Pub Date : 2024-08-09DOI: 10.32677/ijch.v11i5.4691
Amit Agrawal, Rashmi Agrawal
Soaring temperatures, as a result of climate change, is impacting all beings across the globe. This has led to multiple illnesses and emergency room visits, during extreme temperatures, especially summers. The most vulnerable to scorching heat are infants, children and adolescents along with the elderly. Heat-related illnesses (HRIs) may range from minor forms, such as prickly heat, to severe, life-threatening conditions such as heatstroke. Pediatricians need to be aware of the varying physiologies and behaviors the children might present as a result of HRI and predisposing factors that may put them further at risk. Although the pathophysiology of HRI is understood, the scope of pharmacotherapy to treat them is limited. Currently, prevention is the best course of action against HRIs. Thus, the escalating average temperatures and challenges, posed by climate change, demand a review of the existing preventive and treatment strategies for HRIs. This article hence, attempts to compile the different kinds of HRIs along with their pathophysiology, causes, and detection and how they can be prevented and treated among children.
{"title":"An analysis of heat-related illnesses in children due to immoderate temperatures","authors":"Amit Agrawal, Rashmi Agrawal","doi":"10.32677/ijch.v11i5.4691","DOIUrl":"https://doi.org/10.32677/ijch.v11i5.4691","url":null,"abstract":"Soaring temperatures, as a result of climate change, is impacting all beings across the globe. This has led to multiple illnesses and emergency room visits, during extreme temperatures, especially summers. The most vulnerable to scorching heat are infants, children and adolescents along with the elderly. Heat-related illnesses (HRIs) may range from minor forms, such as prickly heat, to severe, life-threatening conditions such as heatstroke. Pediatricians need to be aware of the varying physiologies and behaviors the children might present as a result of HRI and predisposing factors that may put them further at risk. Although the pathophysiology of HRI is understood, the scope of pharmacotherapy to treat them is limited. Currently, prevention is the best course of action against HRIs. Thus, the escalating average temperatures and challenges, posed by climate change, demand a review of the existing preventive and treatment strategies for HRIs. This article hence, attempts to compile the different kinds of HRIs along with their pathophysiology, causes, and detection and how they can be prevented and treated among children.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.32677/ijch.v11i6.4728
Priyabrata Panda, Anil Kumar Sapare, R. Aggarwal
Heiner Syndrome is an unusual form of pulmonary hemosiderosis mostly caused by cow milk. It presents as iron deficiency anemia,and hypoproteinemia. This clinical case describes a female infant with failure to thrive presenting with cough, low grade fever , fastbreathing with refusal to feed. On examination severe anemia with congestive cardiac failure was found, the cause of which wa sevaluated. Chest X ray showed bilateral fluffy infiltrates mimicking pneumonia. Investigations revealed microcytic hypochromicanemia with normal corrected reticulocyte count. Iron deficiency anemia (IDA) was diagnosed. However, the etiology of bilater alfluffy lung infiltrates could not be established in this child. Hence Broncho Alveolar Lavage (BAL) for hemosiderin ladenmacrophages and immunoglobulin for cow milk precipitin was done to establish the diagnosis.
