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Vitamin D plays an important role in glucose tolerance by stimulating insulin secretion and evidences suggest a contradictory result on the association between vitamin D status and risk of developing gestational diabetes mellitus (GDM). The present updated meta-analysis has been undertaken to find out the joined effect of vitamin D status on the risk of effect GDM considering previously published articles. Data were collected through literature search using electronic databases to retrieve relevant published research articles using various combinations of the following keywords, "vitamin D," "vitamin D deficiency," "cholecalciferol," "25-hydroxyvitamin D," "25(OH) D," "gestational diabetes mellitus," and "GDM." A total of 36 studies including 7,596 GDM cases and 23,377 non-GDM controls were involved in this study. Overall, pooled meta-analysis showed that pregnant women diagnosed with GDM have 18% higher risk of GDM risk when compared with controls [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.10-1.25; P = 0.00] with high heterogeneity (I2 = 73.29). The mean difference was also significantly different between cases and controls (OR = -0.18, 95% CI - 0.22 to - 0.14; P = 0.00). Subgroup analysis showed significant results with age more than 30 years, Asian and European regions, and case-control, cross-sectional, and nested case-control study design. Low concentration of vitamin D is associated with the development of GDM. Although in future more studies especially systematically designed clinical trials based on vitamin D supplementation with large sample size on different population are needed to elucidate the exact concentration of vitamin D during pregnancy as well as before and after pregnancy.

Context: The prevalence of hypertension is on the rise in developing countries like India. Physiological parameters such as sleep duration and water intake may be associated with hypertension in young adults. Aims: The aim is to study the association between hypertension and day and nighttime sleep duration and water intake among young adults. Setting and Design: The study was a cross-sectional study, conducted among 596 students of Government Medical College, Kannauj, aged between 17 and 22 years. Materials and Methods: Participants were classified using the diagnostic criteria of the American Heart Association. Data were recorded on a pre-designed and pretested questionnaire. Data analysis was performed using SPSS 22.0. Receiver operator characteristic curve analysis and multiple logistic regression analysis were applied. Results: The prevalence of hypertension was 34.9%, 35.9% among boys, and 33.5% among girls, respectively. Less water intake and shorter sleep duration at nighttime were found to be independent predictors of hypertension. Cutoff of sleep duration at nighttime for predicting hypertension was ≤7.6 h among boys and ≤7.1 h among girls. The sensitivity and specificity of the cutoff for sleep duration at night time in boys was 79.3% and 74.2%, respectively, and that in girls was 81.5% and 75.6%, respectively. The cutoff for water intake for predicting hypertension was ≤2.1 L for boys and ≤1.5 L for girls, respectively. The sensitivity and specificity of the cutoff for water intake in boys was 74.8% and 70.3%, and in girls was 78.3% and 71.5%, respectively. Conclusions: Young adults with longer duration of sleep during night time and more water intake had a lesser risk of hypertension.

Objective: The objective of this study is to identify the various electrolyte abnormalities in critically ill children admitted to pediatric intensive care unit (PICU) and their association with morbidity and mortality. Methods: This was a hospital-based prospective observational study conducted on 180 critically ill children in the age group 2 months to 15 years admitted in the PICU of a tertiary care hospital. Venous blood sample was obtained for the estimation of serum sodium, potassium, calcium, magnesium, and phosphate. The incidence of electrolyte abnormalities and their relation to the primary illness was calculated. Morbidity (mean duration of hospital stay) and mortality rates were evaluated and compared to patients with normal electrolyte levels. Results: Electrolyte abnormalities were seen in 108 children (60%); 72 patients (40%) were having normal electrolyte levels. Most common abnormality seen was hyponatremia in 50.5% patients (n=91). Morbidity and mortality were also higher in these patients. Overall mortality with dyselectrolytemia was 30.5% (n=33) as compared to those with normal electrolyte levels (4.1%, n=3) and was statistically significant (p

