3 (2021)
  • Evaluation of paediatric lymphadenopathy at a rural tertiary care centre

    • Authors: Mamatha Pakala, Shreya Tanneru, Prasada Thanda, Prabhakar Vuppala
      Pages: 507 - 511
      Abstract: Background: The aim and objectives of the present study was to determine the various etiologies of lymphadenopathy in children in our region and its associated clinical findings and prevalence of malignancy in children presented with significant lymphadenopathy.Methods: Sixty-five patients with significant lymphadenopathy charts were reviewed retrospectively from department of Paediatrics and Paediatric Surgery during the period of September 2018-2020. Patient’s records were evaluated in terms of age, gender, complaints, and characteristics of lymph nodes in terms of site, consistency, discharge, sinus and clinical course of a patient. Physical findings of all the cases were noted. Hematological and serological tests were done to know the source of infection. Clinical findings and laboratory results were corroborated with pathological diagnostic tests like FNAC and Excision biopsies in children with significant lymphadenopathyResults: The etiology was confirmed in 94% children and couldn’t be diagnosed in 6% children presented with significant lymphadenopathy. On evaluation commonest etiology was infection with reactive hyperplasia in 58% of children secondary to bacterial or viral infections, Kawasaki disease, suppurative lymphadenitis in 17%, tuberculous lymphadenitis in 14%, and malignancy in 11%. Majority of children presented with cervical lymphadenopathy. An unusual presentation of Non Hodgkin lymphoma as intestinal obstruction with no significant mass per abdomen, a case of nasopharyngeal carcinoma presented as torticollis due to massive unilateral cervical lymphadenopathy were diagnosedConclusions: The most widely encountered cause of lymphadenopathy in children was infection. Most of them are secondary to non specific viral or bacterial infections. The most important concern in children presenting with complaints of lymphadenopathy is the detection of underlying malignant disease. There was significant malignancy rate in our study in children with lymphadenopathy with few atypical presentations. Excisional biopsy is the gold standard method to confirm the diagnosis.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210655
      Issue No: Vol. 8, No. 3 (2021)
  • Comparison of outcomes of thrombocytopenic and non-thrombocytopenic
           culture proven neonatal sepsis

    • Authors: Saumil M. Patel, Kinjal Patel, Karan Patel, Rekha Thaddanee
      Pages: 512 - 516
      Abstract: Background: Due to high incidence of sepsis as a main cause of neonatal mortality, early detection and proper treatment are important in reducing neonatal mortality. Thrombocytopenia is a common hematological problem encountered during neonatal period, particularly in neonatal sepsis. This study was done to know the incidence of thrombocytopenia in neonatal sepsis and to compare clinical outcome in patients with thrombocytopenic and non-thrombocytopenic neonatal sepsis.Methods: This was a prospective study carried out at neonatal intensive care unit of a tertiary care teaching hospital of western Gujarat, India, from October 2018 to August 2020. 2739 neonates were admitted with probable sepsis during study period. 299 neonates with positive blood cultures were recruited for the study. They were divided into two groups; group-1 had patients with thrombocytopenia, while group-2 included patients without thrombocytopenia. Severity of thrombocytopenia was assessed in group-1. Micro-organisms isolated and outcome of sepsis were compared in both the groups. Results: There were 208 neonates in group-1 (thrombocytopenic) and 91 in group-2 (non-thrombocytopenic). There was no significant difference in demographic profiles of neonates in both groups. Klebsiella pneumonia was the most common organism isolated from 79 patients of group-1 and 19 patients of group-2 (p=0.033). Coagulase negative Staphylococci and Candida were the second and third most common micro-organisms isolated from 30.2% and 15.1% of blood cultures respectively. In group-1, 85 (40.8%), 72 (34.6%) and 51 (24.5%) neonates had severe, moderate and mild thrombocytopenia respectively. Klebsiella pneumoniae (45.9%) was the commonest organism isolated in severe thrombocytopenic neonates, followed by Candia (22.4%) and Enterococcus (14.1%).Conclusions: Thrombocytopenia is a specific marker of neonatal sepsis. The platelet count is a simple test that facilitates diagnostic orientation and the establishment of an early empirical treatment. Klebsiella pneumoniae was the commonest organism isolated in severe thrombocytopenic neonates.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210656
      Issue No: Vol. 8, No. 3 (2021)
  • Red cell distribution width as predictor tool in critically ill neonate

