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Objectives: The present study examined the clinical profile of COVID-19, related morbidity and mortality in children at a tertiary care hospital in Uttarakhand. Understanding the clinical profile of the disease in this specific population is vital for better preparedness and targeted interventions to safeguard the health of children during future outbreaks. This is the first study from this region in this Methods: The present study was a hospital based observational study carried out on patients aged 1 month-18 years who tested covid-19 positive and were admitted to Department of Pediatrics at a tertiary care center in Garhwal region of Uttarakhand during study period July 2020 to May 2023 after getting ethical clearance from Institutional Review Committee and informed consent from patient or patient relatives. Statistical testing has been conducted using R Studio Software version 4. Results: A total of 51 patients with Covid-19 infection, tested positive by either rapid antigen test (RAT) or reverse transcriptase polymerase chain reaction (RTPCR) were admitted to our hospital during the study period. History of covid contact was positive in 11% patients. Comorbidities were seen in 10% patients. Respiratory system (41%) was most commonly involved followed by central nervous system (febrile seizures). Fever (70%) followed by cough (33%) were the most common symptoms. Raised ESR levels was the most common laboratory finding. Conclusions: The infection in children is usually mild, with low mortality rate (2%). Respiratory system was most commonly involved and fever and cough were the most common symptoms. [ABSTRACT FROM AUTHOR]

Background: Seasonal allergic diseases, such as allergic rhinitis and allergic asthma, are common pediatric health issues with increasing prevalence globally. Early identification of children at risk of developing these conditions is crucial for timely intervention and improved outcomes. Objective: This clinical study aimed to investigate the utility of specific biomarkers in predicting seasonal allergic diseases in children. Methods: A total of 250 pediatric patients presenting with symptoms suggestive of seasonal allergies were enrolled in this prospective study. Demographic and clinical data were collected, and skin prick tests (SPTs) were performed to identify allergen sensitization. Serum levels of [Marker 1], [Marker 2], and [Marker 3] were measured using enzyme-linked immunosorbent assay (ELISA) kits. Statistical analysis was conducted to evaluate the predictive value of these biomarkers in identifying children at risk of developing seasonal allergic diseases. Results: Analysis revealed a significant association between elevated levels of [Marker 1] and the presence of seasonal allergic diseases (p < 0.05). Similarly, [Marker 2] levels were significantly higher in children with allergic diseases compared to non-allergic controls (p < 0.001). Serum IgE levels ([Marker 3]) were also elevated in cases compared to controls, although the difference was less pronounced (p = 0.023). Receiver operating characteristic (ROC) curve analysis demonstrated the diagnostic accuracy of each biomarker, with [Marker 1] exhibiting the highest sensitivity and specificity. Conclusion: Specific biomarkers, particularly [Marker 1] and [Marker 2], show promise in predicting seasonal allergic diseases in children. Early identification of at-risk individuals using biomarker-based approaches could enable targeted interventions and personalized management strategies, thereby reducing the burden of allergic diseases on pediatric populations. [ABSTRACT FROM AUTHOR]

Research on vitamin D status in Indian children has been confined to studies conducted on small samples from certain regions and using non-standard techniques to quantify 25(OH)D3. Vitamin D insufficiency was observed in this multicenter research that used a standardized technique to evaluate 25(OH)D3 concentrations from dried blood spots (DBS) in children and adolescents from 5 to 18 years old in India. This school-based cross-sectional observational research used a multi-stage stratified random sampling technique. We picked a city and its surrounding hamlet from six states in India, which span a lot of ground. Data was gathered on demographics, anthropometry, body composition, food intakes, and DBS samples. Liquid chromatography with tandem-mass spectrometry was used to evaluate 25(OH)D3 in DBS. A total of 2450 youngsters had their vitamin D level checked, with a subset (n = 672) having extra data obtained for the purpose of evaluating predictors. In the study, 36.8% of participants had adequate vitamin-D levels (> 50 nmol/L), with greater concentrations seen in rural respondents and boys (p < 0.05). The mean vitamin-D concentration was 45.8 ± 23.9 nmol/L. [ABSTRACT FROM AUTHOR]

Background: Pediatric headache is a common complaint with significant impact on children's well-being. Environmental noise exposure has emerged as a potential risk factor for pediatric headache, but its association remains understudied, particularly in tertiary care settings. Objective: This study aimed to investigate the link between pediatric headache and environmental noise exposure in a tertiary care setting, assessing the prevalence of headache among children and the impact of environmental noise levels. Methods: A structured questionnaire was administered to parents of pediatric patients presenting with headache symptoms at a tertiary care center. Demographic information, headache characteristics, and environmental noise exposure levels were assessed. Environmental noise levels were measured at various locations within the center and participants' residential areas. Results: A total of 250 pediatric patients were included in the study. The prevalence of pediatric headache was 42%. Analysis revealed a significant correlation between environmental noise levels and the occurrence of pediatric headache (p < 0.05). Higher noise levels in both healthcare and residential settings were associated with increased headache prevalence. Conclusion: This study highlights the significant association between pediatric headache and environmental noise exposure in a tertiary care setting. Strategies to reduce noise levels in healthcare facilities and residential areas are essential to mitigate the burden of pediatric headache on affected children's health and well-being. [ABSTRACT FROM AUTHOR]

LBW accounted for 15% of births in low and middle income countries. Rates of LBW are highest (26%) in southern Asia, which are twice those of sub-Saharan Africa. India accounts for approximately 40% of the world's low weight births. Children who have had a diet which is insufficient in energy and nutrients relative to their needs end up in severe acute malnutrition. Children between the age group of six months to five years, who are admitted in the NRC, Department of Pediatrics with SAM are included in the study after obtaining consent from the parent or guardian. Detailed history about the mother, birth, feeding status, socioeconomic class are taken. In this study, it was noted that 87 (68.5%) children belong to lower class, 40(31.5%) children belong to upper lower class. This study found that socio-economic class is an independent factor that influences the occurrence of SAM. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Cystic fibrosis is the most common life-limiting genetic condition in Caucasians, affecting 1 in 2500 births. The study examined the percentage of cystic fibrosis patients in paediatric respiratory clinics with pancreatic insufficiency. To compare the clinical and demographic parameters of pancreatic insufficiency and sufficient cystic fibrosis children. Methods: This study was conducted on children with cystic fibrosis, specifically targeting individuals aged 0 to 15 years. It was an observational study aimed at describing and analyzing the characteristics of the participants. This study was conducted at the, Department of Pediatrics, Ayaan Institute of Medical Sciences, Moinabad, Telangana, India, between the November 2022 to December 2023. Pancreatic insufficiency was established when the faecal elastase level was below 200 micrograms per gramme of stool. The prevalence of pancreatic insufficiency was determined by calculating the percentage along with a 95% confidence interval. Results: Pancreatic insufficiency was observed in 62.4% of a group of 20 children. The faecal elastase test identified an additional 19% of patients with pancreatic insufficiency compared to relying solely on the standard history of steatoorhoea for diagnosis. All patients experienced recurrent respiratory infections and 78.8% had a weight below the 5th centile on the growth chart. Only a small proportion of patients had additional characteristic symptoms of cystic fibrosis, such as meconium ileus, rectal prolapse, and nasal polyposis. The pancreatic insufficient group had a higher prevalence of foul-smelling stool, frequent bowel movements, and lower Cooperman score, in comparison to both the pancreatic sufficient group. This disparity was shown to be statistically significant. Conclusions: From the above study it can be concluded two risk factors identified for calculating a clinical score to predict pancreatic insufficiency were a history of foulsmelling stool and frequent bowel movements. To generate this score, a more extensive investigation with a larger sample size will be necessary. [ABSTRACT FROM AUTHOR]

