International Journal of Contemporary Pediatrics <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>Please check out the video on our YouTube Channel:</p> <p>Steps to register and submit a manuscript:<br /><a href="" target="_blank" rel="noopener"></a></p> <p>Problem Logging In-Clear cookies:<br /><a href="" target="_blank" rel="noopener"></a></p> <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> Medip Academy en-US International Journal of Contemporary Pediatrics 2349-3283 The practice of umbilical vessels catheterization in neonatal intensive care units: a survey <p><strong>Background: </strong>Umbilical venous catheterization and umbilical arterial catheterization provides easy access for administering fluids, exchange transfusion, medications, parenteral nutrition, blood pressure monitoring and blood sampling in neonates. Objective was to know the common practices related to the placement and maintenance of umbilical catheters, along with the associated complications in the level 3 and 4 neonatal intensive care units in the USA.</p> <p><strong>Methods: </strong>A questionnaire-based survey study was conducted among NICU practitioners across United States. Only one survey was sent to each NICU.</p> <p><strong>Results: </strong>Among the survey respondents, 50.8% represented level 3 NICUs, while 49.2% represented level 4 NICUs. The maximum duration for both UVC and UAC use was commonly reported as up to 7 days. Birth weight was the predominant method (86.8%) used for calculating catheter length. X-rays were universally employed for position confirmation. Heparin was widely utilized through UVC (96.7%), with a concentration of 0.5 IU/ml (73.7%). In cases of malpositioned UVC, practitioners employed techniques such as inserting another catheter, utilizing twisting movements during insertion, adjusting the UVC to a low position, and replacing the malpositioned UVC with a peripheral intravenous line. Common complications associated with UVC included line occlusion, thrombosis, and infections, while poor extremity perfusion and thrombosis were reported with UAC. Most units allowed feeding even when patients had a UAC in place.</p> <p><strong>Conclusions: </strong>Despite the presence of institutional policies in most NICUs, practitioners encountered several complications during the use of umbilical catheters.</p> Nita Shrestha Manhal Khilfeh Rajesh Dudani Shou-Yien Wu Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 256 260 10.18203/2349-3291.ijcp20240340 Feeding premature babies in the neonatology department of the Androva Mahajanga Hospital <p><strong>Background:</strong> The initiation and progression of enteral nutrition in premature infants remains a challenge. The aim of this study was to evaluate enteral nutritional management in premature infants in the neonatology department at the mother and child complex Androva Mahajanga.</p> <p><strong>Methods:</strong> This was a retrospective descriptive study over a 7-month period, from January to July 2018. All neonates under 37SA who received enteral feeding were included.</p> <p><strong>Results:</strong> During the study period, 74 newborns were able to receive enteral feeding. The mean age of onset of enteral feeding was 10.6 hours. In 89.2% of cases, enteral feeding was started within the first 24 hours of life. On average, the initial quantity administered was 28.4ml/kg/d. Human milk was used most frequently (54.8%). The presence of residue was the most frequently encountered incident (31.5%). Ulcero-necrotizing enterocolitis occurred in 7 newborns (9.5%). Forty-five newborns had a good outcome, with an average weight gain of 9.28 g/kg/d.</p> <p><strong>Conclusions:</strong> The implementation of a nutritional management protocol for newborns, especially premature babies, in the neonatology department would be beneficial for a better outcome and growth of the baby.</p> Safidisoa Nambinina Razanamanana Nirina Henintsoa Raveloharimino Radohery Lovasoa Randriamanga Norotiana Rabesandratana Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 261 263 10.18203/2349-3291.ijcp20240341 Correlation of anthropometric measurements with pretransfusion haemoglobin in transfusion dependent thalassemia major children <p><strong>Background: </strong>The etio-pathogenesis of growth failure in transfusion dependent thalassemia major (TDTM) children is mainly because of chronic anemia, iron overload and endocrine complications. Aim was to determine the association between anthropometric measurements with pre-transfusion haemoglobin in TDTM children.