Indian pediatrics最新文献

{"title":"Methodology Adopted for the Development of Evidence-Based Guideline Recommendations on Childhood Empyema.","authors":"Joseph L Mathew","doi":"10.1007/s13312-026-00347-y","DOIUrl":"https://doi.org/10.1007/s13312-026-00347-y","url":null,"abstract":"<p><strong>Objective: </strong>To describe the methodology adopted for the development of evidence-based guideline recommendations for pediatricians managing childhood empyema.</p><p><strong>Methods: </strong>The methodology followed contemporary methods for evidence-based guideline development. It included ten steps viz. (i) establishing a steering group (SG) and an evidence-based guideline development group (EBGDG), (ii) formal declarations of interest by EBGDG members, and scrutiny for conflicts by the SG, (iii) identifying and prioritizing questions in the PICOTS (Patient/population, Intervention/exposure, Comparison, Outcome, Time-frame, and Setting) format, (iv) building working teams to answer the questions, (v) searching for existing guidelines with potential for adaptation, adoption, or adolopment of recommendations, (vi) identifying existing systematic reviews addressing the prioritized questions, (vii) formal evidence synthesis (through systematic reviews) and critical appraisal of evidence for each question, (viii) drafting recommendation statements and formalizing them with strength and certainty of evidence, (ix) external peer review, and (x) preparation of the guideline document for dissemination.</p><p><strong>Results: </strong>The EBGDG collated 115 potential questions, narrowed them to 18 through the Delphi consensus-building process, and ultimately prioritized 11. The questions covered diverse aspects of empyema management including therapy options, microbiological and radiological investigations, and monitoring issues. There were no recent guidelines or systematic reviews addressing any of the 11 questions, thereby necessitating eleven de novo systematic reviews. The EBGDG examined the evidence from these reviews and certainty estimates, evaluated the criteria in the evidence-to-decision framework, and formulated evidence-based recommendation statements. The draft guideline underwent external peer review and finalization.</p><p><strong>Conclusion: </strong>The methodological rigor resulted in trustworthy recommendations for managing childhood empyema.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Composition Trajectories in Late-Preterm Children: Convergence or Concern?","authors":"Neeraj Gupta, Pasupathi Raj Balamurugan","doi":"10.1007/s13312-026-00349-w","DOIUrl":"https://doi.org/10.1007/s13312-026-00349-w","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Rational Allergy Practice Guidelines by the Indian Academy of Pediatrics (IAP) and IAP-Allergy and Applied Immunology Chapter.","authors":"Neeraj Gupta, R Krishna Mohan, Uppin Narayan Reddy, Dhanesh Volvoikar, Dipti Pujari, Gayatri S Pandit, Jefferson Daniel, Kagithapu Surender, P A Mahesh, Mitesh Kakkad, Mohit Poddar, Naresh Grover, Nayan Mani Deka, Rama Rajyam Datti, Saibal Moitra, Sanjukta Dey, Sinchana Bhat, S Narmada Ashok, Soundarya Mahalingam, Sowmya Arudi Nagarajan, Vikram Patra, Vinay Mehta, Vasant Khalatkar, Neelam Mohan, Yogesh Parikh, Atanu Bhadra","doi":"10.1007/s13312-026-00353-0","DOIUrl":"https://doi.org/10.1007/s13312-026-00353-0","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Longitudinal Study of Clinical Outcomes and Efficacy of Mycophenolate Mofetil in Pediatric Frequently Relapsing and Steroid-Dependent Nephrotic Syndrome.","authors":"Ramesh Abhay, Bobbity Deepthi, Sudarsan Krishnasamy, Sriram Krishnamurthy","doi":"10.1007/s13312-026-00345-0","DOIUrl":"https://doi.org/10.1007/s13312-026-00345-0","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective was to evaluate the efficacy of mycophenolate mofetil (MMF), assessed by stable remission rates, in pediatric frequently relapsing or steroid-dependent nephrotic syndrome (FRNS/SDNS). Secondary objectives included assessing treatment failure, relapse rates, adverse effects, and sustained remission following MMF discontinuation.</p><p><strong>Methods: </strong>This cohort enrolled children aged < 18 years with FRNS/SDNS initiated on MMF between 2010 and 2024. Longitudinal outcomes were noted and analyzed.</p><p><strong>Results: </strong>A total of 101 children with FRNS/SDNS had a median (q1, q3) age of 5.5 (4, 8.8) years at MMF initiation. In the year preceding MMF initiation, children experienced 3.6 (1.3) relapses and a cumulative steroid dose of 5033 (4297, 5969) mg/m². At 12 months of MMF therapy, 81 (80.1%) children were in stable remission (33 in sustained remission, 48 with infrequent relapses), 12 (11.8%) had frequent relapses, and 8 (7.9%) had treatment failure. At a median follow-up of 24 (18, 36) months, 66 (65.3%) children were in stable remission (29 in sustained remission, 37 with infrequent relapses), 16 (15.8%) had frequent relapses, and 19 (18.8%) had treatment failure. Relapse rates reduced by 82% with a relative relapse rate of 0.18 (95% CI 0.15-0.22) relapses/person-year. Cumulative steroid dose decreased by 57.5% in the first year and 91.5% in the second year among those in stable remission. Adverse effects included three serious infections and one persistent thrombocytopenia. The median relapse-free survival was 5 (3, 9) months. The median follow-up post-discontinuation of MMF (n = 34) was 2.1 (0.1, 4.3) years; 15 (44.1%) maintained remission at 1 year.