International Journal of Contemporary Pediatrics 2023-01-24T13:28:36+00:00 Editor Open Journal Systems <p>International Journal of Contemporary Pediatrics (IJCP) is an open access, international, peer-reviewed journal that publishes original research work in all areas of pediatric research. The journal's full text is available online at The journal allows free access to its contents. International Journal of Contemporary Pediatrics is dedicated to publishing research in all aspects of health of infants, children, and adolescents. The journal has a broad coverage of relevant topics in pediatrics: General Pediatrics, Neonatal-Perinatal Medicine, Adolescent Medicine, Infectious Diseases, Vaccines, Allergy and Immunology, Gastroenterology, Cardiology, Critical Care Medicine, Developmental-Behavioral Medicine, Endocrinology, Hematology-Oncology, Nephrology, Neurology, Emergency Medicine, Pulmonology, Rheumatology and Genetics. International Journal of Contemporary Pediatrics (IJCP) is one of the fastest communication journals and articles are published online within short time after acceptance of manuscripts. The types of articles accepted include original research articles, review articles, insightful editorials, case reports, short communications, correspondence, images in pediatrics, clinical problem solving, perspectives and pediatric medicine. It is published <strong>monthly</strong> and available in print and online version. International Journal of Contemporary Pediatrics (IJCP) complies with the uniform requirements for manuscripts submitted to biomedical journals, issued by the International Committee for Medical Journal Editors.</p> <p><strong>Issues: 12 per year</strong></p> <p><strong>Email:</strong> <a href="" target="_blank" rel="noopener"></a>, <a href="" target="_blank" rel="noopener"></a></p> <p><strong>Print ISSN:</strong> 2349-3283</p> <p><strong>Online ISSN:</strong> 2349-3291</p> <p><strong>Publisher:</strong> <a href="" target="_blank" rel="noopener"><strong>Medip Academy</strong></a></p> <p><strong>DOI prefix:</strong> 10.18203</p> <p>Medip Academy is a member of Publishers International Linking Association, Inc. (PILA), which operates <a href="" target="_blank" rel="noopener">CrossRef (DOI)</a></p> <p> </p> <p><strong>Manuscript Submission</strong></p> <p>International Journal of Contemporary Pediatrics accepts manuscript submissions through <a href="" target="_blank" rel="noopener">Online Submissions</a>:</p> <p>Registration and login are required to submit manuscripts online and to check the status of current submissions.</p> <ul> <li><a href="" target="_blank" rel="noopener">Registration</a></li> <li><a href="" target="_blank" rel="noopener">Login</a></li> </ul> <p>If you find any difficulty in online submission of your manuscript, please contact editor at <a href="" target="_blank" rel="noopener"></a>, <a href="" target="_blank" rel="noopener"></a></p> <p><strong> </strong></p> <p><strong>Abbreviation</strong></p> <p>The correct abbreviation for abstracting and indexing purposes is Int J Contemp Pediatr.</p> <p><strong> </strong></p> <p><strong>Abstracting and Indexing information</strong></p> <p>The International Journal of Contemporary Pediatrics is indexed with</p> <ul> <li><strong><a title="PubMed and PubMed Central (PMC)" href="" target="_blank" rel="noopener">PubMed and PubMed Central (PMC)</a></strong> (NLM ID: 101729456, Selected citations only)</li> <li><strong><a title="Scilit (MDPI)" href="" target="_blank" rel="noopener">Scilit (MDPI)</a></strong></li> <li><strong><a href=";journalId=31394" target="_blank" rel="noopener">Index Copernicus</a> </strong></li> <li><strong><a href="" target="_blank" rel="noopener">Index Medicus for South-East Asia Region (WHO)</a></strong></li> <li><a href="" target="_blank" rel="noopener">ScopeMed</a></li> <li><a href="" target="_blank" rel="noopener">Journal Index</a></li> <li><a href="" target="_blank" rel="noopener">J-Gate</a></li> <li><a href="" target="_blank" rel="noopener">Google Scholar</a></li> <li><a href="" target="_blank" rel="noopener">CrossRef</a></li> <li><a href="" target="_blank" rel="noopener">Directory of Science</a></li> <li><strong><a href="" target="_blank" rel="noopener">JournalTOCs</a></strong></li> <li><a href=";issn=23493283&amp;uid=r9e49e" target="_blank" rel="noopener">ResearchBib</a></li> <li><a href="" target="_blank" rel="noopener">ICMJE</a></li> <li><a href=";fIDnum=|&amp;mode=simple&amp;letter=ALL&amp;la=en" target="_blank" rel="noopener">SHERPA/RoMEO</a></li> </ul> Risk factors for mortality of preterm infants in the neonatal medicine department of the ‘Mère-Enfant’ University Hospital Centre of Libreville 2022-12-22T06:44:37+00:00 Eliane K. Kuissi Steeve R. Minto'o Raïssa Koumba Maniaga Nestor Mouboungou Aude Lembet Mikolo Edmée Mintsa-Mi-Nkama Live Kiba Morgane Mboungani Pascal Loulouga Badinga Simon Ategbo Jean Koko <p><strong>Background:</strong> Reducing neonatal mortality of preterm infants is a public health priority in developing countries. The objective of this study was to study the risk factors for mortality of preterm infants in the neonatology department of UHCME-JEF.</p> <p><strong>Methods:</strong> A retrospective, analytical study was done over 36 months (January 2019-December 2021) in the neonatology department of UHCME-JEF. Maternal and newborn parameters were studied. All hospitalized preterm newborns were included.</p> <p><strong>Results:</strong> The prevalence of prematurity was 44.6%. The mortality rate was 18.7%. The mean age of mothers was 28.05±6.5 years. They were unemployed (69.4%) and single (73.6%). The three main causes of death were sepsis (41.7%), respiratory failure (26.0%), and anoxic-ischemic encephalopathy (15.3%). The risk factors associated with death were multiparity [p=0.001, OR=2.0, IC 95% (1.32-3.00)], pre-existing maternal diabetes [p=0.007, OR=2.4, IC 95% (1.31-4.52)], prenatal check-up not done [p=0, 024, OR=1.5 IC 95% (1.04-2.05)], GA&lt;28SA [p&lt;0.001, OR=1.8 IC 95% (1.24 -2.71)], Apgar &lt;3 at the first [p=0.036, OR=1.8, IC 95% (1.21-2.76)] and fifth minute [p=0.010, OR=3.2, IC 95% (1.35-7.74)] resuscitation at birth [p=0.017, OR=1.5, IC 95% (1.04-2.05)], birth weight &lt;1000 g (p=0.001, OR=2.8, IC 95% (1.92-4.23)], hypotonia [p=0.001, OR=1.6, IC 95% (1.23-2.32)], asphyxia [p=0.020, OR=1.7 CI 95% (1.09-2.55)], hypothermia [p&lt;0.001, OR=2.1, CI 95% (1.56-2.86)], the presence of thrombocytopenia [p=0.001, OR=1.9, CI 95% (1.62-2.93)] and glycemic dysregulation [p=0.001, OR=2.8, CI 95% (2.09-3.73)].</p> <p><strong>Conclusions:</strong> The mortality of preterm newborns remains a major problem in our department. It is necessary to promote good surveillance of pregnancy, and correct care of premature infants in the delivery room and hospitalization.