Background: NICU in public hospitals in developing countries face immense challenges in the form of overcrowding, less manpower and lack of equipment. Patient care is the prime responsibility of the health care workers. Parental satisfaction although an important part of health care is not given its due importance. There are very few studies analysing parental satisfaction of NICU babies in the developing countries including India. The objective of this cross-sectional study was to 1. Assess satisfaction regarding medical treatment 2. To assess satisfaction regarding General environment. Take suggestions regarding improvement in services.Methods: A total of four hundred and fifty-nine parents were interviewed. They were parents of babies admitted in NICU, those coming for follow up in the well-baby clinic. Parents of babies who died or left against medical advice were interviewed at the time of leaving the hospital or telephonically later. Results were analysed statistically using the student chi square test.Results: 92.6% of the respondents were satisfied with the medical services and 96.6% were satisfied with the general environment. Reasons for lack of satisfaction were analysed. Nuclear families, urban background, adverse outcome of the baby were the Key factors. Parents gave pertinent suggestions like improvement in cleanliness, more beds, increase in medical staff, better availability of medicines and blood products.Conclusions: There is need to develop standardised protocols to analyse parental satisfaction. This will lead to better understanding of parental expectations and help to improve patient care.

Introduction In India, there are approximately 41 million diabetics to date. Impaired glucose tolerance or pre-diabetes may occur as early as adolescence. Objective To find out the cut-off values of body mass index (BMI) and waist circumference to predict pre-diabetes in adolescents in north India. Methods A cross-sectional study was conducted among 526 students aged 17–19 years, in the Institute of Paramedical Sciences, Chatrapati Shahuji Maharaj University, Kanpur. A pre-tested questionnaire was used and the diagnostic criteria of the American Diabetic Association were applied. Receiver operating characteristic(ROC) analysis was used to assess the cut-offs of BMI and waist circumference for predicting prediabetes. Results ROC analysis showed that BMI is a good predictor of prediabetes for both boys and girls.Area under the ROC curve was 0.828 for boys and 0.838 for girls, respectively. The cut-off values of BMI for predicting prediabetes were identified as ≥22.8 kg/m2 in boys and ≥20.5 kg/m2 in girls. Upon ROC analysis for waist circumference, it was observed that it was a good predictor of prediabetes both for boys (area under the curve 0.804) and girls (area under the curve 0.795). The cut-offs for waist circumference for predicting prediabetes were found to be ≥82.5 cm for boys and ≥80.3 cm for girls. Conclusion BMI and waist circumference estimation can be done for early detection of prediabetes in adolescents for further diagnostic evaluation and management.

Malaria is an important cause of mortality and morbidity in childhood in India. All children aged between 0 and 15 years, with fever, attending the Department of Pediatrics, GSVM Medical College, Kanpur, during the study period were tested for malarial parasites. Those found positive for Plasmodium vivax and/or Plasmodium falciparum were included in the study; clinical findings and laboratory investigations were noted and analyzed. In a total of 183 subjects, P. vivax was found in 70 (60.7%) and P. falciparum in 42 (39.3%). Fever with splenomegaly (97.81%), intermittent fever (92.9%), pallor (90.16%), and splenomegaly (89.07%) were observed to be the most sensitive indicators. Most specific indicators were fever with splenomegaly (89.19%), splenomegaly (82.63%), and pallor (79.54%). Indicators with best positive predictive value were fever with splenomegaly (86.47%), splenomegaly (78.37%), and pallor (75.69%). Fever with splenomegaly was a good predictor.

