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Immunisation status of children up to 15 years of age 15岁以下儿童的免疫状况
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.12
Harshal Dhabe, K. Gandhi, Monali T Bhorge
Aim: To determine the immunisation status of children up to 15 years of age and factors associated with incomplete immunisation. Materials and Methods: Three hundred seventy-seven children in the age group 1 month to 15 years, attending regular outpatient department (OPD) were screened for their immunization status by direct questionnaire method and checking the immunization medical records. Children were divided based on their age in to 3 groups viz. <1yr, 1 to 5yr, >5yr. Information regarding their residence, education status of their parents, community, various vaccines, and whether immunization status was complete, or incomplete was recorded. Results: The mean age of children ranged from 3.68 +3.47 years. Twentythree percent of the infants were incompletely immunised (p=0.006). Twenty seven percent of Muslims and 28% of Buddhists were incompletely immunised (P=0.003). Illiteracy in father and mother is associated with incomplete immunisation by 34.38% (P=0.0004) and 31.15% (P<0.001), respectively. Main reason for incomplete immunisation was non-availability of vaccine, as seen in 57.7% of cases. Other reasons include immunisation facility not available locally (32.7%), parents refusing immunisation for their children (30.8%), child unwell (5.8%), parent out of town (3.8%). We did not find any gender bias in our study. Also, in our study, no vaccine in universal immunization programme (UIP) had lower coverage as compared to other vaccines. Conclusion: Immunization status in children in India needs to be improved. Religious beliefs, literacy rates in parents seem to affect the immunization completion in the child. Introduction Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease.1 According to World Health Organization (WHO), immunization is a proven tool for controlling and eliminating lifethreatening infectious diseases and is estimated to avert between 2 and 3 million deaths each year, but an estimated 18.7 million infants worldwide are still missing out on basic vaccines.1 Every year in India, 500,000 children die due to vaccine-preventable diseases and another 89,00,000 children remain at risk, because they are either unimmunized or partially immunized against vaccine-preventable diseases.2 India has one of the largest Universal Immunization Programs (UIP) in the world in terms of the quantities of vaccines used, number of beneficiaries covered, geographical spread and human resources involved. Despite being operational for over 30 years, UIP has been able to fully immunize only 65% children in the first year of their life and the increase in coverage has stagnated.2 To achieve full immunization coverage for all children, the Government of India launched Mission Indra Dhanush in December 2014. The goal of this program is to ensure full immun
