Jayashree Satish Rao, S. M, M. Savitha, Thrupthi Surendra
Precocious puberty defined by the onset of secondary sexual characteristics before 8 years in girls and 9 years in boys. It is more common in females than males and is usually sporadic. Depending on the primary source of hormonal production, precocious puberty is classified as central and peripheral. Precocious puberty in infants is very rare. While investigating a case of precocious puberty, it is essential to progress systematically, with an identification of isolated or complete precocious puberty followed by bone age estimation, relevant hormonal assays, including GnRH stimulation, as well as neuroimaging when indicated. We present a case of isosexual (central) precocious puberty in a 1 year, 3-month-old girl, who was symptomatic for 1 year of age and was diagnosed to have hypothalamic hamartoma after methodical evaluation and responded to treatment with GnRH agonists.
{"title":"Case report: A rare case of central precocious puberty due to hypothalamic hamartoma","authors":"Jayashree Satish Rao, S. M, M. Savitha, Thrupthi Surendra","doi":"10.32677/ijch.v9i8.3556","DOIUrl":"https://doi.org/10.32677/ijch.v9i8.3556","url":null,"abstract":"Precocious puberty defined by the onset of secondary sexual characteristics before 8 years in girls and 9 years in boys. It is more common in females than males and is usually sporadic. Depending on the primary source of hormonal production, precocious puberty is classified as central and peripheral. Precocious puberty in infants is very rare. While investigating a case of precocious puberty, it is essential to progress systematically, with an identification of isolated or complete precocious puberty followed by bone age estimation, relevant hormonal assays, including GnRH stimulation, as well as neuroimaging when indicated. We present a case of isosexual (central) precocious puberty in a 1 year, 3-month-old girl, who was symptomatic for 1 year of age and was diagnosed to have hypothalamic hamartoma after methodical evaluation and responded to treatment with GnRH agonists.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78979826","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 double-chambered right ventricle (DCRV) is a rare congenital heart disease and an uncommon cause of congestive cardiac failure. An anomalous muscle band divides the right ventricle into two cavities, the proximal high-pressure chamber, and distal low-pressurechamber. Its origin is debated. Most cases are diagnosed and treated during childhood. Furthermore, there is tendency for progression, if not treated. Echocardiography is considered useful for diagnosis. About 80–90% patients have associated congenital anomalies, such as ventricular septal defect, pulmonary stenosis, and subaortic stenosis. Isolated DCRV is exceptionally rare. Hence, we are reporting a case of an isolated DCRV in an asymptomatic young female patient.
{"title":"Isolated double-chambered right ventricle in a young female – a rare congenital heart disease: Evaluation by transthoracic color echocardiography and cardiac computed tomography","authors":"Akhil Mehrotra, Nishant Yadav, Ajay Sharma, Shwati Singh, Shubham Kacker","doi":"10.32677/ijch.v9i8.3597","DOIUrl":"https://doi.org/10.32677/ijch.v9i8.3597","url":null,"abstract":"A double-chambered right ventricle (DCRV) is a rare congenital heart disease and an uncommon cause of congestive cardiac failure. An anomalous muscle band divides the right ventricle into two cavities, the proximal high-pressure chamber, and distal low-pressurechamber. Its origin is debated. Most cases are diagnosed and treated during childhood. Furthermore, there is tendency for progression, if not treated. Echocardiography is considered useful for diagnosis. About 80–90% patients have associated congenital anomalies, such as ventricular septal defect, pulmonary stenosis, and subaortic stenosis. Isolated DCRV is exceptionally rare. Hence, we are reporting a case of an isolated DCRV in an asymptomatic young female patient.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"147 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77106779","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}
Anupa Pillai, Aswathy Rahul, S. Hariharan, Radhika Sujatha, A. Gopal