</p> <p> </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Nutritional status based on anthropometry among primary school children with and without school feeding program 2022-12-28T11:36:02+00:00 Kanij Fatema Ismat Ara Mohammad E. Haque Mohammad A. Rahman <div class="WordSection1"> <p><strong>Background</strong>: Primary school period is a dynamic and growing period. So, school nutrition intervention promotes children’s nutritional status, thereby improving the overall health status of a country as they are the nation's biggest investment. The objective of this study is to compare the nutritional status based on anthropometry among primary school children with and without a school feeding program.</p> <p><strong>Methods</strong>: A comparative cross-sectional study using simple random sampling to select 194 primary school children aged 6-13 years enrolled in two primary schools with (N=97) and without (N=97) school nutrition intervention in two upazilas in Rajbari district, Bangladesh. Data were collected from respondents with the assistance of guardians and teachers. Anthropometric data (height, weight, MUAC, body mass index for age Z score, height for age Z score, weight for age Z score,) were measured by anthro-plus software and overall data were analyzed by SPSS version 25.</p> <p><strong>Results</strong>: Of the total 194 respondents, the prevalence of stunting 9.3%, underweight 20.8%, thinness 27.8%, overweight 8.2%, and obesity 1.5% were observed. The prevalence of stunting 5.2%, underweight 21%, thinness 33%, and overweight 2.1% were found among the SFP group whereas 13.4% stunting, 20.5% underweight, 22.7% thinness, 14.4% overweight, and 3.1% obesity were found among without SFP group. The mean BMI-for-age Z scores were significantly lower (p=0.001) in the SFP group than in without SFP group. Socio-demographic characteristics may overrule this effect.</p> <p><strong>Conclusions</strong>: Findings suggest that determining the dietary pattern, and clinical signs and improving socio-demographic conditions may improve the nutritional status of the children with the school feeding program.</p> </div> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Active disease in juvenile idiopathic arthritis: current patterns and associations: a one-year study 2022-12-21T22:11:39+00:00 Sajib M. Rayhan M. Imnul Islam Mohammad H. Kabir Mahfuza Akter <p><strong>Background:</strong> Juvenile idiopathic arthritis (JIA) is the most common rheumatic ailment of children. JIA is characterized by idiopathic peripheral arthritis with an immunoinflammatory pathogenesis possibly activated by contact with external antigens. To describe the success of active disease (AD) and remission in polyarticular juvenile idiopathic arthritis (JIA) and to measure the associations among patient characteristics, imaging results and these outcomes. The aim of this study is to assess the Active disease in juvenile idiopathic arthritis: current patterns and associations.</p> <p><strong>Methods:</strong> This is an observational study. The study used to be carried out in the admitted patient’s Department of pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. In Bangladesh for the duration of the period from October 2015 to March 2017.</p> <p><strong>Results:</strong> This study shows that the according to age of 33 patients aged 1 to 9 years. Here according to age distribution, 2 (6.1%) were 1-3 years, 10 (30.30%) were &gt;3‑6 years, 9 (27.27%) were &gt;6-9 years and 12 (36.4%) were &gt;9 years. And according to gender 13 (39.4%) were male and 20 (60.6%) were female.</p> <p><strong>Conclusions:</strong> Children with polyarticular JIA spent the majority of their follow-up with active disease. Because children with early radiographic evidence of joint damage have the most active disease, improving outcomes for these subgroups may be an important goal for prospective study.</p> <p> </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Knowledge, attitude and practice of health care workers towards COVID-19 vaccination 2023-01-01T08:36:00+00:00 Kavita Sharma Alok Raina Preeti Sharma <p><strong>Background:</strong> A sound knowledge about vaccination against coronavirus disease-2019 (COVID-19) among health professionals is of great importance in spreading right information to general population. Aim of the study was to find the level of knowledge, attitude and practice (KAP) of health professionals towards COVID-19 vaccination.</p> <p><strong>Methods:</strong> This observational study based on questionnaire done in two district hospitals of North India. Following questionnaire’s content validity, printouts of questionnaire were distributed among the healthcare workers. The assessment was made by a scoring scheme for KAP. The statistical analysis done using SPSS software and Spearman’s rank co-relation used to calculate the correlation between KAP.</p> <p><strong>Results: </strong>Total 300 subjects participated in study. Social networking platform was the major source for acquiring information about COVID-19 vaccination among paramedical staff while the source of knowledge for doctors was mainly scientific websites.62.67% had moderate knowledge, 88% had positive attitude towards vaccination and 73% showed good practice. There was significant difference of KAP towards vaccine between doctors and paramedics.</p> <p><strong>Conclusions:</strong> In most of health care workers level of knowledge towards COVID-19 vaccination was found to be moderate and attitude was predominantly positive. Adequate knowledge and positive of health professionals are very important for increasing the acceptance of vaccination in general population.</p> 2023-01-17T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Academic stress and coping in high school adolescents 2023-01-04T15:20:50+00:00 Jitesh Pillai Soumya Jose Bijumon A. Velukutty A. Riyaz <p><strong>Background:</strong> Education stress is widely recognized as one of the most important precursors leading to depression in adolescent life. This study explores the prevalence of academic stress among high school going adolescents, contributing factors and the coping strategies used by students. The finding of this study aids the teaching institutes to better the understanding of the stress due to present teaching methods.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in 2020 at both private and government schools of Kozhikode, Kerala. 371 students were selected randomly. A questionnaire was developed incorporating educational stress scale for adolescent (ESSA), academic stress scale (ASC) and simplified coping styles questionnaire (SCSQ).</p> <p><strong>Results:</strong> 70.8% students have minimal stress, 25.8% moderate stress, 0.002% high stress, 0.02 did not have stress. Female participants experienced more stress compared to male participants (p value=0.04). Participants with less educated father (p value <strong>&lt;</strong>0.001) and with less educated mother (p value &lt;0.001) experienced more stress. Last year final exam grade (p value=0.005) and parental pressure (p value=0.008) were important factors contributing to stress. With regard to deployment of coping strategies 0.5% never used any coping strategies, 53.6% students used coping occasionally, 45% often used coping, 0.8% used coping frequently.