Indian pediatrics最新文献

Objective: To develop and validate e-portfolios for undergraduate medical students in the subject of Pediatrics.

Method: A descriptive study was conducted among the second year medical undergraduate students. A core committee validated the e-portfolio created on the Google platform. The students were sensitized, trained on the platform, and encouraged to innovate by designing the e-portfolios themselves, and record their clinical experiences under the mentorship of faculty. The feedback was collected using a validated student and faculty questionnaire with closed and open ended questions. Satisfaction index was calculated based on the responses to closed ended questions using Likert scale. Open ended questions were analyzed using thematic approach.

Results: The study enrolled 34 students and 12 faculty members. Students recorded a high satisfaction index on their experience to be interesting (97%), well structured (85%), user-friendly (82%), and on being able to archive their clinical experiences (100%). Faculty members recorded a high satisfaction index (100%) in students' ability to record their clinical knowledge and reflect on their learning and innovation; all were motivated to use e-portfolios in their specialty. The thematic analysis highlighted student satisfaction with accessibility and organized record-keeping, while faculty praised e-portfolios for nurturing creativity and aiding memory retention. Concerns included resource intensiveness, design prioritization, and privacy issues.

Conclusion: E-portfolios are rated as promising tools to record comprehensive clinical experience in pediatric by undergraduate students and faculty. Addressing identified challenges will further optimize their adoption in medical curricula, facilitating informed integration decisions.

Objectives: To assess the mitochondrial dysfunction, oxidative stress and premature aging in children with nutritional rickets.

Methods: This cross-sectional study enrolled children aged 6 months - 5 years with nutritional rickets attending a tertiary care hospital between January 2021 and August 2022. Mitochondrial dysfunction, oxidative stress and premature aging were assessed by measuring the mitochondrial DNA (mtDNA) content, total antioxidant status (TAOS) and telomere length (TL) in 40 children with nutritional rickets and 40 age- and sex- matched healthy children without rickets (controls).

Results: The median (IQR) mtDNA content was significantly higher in children with rickets as compared to controls [152.27 (111.83, 218.66) vs 93.7 (72.5, 134.14); P < 0.001], implying mitochondrial dysfunction attributed to increased mitochondrial biogenesis in children with rickets. The median (IQR) TAOS ( mM Trolox equiv.) was significantly lower in children with rickets than controls [4.54 (3.93, 5.73) vs 7.86 (5.09, 9.58); P < 0.001)]. The median (IQR) TL in cases was significantly longer in children with rickets compared to controls [417.31 (111.83,218.66) vs 93.7 (72.5,134.14); P < 0.001] implying that children with rickets do not have premature aging.

Conclusions: Children with rickets have high oxidative stress and mitochondrial dysfunction but no evidence of premature aging.

Objective: To assess the effect of iron supplementation on symptoms in children with attention deficit hyperactivity disease (ADHD).

Methods: A prospective single arm intervention study was conducted on children aged 4-12 years, newly diagnosed with ADHD, attending the child development clinic in a tertiary centre in Northern India. A baseline hemogram and serum ferritin levels were assessed in all children. ADHD symptom severity was assessed with age-appropriate neuropsychometric questionnaires, and objective tests of attention at baseline and after six weeks of oral iron therapy.

Results: Out of 32 participants, 23 were found to be ferritin sufficient (serum ferritin > 30 ng/mL) at enrolment. There was no difference in the median scores of neuropsychometric tests at the baseline of ferritin sufficient and ferritin deficient children. A statistically significant change in median scores of inattention and hyperactivity subscale on Conner's Rating Scale (P = 0.036) as well as significant improvement on tests of attention; Children's Color Trails Test (CCTT) (P = 0.006) were observed after six weeks of iron therapy in all children.

Conclusion: The study showed promising results of iron supplementation in the treatment of ADHD symptoms in children. Keywords: ADHD, Anemia, Inattention, Serum ferritin.

Objective: To evaluate the role of basal and follicle-stimulating hormone (FSH)-stimulated inhibin B in differentiating premature thelarche from gonadotropin-dependent precocious puberty (GDPP).

Methods: This was a prospective interventional study. Basal and FSH-stimulated inhibin B levels were estimated in girls presenting with thelarche < 8 years age (n = 10), healthy girls with normal pubertal development (pubertal control) (n = 8) and healthy prepubertal girls (prepubertal control) (n = 7). Girls with early puberty were classified as premature thelarche or GDPP based on GnRH agonist stimulation test.

Results: Median (IQR) basal inhibin B levels (pg/mL) in premature thelarche was 5.42 (2.91, 30.58) and FSH-stimulated inhibin B was 236.72 (111.53, 4431.73) (P = 0.043). Median (IQR) basal inhibin B in GDPP was 64.11 (24.96, 792.45) pg/mL and FSH-stimulated inhibin B was 833.66 (500.11-1266.18) pg/mL (P = 0.043). Basal inhibin B was discriminatory between GDPP and premature thelarche (P = 0.032). Median (IQR) basal inhibin B in prepubertal and pubertal controls was 20.36 (9.61, 29.12) and 75.48 (58.55, 165.55) pg/mL, respectively.

Conclusion: Basal inhibin B is useful in differentiation of premature thelarche from GDPP while the role of FSH-stimulated inhibin B needs to be further explored in large sample size.

Predischarge pulse oximetry screening (POS) is recommended to pick up critical congenital heart diseases in apparently well neonates. However, it is possible that cases may be missed during the early POS in the presence of delayed closure of the ductus arteriosus. Repeat POS in the second week of life was found to be helpful and feasible for early detection of pathological states causing hypoxemia in seemingly well neonates. Studies with larger sample size are recommended to establish the role of an additional POS in the second week for enhanced CCHD detection.

We determined the burden of concomitant chronic non-epilepsy drug use in 100 consecutive outpatient children with a diagnosis of epilepsy (mean (SD) age 7.38 (3.24) y), taking anti-seizure medications (ASM) for at least 6 months. Majority (n = 68) of the children had comorbidities; most commonly global developmental delay (27%). 61 children were receiving chronic non-epilepsy drugs; most common being calcium (38%), multivitamins (18%) and folic acid (16%). Of these, 50 children (82%) were prescribed drugs without any documented indication. Another 24 children (39.4%) were using complementary and alternative medications. The observed chronic non-epilepsy drug use, many of which were not indicated, reiterates the need to limit the burden of medications in children with epilepsy.