Primary hemophagocytic lymphohistiocytosis (HLH) is a rare fulminant genetic disease with uncontrolled immune activation and multiorgan involvement. It is quite rare in neonates but a high index of suspicion is needed as the condition will present like sepsis and is associated with high mortality. Persistent fever is a prominent clinical feature. Genetic diagnosis is essential as the condition is autosomal recessive in familial types. Here, we report four cases of HLH diagnosed in the newborn period. We got an uncommon homozygous genetic mutation in STXBP2 involving exon 19, which has been reported only in very few cases. HLH should be considered as a differential diagnosis in any sick neonate who presents with prolonged fever with an unusual clinical course
{"title":"Hemophagocytic lymphohistiocytosis - A fatal cause of persistent fever in neonates: A case series","authors":"Anupa Pillai, Aswathy Rahul, S. Hariharan, Radhika Sujatha, A. Gopal","doi":"10.32677/ijch.v9i8.3580","DOIUrl":"https://doi.org/10.32677/ijch.v9i8.3580","url":null,"abstract":"Primary hemophagocytic lymphohistiocytosis (HLH) is a rare fulminant genetic disease with uncontrolled immune activation and multiorgan involvement. It is quite rare in neonates but a high index of suspicion is needed as the condition will present like sepsis and is associated with high mortality. Persistent fever is a prominent clinical feature. Genetic diagnosis is essential as the condition is autosomal recessive in familial types. Here, we report four cases of HLH diagnosed in the newborn period. We got an uncommon homozygous genetic mutation in STXBP2 involving exon 19, which has been reported only in very few cases. HLH should be considered as a differential diagnosis in any sick neonate who presents with prolonged fever with an unusual clinical course","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78742364","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}
When a child's parents expect him or her to perform much above his or her mental, social, or emotional capacity, the condition known as "Hurried Child Syndrome (HCS)" develops. In today’s world, parents overbook their kids' calendars, push them to do well in school, and demand that they behave and react just like little adults. The current situation of trade is one of the other considerations. We live in a time-restricted culture where the emphasis is primarily on speed, instant gratification, fast meals, etc. This eventually leads to parenting a hurried child. The current research review focuses on the causes, consequences, and preventative approaches of the resulting HCS.
{"title":"Hurried child syndrome: A narrative review","authors":"Amit Agrawal, Shweta Sharma, Jyotshna Shrivastava","doi":"10.32677/ijch.v9i7.3593","DOIUrl":"https://doi.org/10.32677/ijch.v9i7.3593","url":null,"abstract":"When a child's parents expect him or her to perform much above his or her mental, social, or emotional capacity, the condition known as \"Hurried Child Syndrome (HCS)\" develops. In today’s world, parents overbook their kids' calendars, push them to do well in school, and demand that they behave and react just like little adults. The current situation of trade is one of the other considerations. We live in a time-restricted culture where the emphasis is primarily on speed, instant gratification, fast meals, etc. This eventually leads to parenting a hurried child. The current research review focuses on the causes, consequences, and preventative approaches of the resulting HCS.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74829770","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: Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders among school-age children in India. Etiopathogenesis is attributed to abnormal dopamine regulation which is influenced by both genetic (genes encodingdopamine-DRD4, DRD5, and DAT1) and environmental factors. Micronutrients such as iron and Vitamin D play imperative roles in neurologic function, neurotransmitter synthesis, and regulation. Aim: The aim of the study was to study the association between Serum Vitamin D and Serum Ferritin levels in children with ADHD. Materials and Methods: This case–control study was conducted in the outpatient department of a tertiary care hospital, from October 2019 to May 2021. Subjects (n=30) included patients with the diagnosis of ADHD (using child behavior checklist and INDT–ADHD). Healthy children of the comparable age group were taken as controls. Statistical analysis was performed using Statistical Package for the Social Sciences software version 22. Results: The mean value of serum ferritin levels in cases was observed to be 32.55±31.97 ng/ml and in controls was 143.43±260.40 ng/ml. The study found a significant difference in the mean value of serum ferritin levels in cases and controls (p?0.024). No significant difference in the mean value of serum Vitamin D in cases and controls (p–0.229) was noted. Conclusions: An association between low levels of serum ferritin and ADHD was seen.