</p> <p><strong>Conclusions:</strong> Most of the children studying in high school have minimal to moderate stress. The main factors that contribute to stress more are female gender, low parental education level, and poor final exam grade. Positive association for factors like parental pressure with increasing age was present. Most of the students used different coping strategies to cope with the education stress. Students often use active coping strategies compared to passive coping strategies.</p> 2023-01-17T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics A comparative study of head circumference and foot length as a measure of low birth weight in neonates 2022-12-20T09:26:13+00:00 Vaibhav B. Rathod Nitin S. Mehkarkar Vaibhav K. Gode <p><strong>Background:</strong> Birth weight is the single most important indicator of survival, growth and overall development of the child. New-borns with less than 2.5 kg birth weight are termed as low birth weight (LBW). Approximately 28% babies in India are LBW. LBW is associated with high neonatal morbidity and mortality. Early diagnosis of LBW and apt intervention can lead to favourable outcome. The 70-80% of births take place either at home or at peripheral hospitals. Measuring birth weight is difficult in India due to resource limited set up. There is a need of alternative methods to detect LBW which should be simple, handy, quick and cost effective. Hence, we decided to do study of correlation of calf muscle circumference and chest circumference with birth weight to determine LBW in new-borns. Aim of the study was to study head circumference and foot length in diagnosing LBW babies. Objectives were to correlate above-said anthropometric parameters with birth weight and to decide indicator with better correlation with birth weight amongst head circumference and foot length</p> <p><strong>Method:</strong> Its a cross sectional study conducted in tertiary care centre in North Maharashtra. The 162 new-borns (34- 42 weeks gestation) were included in Study. Birth weight, head circumference, and foot length were measured with appropriate scientific method. Results are analyzed with SPSS software and Microsoft excel.</p> <p><strong>Results</strong>: Cut-off value to detect LBW is 31cm and 8.2 cm for head circumference and foot length respectively. Head circumference had better correlation (r=0.73) as compared to foot length (r=0.30). Head circumference has 87% sensitivity and 68% specificity as compare to foot length which has 74.8% sensitivity and 46.8% specificity respectively.</p> <p><strong>Conclusions: </strong>Head circumference and foot length circumference can be used to determine LBW, though larger study with a greater number of patients is needed to establish precise correlation.</p> 2023-01-07T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics A study of predictors of outcome in paediatric intensive care unit with special reference to SOFA score 2022-12-29T07:37:04+00:00 Sucheta S. Munshi Shaishav J. Patel Neha A. Vaghela Mugdha M. Shah <p><strong>Background:</strong> Multi-organ dysfunction syndrome (MODS) is the leading cause of morbidity and mortality for patients admitted in Pediatric Intensive care unit. The Sequential organ failure assessment (SOFA) score is an objective score that allows for calculation of both the number and the severity of organ dysfunction in six organ systems. It is a six-organ dysfunction score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal). This scoring system guides the efficient utilization of hospital resources, especially in a resource starved setting and useful to evaluate the prognostication, to counsel the guardians and to decide therapeutic interventions. The score can also be a useful in clinical research tool to evaluate various therapeutic interventions in MODS. The aim of the study was to predict outcome in pediatric intensive care unit with special reference to SOFA score in patients admitted to civil hospital, Ahmedabad.</p> <p><strong>Methods:</strong> We have randomly selected 120 patients who were admitted in pediatric intensive care unit of tertiary care hospital and full-filing inclusion and exclusion criteria included in our study.</p> <p><strong>Results:</strong> There are multiple factors responsible for predicting the outcome in critically ill patients admitted in pediatric intensive care unit. Patients with complete immunization status have better outcome as compared to patients with incomplete immunization and unimmunized status. Patients with higher socioeconomic class have slightly better outcome as compared to patients with lower socioeconomic class.</p> <p><strong>Conclusions:</strong> SOFA score is a good objective score as a predictor of mortality in critically ill patients. But, if SOFA is calculated at the time of admission, then it has poor diagnostic accuracy in prediction of outcome. So, SOFA score at 72 hours of admission (T72) and delta SOFA (T72-T0) are better predictors of poor outcome as compared to SOFA score at admission (T0).</p> <p> </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Neonatal polycythemia: incidence and associated factors 2023-01-11T14:51:12+00:00 Ashaben Ranchhodbhai Chaudhari Aabha Mohan Phalak Priyanka Girishchandra Chauhan Ankit Narbherambhai Goriya Baldev S. Prajapati <p><strong>Background:</strong> The chief concern in neonatal polycythemia (NPC) is the development of complications due to hyper viscosity. We aimed to study risk factors, clinical features, laboratory investigations, management and outcome of neonates with polycythemia at our set up.</p> <p><strong>Methods:</strong> A prospective study was conducted in the frame of January 2021 to January 2022 at tertiary care institute in Ahmedabad, all neonates with gestational age ≥34 weeks were evaluated and those with venous hematocrit more than 65% or hemoglobin exceeding 22 mg/dl were included in the study. The clinical features and laboratory parameters were noted. Asymptomatic neonates or neonates with mild polycythemia were observed for rising hematocrit or development of symptoms whereas symptomatic neonates or neonates with moderate and severe polycythemia were subjected to interventions as needed.</p> <p><strong>Results:</strong> Incidence of polycythemia in this study was 11.18 per 100 neonates. The most common symptoms observed were jaundice in 68 (43.3%) neonates, followed by lethargy in 33 (21%). Other symptoms observed were refusal to feed (18.4%), respiratory distress (11.4%), jitteriness (6.3%), decrees urine output (2.5%), and cyanosis (1.2%). The noted laboratory abnormalities were hyperbilirubinemia (43.3%) followed by thrombocytopenia (40.1%), hypoglycemia (28%) and hypocalcemia (4.4%). The 35.6% neonates require hydration and 22.5% of neonates required partial exchange transfusion, rest were managed conservatively.