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> en-US (Editor) (Editor) Wed, 27 Mar 2024 19:02:15 +0530 OJS 60 Impact of antibiotic treatment duration on community-acquired pneumonia in children: a systematic review <p>The treatment of pediatric community-acquired pneumonia (CAP) with antibiotics is important due to its substantial global health impact. To support clinical practice and antibiotic stewardship, this narrative review investigates the effects of the length of antibiotic therapy on the outcomes of childhood CAP. A thorough search of PubMed, Scopus, and Google Scholar produced English articles published in the last ten years (2019–2024) and looked at the connection between the length of antibiotic therapy and the outcomes of community-associated pneumonia in children. There is increasing evidence to support the similarity of shorter and longer antibiotic regimens for treating juvenile community-acquired pneumonia. Research continuously shows that shorter periods of antibiotic therapy—usually five days—produce similar clinical results as lengthier regimens that last seven to 10 days. Furthermore, emphasis is placed on tailored treatment plans that take into account the child's age, the severity of the symptoms, and regional trends of antibiotic resistance. The included studies, albeit observational and retrospective, provide important insights into the safety, effectiveness, and consequences of various antibiotic regimens in the therapy of pediatric CAP. This review emphasizes the significance of evidence-based strategies to maximize antibiotic treatment for pediatric CAP, while also noting research limitations. More research is required to enhance treatment methods and results for kids with CAP. This includes carefully planned randomized controlled trials and integrated diagnostic tools.</p> <p> </p> Josselyn N. V. Enríquez, Mateo D. F. Vera, Jessica P. F. Martinez, Diego A. C. López, Cinthya C. U. Abad, Mayra A. C. Merino Copyright (c) 2024 International Journal of Contemporary Pediatrics Fri, 22 Mar 2024 00:00:00 +0530 A 5-year-old girl case of spastic paraplegia type 56, a mutation in the CYP2U1 gene <p>This case report details the presentation, diagnosis, and management of a 5-year-old girl from Saudi Arabia with Spastic Paraplegia Type 56 (SPG56) resulting from a novel mutation in the CYP2U1 gene. SPG56, a rare form of hereditary spastic paraplegia, exhibits genetic variability, impacting neurological and extra-neurological functions. The patient's clinical course involved a fall at age 2, subsequent motor deterioration, cognitive delays, and spasticity. Comprehensive diagnostic evaluations, including genetic testing, identified a homozygous likely pathogenic variant in CYP2U1. Despite outpatient therapy, the patient underwent a four-week intensive rehabilitation course to address spasticity and enhance daily living activities. This case highlights the challenges in diagnosing and managing SPG56 and underscores the importance of genetic testing in complex neurodegenerative cases.</p> Noura Alotayk, Raghad M. Almunyif, Imad S. Moukais Copyright (c) 2024 International Journal of Contemporary Pediatrics Mon, 11 Mar 2024 00:00:00 +0530 Dual cutaneous lymphoid dyscrasias in a pediatric patient, with progression to mycosis fungoides: case report <p>This case report explores the progression of cutaneous lymphoid dyscrasia to a lymphoma in a 13-year-old boy with pityriasis lichenoides chronica and lichenoid pigmented purpuric dermatitis, the latter evolving into mycosis fungoides. We highlight some of the crucial clinical and histological characteristics to differentiate between these entities. Early identification of this progression is critical not only for preventing further lymphoma development but also for initiating prompt therapy.</p> Jorge A. Cortez-Vila, Rosa M. Lacy-Niebla Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Renal primitive neuroectodermal tumor in an adolescent: a case report and review of literature <p>Renal primitive neuroectodermal tumor is a highly malignant neoplasm that commonly affects young adults and infrequently presented in children and adolescents. We report a case of a 14-year-old female child who presented with abdominal mass. PET-CT showed an FDG avid cystic lesion in the inter and lower polar regions of the right kidney, extending into the right renal fat and renal vein, with multiple FDG avid lesions in the axial and appendicular skeleton, suggesting renal mass with bony metastases. Biopsy confirmed the diagnosis of primitive neuroectodermal tumor of the kidney. The patient completed six cycles of chemotherapy with partial response and subsequently the patient defaulted and lost to follow-up. To emphasize the critical significance of renal PNET in the differential diagnosis of renal tumors in children.</p> Abul Hasan Shadali Abdul Khader, Ramya C. T., Sudeep Gaddam, Priyathersini Nagarajan, Natarajan K., Dhaarani Jayaraman, Gokulakrishnan Periakaruppan Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Shaken baby syndrome in neonate: a clinical masquerade <p>Abusive head trauma, which is a subset of Shaken baby syndrome, refers to a type of brain injury that occurs when the baby's head is subjected to undesirable forces. The characteristic lack of contributory history often leads to misdiagnosis, delayed treatment and suboptimal clinical outcome. We reported a neonatal presentation of abusive head trauma which posed significant diagnostic challenges. This manuscript depicts our journey to the correct diagnosis and also a review of current literature on abusive head trauma.</p> Asha Babu, Rekha Zacharias, Mufeethali Thattarathodi, Dimple Patel Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 The silent storm: a case report of missed antenatal diagnosis leading to fatal respiratory distress and death in a rare case of congenital high airway obstruction syndrome <p>Congenital high airway obstruction syndrome in neonates is a rare, life-threatening condition characterized by upper airway obstruction. Typically diagnosed prenatally through advanced imaging, CHAOS results from anomalies such as laryngeal atresia or web or tracheal stenosis. Neonates with CHAOS face respiratory distress at birth, necessitating prompt intervention. Management often involves ex-utero intrapartum treatment procedure or tracheostomy to establish a secure airway. Timely diagnosis and multidisciplinary collaboration are crucial for optimizing outcomes in affected infants. Despite its rarity, CHAOS demands heightened clinical awareness to ensure swift, tailored interventions and improve the chances of neonatal survival. We report here a case of CHAOS which was not diagnosed on antenatal ultrasonography.