Pub Date : 2022-12-28DOI: 10.32677/ijch.v9i12.3725
Sharma Shobha, Kalra Suprita
Renal tubular disorders essentially include all disorders of the highly specialized channels of the renal tubular system, from the proximal convoluted tubule to the cortical and medullary collecting ducts. This tubular system is responsible for reabsorption of 99% of glomerular ultrafiltrate, which contains a large amount of fluid (approximately 180 L/day) as well as most electrolytes and many metabolites such as glucose (G), amino acids, bicarbonate (HCO3-), phosphate (PO4 3-), and low-molecular-weight proteins and is essential for maintaining fluid, electrolyte, and acid–base balance. In this review, we will briefly discuss when to suspect a renal tubular disorder, a simplified algorithm for evaluation, and specific mutations of a few common disorders.
{"title":"Demystifying Renal Tubular Disorders in children : A simplified approach","authors":"Sharma Shobha, Kalra Suprita ","doi":"10.32677/ijch.v9i12.3725","DOIUrl":"https://doi.org/10.32677/ijch.v9i12.3725","url":null,"abstract":"Renal tubular disorders essentially include all disorders of the highly specialized channels of the renal tubular system, from the proximal convoluted tubule to the cortical and medullary collecting ducts. This tubular system is responsible for reabsorption of 99% of glomerular ultrafiltrate, which contains a large amount of fluid (approximately 180 L/day) as well as most electrolytes and many metabolites such as glucose (G), amino acids, bicarbonate (HCO3-), phosphate (PO4 3-), and low-molecular-weight proteins and is essential for maintaining fluid, electrolyte, and acid–base balance. In this review, we will briefly discuss when to suspect a renal tubular disorder, a simplified algorithm for evaluation, and specific mutations of a few common disorders.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77850940","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}
Fructooligosaccharides (FOS) are non-digestible carbohydrates that are one of the major classes of bifidogenic oligosaccharides. Studies find that prebiotics such as FOS display health benefits pertaining to but not restricted to the gastrointestinal tract of an infant. This review article aims to discuss the therapeutic potential of FOS for different pediatric gut conditions. FOS in varying concentration has been found to prevent constipation and soften stools; reduce the incidence and severity of diarrhoea; alleviate GI discomfort symptoms such as vomiting and regurgitation. Infants and children seem to tolerate both short and long chain FOS molecules well. Although FOS is beneficial for infant and child health, there is still a need for rigorous clinical trials and long term follow up studies to understand if FOS supplemented in infancy can confer long term effects in adulthood.
{"title":"Clinical Uses of Fructooligosaccharides for Gastrointestinal health in the Pediatric Population","authors":"Femitha Pournami, Ghazi Sharique Ahmad, Nayankumar Rameshchandra Kalawadia, Ravishankar Kanithi, Samik Hazra, Satyen Kanhiyalal Hemrajani, Shrish Bhatnagar, Preethi Rahul","doi":"10.32677/ijch.v9i12.3769","DOIUrl":"https://doi.org/10.32677/ijch.v9i12.3769","url":null,"abstract":"Fructooligosaccharides (FOS) are non-digestible carbohydrates that are one of the major classes of bifidogenic oligosaccharides. Studies find that prebiotics such as FOS display health benefits pertaining to but not restricted to the gastrointestinal tract of an infant. This review article aims to discuss the therapeutic potential of FOS for different pediatric gut conditions. FOS in varying concentration has been found to prevent constipation and soften stools; reduce the incidence and severity of diarrhoea; alleviate GI discomfort symptoms such as vomiting and regurgitation. Infants and children seem to tolerate both short and long chain FOS molecules well. Although FOS is beneficial for infant and child health, there is still a need for rigorous clinical trials and long term follow up studies to understand if FOS supplemented in infancy can confer long term effects in adulthood. ","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88704322","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 : 2022-12-14DOI: 10.32677/ijch.v9i11.3474
Mansi Arora, P. Rai, P. Prasad
Aim: The aim of this study was to study clinical predictors of hypoxemia in patients of acute lower respiratory infections in children. Materials and Methods: An observational prospective study was conducted for 8 months in the General Pediatric Ward and Pediatric Intensive Care Unit of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, a tertiary care hospital in Rohilkhand region. This is a hospital-based study. All children admitted with acute lower respiratory tract infections between the age group of 1 month to 59 months of age and diagnosed with pneumonia and bronchiolitis were enrolled and oxygen saturation of patients was recorded and compared with arterial blood gas. Results: A total of 40 patients were enrolled in the study. More than 90% cases of pneumonia and bronchiolitis presented with difficulty in breathing followed by rapid breathing as the next most common symptom. The least common symptom was noisy breathing and pain in abdomen. The most common signs observed were tachypnea which was present in 100% cases of mild, moderate, and severe hypoxemia. Tachypnea (91%), pallor (89%) and nasal flaring (84%), crepitations (added sounds), and subcostal retractions had better sensitivity for detecting hypoxemia. Conclusion: It was observed that a combination of clinical signs and symptoms can be used to predict hypoxemia when facilities of pulse oximetry and arterial blood gas analysis are not available, especially in low-resource settings.