</p> <p><strong>Methods: </strong>Present cross-sectional study included total 55 children between 5-18 years of age who were diagnosed as TDTM. Mean pre transfusion hemoglobin of last 1 year was obtained from previous medical records. Anthropometric measurements like weight in kg and height in cm measured while body mass index (BMI) was calculated using standard formula in each patient. Weight for age, height for age, and BMI were plotted on WHO 2006 and Indian academy of paediatrics 2015 combined growth charts in terms of percentile. Data was analysed statistically.</p> <p><strong>Results:</strong> Total 55 children of TDTM between 5-18 years of age were studied. The mean age was 10.42(4.07) years. The mean weight (kg), height (cm) and BMI was 23.76 (7.5), 123.94 (18.13) and 15.24 (1.76) respectively. Fifty-one (92.73%) children were having BMI less than 3<sup>rd</sup> centile (Underweight). Forty (93.02%) and 11 (91.66%) children between age group of 5-10 years and more than 10 years were underweight and was statistically significant (p&lt;0.05). Total 50 (94.33%) children were having mean pre transfusion hemoglobin below 9 gm/dl who were underweight which was statistically significant.</p> <p><strong>Conclusions:</strong> Low pre-transfusion hemoglobin is one of the risk factors for growth failure in children with TDTM and it should be maintained above 9 gm/dl may for normal growth in children with TDTM.</p> Priti Bhimrao Kamble Saiprasad Onkareshwar Kavthekar Amar Vilas Naik Devayani Ajit Kulkarni Bhavana Izardar Nivedita Balasaheb Patil Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-12 2024-02-12 11 3 264 266 10.18203/2349-3291.ijcp20240321 Comparative evaluation of novel tooth brushing with reminder therapy with conventional brushing techniques in children <p><strong>Background: </strong>Dental caries and periodontal diseases are the most prevalent oral diseases in the children. Dental plaque is the main contributing agent for these oral diseases. Tooth brushing is considered to be one of the most efficient ways of maintaining the oral hygiene. Often, it is noted that certain areas of oral cavity and surfaces of the teeth are brushed more, while the other areas are neglected. With this background, we have designed a novel technique of tooth brushing with reminder therapy.</p> <p><strong>Methods:</strong> Oral examination of 180 children aged between 6-12 years was done and Oral Hygiene Index Simplified, Turesky-Gilmore-Glickman modification of Quigley-Hein Plaque Index, Modified Gingival Index were recorded. The children were randomly divided into three groups; Control group; Tooth brushing using Fones technique; Tooth brushing along with a reminder therapy (dantharaag: the tooth tune). Each group was taught their respective techniques and follow up was done at 15 and 45 days interval and all the indices were recorded. The data, thus collected was tabulated and subjected to analysis.</p> <p><strong>Results:</strong> The results showed a reduction in the scores of OHI-S, TMQH and MGI in all the three groups during follow up visits. However, this difference was statistically significantly between the groups where, Group 2 was better than Group 1 and Group 3 was better than Group 1 and 2 by 45 days.</p> <p><strong>Conclusions:</strong> In conclusion, Dantharaag: the tooth tune was readily accepted by children and showed better results in plaque reduction and oral hygiene improvement.</p> Shilpa S. Jyothsna V. Setty Srikanth K. V. Smrithi Srinivasan Ajith Kumar Haridasan Ila Srinivasan Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 267 271 10.18203/2349-3291.ijcp20240342 LATCH score: a tool for identification and correction of breastfeeding problems in a tertiary care hospital of North Karnataka <p><strong>Background:</strong> Breastfeeding, a vital childhood intervention, faces challenges despite being a natural process. Factors such as maternal confidence, latching issues, breast pain, perceived milk insufficiency, and inadequate encouragement contribute to early discontinuation. Assessing breastfeeding in postpartum mothers prior to discharge is important for successful breastfeeding. The LATCH charting system designed by Jensen et al was used to assess the score. Objectives were to determine early breastfeeding problems using LATCH score and to study the impact of breastfeeding supportive measures on LATCH score.</p> <p><strong>Methods:</strong> Hospital-based prospective observational study was conducted among 100 mothers who delivered in hospitals attached to Mahadevappa Rampure Medical College, Kalaburagi. The LATCH score was assessed twice, first within 24 hrs after birth and second 48 hrs after intervention.