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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: 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]

Background. CAST (Caries Assessment Spectrum and Treatment) index is a relatively new caries assessment tool that hierarchically describes the entire caries spectrum. Its comparability with WHO (World Health Organization) criteria in different populations and age groups needs to be investigated. Objective. The objective of this study was to assess caries among 5 and 15-yearold schoolchildren using the CAST index and WHO criteria and to compare both indices on the basis of caries experience and examination time. Methods. A cross-sectional study was conducted among 553 schoolchildren aged 5 and 15 years in the North zone of Bengaluru city, India. Examiners underwent training and calibration for performing the CAST index. The first examination was performed using the CAST index followed by a second examination using the WHO criteria 2013, after some days. Time taken for examination was also recorded. Results. The study sample consisted of 279 five-year-old and 274 fifteen-year-old schoolchildren. The difference in caries experience among 5 and 15-year-old children assessed using the CAST index (52%, 45.6%) and WHO criteria (42.3%, 24.5%) were found to be statistically significant (p < 0.05). The average examination time was longer for the CAST index (93.77±24.77 seconds and 105.04±9.49 seconds) when compared to WHO criteria (61.05±15.91 seconds and 58.72±9.42 seconds) for primary and permanent dentition (p < 0.05). Conclusion. Though the CAST index took a longer examination time, the information obtained was more precise and facilitated researchers in treatment planning encompassing prevention of initial lesions, restoration, and rehabilitation. [ABSTRACT FROM AUTHOR]

Background: India is endemic for enteric fever, and it is not known whether the variations in clinical manifestations between patients are due to host, environmental or pathogen factors. Blood culture surveillance was conducted at St. John's Medical College Hospital, Bangalore, between July 2016 and June 2017. Clinical, laboratory and demographic data were collected from each case, and bacterial isolates were subjected to whole genome sequencing. Comparative analysis between adults and paediatric patients was carried out to ascertain differences between adult and paediatric disease. Results: Among the 113 cases of blood culture-confirmed enteric fever, young adults (16–30 years) and children < 15 years accounted for 47% and 37% of cases, respectively. Anaemia on presentation was seen in 46% of cases, and 19% had an abnormal leucocyte count on presentation. The majority received treatment as inpatients (70%), and among these, adults had a significantly longer duration of admission when compared with children (p = 0.002). There were atypical presentations including arthritis, acute haemolysis and a case of repeated typhoid infection with two separate S. Typhi genotypes. There was no association between infecting genotype/serovar and treatment status (outpatient vs inpatient), month of isolation, duration of admission, patient age (adult or child), antimicrobial susceptibility, Widal positivity or haematologic parameters. Conclusions: Amidst the many public health concerns of South India, enteric fever continues to contribute substantially to hospital burden with non-specific as well as uncommon clinical features in both paediatric and adult populations likely driven by host and environmental factors. Robust clinical surveillance as well monitoring of pathogen population structure is required to inform treatment and preventive strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diwali is a Hindu festival celebrated every year in the month of October/November throughout India. The burning of firecrackers during the festival releases a large number of air pollutants leading rise in ambient air pollution. Children are at risk of exposing to these chemicals and have shown an increased incidence of respiratory morbidities. OBJECTIVE: The objective of this study is to identify the magnitude of respiratory morbidities among school children post Diwali in Bengaluru city. SETTING AND DESIGN: A cross-sectional study was conducted from November 2018 to January 2019 among school children aged between 10 and 16 years. METHODOLOGY: Schools coming under the urban field Practice area of Medical College and consenting for the study were selected by the simple random sampling. Students willing to participate from each school were selected by the simple random sampling. Each student was interviewed using the pretested semistructured questionnaire. STASTICAL ANALYSIS USED: Data were entered and analyzed using Epi-info 7.2.2.1. Descriptive statistics such as mean, standard deviation (SD), and proportions and inferential statistics such as the Chi-square test were used. RESULTS: A total of 637 participants were interviewed, of which 308 (48.35%) were boys and 329 (51.65%) were girls. The mean age of the study participants was 12.53 ± 1.65 years (mean ± SD). It was observed that 263 (41.28%) children were suffering from one or other respiratory morbidities. One hundred and thirty-five (21.19%) children were suffering from upper respiratory tract infection and 138 (21.66%) had lower respiratory tract infections. One hundred twenty-three (19.31%) suffered from allergic rhinitis, of which 59 (47.93%) had an exacerbation following Diwali. Twenty-seven (4.24%) were asthmatic, of which 17 (62.96%) experienced an exacerbation after Diwali. CONCLUSION: There is a high burden of respiratory morbidities among children following Diwali festival in Bangalore city. [ABSTRACT FROM AUTHOR]

