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Context Systemic lupus erythematosus is usually missed in the pediatric population because of lower awareness among pediatricians. Aims The aim of this work was to study the clinical and immunological profile of lupus in children. Settings and design This study was carried out at a tertiary teaching institute of North India; this was a retrospective hospital-based study. Participants and methods Case records of 16 children of systemic lupus erythematosus in the age group 5-15 years were reviewed from hospital records. Statistical analysis used Means, proportions, and percentages were calculated using Epi Info 7. Results The mean age of children at the time of diagnosis was 12.1 years, with a female to male ratio of 5: 1. Fever (81.2%), rash (68.7%), arthritis (56.2%), and photosensitivity (56.2%) were the common clinical manifestations. Anemia was observed in 56.2%, whereas thrombocytopenia was noted in 31.2%. The kidney was the second most common system to be involved, with involvement in 43.7% of cases. Central nervous system involvement was observed in 31.2% of cases. Cardiac involvement was noted in 18% of cases. Antinuclear antibody was positive in all children. Three children died; two died of severe sepsis and one because of cardiogenic shock. Conclusion Systemic lupus should be considered a possible cause in adolescents presenting with multisystem involvement.

Kawasaki disease (KD) is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of five. The cause of KD is unknown, but if the symptoms are recognized early, children with the disease can fully recover within a few days. A generalized vasculitis of unknown etiology, early recognition and treatment of KD can reduce the development of potentially life-threatening coronary artery abnormalities.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has discovered a new disease called multisystem inflammatory syndrome in children (MIS-C). In developing nations, pediatricians must be mindful of the similarities between MIS-C and other tropical fevers such as scrub typhus. Not only should such patients be kept on high alert to rule out tropical diseases and receive appropriate treatment, such as steroids or immunomodulatory medications, but this is also concerning because, if rickettsial or bacterial infection is not detected through cultures and serology, steroid, or immunomodulatory treatment alone can be fatal. [ABSTRACT FROM AUTHOR]

Objective: To describe the patient population, priority diseases, and outcomes in neonates admitted to neonatal unit in the Himalayan region of North India. Study Design: The retrospective study was conducted at a University teaching hospital in Himachal Pradesh, and captured anonymized data on all admissions in newborn unit over 6-year period. Results: Total 12449 newborns were admitted, 4669 were outborn, M:F of 1.35:1 and 81% of them were discharged successfully. Overall admissions surged by 76 percent in six years, preterm admissions increased by 41%. During the same period delivery load grew by 24.7%. Majority 64.9% were full-term; 50.4% (6279/12449) of neonates were low birthweight (LBW; <2.5 kg) and 3.8% were Extreme LBW (ELBW; <1.0 kg). Among intramural, out of 20.2% preterm, 1.8% were <28 week; compared to 1.5% <28 week and 14.1% preterm in extramural. The intrauterine growth restriction rate was 17.6% for intramural and 19.3% for extramural, respectively. The most common morbidities were prematurity (40.2% & 27%), jaundice (32.6% & 27.5%), RDS and respiratory problems (19.2% & 9.8%), sepsis (11.3% & 23.5%), and perinatal asphyxia (6.2% and 7.5%) among inborn and outborn respectively. Total 798 (6.4%) newborns died, 10.5% of all deaths happened within 24 hours; mortality was very high amongst ELBW (110/205, 53.7%) and very preterm infants <28 weeks (81/135,60%). Only 993 inborn and 18 outborn received antenatal corticosteroids, with only 383 inborn and 4 outborn receiving four doses of Dexamethasone. Low gestational age, LBW, less of antenatal corticosteroids, outborns, male sex, and congenital deformity were all found to have a significant association with death (P < 0.001). Conclusion: Preterm accounts for a considerable majority of our total admissions. Greater efforts and investment in better prenatal care, infrastructure, therapeutic facilities, manpower, and periodic training and review of staff nurses are all urgently needed to address the extremely high burden of illnesses and mortality among hospitalized newborns; otherwise, lowering the NMR will remain an unattainable goal. [ABSTRACT FROM AUTHOR]

Byline: Parveen. Bhardwaj, Ravi. Sharma, Minoo. Sharma Homocystinuria is an inborn error of amino acid metabolism in which homocystine accumulates in the blood and produces a slowly evolving clinical syndrome. [...]

Byline: Parveen. Bhardwaj, Ram. Kaushal, Akshat. Chandel Sir, Biotinidase deficiency is a rare metabolic disorder with an estimated incidence of 1:61,067 population, although severe or profound disease is much rarer [...]

Byline: Parveen. Bhardwaj, Ram. Kaushal, Hemant. Gupta Sir, Kawasaki disease (KD) is a generalized vasculitis of unknown etiology and a leading cause of acquired heart disease among children living in [...]

Byline: Parveen. Bhardwaj, Vijay. Sharma, Ravi. Sharma, Piyush. Gautam Sir, The Landau-Kleffner syndrome or the syndrome of acquired epileptic aphasia was first described in 1957.[sup] [1] The disorder is characterized [...]