背景:注意缺陷多动障碍(ADHD)是印度学龄儿童中最普遍的心理健康障碍之一。发病机制归因于多巴胺调节异常，受遗传(编码多巴胺- drd4、DRD5和DAT1的基因)和环境因素的影响。微量营养素如铁和维生素D在神经功能、神经递质合成和调节中起着重要作用。目的:本研究的目的是研究ADHD儿童血清维生素D和血清铁蛋白水平之间的关系。材料与方法:本病例对照研究于2019年10月至2021年5月在某三级医院门诊部进行。研究对象(n=30)包括诊断为ADHD的患者(使用儿童行为检查表和INDT-ADHD)。选取同龄健康儿童作为对照。使用Statistical Package for Social Sciences软件版本22进行统计分析。结果:患者血清铁蛋白水平平均值为32.55±31.97 ng/ml，对照组为143.43±260.40 ng/ml。研究发现，在病例和对照组中，血清铁蛋白水平的平均值有显著差异(p?0.024)。病例组和对照组血清维生素D平均值无显著差异(p-0.229)。结论:低水平的血清铁蛋白与ADHD之间存在关联。
{"title":"Study of the relationship of serum Vitamin D and ferritin levels in children with attention deficit hyperactivity disorder","authors":"Ashima Mehta, B. P. Kalra, Malini Srivastava","doi":"10.32677/ijch.v9i7.3445","DOIUrl":"https://doi.org/10.32677/ijch.v9i7.3445","url":null,"abstract":"Background: Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders among school-age children in India. Etiopathogenesis is attributed to abnormal dopamine regulation which is influenced by both genetic (genes encodingdopamine-DRD4, DRD5, and DAT1) and environmental factors. Micronutrients such as iron and Vitamin D play imperative roles in neurologic function, neurotransmitter synthesis, and regulation. Aim: The aim of the study was to study the association between Serum Vitamin D and Serum Ferritin levels in children with ADHD. Materials and Methods: This case–control study was conducted in the outpatient department of a tertiary care hospital, from October 2019 to May 2021. Subjects (n=30) included patients with the diagnosis of ADHD (using child behavior checklist and INDT–ADHD). Healthy children of the comparable age group were taken as controls. Statistical analysis was performed using Statistical Package for the Social Sciences software version 22. Results: The mean value of serum ferritin levels in cases was observed to be 32.55±31.97 ng/ml and in controls was 143.43±260.40 ng/ml. The study found a significant difference in the mean value of serum ferritin levels in cases and controls (p?0.024). No significant difference in the mean value of serum Vitamin D in cases and controls (p–0.229) was noted. Conclusions: An association between low levels of serum ferritin and ADHD was seen. ","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85737692","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}
D. Lalwani, Aradhna Kankane, Kawalpreet Chhabra, O. Chaurasiya
Aim: The aim of the study was to study management outcomes and risk factors in children with Severe Acute Malnutrition (SAM) <6 months and to assess the role of the Supplementary Suckling Technique (SST) in reestablishing breastfeeding. Materials and Methods: This is a prospective observational hospital-based study done in the Department of Pediatrics in a tertiary teaching institute from October 2019 to September 2020. 75 children who fulfilled the inclusion criteria were included in the study. Children were managed according to the WHO protocol. SST was used to establish breastfeeding in cases of lactation failure. Results: A total of 75 infant’s up to 6 months of age were enrolled. Most infants presented at the age of 2–4 months (42.67%). The male-female ratio was 1.2:1. 50 (66.67%) mothers were illiterate and 65 (82.67%) belonged to the lower socioeconomic status. A history of preterm birth and low birth weight (LBW) was found in 54 (72%) and 62 (82.67%) infants, respectively. Exclusive breast feed was given to 13.33% while top feeding given to 86.6% of infants. With proper management target weight was achieved in 53 (70.66%) infants. Most infants stayed from 11 to 20 days (79.37%). Lactation was re-established in 60.46% of children who tried the supplement suckling technique. Conclusion: Lack of awareness regarding adequate infant feeding practices and illiteracy is an important factor for the high prevalence of malnutrition. SST is an effective way in reestablishing breastfeeding in lactational failure. Proper counseling and education of the mother by health-care professionals can help in improving exclusive breastfeeding rate.