Background: Very few publications report on the relationship between 'salutogenesis', as measured by the concept of Sense of Coherence (SOC), and generally speaking an individual's overall oral healthrelated quality of life (OHRQL). To add to this, there is even lesser information regarding the behavioral aspect of dental anxiety. Aim: The aim of the present study was to evaluate the relationship between dental anxiety, SOC and dental caries in school children from Bangalore North. Materials and Methods: The study had a sample of 529 children from various schools, age between 12-16 in Bangalore north. The study comprised of 17 questions which were handed over to them; and upon receival of the questionnaire the respective decayed, missing, filled tooth surfaces index (DMFS) score was checked which was then compared with dental anxiety and SOC. Statistical Analysis Used: One way analysis of variance (ANOVA) F-test and multiple comparison procedures (MCPs). Result: High dental anxiety predicted high dental caries index and low SOC predicted high dental caries index in association with advancing children's age from 12-16 years. Conclusion: Dental anxiety had a direct relationship with dental caries and SOC had an inverse relationship with dental caries. [ABSTRACT FROM AUTHOR]

Objectives: To develop age and gender specific waist circumference references for urban Indian children aged 3-16 years. Design: Cross-sectional study. Setting: Urban preschools and schools of Bangalore. Participants: 9060 children (5172 boys and 3888 girls) in the age group of 3-16 years. Methods: Weight, height, and waist circumference were measured using standard anthropometric methodology. Percentiles for waist circumference and Waist/height ratio (W/Ht) for each age and gender were constructed and smoothed using the LMS method. Results: Mean waist circumference increased with age for both girls and boys. The upper end of curve in boys continued to increase, whereas in the girls it tended to plateau at 14 years. The waist circumference of the Indian children from the present study was higher than age and sex matched European children. The proportion of children with W/Ht ratio greater than 0.5 decreased as their age increased. Conclusions: These curves represent the first waist and waist height ratio percentiles for Indian children and could be used as reference values for urban Indian children. We suggest that for a start, the 75th percentile of waist circumference from this study be used as an 'action point' for Indian children to identify obesity (as a tautological argument), while retaining the cut-off of 0.5 for the W/Ht ratio; however this underlines the need to derive biologically rational cut-offs that would relate to different levels of risk for adult cardiovascular disease. [ABSTRACT FROM AUTHOR]

In the context of post-disaster reconstruction, there is growing awareness of the need for more integrated inclusive processes that allow people to retake control of their lives, and that ensure practical responses to local conditions. Yet, a range of pressures and challenges conspire to make these approaches appear unworkable. "Participation" in this context, if it happens at all, is often cursory and superficial, whether it involves children or adults. This paper describes an attempt to respond to these challenges in one small community in Tamil Nadu, India, after the 2004 Indian Ocean tsunami. The scope for real involvement on the part of children and their families was limited by a number of factors, but in the end they were able to exercise some genuine control over the reconstruction of their homes and neighborhood. The paper discusses the replicability of this case, and argues for the importance of a process that includes children and adults together. [ABSTRACT FROM AUTHOR]