</p> <p> </p> Roohi Khan Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Developmental delay and autism with hypertrichosis cubiti: a clue to the diagnosis of Wiedemann-Steiner syndrome <p>Wiedemann-Steiner syndrome (WSS) is a rare disorder with dysmorphic features, developmental delay, autism, and hypertrichosis. We report a case of a seven and half year-old female child born to a non-consanguineous couple with developmental delay, autism, behavioral abnormality and hypertrichosis cubiti diagnosed to have <em>KMT2A</em> gene associated WSS. It is important for the treating clinician to be aware of the characteristic signs and symptoms of the disorder and the necessity of genetic testing to be able to confirm the diagnosis and manage by multidisciplinary team in any child with developmental delay and autism.</p> Gayatri Nerakh, Chaitanya Varma Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 A girl with synostotic plagiocephaly: unfolding as rare case <p>Dysmorphic head shape can be a presenting complaint of craniosynostosis which needs to be investigated in detail for any genetic or syndromic associations. Many genetic mutations have been associated with craniosynostosis but ERF gene mutation has been found to be very rare. Here, we have discussed about an 8 years old girl who presented with dysmorphic head shape. She had crouzoid features like exorbitism, malar hypoplasia with copper beaten skull appearance and pansynostosis on CT Head but genetic evaluation revealed ERF gene mutation suggestive of craniosynostosis 4. She had short stature which was the unique association with it. Thus, high index of suspicion should be kept for craniosynostosis 4 when phenotypic features are suggestive of crouzon syndrome as crouzon syndrome can phenotypically mimic craniosynostosis with ERF gene mutation and genetic analysis should be done to look for alternate cause of craniosynostosis; especially to look for ERF gene mutation.</p> Preeti Arya, Sanket Bhadra, Monica Jassal, Vyas K. Rathaur Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Enteric fever masquerading as parotitis <p>Parotitis is commonly associated with viral infections, while some cases can be bacterial. Parotitis with enteric fever is very rare and has not been reported in pediatric population. An 8-years-old girl presented with parotitis, high grade fever, abdominal pain and vomiting. Salient examination findings were bilateral parotitis, cervical lymphadenopathy on right side, tonsillar hypertrophy with exudates over the right tonsil. Abdominal examination did not reveal any hepatosplenomegaly. Blood culture showed <em>Salmonella paratyphi A.</em>, while other test for etiology of parotitis were non-conclusive. Parenteral ceftriaxone was given for a total duration of 14 days. The child responded well clinically and was kept under close follow-up. Presence of parotitis with enteric fever is a very rare finding. Blood culture is a gold standard test for diagnosing enteric fever. It should be incorporated in first line investigations in cases presenting with high grade fever and parotitis.</p> Sanjeev Dutta, Niharika Khullar Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Gum hypertrophy in acute myeloid leukemia: an important clinical finding not to be missed <p>Acute myeloid leukaemia (AML) is characterized by disordered differentiation and proliferation of abnormal hematopoietic stem cells. AML usually presents with symptoms of anemia like pallor and fatigue, recurrent infections, petechiae, and mucosal bleeds. Extramedullary infiltration of leukemic cells is a common finding like proptosis or myeloid sarcoma. The occurrence of gingival hypertrophy in the pediatric age group is uncommon and usually due to inflammation followed by prolonged use of certain drugs like cyclosporin or phenytoin. Gingival infiltration in AML is rare in children, usually associated with subtypes M4/M5 (FAB classification). This case report highlights the importance of considering AML as an important differential diagnosis in cases of gum hypertrophy, as being a less common cause, it is often overlooked. Timely diagnosis and prompt treatment can be lifesaving. Here, we report two cases who presented with gum hypertrophy.</p> Harshita Narendran, Sudeep Gaddam, Vimalnath Shanmugam, Dhaarani Jayaraman, Sri Gayathri Shanmugam, Latha M. Sneha, Julius Xavier Scott Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 COVID-19 pandemic: maker or breaker for families having children with autism spectrum disorder-case series of maternal experiences, strategies and suggestions <p>The COVID-19 pandemic due to prioritization of emergency and COVID-19 patient care at hospitals and disruption of daily routines and finances, impacted significantly families having people with special needs. This case series highlights the problems faced and strategies used by mothers of children having autism spectrum disorder (ASD). It summarizes the experiences of nine families of ASD children (2 to 9 years), selected consecutively from pediatric developmental/disability outpatient department (OPD) of a tertiary care center during i.e. April 2021 to May 2021 (2<sup>nd</sup> wave of COVID-19 pandemic) using a pre-designed proforma. Socio-demographic details, maternal experiences about challenges faced in child’s home care, special therapies, managing child’s behaviour, family support system, adaptations and their suggestions were recorded. The age group was 2 to 9 years and 8 were males. 