Indian pediatrics最新文献

Objectives: To determine the proportion of celiac disease (CD) among children with severe acute malnutrition (SAM) and to evaluate the distribution and association of HLA-DQ2/DQ8 genotypes in affected children.

Methods: Children aged 6-59 months diagnosed with SAM were assessed for inclusion. Those with secondary causes of SAM like underlying chronic illnesses like congenital heart disease, renal disease, or immunodeficiency were excluded. All participants were tested for tissue transglutaminase (tTG) immunoglobulin A serology, endoscopic biopsy of duodenum and HLA DQ2/DQ8 genotyping. tTG IgA serology positive and histopathology compatible (Modified Marsh grade ≥ II) cases were grouped as group A (SAM with CD). Rest of the cases were grouped as group B (SAM without CD).

Results: Out of 140 children with SAM, 20 with secondary causes of malnutrition were excluded. 40 out of 140 participants (28.57%) were tTG IgA positive with duodenal biopsy confirmatory of CD (group A). HLA-DQ2/DQ8 positivity was observed in 95% in group A and 57% of group B (P < 0.001). The most frequent genotype was HLA-DQ2.5 (67.5% in group A, 35% in group B; OR = 3.86, 95% CI 1.72-8.63).

Conclusion: A substantial proportion of children with SAM have undiagnosed CD with HLA-DQ2.5 genotype being the most common genotype.

Wheezing in preschool children is a common clinical challenge characterized by a broad differential diagnosis and marked phenotypic heterogeneity. The Global Initiative for Asthma (GINA) 2025 guidelines introduce a structured framework for diagnosing asthma in this age group, shifting from a probabilistic to a more definitive labelling approach. While this represents a significant evolution, its applicability in low- and middle-income countries (LMICs) faces significant barriers including caregiver misreporting, limited diagnostic tools, and inconsistent follow-up. This article critically examines these challenges, particularly the risks of overdiagnosis and overtreatment in preschool wheeze within the LMIC context.

Objective: To assess the weekly trends in weight and triceps skinfold thickness (TSFT) in children with acute lymphoblastic lymphoma (ALL) during induction chemotherapy.

Methods: Children aged 1 month to 15 years with ALL were followed up during induction phase of chemotherapy. Weight and TSFT were recorded at baseline and on days 8, 15, 22, 29, and 35 and trends of the same were analyzed.

Results: A total of 101 children with median (q1, q3) age 6 (3, 11) years were assessed at baseline, and 95 were assessed on day 8 of induction. The weight loss and TSFT depletion were observed in 74 (77.8%) and 60 (63.1%), respectively, at any time during induction, peaking in severity within the first week of induction therapy. Treatment interruptions were observed in 60.8% children who had weight loss and/or TSFT depletion. Almost 54% and 42% children did not regain baseline weight and TSFT by the end of induction. Standard risk and age < 6.5 years were associated with decreased risk of weight loss and TSFT depletion.

Conclusion: Older children are prone to weight loss and sarcopenic wasting during induction phase of chemotherapy for ALL.

India faces a persistent triple burden of malnutrition characterized by undernutrition, micronutrient deficiencies, and rising childhood overweight and obesity, necessitating strengthened pediatric nutrition leadership. In response, the Nutrition Chapter of the Indian Academy of Pediatrics, also known as the Pediatric and Adolescent Nutrition (PAN) Society, was established as a dedicated academic, advisory, and advocacy platform to advance evidence-based nutrition care. Since its inception, the society has organized annual national conferences (Pednutricon), consultations, workshops, and webinars to promote capacity building, research dissemination, and cross learnings. It has convened multidisciplinary expert groups that developed consensus recommendations and nationally endorsed guidelines on key issues such as unhealthy JUNC foods, vitamin D deficiency, nutritional anemia, obesity, and early growth failure. During the COVID-19 pandemic, activities successfully transitioned to virtual platforms, ensuring continued engagement. Current initiatives include structured competency-based training "NEST" and contributions in Nutrition 360-degree Pediatrics under Central IAP President Action plan 2026.