Background: Development of inhibitors is becoming a great challenge to clinicians in treating patients of Hemophilia. It is one of the most important complication affecting quality of life of patients and cost of treatment. The objective of the study was to study the prevalence of inhibitors in Hemophilia, its clinical presentation and factors (no. of exposure days, age of 1st presentation) affecting the development of inhibitors in Indian context. Methods: We conducted a cross-sectional study on 54 patients of severe Hemophilia admitted in our hospital. We assessed their treatment data and screened their samples for inhibitors by mixing study and confirmation done by Bethesda assay. Results: Out of 54 patients of severe Hemophilia 49 patients was of Hemophilia A and 5 of Hemophilia B. Out of these 49 patients 5 patients (10.2%) was positive for inhibitors. None of the HB is positive. Out of these 4 patients (80%) presented in their infancy. All patients had 20-50 exposure days. 24% patients had >50 exposure days, none of these develop inhibitor. Out of these 5 positive patients 4(80%) were low responders and 1 patient (20%) was high responder. Conclusions: In our study prevalence of inhibitor development is less compared to other western studies. This finding might be due to delayed initiation of factor concentrate treatment. In our study due cost of treatment bleeding prophylaxis is not given; only palliative treatment is available in our hospital. But considering small sample size and absence of genetic factors study it needs further study before reaching a final conclusion.

Benefits of early enteral nutrition in neonates are well established, but the effects of enteral nutrition in neonates with inotropic support for hemodynamic instability are not well studied. A study was planned to compare the clinical outcome in terms of morbidity, mortality, and hospital stay in the neonates with enteral feed versus intravenous (IV) fluid group with inotropes and to evaluate the safety of enteral nutrition in neonates with inotropic support as well as to determine the cutoff levels of the inotropes at which enteral feed is well tolerated. Methods: A randomized control trial was conducted in a tertiary care neonatal intensive care unit, Kanpur, and included 200 neonates on inotropes who were allotted randomly 100 each in enteral feed and IV fluid group. Results: Demographic characteristics were comparable in both the groups, mean gestational age being 36.09 ± 0.4 weeks and 35.96 ± 0.3 weeks, and mean weight on admission being 2321.60 ± 73.9 g and 2214.30 ± 53.1 g for the enteral feed group and IV fluid group, respectively. In enterally fed neonates, 88.3% were discharged and 11.7% were expired, while in the IV fluid group, 69.6% were discharged and 30.4% were expired. There was a significant difference in the mean duration of hospital stay (13.4 ± 5.0 days and 15.5 ± 5.1 days in enteral feed and IV fluid group, respectively). No complications were observed in 88.2% of enterally fed neonates versus 93.5% of neonates in the IV fluid group. There was no significant difference between complications in two groups (P = 0.245). When receiver operating characteristic(ROC) curve analysis was done to find out the cutoff level of inotropes to predict feed tolerance, at cutoff level of dopamine 10 μ/kg/min + dobutamine 7.5 μ/kg/min, the sensitivity and specificity to predict feed tolerance were found to be 61.5% and 77%, respectively.Conclusions: Enteral nutrition in neonates with inotropic support is associated with shorter duration of hospital stay and better survival rate. Neonates can tolerate enteral feed up to dopamine 10 μ/kg/min and dobutamine 7.5 μ/kg/min.

This article aims to study the predictive value of headache for screening of refractive errors in the pediatric age group. This is a cross-sectional study conducted in the outpatient setting of the Department of Ophthalmology of Lala Lajpat Rai Hospital, associated with Ganesh Shanker Vidyarthi Memorial Medical College, Kanpur (India), during a period of 1 year, including 5,398 children in the age group of 5 to 15 years. Data were collected using a predesigned, pretested questionnaire which included demographic data and chief complaints. All the subjects underwent visual acuity and refractive error testing. Visual acuity was conducted using Snellen's chart and Landolt's C chart. Thereafter, refractive testing was done under cycloplegia and corrective spectacles were prescribed to the patient. Data were analyzed using statistical package for social sciences version 16.0. Chi-square test was applied to analyze the discrete variables. Data were also used to calculate the sensitivity, specificity, positive predictive value, and negative predicative value of headache as a screening tool for the predicting refractive errors in children. Twelve percent of the total population attending the ophthalmic outpatient department belonged to the age group of 5 to 15 years. The male:female ratio was 1.3:1. Out of the total, 58.8% of the subjects had refractive errors. Myopia was the most common refractive error (46.4%) followed by astigmatism (31.3%) and then hyperopia (22.3%). Gender difference was significant (p

