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Background: The aim of the study was to determine the practices of face mask use and associated factors during the COVID-19 pandemic among school-going children in Shimla city.Methods: An observational study was performed in October 2021 to November 2021, with 703 students chosen using a simple random sampling procedure in Shimla city. Data was collected based on observation and analyzed using Epi info version 7. To predict the relationship between the student mask-wearing compliance and its associated factors, a univariate analysis was done.Results: A total of 703 students, 41.8% (n=294) were males while 58.2% (n=409) were females, 40.5% (n=285) 15 years of age. 97.2% (n=683) were Hindu and 72% (n=506) were studying in Government schools. All of the observed (100%) were wearing masks. 76.2% (n=536) students were using cloth mask, 12.1% (n=85) N95 masks while 11.7% (n=82) surgical masks. 81.8% (n=575) covered their mouth, as well as nose, 3.7% (n=26), had masks below the chin, 2.6% (n=18) had only their mouth covered while 11.9% (n=84) had partially covered their nose. Cloth mask was considerably more used by girls besides that there was no significant difference in the type of face mask according to age, standard of class, father’s occupation and type of school. The face mask was significantly more appropriately used by the students

Background: Intense anxiety experienced by the parents and their children regarding venous cannulation may result in non-adherence to the recommended procedure. The aim of present study was to compare the effects of eutectic mixture of topical anesthetics, amethocaine and 4% lignocaine on pain responses during venous cannulation in children up to 3 years. Methods: The present hospital based, prospective, randomized comparative study was conducted from December 2019 to November 2020 at KNH and IGMC, Shimla. The study population was divided in to two groups, group I (less than one month) and group II (one month to three years) and were further divided into three groups (amethocaine, EMLA and 4% lignocaine). NIPS and FLACC score for 3 events (pre procedural, immediately after cannulation and three minutes after cannulation) were noted.Results: 99 children were enrolled in our study (59 in group one and 40 in group two) and all were fulfilling inclusion criteria. NIPS score was highest for lignocaine before, immediate and after cannula followed by EMLA and was least for amethocaine. FLACC score was highest for lignocaine before, immediate and after cannulation. FLACC score was lowest for amethocaine, immediately and after cannulation and for EMLA before cannulation.Conclusions: Amethocaine significantly reduces the pain response as compared to EMLA and 4% lignocaine group specifically immediately after cannulation and three minutes post cannulation.

Background: Study was aimed to describe the oxygen requirements among children admitted as multisystem inflammatory syndrome in children (MIS-C) in Indira Gandhi Medical College, Shimla.Methods: We conducted a cross-sectional study, from January 2021 to July 2021, in the pediatric ward of Indira Gandhi Medical College (IGMC), Shimla. Children admitted with a diagnosis of MIS-C were included. Data regarding socio-demographic factors and oxygen requirements were extracted and analyzed using Epi Info V7 software.Results: A total 31 children diagnosed as MIS-C were included. Tachypnea was present in 18 (58.1%) respiratory distress in 15 (48.4%). Optimal oxygen saturation (SpO2) more than 94% in 9 (25.8%), 93-94% in 8 (25.8%), 91-92% in 5 (16.1%), 86-90% in 2 (6.5%), 81-85% in 4 (12.9%), 75-80% in 1 (3.2%), 71-75% in 1 (3.2%) and

Background: The aim of palliative care is most certainly the improvement of quality of life of patients suffering from various haematological diseases like leukaemia, haemophilia, thalassemia owing to the importance of palliative care in ensuring quality end-of-life care, provision of palliative care has been identified as an international human right. The objective of this study was to asses palliative care in chronic haematological conditions using Paediatrics palliative screening scale (PaPaS).Methods: 71 cases who fulfilled inclusion and exclusion criteria were included in the study for assessment of palliative care. Then, the data was analysed using the Statistical Package for Social Sciences (SPSS) software (version 13) and descriptive and interferential statistics were used.Results: In leukaemia patients the mean PaPaS score was reported to be 23.58 (SD: 7.43). Nineteen participants (61.29%) had a PaPaS score of >25 and 12 participants (38.71%) had PaPaS score of less than 25. In thalassemia patients the mean PaPaS score was reported to be 27.42 (SD: 6.54). Twenty participants (64.52%) had a PaPaS score of >25 and 11 participants or 35.48% had PaPaS score less than 25. In haemophilia patients the mean PaPaS score was reported to be 32.88 (SD: 4.94). Seven participants (87.5%) had a PaPaS score of >25 and only single participants or 12.5% had PaPaS score less than 25. In lymphoma patient the PaPaS score was 34.Conclusions: Chronic hematological diseases have lot of unmet needs of palliative care and study calls for creation of hospice and palliative care facility in all hospitals to meet the unmet needs of palliative care.

Background: MIS-C as a disease has varied symptoms and signs that affect multiple organs and systems in the body. The present study aimed to describe the clinical presentation among children admitted as a case of multisystem inflammatory syndrome in children in Indira Gandhi Medical College, Shimla.Methods: We conducted a cross sectional study of children with MIS-C from January to July 2021, in the pediatric ward of Indira Gandhi Medical College Shimla in Himachal Pradesh. All children admitted with a diagnosis of MISC were included in the study. Data regarding clinical presentation was extracted and analyzed using Epi Info V7 software.Results: In the present study, a total of 31 children diagnosed and admitted as a case of multisystem inflammatory syndrome in children (MIS-C) were included. Mean age of these children was 7.12±4.78 years. Among the total 16 (51.6%) were males while 15 (48.4%) were females. All 31 patients had presented with fever and 13 (41.9%) patients had fever with rash. 5 (16.1%) had cough, 1 (3.2%) child presented with hematemesis, 18 (58.1%) had tachypnea at presentation and 15 (48.4%) patients had respiratory distress. 16 (51.6%) children had complaints of vomiting, 1 (3.2%) presented with bleeding diathesis and 12 (38.7%) had hematuria, 5 (16.1%) had seizures and 8 (25.8%) presented with encephalopathy. 19 (61.3%) children had hypotension, 15 (48.4%) had hepatomegaly and 15 (48.4%) had splenomegaly.Conclusions: It is very essential to characterize this syndrome to fully understand its spectrum, therefore we need to be continuously watchful for its varied clinical presentations, both for ensuring an early diagnosis and treatment of patients suffering from MIS-C.

Background: Low birth weight (LBW) is a serious public health problem and a leading cause of death in the first month of life. The present study aimed to study the trends of low birth weight in Shimla district of Himachal Pradesh, India.Methods: Retrospective review of records of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was done. The total number of low-birth-weight babies each year were retrieved.Results: A total of 34769 live births took place in Kamla Nehru Hospital, Shimla from 2016 to 2020. Among the total live births, 8479 (24.39%) were having low birth weight (2500 gm). Out of total 8479 LBW Babies, 7148 (84.3%) were LBW (

VACTERL (Vertebral, anal, cardiac, tracheoesophageal, renal and limb) is an acronym for cluster of congenital malformations including Vertebral or Vascular anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula/Esophageal atresia, Renal and Limb defects. It is a rare association with sporadic and non-random occurrence where multiple organs are affected due to developmental defect during blastogenesis. Exact cause is unknown but multiple environmental and genetic factors have been implicated. For diagnosis, three components of VACTERL association are needed however patient may have other congenital malformations also. Here we report a newborn with VACTERL association born to a healthy mother by cesarean section for polyhydramnios with unstable lie.