海纳综合征（Heiner Syndrome）是一种不寻常的肺血细胞增多症，主要由牛奶引起。它表现为缺铁性贫血和低蛋白血症。本临床病例描述了一名发育不良的女婴，表现为咳嗽、低烧、呼吸急促和拒绝进食。检查时发现婴儿严重贫血，并伴有充血性心力衰竭，需要对病因进行评估。胸部 X 光片显示双侧绒毛状浸润，疑似肺炎。检查发现小红细胞低色素血症，校正网织红细胞计数正常。诊断结果为缺铁性贫血（IDA）。然而，该患儿肺部双侧白细胞浸润的病因无法确定。因此，对该患儿进行了支气管肺泡灌洗液（BAL）检查，以检测含血色素的巨噬细胞和牛乳沉淀蛋白的免疫球蛋白，从而确定诊断。
{"title":"Heiner Syndrome Mimicking Pneumonia with Iron Deficiency Anemia","authors":"Priyabrata Panda, Anil Kumar Sapare, R. Aggarwal","doi":"10.32677/ijch.v11i6.4728","DOIUrl":"https://doi.org/10.32677/ijch.v11i6.4728","url":null,"abstract":"Heiner Syndrome is an unusual form of pulmonary hemosiderosis mostly caused by cow milk. It presents as iron deficiency anemia,and hypoproteinemia. This clinical case describes a female infant with failure to thrive presenting with cough, low grade fever , fastbreathing with refusal to feed. On examination severe anemia with congestive cardiac failure was found, the cause of which wa sevaluated. Chest X ray showed bilateral fluffy infiltrates mimicking pneumonia. Investigations revealed microcytic hypochromicanemia with normal corrected reticulocyte count. Iron deficiency anemia (IDA) was diagnosed. However, the etiology of bilater alfluffy lung infiltrates could not be established in this child. Hence Broncho Alveolar Lavage (BAL) for hemosiderin ladenmacrophages and immunoglobulin for cow milk precipitin was done to establish the diagnosis.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.32677/ijch.v11i5.4681
Goutham Krishna, Hitha Diljith, Abdul Majeed
Haemophilia A is a genetic disorder characterized by the absence or reduced activity of factor VIII (FVIII), a crucial protein for blood clotting. The severity of Haemophilia A is directly related to the level of FVIII activity in the blood. The conventional one-stage clotting assay is the most commonly used diagnostic tool due to its simplicity and widespread availability. However, in cases of mild or moderate Haemophilia A, there can be significant disparities between results obtained from one-stage and two-stage assays. These discrepancies can result in normal FVIII levels being reported by the one-stage assay, potentially leading to a missed diagnosis or underestimation of the patient's bleeding risk. We present a case of a 18-year-old male diagnosed with severe Haemophilia A. The patient’s medical history included multiple severe bleeding episodes, including spontaneous haemarthrosis and prolonged bleeding following minor injuries. Despite these symptoms, the initial diagnostic approach using the one-stage assay suggested normal FVIII activity, which could have led to inadequate treatment and management strategies. Findings in Chromogenic Assay were crucial in correctly identifying the severe nature of the disorder, thus underscoring the importance of using multiple diagnostic tools to confirm FVIII activity levels. This case highlights the role of the chromogenic assay in the accurate diagnosis of Haemophilia A, particularly in patients where clinical symptoms do not match with one-stage assay results. This case emphasizes the need for heightened awareness among clinicians regarding the limitations of the one-stage assay and the benefits of incorporating the chromogenic assay into routine diagnostic practice for Haemophilia A.
血友病 A 是一种遗传性疾病，其特征是缺乏第八因子（FVIII）或第八因子活性降低，而第八因子是凝血的关键蛋白。血友病 A 的严重程度与血液中 FVIII 的活性水平直接相关。传统的单阶段凝血测定法因其简单易行和广泛使用而成为最常用的诊断工具。然而，在轻度或中度血友病 A 的病例中，单阶段检测和双阶段检测得出的结果可能存在显著差异。这些差异可能导致单阶段检测报告的 FVIII 水平正常，从而可能导致漏诊或低估患者的出血风险。我们介绍了一例被诊断为重度血友病 A 的 18 岁男性患者的病例。患者的病史包括多次严重出血，包括自发性血崩和轻伤后长时间出血。尽管出现了这些症状，但使用单阶段测定法进行的初步诊断显示 FVIII 活性正常，这可能导致治疗和管理策略不当。色原测定的结果对于正确识别该疾病的严重性质至关重要，因此强调了使用多种诊断工具确认 FVIII 活性水平的重要性。本病例强调了色原测定在准确诊断甲型血友病中的作用，尤其是在临床症状与单阶段测定结果不相符的患者中。本病例强调了临床医生需要提高对单级测定局限性的认识，以及将显色测定纳入血友病 A 常规诊断实践的益处。
