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A rich and long-standing history of creative arts as an instrument for healing, growth, and self-expression, especially amongst children and youth, has been well-documented across time and cultures. Arts-based therapies within the mental health community have also garnered increasing support for positively contributing to the well-being of various groups and individuals. Therefore, this article further examines the use of arts-based therapy in an eight-session therapeutic group with children. Five children in the age range of 9–12 years met weekly for a course of two months at a child and adolescent mental health service in Delhi-NCR, India. Over the course of these 8 sessions, the individual and collective journey of the group members witnessed many ebbs and flows, eventually leading to a positive shift in the inter-group dynamics. In addition, various therapeutic gains were observed and reported for the group members, showing an increased sense of collaboration, confidence, and community. [ABSTRACT FROM AUTHOR]

Background: Congenital heart disease (CHD) is one of the commonly seen malformations, with incidence varying from 7 to 8/1000 live birth. Causes are multifactorial. Routine examination of neonates may miss more than 50% of cases. Pulse oximetry is a simple, noninvasive, bedside test which estimates the percentage of oxygen bound to hemoglobin (oxygen saturation [SpO2]). Detection of critical CHD (CCHD) has been possible with SpO2 screening. Many countries included SpO2 as part of newborn screening due to this. As a primary approach, both pre- and post-ductal extremity SpO2 is measured after 24 h of life. Echocardiography (ECHO) will be done on neonates with SpO2 readings <95%. Neonates born in high-altitude regions, studies have suggest to use adjusted threshold values. In India, there are limited studies. Aims: The aim of this study was to determine the usefulness of pulse oximetry as a screening tool for early detection of CHD in otherwise asymptomatic newborns. To determine, the accuracy of SpO2 for detecting clinically unrecognized CCHD in newborns. Materials and Methods: This is a prospective observational study done in the department of pediatrics in a tertiary hospital. The study was conducted over 12 months. During the study period, all neonates born who fulfilled the inclusion criteria were included in the study. After 24 h of life, neonates were examined clinically and the pre- and post-ductal SpO2 was measured. Neonates with SpO2 <90% in room air were excluded from the study. If the SpO2 was between 90% and 94%, clinical examination was repeated, if suspicious of CHD, they were referred for ECHO. If there was no suspicion of CHD, SpO2 was repeated after 6 h and ECHO was done if SpO2 ≤95. The difference of SpO2 >3% between the right upper limb and right lower limb was considered positive. Positive neonates were evaluated with two-dimensional echocardiograph. Inclusion criteria - All hemodynamically stable neonates were born during the study period. Exclusion criteria (1) Antenatally diagnosed cardiac anomalies, (2) Outborn neonates, (3) Parents/guardians are not willing to participate in the study and/or further investigation, (4) Sick neonates and those with SpO2 <90% at birth. Results: 1117 (83.7%) were eligible for the study out of 1333 neonates born. 669 (59.9%) were born by cesarean section and 448 (40.1%) by vaginal delivery. 996 (89.2%) were born at term (≥37 weeks of gestation) and 121 (10.8%) were preterm (<37 weeks of gestation). The male-to-female ratio was 1.03:1. The mean birth weight of the neonates was 2.91 ± 0.46 kg (mean ± standard deviation). The mean SPO2 in the right upper limb was 96.62 ± 1.73, in the right lower limb was 96.87 ± 1.76, in the left upper limb was 96.59 ± 1.90, and in the left lower limb was 97.06 ± 1.74. The average SPO2 difference between the right upper limb and right lower limb was 1.04 ± 1.07. Based on SpO2, 858 (76.8%) cases were not suspected of having CHD and 259 (23.3%) were suspected of having CHD and were evaluated with ECHO. Six (0.5%) neonates had CHD in whom echo was done. In our study, for detecting CCHD, SPO2 cutoff value of ≤90% showed 90% sensitivity, 99.94% specificity, 75% positive predictive value, and 99.98% negative predictive value. Conclusions: This study emphasizes noninvasive SPO2 as reliable and feasible, with good negative predictive value screening for CHD in neonates. [ABSTRACT FROM AUTHOR]