</p> <p><strong>Results:</strong> Good LATCH score was found among the rural mothers, multiparous mothers and those who had a normal vaginal delivery. After providing breastfeeding support, a majority (81%) of the mothers transitioned from poor or moderate to a good LATCH score group. The overall mean LATCH score increased from 5.83±1.64 to 9.31±1.5 following intervention. Improvement was seen in all the individual components of LATCH.</p> <p><strong>Conclusions:</strong> This LATCH assessment tool can identify mothers and infants who are at risk of early breastfeeding cessation and serve as a guide to initiate appropriate intervention.</p> Keerti Halgar Roopa B. Mangshetty Apurva A. B. Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 272 276 10.18203/2349-3291.ijcp20240343 A study of level of procalcitonin as marker of early onset sepsis in neonates <p><strong>Background:</strong> Neonatal sepsis is one of the commonest causes of morbidity and mortality. It is one of the four leading causes of morbidity and mortality in India. The purpose of this study was to evaluate the levels of procalcitonin as a rapid diagnostic test, to identify those with infection as soon as possible, and to classify them into definitive, clinical, or no sepsis. The rise in Procalcitonin levels in the neonate with sepsis is very rapid. Hence, it can be used for the diagnosis of early onset neonatal sepsis. Objectives were to estimate the concentration of Procalcitonin for diagnosis of early onset neonatal sepsis and to compare the Procalcitonin levels amongst 3 categories of neonatal sepsis (definite, clinical and no sepsis).</p> <p><strong>Methods:</strong> This is a hospital based analytical prospective study.</p> <p><strong>Results:</strong> 104 babies with early onset sepsis were included in the study from the NICU in tertiary health care center. Procalcitonin is positive in 69 (66.35%) and negative in 35 (33.65%). Out of the total 69 neonates with Procalcitonin positive, 42 (60.8%) neonates are preterm and 27 (39.1%) are term neonates. Out of the total 35 neonates with Procalcitonin negative, 24 (68.5%) neonates are preterm and 11 (31.4%) are term neonates. There was no sepsis observed in 57 (54.8%) of cases, clinical sepsis was observed in 34 (32.6%) of cases and definite sepsis was observed in 13 (12.5%). The mean value of level of Procalcitonin in different categories of sepsis as determined from the data is 3.27 ng/ml in cases of No sepsis, 11.79 ng/ml in cases of clinical sepsis and 17.2 ng/ml in cases of definitive sepsis.</p> <p><strong>Conclusions:</strong> Procalcitonin has good sensitivity and hence can detect most cases of neonatal sepsis and good negative predictive value. Procalcitonin contributes more significantly to the diagnosis of newborn septicemia when paired with additional testing and helps in identifying the categories of sepsis in neonates.</p> Arpita K. Patel Jigar P. Anadkat Nirali J. Mehta Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 277 281 10.18203/2349-3291.ijcp20240344 Perception of oral health professionals towards oral health care in children with attention deficit hyperactivity disorder: a cross-sectional questionnaire study <p><strong>Background: </strong>Attention deficit hyperactivity disorder is one of the most common psychiatric disorders that affects both children and adults and is characterized by inattention, hyperactivity, and impulsivity. Around 9% of worlds’ child population and 20% of India’s is affected by ADHD. A child with ADHD can often have neglected or poor oral hygiene. Attending to the dental treatment of such children can be a challenging task for dentists. The aim of the study was to assess the knowledge, attitude, and practices of oral health care towards children with ADHD among oral health professionals.</p> <p><strong>Methods: </strong>The study was carried out among 151 oral health professionals using a validated questionnaire. The results were tabulated in an excel sheet and analysed using SPSS software version 22.0.</p> <p><strong>Results: </strong>It was found that among the participants, 71.52% had knowledge scores below the mean knowledge score, while 74.83% had attitude scores below the mean and likewise, 53.64% had practice scores below the mean practice scores. A positive correlation was found between knowledge, attitude, and practice by Karl Pearson’s correlation coefficient with a highly statistically significant p value of 0.0001 (p&lt;0.05). This signified low knowledge correlated with less positive attitude leading to poor practices.</p> <p><strong>Conclusions</strong>: Majority of the participating professionals perceive that their training did not prepare them well to treat ADHD affected children. However, practice levels were better among those with more years of experience.