To assess the prognostic value of core to peripheral temperature gradient and blood lactate levels in critically ill children and determine their correlation in terms of patient outcome. It is a prospective observational study conducted on 99 patients admitted in the pediatric emergency ward/ICU of Deptt. Of Pediatrics, G.S.V.M. Medical College, Kanpur. Children between ages of 6 months to 18 years with sequential organ failure assessment (SOFA) score > 5 were included. ROC analysis and multiple logistic regression analysis were used to analyse the data. ROC curve analysis showed that core to peripheral temperature gradient and blood lactate levels had similar predictive values for increased risk of death (area under the curve, 0.852 and 0.825, respectively) with the best cut-off values of 3.4° C for core to peripheral temperature gradient and 44 mg/L for blood lactate levels. Among infants aged 6 months to 18 years, core to peripheral temperature gradient and blood lactate levels are good prognostic indicators in identifying critically ill children at increased risk of death.

Background: To evaluate the cardiotocographic abnormalities associated with induction of labour with misoprostol and dinoprostone and comparing the perinatal outcome in terms of cord blood analysis. Methods: This study was conducted in the department of Obstetrics and Gynecology of G.S.V.M. Medical College, Kanpur with 80 patients. Cases were randomly divided into two groups with n=40. In first group 50 µgm misoprostol per vaginally and in second group 0.5 mg of dinoprostone gel was used for induction. Cardiotocography of all the study candidates was performed and following delivery cord blood gas analysis was done. Results: It was found that 45% percent of women treated with misoprostol demonstrated an abnormal tracing event within the initial 24 hours of induction, compared with 17.5% in the dinoprostone gel. Both hypertonus and tachysystole events were significantly more frequent in women treated with misoprostol group and this difference is statistically significant (p=0.0099). We also found that these events occurred earlier after initial misoprostol dosing (6.98 ± 4.14hr), compared with the dinoprostone gel (9.19 ± 6.29 hr). Conclusions: Cardiotocographic abnormalities are more frequent after misoprostol administration compared with the dinoprostone gel. Neonatal outcome in terms of NICU admission and Umbilical artery cord blood changes are apparently similar in both.

Background: Febrile seizures are commonly seen in children and about one-third of the children develop a recurrence of febrile seizures. Objectives: The main objective is to study the risk factors associated with recurrence of febrile seizures in Indian children. Methods: This prospective, longitudinal study was carried out in the Department of Pediatrics, GSVM Medical College, Kanpur. All children, 6 months to 5 years of age, attending the department from February 2015 to January 2016 presenting with first febrile seizures were included in the study and followed up for recurrence. Results: Of 528 children, 174 (32.9%) had recurrence and 354 (67.1%) had a single episode of febrile seizures. Recurrence was more in children

Objectives: To study the effect Vitamin D supplementation on weight and height standard deviation score in Vitamin D deficient children. Material and methods: The study was conducted by selecting Vitamin D deficient children based on serum. Vitamin D level and their Weight and Height was measured. One dose of 3,00,000 IU intramuscular along with calcium (50 mg/kg/day) was given to all the children. After 3 months, serum Vitamin D level, weight and height standard deviation Score was measured and the subjects were randomly divided into two groups. A balanced block randomization method was used to randomize the participants, into Group 1 and 2. The first group received calcium (50 mg/kg/day) and the second Group received 400 IU/day of Vitamin D3 along with calcium (50 mg/kg/day) for 9 months. After 9 months, serum Vitamin D level, weight and height standard deviation score was measured. Results: Age of the study subjects in group 1 was 3.5 ± 0.8 years whereas that in group 2 was 3.3 ± 0.7 years. Mean Wtsds in group 1 was 0.42 ± 0.01 whereas that in group 2 was 0.39 ± 0.02. There was a significant positive correlation between serum vitamin D level and Wtsds and Htsds. The increment in Wtsds was much lower in group 1(0.42 ± 0.07) as compared to group 2 (1.15 ± 0.01) and this difference was statistically significant. The increment in mean Htsds was 0.07 ± 0.01 in group 1 which was significantly lower than that in group 2 (0.35 ± 0.02). Conclusion: The present study showed that the weight standard deviation score and height standard deviation score progressively improved with the vitamin D supplementation.