Introduction: Preterm infants' thermoregulation in the first few minutes after birth remains a contentious issue, but studies show that focusing on the issue and developing a guideline can reduce hypothermia in these patients. By implementing the thermoregulation bundle, this study aims to reduce the incidence of hypothermia on admission to the neonatal intensive care unit (NICU) by 50% in infants born at 32 weeks' gestation or less. Materials and Methods: Neonatology unit at a private medical college in the Chennai district was studied for 6 months from July 2021 to December 2021. The Plan-Do-Study-Act cycle from the "WHO Point-of-Care Quality Improvement Model" was used. Thermoregulation bundle was used to standardize thermoregulation management from predelivery through admission to the NICU. Results: The NICU temperature had spiked significantly to 36.38°C ± 0.67°C (P < 0.001) from the previous two readings, which was statistically significant (P = 0.001). Results from Bonferroni corrections show that the temperature induced during implementation had a statistically significant increase in temperature (23°C vs. 34°C, respectively) from the delivery point to the point of baby shifting (P = 0.001) which accounted for a 67% reduction of hypothermia. Conclusion: The present study successfully achieved its objective of reducing hypothermia by more than 50%, with a rate of 67%. Premature infants can be saved from hypothermia by implementing a standard protocol in the delivery room at the time of baby transfer and admission to the NICU. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand the parental stress, psychological distress, and parenting practices of parents of pre-schoolers during the COVID-19 pandemic. Methods and Materials: An online cross-sectional survey was conducted with the parents of preschool children aged 3–6 years. Researchers used the Parental Stress Scale, Self-Reporting Questionnaire, and Parent Practice Interview to collect data from parents in the Southern Indian city of Bengaluru. Results: A total of 60 responses were obtained from the online survey. Moderate to a high level of parental stress and mild to moderate levels of psychological distress were found among the parents. Around 21 (35%) of parents were found in need of mental health consultation. The study found no group differences in parental stress and psychological distress among various socio-demographic variables. The study found a significant association between parental stress and the parenting practices of participants. Higher mean scores were observed on mothers in setting clear expectations of pre-schoolers. Conclusion: Parenting young pre-schoolers is a difficult task. COVID-19 pandemic has made the parenting process challenging for parents. Parents must engage the children at home, and helping them cope with the new environment is a tightrope walk. Such uncertainties are supposed cause distress and lead to poor parenting parents among the parents, especially with pre-schoolers who are more demanding. There is a need to address parents' concerns and train them to deal with the situations effectively. [ABSTRACT FROM AUTHOR]

Objectives: Lead investigators in North Carolina found evidence that contaminated spices may contribute to children's elevated blood lead levels. We compared lead levels in samples of spices and other consumable products by country of purchase to inform consumer safety interventions and regulations. Methods: From February 1, 2011, through October 22, 2020, North Carolina lead investigators sampled spices and other consumable products from 103 homes of children with confirmed elevated blood lead levels. In 2017, the study team purchased 50 products frequently sampled during lead investigations, as a "market basket" sample, from local stores in or near Raleigh, North Carolina. The State Laboratory of Public Health analyzed 423 product samples using mass spectrometry. We extracted environmental sample results from lead investigations from the North Carolina Electronic Lead Surveillance System. Results: The median market basket lead result was 0.07 mg/kg (SD = 0.17); the maximum lead result was 0.88 mg/kg. The median home lead investigation sample result was 0.26 mg/kg (SD = 489.44); the maximum lead result was 6504.00 mg/kg in turmeric purchased in India. Among all samples, products purchased in India had more than triple the median lead levels (0.71 mg/kg) of those purchased in the United States (0.19 mg/kg). Conclusions: Purchasing spices in the United States is an action that consumers can take that may reduce their lead poisoning risk. Regulatory agencies should consider a lead limit of <1 mg/kg as attainable for spices sold in US stores and for ingredients of any foods that may be consumed by children. [ABSTRACT FROM AUTHOR]

The article advocates for an inclusive immunization schedule in India, emphasizing the need to extend the current program to cover individuals up to the age of 26. It highlights the potential benefits, including enhanced individual protection, reduced disease transmission and prevention of outbreaks and proposes a comprehensive vaccine schedule tailored to different age groups to address the unique healthcare challenges in India.