</p> Sanika U. Karmarkar Shivayogi M. Hugar Chandrashekhar M. Badakar Niraj Gokhale Bhuvanesh N. Bhusari Krishna S. Kadam Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 282 287 10.18203/2349-3291.ijcp20240345 Clinical profile of pediatric acute renal failure patients requiring renal replacement therapy age less than 15 years: an ambivalent COHORT study <p><strong>Background:</strong> Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. There is minimal data on the clinical profile of pediatric AKI patients age less than 15 years who required renal replacement therapy (RRT).</p> <p><strong>Methods:</strong> A total of 301 patients (3%) were diagnosed with AKI, amongst them 66 patients who required RRT from January 2021 to December 2022 were enrolled. Their clinical, biochemical, and etiological profile were studied to find out their influence in modifying the outcome of AKI patients requiring RRT.</p> <p><strong>Results:</strong> AKI was noted in 301 patients (3%), amongst them 66 patients we had analyzed who underwent RRT. Result were analyzed in three age group (0-2 month, 2 month-8 year, 8 year-15 year). Male preponderance was seen amongst all age groups with male: female ratio being 2:1, 5:1 and 1.8:1 respectively and rural area preponderance seen in all age groups. Birth asphyxia, neonatal sepsis and septicemia were leading etiologies in different groups. Peritoneal dialysis (PD) was only RRT modality in the 0-2 month age group, while hemodialysis and PD modalities were used in rest groups. Multi-organ dysfunction syndrome was commonly seen comorbidity associated with all groups along with pyogenic meningitis, and encephalopathy. Mortality rate was observed at 47% (n=31).</p> <p><strong>Conclusions:</strong> From our study, we conclude that to expand the facility of point of care, hemodialysis facility in ICUs with a larger study or multicentric study in the pediatric age group is required.</p> <p> </p> Jayesh R. Solanki Kishan S. Patel Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 288 295 10.18203/2349-3291.ijcp20240346 Intraventricular hemorrhage on mortality and neurological outcomes in premature infants <p><strong>Background:</strong> Intraventricular hemorrhage (IVH) is the commonly encountered clinical event in preterm neonates which imposes significant morbidity and mortality. Although there is a rapid advancement in the neonatal care, IVH is the common cause of neonatal intensive care units admissions. The present study was carried out to evaluate the risk factors, mortality and neurological outcomes in preterm neonates with IVH.</p> <p><strong>Methods:</strong> This was a prospective study conducted on 75 preterm neonates who were delivered before 37 weeks of gestation. The neonates were subjected to cranial ultrasound for the diagnosis of IVH and graded as per the severity. The neonatal and prenatal variables were recorded and analysed to find its association with IVH progression and mortality. Immediate neurological outcome was also assessed among the IVH preterm neonates. </p> <p><strong>Results:</strong> In this study out of 75 preterm neonates, the prevalence of IVH was 18 (24%). The main neonatal factors for IVH are less gestational age at delivery, 28-31 weeks (p=0.001), birth weight &lt;1500 gm (p=0.001), APGAR scores &lt;5 at 1 and 5 minutes (p&gt;0.05) and maternal factors associated with IVH is premature rupture of membranes (p=0.01). The mortality rate among the IVH preterm neonates was 7 (38.9%). The significant predictors of mortality were male gender (p=0.004), grade III and IV IVH (p=0.001) and birth weight (p=0.001). The main neurological outcomes observed were seizures and post-hemorrhagic ventricular dilatation.</p> <p><strong>Conclusions: </strong>Increased severity of IVH, early gestational age and low birth weight were associated with mortality in preterm neonates with IVH.</p> Madhuri Kadam Abhijeet Trivedi Vishal Sachede Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 296 302 10.18203/2349-3291.ijcp20240347 Change in the trend of diet and lifestyle patterns among Indian children during COVID-19 confinement: a cross-sectional study <p><strong>Background:</strong> To assess the change in the trend of diet and lifestyle behaviours during the COVID-19 pandemic in children and their association with various COVID-19-related consequences.