Developing countries are now facing the double burden of childhood underweight and obesity. Childhood obesity is a recent epidemic with a high magnitude in India. Therefore, the authors decided to assess the prevalence of overweight and obesity among Indian children. Studies were identified through computer-based and manual searches. Estimates of prevalence were studied using random effects meta-analysis. Nine studies including 92,862 subjects were identified and analysed. The prevalence of overweight was estimated to be 12.64% (95% CI 8.48-16.80%) and that of obesity to be 3.39% (95% CI 2.58-4.21%). Current evidence suggests that policies and interventions for children should prioritize reduction of obesity and overweight.

Background: This impression of multiple micronutrients during pregnancy emphasizes to relatively neglected issues. Objectives was to evaluate the status and benefits of multiple micronutrient during pregnancy.Methods: Total 180 healthy pregnant women were included, first trimester 60 cases, second trimester 60 cases and third trimester 60 cases in the age group of 18-40 years. Haemoglobin was estimated by cyanmethemoglobin method, estimation of iron was done by ferrozine method, for zinc colorimetric method, estimation of calcium OCPC method and estimation of urinary iodine was done by ammonium persulfate oxidation method.Results: Haemoglobin are found to be in the Ist trimester 11.3g/dl, in the IInd trimester of haemoglobin 10.5g/dl, and in the IIIrd trimester it was 11g/dl and Serum iron was 71.9ug/dl in Ist trimester, 74.8 ug/dl during IInd trimester, 80.9ug/dl in IIIrd trimester. The mean serum calcium during Ist trimester was found to be 8.0 ug/dl, in the IInd trimester 7.2 ug/dl and in the IIIrd trimester 8.1ug/dl. Serum zinc in the Ist trimester 72.6 ug/dl, in the IInd trimester 70.1ug/dl, in the IIIrd trimester 66.7 ug/dl respectively. Iodine level during Ist, IInd, IIIrd trimester was found to be 122.5ug/dl, 149.1ug/d, 158.7ug/dl respectively.Conclusions: Finding of our study shows that Poor nutrition during pregnancy has been associated with adverse maternal and child outcomes such as increased risks of infertility, abortion, fetal intrauterine growth restriction and prenatal mortality.

Background: Malaria, the most important protozoal disease in humans remains the significant health problem globally. The objective of this study was to study the acute respiratory distress syndrome in children in vivax malaria.Methods: This prospective study enrolled children with acute febrile illness aged 1-15 years who diagnosed as malaria. Then we searched the children who present with acute (