{"title":"Chromogenic Assay : A Critical Diagnostic Tool for Accurate Diagnosis of Severe Hemophilia A","authors":"Goutham Krishna, Hitha Diljith, Abdul Majeed","doi":"10.32677/ijch.v11i5.4681","DOIUrl":"https://doi.org/10.32677/ijch.v11i5.4681","url":null,"abstract":"Haemophilia A is a genetic disorder characterized by the absence or reduced activity of factor VIII (FVIII), a crucial protein for blood clotting. The severity of Haemophilia A is directly related to the level of FVIII activity in the blood. The conventional one-stage clotting assay is the most commonly used diagnostic tool due to its simplicity and widespread availability. However, in cases of mild or moderate Haemophilia A, there can be significant disparities between results obtained from one-stage and two-stage assays. These discrepancies can result in normal FVIII levels being reported by the one-stage assay, potentially leading to a missed diagnosis or underestimation of the patient's bleeding risk. We present a case of a 18-year-old male diagnosed with severe Haemophilia A. The patient’s medical history included multiple severe bleeding episodes, including spontaneous haemarthrosis and prolonged bleeding following minor injuries. Despite these symptoms, the initial diagnostic approach using the one-stage assay suggested normal FVIII activity, which could have led to inadequate treatment and management strategies. Findings in Chromogenic Assay were crucial in correctly identifying the severe nature of the disorder, thus underscoring the importance of using multiple diagnostic tools to confirm FVIII activity levels. This case highlights the role of the chromogenic assay in the accurate diagnosis of Haemophilia A, particularly in patients where clinical symptoms do not match with one-stage assay results. This case emphasizes the need for heightened awareness among clinicians regarding the limitations of the one-stage assay and the benefits of incorporating the chromogenic assay into routine diagnostic practice for Haemophilia A.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.32677/ijch.v11i6.4730
Sharanabasappa S Dhanwadkar, Ashwini G. Rayee, Sandeep H, Ashwini Kumari N B
Background: Thalassemia is a public health problem worldwide. With the high disease burden of thalassemia, low socioeconomic conditions and poor preventive strategies, our patients are left with no other option except the repeated blood transfusion. So prevention is the only tool to reduce the burden of this disease. This study was done to identify the gap in knowledge, attitude and practices (KAP) about β-thalassemia among the parents of beta thalassemia children. So that it will be helpful to reduce the burden of the disease in the society in the near future. Objectives: To assess the Knowledge (K), attitude (A) and practices (P) among parents with beta thalassemia major children regarding beta thalassemia major disease. Materials and Methods: A semi structured pre-validated questionnaire designed to assess the Knowledge, Attitudes and Practices in relation to beta thalassemia major disease was administered to all the parents fulfilling the inclusion criteria. Collected data was analysed. Results: In this study, None of the participants had knowledge about thalassemia before their first child was born. In this study, 76.9% study subjects knew and understood the genetic nature of Thalassemia. In our study, about 75.4% participants didn’t know about premarital screening and 50.8% didn’t know about prenatal diagnosis. About 18.5% of them are practising chorionic villous sampling test. Only 60.0% of them got other siblings of the thalassemia children screened for thalassemia. Only 43.1% received genetic counselling about thalassemia major. Conclusion: It was seen from our study that parents don’t have adequate knowledge, positive attitude and practice on thalassemia major. Health education and periodic counselling of parents and care takers about prevention of thalassemia needs to be implemented at every thalassemia day care centre.