    • Authors: Kotyal B. Mahendrappa, Shravya S. Rao
      Pages: 517 - 521
      Abstract: Background: Neonatal sepsis is one of the most common causes for critically ill neonate. Early recognition and prompt treatment are crucial. Red cell distribution width (RDW) varies significantly in such conditions. This study aims at finding the relation between RDW and critically ill neonate.Methods: This hospital based prospective cohort study was conducted on 60 neonates with suspected sepsis. The RDW values were collected at admission and after 72 hours of admission. The primary outcome measures were mortality and recovery from illness. Statistical analysis was done using statistical package for the social sciences (SPSS) 22 version software with appropriate statistical methods applied.Results: The mean RDW in our study group was 14.788±2.138. Receiver operating characteristic (ROC) curve for RDW at 72 hours of admission revealed area under curve (AUC) 0.810 at 14% cut-off with sensitivity of 81.25%, specificity of 72.73%, positive predictive values (PPV) 52% and negative predictive values (NPV) 91.4% with p<0.0001.Conclusions: RDW is a simple, easily available, rapid test to predict the outcome in critically ill neonate.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210657
      Issue No: Vol. 8, No. 3 (2021)
  • Study of platelet parameters in sick children

    • Authors: Varada Vidya Rani, Ravichandrer Balasundaram
      Pages: 522 - 527
      Abstract: Background: Prediction of outcome of a patient plays a key role in the management of PICU. Studies have predicted that platelet parameters are novel predictors of mortality. Hence, present study was designed to assess the accuracy of platelet parameters (platelet count, MPV (mean platelet volume), PDW (platelet distribution width), PCT (Plateletcrit), MPV/PCT, PDW/Platelet count, MPV/platelet count in prediction of mortality and morbidity.  Methods: Total 66 children requiring admission to PICU, were divided as sick (with sick score≥3) and non-sick (with sick score<3). Their platelet parameters were compared. Platelet parameters were further studied with respect to morbidity and mortality. Statistical analysis was done using SPSS 22 version software. Chi-square test was used as test of significance for qualitative data. Continuous data was represented as mean and standard deviation. Independent t test was used as test of significance to identify the mean difference between two quantitative variables.  Results: Both groups were comparable in terms of age and gender. Significant difference in all platelet parameters were noted in between groups (p<0.001). Platelet parameters and their ratios were significant predictors of mortality and morbidity, with negative correlation to platelet count and plateletcrit (PCT), and positive correlation to the rest.Conclusions: Simple analysis of platelet indices at admission by haematology counter analysers could give us a great idea in predicting the mortality and morbidity of the children.  
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210658
      Issue No: Vol. 8, No. 3 (2021)
  • The physical characteristics and anthropometric measurements among
           different gestational age of newborn infants

    • Authors: Santosh Kumar Roy, Ajit Kumar Shrivastava, Prema Ram Choudhary
      Pages: 528 - 534
      Abstract: Background: Prematurity or short gestational age is associated with increased neonatal mortality and morbidity. In low income or developing countries precise gestational age is still frequently not known and making the identification of premature newborns is not easy. The aim of this study was to investigate the physical characteristics and anthropometric measurements to estimate gestational age of newborn infants.Methods: In a cross-sectional study, we included 90 pregnant women, 27 were preterm with gestational age 28-36 weeks, 55 were term with gestational age 37-41 weeks and remaining 8 were post term with gestational age 42-43 weeks. After normal delivery the physical characteristics and anthropometric measurements were recorded in all 90 singleton live newborns. Statistical analysis was performed using SPSS windows version 20.0 software.Results: The physical characteristics namely sole creases, ear firmness, skin texture, skull firmness, hair texture and anterior Fontenelle were well developed in term and post term newborns as compared pre term newborns babies. All the anthropometric measurements such as length of infants, birth weight, head circumference, chest circumference and crown rump length were significantly higher in newborns of post term (p<0.0001) and term (p<0.001) groups as compared to newborns in preterm group.Conclusions: It is concluded from this study that the physical characteristics and anthropometric measurements in generally have increased with the advancement of gestational age. Hence, physical characteristics and anthropometric measurement can be used to estimate the gestational age of newborn babies.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210523
      Issue No: Vol. 8, No. 3 (2021)
  • A clinical and biochemical laboratory profile to measure the severity of
           dengue fever in paediatric population and their outcome