{"title":"Clinical predictors of hypoxemia in patients of acute lower respiratory tract infections: A hospital-based study","authors":"Mansi Arora, P. Rai, P. Prasad","doi":"10.32677/ijch.v9i11.3474","DOIUrl":"https://doi.org/10.32677/ijch.v9i11.3474","url":null,"abstract":"Aim: The aim of this study was to study clinical predictors of hypoxemia in patients of acute lower respiratory infections in children.\u0000Materials and Methods: An observational prospective study was conducted for 8 months in the General Pediatric Ward and Pediatric Intensive Care Unit of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, a tertiary care hospital in Rohilkhand region. This is a hospital-based study. All children admitted with acute lower respiratory tract infections between the age group of 1 month to 59 months of age and diagnosed with pneumonia and bronchiolitis were enrolled and oxygen saturation of patients was recorded and compared with arterial blood gas.\u0000Results: A total of 40 patients were enrolled in the study. More than 90% cases of pneumonia and bronchiolitis presented with difficulty in breathing followed by rapid breathing as the next most common symptom. The least common symptom was noisy breathing and pain in abdomen. The most common signs observed were tachypnea which was present in 100% cases of mild, moderate, and severe hypoxemia. Tachypnea (91%), pallor (89%) and nasal flaring (84%), crepitations (added sounds), and subcostal retractions had better sensitivity for detecting hypoxemia.\u0000Conclusion: It was observed that a combination of clinical signs and symptoms can be used to predict hypoxemia when facilities of pulse oximetry and arterial blood gas analysis are not available, especially in low-resource settings.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82379665","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 : 2022-12-13DOI: 10.32677/ijch.v9i11.3696
Hari Nishanthi V, Ekta Chheda, Siranjeevi Gurumaani, Vani Gangwar, A. Saxena, K. Lomore, M. Marathe, Preethi Rahul, Venkatesh Kareenhalli
Introduction: Optimum nutrition is the cornerstone of child growth and development. Childhood is a period of rapid growth and development. Children of preschool age have higher nutritional needs and are often at risk of nutrient deficiencies. Objective: The present study was designed to evaluate the effect of an oral nutritional supplement (ONS) on growth parameters in a representative population. Methods: We used the systems-biology-based mathematical model for child growth to analyze the effect of ONS on growth in a representative in silico population of preschool children. The analysis included changes in average growth velocities of weight, height, muscle mass, fat mass, fat-free mass, and bone mass. We used meta-data analysis for evaluating the absorption of micronutrients present in the ONS that affects growth in preschool children. Results: The results of the analysis showed one serving of ONS in milk/day improved the weight gain velocity by 1.7 times in preschool children. The linear growth was 1.04 times higher than the control. The absorption of micronutrients such as iron, vitamin K, calcium, and magnesium was higher in the ONS group. Conclusions: This study indicates that the ONS containing macro and micronutrients, docosahexaenoic acid (DHA), and prebiotics can potentiate growth and development in preschool children. It provides micronutrients that can be readily absorbed which are essential for other vital functions in the body.