7 out of 9 mothers reported that their child’s interaction with father and other family members improved. Institutional therapy was discontinued by all mothers. Two mothers reported increased aggression in the child. Mothers from joint family and having supportive families reported less stress. Children who had company of parents/grandparents/sibling and availability of indoor games, art and craft and storytelling, reported less screen time and less behavioural disturbances though all the mothers reported increased screen time compared to pre COVID times. Mother’s empowerment is key to success. Indoor physical games, unstructured play, increasing social awareness, supportive families, tele-rehabilitation services can improve overall progress in ASD children. Health care practices need to be revised from time to time for special needs/situations.</p> <p> </p> Nusrat R. Inamdar, Minal R. Wade, Anupama V. Mauskar Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Experience of pediatric palliative care among children with cancer in a tertiary care hospital in Bangladesh <p><strong>Background:</strong> Palliative care is a holistic approach which can improve patients and their family’s quality of life through the prevention and relief of physical symptoms as well as support for emotional, social and spiritual suffering. Despite the substantial need for palliative care there is very limited access in Bangladesh, with only a few palliative care services focused on children including several hospital-based services as well as home and hospice-based services, within the capital city of Dhaka. The aim of the study was to evaluate the effect of pediatric palliative care on quality of life in children with cancer.</p> <p><strong>Methods:</strong> This was an institutional based descriptive study conducted in the department of pediatric hematology and oncology and pediatric palliative care unit, Dhaka medical college hospital, Dhaka, from May to August 2023. A total of thirty child and parent pairs were taken as the study population according to inclusion and exclusion criteria. Outcome was evaluated by the CPOS-2 questionnaires for symptom and Lanskys performance status scale for assessment of activity level.</p> <p><strong>Results:</strong> The median age of the children were 5.7 years where 70.0% were male. The duration of disease of the patients was up to 6 months in 63.3% cases. One third of the patients had ALL, 13.3% had NHL, and 10.0% had Ewing sarcoma while another 10.0% having neuroblastoma.</p> <p><strong>Conclusions:</strong> There is significant improvement in the quality of life of pediatric cancer patients and their parents, as well as the enhanced performance status of patients with cancer after receiving pediatric palliative care.</p> <p> </p> M. Shaidur Rahman, Sabikun Naher Urmy, Moshrefa Newaz, M. Atiqul Islam, Tasnuva Khan, Habiba Khatun, Maliha Alam Simi Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Neurobiological developmental disorders in preschool girls are associated with obesity <p><strong>Background:</strong> The prevalence of abnormal weight in young children with neurobiological developmental disorders is not known. Children with abnormal weight are at risk for both mental health problems now and in their future. Moreover, abnormal weight can have a detrimental effect on their treatment. This prospective study examines the length and weight in preschool children with neurobiological developmental disorders requiring special day care.</p> <p><strong>Methods:</strong> Trained medical employees measured height and weight of children aged 3 till 5 years old with developmental disorders, who started special youth day care between 2019 and 2021 in the province of Drenthe in the Netherlands.</p> <p><strong>Results:</strong> A total 73% of the children had normal weight, 16% had overweight, 12% were underweight. Girls had more often overweight (28%) and underweight (14%), compared to boys.</p> <p><strong>Conclusions:</strong> Our results suggest that pre-school children and especially girls with psychological problems, have already a significant increased risk of an abnormal body mass index (BMI). Although studies with a larger study population are needed to ascertain this conclusion, screening for an abnormal BMI should be conducted as a standard procedure in this group of children, since it can affect their therapy and future health.</p> Wilma J. van Veen, Michiel Burger, Michel J. van Vliet Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Clinical profiles and causes of ascites in children at a tertiary care hospital, Bangladesh <p><strong>Background:</strong> Ascites is an accumulation of serous fluid within the peritoneal cavity. Combined analysis of laboratory data and clinical and pathological details are essential for establishing a differential diagnosis. In children of Bangladesh our context, etiologies behind ascites are not yet studied well. The aim of our study was to evaluate the causes of ascites in the basis of clinical feature and laboratory investigation in children.</p> <p><strong>Methods:</strong> This was a cross-sectional retrospective descriptive hospital-based record review of a tertiary center of hospital, Bangladesh. All children aged between 6 months to 17 years with ascites, irrespective of their primary cause admitted in pediatric ward were included in this study. The study was conducted during September 2019 to September 2020. During this period, 50 children presented with ascites were enrolled in the study.</p> <p><strong>Result:</strong> The mean age was 8.174. The age range of the patients was from 6 months to 17 years. Twenty-eight (56.0%) of them were males and 44% of the participants were female. Maximum 54% have duration more than 7 days. The most common previous symptoms were fever (68%) and jaundice (38%) followed by bleeding manifestation (30%). The most common etiology of ascites was Chronic liver disease with portal HTN (48%), followed by abdominal tuberculosis (14%).</p> <p><strong>Conclusion:</strong> This study found that CLD with Portal HTN is the most common cause of ascites in pediatric age group and second most common cause is infectious cause e.g. abdominal tuberculosis. This also highlighted that the presenting symptoms and laboratory parameter that guided to find out the causes of ascites.