</p> <p><strong>Conclusions:</strong> the study suggested that polycythemia is a frequent problem among neonates. More than one third of them can be asymptomatic indicating the importance of assessing the associates’ risk factors.</p> <p><strong> </strong></p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Study of severe anemia in hospitalized children in Ahmedabad (Gujarat), India 2023-01-13T15:13:30+00:00 Harsh J. Muliya Maulika V. Shah Hetal N. Jeeyani Divy H. Dudhia Arjun J. Jalandhra <p><strong>Background:</strong> Anemia is a major nutritional problem worldwide especially in developing countries. This research was conducted to find the incidence of severe anemia, to identify the common clinical features and etiology of it and to assess the requirement of packed red cell transfusion.</p> <p><strong>Methods:</strong> All patients having severe anemia (hemoglobin &lt;7 gm/dl in 6-59 months and &lt;8 gm/dl in 5-14 years as per WHO definition) between 6-14 years were included in this study. Detailed medical history, anthropometric measurements and clinical examination were done. Complete blood count, peripheral smear, reticulocyte count and stool microscopy were done in all patients. Then anemia classified morphologically into microcytic, normocytic, macrocytic and dimorphic. Further investigations were done according to the peripheral smear to identify the etiology of severe anemia.</p> <p><strong>Results:</strong> During the study period, 84 patients of severe anemia were hospitalized with incidence of 2.57%. It was more common in male in 6 months to 5 years and in female in 10-14 years age. 67% patients had microcytic, 28% had dimorphic and 2.5% each had normocytic and macrocytic anemia. The most common anemia was iron deficiency (82%) followed by anemia of chronic disease (17%), hemolytic anemia (12%), megaloblastic anemia (7%) and blood loss anemia (1%). Packed red cell transfusion was required in 16 (19%) patients with severe anemia.</p> <p><strong>Conclusions:</strong> Good clinical examination with peripheral smear is helpful in classifying the anemia morphologically. Following this, the use of investigations as per the standard flow charts, helps in identification of etiology.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics A clinical and radiological profile of short stature in Central India 2022-08-11T23:34:45+00:00 Nidhi Agrawal Devendra Barua Pranay Bhandari <p><strong>Background:</strong> Stature is methodically described as height vertex. Short stature can be defined as an individual in whom height is two standard deviations below the standard mean height of a given sex, age and population.</p> <p><strong>Methods:</strong> A cross sectional study was conducted in 200 children attending endocrine OPD over 12 months from October 2019 to September 2020 with complaints of short stature to study the clinical and radiological profile of children between 2-15 years of age.</p> <p><strong>Results:</strong> Totally 200 children with short stature were studied in age group less than 15 years. Total no. of males were 105 (52.5%) and females were 95 (47.5%). The highest percentage of patients i.e., 38.5% belonged to 5-10 years followed by 36% who were of 10-15 years of age group while, the least i.e., only 25.5% belonged to &lt;5 years of age group.</p> <p><strong>Conclusions:</strong> In our study endocrine causes are most common including hypothyroid (27.5%), GHD (2.5%) and adrenal insufficiency (1%). 2nd most common are normal variants CDGP (11.5%) and FSS (9%). After endocrine causes this dominance of normal variants of growth is in accordance with other worldwide studies. Thus, it is very important to remember that many cases of short stature in general population may be normal, as determined by meticulous measurements, and determination of bone age using standard charts and expert’s radiological opinion.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics The effect of kangaroo mother care on stabilization of vital signs heart rate, respiratory rate and arterial saturation in low-birth-weight preterm babies 2022-12-21T23:47:23+00:00 Deepak D. H. <p><strong>Background: </strong>Kangaroo mother care (KMC) have positive effects on the preterm infant's health status in the form of stabilization of vital parameters. Therefore, this study was conducted to evaluate the effect of KMC on stabilization of vital signs in low-birth-weight premature babies. </p> <p><strong>Methods: </strong>This is a quasi-experimental study. One hundred and seventy newborns who were admitted to in neonatal intensive care unit of Karnataka institute of medical sciences Hubli, India were selected by convenience sampling. They were randomly divided into experimental group, n=85 and control group, n=85. In the experimental group, newborns were taken daily KMC for four hours during 7 days. In the control group, routine care was performed. The data gathering tool was questionnaire of infants and mother characteristics, checklists of vital signs using SPSS 22 version software. Chi-square test was used as test of significance for qualitative data. Continuous data was represented as mean and SD. P&lt;0.05 was considered as statistically significant.</p> <p><strong>Results: </strong>Before intervention, there was no significant difference between the vital signs of the infants in experimental and control groups. However, after intervention, there was a significant difference between the two groups in terms of vital parameters (p&lt;0.001).</p> <p><strong>Conclusions: </strong>The findings of this study indicate the effect of KMC on stabilization of vital signs, it is recommended that KMC is taken as one of the routine cares of premature low birth weight babies. </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Effect of maternal haemoglobin, serum ferritin and gestational age on neonatal iron indices 2022-11-23T05:08:30+00:00 Chandra Deve Varma B. S. K. Dantuluri Vineela Alavilli Suma Santhi Viyyapu Venkata Deepika <p><strong>Background:</strong> Iron is the most common micronutrient deficiency in pregnant women and infants throughout the world, mainly in developing countries like India. 30 to 50% of the pregnancies are affected by maternal iron deficiency and in developing countries, more than 80% of the pregnant women are estimated to be anemic. The effects of perinatal iron deficiency are anemia and most importantly neurodevelopmental impairments which are long-lasting and sometimes irreversible. The main goal of this study was to determine the influence of maternal and neonatal factors on the iron stores in neonates and to estimate the appropriate time to supplement iron for neonates in different scenarios.