{"title":"Effect of oral nutrition supplement on growth in preschool children – a systems physiology-based in silico analysis","authors":"Hari Nishanthi V, Ekta Chheda, Siranjeevi Gurumaani, Vani Gangwar, A. Saxena, K. Lomore, M. Marathe, Preethi Rahul, Venkatesh Kareenhalli","doi":"10.32677/ijch.v9i11.3696","DOIUrl":"https://doi.org/10.32677/ijch.v9i11.3696","url":null,"abstract":"Introduction: Optimum nutrition is the cornerstone of child growth and development. Childhood is a period of rapid growth and development. Children of preschool age have higher nutritional needs and are often at risk of nutrient deficiencies.\u0000Objective: The present study was designed to evaluate the effect of an oral nutritional supplement (ONS) on growth parameters in a representative population.\u0000Methods: We used the systems-biology-based mathematical model for child growth to analyze the effect of ONS on growth in a representative in silico population of preschool children. The analysis included changes in average growth velocities of weight, height, muscle mass, fat mass, fat-free mass, and bone mass. We used meta-data analysis for evaluating the absorption of micronutrients present in the ONS that affects growth in preschool children.\u0000Results: The results of the analysis showed one serving of ONS in milk/day improved the weight gain velocity by 1.7 times in preschool children. The linear growth was 1.04 times higher than the control. The absorption of micronutrients such as iron, vitamin K, calcium, and magnesium was higher in the ONS group.\u0000Conclusions: This study indicates that the ONS containing macro and micronutrients, docosahexaenoic acid (DHA), and prebiotics can potentiate growth and development in preschool children. It provides micronutrients that can be readily absorbed which are essential for other vital functions in the body.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90078836","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 : 2022-12-07DOI: 10.32677/ijch.v9i11.3741
Rashmi Agrawal, Amit Agrawal, J. Jacson
Inflammatory bowel disease (IBD) is known to affect millions of people worldwide and is primarily caused due to abnormal due to abnormal immune responses to intestinal microbes. IBD is primarily categorized under two main types – ulcerative colitis and Crohn’s disease. Although the cause of IBD is still an unsolved puzzle, its development can be attributed to the presence of various risk factors including antibiotic use. The intestinal immune system is the point of genesis of IBD and anything that creates an imbalance can trigger IBD. Alterations in the gut microbiota can lead to reduced microbial populations and lead a chronic inflammation state. Antibiotics may influence microbial maturity and can hamper the formation of a strong immune system. This makes an individual vulnerable to the threat of infections and subsequent development of a chronic inflammation state. Studies have implicated that the use of antibiotics during pregnancy, antepartum, and among neonates is associated with the development of IBD. Adequate development of the microbial niche takes place within the first 2 years of life and extensive administration of antibiotics during this period can pose a significant risk for the development of IBD. Animal studies have also documented the role of in utero antibiotic exposure during the antepartum period and the subsequent risk of developing IBD in the offspring. This review summarizes the role of antibiotic exposure during pregnancy and infancy in the development of IBD.
{"title":"Early life antibiotic exposure and inflammatory bowel disease","authors":"Rashmi Agrawal, Amit Agrawal, J. Jacson","doi":"10.32677/ijch.v9i11.3741","DOIUrl":"https://doi.org/10.32677/ijch.v9i11.3741","url":null,"abstract":"Inflammatory bowel disease (IBD) is known to affect millions of people worldwide and is primarily caused due to abnormal due to abnormal immune responses to intestinal microbes. IBD is primarily categorized under two main types – ulcerative colitis and Crohn’s disease. Although the cause of IBD is still an unsolved puzzle, its development can be attributed to the presence of various risk factors including antibiotic use. The intestinal immune system is the point of genesis of IBD and anything that creates an imbalance can trigger IBD. Alterations in the gut microbiota can lead to reduced microbial populations and lead a chronic inflammation state. Antibiotics may influence microbial maturity and can hamper the formation of a strong immune system. This makes an individual vulnerable to the threat of infections and subsequent development of a chronic inflammation state. Studies have implicated that the use of antibiotics during pregnancy, antepartum, and among neonates is associated with the development of IBD. Adequate development of the microbial niche takes place within the first 2 years of life and extensive administration of antibiotics during this period can pose a significant risk for the development of IBD. Animal studies have also documented the role of in utero antibiotic exposure during the antepartum period and the subsequent risk of developing IBD in the offspring. This review summarizes the role of antibiotic exposure during pregnancy and infancy in the development of IBD.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90208379","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: Neonatal purpura fulminans (NPF) is a life-threatening rare disease, which can be caused by deficiencies of protein C or protein S in a congenital or acquired manner. It is characterized by thrombosis of microvasculature, peri-vascular hemorrhage, and disseminated intravascular coagulation (DIC) occurring in the neonatal period. Clinical Description: A term female baby presented at 40 h of life with multiple purpuric rashes over the left foot which over 1 day extended until the knee. Over the next 3 days, there was rapid progression to involve extensive areas of necrosis with gangrene of toes of left foot, both forearms, bilateral temporal areas, peri-orbital regions, and left ear, in addition to multiple hemorrhagic blebs. Management and Outcome: Investigations showed anemia and thrombocytopenia with normal leucocyte count. DIC was suspected (INR 2), sepsis screen was negative, and fresh frozen plasma (FFP) was transfused 8th hourly. Arterial and venous Doppler was normal and blood culture showed no growth. Suspecting NPF, protein C, protein S, and anti-thrombin levels were sent, which showed a low protein C and protein S value. Mutations involving factor V Leiden, prothrombin gene, and MTHFR gene were not detected. The baby was started on low molecular weight heparin and, FFP and platelet concentrate replacement were continued, but she succumbed to the illness. Conclusion: NPF is a rare life-threatening entity that is fatal without prompt recognition of the condition. Therefore, it is necessary to recognize it early and initiate treatment.