</p> Wahiduzzaman Mazumder, Urmy Roy, M. Farid Raihan Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 A study of safety and effectiveness of amino-acids based multi-nutrient fortifier in preterm infants <p><strong>Background:</strong> Fortification plays a vital role in supporting the nutritional requirements in the premature infants. Currently in India, fortifiers are either whole protein based or whey protein which are bovine milk- based, which has been associated with increased risk of feed intolerance and necrotizing enterocolitis (NEC), to circumvent this, an amino-acids based fortifier has been made available which provides more proteins (0.35 g/1 g sachet) thereby meeting the nutritional requirements of preterm infants. Aim was to study effect (safety and efficacy) of fortification with the amino-acids based fortifier (HMF-ADVANCE, Analeptik Biologicals) in premature infants admitted in the neonatal intensive care unit (NICU).</p> <p><strong>Methods:</strong> A single centre pilot study was conducted on preterm infants with &lt;1800 g birth weight and/or &lt;32 gestational age, amino-acids based fortifier (AABF) was used as the fortification option once the infants reached 100 ml/kg/day feed volume. 1 g of HMF-ADVANCE was mixed in 25 ml of mother’s own milk (MOM) and the fortification was continued till discharge from NICU.</p> <p><strong>Results:</strong> A total 100 preterm infants were included for the study, mean gestational age (GA) was 29.38±1.61 weeks, mean birth weight was 1159.90±301.9. Growth outcomes at the end of the study: mean weight gain was 23.73±7.62 g/day, mean head circumference gain was 1.02±0.41 cm/week, mean length gain was 1.01±0.15 cm/week and weight gain velocity were 17.13±2.38 g/kg/day. Blood urea nitrogen (BUN) showed an increasing trend from baseline (before starting fortification: 3.2 mg/dl), 1 week after fortification (6.3 mg/dl) and at the end of study (11.2 mg/dl). AABF was also used in three neonates post NEC. There were no episodes of feed intolerance or necrotising enterocolitis episodes and none of neonates discontinued fortification till discharge from NICU.</p> <p><strong>Conclusions:</strong> AABF was well tolerated without any feed intolerance episodes and helped to achieve optimal growth. AABF can be the optimal choice of fortification in low-birth-weight neonates.</p> Prathap Chandra, Deepa M. Sharma, Suresh Gowda, Ramitha L., Laxmi Kamath Copyright (c) 2024 International Journal of Contemporary Pediatrics Tue, 19 Mar 2024 00:00:00 +0530 Under 5 pneumonia a forgotten pandemic: an insight into risk factors predicting outcome of severe pneumonia in children aged 2 months to 5 years of age <p><strong>Background:</strong> Pneumonia is the leading cause of morbidity and mortality in the pediatric population. In developing countries like India, multiple sociodemographic and environmental factors influence the outcome of severe pneumonia so this study explores these risk factors with aim of finding ways to improve the outcome.</p> <p><strong>Methods:</strong> It is a prospective observational study conducted over a period of 12 months on 2 months to 5 years, children with severe pneumonia admitted in ward and PICU of tertiary medical care institute. A total of 100 patients were enrolled in the given study after meeting the inclusion criteria. Predesigned proforma was used to record sociodemographic details, patient history, detailed examination findings and laboratory reports. Outcome in terms of mortality and morbidity was noted. Data analyzed using appropriate statistical tests, p values &lt;0.05 accepted as statistically significant.</p> <p><strong>Results:</strong> The severe pneumonia was more common in the age group of 2 months to 1 year of age (59%) and in males (60%). Malnutrition and leukocytosis was statistically significant. 53 subjects were exclusively breastfed. Type of family, mother &amp; father’s education status, mother’s employment status, tobacco exposure and contact with tuberculosis were not found statistically significant in the given study. 21 participants required PICU and 10 patients required mechanical ventilation. 92 patients were discharged, while 2 patients expired.</p> <p><strong>Conclusions:</strong> Pneumonia is an important preventable and treatable cause of under 5 mortalities. In developing countries like India an awareness and proper management of risk factors like malnutrition, low birth weight, immunization status can improve the outcome.</p> <p> </p> Naresh D. Gaikwad, Nusrat R. Inamdar, Anupama V. Mauskar Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 A study on complications and outcome of hypospadias repair at tertiary care hospital <p><strong>Background: </strong>The surgical procedure used to treat hypospadias varies widely in clinical practice due to several considerations. In light of this, we assessed the risks and results of many surgical techniques for correcting hypospadias.</p> <p><strong>Methods: </strong>It was a prospective hospital-based study done for a period of 1 year. All patients with age greater than 12 months who underwent hypospadias repair in the surgery department of PMSSY super speciality hospital (KIMS, Hubballi) from January 2022 to December 2023 were included in the study. Approval from institutional ethical committee was taken before initiation of the study. Written informed consent was taken from the parents of the study participants. Total 42 patients with hypospadias were included in the present study.</p> <p><strong>Results: </strong>The most common type of hypospadias was distal seen in 67% of patients among distal the most common site of urethral opening was distal penile in 43% followed by mild penile in 40%. Proximal type was second most common type seen in 24% and 7% were granular. TPIF repair was the most common choice of operation among surgeons in distal and proximal hypospadias due to ease of application and less complications and it was statistically significant followed by Snodgrass repair mostly seen in distal hypospadias.</p> <p><strong>Conclusions: </strong>In this study, distal type hypospadias was the most prevalent form. Roughly one-third of the patients received TPIF surgery, whereas the same percentage had Snodgrass repair for their hypospadias.