Background: Acceptance of vaccines has been on a decline in recent times, with vaccine hesitancy being listed as one of the top 10 global health threats. This study analysed vaccine hesitancy and belief towards vaccination among caregivers of children aged below 5 years. Methods: In this cross-sectional study, 196 caregivers of children aged 6 months to below 5 years who had attended an immunization clinic at a tertiary care institute of Eastern India from March to May 2019 were surveyed. Consecutive sampling was used to recruit eligible study participants. The survey assessed the attitudes of parents towards childhood vaccination by using the Vaccine Hesitancy Scale and their beliefs towards vaccination. Univariate analysis was performed to assess the association of various sociodemographic factors with vaccine hesitancy. Results: Among the caregivers, most (48%) mothers were aged 26–35 years, literate and homemakers. Vaccine hesitancy was observed in 9.18% of the participants. Only the age of the child was significantly associated with vaccine hesitancy. Nearly half (48.5%) of the participants were concerned about the serious adverse effects of vaccines, and a third (30.6%) agreed that newer vaccines are associated with higher risks than the older ones. Caregivers felt that vaccines are no longer required for uncommon diseases. Conclusion: Concerns regarding vaccine hesitancy are prevalent even among caregivers attending a tertiary care institute. Thus, additional studies are required to assess hesitancy in urban, rural, remote and inaccessible areas. Policymakers ought to conduct periodic assessments and implement necessary remedial measures for the long-term sustenance of the benefits of the national immunization programme. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic-caused burden among the pediatric age group was less in terms of severity and mortality; indirect impacts of the pandemic on the mental health of children are huge and largely unnoticed. The main objective of this exploratory study was to analyze the association between screen time exposures among preschool children aged 3-6 years during the lockdown period in Tamil Nadu, India. Materials and Methods: An exploratory and anonymous population-based e-survey through social networks, including social media platforms (Facebook, LinkedIn, and WhatsApp) and researchers' acquaintances (email), using a snowball sampling strategy was conducted among parents of preschool children (aged 3-6 years) residing in different states of Tamil Nadu. Data were collected using Google Forms, and statistical, analysis was conducted. Results: Among 427 study participants, the mean age of screen introduction was 19.88 ± 11.73 months, and the mean age of independent operation of screen devices was 3.29 ± 1.16 years. Demanding extra attention (25.53%), temper tantrums (21.31%), increased aggressiveness (19.90%), more fussy (18.74%), altered night sleep (18.5%), and clinging (18.27%) were the frequently reported behavioral changes apart from increased screen time (60.88%) and decreased physical activity (28.80%) during the lockdown period. Conclusion: Excessive screen time beyond the recommended 1 h/day was seen in 94.1% of children, and screen exposure was inversely correlated with the duration of outdoor play. Among the behavioral changes, temper tantrums and fussiness were found to be significantly associated with increased recreational screen time. [ABSTRACT FROM AUTHOR]

Background: Understanding the perceptions of patients regarding tuberculosis (TB) will enable better design of a comprehensive, client-oriented program for the disease. Methods: This study was conducted district-wise across India in 2015–2016 as part of the National Family Health Surveys (NFHS). Results: We discovered that the prevalence of TB remains significantly high, with quite a high percentage of people being unaware of the exact cause of disease proliferation. The majority of people believed that touching or sharing utensils can be a source of TB. This perception affected the participants' responses about seeking diagnosis and treatment. However, it is a good sign that most people knew that TB is a curable disease that can be prevented to some extent if immunization with the Bacillus Calmette-Guérin (BCG) vaccine is done at the correct stage. So, a large section of the population had their children vaccinated. In addition, they would go for diagnosis if they had symptoms suggestive of the disease. Conclusion: Findings from this study are indicative of the fact that a large population is aware that health facilities can make a significant contribution to the treatment of tuberculosis. There is a need to further investigate how this information could potentially be used to enhance early seeking of appropriate services among TB patients. [ABSTRACT FROM AUTHOR]