    • Authors: Sandhya Rani Talari, Gangadhar Belavadi
      Pages: 535 - 540
      Abstract: Background: Aim of the study was to assess various clinical manifestations of dengue fever, and complications, to establish the diagnosis of dengue fever based on dengue antigen (NS 1) and antibody (IgM, IgG) and to find the association between the clinical findings with laboratory findings.Methods: 100 cases of suspected children below 18 years of age with clinical features suggestive of dengue infection and children presenting with fever of acute onset (<2 weeks), pain abdomen, vomiting, rash, flushed appearance and bleeding manifestation were studied. The cases were followed up for the clinical and laboratory parameters and were treated according to WHO guidelines.Results: Out of total 100 cases studied 36 were classified as classical dengue fever, 33 as DHF, 15 as DSS, 16 as DLI. It was observed that the disease was common in age group of 5-11 year (54%). Most of the patients were male (66%) with an M:F ratio of 1.94:1. The common presenting symptoms were fever (96%), vomiting (49%), abdominal pain (42%), headache (12%), myalgia (7%), arthralgia (4%), retro orbital pain (1%). General physical examination revealed presence of hypotension, tachycardia, rashes, facial puffiness (28%), pedal oedema (21%), and conjunctival congestion (18%). The skin bleeding was the most common manifestation noted in 12 cases (12%) followed by GIT bleeding like hematemesis 4 cases (4%) followed by epistaxis 4 cases (4%), haematuria 2 cases (2%) and gum bleeds 2 cases (2%). In systemic examination patients were found to have hepatomegaly (53%), ascites (13%), splenomegaly (8%), and pleural effusion (27%). 36 (36%) patients in the study had leucopoenia and mean total leukocyte count of 6014.5 cells/cu mm. The highest and lowest TLC was 22000 and 1400 cells/cumm respectively. 85% cases had thrombocytopenia in the present study. The mean platelet in the present study was 41870 cells/cu mm. Elevated liver enzymes and elevated serum creatinine count was found in complicated forms of disease.Conclusions: The treatment of dengue is mainly supportive, but early institution and meticulous monitoring are the corner stone for positive outcome. Much more awareness, vigilance and research in the diagnostic modalities is further needed to avoid unnecessary panic and platelet transfusions.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210659
      Issue No: Vol. 8, No. 3 (2021)
  • Antibiotic associated diarrhoea in paediatric outpatient practice

    • Authors: Srimukhi Anumolu, Gowri Edagotti, M. A. Rahman
      Pages: 541 - 544
      Abstract: Background: To document the profile of antibiotic associated diarrhoea (AAD) in children aged 6 months to 15 years receiving oral antibiotics.Methods: Prospective study of children attending the out-patient department, who were started on oral antibiotic for indications other than gastrointestinal infections. Data collection was done with a questionnaire and follow up was done by telephone.Results: Of the 1022 children, seven developed AAD (0.68%). Twenty-nine other children had loose stools but did not fulfil the criteria of AAD. Of 436 children who received Amoxicillin clavulanate, 4 developed AAD. One each from 361 on amoxicillin, 9 on ciprofloxacin and 8 on erythromycin developed AAD. Five of the seven children who had diarrhoea were less than two years (71.4%).Conclusions: Incidence of AAD is very low in an out-patient setting. In all cases, diarrhoea subsided on stopping the antibiotic. Children below two years of age and those on Amoxicillin clavulanate have a significantly higher risk. 
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210660
      Issue No: Vol. 8, No. 3 (2021)
  • Clinical profile and complications: scrub typhus in children at a tertiary
           hospital in south India, Nellore