</p> Achyuth A. Shivapur, Advaith A. Shivapur, Ravinda Khasnis Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Growth monitoring and nutritional outcome of severe acute malnutrition children in the presence and absence of edema: a facility based retrospective study <p><strong>Background: </strong>Severe acute malnutrition (SAM) is the leading cause of death in children. SAM affects approximately 20 million preschool children, mainly in Africa and South Asia. Children with severe acute malnutrition and severe edema (+++) have an increased risk of death compared with children with severe acute malnutrition and no edema. This study evaluated the nutritional outcome of SAM patients in the presence and absence of edema.</p> <p><strong>Methods: </strong>This retrospective study was conducted in malnutrition treatment centre, JK Lon Hospital attached with Govt Medical College, Kota from January 2021 to December 2022 on children of age 6 months to 59 months, with clinical diagnosis of severe acute malnutrition. Ethics committee approval was not required as the study was a retrospective observational study. Patients were divided into three categories, viz. recovered, defaulted and non-responders.</p> <p><strong>Results:</strong> A total of 270 patients were selected for this study on the basis of date made available through past records. Of the total patients studied, 32.2% (87) had bilateral edema while the rest (183) were non edematous. From edematous arm, 79.9% children recovered, 9.1% defaulted, and 11% were non-respondents. Conversely, of those without oedema 55.7% recovered, 7.0% defaulted, and 37.3% were non-respondents.</p> <p><strong>Conclusions: </strong>Severe acute malnutrition is a preventable and treatable cause of childhood morbidity and mortality. The determinants of SAM include illiteracy, low socio-economic status, malnourished mother, low birth weight, ignorance about specific nutritional requirements of infants and young children, repeated infections, etc. In this study, we documented that the edematous children in the study area had a better likelihood of recovery as compared to those with severe wasting.</p> Ahmed Zuber, Sunita Khandelwal, Chandan Gupta Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Sacrococcygeal teratoma: an experience from a high-volume tertiary institute in North India <p><strong>Background:</strong> Sacrococcygeal teratoma (SCT) is the most common tumour in the newborn. The majority is present in neonates as a sacral mass; however, some may be present late with varied clinical presentation. The study aims to evaluate the clinical presentation and management of patients with SCT in our high-volume tertiary institute in North India.</p> <p><strong>Methods:</strong> This is an observational study of infants and children treated between May 2021 to April 2022 in the department of pediatric surgery, SMS Medical College, Jaipur (a high-volume tertiary institute in North India). Data collected included antenatal diagnosis, mode of delivery, age at diagnosis, clinical presentation, Altman classification, surgical approach, histopathology and complications. Functional results were evaluated clinically and radiologically.</p> <p><strong>Results:</strong> Twenty-one patients (M: F=1:3.2) with a median age of 40 days (range: 1 day to 5.8 years) with SCT were managed at our centre. Nearly, two-thirds of the tumors were either Altman type 1 or 2. Yolk sac tumour was present in 2 (9.5%) patients, while the rest had either mature or immature teratoma. Tumours were removed through a posterior sagittal approach (chevron incision). In five patients, an abdominoperineal approach was used. Early complications were surgical site infection (n=5; 23.8%), superficial wound dehiscence (n=2; 9.5%), complete wound dehiscence (n=1; 2.4%), and urinary tract infection (n=1; 4.7%). Late complications were urinary dribbling or poor stream (5/21; 23.8%) and faecal soiling (n=3; 14.2%).</p> <p><strong>Conclusions:</strong> Most of the sacrococcygeal tumours are benign, and the incidence of malignancy increases with age. Morbidity due to associated malformation and treatment may persist in these patients, especially like urinary complications stream (one-fifth) and faecal incontinence (one-seventh), as seen in our series. A proper long-term follow-up is needed for the management of late complications.</p> Ajay Jhalani, Vinita Chaturvedi, Neeraj Tuteja, Atul K. Khare Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 A study on risk factors, clinical profile, spectrum of comorbidities in children with cerebral palsy and efficacy of early intervention by rehabilitation units on neurodevelopmental outcome in these children <p><strong>Background:</strong> Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide with the greatest burden found in developing countries. This study is undertaken as there is limited data available regarding CP children in the Andhra Pradesh region. This study was done to evaluate the clinical spectrum, risk factors, and comorbidities associated with CP that will help in better understanding of etiology and for early intervention by District early intervention centers.</p> <p><strong>Methods:</strong> This is a hospital-based prospective observational study conducted over 18 months among children from 6 months to 5 years of age visiting a tertiary care hospital.</p> <p><strong>Results:</strong> Among 65 enrolled children majority of the children (74%) were between 2 to 5yrs with a male-to-female ratio of 4:1. Consanguinity was observed in 33.8% and the majority were from rural areas (71%). The most frequent presenting complaint was delayed milestones (33.4%). 67.6% of subjects were born at term with the most common risk factor being birth asphyxia (27.6%). The most common type was spastic CP (87%) in whom the Developmental quotient (DQ) was severely affected (56.7%) and 32.3% of children belong to GMFCS level III. Comorbidities like feeding difficulties and GERD (47.6%), visual problems (24.8%), and hearing problems (30%) were commonly associated. At the time of enrollment, only 21.5% of children had normal nutritional status which improved to 30.7% after 12 months of follow-up.