Background: Little information is available about dropout from treatment for children and adolescents attending the various psychiatric services. Aim: This study aimed to evaluate the drop-out rates of patients attending child and adolescent psychiatry services. Methods: A retrospective review of 2249 case records of all patients aged up to 15 years registered in child and adolescent psychiatry services from 1st January 2017 to 31st December 2018 was carried out. Details regarding socio-demographic data, clinical data and follow up status were extracted from the records. Results: The mean age of the study sample was 11.11(SD: 3.58) years. About two-fifth (n=1003; 43.99 %) did not follow up at all after the first walk-in contact. Additionally, about one-tenth (n=247; 11 %) dropped out by the one month of the first contact, another one-eighth (n=275; 12.2 %) dropped out by 3 months of the first contact with outpatient services and another one-eighth (n=301; 13.4%) dropped out of the follow-up by 6 months of the first contact. Only one-fifth (n=423; 18.8%) of the patients followed up beyond 6 months of the first walk-in contact. No significant difference was noted between those who continued to follow-up and those who dropped out in terms of age group, gender, and the number of diagnoses made at the initial evaluation. Those who dropped out of treatment were less often prescribed medications in the form of antipsychotics or antidepressants. Conclusion: This study shows that there is a high dropout rate from the child and adolescent psychiatric outpatient services. Accordingly, strategies need to be developed to minimize dropout rates. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children. Globally, there is huge disease burden, high treatment cost, and health impact beyond acute episodes due to RSV which necessitate development and implementation of preventive strategies for the control of RSV infection. The disease burden due to RSV in pediatric population across India is still not clearly understood so this literature review was therefore conducted to gather data on disease burden due to RSV in Indian pediatric population. Systematic literature search was performed using PubMed and Google search with different medical subject headings from 2007 to 2020. Studies performed in Indian pediatric population were selected for review. Literature review revealed that in India, epidemiology of RSV infection is well documented in young children (0-5 years) as compared to children from other age groups. The rates of RSV detection in various studies conducted in younger children (0-5 years) vary from 2.1% to 62.4% in India which is higher as compared to children from other age groups. In India, RSV mainly peaks around rainy to early winter season, that is, during months of June through October while smaller peak was noted during December, January, and February. In 2020, higher RSV-associated disease burden was reported among children (<5 years) in low-income and lower-middle-income countries. Considering significant disease burden due to RSV in young Indian children, availability of RSV vaccine would be crucial to prevent RSV infections in children and its spread in the community. [ABSTRACT FROM AUTHOR]

Objectives: To address pneumonia, a major killer of under-5 children in India, a multimodal pulse oximeter was implemented in Health and Wellness Centers. Given the evidence of pulse oximetry in effective pneumonia management and taking into account the inadequate skills of front-line healthcare workers in case management, the device was introduced to help them readily diagnose and treat a child and to examine usability of the device. Design: The implementation was integrated with the routine OPD of primary health centers for 15 months after healthcare workers were provided with an abridged IMNCI training. Monthly facility data was collected to examine case management with the diagnostic device. Feedback on usefulness of the device was obtained. Setting: Health and Wellness Centers (19) of 7 states were selected in consultation with state National Health Mission based on patient footfall. Participants: Under-5 children presenting with ARI symptoms at the OPD. Results: Of 4846 children, 0.1% were diagnosed with severe pneumonia and 23% were diagnosed with pneumonia. As per device readings, correct referrals were made of 77.6% of cases of severe pneumonia, and 81% of pneumonia cases were correctly given antibiotics. The Pulse oximeter was highly acceptable among health workers as it helped in timely classification and treatment of pneumonia. It had no maintenance issue and battery was long-lasting. Conclusion: Pulse oximeter implementation was doable and acceptable among health workers. Together with IMNCI training, PO in primary care settings is a feasible approach to provide equitable care to under-5 children. [ABSTRACT FROM AUTHOR]