    • Authors: E. Kishore, S. V. S. Sreedhar
      Pages: 545 - 549
      Abstract: Background: Rickettsial diseases, including scrub typhus, are emerging across the Asia-Pacific region as a significant source of acute undifferentiated febrile disease. The purpose of the research is to study the clinical profile, symptoms, and results of cases of scrub typhus admitted to rural medical colleges.Methods: From November 2019 to August 2020, this prospective descriptive research was performed at Narayana Medical College, Nellore, Andhra Pradesh, India. Children who were scrub typhus-positive by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) were tested.Results: 164 children (more than 40 percent of fever cases) were scrub typhus-positive during the study time. Many of the children had a fever. 84.15 percent, 49.40 percent, 37.20 percent, 56.10 percent, and 25 percent respectively saw high-grade fever, chills, vomiting, cough, and headache. In 63.41 percent of children, Eschar was shown. The typical findings were lymphadenopathy (68.30 percent) and hepatomegaly (more than 57 percent). In 47.56 percent, 25.60 percent, 39.63 percent, and 37.19 percent, shock, respiratory failure, pleural effusion, and ascites were observed. Popular lab results were anemia (70.12 percent) and thrombocytopenia (74.40 percent). Complications were recorded in shock (47.56 percent), ARDS (10.36 percent), meningoencephalitis (7.32 percent), and MODS (1.22 percent). The complications were treated with doxycycline (51.21 percent), azithromycin (12.80 percent), and both drugs (35.97 percent) were used to treat the complications.Conclusions: When a child presents with acute febrile illness, hepatosplenomegaly, lymphadenopathy, anemia with thrombocytopenia, and features suggestive of capillary leak diagnosis of scrub typhus must be considered. Doxycycline or azithromycin, proper fluid boluses, inotropes, and O2 through Jackson-Rees circuit are life-saving for scrub typhus and its complications.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210661
      Issue No: Vol. 8, No. 3 (2021)
  • Mycoplasma pneumonia among children with acute respiratory infection

    • Authors: Anjali Ann Chacko, Ramaraj Subbiah, Tharun C. Varghese, Kundoly Velayudhan Susheela
      Pages: 550 - 553
      Abstract: Background: Acute respiratory infection (ARI) is one of the leading causes of mortality and morbidity in children. Mycoplasma pneumonia remains the most common species causing ARI in school going children. IgM ELISA is considered as the single most appropriate test for diagnosis of acute mycoplasma pneumonia infection. Objectives of the study was to assess the proportion of mycoplasma pneumonia among children aged 2-12 years admitted with ARI using IgM ELISA kit.Methods: Study design included prospective descriptive study. Study carried out at Amala institute of medical sciences, Thrissur, Kerala, India. Study period from January 2019 to June 2020. Inclusion criteria included all children between age group 2-12 years admitted in paediatrics department with clinical features of ARI. Exclusion criteria excluded parents/patients who are not willing to participate in the study and patients who are known cases of reactive airway disease. A total of 124 children, aged 2-12 years with clinical features of ARI admitted during January 2019 to June 2020 were included in this study. This was to know the proportion of Mycoplasma pneumonia among these children using IgM ELISA test kit and to understand their clinical profile.Results: 71 were males. Mean age of children in the study group was 4.4±2.4. IgM ELISA was positive in 9 subjects (7.3%). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 50, 85, 40, 89.7 and 79.5% respectively.Conclusions: Prevalence of Mycoplasma pneumonia in our population based on IgM ELISA was 7.3%. Mycoplasma pneumonia IgM ELISA test is superior to cold agglutinin test.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210662
      Issue No: Vol. 8, No. 3 (2021)
  • Effectiveness of montelukast in childhood asthma: a prospective
           observational study