Background: Vitamin D deficiency remains the most common cause of rickets globally and is highly prevalent in developing countries including India. This study aimed to compare the efficacy of vitamin D and calcium together with calcium alone on growth parameters of children with vitamin D deficiency in community based setting.Methods: A randomized controlled trial was conducted in community based setting in Kanpur district. Multistage random sampling technique was used to select a total of 395 children between 2 years to 5 years from 5 villages of block Vidhunu. Of these, 138 children were randomized into two groups using balanced block randomization technique. Group 1 received vitamin D with calcium together and group 2 received calcium alone for a period of 12 months. Anthropometry, serum vitamin D, calcium, alkaline phosphatase levels were estimated at baseline and after 12 months. Data was analyzed using SPSS 20. Student’s t test was used to analyze the differences in growth and laboratory parameters in the two groups. Multiple linear regression analysis was used to assess the effect of various factors on the growth parameters.Results: Prevalence of vitamin D deficiency was 78.7%. Baseline characteristics of both groups were similar. After 12 months, group 1 demonstrated significantly greater improvement in weight SD score (21.4%) and height SD score (10.3%) and growth velocity (9.1 cm/year) compared to group 2 (14.3%, 7.8% and 6.9 cm/ year respectively). Also subjects in group 1 showed significantly greater improvement in serum levels of vitamin D, calcium and alkaline phosphatase than group 2.Conclusions: Vitamin D supplementation along with calcium improves the growth of children. Regular supplementation of all children with vitamin D can be considered as a policy for prevention of malnutrition.

AIM: To assess the correlation between blood pressure levels and fasting plasma glucose levels among young adults attending Chatrapati Shahuji Maharaj University, Kanpur, India. METHODS: The present study was cross-sectional in nature, conducted among students in the Institute of Paramedical Sciences, Chatrapati Shahuji Maharaj University, Kanpur. Study subjects included 185 young adults. Among them, 94 were males and 91 were females, in the age group 17 to 19 years. RESULTS: Mean age among males was 18.5 ± 1.5 years and among females was 17.9 ± 1.8 years. Of the total 185 study subjects, 61 (32.9%) were classified as pre-diabetic and 20 (10.8%) as pre-hypertensive. Mean waist circumference, systolic blood pressure and serum high density lipoprotein did not vary significantly between normoglycemic and pre-diabetic subjects. However, the mean diastolic blood pressure of pre-diabetics (82 ± 5 mmHg) was significantly higher than normoglycemics (79 ± 6 mmHg). Mean serum cholesterol, serum triglycerides, serum low density lipoprotein (LDL) and serum very low density lipoprotein was also higher among pre-diabetic subjects in comparison to normoglycemic subjects and the difference was statistically significant. Upon multiple linear regression analysis, it was observed that body mass index (BMI) (β = 0.149), diastolic blood pressure (β = 0.375) and serum LDL (β = 0.483) were significantly associated with fasting plasma glucose. Multiple linear regression with diastolic blood pressure as the outcome variable showed that BMI (β = 0.219), fasting blood glucose (β = 0.247) and systolic blood pressure (β = 0.510) were significantly associated. CONCLUSION: A significant prevalence of pre-diabetes and pre-hypertension in young adults is a matter of concern therefore all young adults need to be targeted for screening of diabetes and hypertension and lifestyle modification.

AIM: To determine the cut-off values of body mass index (BMI) and waist circumference to predict hypertension in adults in north India. METHODS: A community based cross-sectional study was conducted in 801 subjects in Kanpur, aged 20 years and above, using multistage stratified random sampling technique. A pre-tested structured questionnaire was used to elicit the required information from the study participants and the diagnostic criteria for hypertension were taken according to the Seventh Joint National Committee Report on Hypertension (JNC-7). Receiver operating characteristic (ROC) analysis was used to estimate the cut-off values of BMI and waist circumference to predict hypertension. RESULTS: The ROC analysis revealed that BMI is a good predictor of hypertension for both men (area under the ROC curve 0.714) and women (area under the ROC curve 0.821). The cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m2 in men and ≥ 24.9 kg/m2 in women. Similarly, the ROC analysis for waist circumference showed that it is a good predictor of hypertension both for men (area under the ROC curve 0.784) and women (area under the ROC curve 0.815). The cut-offs for waist circumference for predicting hypertension were estimated as ≥ 83 cm for men and ≥ 78 cm for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension, respectively. CONCLUSION: Simple anthropometric measurements such as BMI and waist circumference can be used for screening people at increased risk of hypertension in order to refer them for more careful and early diagnostic evaluation. Policies and programs are required for primary and secondary prevention of hypertension.