Childhood anxiety disorders are common, chronic and cause impairment if left untreated. Early identification and treatment are, therefore, essential. Cognitive Behaviour Therapy (CBT) for children with anxiety has increasingly received attention from researchers worldwide. It is now accepted that CBT should be the first line of treatment for children with anxiety. The fact that it is based on skills training for the child and also incorporates parents as co-therapists make it important to establish a strong foundation for problem-solving, anxiety management and coping skills which will be useful for all future encounters with anxiety provoking situations. It is necessary to modify the CBT techniques based on the population that is being catered to, and it is also important to incorporate cultural, social and language factors into the modules that are created for specific populations. In India, common presentations of anxiety could be in the form of somatic symptoms or academic underachievement. The primary focus of this paper is to highlight the utility of this approach in low resource settings such as India with suggestions for its modifications for use in the clinical setting. Existing lowcost models are described. Unique issues in implementing CBT in India are discussed. [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental disorders (NDD), especially autism spectrum disorder (ASD), have a substantial impact on the family, with a consequent decrease in the quality of life. The current study was undertaken to understand if having ASD contributed to a higher impact on families compared to other NDD and to understand additional factors impacting families of children with either disorder in a low-middle income country (LMIC) setting. Methods: Impact of ASD and other NDD along with sociodemographic factors was examined, by a retrospective analysis, among 540 children in a tertiary care center in South India. Results: Both ASD and NDD had high, but comparable, impact on the family. Being a girl child, having seizures, and having sleep problems predicted a higher impact. Conclusions: In children with NDD, managing co-morbidities such as achieving better seizure control and addressing sleep-related problems may improve the impact of NDD on the family. Gender disparity in disability needs to be studied within the local cultural context. [ABSTRACT FROM AUTHOR]

Background: Depression is a common mental disorder seen across all age groups, including children and adolescents. Depression is often associated with significant disability in children and adolescents. Aim: This review aims to evaluate the Indian research on depression in children and adolescents. Results: Available data suggest that the point prevalence of depression/affective disorders ranges from 1.2% to 21% in the clinic-based studies; 3%–68% in school-based studies and 0.1%–6.94% in community studies. There has been only one incidence study from India which estimated the incidence to be 1.6%. With respect to the risk factors for depression, studies have reported various education-related difficulties, relationship issues with parents or at home, family-related issues, economic difficulties, and other factors. A limited number of studies have evaluated the symptom profile, and the commonly reported symptoms include depressed mood, diminished interest in play activities, concentration difficulties, behavior problems in the form of anger and aggression, pessimism, decreased appetite, decreased sleep, anhedonia, and somatic symptoms. None of the studies from India has evaluated the efficacy/effectiveness of various antidepressants in children and adolescents with depression. Conclusion: There is a wide variation in the point prevalence reported across different studies, which is mainly due to methodological differences across studies. Limited data are available with respect to symptom profile and factors associated with depression in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: The flood disaster of 9th-10th September 2014 wreaked havoc in the Jammu and Kashmir region of India. Incessant rains and deluge claimed 283 lives and damaged 2.53 lakh houses. This article presents the findings of the psychosocial care team from the National Institute of Mental Health and Neuro Sciences, Bengaluru, India, during the early phase of disaster. Materials and Methods: The team assessed posttraumatic stress symptoms of 64 child survivors from six villages of two districts struck by floods using Children's Revised Impact of Event Scale (CRIES)-8 and qualitative narrations. Results: Children showed high levels of intrusion and avoidance in the aftermath of floods. Both boys and girls showed moderate to severe level of psychological impact on the domains of CRIES-8. The narrations by the children centred on the theme of "water" and "enjoyment in seeing lots of water;" followed by "fearing of the parent's life," later on "fear of their own life," and subsequently to avoidance to go near the river and nightmares like "floating in the water." Conclusion: Disasters immensely impact children because of their particular stage of psychological and social development. This highlights the need for psychosocial interventions to minimize the impact of disasters on children at the earliest using simple psychosocial care techniques by employing available community-based manpower. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is a significant issue present in almost every society cuttings across all classes nationally. Even if the estimates can vary extensively based on the country under study, the definitions used, the type of CSA studied, the extent of coverage and quality of data it is observed that the overall rates are comparable universally. The estimated prevalence is considered to be higher than recorded not only in India but throughout the world. Considering the magnitude and importance the issue is gaining in India especially in the background of the recent increase in reporting of CSA cases. This article intends to provide relevant information focusing on the Indian aspects of the scenario. [ABSTRACT FROM AUTHOR]