    • Authors: Krutika Gangdev, Hemant Jain, Atul Luhadia
      Pages: 554 - 560
      Abstract: Background: Asthma is characterized by hyperresponsiveness of airways to various stimuli, manifested by widespread narrowing of airways causing paroxysmal dyspnoea, wheezing or cough. Most asthma medications are inhalational and compliance is difficult. So, development of an orally active and once daily drug with additional bronchodilator properties would lead to a major advance for managing young patients with asthma.Methods: Children between 6-18 years with not well controlled asthma on daily controller therapy were enrolled. Their personal data and history regarding the duration of asthma symptoms, frequency and severity of exacerbations was noted. Diagnosis and grading of severity of asthma was confirmed by spirometry. Then subjects were started on montelukast as add on to their daily controller therapy and were reassessed at 4, 8 and 12 weeks by clinical symptoms and PEFR. The change in frequency of symptoms and PEFR at the end of 12 weeks gave the outcome of efficacy of montelukast. Side effects of montelukast were also assessed.Results: Among total 64 subjects, at 4 weeks, 52 improved to well-controlled asthma. The remaining 12 did not improve, so required an increase in dose of their daily controller medication. Out of those 12 subjects, 10 subjects improved to well-controlled asthma at 8 weeks and 2 subjects still did not improve, so, their inhaled corticosteroids (ICS) dose was further increased. All 64 subjects showed improvement at 12 weeks. No serious side effects were observed.Conclusions: 81.25% subjects showed improvement at the 1st follow up itself and no serious complications were observed. So, it can be suggested that montelukast is a safe drug.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210663
      Issue No: Vol. 8, No. 3 (2021)
  • The circumcision blues: a case report with literature review

    • Authors: Meng Li, Kristen C. Lee, Thomas A. Nakagawa
      Pages: 561 - 564
      Abstract: An 11-day-old Caucasian male developed acquired methemoglobinemia as a result of repeated exposure to topical lidocaine/prilocaine cream following a circumcision. Our patient responded well with treatment of a single dose of intravenous (IV) methylene blue. Methemoglobinemia is a rare but well-explained complication of local anesthetics. It is important for providers to prescribe local anesthetics safely to avoid serious complications, especially with neonates who are at higher risk of developing methemoglobinemia.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210664
      Issue No: Vol. 8, No. 3 (2021)
  • Common variable immunodeficiency disorder associated with bronchiectasis:
           a case report

    • Authors: Mohammad Zahirul Islam Khan, Kamrul Laila, Mohammed Mahbubul Islam, Mohammad Imnul Islam, Shahana Akhter Rahman
      Pages: 565 - 568
      Abstract: Common variable immunodeficiency disorder (CVID) is the commonest type of primary immunodeficiency disorders (PIDs) characterized by hypogammaglobulinemia, defective specific antibody production and increased susceptibility of recurrent infections. Autoimmunity, neoplasm and lymphoproliferative disorders are usually associated with CVID. In most cases, the cause is unknown, but multiple gene mutations (10%) may be associated with CVID. Here, we report an eight years old girl with CVID presented with recurrent infections, growth failure, generalized lymphadenopathy and hepatosplenomegaly. Chest examination and radiological findings of this girl were consistent with bronchiectasis. Lack of awareness among health care providers is the reason for delayed diagnosis of several years for this girl. Therefore, it is essential to raise awareness regarding PID patients among the physicians to improve the quality of life.  
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210665
      Issue No: Vol. 8, No. 3 (2021)
  • Cockayne syndrome, xeroderma pigmentosa: a rare case report

    • Authors: Latha Gowdru Shamanuru, Veeresh Babu Doddamane, Veeranna Preeti
      Pages: 569 - 572
      Abstract: Cockayne syndrome is a rare autosomal recessive disorder characterized by premature ageing (progeria), facial anomalies, cachectic dwarfism, mental retardation, cutaneous photosensitivity, and retinopathy, loss of adipose tissue and muscle, and neurological abnormality which are associated with the changes in the brain parenchyma. The findings of computed tomography scan and especially magnetic resonance imaging of the brain support the clinical diagnosis of CS. There is no permanent cure of this condition and death usually occurs in the second or third decade due to functional disability and multiple infections.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210666
      Issue No: Vol. 8, No. 3 (2021)
  • Neurological presentation of Wilson’s disease without overt hepatic