目的:确定15岁以下儿童的免疫状况和与不完全免疫有关的因素。材料与方法:采用直接问卷调查法和检查免疫病历的方法,对377例1月龄~ 15岁门诊儿童进行免疫接种状况筛查。孩子们按年龄分为3组,每组5岁。记录了他们的居住地、父母的教育状况、社区、各种疫苗以及免疫状况是否完整。结果:患儿平均年龄3.68 +3.47岁。23%的婴儿未完全免疫(p=0.006)。27%的穆斯林和28%的佛教徒未完全免疫(P=0.003)。父亲和母亲文盲与免疫不完全相关的比例分别为34.38% (P=0.0004)和31.15% (P<0.001)。免疫不完全的主要原因是无法获得疫苗,占57.7%。其他原因包括当地没有免疫设施(32.7%)、父母拒绝为孩子接种免疫(30.8%)、孩子身体不适(5.8%)、父母出城(3.8%)。我们在研究中没有发现任何性别偏见。此外,在我们的研究中,与其他疫苗相比,普遍免疫规划(UIP)中没有疫苗的覆盖率较低。结论:印度儿童免疫状况有待提高。父母的宗教信仰、识字率似乎会影响儿童的免疫接种完成情况。免疫是使人对传染病具有免疫力或抵抗力的过程,通常是通过接种疫苗。疫苗刺激人体自身的免疫系统,以保护人体免受随后的感染或疾病根据世界卫生组织(卫生组织)的资料,免疫接种是控制和消除威胁生命的传染病的行之有效的工具,估计每年可避免200万至300万人死亡,但全世界估计仍有1 870万婴儿未能获得基本疫苗在印度,每年有500 000名儿童死于疫苗可预防的疾病,另有89 000名儿童仍然处于危险之中,因为他们没有接种疫苗或部分接种疫苗来预防疫苗可预防的疾病就使用的疫苗数量、受益人人数、地理分布和涉及的人力资源而言,印度拥有世界上最大的普遍免疫规划(UIP)之一。尽管实施了30多年,但统一免疫计划仅能使65%的儿童在出生后第一年获得全面免疫,而且覆盖率的增加停滞不前为了实现对所有儿童的全面免疫覆盖,印度政府于2014年12月启动了Indra Dhanush特派团。该方案的目标是确保两岁以下儿童和孕妇充分接种所有现有疫苗。根据这一方案,所有疫苗均免费提供印度政府的统一免疫计划向所有婴儿免费提供六种疾病的疫苗:一剂卡介苗;肺结核);三剂白喉三联疫苗;口服脊髓灰质炎疫苗(OPV)三剂;一剂含麻疹疫苗(MCV)。所有这些疫苗剂量应在12个月大时接种世卫组织认为,接受这四种联合免疫方案疫苗所有推荐剂量的印度儿童已完全接种疫苗;缺乏任何推荐剂量的儿童被认为未接种疫苗,未接种任何疫苗的儿童被认为未接种疫苗我们进行了这项研究,以确定马哈拉施特拉邦儿童的免疫状况,这些儿童过去曾到三级医院就诊,以满足他们的保健需求。通讯地址:印度马哈拉施特拉邦奥兰加巴德A.I.M.S医院儿科Harshal Dhabe医生。电子邮件:drharshal101@gmail.com©2021 Pediatric Oncall文章历史2021年6月23日接收2021年8月20日接受
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引用次数: 0
Outcome of Bone Tuberculosis in Children in Rural India - A case series 印度农村儿童骨结核的预后-一个病例系列
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.21
A. Rahangdale
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引用次数: 0
Overdiagnosis of Tuberculosis and Role of Tuberculin Test 结核病的过度诊断及结核菌素试验的作用
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.35
Pradnya Paikrao, Shefal S. Parikh, I. Shah
This is a retrospective analysis of children who were referred to our tuberculosis (TB) clinic from March 2010 to Feb 2011 but were not started on ATT and none of them subsequently developed TB. Interpretation of tuberculin test as a means of diagnosis was analysed. Results: Thirty-four (11.2%) children were overly diagnosed as TB. Seventeen out of 28 referred children were tuberculin positive and 8 were tuberculin negative. Also, 12 of tuberculin positive children had a reading of ≥15mm, yet none of them developed active disease. Although 2 TU is the recommended standard dose for tuberculin testing in India, in our study no child had received 2 TU, 23.5% of tuberculin positive patients had received a 5 TU dose and 35.3% a 10 TU dose. Conclusion: Most children with over-diagnosis of TB receive TT with more than 2TU units. The size of tuberculin reaction needs to be interpreted carefully. Introduction A major challenge of childhood tuberculosis (TB) is establishing an accurate diagnosis. Less than 15% of cases are sputum acid-fast bacilli smear positive, and mycobacterial culture yields are 30%–40%.1 Diagnosis of most paediatric TB cases is dependent on the tetrad of 1) careful history (including history of TB contact and symptoms consistent with TB. 2) Clinical examination (including growth assessment). 