</p> <p><strong>Methods:</strong> A cross-sectional study that employed a structured 22-item questionnaire through teledentistry to 1500 children who previously visited the dental department of a tertiary hospital in Delhi. The dietary habits lifestyle changes (DHLC-COVID19) questionnaire, which was customized and validated for the study, and their COVID-19 related consequences were administered.</p> <p><strong>Results:</strong> A statistically significant decreased intake of certain types of foods, high-carbohydrate snacks with a lower trend in snacking frequency was observed in children during COVID-19. The study investigated the association of variation of food intake in children i.e., ‘no consumption’ and ‘decreased consumption’ in relation to family members who lost their job during COVID-19 and depicted significant relation w.r.t families who got infected, lost their life during COVID-19. Determinants of these perceived changes were examined in multivariable regression models, Chi-square test and Mc Nemar test. Moreover, a significant change in lifestyle behaviours was also observed in children during COVID-19. The comparison of weight assessment during COVID-19 and performing/ engaging in physical activity during the period depicted that there was a statistically significant difference in proportion (p&lt;0.05).</p> <p><strong>Conclusions:</strong> This study provides evidence of the detrimental effects of COVID-19 be taken into consideration when developing and implementing public health policies to protect children's health both during and after the pandemic, especially among vulnerable youngsters on the social spectrum.</p> Padma Yangdol Namita Kalra Rishi Tyagi Amit Khatri Deepak Khandelwal Tavisha Goyal Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 303 314 10.18203/2349-3291.ijcp20240348 Excessive maternal iced-tea intake-reversible cause of premature ductus arteriosus constriction <p>Premature ductus arteriosus constriction is a rare entity associated with high neonatal morbidity and mortality. Most cases are idiopathic, with the major known cause being maternal use of nonsteroidal anti-inflammatory drugs. Polyphenol-rich foods have been proven to have a deleterious fetal hemodynamic effect that can lead to premature ductal constriction. We report a case of a neonate diagnosed with premature ductal arteriosus closure, whose only risk factor was an excessive maternal intake of commercial iced-tea during pregnancy. The authors aim to raise awareness to the impact of polyphenol-rich food consumption on ductus arteriosus, since maternal dietary advice can have a major preventive role. Furthermore, a timely diagnosis and intervention can prevent significant morbidity and mortality.</p> <p> </p> Vilma Lopes Joana Pinho Beatriz Vieira Maria A. Rangel Ana Carriço António Vinhas Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 319 321 10.18203/2349-3291.ijcp20240350 Typical presentation of mucopolysaccharidosis type IVA: a case report <p>Mucopolysaccharidosis (MPS) IVA, or Morquio syndrome, is a rare lysosomal storage disorder characterized by skeletal dysplasia. It is caused due to deficiency in the enzyme N-acetylgalactosamine-6-sulfatase (GALNS), which results from an autosomal recessive mutation in the GALNS gene. The frequency of this mutation is equivalent in men and women. Here in, we present the case of Morquio syndrome, in a male child of twin gestation with poor antenatal and natal history. The peculiar presentations are those of skeletal deformities, coarse facial features, recurrent respiratory tract infections, and a history of NICU admission for meconium aspiration syndrome. This case is unique because, despite a negative family and prenatal history, and one of the twins being unaffected which adds to its appeal. Later, on biochemical and radiological investigations, he was diagnosed with mucopolysaccharidoses IVA and ultimately managed him supportively.</p> Kovvuru Ashrita Ethuri Lokesh Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-16 2024-02-16 11 3 322 325 10.18203/2349-3291.ijcp20240328 Ethmocephaly: a rare but lethal congenital anomaly <p>Ethmocephaly is a rare but lethal congenital anomaly. Its incidence rate is 1 in 15,000 live births and 1 in 250 in abortuses. Babies have typical dysmorphic facies in form of orbital hypotelorism, proboscis and low set malformed ears. 32 years old, daily wage labourer delivered a baby with ethmocephaly. Baby had typical facies, and no extracranial abnormality present. Baby was stillborn. She had no antenatal checkup or ultrasonogram done. However, she had history of ingestion of certain plants during early months of pregnancy. Ethmocephaly is a lethal anomaly and mostly eliminated prenatally. Although there is no diagnostic test for ethmocephaly, and confirmation of it is done only by appearance of baby after birth, important clues like recognition of risk factors like maternal diabetes, alcohol intake, ingestion of certain plants, antenatal hydrocephalus, should not be missed. Importance of routine antenatal checkup and ultrasonogram is emphasized. Recognition of risk factors and a possible co-relation with ingestion of certain other plants is also emphasized.