</p> <p><strong>Conclusions:</strong> Efforts should be made to increase awareness among parents regarding the availability of encouraging utilization of the services to relieve the burden of disorder.</p> <p> </p> N. Madhavi, O. Jyothi, V. V. Vijayalakshmi, D. Manikyamba Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Outcome of neonatal transport in newborn with weight less than 1.5 kg and role of TOPS score as mortality predictor <p><strong>Background: </strong>Neonatal period is the most vulnerable time for individual survival and newborn with weight &lt;1.5 kg are having more morbidity then newborn with appropriate weight for age. Many of these are easy to manage and neonatal mortality can be decrease with regionalization of perinatal care and transportation in stable condition.</p> <p><strong>Methods</strong>: The study was conducted at B. J. Medical College, Ahmedabad and Civil Hospital, Ahmedabad. A prospective, observational study consisting of total 140 patients, admitted in neonatal intensive care unit during the period from October 2022 to September 2023 with inclusion criteria of newborn &lt;1.5 kg and ≤28 days of life. Study was questionnaire based, TOPS scoring was done on admission (temperature by digital thermometer, SpO2 by pulse oximeter, perfusion by CRT in midsternum, blood sugar by reagent strip). Analysis of outcome done using Chi square.</p> <p><strong>Results</strong>: Out of 140 enrolled patients 134(95.8%) neonates were hospital delivered and 6 (4.3%) home delivered. Most common indication of referral was respiratory distress syndrome (27.8%). 85 (60.7%) of neonates were transferred in ambulance and 44 (31.4%) neonates were transferred in private vehicle. 58 (41.4%) were given intra-transport support in form of O2 prongs, Incubator, bag and tube ventilation and IV fluids. 72 (51.5%) and 68 (48.6%) transferred with untrained and trained personal respectively. 30.7% of the patients were expired and 69.3% of neonates were either discharged or took LAMA.</p> <p><strong>Conclusions</strong>: To reduce neonatal mortality rate, neonatal facility should be upgraded, intra transport stabilization, proper referral notes and specialised neonatal ambulance will be helpful.</p> Sucheta S. Munshi, Kajal R. Baldaneeya, Neha A. Vaghela, Shaishav J. Patel Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Impact of therapeutic hypothermia (whole body cooling) on severely asphyxiated term neonates: a prospective non-randomized comparative study in an Indian tertiary care setting <p><strong>Background:</strong> Early application of Therapeutic Hypothermia within 6 hours of birth is neuroprotective. We aimed at examining whether therapeutic hypothermia alongside standard optimal intensive care improves immediate survival outcome and reduces neuro-disability.</p> <p><strong>Methods:</strong> This was a prospective non-randomized study involving inborn and out born newborns admitted at NICU, carried out from March 2022 to December 2022. Eligible candidates were enrolled as cases and therapeutic hypothermia was offered while rest were included as a control group and monitored likewise for the overall survival and neurological outcome. These babies were followed up till 1 month and 3 months of age to assess neurological outcome.</p> <p><strong>Results:</strong> In this study, a total of 47 patients were enrolled both from extramural and intramural NICU set ups. Of them, 22 patients were offered Therapeutic Hypothermia and 25 patients were given standard post asphyxia care. 7 out of 9 inborn patients and 3 out of 13 out born neonates who were offered therapeutic hypothermia survived whereas 5 out of 11 inborn and 4 out of 14 out born neonates who were offered standard post asphyxia care survived.</p> <p><strong>Conclusions: </strong>Therapeutic hypothermia cannot be attributed to significant increase or decrease in mortality when compared with standard care group. No inference could be made about hypothermic neuroprotection in the follow up study. Overall survival outcome was better in inborn patients than that of outborn. Inborn neonates subjected to therapeutic hypothermia, showed a trend towards better survival than those given standard post asphyxia care.</p> Kruti Shah, Sheila Aiyer, Saumitra Singh Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Correlation of cerebral blood flow velocity with haematocrit in neonates at risk of polycythaemia: a COHORT study <p><strong>Background:</strong> The incidence of polycythemia is 1.5-4% of all live births. To diagnose polycythemia, a venous hematocrit is necessary, and polycythaemia is linked to changes in cerebral blood flow. The primary objective is to compare cerebral blood flow velocity (CBFV) and resistance index (RI) between polycythemia and normocythemia groups. The secondary objective is to correlate the peak systolic velocity (PSV) of anterior and middle cerebral arteries (ACA and MCA) with hematocrit in neonates at risk for polycythemia.</p> <p><strong>Methods:</strong> In a prospective observational study, babies with a gestational age of &gt;35 weeks and a risk factor for polycythaemia were enrolled in the study. Free-flowing venous blood was sent for haematocrit measurement between 2 and 6 hours of life. Repeat PCV is sent to babies with a prior value of PCV &gt;65% at 36 hours of life or before discharge. PSV, end diastolic velocity (EDV), RI of ACA and MCA were measured using Mindray portable ultrasound machine with a mini- curved ultrasound transducer (8-13 mhz). Data is entered in excel and analysed.</p> <p><strong>Results:</strong> Out of 75 enrolled babies, 19 had polycythaemia. The mean PSV±SD of MCA was 27.84±6.04 cm/s and 27.27±5.74 cm/s in the normocythemia and polycythemia groups, respectively, at 6 hours of life, which is statistically insignificant. The mean PSV±SD of MCA was 31.41±6.92 cm/s and 29.61±6.57 cm/s in normocythemia and polycythaemia groups, respectively, at 36 hours of life, which is statistically insignificant too.</p> <p><strong>Conclusions:</strong> Cerebral Doppler values did not correlate with haematocrit between the normocythemia and polycythemia groups in the neonates at risk of polycythemia.