BACKGROUND: Childhood diarrheal diseases remain highly endemic in India, but the emergence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli among children with diarrhea in Bihar remains elusive. In this study, we determine and characterize ESBLproducing E coli pathotypes among hospitalized diarrheal preschool children living in low socioeconomic level communities in Bihar, India. MATERIALS AND METHODS: The stool samples were collected everyday throughout the year for 2 consecutive years. In our study, we collected stool samples randomly from every fifth patient. Stool samples were collected from a total of 633 randomly selected diarrheal children (age: 0-60 months) belonging to 17 communities and screened for identification of virulent diarrheagenic E coli (DEC) pathotype (viz, enteropathogenic E coli [EPEC], enteroaggregative E coli [EAEC], enterotoxigenic E coli [ETEC], enteroinvasive E coli [EIEC], and enterohemorrhagic E coli [EHEC]) by a multiplex polymerase chain reaction (PCR) assay. Furthermore, ESBLs were screened by conventional antibiotic resistance pattern testing and later characterized for the presence of β-lactamase (bla) genes by PCR and DNA sequencing. RESULTS: Diarrheagenic E coli was detected in 191 cases (30.2%) of the total 633 diarrheic children. Maximum occurrence of DEC was found in ≤12 months age group (72.7%) with prevalence of the EAEC pathotype. Most isolates were resistant to ampicillin, ciprofloxacin, piperacillin, levofloxacin, ceftazidime, cefotaxime, ceftriaxone, and gentamicin, whereas over 96% of them were sensitive to amikacin. About 37.6% of total 191 DEC isolates were ESBL producers (n = 72), being prevalent among ETEC (n = 35; 18.32%), followed by EPEC (n = 21; 10.9%), EAEC (n = 13; 6.8%), and EIEC (n = 3; 1.57%). Interestingly, the commonest β-lactamase was CTX-M type (blaCTX-M) in 86.1% (n = 62) of the ESBL isolates, followed by blaSHV (n = 49; 68%), blaTEM (n = 37; 51.8%), and blaOXA (n = 21; 29.1%) determinants. Resistance of ESBL isolates was mostly related to ampicillin (100%), ceftriaxone (98.1%), cefotaxime (92.4%), gentamicin (74.1%), and levofloxacin (73.2%), whereas best antimicrobial activities were observed for piperacillin-tazobactam, amikacin, meropenem, and imipenem. CONCLUSIONS: This study revealed that EAEC (72.1%) is the predominant pathotype in Bihar, significantly high in ≤12 months age group children (P = .04). Moreover, the widespread prevalence of ESBLs in children, especially the CTX-M type, is of great concern, which requires monitoring of infection control measures through efficient antimicrobial management and detection of ESBL-producing isolates. [ABSTRACT FROM AUTHOR]