</p> Aneeta Chaudhary Arun Kumar Arya Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 326 328 10.18203/2349-3291.ijcp20240351 Septic arthritis following mumps in a case of steroid dependent nephrotic syndrome: a case report <p>Nephrotic syndrome is a common renal disorder with an incidence of 20 to 40 per million population in developed countries. Children with nephrotic syndrome are especially susceptible to infections such as cellulitis, spontaneous bacterial peritonitis, and bacteremia. However, septic arthritis is an extremely rare complication in nephrotic syndrome. A 6-year-old girl with steroid dependent nephrotic syndrome relapsed following mumps parotitis and developed swelling of the right knee with restricted movements. Ultrasonography (USG) and magnetic resonance imaging (MRI) were suggestive of septic arthritis. The child responded to intravenous Vancomycin and Ceftazidime. We present a rare complication of nephrotic syndrome as septic arthritis, previously reported only once.</p> <p> </p> Karan J. Bhoomraddi Vaishnavi G. Koshatwar Prithi Inamdar Rajesh K. Rai Ravi P. Naulakha Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 329 331 10.18203/2349-3291.ijcp20240352 A mysterious hematochezia in an adolescent boy: atypical presentation of childhood systemic lupus erythematosus <p>Thrombosis is a well-known entity in presence of antiphospholipid antibody (APLA) associated with systemic lupus erythematosus (SLE) as a hematological complication. Bleeding manifestations instead of thrombosis is hardly found in literature in presence of APLA seromarkers in SLE. Since these can range from minor bleeding like epistaxis to major life-threatening intracranial bleeding, early diagnosis and prompt treatment is essential to manage such condition. We report a 12 years old boy with no significant past history presented with hematochezia and epistaxis along with pallor requiring blood transfusion. Hematological investigations were normal except for elevated PT, aPTT and INR. Common causes of coagulopathy were ruled out. Upon suspecting systemic diseases, the investigations were carried out which revealed ANA 4+ along with high titre of dsDNA, low C3 and C4 complement and positive anti-β2 glycoprotein, anticardiolipin antibody and lupus anticoagulant. Diagnosis of SLE was made according to ACR-EULAR criteria with no renal involvement. Immunological basis was considered for coagulopathy in this child. He was started on oral prednisolone, hydroxychloroquine and methotrexate. He is now under close monitoring of the coagulation profile for titration of steroid dose. We want to create awareness about the uncommon hematological manifestation of SLE presenting as bleeding diathesis instead of thrombosis through this case report and that can be life threatening too if not treated promptly. A high index of suspicion and careful follow-up may help in preventing adverse outcome of the disease.</p> <p> </p> Abhik Paul Sandeep Ghosh Saherin Jesmin Sananda Pati Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 332 336 10.18203/2349-3291.ijcp20240353 Congenital anomalies with pancytopenia: the vital role of physical examination in the diagnosis <p>Fanconi anemia is a rare autosomal recessive inherited disorder impacting the interstrand cross-link DNA repair pathway, leading to systemic and hematologic manifestations as well as an increased susceptibility to malignancies. Diagnosing FA involves a comprehensive approach, combining physical examinations, clinical investigations, and genetic analysis. In this report, we present the case of an 11-year-old girl with FA who exhibited notable physical characteristics such as short stature, microcephaly, hyperpigmentation, and bifid thumbs in both hands, coupled with the hematologic complication of pancytopenia. The challenge often lies in the delay of identifying physical findings, given the variable and subtle nature of these anomalies. Although genetic analysis confirms the diagnosis, the child had regular visits to pediatrician elsewhere for immunization, congenital anomalies, hyperpigmentation, short stature and received blood transfusions, this delay in recognizing physical manifestations underscores the need for heightened awareness among healthcare professionals to ensure an early diagnosis.