{"title":"A study on awareness among parents with beta thalassemia major children in government district hospital, Kalaburagi","authors":"Sharanabasappa S Dhanwadkar, Ashwini G. Rayee, Sandeep H, Ashwini Kumari N B","doi":"10.32677/ijch.v11i6.4730","DOIUrl":"https://doi.org/10.32677/ijch.v11i6.4730","url":null,"abstract":"Background: Thalassemia is a public health problem worldwide. With the high disease burden of thalassemia, low socioeconomic conditions and poor preventive strategies, our patients are left with no other option except the repeated blood transfusion. So prevention is the only tool to reduce the burden of this disease. This study was done to identify the gap in knowledge, attitude and practices (KAP) about β-thalassemia among the parents of beta thalassemia children. So that it will be helpful to reduce the burden of the disease in the society in the near future. Objectives: To assess the Knowledge (K), attitude (A) and practices (P) among parents with beta thalassemia major children regarding beta thalassemia major disease. Materials and Methods: A semi structured pre-validated questionnaire designed to assess the Knowledge, Attitudes and Practices in relation to beta thalassemia major disease was administered to all the parents fulfilling the inclusion criteria. Collected data was analysed. Results: In this study, None of the participants had knowledge about thalassemia before their first child was born. In this study, 76.9% study subjects knew and understood the genetic nature of Thalassemia. In our study, about 75.4% participants didn’t know about premarital screening and 50.8% didn’t know about prenatal diagnosis. About 18.5% of them are practising chorionic villous sampling test. Only 60.0% of them got other siblings of the thalassemia children screened for thalassemia. Only 43.1% received genetic counselling about thalassemia major. Conclusion: It was seen from our study that parents don’t have adequate knowledge, positive attitude and practice on thalassemia major. Health education and periodic counselling of parents and care takers about prevention of thalassemia needs to be implemented at every thalassemia day care centre.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.32677/ijch.v11i2.4597
Amit Agrawal, Rashmi Agrawal
Allergic reactions in children are a major concern globally. The ever-changing environment, exposure to new and chemically altered compounds, genetically modified food products, variations in hygiene parameters, and most importantly, questionable immunity, together influence the pattern of allergic diseases in children. The most favorable and convenient mode of treatment sought is the use of over-the-counter drugs like antihistamines. However, they tend to lose their efficacy when used over a long period of time. Immunotherapy, for the management of allergic conditions, is considered a gold standard and is still a promising tool. Subcutaneous immunotherapy and sublingual immunotherapy together comprise the two modes of allergen-specific immunotherapy. Each method differs in its mode of administration and role in allergic diseases, in terms of, efficacy and safety measures. The choice between the two is dependent on the type of allergic disease and personal preferences opted either by the specific patient, or by the health-care professional involved in the treatment. The convenience of administration and compliance are also major grounds to consider while opting for the most appropriate mode of treatment. This review hence highlights new advancements in the field of immunotherapy, the efforts to achieve the goals envisioned and literature focusing on better outcomes in managing allergic reactions.
{"title":"Immunotherapy approaches for managing allergic conditions in children – A narrative review","authors":"Amit Agrawal, Rashmi Agrawal","doi":"10.32677/ijch.v11i2.4597","DOIUrl":"https://doi.org/10.32677/ijch.v11i2.4597","url":null,"abstract":"Allergic reactions in children are a major concern globally. The ever-changing environment, exposure to new and chemically altered compounds, genetically modified food products, variations in hygiene parameters, and most importantly, questionable immunity, together influence the pattern of allergic diseases in children. The most favorable and convenient mode of treatment sought is the use of over-the-counter drugs like antihistamines. However, they tend to lose their efficacy when used over a long period of time. Immunotherapy, for the management of allergic conditions, is considered a gold standard and is still a promising tool. Subcutaneous immunotherapy and sublingual immunotherapy together comprise the two modes of allergen-specific immunotherapy. Each method differs in its mode of administration and role in allergic diseases, in terms of, efficacy and safety measures. The choice between the two is dependent on the type of allergic disease and personal preferences opted either by the specific patient, or by the health-care professional involved in the treatment. The convenience of administration and compliance are also major grounds to consider while opting for the most appropriate mode of treatment. This review hence highlights new advancements in the field of immunotherapy, the efforts to achieve the goals envisioned and literature focusing on better outcomes in managing allergic reactions.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.32677/ijch.v11i1.4543
P. R. Jayakumar, P. S. Sukumaran
Objectives: The objective of this study was to determine the neurodevelopmental status of pre-term babies between <34 weeks of gestation and equal to or more than 25 weeks of gestation, at corrected 2 years of age with respect to their antenatal steroid status. Materials and Methods: This population-level prospective study was conducted over a period of 6 years from 2017 to 2023 in middle Kerala. Pre-term babies with gestational age at birth between <34 weeks and equal to or more than 25 completed weeks, presenting for follow-up within 3 months of delivery, were randomly enrolled for the study. A total of 150 children were followed up and neurodevelopmental assessment done using Bayley Scales of Infant and Toddler Development edition-3 at their corrected 2 years of age. Approval for this prospective observational study was obtained from the Institutional Ethics Committee, School of Behavioral Sciences, Mahatma Gandhi University, Kottayam, Kerala, dated September 22, 2017. Results: Eighty-one pre-term <34 weeks babies belonged to the antenatal steroid complete group, 40 pre-term <34 weeks babies belonged to the antenatal steroid partial group, and 29 pre-term <34 weeks babies belonged to the nil steroid group. Total neurodevelopmental status score and domain-wise, cognitive, language, motor, and social-emotional developmental scores show significantly higher scores for pre-term <34 weeks with antenatal history of complete course steroid administered before pre-term delivery compared to partial and nil antenatal steroid group. Conclusions: Antenatal steroids are having a significant impact on the overall neurodevelopmental outcome of pre-term babies equal to or more than 25 weeks of gestation and <34 weeks of gestation, at their corrected 2 years of age, the maximum benefit for complete antenatal steroid group pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation when compared with pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation without any antenatal steroids.