{"title":"Neonatal purpura fulminans: A rare, life-threatening, and rapidly progressing disorder of coagulation","authors":"S. Rudrappa, Thanuja B, Chandana N S","doi":"10.32677/ijch.v9i9.3588","DOIUrl":"https://doi.org/10.32677/ijch.v9i9.3588","url":null,"abstract":"Background: Neonatal purpura fulminans (NPF) is a life-threatening rare disease, which can be caused by deficiencies of protein C or protein S in a congenital or acquired manner. It is characterized by thrombosis of microvasculature, peri-vascular hemorrhage, and disseminated intravascular coagulation (DIC) occurring in the neonatal period. Clinical Description: A term female baby presented at 40 h of life with multiple purpuric rashes over the left foot which over 1 day extended until the knee. Over the next 3 days, there was rapid progression to involve extensive areas of necrosis with gangrene of toes of left foot, both forearms, bilateral temporal areas, peri-orbital regions, and left ear, in addition to multiple hemorrhagic blebs. Management and Outcome: Investigations showed anemia and thrombocytopenia with normal leucocyte count. DIC was suspected (INR 2), sepsis screen was negative, and fresh frozen plasma (FFP) was transfused 8th hourly. Arterial and venous Doppler was normal and blood culture showed no growth. Suspecting NPF, protein C, protein S, and anti-thrombin levels were sent, which showed a low protein C and protein S value. Mutations involving factor V Leiden, prothrombin gene, and MTHFR gene were not detected. The baby was started on low molecular weight heparin and, FFP and platelet concentrate replacement were continued, but she succumbed to the illness. Conclusion: NPF is a rare life-threatening entity that is fatal without prompt recognition of the condition. Therefore, it is necessary to recognize it early and initiate treatment.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76442180","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}
S. Bhor, C. Oza, A. Khadilkar, Dipali Ladkat, K. Gondhalekar, V. Khadilkar
Objectives: India is home to the highest number of prevalent cases of Type-1 diabetes (T1D) in children. There is scarcity of data on the growth failure of children with diabetes, especially those having complications and comorbidities, thus, we conducted this study with the objective to determine the prevalence and predictors of stunting in children with T1D. Methods: This cross-sectional study included 350 children and adolescents aged 1–18 years with T1D. Demographic data, anthropometry, diet, sexual maturity rating, and biochemical measurements were performed using standard protocols. Short stature was defined as height for age Z-score <−2. p<0.05 was considered statistically significant. Results: We report a 15.7% prevalence of stunting in our cohort of children with T1D. Stunted children had higher cholesterol, lower hemoglobin, lower mid-parental height Z-scores, and higher urinary albumin creatinine ratio. Binary logistic regression revealed that pre-existing comorbidities, compromised renal function, longer disease duration, and short mid-parental height were significant predictors of stunting. Conclusion: A little under one-sixth of children with T1D had short stature. Monitoring growth in these patients, especially in subjects with short parents, prolonged duration of diabetes, existing comorbidities, and deteriorating renal function are critical.
