Indian pediatrics最新文献

Adolescent pregnancy is a significant public health issue, especially in low- and middle-income countries (LMICs). According to recent estimates, about 21 million girls aged 15-19 in developing regions become pregnant each year, with roughly 50% of these pregnancies being unintended. It has serious health, social, and economic effects, making it essential to address the root causes and impacts of adolescent pregnancy. Herein, we provide a brief overview of the scope of the problem, the context in which teenage pregnancies occur, and the global response to this critical issue. In the Indian context, the call for action requires strengthening legal frameworks against child marriage, expansion of comprehensive sexuality education (CSE), and scale-up of adolescent-friendly health services.

For neonates with congenital diaphragmatic hernia (CDH), the challenges start immediately after birth. Respiratory distress and hemodynamic compromise set in with the herniation of the contents of the abdomen into the thoracic cavity. Though definitive surgical correction and long-term follow-up are required, the immediate postnatal stabilization is of paramount importance. Depending on the extent of herniation, the associated physiological impairment is variable. With extensive research over the past few decades and a better understanding of the disease physiology, coupled with newer modalities in management, various multi-institutional bodies have proposed clinical practice guidelines. This study aims to compare these guidelines for the management of CDH neonates and to understand their implications for resource-poor settings.

Objective: Children with transfusion-dependent thalassemia (TDT) face significant physical, emotional, and social challenges that affect their and their families' lives. This study aimed to examine and compare the coping mechanisms of children with TDT and the disease-related impact on their parents' functioning.

Methods: This study enrolled children with TDT aged 8-16 years and age-matched healthy controls (ratio 1:2), and their respective parents. Psychological assessment of the children and their families was conducted using the PedsQL™ Family Impact Module and KidCOPE. Scores obtained from cases and controls were compared using the Mann-Whitney U test.

Results: Children with TDT (n = 75) showed significantly lower frequency of self-criticism (P = 0.001), higher perceived efficacy of problem-solving as a coping strategy (P = 0.008) and greater use of social support (P = 0.018) compared to the control group (n = 150). The respective parents of children with TDT experienced poorer overall family functioning and lower quality of life compared to parents of healthy children (P = 0.001).

Conclusions: The findings indicate that while children with TDT use certain adaptive coping strategies more frequently than their healthy peers, the overall family functioning and parental quality of life remain significantly compromised. These results highlight the need for psychosocial support addressing both child coping and caregiver well-being.

Over the past 25 years, the Indian Academy of Pediatrics-Intensive Care Chapter has transformed pediatric critical care in India from scattered efforts into a structured national system for training, accreditation, and policy. After its establishment in 1999, IAP-Intensive Care Chapter has bridged key gaps in training, evidence, and systems through competency-based fellowships, accreditation of teaching units, and the development of national guidelines. Its educational ecosystem now includes training programs for physicians and nurses, simulation-based learning, and quality improvement initiatives. The Journal of Pediatric Critical Care and PediCritiCon, the annual national conference of the Chapter, has fostered scholarship and collaboration, while research and innovation at individual and institutional levels are strengthening national evidence base. Despite major gains, challenges persist in ensuring equitable access, workforce sustainability, and outcome measurement. Future priorities include digital integration, simulation expansion, multicenter research, and national quality dashboards. The IAP-Intensive Care Chapter's journey illustrates how a professional society can drive systemic improvement in pediatric intensive care across a diverse, resource-limited nation.

Objective: There is dearth of clinical data from India regarding outcomes of umbilical cord blood transplant (UCBT). This study aimed to analyze the long-term outcomes in children who underwent UCBT at a single Indian center.

Methods: This retrospective study included patients who underwent UCBT between 2011 and 2024 in a tertiary care center in Northern India. Data on HLA-matching, cell dose, conditioning, engraftment, toxicities and survival outcomes were recorded.

Results: Out of 20 patients with median (Q1, Q3) age 4 (2, 6) years, 11 had leukemia and 9 had immunodeficiencies or enzymopathies. Majority (90%) received myeloablative-conditioning. Median CD34 + cell dose and total nucleated-cell dose were 3.3 × 10⁵/kg, and 9.6 × 10⁷/kg, respectively, with median (Q1, Q3) time for neutrophil engraftment of 28.5 (23, 36) days. The disease-free-survival (DFS) was 40.3, 77.8 and 10.2% in the overall cohort, benign- and malignant-cohorts, respectively, with 20% transplant-related mortality.

Conclusions: Umbilical cord blood-transplant showed good outcomes in non-malignant diseases in the absence of matched-related-donors, while, for malignancies, outcomes were suboptimal compared to global figures.