</p> <p><strong>Methods:</strong> This is a prospective observational study. Mother-infant pairs were enrolled in the study by following specific inclusion and exclusion criteria. Maternal demographic details, complications during pregnancy, intrapartum details, and neonatal details were recorded. The maternal and cord blood samples were collected for measurement of hemoglobin, serum ferritin, serum iron, total iron-binding capacity, and transferrin saturation. If failed to collect the cord blood sample, the first 24hour sample of the baby was taken into consideration in place of it. The correlation between maternal neonatal iron indices and the influence of the gestational age and IUGR on cord serum ferritin levels was analyzed by using paired t-test and chi-square test for multiple groups. A probability of p&lt;0.05 (two-sided) was used to consider the difference as significant.</p> <p><strong>Results: </strong>125 term and 47 preterm neonates were included in the study. There was correlation between maternal and neonatal iron profiles at birth when there was severe depletion of maternal ferritin (&lt;12µg/dl) with p values less than 0.05 for hemoglobin and serum ferritn levels. Serum ferritin levels at birth were less in preterm as compared to term neonates (mean of 128.9µg/l in the preterm vs. 156.9µg/l in the term, p=0.04). There was a significant correlation between neonatal iron indices at birth with that at 28 days of life (p&lt;0.01).</p> <p><strong>Conclusions:</strong> Neonatal iron stores are not affected unless there was severe depletion of maternal iron stores. Preterm neonates have low iron stores compared to term neonates. Gestational age is the major determinant for iron stores at birth as compared to other maternal and neonatal factors. As the most significant adverse effects of iron deficiency are irreversible and long-lasting neurodevelopmental impairments. The term and preterm babies should take prophylactic iron from eight weeks and four weeks of age respectively and continued up to the introduction of iron-fortified cereals as recommended by the American academy of paediatrics.</p> <p> </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Pediatric penile biometry guides the surgical outcome following tubularised incised plate urethroplasty for hypospadias: a single centre study 2022-11-30T06:50:50+00:00 Debjani Das Arindam Ghosh Aloke Kumar Sinhababu Sujay Pal Rishavdeb Patra Debojyoti Sasmal <p><strong>Background:</strong> In hypospadias urethral meatus opens onto the ventral surface of the penis proximal to tip of glans and its surgery is challenging. Recent focus of hypospadias surgery is on reduction of postoperative complications and objective assessment of penile anthropometry which can affect outcome. Aim of study was to assess the surgical outcome of tubularised incised plate urethroplasty on penile biometric parameters among children with coronal, distal penile and mid penile hypospadias.</p> <p><strong>Methods:</strong> Study was conducted in the department of pediatric surgery in IPGMER and SSKM Hospital in Kolkata during November 2019 to October 2021.</p> <p><strong>Results:</strong> Among 42 boys mean urethral plate length is 4.286 (coronal), 7.643 (distal penile) and 8.846 (mid penile), mean urethral plate width is 3.321 (coronal), 5.786 (distal penile) and 5.923 (mid penile), mean diameter at mid glans level is 4 (coronal), 5.071 (distal penile) and 5.923 (mid penile), mean diameter at coronal level is 5.75 (coronal), 6.429 (distal penile) and 6.769 (mid penile), mean stretched penile length is 39.2143 (coronal), 41.857 (distal penile) and 40.308 (mid penile) hypospadias respectively. P value is less than 0.05 for all except urethral plate depth which has a non-significant p value.</p> <p><strong>Conclusions:</strong> Urethral plate length, urethral plate width, mid glans diameter, glans diameter at coronal sulcus level and stretched penile length affect the outcome of the surgical process TIP urethroplasty in coronal, distal penile and mid penile type hypospadias but urethral plate depth does not.</p> <p> </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Clinical profile of low-birth-weight neonates admitted in NICU: a tertiary care hospital-based study 2022-11-29T04:07:31+00:00 Gargi H. Pathak Anuya V. Chauhan Dhara K. Gosai Maulik Kumar R. Patel <p class="abstract" style="margin-bottom: 0cm;"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> LBW is defined as weight at birth less than 2.5kg irrespective of gestational age. LBW neonate remains at much higher risk of morbidity and mortality than normal birth weight baby. Morbidity and mortality among LBW babies are a major health problem in our country, so it’s important to identify risk factors.</span></p> <p class="abstract" style="margin-bottom: 0cm;"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> A prospective observational study was conducted on 153 extramural LBW neonates admitted in Neonatal intensive care unit of civil hospital, BJ medical college Ahmedabad from April 2021 to January 2022. </span></p> <p class="abstract" style="margin-bottom: 0cm;"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> Out of 153 neonates, 94 (61.4%) were preterm, appropriate for gestational age and 59 (38.6%) were small for gestational age including 41 (26.8%) term and 18 (11.8%) preterm. 16 (10%) were extremely LBW neonates and 28 (18%) were very low birth weight neonates. 77 (53%) neonates were late preterm and term gestational age. Most common indication of NICU admission was respiratory distress syndrome in 53 (27.8%) followed by sepsis 35 (18.4%), neonatal hyperbilirubinemia 22 (11.6%), birth asphyxia 15 (7.8%) and prematurity+LBW 16 (8.4%).</span></p> <p class="abstract" style="margin-bottom: 0cm;"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> Majority of LBW babies were preterm AGA babies. Respiratory distress syndrome, sepsis, birth asphyxia, prematurity and neonatal hyperbilirubinemia are major causes of admission. While, Respiratory distress syndrome, sepsis and birth asphyxia were common causes of expires. Respiratory distress syndrome is most common cause of morbidity and mortality in low-birth-weight babies. Appropriate and effective use of oxygen delivery system, surfactant, safe, early and effective transportation of neonates should be advised.</span></p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Pediatric Hodgkin’s lymphoma: experience from a tertiary cancer center in North East India 2022-12-12T18:05:58+00:00 Munlima Hazarika Cliffton Sutnga Nithin Raj D. Partha S. Roy Satya S. Sarangi Raghavender Reddy Sreya Mallik Anupam Sharma <p><strong>Background:</strong> Hodgkin’s lymphoma is a clonal malignant lymphoid proliferation, which originates from the germinal centers of B cells. This study was conducted to observe the socio-epidemiological profile of Hodgkin’s lymphoma in a tertiary cancer care centre from North East India.</p> <p><strong>Methods:</strong> All patients from 0 to 18 years of age group with histopathologically proven diagnosis of HL, presenting to department of medical &amp; pediatric oncology at Dr. Bhubaneswar Borooah cancer Institute during the period January 2012 to December 2019 were included in the study. Clinical parameters assessed included age, sex, locality, occupation, presenting symptoms, performance status, site of lymph node involvement, treatment modality, response to treatment, progression free survival and overall survival.