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Acute bacterial meningitis (ABM) is a life-threatening and neurologically debilitating infectious disease. We studied the clinical profile, organisms involved in bacterial meningitis in children, and compared the tests on cerebrospinal fluid (CSF), latex agglutination test (LAT), polymerase chain reaction (PCR), Gram stain (conventional) and Cyto-Tek cytospin centrifuge Gram stain to culture which is the gold standard. This was an observational cross-sectional study (age range 3 to 12 months) conducted in a tertiary care hospital, New Delhi, India over 1 year. A total of 101 patients were enrolled and divided into three age groups, namely, 5 years. Fever was the most common presenting symptom in all groups (84.2%). Refusal to feed, headache, altered sensorium, vomiting, and blurring of vision were significantly associated with bacterial meningitis in all age groups. Cranial nerve palsies and neck rigidity were significantly higher in older children. Age

Rickettsial diseases are caused by arthropod-borne obligate intracellular parasites. One such rickettsial infection is scrub typhus, which is an important cause of fever of unknown origin. Spectrum of presentation is variable. There are reports of scrub typhus with CNS complication, like meningoencephalitis, in adolescents and adults from various parts of India but not from Delhi. There are recent case reports of scrub typhus without CNS involvement in adults from Delhi. Its occurrence in the form of hemorrhagic fever with meningoencephalitis is rarer in children and is not so far reported from the state of Delhi. We present a case of a 4-year-old child from Delhi presenting with hepatosplenomegaly, thrombocytopenia, and altered sensorium, whose timely diagnosis and management saved her life, and this brings to our notice the emergence of scrub encephalitis in children.

BackgroundCommunity health workers known as mitanins undertook family-level counseling and mobilized the community to improve coverage of maternal and child health services in the state of Chhattisgarh, India. The Nutrition Security Innovation (NSI) project was launched in selected blocks with additional inputs for promoting appropriate complementary feeding practices and disseminating information on Public Distribution System (PDS) entitlement. Within 3 years of project implementation, all NSI inputs in the project group (PG) were scaled up in the entire state.ObjectiveTo study the impact of interventions on nutritional status in PG and non-NSI comparison group (CG) blocks.MethodsQuasi-experimental mixed methods were used. The sample consisted of 3,626 households with children under 3 years of age and 268 mitanins.ResultsA ratio of 1 mitanin per 250 to 500 population was effective. The coverage of exclusive breastfeeding, timely introduction of complementary feeding, DPT immunization, and antenatal care services was more than 70%. The PDS reached almost 90% of beneficiaries. In both the PG and the CG, one-third of children were undernourished, with one-quarter of children under-nourished by 6 months of age. The prevalence of low birthweight was over 40%, and half of all women were undernourished. The estimated annual average reduction rate (AARR) for the entire state was estimated to be 4.22% for underweight and 5.64% for stunting.ConclusionsThe strategy of Mitanin Programme in the Indian state of Chhattisgarh was unique with the implementation of direct nutrition actions being spearheaded by the health sector and community health volunteers in coordination with the Integrated Child Development Services (ICDS) and the Public Distribution System (PDS). The highest priority was given to interventions in the first 92 weeks of life. This implied ensuring frequent counseling and delivery of services through the entire pregnancy period and continued follow up till the children were at least one year of age. An accelerated decrease in the annual rate of reduction of underweight and stunting was observed. The emerging findings point to the significant contributions that can be made by the National Rural Health Mission (NRHM) in India by involvement of community health volunteers known as Accredited Social Health Activists (ASHAs) towards reducing the persistent problem of undernutrition in the country.