The nonpharmacological treatments for children with attention deficit hyperactivity disorder (ADHD) have witnessed a sea change from a rudimentary and haphazard psychosocial to cognitive interventions to social and behavioral skills to body oriented interventions to more sophisticated neurocognitive interventions. As the objective of each treatment varied, the method or procedure of each treatment also differed across studies. Indian research although not very rigorous, did witness changes emphasizing on exploring interventions in reducing symptoms and improving overall behavior. The research literature between 2005 and 2015 was searched using PubMed, Google Scholar, IndMED, MedIND, ResearchGate, and other indexed databases. Results of 110 studies were organized into five broad categories of themes of interventions such as psychosocial, body-focused, cognitive/neuro-cognitive, and cognitive behavioral. Effects of ADHD on cognitive, academic, and behavioral outcomes were also highlighted before the themes of intervention to establish linkage with discussion. However, a limited number (n = 9) of reported Indian studies focusing either on the impact of ADHD on the function of children or on interventions were found, suggesting a huge gap between global and Indian research in the area of children with ADHD. It also highlights the need for development and efficacy testing of indigenous intervention program in different areas of intervention for research and clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To study the incidence and risk factors of bacterial colonisation of peripheral venous catheters during the early neonatal period. Design: Prospective observational clinical study. Setting: Level II neonatal intensive care unit. Patients: Consecutive neonates in whom peripheral catheter was inserted were recruited. Methods: The insertion site was cleaned with isopropyl alcohol and chlorhexidine for 30 s consecutively. A needleless catheter access device was attached to peripheral catheters. A dedicated observer reviewed the catheter sites regularly for complications. On removal, the tip of the catheter was cut under sterile conditions and sent to the laboratory for culture. Only catheters indwelling for >12 h were sent for culture. Findings: Bacteria were isolated from 22 out of 154 catheter tips. Methicillin-sensitive Staphylococcus aureus (n = 13) was the most common organism constituting more than 50% of isolates. In five out of 22 isolates, the organism from the catheter tip was identical to the one from the skin. Systemic sepsis at enrolment was positively associated with colonisation of peripheral catheter. None of the neonates developed peripheral catheter-related bloodstream infection. Conclusion: When proper infection control measures are in place, risk of peripheral venous catheter-related infection appears extremely low in spite of frequent colonisation of the catheter. [ABSTRACT FROM AUTHOR]

The article presents a study related to sickle cell disease screening and follow-up programme for the newborn infants in the tribal populations of South Gujarat, India. It mentions that high performance liquid chromatography with molecular analysis was used in 5467 newborn babies and were clinically followed-up and haematologically regularly for 1.5 to 5 years and results shows that 33 babies are sickle homozygous, 13 are thalassaemia, and 687 are heterozygous while 4736 are unaffected.

Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed. [ABSTRACT FROM AUTHOR]

The Vineland Adaptive Behavior Scales - II Edition 2005 (Vineland-II) is useful in assessing abilities in autism spectrum disorder, where an accurate assessment of intelligence using standardized tools is difficult both due to the unique social and communication difficulties that these children present with and the behavioral issues that occur as co morbidity. We describe the scale and our experience in using the scale. Difficulties in administration of the scale to Indian children are illustrated. The main reasons for these difficulties center on cultural differences in gender roles and differences in the way some self care tasks are performed. [ABSTRACT FROM AUTHOR]

Background. Nutritional status is the best indicator of the global well-being of children. In India every third child is underweight, whereas in the Garhwal Himalayas only one-fifth of the children are nutritionally normal. Information regarding the causes of such low nutritional status in children of Garhwal is lacking. Objective. The present study was designed to identify factors that may influence the nutritional status of the children of the Garhwal Himalayas. Stunting, signifying long-term irreversible chronic undernutrition, was studied, along with wasting, which signifies acute undernutrition among children. Methods. Forty families from one town and one village in each of the three major agroclimatic situations (high, middle, and low hills) were selected at random (total 240 families). The nutritional status of 353 children (0 to 12 years of age) was assessed by nutritional anthropometry and compared with tables of weight-for-age and height-for-age z-scores (WAZ and HAZ) identifying wasting and stunting, respectively, and compared with the World Health Organization (WHO) Growth Reference charts 2007. Chi-square test was applied to analyze the effects of age, sex, altitude, and area on the nutritional status of children. Results. Of the 353 children studied, 38.2% belonged to the school-aged group, with 7% more girls than boys. Only 11.3% of the children had normal HAZ while 10.3% had normal WAZ. The largest percentages of children (31.8% HAZ and 29.1% WAZ) were clustered in the SD I group, that is the severely stunted or wasted group. In every age group except the 9- to 12-year group, most of the children were found in the WAZ SD1 category. Gender appeared to influence the SD1 category significantly There were 17.0% severely stunted girls ( SD1), as compared to 14.8% boys; while the percentages of WAZ girls was 16.1% and boys was 13%. The situation in the urban areas was slightly better: 6.4% of the sample had normal HAZ and 7.1% had normal WAZ, compared with 4.4% and 4.6% of the rural children. In all three agroclimatic situations, the largest percentage of children fell in the HAZ SD1 (stunted) category (15.3% in the high hills, 7.3% in the middle hills, and 9.5% in the low hills). There is a significant effect of area (rural vs. urban) on stunting and wasting among children. The child's sex affects stunting only. The other two variables, altitude and age, do not show a significant relationship with stunting or wasting. Conclusions. The rate of malnutrition among children in the Garhwal is very high. The majority are severely stunted and wasted, indicating a high prevalence of both chronic and acute malnutrition. Only the area of residence (rural or urban) had an influence on a child's nutritional status. [ABSTRACT FROM AUTHOR]

