Indian pediatrics最新文献

The national guidelines for evaluation of aggressive retinopathy of prematurity (AROP) in preterm neonates recommend the first examination at 2-3 weeks of age. This retrospective study investigated the yield of AROP checks performed at 3 weeks of postnatal age in neonates delivered between 23 and 28 weeks of gestation. Of the 260 eye examinations done at 3 weeks of age, none resulted in need for therapy for ROP over the ensuing week. Feed intolerance and cardiorespiratory events were noted after/during the AROP screening in one-third of the neonates. The median (Q1, Q3) time gap between the first AROP screening and any need for therapy was 8 (5, 9) weeks. This suggests that more evidence from prospective studies is required to corroborate the existing national guidelines for early retinal examinations.

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.

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.

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.

Objectives: To analyze the profile and outcomes of Indian children with hereditary tyrosinemia type 1 (HT-1).

Methods: In this retrospective study, the data of children with a confirmed diagnosis of HT-1 from 2013 to 2024 admitted in the pediatric hepatology unit of a tertiary care referral center were analyzed.

Results: Eighteen children with HT-1 with a median (Q1, Q3) age of diagnosis of 15.5 (6, 44) months were included. All children had established cirrhosis. Hepatocellular carcinoma (HCC) was noted in 4 patients at baseline, while HCC developed in 4 children on follow-up. Only 7 (38.9%) children could be initiated on nitisinone or 2-[2-nitro-4-trifluoromethylbenzoyl]-1,3-cyclohexanedione (NTBC). In the NTBC group (n = 7), one child survived with native liver, 3 children underwent liver transplant (LT) and 3 died. In the non-NTBC group (n = 11), 4 underwent LT (rest died). Post-LT survival was 100% without new-onset/recurrent HCC.

Conclusion: Native liver outcomes for HT-1 in the Indian subcontinent remain dismal with a high proportion developing HCC and requiring LT for optimum outcomes.