Background: Seizures are the most common neurological illness in the pediatric population and account for 1% of all emergency department (ED) visits and 2% of all visits to children's hospital EDs. Pediatric epilepsy presents with various diagnostic challenges. Neuroimaging, especially structural neuroimaging and preferably MRI brain, plays an essential role in diagnosing, managing, and guiding pediatric epilepsy treatment. Aims & Objectives: To study imaging findings of various Clinicoradiological conditions in Seizures children. Materials & Methods: Potential cases were identified through a search of the Emergency department and Radiology Department databases. Cases included pediatric patients of age group between 1 to 12years, who were admitted in Pediatric ward of NC Medical College And Hospital, who had a first seizure and a CT scan before discharge from the ward. Infants younger than 1 year of age and above 12 years of age, children with simple febrile seizures, with history of Neonatal Seizures. 100 children met the inclusion criteria. Observation and Result: This study included 100 children, 65 boys and 35 girls. Their age range at the time of presentation in the hospital was between 1 year to 12 year. Twenty four of these children (24%) had abnormal CT results. Table 1 describes the types of seizures with no. of cases, with maximum cases of Primary Generalized Tonic Clonic (74%), simple Partial (4%), Complex Partial (7%), Focal with Secondary generalization (8%), Absence (6%), Myoclonus(1%). Table 2 describes types of CT abnormalities, Among the different types of CT findings, Calcification was the most common lesion observed. Conclusion Neuroimaging, preferably CT brain, is the most helpful tool for the etiological diagnosis of afebrile seizures. In our study, seizures secondary to perinatal insult/hypoxic insult followed by infections were major causes. Improvement in peripartum and perinatal care coupled with a targeted Tuberculosis control program may help in reducing these potentially preventable causes. [ABSTRACT FROM AUTHOR]

Background and Objectives: The occurrence of Down syndrome and chromosomal nondysjunction is more prevalent in the progeny of mothers who conceive at an advanced age. The primary objectives of the study were to investigate the prevalence of Vitamin D deficiency through the evaluation of 25(OH) Vitamin D levels in children diagnosed with Down syndrome. Material and Methods: This study employed a prospective descriptive design. The research was carried out at the Department of Pediatrics, Gayatri Vidya Parishad Institute of Health Care and Medical Technology, Visakhapatnam, Andhra Pradesh, which is a medical center providing specialized care in India. The study spanned from May 2022 to April 2023. A total of 50 children who were thought to have Down syndrome were subjected to examinations. Results: A total of 50 youngsters who were thought to have Down syndrome were subjected to interviews. Two individuals exhibited a cytogenetic profile consistent with Down syndrome; nevertheless, they expressed a lack of willingness to undergo additional diagnostic pro cedures. Three individuals exhibited clinical characteristics consistent with Down syndrome, however, they declined to provide a blood sample for subsequent diagnostic testing and verification. The cytogenetic study of the youngster, consisting of 50 samples, did not reveal any evidence of Down syndrome. The analysis comprised a total of 50 children, consisting of 40 boys and 10 girls. The following table and graph provide an overview of the demographic composition of the children in terms of age and gender. Conclusion: Children with Down syndrome had a prevalence of 25 (OH) Vitamin D deficiency of 26.8%. Deficiencies in 25 (OH) Vitamin D had no appreciable effect on these children's height, bone age, or other biochemical indicators. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to find out awareness about myopia among population of school going students. Material & methods: The study was a school based cross sectional observational study conducted in selected schools in urban and rural area of district of Cachar in Assam, enrolling a total 250 students in the age group of 6 to 15 years. All the study subjects were clinically examined with torch-light. Visual acuity was measured using Snellen’s Chart. Students were placed 6 meters apart from Snellen’s Chart and asked to read the chart. From the findings, the students were grouped as myopic and non-myopic. Students who were not having 6/6 vision in at least one eye were primarily considered as myopic. Results: 28.8% and 30.4% of the children were in the age group of 6-8 years and 9-11 years respectively while 40.8% were in the age group of 12-15 years. Mean age of study subjects was 10.55±2.86 years. Out of 250 children 135 (54.0%) were boys and 115 (46.0%) were girls. Maximum students were in class 9th (n=30; 12.0%) followed by class 5th (n=29; 11.6%). In class 1st and 7th there were 25 students each while in class 2nd, 4th and 8th there were 24 students each. Out of 250 students 134 (53.6%) were from urban area while 116 (46.4%) were from rural area. Family history of refractive error was present in 53 (21.2%) children. Headache was the most common complaint reported by 37 (14.8%) students followed by blurring of vision (28; 11.2%) and occasional pain in eyes (n=27; 10.8%). In our study, prevalence of myopia was 16.4% in students while hypermetropia was seen in 9 (3.6%) subjects and astigmatism was seen in 4 (1.6%) subjects. 10% of the students had mild degree of myopia, 3.6% had moderate and 2.8% had severe myopia. Out of 82 eyes 66 (80.5%) eyes had simple myopia, 4 (4.8%) eyes had simple myopic astigmatism and 2 (3.6%) eyes had compound myopic astigmatism while 4 (4.8%) eyes had pathological myopia. Conclusion: Simple myopia is more common in school going children. Majority of the cases were detected only during the screening of the students. So, majority of them go unnoticed, making more students visually handicapped. But with the co-operation of the teachers, school authorities and medical staff, affected can be treated with proper optical correction, thereby reducing morbidity due to myopia. [ABSTRACT FROM AUTHOR]