{"title":"Neurodevelopmental outcome of pre-term babies less than 34 weeks of gestation at corrected 2 years of age, with respect to their antenatal steroid status","authors":"P. R. Jayakumar, P. S. Sukumaran","doi":"10.32677/ijch.v11i1.4543","DOIUrl":"https://doi.org/10.32677/ijch.v11i1.4543","url":null,"abstract":"Objectives: The objective of this study was to determine the neurodevelopmental status of pre-term babies between <34 weeks of gestation and equal to or more than 25 weeks of gestation, at corrected 2 years of age with respect to their antenatal steroid status. Materials and Methods: This population-level prospective study was conducted over a period of 6 years from 2017 to 2023 in middle Kerala. Pre-term babies with gestational age at birth between <34 weeks and equal to or more than 25 completed weeks, presenting for follow-up within 3 months of delivery, were randomly enrolled for the study. A total of 150 children were followed up and neurodevelopmental assessment done using Bayley Scales of Infant and Toddler Development edition-3 at their corrected 2 years of age. Approval for this prospective observational study was obtained from the Institutional Ethics Committee, School of Behavioral Sciences, Mahatma Gandhi University, Kottayam, Kerala, dated September 22, 2017. Results: Eighty-one pre-term <34 weeks babies belonged to the antenatal steroid complete group, 40 pre-term <34 weeks babies belonged to the antenatal steroid partial group, and 29 pre-term <34 weeks babies belonged to the nil steroid group. Total neurodevelopmental status score and domain-wise, cognitive, language, motor, and social-emotional developmental scores show significantly higher scores for pre-term <34 weeks with antenatal history of complete course steroid administered before pre-term delivery compared to partial and nil antenatal steroid group. Conclusions: Antenatal steroids are having a significant impact on the overall neurodevelopmental outcome of pre-term babies equal to or more than 25 weeks of gestation and <34 weeks of gestation, at their corrected 2 years of age, the maximum benefit for complete antenatal steroid group pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation when compared with pre-term babies, equal to or more than 25 weeks and <34 completed weeks of gestation without any antenatal steroids.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.32677/ijch.v11i1.4510
R. Ghritlaharey
Keratinous cysts, the most common kind of epidermal cysts, are filled with keratin originating from the epidermis, most often from the hair follicle. Keratinous cyst is one of the most common skin lesions and occurs most commonly in the face, head, trunk, extremities, and genitals. A 7-year-old girl reported to the pediatric surgery department with a painless, small tumor arising from her umbilicus. There was no history of trauma, and it has been slowly growing for the past many years. Clinical examination revealed a 3-cm-long skin tag with three small interconnected tumors from the umbilicus. It was soft, and the parts of the tumors looked like they contained whitish material inside. Her general and other systems, including the abdominal examinations, were within the normal limits. The tumor was resected through a sub-umbilical skin incision. She made an uninterrupted recovery. The excised specimens subjected to histology were reported as superficial keratinous cysts. Keratinous cysts are one of the most common benign skin lesions, but not the most common, at the umbilicus. Clinicians need to be aware of such pathology during the evaluation of the umbilical swellings and tumors, especially in children.