</p> <p><strong> </strong></p> Babu S. Madarkar, Chandan C., Ranganatha A. Devaranavadagi Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 The study of clinical profile of severe dengue in children <p><strong>Background: </strong>Dengue fever is one of the most important vectors borne viral diseases, causing the significant burden due to high admissions and mortality in southern parts of India. Early detection and early intervention of sickness can reduce this burden for which we should know the clinical features and other parameter in dengue so that mortality rate can be reduced.</p> <p><strong>Methods: </strong>It was a retrospective single center study which included patients admitted to department of pediatrics from a period of October 2022 to November 2023. A total of 30 cases of severe dengue admitted in a span of 6 months. A detailed clinical and laboratory data was recorded in a questionnaire format which was analyzed using statistical tool.</p> <p><strong>Results: </strong>Among 30 cases of severe dengue the most common clinical feature was shock (53%), hepatitis (36%), clinical fluid accumulation (33%), mucosal bleeding (26%) and ARDS (165). Severe dengue was frequently found in the range of white cell count 1000-4000/ul and platelet count 12000-50000/ul.</p> <p><strong>Conclusions: </strong>The key to the management of severe dengue illness lies in the in-depth knowledge of clinical manifestation among children. Thus, it is important to be aware of warning signs and varied presentations of severe dengue so that there will be accurate management of in resource limited setups.</p> <p><strong> </strong></p> Vinaykumar S. A., Gouli Chandrasekhar, Vinaykumar S. Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Atopic dermatitis in children: a cross-sectional study of its impact on quality of life <p><strong>Background:</strong> Atopic dermatitis, characterized by chronic inflammation of the skin, manifests with symptoms such as itching, skin discomfort, and sleep disturbances, significantly impacting the physical health and daily functioning of affected children. We embarked on this study to assess the Quality of Life of children with AD, identify factors that influence their QoL, and determine the specific domains of QoL most affected by the condition.</p> <p><strong>Methods:</strong> Children up to 16 years of age, who met the Hanifin and Rajka’s diagnostic criteria for AD, were identified. The severity of AD was assessed using the severity scoring of atopic dermatitis index, and QoL was assessed using validated questionnaires: the infants dermatitis quality of life index for children under 4 years and the children’s dermatology life quality index for children 4 years and above.</p> <p><strong>Results:</strong> A total of 70 children with AD were enrolled in the study. The mean QoL (IDQOL/CDLQI) score for children with AD was 6.7±5.05 and QoL was significantly impaired in children with more severe disease. The domains of QoL most affected by AD were related to pruritus, sleep disturbances, mood changes and treatment related issues. The duration of illness and the presence of other atopic comorbidities showed a significant correlation with QoL impairment, whereas age, gender and socioeconomic status demonstrated no such correlation.</p> <p><strong>Conclusions:</strong> This study highlights the substantial impact of AD on the QoL of affected children, especially due to symptoms like itching and sleep disturbances.</p> Asha Babu, Naveen Thomas, Rekha Zacharias, Johny Vakayil Francis, Dimple Patel Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Exploring breastfeeding patterns and barriers in a Kerala tertiary care hospital: a cross-sectional study <p><strong>Background:</strong> Exclusive breastfeeding is vital for maternal and child health, yet challenges persist. This study in a Kerala tertiary care hospital aimed to assess prevalence, identify barriers, and explore cultural influences. Aim was to determine the prevalence of exclusive breastfeeding, uncover the barriers mothers face, and explore cultural factors affecting infant feeding choices.</p> <p><strong>Methods:</strong> Utilizing Google forms, 274 postpartum women were surveyed. Participants provided data on awareness, practices, challenges, and factors influencing their infant feeding choices.</p> <p><strong>Results:</strong> While 94.9% were aware of the ideal breastfeeding duration, only 74.1% practised exclusive breastfeeding until six months. Inadequate breast milk, sore nipples, and family pressure emerged as challenges. The timing of solid food introduction significantly impacted exclusive breastfeeding.</p> <p><strong>Conclusions:</strong> Our study offers insights into exclusive breastfeeding practices. Culturally sensitive interventions, comprehensive support systems, and healthcare provider engagement are crucial. This study echoes recent research, emphasizing the multifaceted nature of exclusive breastfeeding practices, calling for diverse and context-specific strategies to empower mothers and ensure infants receive the best nutritional start.</p> Ananthakrishnan Suresh, Jino Joseph K., Mary Andrea Simethy Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Factors associated with exclusive breastfeeding knowledge and practices in a tertiary hospital of Central India <p><strong>Background: </strong>Breastfeeding is a behavioural act of the mother, one that is affected by demographic, socioeconomic, and faith factors as well as by cultural traditions and beliefs. However, there is little scientific literature on potential gaps between knowledge and standard practices regarding exclusive breastfeeding and its predictors among mothers in central India.</p> <p><strong>Methods: </strong>A cross sectional study was conducted to explore the knowledge, perceptions, practices, and the associated factors of exclusive breastfeeding among urban and rural mothers at a tertiary hospital of central India.