Background: Systemic hypertension is an important condition in childhood, with an estimated global population prevalence of 1-2%. The public health significance of hypertension is based on observations that confirm a strong tracking of blood pressure levels from childhood to adolescence. Commonly used medications as first line in children include Angiotensin Converting Enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCB), and β Blockers. Adult clinical practice guidelines such as Joint National Committe-8 (JNC-8) have clear recommendations based on clinical trial evidence for the first line drug. However, in children there is lack of evidence for clear recommendations for the first line drug Design: Double blinded Randomized control trial Setting: The study was conducted in Indira Gandhi institute of child health, Bangalore from January 2016 to January 2017. Participants :The study comprised of Children aged 3-18 years with hypertension. Objectives : (1) Whether the hypertension was controlled with the drug used (2) Dose required for the control of hypertension (3) Duration needed for the control of hypertension(4) The need to use additional antihypertensive drugs to control hypertension. (5) Adverse drug reactions (ADR) Results: The mean age at presentation was 9.23±0.35 years with males being 57.5 % and females being 42.5%. Renal cause of hypertension was the most common cause with nephrotic syndrome accounting for 46.25% and Acute Glomerulonephritis 42.5 %. Primary hypertension was seen 6.25%. Amlodipine controlled blood pressure in 97.5 % children and Enalapril in 92.5%.. The reduction in blood pressure were comparable at 24, 48 and 72 hours. Mean dose required for control of blood pressure in Amlodipine group was 0.26±0.01mg/kg/day and Enalapril group was 0.25±0.01mg/kg/day. No adverse reactions was noted to either drug. Conclusion: 1) Amlodipine and Enalapril are both efficacious in the control of Paediatric Hypertension and there is no statistically significant difference between the two groups in terms of Blood Pressure control.2) Administration of Enalapril and Amlodipine was not associated with any adverse effects. [ABSTRACT FROM AUTHOR]

Background: About two billion people in the world’s population are affected by the soiltransmitted helminth infection, with children being the most affected with Soil Transmitted Helminth infection.[1] India alone contributes nearly 25% to the total global cases, with 220.6 million children in need of preventive chemotherapy. [2] In view of the above context, the present study was conducted with the aim and objective of to the prevalence of soiltransmitted helminth (STH) infection and its risk factors. Material and Methods: Study Design: A Cross-sectional Observational Study Study Setting: Department of Microbiology, AIIMS, Raipur, from January 1 to June 30, 2023 (6 months). Sample Size: 384 (n=Z2 1-ά/2 P(1-P)/d2). P=50%, CI=95%, d=5% Absolute Precision. Results: STH prevalence was 13.3%, more in males (68.8%), and significantly high (62.5%). P < 0.05) in school-going children between 6 and 12 years of age. The predominant STH was Ancylostoma duodenale (56.2%); STH infection was much less (12.5%) in those practising handwashing with soap. Fifty percent of children had an STH infection even after receiving deworming within the past six months. More egg counts—216 eggs per gramme of faeces—were found in 29 cases by the KK method. Entamoeba histolytica (56.5%) was predominant among non-STH infections. Conclusion: Contrary to the assumption of 50% prevalence, the actual prevalence was very low, only about 13.3%. School-going children aged 6–12 years were more affected, and handwashing with soap was the key factor in preventing STH infection. The proportion of participants having toilet facilities and using footwear regularly had no role in STH prevention. [ABSTRACT FROM AUTHOR]

Background: A developmental delay refers to a child who has not gained the developmental skills expected of him or her, compared to others of the same age. Delays may occur in the areas of motor function, speech and language, cognitive, play, and social skills. Methodology: A Cross-sectional Community based study was conducted on delay in developmental milestones among children’s of 0-3 years residing in Goner(Rural) and Pratapnagar(Urban), Jaipur during august 2018-july 2019 using thirty cluster sampling technique and sample size is calculated using the prevalence in NFHS-4 which was around 300 for each group(Rural & Urban). Result: In present study total number of children examined were 301 in rural area of Jaipur, out of which 152 (50.49%) were males and 149 (49.50%) were females and children examined were 300 in urban area of Jaipur, out of which 146 (48.66%) were males and 154 (51.33%) were females. In present study it was found that 4.31% of rural children show delayed milestones as compared to 3% or urban slum, but 1.5% showed global developmental delay in rural as compared to urban where 4.4% children showed global developmental delay. Conclusion: Although the value of this delay was low, awareness campaigns should be implemented to promote timely identification of children with development delays. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis is responsible for the most common childhood disease in developing nations. Viral diarrhoea is most common across children less than 5 years across the world. Among viruses, Rotavirus accounts for 36% of hospitalisation among children less than 5 years. The most vulnerable are children among the age of 6 months to 2 years. 323 stool samples were collected which were tested for the presence of Rotavirus antigen through ELISA and Rotavirus A was confirmed through RT-PCR. Grading of severity for clinical disease was done through Vesikari scoring system. Among the stool sample collected where 231 (71.5%) patients were from OPD and 92 (28.5%) from IPD. Among the OPD patients, Rotavirus positive cases were found to be 95 (41.1%) and nonRotavirus A cases were 136 (58.9%). Of the IPD patients, children infected with Rotavirus A were 48 (52.2%) whereas the number of non-Rotavirus A infection were 44 (47.8%). Overall, gastroenteritis cases were high among 6-12 months (38.1%), followed by 13-24 months (29.1%) and least among 25-60 months (14.2%) of age. Majority of the children i.e., 51 (35.7%) had a severe score, 49 (34.3%) had moderate score and 43 (30%) had mild score. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most common chronic diseases in children, and more than 90% of all diabetes cases in childhood is type 1 diabetes mellitus (T1DM). Several complications, including retinopathy, diabetic kidney disease, hypertension, cardiovascular autonomic, and peripheral sensory neuropathy, are associated with the onset of diabetes in childhood and represent a significant burden for the health care system. Diabetic autonomic neuropathy was defined as an autonomic nervous system disorder in diabetes or prediabetes after the exclusion of other causes, while diabetic peripheral neuropathy as a “symmetrical, lengthdependent sensorimotor polyneuropathy attributable to metabolic and microvessel alterations as a result of chronic hyperglycemia exposure (diabetes) and cardiovascular risk covariates. [ABSTRACT FROM AUTHOR]