{"title":"Umbilical keratinous cyst in a 7-year-old girl: A case report","authors":"R. Ghritlaharey","doi":"10.32677/ijch.v11i1.4510","DOIUrl":"https://doi.org/10.32677/ijch.v11i1.4510","url":null,"abstract":"Keratinous cysts, the most common kind of epidermal cysts, are filled with keratin originating from the epidermis, most often from the hair follicle. Keratinous cyst is one of the most common skin lesions and occurs most commonly in the face, head, trunk, extremities, and genitals. A 7-year-old girl reported to the pediatric surgery department with a painless, small tumor arising from her umbilicus. There was no history of trauma, and it has been slowly growing for the past many years. Clinical examination revealed a 3-cm-long skin tag with three small interconnected tumors from the umbilicus. It was soft, and the parts of the tumors looked like they contained whitish material inside. Her general and other systems, including the abdominal examinations, were within the normal limits. The tumor was resected through a sub-umbilical skin incision. She made an uninterrupted recovery. The excised specimens subjected to histology were reported as superficial keratinous cysts. Keratinous cysts are one of the most common benign skin lesions, but not the most common, at the umbilicus. Clinicians need to be aware of such pathology during the evaluation of the umbilical swellings and tumors, especially in children.\u0000 \u0000 ","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In 1993, Richardson et al. introduced the score for neonatal acute physiology (SNAP), a 34-parameter system predicting mortality and morbidity in neonates. To enhance simplicity, it was later refined to nine parameters and renamed SNAP-II. Additionally, a perinatal extension known as SNAP Perinatal Extension, Version II (SNAPPE-II) was developed for broader applicability. Objectives: To determine the validity of SNAPPE-II in predicting the outcome in terms of mortality in premature babies of gestational age between 32 and 36 weeks in a tertiary care neonatal intensive care unit (NICU) of Cheluvamba Hospital, Mysore, Karnataka. Materials and Methods: The diagnostic study was conducted in the NICU of a tertiary care center in Mysore, India. The sample size of 138 subjects was calculated using a formula, and simple random sampling was used. The study included newborns with gestational ages between 32 and 36 weeks, and data was collected within 48 h of birth as per the proforma. The study assessed the correlation between the SNAPPE II score and mortality rate in babies admitted to the NICU. Data were analyzed using various statistical methods. Results: This study finds that the SNAPPE-II score has a moderate ability to distinguish between those newborns who will end up with mortality and those who will survive, as indicated by an area under ROC curve of 0.724, and has moderate diagnostic accuracy as indicated by a Youden index of 0.3974. The associated criterion for the SNAPPE-II score is >57, indicating newborns are more likely to have mortality. Conclusion: The SNAPPE-II score can be used to predict neonatal mortality rates in moderate-to-late preterm babies of gestational age between 32 and 36 weeks.
{"title":"Neonatal mortality risk assessment using SNAPPE-2 score in a neonatal intensive care unit in moderate-to-late preterm Newborns","authors":"Divyashree Devaramuddinahalli Annegowda, Chandana Nanjaiah Shetty Srinivas, Prashanth Siddaiah","doi":"10.32677/ijch.v10i11.4289","DOIUrl":"https://doi.org/10.32677/ijch.v10i11.4289","url":null,"abstract":"Background: In 1993, Richardson et al. introduced the score for neonatal acute physiology (SNAP), a 34-parameter system predicting mortality and morbidity in neonates. To enhance simplicity, it was later refined to nine parameters and renamed SNAP-II. Additionally, a perinatal extension known as SNAP Perinatal Extension, Version II (SNAPPE-II) was developed for broader applicability. Objectives: To determine the validity of SNAPPE-II in predicting the outcome in terms of mortality in premature babies of gestational age between 32 and 36 weeks in a tertiary care neonatal intensive care unit (NICU) of Cheluvamba Hospital, Mysore, Karnataka. Materials and Methods: The diagnostic study was conducted in the NICU of a tertiary care center in Mysore, India. The sample size of 138 subjects was calculated using a formula, and simple random sampling was used. The study included newborns with gestational ages between 32 and 36 weeks, and data was collected within 48 h of birth as per the proforma. The study assessed the correlation between