</p> <p><strong>Results: </strong>A total of 500 post-natal mothers at the study hospital were interviewed to assess their knowledge and practices of exclusive breastfeeding. The study revealed that knowledge of exclusive breastfeeding was 47% while breastfeeding practices for up to six months of babies was reported by only 15% of participants. Breastfeeding within one hour of birth was reported by 31% of mothers. About 62% did not feed colostrum, while 57% fed their baby pre-lacteal feed. Mothers belonging to a rural community, living in joint family, literate, employed, better-off economic status, multigravida, having a previous history of vaginal delivery, and male child, and those counselled regarding breastfeeding during ANC visits had higher knowledge and better practices of exclusive breastfeeding.</p> <p><strong>Conclusions: </strong>The findings of the study suggest an urgent need for regular counselling in ANC clinics to promote exclusive breastfeeding among women and their family caregivers. Breastfeeding awareness education programs for all pregnant women are recommended to ensure that mothers learn best practices regarding breastfeeding and its benefits.</p> Bharti Sahu, Archana Thakur, Deepti Gupta, Mrigendra P. Singh, Ananya Shrivastava, Priyanka Diwakar, Lora L. Sabin Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Clinical profile, etiological factors and outcome of children with status epilepticus admitted in tertiary hospital: a prospective study <p><strong>Background:</strong> Status epilepticus (SE) is a medical emergency, and its neurological outcome is a concern to every pediatrician in developing countries. The incidence of convulsive SE in children is approximately 10–27/100,000 per year, with the highest incidence in children less than one year of age. Approximately 30% of patients presenting with status epilepticus are having their first seizure. The objective of the study is to evaluate the clinical and etiological pattern of SE and its outcome in children admitted to PICU.</p> <p><strong>Methods:</strong> This was a prospective study conducted among 50 patients aged 1 month to 12 years presenting with status epilepticus. The study was conducted over a period of one year from April 2022 to April 2023.</p> <p><strong>Results:</strong> A majority of the patients were in the age group of 1-5 years (64%) and higher incidence of male children was observed (74%). Generalized tonic clonic seizure (GTCS) was predominant in 76% of the children and seizure duration was 10-20 minutes in 44% of the children. The most common etiologies were Meningoencephalitis (44%) and febrile seizures (20%). Nearly 70% of the children showed complete recovery with no neurological symptoms and 5 (10%) children died.</p> <p><strong>Conclusions:</strong> Status epilepticus is a life-threatening emergency and timely management is essential to prevent morbidity and mortality. CNS infection is a major etiology and majority of the children showed good response with AED treatment.</p> <p> </p> Nazeer A. Jeergal, Darla S. S. Lahari, A. N. Thobbi Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Prevalence of cardiac complications in perinatally acquired human immunodeficiency virus infection in children in Southern India: an observational study <p><strong>Background</strong>: Human immunodeficiency virus (HIV) infection is a multisystemic illness that impacts most organ system, to investigate prevalence of cardiovascular abnormalities in children with perinatally acquired HIV infection.</p> <p><strong>Methods:</strong> This observational study was conducted in a tertiary care centre in Southern India. HIV-positive children between the ages of 18 months and 15 years were included. Cardiac abnormalities were defined as abnormalities identified on 2D echocardiography and/or electrocardiogram.</p> <p><strong>Results:</strong> The 73 children with HIV infection had their cardiac manifestations assessed. Median age of children was 8 years with 52% of female participants, 22 (30.13%) children had cardiac abnormalities, of which 5 (27.27%) were symptomatic. Overall, 21/22 (95.45%) children had abnormalities on their ECG, 16 (72.72%) had abnormalities on 2D echocardiography. Of these, we found that children with delayed diagnosis of HIV infection and with more advanced clinical and immunological staging in HIV are more prone to develop cardiac complications irrespective of antiretroviral therapy (ART).</p> <p><strong>Conclusions: </strong>HIV-related heart involvement is not uncommon, rather occur subclinical. A decreasing CD4 count and worsening clinical status are associated with increased risk. Hence its crucial to screen the children, diagnose at the earliest and timely manage the complications appropriately for prevention of early mortality.</p> <p><strong> </strong></p> Shambu S. Angadi, Chaitra Angadi, Prakash K. Wari Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530 Pediatric autoimmune encephalitis: a review <p>Autoimmune encephalitis has been an emerging disease in the pediatric age group for the last few years. It is of utmost importance to recognize the disease for the timely initiation of immunotherapy. The antibody-mediated encephalitis should be considered in the differentials apart from vasculitic, metabolic encephalopathy after ruling out bacterial, viral, tubercular, parasitic, and rickettsial causes. It can even coexist with herpes encephalitis in a quarter of the cases. The prodromal symptoms and progression to psychiatric, memory, speech disturbance, movement disorder, altered mental status, dysautonomia, and seizures within a span of a month characterize the disease. The approach to diagnosis involves various antibody testing in serum and cerebrospinal fluid along with brain imaging and electroencephalography. Early treatment with steroids, intravenous immunoglobulin, and plasmapheresis leads to better outcomes. A literature search was made using keywords in the Google Scholar and Pubmed databases before January 2024. The collected materials were reviewed for appropriate titles and content focusing on diagnosis and management. The article aims to provide a comprehensive review regarding the differential diagnosis and management of autoimmune encephalitis in children.</p> <p> </p> Bipesh K. Shah, Arun K. Singh Copyright (c) 2024 International Journal of Contemporary Pediatrics Wed, 27 Mar 2024 00:00:00 +0530