</p> <p><strong>Results:</strong> A total of 64 patients with histopathologically confirmed diagnosis of HL were registered in lymphoma joint clinic of BBCI from January 2012 to December 2019. The mean age was 12.68±4.71 years. Out of 64 patients, 54 (84.4%) belonged to rural areas and 10 patients (15.6%) to urban areas. Complete response was observed in 93.5% patient with limited risk disease, 73.24% with intermediate risk and 60% with advance stage. The overall survival and event free survival rates of 91% and 78.1%, respectively, were observed at 4 years.</p> <p><strong>Conclusions:</strong> This study provides insight to incidence, demographic profile, overall response rates and survival pattern with other secondary objectives such as complete response rate, compliance rate and toxicity assessment among children with Hodgkin lymphoma belonging to Northeastern India.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Comparative study of outcome between IAP versus WHO guideline for initial fluid bolus therapy in severely malnourished children with shock 2022-12-29T07:19:17+00:00 Jaimin R. Oza Bakul B. Javadekar Dipal M. Zanzrukiya <p><strong>Background: </strong>Severe acute malnutrition is a major cause of mortality in children under 5 years of age in developing countries. Dehydration and Shock are the common serious complications of SAM and require cautious treatment. We carried out this study to compare 2 different guidelines given by WHO and IAP in patient of SAM with shock to compare their outcome and complications.</p> <p><strong>Methods: </strong>A randomized controlled trial was conducted during January 2019 to October 2019 at tertiary care centre of central Gujarat. Total 40 patients were enrolled according to inclusion criteria and randomized into two groups equally, Group A (following WHO guidelines) and Group B (following IAP guidelines). Rehydration therapy was given accordingly and patients were assessed for improvement in shock, developing complications and outcome as discharge or death.</p> <p><strong>Results: </strong>Out of 20 patients in each group, after bolus, not a single patient in group A showed improvement after 1 hour while in Group B 3/20 (15%) patients were improved. In Group A 8/20 (40%) and in Group B 12/20 (60%) patients showed improvement within 12 hours of bolus. In Group A 7/20 (35%) patients and in Group B 6/20 (30%) patients developed complication of fluid overload. In Group A 12/20 (60%) while in Group B 8/20 (40%) patients expired during the treatment.</p> <p><strong>Conclusions: </strong>Rehydration therapy according to IAP guidelines showed better improvement in shock, less incidence of complications and better outcome as compared to WHO Guidelines in SAM patients, however no significant difference was achieved due to smaller sample size.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Prevalence of severe acute malnutrition among 6-59 months children from community-based SAM management program in Dungarpur district of southern Rajasthan: diving deeper through study of block-wise prevalence 2022-12-13T04:04:04+00:00 R. L. Suman Madhusudan Singh Tomar Kumaril Agrawal Sushma Dangi Manju Yadav Minakshi Singh Vanita Dutta Shiv Raj Singh Chauhan Sheela Rameshwar Rajnish Chordia B. S. Yadav <p><strong>Background</strong>: Acute malnutrition (severe and moderate) is a major public health problem in India and especially Rajasthan. National family health surveys now provide prevalence of SAM children till district level but there’s an undenying need for data at even more granular, like block level, to assess the field reality in more depth. The present study tries to demystify the same at block level by studying data collected from a community-based SAM management program i.e., AMMA (acute malnutrition management action) program in Dungarpur.</p> <p><strong>Methods</strong>: As part of AMMA program, block wise data from 20 districts of Rajasthan was collected monthly during implementation and its dedicated MIS was used as the source of this data. The data includes information of all children screened in the age-group of 6-59 months in Dungarpur district which was subsequently analyzed and studied till block level. The SAM prevalence is assessed, using Mid Upper Arm Circumference (MUAC) of 6-59 months children. &lt;12.5 cm of MUAC was considered as acute malnutrition while &lt;11.5 cm of MUAC was considered as SAM as per WHO standards.</p> <p><strong>Results</strong>: A total of 1,13,547 children were screened (84.91%) in the study period. A total of 4829 children (4.25%) were found with Acute Malnutrition, out of which 4622 were identified with moderately acute malnutrition (MAM) and 207 are identified with SAM. Out of total 207 children with SAM, 118 were girls (57%) while 89 (43%) were boys. The prevalence of SAM children in the district came out as 0.18% whereas state prevalence is 0.9%. Among blocks the SAM prevalence varied from as low as 0.02% in Dowda and Chikhali to as high as 0.63% in Jothari block.</p> <p><strong>Conclusions:</strong> Prevalence of SAM in Dungarpur district is low at 0.18% but block-wise analysis helped in further disaggregating the burden. To identify all children with acute malnutrition in the district there’s an urgent need to do screening based on WFH Z-score instead of complete reliance on MUAC tape.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics A study of serum electrolyte imbalances and its impact in children of 4 months to 5 years of age group presenting with acute gastroenteritis 2022-12-14T06:34:30+00:00 Dibin Joseph Sunilbala Keithellakpam <p><strong>Background:</strong> Fluid and electrolyte derangement are the immediate causes that increases the mortality in diarrhea. The present study was carried out among children of 4 months to 5 years with dehydration due to acute diarrhea to determine the serum electrolyte profile.</p> <p><strong>M</strong><strong>ethods:</strong> A hospital based cross sectional study was carried out in department of pediatrics, RIMS during a period of two years (sept 2019-Aug 2021).</p> <p><strong>Results: </strong>A total of 195 patients of 4 months to 5 years of age group presented with acute gastroenteritis were included in the study, among them hyponatreamia was the most frequent electrolyte abnormality noted (37.4%). Most (65.5%) of hyponatremic patients in our study took dilute ORS whereas majority (64.2%) of patients who took appropriate ORS had normal serum sodium levels. Frequency and duration of diarrhea, dehydration status and inappropriate ORS were significant risk factors for serum electrolyte and acid base imbalances.