{"title":"Prevalence of stunting and determinants of growth failure in children with Type 1 diabetes","authors":"S. Bhor, C. Oza, A. Khadilkar, Dipali Ladkat, K. Gondhalekar, V. Khadilkar","doi":"10.32677/ijch.v9i9.3635","DOIUrl":"https://doi.org/10.32677/ijch.v9i9.3635","url":null,"abstract":"Objectives: India is home to the highest number of prevalent cases of Type-1 diabetes (T1D) in children. There is scarcity of data on the growth failure of children with diabetes, especially those having complications and comorbidities, thus, we conducted this study with the objective to determine the prevalence and predictors of stunting in children with T1D. Methods: This cross-sectional study included 350 children and adolescents aged 1–18 years with T1D. Demographic data, anthropometry, diet, sexual maturity rating, and biochemical measurements were performed using standard protocols. Short stature was defined as height for age Z-score <−2. p<0.05 was considered statistically significant. Results: We report a 15.7% prevalence of stunting in our cohort of children with T1D. Stunted children had higher cholesterol, lower hemoglobin, lower mid-parental height Z-scores, and higher urinary albumin creatinine ratio. Binary logistic regression revealed that pre-existing comorbidities, compromised renal function, longer disease duration, and short mid-parental height were significant predictors of stunting. Conclusion: A little under one-sixth of children with T1D had short stature. Monitoring growth in these patients, especially in subjects with short parents, prolonged duration of diabetes, existing comorbidities, and deteriorating renal function are critical.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77763486","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}
Cough in children and adults is a commonly witnessed symptom that can be related to a serious underlying disease. It is a reflex phenomenon that protects the airways and lungs by eliminating mucus, inhaled irritants, pathogens, and particulates and further helps in clearing out the air spaces of accumulated secretions. However, cough in children and adults has some notable differences based on various parameters, including duration, symptoms witnessed, duration, and etiology. Therefore, the tools and processes commonly employed for evaluating cough in adults may not apply to pediatric patients. Furthermore, the management of cough, in general, should be based on the etiology instead of the underlying disease condition. There is a relative paucity of data related to pediatric cough in comparison to adult cough, making the management of cough challenging. This article provides a comprehensive review of cough management in children in Indian scenarios.
{"title":"Pediatric cough as a symptom: Tips for management","authors":"S. Bavdekar, A. Vora, Sonali Karekar","doi":"10.32677/ijch.v9i9.3362","DOIUrl":"https://doi.org/10.32677/ijch.v9i9.3362","url":null,"abstract":"Cough in children and adults is a commonly witnessed symptom that can be related to a serious underlying disease. It is a reflex phenomenon that protects the airways and lungs by eliminating mucus, inhaled irritants, pathogens, and particulates and further helps in clearing out the air spaces of accumulated secretions. However, cough in children and adults has some notable differences based on various parameters, including duration, symptoms witnessed, duration, and etiology. Therefore, the tools and processes commonly employed for evaluating cough in adults may not apply to pediatric patients. Furthermore, the management of cough, in general, should be based on the etiology instead of the underlying disease condition. There is a relative paucity of data related to pediatric cough in comparison to adult cough, making the management of cough challenging. This article provides a comprehensive review of cough management in children in Indian scenarios.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77171096","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}
A. Yadav, S. Gupta, Kawalpreet Chhabra, O. Chaurasiya, M. Shastri
Introduction: Asthma is a common chronic disease in childhood and has been subject of studies for at least two decades, due to its increasing prevalence. The symptoms are persistent, recurrent, and entirely related to bronchial hyper-responsiveness to many environmental triggers. Nebulization and metered dose inhaler (MDI) are two available modalities of salbutamol administration in patients with acute asthmatic attack. Aim: The aim of the study was to compare the relative efficacy of nebulizer and MDI with spacer for the administration of salbutamol in the treatment of acute asthmatic attack. Materials and Methods: A randomized, prospective, and interventional study was conducted on 100 children aged 1–12 years with acute asthmatic attack at a tertiary care. The subjects were randomized into two groups for salbutamol administration. Group I was given salbutamol by nebulizer and Group II by MDI with spacer. Demographic data and detailed history was collected. Children were categorized into mild, moderate, and severe grade according to peak expiratory flow rate (PEFR) and pulmonary index (PI) score. Oxygen saturation, PEFR, and PI were monitored at 0, 20, 40, and 60 min of therapy. Other details such as duration of hospital stay and oxygen requirement were also noted. Results: One hundred children with male female ratio of 1.12:1 were included in the study. Highest incidence was seen in age group of 1–3 years (38%). Statistically significant change in PI and PEFR was noted with treatment in both the groups (p<0.05). On comparison between MDI and nebulizer group, no statistically significant difference was found (p>0.05). Conclusion: MDI with spacer is an effective alternative to nebulizer for the administration of salbutamol drug in acute asthmatic attack in pediatric patients.