{"title":"Management outcome and risk factor in children with severe acute malnutrition in <6 months of age and role of supplementary suckling technique in re-establishing breastfeeding","authors":"D. Lalwani, Aradhna Kankane, Kawalpreet Chhabra, O. Chaurasiya","doi":"10.32677/ijch.v9i7.3434","DOIUrl":"https://doi.org/10.32677/ijch.v9i7.3434","url":null,"abstract":"Aim: The aim of the study was to study management outcomes and risk factors in children with Severe Acute Malnutrition (SAM) <6 months and to assess the role of the Supplementary Suckling Technique (SST) in reestablishing breastfeeding. Materials and Methods: This is a prospective observational hospital-based study done in the Department of Pediatrics in a tertiary teaching institute from October 2019 to September 2020. 75 children who fulfilled the inclusion criteria were included in the study. Children were managed according to the WHO protocol. SST was used to establish breastfeeding in cases of lactation failure. Results: A total of 75 infant’s up to 6 months of age were enrolled. Most infants presented at the age of 2–4 months (42.67%). The male-female ratio was 1.2:1. 50 (66.67%) mothers were illiterate and 65 (82.67%) belonged to the lower socioeconomic status. A history of preterm birth and low birth weight (LBW) was found in 54 (72%) and 62 (82.67%) infants, respectively. Exclusive breast feed was given to 13.33% while top feeding given to 86.6% of infants. With proper management target weight was achieved in 53 (70.66%) infants. Most infants stayed from 11 to 20 days (79.37%). Lactation was re-established in 60.46% of children who tried the supplement suckling technique. Conclusion: Lack of awareness regarding adequate infant feeding practices and illiteracy is an important factor for the high prevalence of malnutrition. SST is an effective way in reestablishing breastfeeding in lactational failure. Proper counseling and education of the mother by health-care professionals can help in improving exclusive breastfeeding rate.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83038758","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}
Situs ambiguous accounts for 4% of all congenital heart disease (CHD) and has an incidence of 1:10,000 new born births. To standardize the nomenclature for CHD, the international nomenclature society published a globally accepted nomenclature tree for CHD with the 11th Iteration of international classification of disease. According to this publication common atrium, single atrium and atrium communis are denoted as synonyms. The incidence of common atrium among atrial septal defect (ASD) patients is 3–4% only and thus denoting it to be a rare entity. We are presenting an exceedingly rare case of a patient of situs ambiguous, left isomerism, and single atrium with a cleft on the anterior mitral leaflet, evaluated comprehensively by four-dimensional X-strain color Doppler echocardiography.
{"title":"Situs ambiguous with three chambered heart (single atrium), evaluation by four-dimensional X-strain color echocardiography – A case report","authors":"Akhil Mehrotra, Ajay Sharma, Swati Singh, Shubham Kacker","doi":"10.32677/ijch.v9i7.3534","DOIUrl":"https://doi.org/10.32677/ijch.v9i7.3534","url":null,"abstract":"Situs ambiguous accounts for 4% of all congenital heart disease (CHD) and has an incidence of 1:10,000 new born births. To standardize the nomenclature for CHD, the international nomenclature society published a globally accepted nomenclature tree for CHD with the 11th Iteration of international classification of disease. According to this publication common atrium, single atrium and atrium communis are denoted as synonyms. The incidence of common atrium among atrial septal defect (ASD) patients is 3–4% only and thus denoting it to be a rare entity. We are presenting an exceedingly rare case of a patient of situs ambiguous, left isomerism, and single atrium with a cleft on the anterior mitral leaflet, evaluated comprehensively by four-dimensional X-strain color Doppler echocardiography.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"74 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83681405","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 analyze the risk factors and vital role of mothers in prevention of nutritional anemia in the early childhood. Methods: A hospital-based cross-sectional study done in Coimbatore for 2 years. Using a pre-tested structured validated tool, mothers of children aged 6 months–2 years were interviewed to collect information on factors contributing to anemia with special regard to maternal knowledge. Results: Anemia was more in the latter half of infancy (67.2%) with male predominance (60.5%). An affirmative association between increased cow’s milk intake and low hemoglobin was present (p=0.002). Employed and less educated mothers had more anemic children (p<0.05). Of 16% mothers classified as “poor” awareness, 95.45% children had low hemoglobin (p<0.05). Conclusion: Recognizing the causative factors plays an essential role in preventing iron deficiency anemia (IDA). Exclusive breastfeeding must be promoted, along with avoiding excessive cow’s milk intake. Intervening at the right period with age-appropriate foods becomes a necessity. Maternal illiteracy has a positive correlation with anemia in infants. Improving maternal awareness by the physicians will pave the road toward a nation free from anemia.