Background and Aims: Antibiotics are frequently prescribed for sore throat in developing countries, that in turn leads to huge healthcare expenditure and their irrational use may lead to antimicrobial resistance in the community. The aim of this study is to investigate the effect of environmental factors on the frequency of occurrence of group A beta hemolytic streptococcus (GABHS) sore throat and to work out enhancing effect on the sensitivity and specificity and positive predictive value of the signs and symptoms of GABHS sore throat for facilitation of rational antibiotic use. Settings and Design: This was a prospective, cross sectional study conducted over period of one year in Pediatric Outpatient Department (OPD) of a Tertiary care teaching hospital. Methods: All the children between the age of 5 years and 15 years of age presenting in OPD with the signs and symptoms of sore throat were included in the study. Statistical Analysis Used: Statistical analysis was carried out by using Statistical Package for Social Sciences software and statistical tests of Pearson's Coefficient, Chi-square Test, Fischer's Test, Likelihood Ratio, Odds Ratio, and ROC Curve were applied. Results: Out of 225 children of the study group, 153 (68%) of the children were in the 5-10 years' age group. Positive throat swab culture was found to be positively associated with high grade fever, pain in throat while swallowing, severely enlarged tonsils, tender lymphadenopathy, poor housing condition, fuel used for cooking, and presence of smoker in house. Conclusions: The study stresses on the need of carefully evaluating children presenting with the symptoms of sore throat as majority of the cases may be viral and thus, self-limiting. Poor housing conditions and indoor pollution contribute to the increased prevalence of sore throat. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease (KD) is an important cause of acquired heart disease with significant morbidity if not diagnosed and managed appropriately. It is usually under-diagnosed due to lack of knowledge regarding this entity among pediatricians and dermatologists. In this retrospective, tertiary care teaching institute based study clinical profile and outcome of KD in children from Himalayan region of north India was appraised. Methods: Clinical details of all the cases diagnosed as KD over 3 years from January 2011 to December 2013 were collected from inpatient files and outpatient follow-up clinical records. Results: Twelve children were diagnosed to have KD out of which seven had classical KD and five had incomplete KD. Mean age at presentation was 2.45 years and male to female ratio was 1.4:1. All children were treated with intravenous immunoglobulin and aspirin. Two out of 12 children had residual coronary artery disease at 6 weeks, 3 and 6 months of follow-up echocardiography. Conclusions: KD remains an important differential diagnosis for fever, rash, and lymphadenopathy in children <5 years. [ABSTRACT FROM AUTHOR]

Background: National surveys in India have documented an increasing number of adolescent girls suffering from anemia. Efforts to build iron stores in adolescent girls will help them improve their prepregnancy hemoglobin level. To assess the effectiveness of school-based supervised weekly, bi-weekly, and daily regimen of iron folic tablets in the treatment of anemia among adolescent girls. Methods: This randomized clinical trial included 331 anemic school going adolescent girls of Shimla district of North India. Study subjects were randomized to once weekly, bi-weekly, and daily iron folic acid regimen group. An intent-to-treat approach was used to analyze the change in hemoglobin level and serum ferritin levels at the end of the trial period. Results: The rate of change of hemoglobin and serum ferritin levels from baseline to the end of the intervention was found to be similar in all the three groups (P = 0.64 and 0.98 for change in hemoglobin and serum ferritin). Bi-weekly treatment regimen results in comparatively more increase in hemoglobin levels (3.1 g/dl) as compared to once weekly (2.4 g/dl) and daily groups (2.3 g/dl) (ANOVA F statistics = 6.08, P = 0.003). Among the study subjects who reported side effects, more were from daily regimen group (55%) as compared to intermittent regimen group (25% in bi-weekly group; 18% in weekly group; P < 0.001). Conclusions: In Shimla hills of North India, school-based intermittent iron-folic acid therapy is a feasible and effective intervention for increasing hemoglobin and serum ferritin levels of anemic adolescent girls. [ABSTRACT FROM AUTHOR]

Autoimmune lymphoproliferative syndrome (ALPS) is an inherited disorder characterized by chronic splenomegaly, lymphadenopaphy hypergammaglobulinemia and autoimmune phenomena especially immune-mediated cytopenias. The disease is characterized by presence of "double-negative (CD3+ CD4- CD8-)" T-cells in the peripheral blood and lymphoid tissue. Rarely it can also present as urticaria. We report a child of ALPS who presented to us with fever, generalized lymphadenopathy, chronic urticaria and hepatosplenomegaly. [ABSTRACT FROM AUTHOR]

Peak expiratory flow rate (PEFR) is a measure of ventilatory capacity measured by peak flow meter. It is regarded as a basic physiological parameter for the diagnosis, follow up and treatment of patients with respiratory illnesses such as asthma, chronic bronchitis, and emphysema. This study establishes the relationship of PEFR with age and BMI in healthy adult males (N=300) of Kumaon region of Uttarakhand. Overall, the mean PEFR is 478.37±68.14. The age is significantly affecting the PEFR unlike BMI. Age as an independent predictor predicts the 72.3% variability (R2 is 72.3%) in PEFR while BMI > 23 as an independent predictor predicts only 1.4% variability (R2 is 0.014). PEFR declines with advancing age due to degenerative changes in musculoskeletal system leading to decrease in respiratory muscle strength. PEFR shows some decline with high BMI in elderly age group.

Down syndrome is the commonest chromosomal anomaly. It is often associated with hypothyroidism, which may rarely present with cardiac tamponade as the earliest manifestation and prompt treatment with L-thyroxine is life saving. A six-month-old female child diagnosed as a case of Down syndrome presented with shortness of breathing for last 1 1/2 months. Facial dysmorphism, characteristic of Down syndrome was present. Echocardiography revealed large pericardial effusion and right ventricular diagnostic collapse. A case of Down syndrome with hypothyroidism and cardiac tamponade was kept in mind. She was treated with L-thyroxine and clinical status improved.