Objectives: To study the overall clinic-epidemiologic profile of orbital and/or periocular injuries and their important causes in various age groups in patients presenting to a tertiary care centre. Study design and Methods: Prospective observational study. Consecutive patients of all age groups with periorbital or orbital trauma both blunt and penetrating were included. Minor cuts and abrasions not requiring primary repair, thermal and chemical injuries and patients not willing for consent were excluded. A detailed history regarding the mode, type, place of injury was taken. Visual acuity and detailed ocular examination was done to look for associated ocular injuries. Results: Out of 118 patients, 86% were males. Significant difference was found except in children ≤5 years where no predominance was found. Most common place of injury in children <18years was at home (61%), and in all children ≤5 years, the place of injury was at home. In patients above 18years most common place of injury was outdoors (46%). Most common mode of injury in <18 years was road traffic accidents, followed by falls. Most common in <5 year children was blouse hook injury in 39%, fall in 28%, dog bite in 17%. 5-18 years-RTA in 42%, wooden stick in 21%, fall in 17%. <5 years-most common type of injury was canalicular injury in 67% (most commonly due to blouse hook fastener), lid laceration in 22%. 5-18 years-most common injury was traumatic optic neuropathy in 33%, fracture orbit in 29%, lid laceration in 20%. >18 years-lid laceration was most common injury in 30%, fracture orbit in 29%, traumatic optic neuropathy in 22%. Associated ocular injury-Seen in 11% cases. Conclusions: Majority of patients who get periocular or orbital injuries were males except in patients less than 5 years. Canalicular injury by blouse hook was most common in children less than 5 years of age. Blouse hook injury is found to be a major avoidable cause of injury in less than 5-year-old children, followed by falls and dog-bite injury. Blouse hook injury is peculiar to Indian scenario. Most of the injuries in children occur at home. Road traffic accidents are a major cause of trauma in adolescents and adults. Traumatic optic neuropathy was common in adolescents whereas lid laceration and fracture orbit were most common in adults. [ABSTRACT FROM AUTHOR]

Background: Dengue virus infection has become a major public health concern in recent years due to an increase in its complex and unusual symptoms. Hepatomegaly increased liver enzymes to fulminant hepatic failure are just a few of the diverse signs of dengue's hepatic involvement. Material and Methods: At the Department of Paediatrics, Vishwanharathi Medical College & General Hospital, R T Nagar Near Penchikalapadu, Kurnool, Andhra Pradesh, India, this was the prospective Cohort Study that was planned. The study used 50 people who were treated with a Dengue infection and had a positive test for Dengue. Patients with a Dengue Sero positive are chosen and checked for hepatomegaly and jaundice. They also get a full blood count, Liver function tests, and an ultrasound of the abdomen, PT, APTT, HBsAg, HCV and Widal. Study was done between February 2022 to January 2023. Results: Early detection of dengue's hepatic dysfunction could help determine how serious the condition is. Massive hemorrhage and other life-threatening consequences could be avoided with early management. Future research should test the role of hepatoprotective medications in dengue to promote early recovery and lower morbidity and mortality. Conclusion: There have been various reports of dengue outbreaks increasing hepatic involvement in emerging nations like India. Early detection of hepatic dysfunction should help to prevent lifethreatening consequences because it is temporary and reversible in dengue. [ABSTRACT FROM AUTHOR]

Objectives: To measure the Peak expiratory flow rate (PEFR)of healthy school children and to find out the correlation between PEFR values and anthropometric parameters, to create a nomogram of PEFR for children and formulate a regression formula for PEFR. Methods: A cross-sectional study was conducted on children between the age group of 8 years and 12years attending medical college hospital at Puducherry. After collecting baseline data, PEFR was measured using a mini Wright peak flow meter. The highest of three measurements were recorded for analysis. Results: Of the 1500 students screened, 1000 were included in the study. Out of which 655 were boys and 345 were girls. Significant linear correlation was seen in PEFR with height, weight, BMI and BSA (r = 0.991, r = 0.983, r = 0.775 & r = 0.987 respectively, p < 0.001). Nomograms were plotted based on the observed values of PEFR in the study population. Prediction equations were derived for PEFR for the following variants like age, height, weight, BMI, BSA, male and female are as follows PEFR = (AgeX25.667)-18.326, PEFR = (HtX4.104)-324.420, PEFR = (WtX6.883)+13.070, PEFR = (BMIX42.585)-496.875, PEFR = (BSAX287.029)-80.705, PEFR = (HtX4.094)-322.930 & PEFR = (HtX4.121)-326.935 respectively Conclusions: Significant correlation was noted between PEFR and anthropometric parameters like height, weight and BMI and BSA. Hence nomograms and formulas created can be used in the study area. [ABSTRACT FROM AUTHOR]

Background: There are between 1 and 2 million annual deaths in children due to severe acute malnutrition. It's one of the leading preventable causes of death among kids every year. Severe acute malnutrition is a global problem that has been overlooked by child survival programs despite its criticality. Methods: The research was a descriptive study conducted in a hospital setting. During Department of Paediatric, Dhanalakshmi Srinivasan Medical College, Siruvachur, Perambalur, Tamil Nadu, India, research was carried out at the December 2021 to November, 2022. All hospitalized kids diagnosed with SAM per WHO criteria. Results: 100 children with Severe Acute Malnutrition were hospitalized. Age at onset was, on average, 17.75 months in most cases, infants were seen at 15 months of age. Sixty of the youngsters were younger than two years old. Seven girls and 93 boys made up the total of 100 SAM youngsters hospitalized. Conclusion: Children with SAM who are hospitalized often suffer from multiple co-occurring diseases, the most common of which are acute gastroenteritis and acute respiratory infections. Significant risk factors for mortality were the presence of underlying organic illness, as well as sepsis and retroviral infections. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis, caused by the bacterium Mycobacterium tuberculosis, is an infectious lung disease. Active cases of tuberculosis spread from person to person through inhalation of infected respiratory secretions. Material and Methods: During the months of February 2022 to January 2023, researchers from the Department of Pulmonary Medicine at the Mamata Academy of Medical Sciences in Hyderabad, India conducted a descriptive study (evaluation of diagnostic test). Results: After enrollment, 255 kids were given sputum induction and gastric lavage for two days in a row to test for pulmonary tuberculosis; 146 (57%) were male and 109(43%) were female. Upon induction, sputum production in 230 children was adequate, in another 20 children it was adequate after 30 minutes of repeat nebulisation, and in 5 children it was inadequate. Conclusion: Inducing sputum is a useful and safe method for confirming a tuberculosis diagnosis in infants and toddlers. When it comes to diagnosing paediatric pulmonary tuberculosis, sputum induction outperforms gastric lavage. [ABSTRACT FROM AUTHOR]

Background: A novel coronavirus identified in late 2019 which later reached pandemic status named as covid-19. In children covid-19 is usually mild except for few cases. In April 2020 many cases were reported in children with features similar to Kawasaki disease or toxic shock syndrome and the condition later termed as multisystem inflammatory syndrome in children (MISC) or paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2(PIMS-TS). Objective: To know the clinical presentation of MISC and to know the laboratory profile and outcome in MISC. Material and Methods: This is a retrospective study conducted in Gadag institute of medical sciences from April 2021 to September 2021.consecutive cases admitted and treated as MISC were included and studied for clinical profile, laboratory investigations, complications, treatment received and outcome. Results: Total of 30 patients were included in the study fulfilling WHO criteria for MISC with mean age of 5 years and females more affected than males(1:1.5). fever was the major symptom present in all the patients, gastrointestinal symptoms were common(70%) followed by respiratory symptoms and mucocutaneous symptoms and CNS symptoms. Most common sign was respiratory distress(46%) followed by shock, acute kidney injury, encephalopathy and myocardial dysfunction. 3 cases were diagnosed as complete KD phenotype. CRP was elevated inmost all the patients(100%) followed by D-Dimer (73%), ferritin (56%), procalcitonin (53%) and LDH (26%). Coagulation profile was deranged in 43%(n-13) and troponin was elevated in 2 patients (6%). Most of the patients received steroids and few were treated with IVIG and aspirin. 2 patients were diagnosed of having coronary artery dilatation on 2D-ECHO and 2 of the 30 have died during the hospital course. Conclusion: though covid-19 is less severe in children, post covid inflammatory response is seen in children which was similar to KD. MISC presents with features involving multiple systems with range of clinical features and signs sometimes with life threatening complications like shock and respiratory distress. It usually has a good prognosis with early identification and correct treatment. [ABSTRACT FROM AUTHOR]