</p><p><strong>Conclusion: </strong>MMF is an efficacious steroid-sparing agent for pediatric FRNS/SDNS with minimal residual effect.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Challenges of Implementing Tuberculosis Research During COVID-19 Pandemic: Insights from the Pediatric Tuberculosis-Moderate Acute Malnutrition Study.","authors":"Aishwarya Venkataraman, Nancy Hilda Joseph, Gopika Sadanandan, S Balasubramanian","doi":"10.1007/s13312-026-00343-2","DOIUrl":"https://doi.org/10.1007/s13312-026-00343-2","url":null,"abstract":"<p><p>Clinical research involving children presents significant challenges due to physiological, ethical, regulatory, and practical considerations unique to this vulnerable population. These intrinsic challenges were amplified during the COVID-19 pandemic, which substantially disrupted pediatric research and child health services. The pandemic exposed critical ethical, operational, and communicative tensions, especially with respect to informed consent, caregiver trust, and safe research implementation. Examining these intersecting challenges can improve and strengthen pediatric research to remain ethically robust and child-centred in the event of future public health crises.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Adult Height in Familial Male-Limited Precocious Puberty: A Case Report.","authors":"Sukanya Priyadarshini, Shreyash Gandhi, Konpal Paharia, Rajni Sharma","doi":"10.1007/s13312-026-00359-8","DOIUrl":"https://doi.org/10.1007/s13312-026-00359-8","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Neonatal Sepsis Screen More Futile than Useful in Clinical Practice? No.","authors":"Shashi Kant Dhir","doi":"10.1007/s13312-026-00332-5","DOIUrl":"10.1007/s13312-026-00332-5","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From 10-Valent to 21-Valent Pneumococcal Conjugate Vaccines: Divergent Global Pathways and Future Directions for India.","authors":"Rajeev Zachariah Kompithra, Rosemol Varghese, Gurumoorthy Muruganantham, Georgie Mathew, Balaji Veeraraghavan","doi":"10.1007/s13312-026-00331-6","DOIUrl":"https://doi.org/10.1007/s13312-026-00331-6","url":null,"abstract":"<p><p>Pneumococcal conjugate vaccines (PCVs) have greatly reduced invasive pneumococcal disease worldwide, though outcomes vary with the serotype formulation and regional context. India's introduction of indigenous 10-valent PCV into its Universal Immunization Program (UIP) was a major milestone, differing from the earlier globally available PCV10 by including serotypes 19A and 6A-both of which have been linked to antimicrobial resistance (AMR) in countries such as Belgium and Brazil. This review synthesizes global vaccine experiences, explores serotype biology, cross-protection, and the emergence of non-vaccine types, and considers the spectrum of higher-valency options (PCV14, PCV20, and PCV21). India's pediatric PCV coverage has expanded rapidly, though unevenly, while adult uptake remains limited. While indigenous PCV10 introduction and scale-up, followed by indigenous PCV14 introduction seems a pragmatic policy for India's UIP today, sustained genomic and AMR surveillance, plus eventual transitions to broader PCVs, will be essential for long-term, adaptable immunization strategies.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Sequential Organ Failure Assessment Score (nSOFA) for Prediction of Mortality Among Preterm Neonates with Respiratory Distress Syndrome: A Prospective Observational Study.","authors":"Vaishali Sahu, Shalini Tripathi, Mala Kumar, S N Singh","doi":"10.1007/s13312-026-00350-3","DOIUrl":"https://doi.org/10.1007/s13312-026-00350-3","url":null,"abstract":"<p><p>Preterm birth is a major contributor to neonatal morbidity and mortality. This study evaluated the neonatal Sequential Organ Failure Assessment (nSOFA) score for predicting mortality in preterm neonates (< 34 weeks) with respiratory distress syndrome. Among 113 neonates, median (q1, q3) nSOFA scores at 0-6 h of life were higher in non-survivors than survivors [4 (4, 6) vs 0 (0, 2); P = 0.001], with an area under the curve (AUC) of 0.80 and a cutoff of 3. Predictive performance improved at 24 ± 3 h (AUC 0.93), with higher scores in non-survivors [8 (5, 11) vs 0 (0, 2); P < 0.001] and a cutoff of 4. Neonates with composite morbidity had significantly higher nSOFA scores at both time points.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Concerns in the Randomized Trial Comparing Antihelminthics for Enterobiasis.","authors":"Tamidela Poornima Devi, Thirunavukkarasu Arun Babu","doi":"10.1007/s13312-026-00337-0","DOIUrl":"https://doi.org/10.1007/s13312-026-00337-0","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}