3) Tuberculin Skin Testing with Tuberculin test (TT) 4) Lesions suggestive of active TB on chest radiography. However, in developing and endemic countries, most individuals acquire latent infection and become tuberculin positive in childhood itself and chest radiography can be difficult to assess. With difficulty of conclusive diagnosis, it can lead to overdiagnosis of TB. This retrospective study was undertaken to assess the overdiagnosis of TB, and to discuss the role of TT for treatment of TB, with emphasis on the prevalent practices of administration and interpretation of TT. Methods & Materials A retrospective study was carried out in the paediatric department of a tertiary care hospital in Mumbai. During the study period of March 2010 to Feb 2011, all patients who were diagnosed as TB and were referred from other centres to our TB clinic for starting Anti tuberculous therapy (ATT) were assessed. These children were diagnosed as TB based on either a positive tuberculin test; or symptoms suggestive of TB; or history of contact with a patient suffering from TB; or ultrasound (USG) abdomen showing abdominal lymph nodes; or palpable cervical lymph nodes. Children were assessed by detailed history, through physical examination and diagnostic investigations. In the historydetails on the presence of TB contact, previous TB infection, BCG vaccination status and symptoms of illness in the form of cough, fever, weight loss and loss of appetite were enquired. Investigation reports of child having undergone past tuberculin testing, the results of recent (within previous one month) tuberculin test done in other centres and findings of abdominal USG for ly
这是对2010年3月至2011年2月期间转诊至我们结核病诊所但未开始接受抗逆转录病毒药物治疗且随后未发生结核病的儿童的回顾性分析。分析了结核菌素试验作为诊断手段的解释。结果:34例(11.2%)儿童被过度诊断为结核。28例患儿中17例结核杆菌素阳性,8例结核杆菌素阴性。结核菌素阳性儿童中有12例读数≥15mm,但未发生活动性疾病。虽然2tu是印度结核菌素检测的推荐标准剂量,但在我们的研究中,没有儿童接受过2tu, 23.5%的结核菌素阳性患者接受了5tu剂量,35.3%的结核菌素阳性患者接受了10tu剂量。结论:大多数过度诊断的儿童接受超过2TU单位的TT治疗。结核菌素反应的大小需要仔细解释。儿童结核病(TB)的一个主要挑战是建立准确的诊断。不到15%的病例痰抗酸杆菌涂片阳性,分枝杆菌培养率为30% - 40% 1大多数儿科结核病病例的诊断取决于以下四项:1)仔细的病史(包括结核病接触史和与结核病相符的症状)。2)临床检查(包括生长评估)。3)结核菌素皮肤试验与结核菌素试验(TT) 4)胸片提示活动性结核病变。然而,在发展中国家和流行国家,大多数个体在儿童时期获得潜伏感染并成为结核菌素阳性,胸部x线摄影可能难以评估。由于难以结论性诊断,可导致结核病的过度诊断。本回顾性研究旨在评估结核病的过度诊断,并讨论结核治疗在结核病治疗中的作用,重点是结核治疗的普遍做法和解释结核治疗。方法与材料在孟买某三级医院儿科进行回顾性研究。在2010年3月至2011年2月的研究期间,对所有被诊断为结核病并从其他中心转介到我们的结核病诊所开始抗结核治疗(ATT)的患者进行了评估。根据结核菌素试验阳性,这些儿童被诊断为结核病;或有结核症状;或与结核病患者有接触史;或腹部超声(USG)显示腹部淋巴结;或可触及的颈部淋巴结。通过详细的病史、体格检查和诊断调查对儿童进行评估。在病史中,详细询问了结核病接触者、既往结核病感染、卡介苗接种情况以及咳嗽、发烧、体重减轻和食欲不振等疾病症状。注意到儿童既往接受结核菌素试验的调查报告,最近(过去一个月内)在其他中心进行结核菌素试验的结果以及腹部淋巴结USG的发现。检查包括一般体格检查和营养状况评估。所有患者均行常规血象、胸片检查。在解释结核菌素试验时,根据一般惯例,硬结≥10 mm被认为是阳性,5 TU单位。没有患者接受过宫颈淋巴结活检、TB Elisa或QuantiFERON Gold Assay的调查。如果TT阳性,10 TU单位的患者不开始ATT治疗;宫颈结小于1cm且离散;如腹部淋巴结无簇状,无干酪样;如果感染结核病的接触者没有患有开放性结核病;患者最近有5 TU单位的TT阳性,但过去也有TT阳性;患者近期接受了5个TU单位的TT治疗,但过去曾接受过抗结核治疗,并且/或者患者在接受其他治疗2周后症状缓解。根据描述性统计对数据进行分析。采用SPSS 18版对数据进行统计相关,采用Fischer精确检验。通讯地址:Dr.Pradnya Paikrao Bansod, C/O K.N Dupare, PLOT No.6/7, Beside Nakshatra Heights, Near Balbharti, Rammohan Nagar, Amravati, amharashtra, 444607,印度电子邮件:paikraopl@gmail.com©2021 Pediatric Oncall文章历史2021年3月13日收到,2021年8月3日接受