{"title":"Efficacy of inhaled salbutamol therapy through nebulizer versus mdi with spacer in children with acute asthmatic attack and short-term course","authors":"A. Yadav, S. Gupta, Kawalpreet Chhabra, O. Chaurasiya, M. Shastri","doi":"10.32677/ijch.v9i8.3433","DOIUrl":"https://doi.org/10.32677/ijch.v9i8.3433","url":null,"abstract":"Introduction: Asthma is a common chronic disease in childhood and has been subject of studies for at least two decades, due to its increasing prevalence. The symptoms are persistent, recurrent, and entirely related to bronchial hyper-responsiveness to many environmental triggers. Nebulization and metered dose inhaler (MDI) are two available modalities of salbutamol administration in patients with acute asthmatic attack. Aim: The aim of the study was to compare the relative efficacy of nebulizer and MDI with spacer for the administration of salbutamol in the treatment of acute asthmatic attack. Materials and Methods: A randomized, prospective, and interventional study was conducted on 100 children aged 1–12 years with acute asthmatic attack at a tertiary care. The subjects were randomized into two groups for salbutamol administration. Group I was given salbutamol by nebulizer and Group II by MDI with spacer. Demographic data and detailed history was collected. Children were categorized into mild, moderate, and severe grade according to peak expiratory flow rate (PEFR) and pulmonary index (PI) score. Oxygen saturation, PEFR, and PI were monitored at 0, 20, 40, and 60 min of therapy. Other details such as duration of hospital stay and oxygen requirement were also noted. Results: One hundred children with male female ratio of 1.12:1 were included in the study. Highest incidence was seen in age group of 1–3 years (38%). Statistically significant change in PI and PEFR was noted with treatment in both the groups (p<0.05). On comparison between MDI and nebulizer group, no statistically significant difference was found (p>0.05). Conclusion: MDI with spacer is an effective alternative to nebulizer for the administration of salbutamol drug in acute asthmatic attack in pediatric patients.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77868637","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}
Anu Sharma, Radhika Sujatha, S. H, Krishna Neisseril, Akash G. Nair
Galactosialidosis is a rare autosomal recessive lysosomal storage disorder (LSD). It results from defects in glycoprotein degradation due to mutation in a single gene, encoded by the protective protein cathepsin A, (CTSA), located on chromosome 20q13.12. Most cases of non-immune hydrops fetalis (NIHF) nowadays being recognized are due to cardiac, lymphatic dysplasia, and hematological disorders. Inborn errors of metabolism account for NIHF in 1.3% of patients. Among metabolic disorders, around 14 LSDs have been reported as being associated with NIHF and congenital ascites. In the present case, we report an early infantile form of galactosialidosis with a novel homozygous miss-sense mutation c.319 A>C (p. Ser107 Arg) in exon 3 of CTSA gene in a newborn who presented as non-immune hydrops. The baby also had coarse facies, wide anterior fontanelle, hypertelorism, bilateral congenital talipes equinovarus, hepatosplenomegaly, nephrocalcinosis, and disproportionately small limbs with metaphyseal irregularity. Gradually, he developed worsening cardiac functions and cardiomyopathy and succumbed to death on day 47 of life. Being an autosomal recessive disorder, it can recur in the next pregnancy and treatment is mainly supportive. Targeted prenatal diagnostics in subsequent pregnancies can help in early diagnosis.
{"title":"Galactosialidosis presenting as non-immune hydrops in a newborn: A case report","authors":"Anu Sharma, Radhika Sujatha, S. H, Krishna Neisseril, Akash G. Nair","doi":"10.32677/ijch.v9i8.3568","DOIUrl":"https://doi.org/10.32677/ijch.v9i8.3568","url":null,"abstract":"Galactosialidosis is a rare autosomal recessive lysosomal storage disorder (LSD). It results from defects in glycoprotein degradation due to mutation in a single gene, encoded by the protective protein cathepsin A, (CTSA), located on chromosome 20q13.12. Most cases of non-immune hydrops fetalis (NIHF) nowadays being recognized are due to cardiac, lymphatic dysplasia, and hematological disorders. Inborn errors of metabolism account for NIHF in 1.3% of patients. Among metabolic disorders, around 14 LSDs have been reported as being associated with NIHF and congenital ascites. In the present case, we report an early infantile form of galactosialidosis with a novel homozygous miss-sense mutation c.319 A>C (p. Ser107 Arg) in exon 3 of CTSA gene in a newborn who presented as non-immune hydrops. The baby also had coarse facies, wide anterior fontanelle, hypertelorism, bilateral congenital talipes equinovarus, hepatosplenomegaly, nephrocalcinosis, and disproportionately small limbs with metaphyseal irregularity. Gradually, he developed worsening cardiac functions and cardiomyopathy and succumbed to death on day 47 of life. Being an autosomal recessive disorder, it can recur in the next pregnancy and treatment is mainly supportive. Targeted prenatal diagnostics in subsequent pregnancies can help in early diagnosis.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80630090","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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