    • Authors: Sunita Arora, Arshpuneet Kaur
      Pages: 573 - 575
      Abstract: Wilson disease (hepatolenticular degeneration) is a rare autosomal recessive disease. Here, we report a child affected by Wilson disease with only neurological manifestations without hepatic involvement.  
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210667
      Issue No: Vol. 8, No. 3 (2021)
  • Hypo-cortisolism, early onset obesity and liver disease in a child with
           homozygous proopiomelanocortin mutation

    • Authors: Rajesh Joshi, Krishna Malagi
      Pages: 576 - 577
      Abstract: The peptide derivatives of proopiomelanocortin molecule are involved in energy homeostasis, regulation of food intake, skin pigmentation and augment biliary flow. Homozygous mutation in POMC gene, which is inherited in an autosomal recessive pattern, is associated with hyperphagia leading to early onset obesity, hypoglycaemia and neonatal cholestasis due to cortisol deficiency and red hair pigmentation as a result of alpha MSH deficiency. We report a child having multiple episodes of hypoglycemia with this disorder who presented like liver disease. Our case report highlights the importance of early suspicion of this rare condition and confirmation with genetic analysis.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210668
      Issue No: Vol. 8, No. 3 (2021)
  • Spigelian hernia with bilateral undescended (impalpable) testis in a
           child: rare scenario

    • Authors: Gaurav Singh, Garvita Singh, Satish K. Aggarwal
      Pages: 578 - 580
      Abstract: Spigelain hernia (SH) is rarely seen in children. Various mechanisms has been described for the co-existence with cryptorchidism. A 4 month old boy, a known case of bilateral impalpable testes and intermittent right lower abdominal swelling was brought to paediatric emergency with complaints of excessive cry, poor feeding and irreducible right lower abdominal swelling - the swelling was a little higher than the usual inguinal hernia. On exploration, SH was seen coming off the deep ring then turning around the conjoint tendon and dissecting between internal oblique and external oblique aponeurosis. The hernia contained oedematous but viable gut with compression over the testicular vessels. Gut was viable. The testes was mobilized and fixed into the scrotum. Left testis was impalpable for which nubbin excision was done at a later date. A SH in the lower abdomen may be confused with a high inguinal hernia. In acute obstruction, emergent exploration and reduction is the cornerstone of treatment.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210669
      Issue No: Vol. 8, No. 3 (2021)
  • Menorrhagia in a teenager: a rare presentation of paroxysmal nocturnal

    • Authors: Salma Sadaf, Pushpalatha Kariyappa
      Pages: 581 - 584
      Abstract: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal disorder characterised by complement mediated hemolysis, thrombosis and bone marrow failure due to mutation of PIG A gene on chromosome X which codes for decoy proteins Glycoprotein anchor (CD55 and CD59) on hematopoietic stem cells. Onset of PNH is typically seen in adulthood. Pediatric cases account for 5-10% of all reported cases. It is largely underdiagnosed in children because of varied presentation and atypical symptoms. Here, we report a young girl who presented with menorrhagia and severe pallor which when evaluated unmasked the underlying PNH with aplastic anemia. She underwent a successful hematopoietic stem cell transplant. She has remained asymptomatic for 2 years highlighting the need for early evaluation and management for a better outcome.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210670
      Issue No: Vol. 8, No. 3 (2021)
  • Uncommon etiology of a common presentation

    • Authors: Akila Venkatkrishnan, Suresh Chelliah, Meganathan Pachamuthu, Sathia Dev Jayabalan
      Pages: 585 - 587
      Abstract: Intussusception is the most common cause of bowel obstruction in infants. The authors present a rare case of intussusception in a SARS-CoV-2 positive infant, and a severity score of 5 on HRCT. This is the first documented case of survival in SARS-CoV-2 patient where intussusception was the primary manifestation, which required surgical intervention.  
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210671
      Issue No: Vol. 8, No. 3 (2021)
  • Immune thrombocytopenic purpura with psoriasis: a rare association in