Aim: To compare the occurrence of neurological soft signs (NSS) in children with specific developmental disorders of scholastic skills (SDDSS) and normal children. Methods: 36 cases of SDDSS were compared with 30 control children regarding sociodemographic and clinical variables and neurological soft signs. Results: Children with SDDSS had significantly more problems in graphaesthesia, motor task, face-hand and face-noise test, 2-point discrimination, maintenance of posture, and rhythmic movements. Conclusions: Children with SDDSS had more NSS in the form of impaired motor task, poorly developed cortical sensory perception and poor body and space concepts. However, the presence of co-morbid hyperkinetic disorder in a large number of SDDSS subjects might have confounded the result. [ABSTRACT FROM AUTHOR]

Aim: The present study assessed the prevalence of child exposure to environmental tobacco smoke (ETS) among families with smoking members. Methods: Secondary analysis was conducted on data from a survey done in Jodhpur district (Rajasthan) on substance use in 11459 households. Frequency of smoking by residents in households with children below 10 years of age was ascertained. Results: About 24.5% of children were exposed to ETS. Among surveyed households about 40% had at least one tobacco user and 22.9% at least one smoker. About 86.9% of smokers reported dependent use of tobacco. Among smoking households, 82.7% had at least one child below 10 years of age. Almost all (99.3%) of these households reported daily smoking by members and 55.4% the use of more than 20 cigarettes per day. Conclusions: Tobacco users should be advised about how to limit children's ETS exposure and policy formulation on tobacco control programmes should take this aspect of tobacco use into account. [ABSTRACT FROM AUTHOR]

There is little information on the lead levels of Indian children nationally. In the late 1990s, members of the Chippewa and Cree tribes living on the Rocky Boy Reservation near Box Elder, Montana, were concerned about environmental pollution and how it might be affecting the health of their children. With financial assistance from the Environmental Protection Agency, the tribes designed and implemented an innovative lead screening program for young children. Because most children on the reservation participated in WIC and Head Start, those programs were used to identify and screen close to 100% of young children on the reservation. The average blood lead level for children ages 1-5 on the Rocky Boy reservation was 2.4μg/dL, which is not significantly different from that of children of the same age nationally. The project showed that Indian families will participate readily in screening programs that may improve their children's health. [ABSTRACT FROM AUTHOR]

The aim was to study the prevalence of complementary and alternative medicine use in acutely sick hospitalized children and factors associated with it. This is a cross-sectional, hospital-based study in a tertiary care center of Delhi, India. Children admitted to a pediatric unit during the study period were assessed using a specially designed questionnaire. Out of the total 887 admitted children, 161 (18.1%) were using complementary and alternate medicine in one form or another. Of these, 113 (70.2%) were using complementary and alternate medicine for the current illness directly leading to admission and the remaining 48 (29.8%) had used complementary and alternate medicine in past. The common complementary and alternate medicine use observed in our study was combined ayurveda and spiritual approach (25.5%), ayurveda (24.8%), spiritual (21.7%), homeopathic (13%), and 47.2% of children were using spiritual approach in form of Jhada (tying piece of cloth on arm or leg or keeping a knife by the side of child). The significant factors associated with complementary and alternate medicine use were younger age, female gender, and father being employed. Complementary and alternate medicine is commonly used even in acutely sick children. [ABSTRACT FROM AUTHOR]