{"title":"Maternal nutritional awareness and iron deficiency anemia in children aged 6 months–2 years in a tertiary care hospital in Coimbatore, Tamil Nadu","authors":"Shahana Parvin Sheik, F. Saidalikutty","doi":"10.32677/ijch.v9i7.3546","DOIUrl":"https://doi.org/10.32677/ijch.v9i7.3546","url":null,"abstract":"Objective: This study aims to analyze the risk factors and vital role of mothers in prevention of nutritional anemia in the early childhood. Methods: A hospital-based cross-sectional study done in Coimbatore for 2 years. Using a pre-tested structured validated tool, mothers of children aged 6 months–2 years were interviewed to collect information on factors contributing to anemia with special regard to maternal knowledge. Results: Anemia was more in the latter half of infancy (67.2%) with male predominance (60.5%). An affirmative association between increased cow’s milk intake and low hemoglobin was present (p=0.002). Employed and less educated mothers had more anemic children (p<0.05). Of 16% mothers classified as “poor” awareness, 95.45% children had low hemoglobin (p<0.05). Conclusion: Recognizing the causative factors plays an essential role in preventing iron deficiency anemia (IDA). Exclusive breastfeeding must be promoted, along with avoiding excessive cow’s milk intake. Intervening at the right period with age-appropriate foods becomes a necessity. Maternal illiteracy has a positive correlation with anemia in infants. Improving maternal awareness by the physicians will pave the road toward a nation free from anemia.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82402800","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}
Aim and Objectives: The goal of this research was to assess the demographic, clinical, and radiological characteristics of children brought to the hospital with acute bronchiolitis. Materials and Methods: This is a prospective study of children aged 1–3 years whowere admitted to a tertiary care center with acute bronchiolitis between June and August 2021. The research excludes infants <1 month. Age, sex, comorbidities, tachypnea, respiratory distress, saturations, nebulizations’, oxygen therapy, and mortality were all recorded as variables. The data were analyzed using appropriate statistical methods. Results: About 60% of the 162 children admitted with bronchiolitis are males, and 68% of the babies had been exposed to passive smoking. Cough (98%) and wheeze (91%) were the mostcommon symptoms and signs, respectively. On chest X-rays, 73% of the children had hyperinflated lung fields and 8% had atelectasis. Out of 29 children with severe hypoxemia and respiratory failure, 25 children responded to high-flow nasal cannula or continuouspositive airway pressure, and only four required intubation and invasive ventilation. In our study, there was no mortality. Conclusion: The most common reason for hospitalization among infants is acute bronchiolitis. We have significantly reduced the use of antibiotics,systemic steroids, and bronchodilators in our hospital after developing standard treatment protocols for acute bronchiolitis and strictly following them.