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引用次数: 0
Is Cytomegalovirus a Partaker or a By-stander in Congenital Nephrotic Syndrome? : A novel mutation update. 巨细胞病毒是先天性肾病综合征的参与者还是旁观者?一种新的突变更新。
Pub Date : 2022-01-01 DOI: 10.7199/ped.oncall.2022.46
G. Jose, Shraddha Lohia, Anilkumar M. Khamkar, P. Pote
Congenital nephrotic syndrome (CNS) is a rare and serious disease of infants, which is due to a genetic and or an infectious cause. First case is an 11-week old baby, a completely worked-up case which includes the tetrad of clinical manifestations (neurological, gastro-intestinal and renal), virological findings (positive CMV antibody and DNA PCR), histo-pathological findings and novel genetic mutation (c.712+1G>C) in NPHS 1 gene. On the contrary, the second case is an 8-week old baby with isolated renal involvement of CMV infection. CMV IgM was positive but CMV DNA polymerase chain reaction (PCR) was negative. Parents were unwilling to do a genetic work up. In the first case partial remission of renal symptoms were achieved with Ganciclovir in four weeks, but she succumbed due to sepsis after being followed up for 730 days. The pediatrician of the second child skipped Ganciclovir and gave four weeks steroid trial. Due to absence of remission, renal biopsy was done and Tacrolimus was started. No recurrence of proteinuria was observed during the 14-month follow-up period. The need of anti-CMV therapy in isolated renal involvement of congenital CMV infection is questionable as the insult to the kidney has already occurred. It also highlights the dilemma perceived by a pediatrician, in starting anti-CMV therapy when CMV IgM antibodies are positive but CMV DNA PCR result is negative. This paper emphasizes the importance of performing a genetic test in every case of CNS to rule out any hereditary causes. Background Nephrotic syndrome presenting within first three months of life is defined as congenital nephrotic syndrome (CNS). It can be caused by genetic defects in structural proteins that form the glomerular filtration barrier or secondary to infections like congenital syphilis, toxoplasmosis and cytomegalovirus infection (CMV) which disrupt the podocytes and/or the basement membrane.1 Till 2020, only four completely worked up CMV IgM positive CNS cases were reported globally signifying the low incidence of detection.2 We present the case of two infants with congenital CMV infection and nephrotic syndrome, one of whom one received anti-CMV therapy while the other did not, and both of them experienced proteinuria remission.
