Indian pediatrics最新文献

Data on the use of infliximab (IFX) in infants with Kawasaki disease (KD) are scant. We retrospectively analyzed data of 35 infants with KD who received IFX. Effectiveness of IFX was assessed in the presence of intravenous immunoglobulin (IVIG) resistance and coronary artery aneurysm (CAA) regression. Fifteen of thirty-five received IFX in the presence of IVIG resistance; nineteen of thirty-five for CAA; and one for persistently high c-reactive protein. Thirteen out of fifteen with IVIG resistance became afebrile by 24 h. Twelve medium CAA regressed over 3 months, four of ten giant CAA normalized, and three regressed to small CAA, median time being 7.5 (3.5, 18) months. IFX was well-tolerated, safe, and effective in infants with KD.

Objective: To assess the cognitive and behavioral outcomes of very low birth weight (VLBW) as compared to normal birth weight (NBW) neonates in middle childhood.

Methods: In this observational study, the first 50 VLBW (≤ 1250 g) children from an original cohort of 2009-2011, who agreed to participate, and 50 age and sex-matched NBW children were assessed at 6-11 years age. Cognitive function, behavior, psychopathology, self-concept, adjustment and memory parameters were assessed by a certified psychologist using Malin's Intelligence Scale for Indian Children (MISIC), Childhood Psychopathology Measurement Schedule, Children's Self-concept Scale, Preadolescent Adjustment Inventory, and PGI Memory Scale for Children (PGIMC), respectively.

Results: Compared to NBW, the VLBW children had significantly lower Verbal Intelligence Quotient (IQ) (P = 0.008), Performance IQ (P < 0.001), and Full-Scale IQ (FSIQ) (P < 0.001). VLBW cohort had significantly lower scores in remote memory (P < 0.001), mental balance (P = 0.001), attention (P = 0.005), visual retention (P < 0.001), and recognition (P = 0.003). VLBW cohort exhibited significantly higher scores on psychopathology (P = 0.036), anxiety (P = 0.034), significantly lower self-concept (P < 0.001) and adjustment scores (P < 0.001) than NBW.

Conclusions: VLBW children have significant cognitive, behavioral and adjustment issues as compared to NBW children.

This case-control study assessed the inflammatory response and oxidative stress associated with snakebites in 116 children in comparison with 116 age-matched healthy controls. The median (Q1, Q3) levels of serum C-reactive protein [11.1 (4.2, 14.4) vs 2.6 (1.9, 3.3) mg/L, P < 0.001], interleukin-6 [84.8 (75.0, 95.0) vs 15.2 (12.2, 18.0) pg/mL, P < 0.001], and malondialdehyde [1.4 (1.1, 1.5) vs 1.0 (0.9, 1.1) nmol/mL, P < 0.001] were significantly higher in children with snakebites compared to the control group. Snakebite was associated with significant inflammation and oxidative stress in children.

Objective: To assess the prevalence of bacterial contamination of spacer devices used by asthmatic children.

Methods: A cross-sectional study at a tertiary centre in India included asthmatic children aged 5 to 17 years who were using metered-dose inhaler (MDI) with a spacer for at least three months. A sterile cotton swab pre-moistened in sterile brain heart infusion (BHI) broth, rotated around the inner surface of the spacers, was smeared on blood agar and MacConkey agar plates. Plates were incubated for bacterial growth and examined for colony growth.

Result: A total of 180 children were enrolled with a median (Q1, Q3) age of 12 (9, 14) years. Out of 180 spacer devices, 72 (40%) had pathogenic isolates and 108 (60%) had non-pathogenic isolates; Pseudomonas aeruginosa (28%) was the most common pathogenic bacteria. Only 17.8% (n = 32) were washing the spacer using soap and water; 84.4% (n = 152) patients used the air-dry method, and 15.6% (n = 28) dried the spacer using a cloth. There was no significant association between bacterial contamination and/or washing technique (P = 0.079). However, drying of spacer with a cloth was significantly associated with the growth of pathogenic bacteria as compared to air drying (P < 0.001). Bacterial contamination did not impact the asthma control (P = 0.491).

Conclusion: A high prevalence of bacterial contamination of spacer devices was noted in asthmatic children, although it was not associated with asthma control.

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.