    • Authors: Karthik V Badarayan, Jitendra S. Oswal, Sunil V. Kapur
      Pages: 588 - 589
      Abstract: Autoimmune thrombocytopenia (ITP) is one of the best characterized autoimmune diseases which is classified into primary (idiopathic) and secondary forms. A high index of suspicion is warranted for the diagnosis of secondary ITP. There is limited data on association of ITP with Psoriasis. We herein describe a 11 years old girl who presented with a rare association of ITP and Psoriasis who responded to oral steroids.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210672
      Issue No: Vol. 8, No. 3 (2021)
  • An infant with hypertriglyceridemia presenting as failure to thrive: a
           case report

    • Authors: Rajesh K. Srinivas, Ashok Gupta, Priyanshu Mathur, Kamlesh Agarwal, Anil Sharma
      Pages: 590 - 593
      Abstract: Familial hypertriglyceridemia is rare in infancy. Diagnosis in infancy is very difficult and is usually diagnosed when acute pancreatitis sets in. Early diagnosis is important as it can prevent the complications associated with acute pancreatitis and pancreatic necrosis. Here is a case familial hypertriglyceridemia in an infant who presented to us with failure to thrive but was diagnosed early due to presence of highly viscous and milky blood. This holds importance as early treatment can reduce the complications and morbidity associated with familial hypertriglyceridemia.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210673
      Issue No: Vol. 8, No. 3 (2021)
  • Children with complex chronic conditions: an evaluation from the
           standpoint of academic publications

    • Authors: Karinne M. Carvalho, Mariana S. N. de Carvalho, Rafaela L. Grando, Livia A. de Menezes
      Pages: 594 - 601
      Abstract: Children with complex chronic conditions (CCC) belong to a distinct pediatric group, characterized by the (potential) manifestation of a wide range of pathologies requires long-term multidisciplinary health care, alongside recurrent hospitalizations and, in many cases, dependent on the use of technology for life maintenance. The need to seek, organize and disseminate bibliographic information on CCC led us to chart the scientific production on this theme, and a complete search of the academic publications was conducted in two scientific databases, the Web of Science and Scopus. The results indicate a significant growth in CCC research over the years, matching both, the increased number of cases and the consequent rise in life expectancy of these children. The scientific production on CCC is concentrated in the United States of America, reflecting and discussing the access to the health system of that country. We observed that the main thematic areas of the publications were related to hospitalization, health needs, coordination of care and oral health. Children have inequitable levels of access to treatment for CCC, according to family income, place of residence, educational level, race/ethnicity, evidencing the urgent need for formulation and implementation of public policies that address this portion of the population. Thus, it is expected that the present study will serve as a bridge guide for the development of potential new research projects, actions to promote and stimulate studies on this relevant theme and so far, neglected.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210674
      Issue No: Vol. 8, No. 3 (2021)
  • Pediatric tracheostomy in COVID-19 pandemic: a review

    • Authors: Santosh Kumar Swain, Ishwar Chandra Behera, Nishtha Ananda
      Pages: 602 - 608
      Abstract: Coronavirus disease 2019 (COVID-19) is a highly contagious infection caused by a novel strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity of the COVID-19 infection of the pediatric patient varies broadly between a mild cough and fever to severe form of diseases such as acute respiratory distress syndrome (ARDS) for which some may need intubation and followed by mechanical ventilation through tracheostomy in case of prolonged ventilation. Performing tracheostomy in pediatric patient pose a challenge for health care professional as there is high chance of spread of the disease in COVID-19 pandemic. Surgical tracheostomy is an aerosol generating procedure which causes high chance of spread of infections. There is increasing concern for high transmissibility of the virus to the operating surgeon with their assisting staff and other nearby patients. Pediatric tracheostomy should be performed with close association with pediatric otolaryngologists, anesthesiologists and pediatric intensive care physicians along with adequate personal protective equipment (PPE) for smooth and safe execution of the procedure.
      PubDate: 2021-02-23
      DOI: 10.18203/2349-3291.ijcp20210675
      Issue No: Vol. 8, No. 3 (2021)
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