{"title":"Demographic, clinical, chest X-ray characteristics, and outcome of children admitted with acute bronchiolitis in the tertiary care hospital South India","authors":"Chandradeve Varma B S K Buddharaju","doi":"10.32677/ijch.v9i6.3471","DOIUrl":"https://doi.org/10.32677/ijch.v9i6.3471","url":null,"abstract":"Aim and Objectives: The goal of this research was to assess the demographic, clinical, and radiological characteristics of children brought to the hospital with acute bronchiolitis. Materials and Methods: This is a prospective study of children aged 1–3 years whowere admitted to a tertiary care center with acute bronchiolitis between June and August 2021. The research excludes infants <1 month. Age, sex, comorbidities, tachypnea, respiratory distress, saturations, nebulizations’, oxygen therapy, and mortality were all recorded as variables. The data were analyzed using appropriate statistical methods. Results: About 60% of the 162 children admitted with bronchiolitis are males, and 68% of the babies had been exposed to passive smoking. Cough (98%) and wheeze (91%) were the mostcommon symptoms and signs, respectively. On chest X-rays, 73% of the children had hyperinflated lung fields and 8% had atelectasis. Out of 29 children with severe hypoxemia and respiratory failure, 25 children responded to high-flow nasal cannula or continuouspositive airway pressure, and only four required intubation and invasive ventilation. In our study, there was no mortality. Conclusion: The most common reason for hospitalization among infants is acute bronchiolitis. We have significantly reduced the use of antibiotics,systemic steroids, and bronchodilators in our hospital after developing standard treatment protocols for acute bronchiolitis and strictly following them.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88549853","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}
Introduction: In the 21st century, with growing concerns over over-diagnosis of asthma in children; the diagnosis of asthma is left as diagnosis by exclusion. On the same lines, an attempt had been made to device a criteria to exclude diagnosis of asthma. The criteria are labeled as other than asthma (OTA) criteria. It is assumed that if a case does not satisfy OTA tool, then it is likely to be asthma. This study had objectives of validation of screening tool by expert and validation of OTA tool by direct application on patients. Materials and Methods: This was an observational and prospective study only. Total 120 cases were enrolled. Questionnaire applied on all cases and all of the 120 cases were followed up on day 30 with clinical diagnosis and were included in results estimation. Results: According to the screening tool, out of 120 cases, 83 cases (69.2%) were found to have OTA while 37 cases (30.8%) werefound to have non-OTA. However, among this study population, 94 cases (78.3%) had non-asthma and 26 cases (21.7%) had clinical diagnosis of asthma taken as gold standard. The association between clinical diagnosis and total score based diagnosis was found to bestatistically significant (p=1.96E-07). Sensitivity was 91.57% and specificity was 51.35% which helps detect OTA cases effectively. Predictive value of positive test is 80.85% and predictive value of negative test was 73.08%. OTA category has relative risk of 3.003 for diagnosis of non-asthma as compared to 0.262 for non-OTA category being almost 3 times in comparison to non-OTA category. Thus, OTA was consistent with non-asthma diagnosis. Conclusion: On direct application of patients in prospective study, this tool has proven its value as an effective screening tool. This was the first such study to diagnose asthma by exclusion, devising a criterion for other than asthma conditions.
{"title":"Validation of screening tool for diagnosis of childhood asthma by exclusion method","authors":"S. Kondekar, Nimisha S. Dange, S. Rathi","doi":"10.32677/ijch.v9i6.3263","DOIUrl":"https://doi.org/10.32677/ijch.v9i6.3263","url":null,"abstract":"Introduction: In the 21st century, with growing concerns over over-diagnosis of asthma in children; the diagnosis of asthma is left as diagnosis by exclusion. On the same lines, an attempt had been made to device a criteria to exclude diagnosis of asthma. The criteria are labeled as other than asthma (OTA) criteria. It is assumed that if a case does not satisfy OTA tool, then it is likely to be asthma. This study had objectives of validation of screening tool by expert and validation of OTA tool by direct application on patients. Materials and Methods: This was an observational and prospective study only. Total 120 cases were enrolled. Questionnaire applied on all cases and all of the 120 cases were followed up on day 30 with clinical diagnosis and were included in results estimation. Results: According to the screening tool, out of 120 cases, 83 cases (69.2%) were found to have OTA while 37 cases (30.8%) werefound to have non-OTA. However, among this study population, 94 cases (78.3%) had non-asthma and 26 cases (21.7%) had clinical diagnosis of asthma taken as gold standard. The association between clinical diagnosis and total score based diagnosis was found to bestatistically significant (p=1.96E-07). Sensitivity was 91.57% and specificity was 51.35% which helps detect OTA cases effectively. Predictive value of positive test is 80.85% and predictive value of negative test was 73.08%. OTA category has relative risk of 3.003 for diagnosis of non-asthma as compared to 0.262 for non-OTA category being almost 3 times in comparison to non-OTA category. Thus, OTA was consistent with non-asthma diagnosis. Conclusion: On direct application of patients in prospective study, this tool has proven its value as an effective screening tool. This was the first such study to diagnose asthma by exclusion, devising a criterion for other than asthma conditions.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84132024","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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