the SNAPPE II score and mortality rate in babies admitted to the NICU. Data were analyzed using various statistical methods. Results: This study finds that the SNAPPE-II score has a moderate ability to distinguish between those newborns who will end up with mortality and those who will survive, as indicated by an area under ROC curve of 0.724, and has moderate diagnostic accuracy as indicated by a Youden index of 0.3974. The associated criterion for the SNAPPE-II score is >57, indicating newborns are more likely to have mortality. Conclusion: The SNAPPE-II score can be used to predict neonatal mortality rates in moderate-to-late preterm babies of gestational age between 32 and 36 weeks.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to determine the correlation between clinical as well as laboratory profile changes with the outcome of acute encephalitis syndrome (AES) cases. Materials and Methods: This prospective observational study was conducted in the Department of Pediatrics at Jorhat Medical College and Hospital, Assam over a period of 1 year where 49 diagnosed cases of AES in children aged between 1 month and 12 years were enrolled. Results: The study found that fever (100%) and altered sensorium (100%) were the most common clinical presentations in AES cases, followed by seizure (63%), headache (34.7%), vomiting (26.5%), diarrhea (22.4%), etc. Japanese encephalitis (JE) was the most common cause of AES (28.6%), followed by herpes simplex virus (4.1%), pyogenic meningitis (4.1%), and tubercular meningitis (2%), etc. However, the majority of cases (61.2%) were found to have an unknown etiology. Among the 49 cases, 27 (55.1%) recovered without neurological sequelae, 8 (16.8%) had neurological sequelae, and 14 (28.6%) died during the course of treatment. The most common neurological sequelae observed were motor deficit (37.5%), behavioral disorders, aphasia (25% each), and cranial nerve palsy. Glasgow coma scale (GCS) at the time of admission and during the time of hospital stay was found to have a significant (p<0.05) correlation with outcome in AES patients. Conclusion: The study concludes that AES cases commonly present with fever, altered sensorium, seizure, headache, vomiting, and signs of meningeal irritation. JE remains a major known cause of AES in children in this region of India. GCS at the time of admission and during the time of hospital stay were found to have a significant correlation with outcome. The neurological sequelae highlight the need for global attention to combat them save the lives of children.
{"title":"Correlation between clinical-laboratory profile and outcome of AES cases in children: A hospital-based study","authors":"Sandeep Kumar Baranwal, Pranabjit Biswanath, Gitali Kakoti, Pankaj Pradeep Panyang, Anowar Hussain","doi":"10.32677/ijch.v10i11.4394","DOIUrl":"https://doi.org/10.32677/ijch.v10i11.4394","url":null,"abstract":"Objective: This study aims to determine the correlation between clinical as well as laboratory profile changes with the outcome of acute encephalitis syndrome (AES) cases. Materials and Methods: This prospective observational study was conducted in the Department of Pediatrics at Jorhat Medical College and Hospital, Assam over a period of 1 year where 49 diagnosed cases of AES in children aged between 1 month and 12 years were enrolled. Results: The study found that fever (100%) and altered sensorium (100%) were the most common clinical presentations in AES cases, followed by seizure (63%), headache (34.7%), vomiting (26.5%), diarrhea (22.4%), etc. Japanese encephalitis (JE) was the most common cause of AES (28.6%), followed by herpes simplex virus (4.1%), pyogenic meningitis (4.1%), and tubercular meningitis (2%), etc. However, the majority of cases (61.2%) were found to have an unknown etiology. Among the 49 cases, 27 (55.1%) recovered without neurological sequelae, 8 (16.8%) had neurological sequelae, and 14 (28.6%) died during the course of treatment. The most common neurological sequelae observed were motor deficit (37.5%), behavioral disorders, aphasia (25% each), and cranial nerve palsy. Glasgow coma scale (GCS) at the time of admission and during the time of hospital stay was found to have a significant (p<0.05) correlation with outcome in AES patients. Conclusion: The study concludes that AES cases commonly present with fever, altered sensorium, seizure, headache, vomiting, and signs of meningeal irritation. JE remains a major known cause of AES in children in this region of India. GCS at the time of admission and during the time of hospital stay were found to have a significant correlation with outcome. The neurological sequelae highlight the need for global attention to combat them save the lives of children.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29DOI: 10.32677/ijch.v10i11.4439
