Indian pediatrics最新文献

{"title":"Children Discharged Against Medical Advice and Their Outcome in a Public Hospital in India: A Prospective Cohort Study.","authors":"Shilpi Jha, Devendra Mishra, Anurag Agarwal","doi":"10.1007/s13312-025-00108-3","DOIUrl":"https://doi.org/10.1007/s13312-025-00108-3","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the factors associated with discharge against medical advice (DAMA), and the readmission and mortality rate at one-month follow-up among these children.</p><p><strong>Methodology: </strong>This prospective cohort study enrolled consecutive children (6 months-12 years) from one designated inpatient ward. Clinical and demographic data, and information about reasons for DAMA were collected using a structured interview. Outcome of DAMA patients was assessed telephonically at one month after discharge.</p><p><strong>Results: </strong>Out of 538 children, 28 (5.2%) obtained DAMA. Predictors of DAMA on multivariate analysis were partial/unimmunized status, underlying chronic disease, and higher Pediatric Early Warning Score (PEWS) at admission. The most common contributors to DAMA included hospital-related reasons (n = 17, 60.7%), disease-related reasons (n = 9, 32.1%), and sociodemographic reasons (n = 7, 25%). A total of 25 children could be followed up at one month; of these 10 were readmitted at another hospital, and 5 died.</p><p><strong>Conclusions: </strong>The high rates of readmission and mortality among these children emphasize the need for targeted interventions to address the underlying causes of DAMA.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215619","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":"Accuracy of 'Communication and Symbolic Behaviour Scales Developmental Profile-Infant Toddler Checklist' for Screening Communication Delay in Children Aged 6-24 Months Referred to a Child Developmental Clinic.","authors":"Ashima Mehta, Praveen Suman, Imran Noorani","doi":"10.1007/s13312-025-00109-2","DOIUrl":"https://doi.org/10.1007/s13312-025-00109-2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy of the Communication and Symbolic Behaviour Scales Developmental Profile-Infant Toddler Checklist (CSBS-ITC) for screening communication delay in children aged 6-24 months.</p><p><strong>Method: </strong>This hospital-based observational cross-sectional study included 200 children aged 6-24 months of either sex attending the child development clinic. Participants were categorized into high- and low-risk groups based on perinatal and neurological risk factors. The CSBS-ITC was administered to parents, followed by a standardized developmental assessment using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CSBS-ITC were calculated.</p><p><strong>Results: </strong>Communication concerns were identified in 69% of children using the CSBS-ITC, and among these, 65% was confirmed to have language delays on the BSID-III assessment. CSBS-ITC demonstrated a high sensitivity (94%) and specificity (82%), with a positive predictive value of 87% and a negative predictive value of 80%.</p><p><strong>Conclusion: </strong>CSBS-ITC is a useful tool for screening communication delay in high-risk children aged 6-24 months, and the tool exhibits good screening accuracy.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215618","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":"Prevention of VAP Using Hypertonic Saline Nebulization in NICU: A More Nuanced Perspective is Required.","authors":"Shubhangi Chaturvedi, Manish Kumar","doi":"10.1007/s13312-025-00114-5","DOIUrl":"https://doi.org/10.1007/s13312-025-00114-5","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215620","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":"Invasive Ventilation Strategies in Neonates.","authors":"Jogender Kumar, Praveen Kumar, Vineet Bhandari","doi":"10.1007/s13312-025-00094-6","DOIUrl":"10.1007/s13312-025-00094-6","url":null,"abstract":"<p><p>We provide evidence-based recommendations and clinical guidance on strategies for invasive mechanical ventilation in neonates until successful extubation in the neonatal intensive care unit. A systematic search of the PubMed, Embase, and CENTRAL databases was performed to identify relevant published literature from the past five years. A critical review of the current literature was conducted to provide context-specific recommendations. We discuss the various modes of invasive mechanical ventilation in neonates, with specific recommendations for neonates with persistent pulmonary hypertension, congenital heart disease, congenital diaphragmatic hernia, pneumonia, meconium aspiration syndrome, air leak syndromes, evolving and established bronchopulmonary dysplasia, apnea, and very preterm infants with respiratory distress. Practical guidance for the initiation, titration, and weaning of volume-targeted ventilation is also provided. Synchronized patient-triggered modes (synchronized intermittent mandatory ventilation + pressure support ventilation/assist control ventilation) and volume-target/guarantee modes are the preferred modes of invasive mechanical ventilation in neonates with respiratory distress.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208427","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":"Seroprevalence of Hepatitis A in Non-vaccinated Adolescents Aged 9 to 12 Years in New Delhi, India: A Cross-Sectional Study.","authors":"Anurag Agarwal, Shweta Sajlan, Rohit Chawla, Surendra Bahadur Mathur","doi":"10.1007/s13312-025-00090-w","DOIUrl":"https://doi.org/10.1007/s13312-025-00090-w","url":null,"abstract":"<p><strong>Objective: </strong>To determine the seroprevalence of hepatitis A among non-vaccinated adolescents aged 9-12 years and to ascertain the sociodemographic factors associated with seropositivity.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among non-vaccinated adolescents aged 9-12 years from urban and semi-urban settings in New Delhi. Sera were analyzed using competitive ELISA to detect IgG antibodies against hepatitis A. Sociodemographic data were collected using a structured pro forma.