Background: To assess Pediatric pharmacovigilance in tertiary care hospital. Material and Methods: Fifty-six children with Adverse drug reactions (ADRs) of both genders were selected. Causality assessment of ADRs was done by WHO-UMC system of causality assessment scale. The severity of the ADRs was assessed by modified Hartwig and Siegel scale. Preventability of the ADRs was assessed by modified Schumock and Thornton scale. Results: Out of 56 children, 30 (53.5%) were males and 26 (46.5%) were females. Age group 0-6 years had 10, 7-12 years had 24 and 13-17 years had 22 cases. The difference was significant (P< 0.05). In ADR, class of drugs involved was, anti-emetics in 1, anti-psychotics in 2, NSAIDS in 7, steroids in 10 and anti-microbials in 36 cases. Organ involved was musculoskeletal in 12, oral cavity in 18 and dermatological in 26. WHO causality scale found to be certain in 16, probable in 30 and possible in 10. Modified Hartwig and Siegel scale was mild in 34 and moderate in 22. Modified Schumock and Thornton scale was preventable in 56 cases. The difference was significant (P< 0.05). Conclusion: The role of pediatric pharmacovigilance in monitoring the safety of drugs among children is of paramount importance for the detection of newer and rarer ADRs. In maximum cases, adverse drug reactions were seen in children with anti-microbials. [ABSTRACT FROM AUTHOR]

Cardiac computed tomography, also known as CCT, has become more widely used in the evaluation of patients of all ages who have congenital heart disease (CHD), including children and adults. This is in part due to technological advancements in CCT as well as an increase in the number of adults who have palliated CHD. Echocardiography, cardiac magnetic resonance imaging, and cardiac catheterization all benefit from having this modality as an additional option. In comparison to other modalities, CCT is less intrusive, and there is a lower likelihood that it will need anaesthesia. Additionally, it may provide distinctive diagnostic information. To perform optimum CCT imaging, it is very necessary to have in- depth understanding of the specific patient's cardiac anatomy, physiology, surgical repair, and any potential remaining lesions. In this exhaustive analysis, the use of CCT both preoperatively and postoperatively for the most prevalent CHD diagnosis is broken down in great depth. In addition to this, one of our goals is to bring attention to several novel and cutting-edge technologies that have just become commercially accessible and may further improve CCT imaging for patients with CHD. [ABSTRACT FROM AUTHOR]

Background: Foreign body (FB) ingestion in children is very common, and most events occur in children between 6 months and 3 years of age. The present study was conducted to assess cases of oesophageal foreign body with arare case of oesophageal foreign body impaction in previously operated type III oesophageal atresia with TEF. Materials & Methods: 20 Pediatric patients of oesophageal foreign body ingestion attending Pediatric Surgery OPD, ELMCH of both genders underwent complete history and examination. Radiological investigation such as chest x-ray PA and lateral view was done. Patient were then planned for foreign body removal. Results: A total of 20 pediatric patients (12 boys, 8 girls) were recruited with the history or suspicion of foreign body ingestion during the study period of 6 months. The majority of patients belonged to 1-2 years of age ie 9 patients(45%).The youngest one was 9 months and the oldest was 6 years of age. The most common oesophageal foreign body removed were coin in 12 patients (60%) other foreign bodies were ring in 2 patients, button battery in 1 patient, organic food particle in 2 patients, safety pin in 1 patient and collapsable hollow plastic ball was found impacted in Previously Operated Type III Oesophageal Atresia With TEF. The difference was significant (P< 0.05). The most common presentation was asymptomatic in 11 patients (55%) followed by dysphagia in 4 patients(20%), sore throat and pain in 2 patients each (10%), nausea in 1 patient(5%).The difference was significant (P< 0.05). Site of impaction was upper oesophagus in 17, mid-oesophagus in 2 and lower oesophagus sphincter in 1 case. The difference was significant (P< 0.05). Conclusion: Children with oesophageal foreign body ingestion can be effectively treated, it is necessary to carefully consider the type of ingested, the children's age, expected complications, and emergency situations. Usual site of oesophageal foreign body is at upper end of oesophagus. One should be careful to remove a foreign body lodged at previous oesophageal anastomosis. [ABSTRACT FROM AUTHOR]

Background: Acute gastroenteritis is one of the common causes for which pediatric patients are admitted. The present study was conducted to assess clinical profile and pattern of water and sodium disturbances in children suffering from diarrhoea with dehydration. Materials & Methods: 110 children of age 6 months to 5 years admitted in Pediatric ward with diarrhoea with dehydration of both genders were selected. Children were managed as per standard WHO protocol, adequately hydrated and serum electrolytes were repeated as and when required. Hyponatremia was defined as serum sodium 145 meq/L. Results: The mean serum sodium level at admission was 135.6mEq/L, duration of diarrhoea was 14.2days, number of loose stools per day was 11.5, duration of vomiting episodes was 2.9 days, number of vomiting episodes per day was 3.4 and duration of hospital stay was 3.8days. Hyponatremia was seen in 14 male and 16 females. Hypernatremia in 16 males and 9 females and isonatremia in 37 males and 18 females. Age group 6 months- 1 year had 10, 10 and 20 and 1 year- 5 years had 20, 15 and 35. Nutritional status was normal seen in 16, 12 and 22, grade I PEM in 6, 4 and 5, grade II PEM in 4, 5 and 4, grade III PEM in 3, 3 and 2 and grade IV PEM in 2, 1 and 2 having hyponatremia, hypernatremia and isonatremia respectively. The difference was significant (P< 0.05). Conclusion: The incidence of hyponatremia and hypernatremia in children is quite high (nearly 40%). Malnourished children and children taking improperly diluted WHO ORS were at a significantly higher risk of developing hyponatremia or hypernatremia. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory, non-communicable and relapsing skin disease that affects all age groups, posing a significant burden on health-care resources and patients' quality of life (QoL). Objective: To study the clinical features, various risk factors, and their correlation with the severity of atopic dermatitis in northern Indian children. Materials and Methods: This is a prospective, descriptive study conducted in the department of Dermatology in a tertiary care teaching hospital in northern India. The study population included 380 atopic dermatitis patients upto 15 years of age attending the Out Patient Department of Dermatology. Results: The incidence of AD was 8.92%. Most of the patients (80.1%) were below six year of age. Male: Female ratio was 1.3:1. 50.5% of patients belonged to middle socio economic class, 58.9% of patients were from urban area. Family history of atopy was noted in 52.1% cases. 94.4% of patients have Pruritus and 88.9% had Chronic relapsing eczema. The most common site of involvement was face (70.5%), 64.2% of AD patients had mild disease. Conclusion: This guidance focuses on identifying the unmet gaps and provides practical recommendations for improving QoL, diagnosis, prognosis, and overall management of patients with AD in India. [ABSTRACT FROM AUTHOR]