先天性肾病综合征(CNS)是一种罕见和严重的婴儿疾病,这是由于遗传和/或传染性的原因。第一例病例为11周龄婴儿,是一个完全成熟的病例,包括临床表现(神经、胃肠和肾脏)、病毒学表现(巨细胞病毒抗体和DNA PCR阳性)、组织病理表现和NPHS 1基因新基因突变(C .712+1G>C)的四联体。相反,第二个病例是一个8周大的婴儿,孤立的巨细胞病毒感染肾脏受累。CMV IgM阳性,CMV DNA聚合酶链反应(PCR)阴性。父母不愿意做基因检测。在第一个病例中,更昔洛韦在4周内实现了肾脏症状的部分缓解,但在随访730天后,她因败血症而死亡。第二个孩子的儿科医生跳过了更昔洛韦,给了四周的类固醇试验。由于没有缓解,进行了肾活检并开始使用他克莫司。随访14个月,无蛋白尿复发。先天性巨细胞病毒感染的孤立性肾脏受累是否需要抗巨细胞病毒治疗值得怀疑,因为对肾脏的损害已经发生。当CMV IgM抗体呈阳性但CMV DNA PCR结果呈阴性时,开始抗CMV治疗,这也突出了儿科医生所感知到的困境。本文强调在每一例中枢神经系统病例中进行基因检测以排除任何遗传原因的重要性。出生后三个月内出现的肾病综合征被定义为先天性肾病综合征(CNS)。它可以由形成肾小球滤过屏障的结构蛋白的遗传缺陷引起,也可以继发于先天性梅毒、弓形虫病和巨细胞病毒感染(CMV)等破坏足细胞和/或基底膜的感染截至2020年,全球仅报告了4例CMV IgM阳性中枢神经系统病例,这表明检测率很低我们报告了两个患有先天性巨细胞病毒感染和肾病综合征的婴儿,其中一个接受了抗巨细胞病毒治疗,而另一个没有,他们都经历了蛋白尿缓解。
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引用次数: 0
Hyperplastic duodenal and jejunal polyps in a child with portal cavernoma 儿童门脉海绵状瘤并发十二指肠和空肠增生性息肉
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.7
A. Dashputra, I. Shah
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引用次数: 0
Interpretation of Tuberculin Skin test in BCG vaccinated children 卡介苗接种儿童结核菌素皮肤试验的解释
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.22
V. Raut, I. Shah
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引用次数: 0
Correlation between Proteinuria Degree and Neutrophil-To-Lymphocyte Ratio for the Early Diagnosis of Systemic Lupus Erythematosus in Children 蛋白尿程度与中性粒细胞与淋巴细胞比值在儿童系统性红斑狼疮早期诊断中的相关性研究
Pub Date : 2022-01-01 DOI: 10.7199/ped.oncall.2022.40
Muhammad Adityansah, R. Ghrahani, Gartika Sapartini, B. Setiabudiawan
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引用次数: 1
Unilateral breast mass in a newborn 新生儿单侧乳房肿块
Pub Date : 2022-01-01 DOI: 10.7199/ped.oncall.2022.25
S. Pimenta
{"title":"Unilateral breast mass in a newborn","authors":"S. Pimenta","doi":"10.7199/ped.oncall.2022.25","DOIUrl":"https://doi.org/10.7199/ped.oncall.2022.25","url":null,"abstract":"","PeriodicalId":19949,"journal":{"name":"Pediatric Oncall","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83966465","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}
引用次数: 0
Amniotic band syndrome: A case report and review of literature 羊膜带综合征1例报告及文献复习
Pub Date : 2022-01-01 DOI: 10.7199/ped.oncall.2022.49
K. Kumaravel, R. Sujetha, T. Palanivelraja, S. Gobinathan, P. Sampathkumar
{"title":"Amniotic band syndrome: A case report and review of literature","authors":"K. Kumaravel, R. Sujetha, T. Palanivelraja, S. Gobinathan, P. Sampathkumar","doi":"10.7199/ped.oncall.2022.49","DOIUrl":"https://doi.org/10.7199/ped.oncall.2022.49","url":null,"abstract":"","PeriodicalId":19949,"journal":{"name":"Pediatric Oncall","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87334942","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}
引用次数: 0
Caroli's disease in infancy - A report of 2 cases 婴儿期卡罗里氏病2例报告
Pub Date : 2022-01-01 DOI: 10.7199/PED.ONCALL.2022.50
Nupur Sanklecha, A. Doshi, I. Shah
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引用次数: 0
期刊
Pediatric Oncall
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