Amitava Sengupta, Ajay Lal, Harsh Bhayana
Background: Premature infants with low birth weight are at risk of growth failure and neurodevelopmental impairment. Human milk oligosaccharides (HMOs) are bioactive components of human milk that may enhance growth and development. The novel HMO-based human milk fortifier (HMoF), which also contains lactoferrin, docosahexaenoic acid (DHA), and arachidonic acid (ARA), can help provide a safer nutritional option for the growth of premature infants. Materials and Methods: We conducted a non-comparative observational study using data from multiple centers that used novel HMO-based HMF (HMoF) in premature infants (n=14) with birth weights of 700–1800 g. The primary outcome of the study was to assess tolerability (in terms of feed tolerance), and secondary outcomes included growth outcomes defined by weight, length, and head circumference during the stay in the NICU and at discharge. Results: A cohort consisting of 14 infants with a mean gestational age of 30.21±2.04 weeks and a birth weight of 1246.36±39.98 g comprised the study. During the study period, incidences of feed interruptions due to feed intolerability were nil, and no infant presented with any signs of adverse effects. The novel HMO-based HMF (HMoF)-fed infant cohort had a mean weight gain of 21.89±5.23 g/day, a mean length gain of 1.01±0.48 cm/week, and mean head circumference gain of 0.89±0.32 cm/week. The mean growth velocity recorded was 16.03±1.73 g/kg/day. Conclusions: Novel HMO-based HMF (HMoF) containing lactoferrin, DHA, and ARA demonstrated acceptable feed tolerance and weight gain without any clinically significant adverse effects. Data indicates that the novel HMoF containing lactoferrin, DHA, and ARA is a safe option for supporting the growth of preterm babies. However, further studies are needed to compare novel HMO-based HMF (HMoF) with standard HMF in a randomized controlled trial.
{"title":"Effect of novel human milk oligosaccharides-based human milk fortifier containing lactoferrin, docosahexaenoic acid, and arachidonic acid on the growth of preterm infants with birth weight of 700–1800 g","authors":"Amitava Sengupta, Ajay Lal, Harsh Bhayana","doi":"10.32677/ijch.v10i11.4439","DOIUrl":"https://doi.org/10.32677/ijch.v10i11.4439","url":null,"abstract":"Background: Premature infants with low birth weight are at risk of growth failure and neurodevelopmental impairment. Human milk oligosaccharides (HMOs) are bioactive components of human milk that may enhance growth and development. The novel HMO-based human milk fortifier (HMoF), which also contains lactoferrin, docosahexaenoic acid (DHA), and arachidonic acid (ARA), can help provide a safer nutritional option for the growth of premature infants. Materials and Methods: We conducted a non-comparative observational study using data from multiple centers that used novel HMO-based HMF (HMoF) in premature infants (n=14) with birth weights of 700–1800 g. The primary outcome of the study was to assess tolerability (in terms of feed tolerance), and secondary outcomes included growth outcomes defined by weight, length, and head circumference during the stay in the NICU and at discharge. Results: A cohort consisting of 14 infants with a mean gestational age of 30.21±2.04 weeks and a birth weight of 1246.36±39.98 g comprised the study. During the study period, incidences of feed interruptions due to feed intolerability were nil, and no infant presented with any signs of adverse effects. The novel HMO-based HMF (HMoF)-fed infant cohort had a mean weight gain of 21.89±5.23 g/day, a mean length gain of 1.01±0.48 cm/week, and mean head circumference gain of 0.89±0.32 cm/week. The mean growth velocity recorded was 16.03±1.73 g/kg/day. Conclusions: Novel HMO-based HMF (HMoF) containing lactoferrin, DHA, and ARA demonstrated acceptable feed tolerance and weight gain without any clinically significant adverse effects. Data indicates that the novel HMoF containing lactoferrin, DHA, and ARA is a safe option for supporting the growth of preterm babies. However, further studies are needed to compare novel HMO-based HMF (HMoF) with standard HMF in a randomized controlled trial.","PeriodicalId":13441,"journal":{"name":"Indian Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140413757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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