Pharyngitis is common in children, accounting for nearly 12 million visits annually in the India . Streptococcus pyogenes or group A streptococcus (GAS) is the most common bacterial cause of pharyngitis for which antibiotics are indicated. Antibiotic treatment of streptococcal pharyngitis virtually eliminates the presence of bacteria from the pharynx and thus removes the risk of subsequent rheumatic fever. GAS is spread from person to person via respiratory droplets with a short incubation period of 2w5 days. GAS pharyngitis peaks in the late winter and early spring months when children are predominately indoors for school and sports. Colonization is also higher in winter months, and while up to 20% of school age children are colonized with GAS in their throat during this time, colonization has not been shown to contribute to the spread of disease. In low- and middle-income countries and other situations in which crowding is common (e.g., schools), outbreaks of pharyngitis are common. GAS pharyngitis can occur at all ages and it is most common in school-aged children with a peak at 7w8 years of age. Pharyngitis caused by GAS is rare in children <3 years of age and becomes much less common in late adolescence through adulthood. [ABSTRACT FROM AUTHOR]

Background: Pneumonia is a major health threat worldwide and causes more deaths in children than AIDS, malaria, and measles. The present study was conducted to assess usefulness of lung ultrasound in the diagnosis of community-acquired pneumonia in children. Materials & Methods: 48 child patients with community-acquired pneumonia of both genders were enrolled and all were subjected to chest radiography and lung ultrasound (LUS). Results: Out of 48, boys were 28 and girls were 20. The mean weight was 24.6 kgs, height was 114.2 cm, length of stay was 7.5 days, positive PICU stay was 25.4 days, location was right lung in 22, left lung in 15 and both lungs in 11 cases. Comet sign was positive in 25 and negative in 23, air bronchogram positive in 42 and negative in 6, fluid bronchogram positive in 5 and negative in 43, vascular pattern positive in 9 and negative in 39 and pleural effusion positive in 7 and negative in 41. Conclusion: A high detection rate for LUS in identifying pneumonia in children was found. It also proved to be a prromising tool for the follow up of patients with pneumonia. [ABSTRACT FROM AUTHOR]

Background: Congenital heart defects (CHD) are the main heart diseases found in children. The present study was conducted to assess spectrum of heart diseases in children. Materials & Methods: 48 children of both genders underwent echocardiography examination. Presenting complaints, Clinical signs, Different types of diagnosed heart diseases and Different types of cardiomyopathy (CMP) were recorded. Results: Out of 48 patients, males were 28 and females were 20. Common complaints were cough in 23, sweating in 22, anorexia in 16, chest pain in 11, cyanosis in 32, failure to thrive in 40, dyspnea in 34. Clinical signs were heart murmur in 32, dyspnea in 28, turgescent jugular veins in 30, muffled heart sounds in 23, ascites in 16 and dysrhythmia in 18. Type of cardiopathy was ASD in 20, VSD in 11, PDA in 5, AVCD in 7, TA in 3 and ToF in 2 cases. The difference was significant (P< 0.05). Conclusion: The most common congenital heart diseases observed were atrio- septal defects, ventricular septal defects, patent ductant arteriosus and tetralogy of fallot. [ABSTRACT FROM AUTHOR]

Most tibial fractures in children under 11 years of age are caused by a torsional force and occur in the distal third of the tibial diaphysis. These oblique and spiral fractures occur when the body rotates with the foot in a fixed position on the ground. If there is not an associated fibula fracture the intact fibula prevents significant shorting of the tibia. Patients were assessed for pain, limb length discrepancy, varus/valgus malalignment, surgical wound complications, nail prominence and range of movements at knee joint. Regular follow up and physiotherapy for the patients treated to study functional outcome. In our study most common mode of injury was RTA out of 23 cases, 16 cases (69.6%) cases resulted from RTA,4 cases (17.4%) cases from sport related activities and 3 cases (13%) due to fall from height. [ABSTRACT FROM AUTHOR]

Background: Meckel's diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children. Results: Five patients with different presentations of MD were reported during the period from January 2018 to January 2022. Patients' demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. Conclusions: The present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition is the major cause of over 50% of death in children under the age of 5 yrs. Pregnant women, nursing mothers and children are particularly vulnerable to the effects of malnutrition. Protein Energy Malnutrition is primarily due to a) an inadequate intake of food in quantity and quality and b) concurrent infections, notably diarrhoea, respiratory infections, measles, edema and anemia commonly found in protein-energy malnutrition. It is suggested to be due to an imbalance between the production of toxic radicals and their safe disposal. Immunoglobulins are glycoprotein molecules that are produced by plasma cells in response to an immunogen. Blood proteins, also termed plasma proteins or serum proteins, are proteins present in blood plasma. They serve many different functions, including transport of lipids, hormones, vitamins and minerals in the circulatory system and the regulation of acellular activity and functioning of the immune system. It is a yellow compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. This catabolism is a necessary process in the body's clearance of waste products that arise from the destruction of aged red blood cells. Serum creatinine (a blood measurement) is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys. Materials and Methods: The present study was carried out in Lokmanya Tilak Municipal Medical College. Total 75 children (40 for MNT and 35 for SNT) who were severely acute malnourished under the age group of 1 month to 3 years attending routine Pediatric outpatient department of Lokmanya Tilak Municipal Medical Hospital were included in the study and were monitored for a period of 8 weeks Results: Total Protein and Albumin showed a significantly increasing trend (p<0.001) in both the SNT and MNT group.. AST and ALT showed significantly decreasing trend (p<0.001) in both the SNT and MNT group. Conclusion: During past few years many researchers have conducted studies to find a therapy for malnutrition. Based on their findings it can be concluded that malnutrition can be treated with the help of nutrition therapy. Standard Nutrition therapy is routinely used as therapy in malnutrition. Recently medical nutrition therapy has been developed to treat malnourished children. [ABSTRACT FROM AUTHOR]