</p> <p><strong>Conclusions</strong>: Electrolyte abnormalities were significantly associated with frequency and duration of diarrhea, dehydration status and inappropriate ORS administration. Hence, timely recognition and management of electrolyte abnormalities and appropriate ORS administration improves outcome in acute gastroenteritis related dehydration in children.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics A study of risk factors and clinical characteristics of neonatal pneumonia in a tertiary care centre 2022-12-19T00:16:54+00:00 Arshiya Syeda Lohith Reddy Ksl Sowmya Santosha Manta Nisar Ahmed <p><strong>Background:</strong> Neonatal pneumonia accounts for significant morbidity and mortality, especially in developing countries. Throughout childhood, the greatest risk of death from pneumonia is in the neonatal period. This study is done to study the risk factors and clinical characteristics of neonatal pneumonia. Aim of the study was to study the risk factors and clinical characteristics of neonatal pneumonia.</p> <p><strong>Methods:</strong> This was a hospital-based observational study conducted in the department of paediatrics, Gandhi medical college and hospital, Hyderabad. A detailed antenatal and postnatal risk factors were taken, and the clinical signs and symptoms of neonatal pneumonia were noted.</p> <p><strong>Results:</strong> Of the 100 neonates 30% of cases had early onset pneumonia and 70% had late onset pneumonia.50% of early onset pneumonia cases had antenatal risk factors. There is a statistically significant association of age of onset of pneumonia with gestational age (p=0.002) late onset pneumonia being more common &gt;37 weeks of gestational age. 80% of early onset pneumonia cases were associated with septicaemia.</p> <p><strong>Conclusions:</strong> Pneumonia is one of the most common causes of respiratory distress in neonates. Late onset pneumonia was more common. Major predisposing factors for early onset pneumonia are antenatal risk factors like premature rupture of membranes, maternal fever, major predisposing factors for late onset pneumonia are pre-lacteals, oil instillation in the nose, and aspiration of milk. Cough as a symptom was observed in late onset pneumonia.</p> <p><strong> </strong></p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Utilization of Nikshay Poshan Yojna in tuberculosis patients in two tuberculosis units of North India 2023-01-18T12:42:12+00:00 Preeti Sharma NUSO2083@GMAIL.COM Alok Raina Kavita Sharma <p><strong>Background:</strong> Nikshay Poshan Yojana (NPY) was launched in 2018 aiming to provide nutritional incentive of INR 500 per month to all tuberculosis (TB) patients till they complete their treatment. Aim of present study is to determine the number (proportion) of patients being treated for tuberculosis who received the benefits of NPY and to explore the ways incentives were utilized by the patients.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted in two tuberculosis units of North India from June 2022 to Dec 2022. All newly diagnosed TB patients registered and receiving treatment in these two Units were included in the study. Defaulters, relapse, failure and multidrug-resistant TB cases were excluded. Data was collected from Nikshay portal. All the patients were contacted telephonically to know whether the incentive was utilized for nutrition.</p> <p><strong>Results:</strong> Total 189 patients were included in the study. All patients received benefit under NPY. But only 26 (13.7%) received incentive in scheduled time. Out of 189 patients 56 refused to give telephonic interview about the utilization of incentives. Out of 133 patients who gave interview 85 (64%) patients utilized incentive entirely for nutrition.</p> <p><strong>Conclusions:</strong> Government should assure timely availability of funds so that patients can be benefitted timely particularly during initial months of their treatment. Also, there is a need of counselling of patients receiving treatment for tuberculosis about the importance of nutrition in their treatment so that they can utilize financial incentive for nutrition.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Neurodevelopmental outcome of children with severe acute malnutrition 2022-12-17T06:48:01+00:00 Irfan B. Bhat Muzafar Jan Abdus S. Bhat <p><strong>Background: </strong>Severe acute malnutrition is known to be a major risk factor for impaired motor, cognitive, and socio-emotional development. Not much work has been done to study the neuro development of these patients. The aim of this study was to assess the neurodevelopment and outcome of children between 1 and 30 months with diagnosis of SAM</p> <p><strong>Methods:</strong> The study was an observational prospective study conducted from November 2018 to April 2020. A total of 61 patients were enrolled in our study. Patients admitted in NRC with diagnosis of SAM were assessed for neurodevelopment after stabilization. Developmental assessment scale of Indian infants was used to calculate the motor developmental quotient and mental developmental quotient. Patients were followed till 6 months and after 6 months, they were again assessed by DASII to see the improvement in neurodevelopment status. Developmental quotient of less 70 was taken as delayed.</p> <p><strong>Results: </strong>Mean DMeQ after stabilization and at 6 months after discharge was 53.672 and 72.591 respectively. Mean DMoQ after stabilization and at 6 months after discharge was 50.50 and 68.23 respectively. Mean DQ after stabilization and at 6 months after discharge was 52.186 and 70.4105 respectively.</p> <p><strong>Conclusions: </strong>Severe acute malnutrition results in neurodevelopmental impairment in children but early and effective intervention results in significant improvement in neurodevelopment status.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Face mask and affective development in children: time to ponder and sort issues afore it’s too late 2022-12-26T23:23:09+00:00 Rachna Pasi Kumar Satish Ravi <p>Wearing face mask can cut down the odds of infections entering sound individual as respiratory droplets/ aerosols while additionally lessening danger of ejection from contaminated individual. Respiratory transmission of CORONA VIRUS by means of droplets or aerosols can be forestalled by the suitable utilization of face mask. Since COVID-19 contamination has arisen as pandemic, entire world is bound to follow the COVID-appropriate behaviours. Among all actions to battle COVID contamination, most talked about and investigated is utilization of face mask. Utilization of face mask by grown-ups are likewise problematic, then, at that point, considering their utilization in kids are genuinely quite difficult. Many research studies have attempted to discover the relationship of mask and actual uneasiness or respiratory long-haul issues, however veils innocuously relating to these boundaries.<sup> </sup>This letter is to stress the use of mask with an affective domain of development of children. Development of children is partitioned into language, cognitive, affective and psychomotor development. Affective development is defined as ability to perceive and respond/ react to assortment of emotions from others.