A Study on Japanese Encephalitis in and around Kanpur, Uttar Pradesh, India Japanese encephalitis (JE), is mosquito borne viral disease, caused by arbovirus; a member of the family Flaviviridae and is transmitted to humans through a pig-culex mosquito-pig cycle. Humans are an incidental host and most infections of JE virus are asymptomatic. The ratio of unapparent to apparent infection is 200:1 to 300:1 but if clinical illness develops, it causes significant morbidity and mortality. Approximately 3 billion people and 60 per cent of the world population live in JE-endemic regions, and inspite of being a vaccine preventable disease there are approximately 50,000 cases and 15,000 deaths per annum notified from wide geographical range, and half of the survivors suffer severe neuropsychiatric sequelae of the disease.

Tumoural calcinosis (TC) is a benign gradually developing disorder that can occur in a variety of clinical settings, characterised by subcutaneous deposition of calcium phosphate with or without giant cell reaction. We describe a case of 11-year-old girl presenting with recurrent hard swellings in the vicinity of shoulder and hip joints associated with elevated serum phosphate and normal serum calcium levels. TC has been mainly reported from Africa, with very few cases reported from India. After the diagnosis of hyperphosphatemic TC was established, the patient was treated with oral sevelamer and is under constant follow-up to detect recurrence, if any. The present case highlights the fact that although an uncommon lesion, TC must be considered in the differential diagnosis of subcutaneous hard lump in the vicinity of a joint.

Sri Lanka Journal of Child Health , 2015; 44 (4): 209-212 Introduction: The prevalence and types of poisoning vary in different geographical locations. Objectives: To study poisoning among children in 3 medical college centres across 3 different states in India. Method: A multi-centric retrospective study was conducted from March 2013 to February 2014. The collected data was tabulated and analysed and results were evaluated. Results: A total of 290 cases of poisoning in the 3 Medical Colleges was included in the study. Poisoning cases constituted about 1% of hospital admissions. The commonest age group was 1-5 years. Kerosene oil constituted 30.3% of poisoning cases. Snake bite envenomation constituted 10% of poisoning. Corrosive poisons constituted 7.5% and drugs 6.0% of poisoning. There were 12 deaths. Conclusions: Kerosene oil was the commonest cause of poisoning in children in all 3 centres. Envenomation due to snake bites was the next common cause. Overall mortality rate was 4.1%. Sri Lanka Journal of Child Health , 2015; 44 (4): 209-212

An 18-month-old boy was admitted with fever, abdominal pain, and hepatomegaly. CT scan revealed dilatation of intrahepatic biliary radicals with central dot sign, bilateral nephrocalcinosis, multiple ureteric and urinary bladder stones and right-sided obstructive hydroureteronephrosis due to a ureterovesical calculus of about 1.5 cm. Liver biopsy showed early hepatic fibrosis.

The present hospital based cross sectional study was done on 214 paediatric patients attending O.P.D for symptoms other than those of gastrointestinal disorders and the prevalence of H.pylori was found using Stool Ag card test. Out of these 214 patients,112 were found positive for H.pylori by stool antigen card test giving a prevalence of 52.34.%. A detailed proforma was filled having information regarding age and sex of the patient, education and occupation of the head of the family, sanitary practices, dietary habits of the patient was also observed for pallor. Among a total of 117 males, 64 were positive for H.pylori (54.7%) and among 97 females, 48 were positive (49.5%). Age wise distribution showed maximum prevalence of H.pylori in the age group of 15–18 years (75.9%) and minimum in the age group of 3–6 years (30.4%). A higher prevalence of H.pylori was found among non-vegetarians (53.1%) and among patients having pallor (75.8%) which was significant. A study of socio-economic status showed a prevalence of H.pylori as 52% in upper lower and 52.6% in lower middle socio-economic group.