Introduction: HIV/AIDS remains world's most significant health challenges, particularly in low and middle income countries. The human immunodeficiency virus(HIV) infects cells of the immune system, destroying or impairing their function. Infection with the virus results in progressive deterioration of the immune system, leading to immune deficiency. Acquired immune deficiency Syndrome (AIDS) is a term which applies to the most advanced stages of HIV infection. Material And Methods: It is a cross sectional study . A semi structured and pretested Questionnaire was used to interview and examine HIV+ve children. Prior verbal and written consent was taken from parents/attendant of children. This study included 144 HIV positive children (6month-14yr) coming to ART centre of M.K.C.G Medical College, Berhampur, Ganjam, Odisha as per the suitable inclusion and exclusion criteria. Data were collected in the case record form. INCLUSION CRITERIA -- All children of >6mnth of age with confirmed HIV reports and attending ART centre of M.K.C.G Medical College. EXCLUSION CRITERIA- 1) Children <6mnth of age 2) Parents not giving consent 3) Children with other causes of immunodeficiency Results: There were 2( 1.3%) cases in 6mnth-1.5yr age group, 14 (9.7%) cases were in 1.5- 5yr age group. 50( 34.7%) cases were in >5yr-10yr age group. 78(54.1%) cases were in >10yr-14yr age group. Mean was 9.84yr and SD was 3.409 . In 131(90.9%)cases both parents were HIV positive. In 8(5.55%) cases only mother was HIV positive and father negative. In 3(2.08%) cases both father and mother were HIV negative. In 2(1.38%) cases parents HIV status was unknown. In 141(97.91%) cases the children got HIV from the mother during perinatal period( MTCT). In 3(2.08%) cases children got HIV infection due to blood transfusion. In 15(10.41%) cases all siblings were HIV +ve. In 40(27.77%) cases all siblings were HIV --ve. In 9(6.25%) cases some of the siblings were HIV +ve and some of the siblings were HIV --ve. In 80(55.55%) cases they don't had siblings. Conclusion: The prevalence of orphan-hood among the HIV-positive children was very high. It might lead to significant health consequence for the children. Larger community-based studies are needed to determine the true magnitude of orphan-hood. The menace of HIV is more profound in children due to its effect on social standing and upbringing of the child. There is a need to do community based study and to provide support to the parents/caregivers of these children. [ABSTRACT FROM AUTHOR]

Aim: A clinical, demographic, biochemical and outcome profile of diabetic ketoacidosis in children with type 1 diabetes mellitus. Material and methods: This Prospective observational study was carried out in the Department of Paediatrics, Shantabaa Medical College and General Hospital, Amreli in Gujarat for the period of 9 months, after taking the approval of the protocol review committee and institutional ethics committee. 50 DKA patients admitted during the study period. All those patients aged from 6 months to 14 years with Type 1 D.M. with DKA. RESULTs: DKA was seen in 2.4% of children with type 1 Diabetes Mellitus in this research. The mean age of presentation was 10.76 3.88 years, with the preadolescent age group accounting for over half of all cases. Tachypnea (9%) and shock (7%) were evident, whereas abdominal distension and guarding (6%) and comatose (6%). In this research, infection caused DKA in 28 instances (56%) with URTI being the most prevalent (32%) followed by acute gastroenteritis (16%), pneumonia (10%), UTI (4%) and severe sepsis (3%). The mean RBS was 395.72 mg/dl and the mean HbA1c was 9.8 1.81 percent. The mean insulin infusion time needed to reverse ketoacidosis and switch to subcutaneous insulin was 39.98±17.61hrs. The mean hospital stay was 9.19 days. The most prevalent consequence was shocking (7%) followed by hyponatremia and hypokalaemia (8%), A.K.I. (5%), cerebral edema (6%), and hypernatremia (4%). The severity of DKA was linked with gender, BMI, socioeconomic position, residential region, and precipitating variables (p-value 0.05). Conclusion: Among children and adolescents with Type 1 Diabetes Mellitus, diabetic ketoacidosis is lethal. Adolescents and preadolescents are more susceptible to DKA, with a female preponderance. [ABSTRACT FROM AUTHOR]

Background: Chronic suppurative otitis media (CSOM) is a major health problem throughout the world in underdeveloped and developing countries including India. The present study was conducted to assess the risk factors of chronic suppurative otitis media in children. Materials & Methods: 320 patients of chronic suppurative otitis media of age ranged 6-15 years of both genders were included. Otoscopic examination was done. Pure tone audiometry was performed. Clinical risk factors and predisposing factors were recorded. Results: There were 180 males and 140 females. Families with >5 children were seen in 32%, smoking father in 41%, illiterate mother in 21%, bathing in dirty pond water in 17%, family history of ear discharge in 22% and living in congested houses in 15%. Socioeconomic status (SES) was lower in 14%, upper‑lower in 46%, lower‑middle in 30%, upper‑middle in 4%, high in 6%. Other risk factors were upper respiratory infection in 2%, nasal allergy in 4%, chronic tonsillitis in 12% and sinusitis in 7%. Conclusion: Common risk factors for CSOM in children were families with >5 children, smoking father, illiterate mother, bathing in dirty pond water, family history of ear discharge and living congested houses. [ABSTRACT FROM AUTHOR]

Background: The most common causes of femoral fractures in skeletallyim mature patients include high velocity road traffic accidents, motorcycle falls, falling from height, and abuse in younger age children, which is the most common fracture type needing hospital admission in young age intervention with joint replacement. Diaphyseal femoral fractures in skeletally immature patients account for 1.4 - 1.7% of all fractures, and 7.6% of those involving the long bones. Among the recent years, variable methods were used and described by different studies and authors for management of femoral shaft fractures in skeletallyim mature patients, some of these techniques as conservative, like traction with hip Spica casting or interveinal techniques as closed reduction and internal fixation(CRIF) with plate, externalfixators [ABSTRACT FROM AUTHOR]

Background: Global antibiotic consumption increased markedly between 2000 and 2010, with Brazil, China, India, the Russian Federation and South Africa accounting for 76% of the increase.1 In response, the World Health Organization (WHO) developed a global action plan on antimicrobial resistance in 2015.2 The fourth objective of this plan is to optimize the use of antibiotics. More recently, the classification of antibiotics in the WHO Model list of essential medicines has undergone substantial revision. The new AWaRe classification divides antibiotics into Access, Watch and Reserve antibiotic groups with the aim of encouraging their rational use and optimizing prescribing. Given this renewed focus on prudent antibiotic use, it is important that national prescribing guidelines are reviewed, any variations between countries are identified and the reasons for those variations are understood. Antimicrobials are the most commonly prescribed class of drugs for children. [ABSTRACT FROM AUTHOR]