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Tailored therapy and bloodless supportive care measures for a Jehovah’s witness with metastatic Ewing sarcoma 2022-12-09T23:45:10+00:00 Erlyn Smith Naresh Redivalla <p>A seventeen-year-old Jehovah’s witness with metastatic Ewing sarcoma initially declined cancer therapy due to the risk of life-threatening bone marrow suppression. He then subsequently agreed to other treatment options with bloodless supportive care measures in order to achieve quality of life and long-term control of his disease. This case report adds to the collective knowledge of providing treatment options including bloodless supportive care measures for Jehovah’s witness patients with cancer. </p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics When Guillain-Barre syndrome took a wrong path 2022-11-29T06:32:54+00:00 Supriya K. Gowda Prashanth S. Savitha M. R. <p>The pharyngeal cervical brachial (PCB) variant of Guillain-Barre-syndrome (GBS) is defined by rapidly progressive oropharyngeal and cervicobrachial weakness associated with areflexia in upper limbs. On nerve conduction study PCB represents a localized subtype of GBS characterized by axonal rather than demyelinating neuropathy. PCB is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. Herein we describe a case of symmetric descending type of acute flaccid paralysis with predominant upper limb involvement and also lower limb involvement diagnosed as a PCB- GBS overlap mainly based on nerve conduction study.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Radiological signs in osteopetrosis 2022-11-28T22:25:26+00:00 Nitish Kumar Tanya Singh <p>Osteopetrosis, or marble bone disease, is a rare genetic metabolic bone disease initially described by Albers-Schönberg in 1904. Osteopetrosis includes a clinically heterogeneous group of conditions characterized by increased bone density due to a defect in bone resorption by osteoclasts. The osteoclasto-genesis as well as the osteoclastic activity may be distorted. Clinical symptoms of osteopetrosis vary greatly in their presentation and severity as the spectrum ranges from the neonatal onset with life-threatening complications to incidental findings of osteopetrosis on radiographs. Diagnosis is based on clinical and radiographic evaluation, confirmed by bone biopsy and genetic testing. Treatment depends on the symptoms and severity of the disease and requires a multidisciplinary team approach.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Shoulder joint septic arthritis with scapular osteomyelitis a rare presentation in an infant with sickle cell disease: a challenging diagnosis; a case report from rural central India 2022-12-10T05:47:12+00:00 Hrutuja Hande Jennifer N. Nongrum Swapnil Kolhe Payal Meshram Smita Jategaonkar Manish Jain <p>Sickle-cell disease (SCD) a hereditary autosomal recessive disorder is the most common haemoglobinopathy worldwide. In India, it is the second most common haemoglobinopathy next to Thalassemia, prevalent in the tribal population of Central and Southern parts of India. The pathophysiology of the disease is point mutation in the beta globin chain leading to sickling of RBCs which causes obstruction in microvasculature leading to acute events like Vaso-occlusive crisis. Patients with SCD are also at an increase of orthopaedic manifestation like osteomyelitis, septic arthritis or osteonecrosis. We report a case of a 10 months old male child who presented with anaemia and fever. Child was diagnosed with SCD, later developed swelling of right shoulder joint and restrictions of movements. Diagnosis of septic arthritis of shoulder with scapular osteomyelitis was made with the help of radiological and laboratory investigations. Child was managed with injectable antibiotics and symptomatic treatment. Patients with SCD as a result of occlusion of microvasculature along with immunocompromised state are at higher risk of bacterial infections. Osteomyelitis is one of the dreaded complications. Its clinical presentation is similar to that of VOC hence there occurs a dilemma in diagnosis. A multidisciplinary approach including high degree of clinical suspicion, laboratory investigation and radiological imagining can help in early diagnosis and management.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Vitamin D dependent rickets type 2: a case-based review of patient with alopecia and rickets 2022-12-14T05:06:47+00:00 Rajan Kumar Akanksha Raj Manoj Kumar Deepak Kumar <p>Vitamin D dependent rickets (VDDR) type 2 is a very rare hereditary disease which has an autosomal recessive mode of inheritance. Patients with VDDR type 2 have a mutation in the gene encoding for vitamin D receptor on chromosome 12q12-q14, thus averting normal physiological action of 1,25 vitamin D. It's presents with the developmental delay in motor domain with features of rickets usually in the first year of life. Alopecia totalis has a frequent association with the disease. We are reporting a case of a 5-year-old boy who has a history of difficulty walking since 2 year of life, with a gradually progressive motor weakness course. Patients have a history of alopecia since 2 months of age, which progressed to alopecia totalis. On investigation, serum calcium was 7.2 mg/dl with a very high alkaline phosphate level of 1065 IU/ML with a normal vitamin D level was reported. The initial treatment started with IV calcium followed by 1000mg of oral calcium, along with a high dose of calcitriol. The patient was under periodic follow-up showing improvement in biochemical parameters. We reviewed literature of seven patient out of which 5 patients had alopecia and found 2 patients had enamel hypoplasia and all had features of rickets.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics Hepatopathy in sickle cell disease with osteomyelitis: a challenging diagnosis: case report 2022-12-25T02:15:10+00:00 M. Sushmitha Ashma N. Nazir Sravyasree Sreekantham N. Pradeep <p>‘Sickle hepatopathy’ is a condition which is seen in only 10% cases of sickle cell disease (SCD). Sickle hepatopathy could be due to acute sickle crisis, sequestration, cholangiopathy, severe intrahepatic cholestasis or as a result of chronic blood transfusion related infection and hemosiderosis. Differentiating the cause for hepatopathy in SCD is challenging. Hepatopathy manifestation can range from mild liver function test abnormality to life threatening fulminant hepatic failure. Hence, demanding prompt recognition and management. Here we reported a one such case of 13 year old male with progressing jaundice and bony pain with swelling of lower limbs was diagnosed as SCD with right proximal tibia sickle osteomyelitis and left knee septic arthritis with hepatopathy who was managed with supportive care and surgical intervention.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 International Journal of Contemporary Pediatrics