</p> Harshith Siddappaswamy Arumugam R. Sudeep Gaddam Dhaarani Jayaraman Niranjani Maniurmila Julius Xavier Scott Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 337 339 10.18203/2349-3291.ijcp20240354 An interesting case of dengue masquerading a splenic brucellosis <p>Mixed infections or co-infections are not uncommon in dengue fever which can occur as a result of transient suppression of host immunity by unknown mechanisms or as a part of its complication. Brucellosis co infection or post dengue complication can occur due to the indigenous practice of consumption of raw unpasteurized cattle milk. Here is a case report of a 14-year-old girl who presented with dengue fever but then continued to have persistence of fever spikes with abdominal pain requiring administration of antibiotics as well as upgradation, on evaluation was found to have splenic abscess with prior history of ingestion of raw goat’s milk with serology suggestive of Brucellosis. This case report was done to elucidate the likelihood of co infection of zoonoses like dengue and brucellosis and the importance of consideration of brucellosis as a differential in cases of unresolving pyrexia post dengue fever especially in countries with wide prevalence of this practice of consumption of unpasteurized cattle milk.</p> Nimisha Sharma Ryan Maclean D. Souza Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 340 343 10.18203/2349-3291.ijcp20240355 A rare presentation of severe alloimmune hemolytic disease of newborn pertaining to minor blood group ‘c’ incompatibility: a case report and review of literature <p>Hyperbilirubinemia is one of the most widely seen causes of neonatal morbidity. Haemolytic disease of fetus and newborn is caused by maternal alloantibodies to the fetal RBCs. It is responsible for incompatibility between maternal and fetal blood groups, which results in destruction of fetal red blood cells causing hyperbilirubinemia. ABO and Rh incompatibility are the most common causes of severe indirect hyperbilirubinemia. Besides ABO and Rh isoimmunization, minor blood group incompatibilities such as anti-Kell, anti-C, anti-c, anti-E, anti MNS, Duffy, KIDD, P, Lutheran and Lewis have also been identified as causes of severe neonatal jaundice with an incidence of 385/1,00,000 live births in South-East Asia. We, hereby report a rare case of a full term 2.2 kg newborn presented with severe anemia with reticulocytosis and neonatal hyperbilirubinemia at second hour of life. In view of strongly positive DCT and no Rh negative or ABO setting, minor blood group incompatibility screening test was performed in the mother which revealed presence of multiple alloantibodies; however, the red cell phenotyping confirmed the presence of anti-c antibodies in maternal sera responsible for neonatal alloimmune haemolytic anemia. The baby was offered intensive phototherapy with intravenous immunoglobulin.</p> Kruti Shah Shwetal Bhatt Vaishali Chanpura Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 344 347 10.18203/2349-3291.ijcp20240356 Profile of adenoviral infection in hospitalized children <p>This single-center, retrospective study was conducted at Marengo Asia Hospital, Haryana from January 2023 to November 2023. Children aged 1 month to 16 years, admitted with a positive adenovirus polymerase chain reaction (nasopharyngeal swab) were included. Symptomatic management was provided to all children. The study focuses on discussing the demographic, clinical, laboratory and radiological profiles of hospitalized children with human adenovirus infection. Among the 25 children with a positive adenovirus polymerase chain reaction, 18 (72%) were males, 15 (60%) were within the age group of 1 month to 5 years. Furthermore, 13 (52%) children were hospitalized during summer season. The most prevalent symptoms observed in children admitted with adenovirus infection were high-grade persistent fever in 25 cases (100%), cough and cold in 15 cases (60%), 14 (56%) vomiting in 14 cases (56%), pain abdomen and loose stools in 10 cases (40%), conjunctivitis in 6 cases (24%), and adenoviral pneumonia in 4 cases (16%). Notably all children were discharged successfully without encountering any complications. HAdV infections are commonly associated with high- grade fever, challenging the conventional perception that respiratory infections are their predominant manifestation. Equally noteworthy is the prevalence of gastrointestinal symptoms in HAdV infections</p> <p> </p> Sanjeev Dutta Niharika Khullar Copyright (c) 2024 International Journal of Contemporary Pediatrics 2024-02-22 2024-02-22 11 3 315 318 10.18203/2349-3291.ijcp20240349