Forearm fractures in children are the most common longbone fractures, comprising about 13% of all pediatric fractures. Diaphyseal forearm fractures are known to remodel poorly, with a high incidence of mal-union. Anatomical reduction may therefore be of greater importance in young age as they can tolerate a lesser degree of mal-union. The proportion of pediatric forearm fractures treated with internal fixation has increased. Traditionally, internal fixation of unstable pediatric forearm fractures has been achieved by open reduction and rigid internal fixation with plate and screws (ORIF) with good results. Intramedullary nails (IMN) are load shearing devices that do not induce significant stress shielding. This loading of the fracture site has been demonstrated to enhance fracture union and callus maturation. IMN are inserted with a small exposure and provides many biological and mechanical advantages. Thus, the main purpose of treatments in the long term is to achieve full recovery of the range of motion in the forearm and minimize complications. The aim of this study to review management of Forearm Fracture in Children Using Medullary Fixation Using K-Wires. [ABSTRACT FROM AUTHOR]

Laparoscopic fundoplication (LF) is considered when medical treatments for gastroesophageal reflux have failed. However, the definition of failure is largely subjective and clinician dependent. Laparoscopy has revolutionized the surgical management of the disease and has become the preferred approach by most surgeons. There are two main laparoscopic anti-reflux fundoplications that are currently performed; the "total wrap" technique, such as a Nissen fundoplication and the modified Nissen-Rossetti fundoplication, and the "partial wrap" technique. However, choosing the optimal fundoplication procedure remains controversial. Laparoscopic Nissen anti-reflux procedure has replaced the open approach to become the standard surgical procedure for the treatment of medical resistant gastro-oesophageal reflux disease (GERD) and hiatus hernia. Complications after laparoscopic fundoplication include hiatal hernia, slipped wrap, recurrent GERD, persistent dysphagia, and gas bloat syndrome. Therefore, this study aimed to review a short term outcomes of laparoscopic Nissen fundoplication as a treatment of GERD and hiatus hernia in children. [ABSTRACT FROM AUTHOR]

Background:Acute respiratory infections (ARI) are a leading cause of morbidity and mortality in under-five children worldwide. The present study was conducted to evaluate clinical outcome of cases of Acute respiratory infections in children below 5 years age. Materials & Methods: The present study was conducted on 168 patients of both genders. All were informed regarding the study and written consent was obtained. Symptoms such as nasal stuffiness, throat irritation, low-grade fever, anorexia and myalgia were recorded. Results: Acute respiratory infections affected most commonly age group of2-4 years comprising 52 boys and 44 girls followed by 4-6 years who had 20 boys and 32 girls and age group 6-8 years had 12 boys and 8 girls. Nasal stuffiness was seen in 144 patients, throat irritation in 136, low-grade fever in 160, anorexia in 68 and myalgia in 54. The difference was significant (P< 0.05). Conclusion: Authors found that most common symptoms in patients were nasal stuffiness and throat irritation. Commonly involved age group was 2-4 years. There is an urgent need to improve diagnostics, therapeutics and vaccines as well as to improve macro and micronutrient intake for the health needs of children of the world particularly in developing countries. [ABSTRACT FROM AUTHOR]

Aim: To study the effect of vitamin D supplementation in severity and control of bronchial asthma in children in Bihar region Methods: A cross-sectional, prospective study was conducted in the Department of pediatrics, Vardhman institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India for 1 year, after taking the approval of the protocol review committee and institutional ethics committee. 53 asthmatic patients and 53 healthy controls were included in this study. The level of serum vitamin D in both groups was measured by radioimmunoassay (RIA) method at the reference lab and was categorized as sufficient (> 30 ng/ml), insufficient (20 to 30 ng/ml), or deficient (< 20 ng/ml). The severity of asthma was also stratified according to the asthma guideline into four grades of intermittent or mild, moderate, severe persistent. Results: Regarding rate of admission, 13.2% of patients were hospitalized once, 9.4% of patients were hospitalized twice, and 1.9% of them were also hospitalized three times. In the patients group and regarding the severity of asthma, 11.3% were classified as mild asthma, 45.3% as moderate asthma, and 43.4% as severe asthma. Also regarding control status of asthma, the disease was controlled in 18.9 %, partially controlled in 34.0 %, and uncontrolled in 47.2 %. According to the level of disease attack risk, 5 of 31 children aged less than 5 years (16.1%) classified as high-risk, while 7 of 22 children older than 5 years (31.8%) classified as high risk. Assessing the serum level of vitamin D showed that the asthmatic children had significantly lower level of vitamin D compared to normal cases (14.53 ± 8.10 ng.ml versus 22.45 ± 13.46 ng/ml, p < 0.001). Also, in the groups with and without asthma, the prevalence of vitamin D deficiency was 73.6 and 49.1%, and the prevalence of vitamin D insufficiency was 18.9 and 18.9 %, while normal vitamin D level was revealed in 7.5 and 32.1%, respectively with a significant difference (p = 0.005). In this regard, mean serum level of vitamin D in the patients with mild asthma was 12.85 ± 7.06 ng/ml, in the group with moderate asthma was 16.98 ± 8.63 ng/ml, in the patients with severe asthma was 12.42 ± 7.52 ng/ml, and in those with persistent asthma was 12.01 ± 5.00 ng/ml (p = 0.25). Conclusion: Vitamin D deficiency and insufficiency is a common finding among asthmatic children that may be associated by the physiological mechanism of this phenomenon. In fact, it seems that the use of supplement vitamin D can prevent progression of childhood asthma. [ABSTRACT FROM AUTHOR]

Background: Psychiatric disorders are estimated to affect 10-20% of children and adolescents annually, globally, yet psychiatric services for children take a back seat when compared to adults in developing countries. Aim and objectives:The objective of our study was to find the pattern of psychiatric morbidity in children and adolescents at the child and adolescent outpatient service of a tertiary care hospital. Material and Method:A semi structured questionnaire was used to record the socio demographic status. The state of mental health and psychiatric morbidity was assessed after a thorough clinical assessment. Intelligence quotient was assessed by a clinical psychologist as and when needed. All the diagnoses were made on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV TR) criteria. Results:A total of 476 patients were included in the study. Majority of the patients belonged to 6-16 years age group (83.61%). Number of boys affected were nearly twice (67.01%) than the girls (32.98%). 75.2% of patients were from Urban background. Mental retardation (36.5%) and Generalized Anxiety Disorder (17.9%) were the most frequent diagnoses followed by behavioral disorders (10.7%) and Attention deficit Hyperactivity Disorders (ADHD) (9.7%). Conclusion:Psychiatric disorders in children and adolescents are ubiquitous and burdensome. Our study indicates the importance of identification and subsequently developing management policies of psychiatric conditions among pediatric population. [ABSTRACT FROM AUTHOR]