</p><p><strong>Results: </strong>Of the 94 participants, 85 (90.4%) were seropositive for hepatitis A. Seropositivity was significantly associated with low socioeconomic status, lower parental education levels, lower parental occupation status, and low monthly household income.</p><p><strong>Conclusions: </strong>Despite improved sanitation, lower socioeconomic groups remain highly endemic for hepatitis A. Catch-up vaccination may have limited utility in adolescents aged 10 years or older from these backgrounds. Targeted public health strategies and further evaluation of vaccination policies in specific populations are needed.</p><p><strong>Trial registration: </strong>Clinical Trials Registry-India No. CTRI/2022/10/046790.Obtained.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208428","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":"Effect of Antiretroviral Therapy and Vitamin E Supplementation on Total Antioxidant Capacity in Children Living with HIV.","authors":"K Jai Kumar, Pooja Dewan, Rajarshi Kar, Edelbert Anthonio Almeida, Deepika Harit, Mrinalini Kotru, Mukesh Yadav","doi":"10.1007/s13312-025-00111-8","DOIUrl":"https://doi.org/10.1007/s13312-025-00111-8","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the total antioxidant capacity (TAC) in children living with HIV (CLHIV) and to evaluate the effect of antiretroviral therapy (ART) and vitamin E supplementation on TAC.</p><p><strong>Methods: </strong>The study included CLHIV on ART ≥ 2 years, ART-naïve CLHIV and healthy controls. CLHIV on ART ≥ 2 years received vitamin E supplements in addition to combination ART for three months duration. TAC levels, α-tocopherol levels, hemogram, red blood cell indices, viral load and CD4 counts were estimated at baseline and after three months of ART.</p><p><strong>Results: </strong>A total of 25 children were included per group. The median (IQR) TAC levels (mM Trolox Equiv) were significantly lower in CLHIV ART for ≥ 2 years [6.32 (8.7, 13.28)], compared to controls [11.89 (8.15, 14.38)] and ART-naïve CLHIV [12.69 (7.61, 16.78)]. TAC levels increased after 3 months of starting ART [15.57 (9.90, 17.49); P = 0.178]. α-tocopherol levels (µmol/L) were significantly different among the three groups, viz controls [72 (28.86, 80)], ART-naïve CLHIV [40.24 (30.36, 71.59)] and CLHIV on ART ≥ 2 years [16.77 (13.15, 20.21)]. Three months of vitamin E supplementation, failed to produce a significant increase in TAC levels [10.4 (7.28, 14.92)] while the red cell indices and CD4 counts improved significantly with a marginal reduction in HIV viral load.</p><p><strong>Conclusion: </strong>Prolonged ART reduced antioxidant capacity. Three months of vitamin E supplementation produced marginal increase in TAC levels.</p><p><strong>Trial registry: </strong>CTRI/2022/12/047960 [Registered on: 08/12/2022] Trial Registered Prospectively.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198959","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":"Stakeholder's Perspectives on the Barriers and Facilitators of Childhood Cancer Care in India.","authors":"Anita Nath, Prashant Mathur, Kondalli Lakshminarayana Sudarshan, Ramandeep Arora, Rachna Seth, Sanjiv Kumar, Girish Chinnaswamy, Atul Budukh, Varinder Singh, T Priya Kumari, Raja Paramjeet Singh Banipal, Vijay Kumar Bodal, A R Arun Kumar, C R Vijay, T Avinash, C Ramesh, Sadashivudu Gundeti, Shikha Malik, Narendra Kumar Chaudhary, Gautam Majumdar, Deepshikha Das, Nita Radhakrishnan, V Surya Rao, Manoj Rawal, Jeremy L Pautu, Deepak Sundriyal, Munlima Hazarika, Caleb Harris, Sunil Natha Jondhale, Vinotsole Khamo, Arshad Manzoor Najmi, Puneet Pareek, Ratan Konjengbam, Saroj Kumar Das Majumdar, Shashank Pandya, Anand Shah, S B Singh, Venkatraman Radhakrishnan, R Swaminathan, Chandra Mohan Kumar, Pritanjali Singh, Lokesh Tiwari, Syamsundar Mandal, Sopai Tawsik, Awadhesh Kumar Pandey, K Gunaseelan, Tseten W Bhutia","doi":"10.1007/s13312-025-00098-2","DOIUrl":"https://doi.org/10.1007/s13312-025-00098-2","url":null,"abstract":"<p><strong>Objective: </strong>To explore the stakeholders' perspectives on barriers and facilitators influencing childhood cancer care delivery in India.</p><p><strong>Methods: </strong>A nationwide survey was conducted across 26 states and 4 Union Territories, involving childhood cancer physicians from tertiary and secondary hospitals, state nodal officers (SNOs) for the National Programme for Control of Non-Communicable Diseases (NP-NCD), and representatives from Civil Society Organizations (CSOs) and Non-Governmental Organizations (NGOs). A hub-and-spoke sampling model was employed, with designated tertiary hospitals coordinating data collection from secondary hospitals. An online survey tool assessed perceived challenges and facilitators in childhood cancer care. Data collection occurred from July to September 2021, and descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Responses were received from 137 tertiary hospitals (100%), 92 secondary hospitals (91%), 16 SNOs (53.3%), and 9 CSO/NGO representatives (23.1%). Key barriers to diagnosis and treatment included shortage of human resources, beds, and equipment, along with advanced-stage presentation and inadequate back-referrals from tertiary to secondary hospitals. Treatment abandonment and denial were highlighted as major concerns. SNOs and CSOs identified financial constraints, limited insurance coverage, and reliance on traditional healers as additional challenges. Facilitators included strengthening referral networks, expanding diagnostic capabilities, ensuring free treatment and medications, and improving infrastructure and workforce capacity.</p><p><strong>Conclusion: </strong>Resource constraints, late-stage presentation, treatment abandonment, and financial challenges are the significant barriers to childhood cancer care in India. Addressing these through improved referral systems, expanded diagnostic services, financial support mechanisms, and policy-level interventions are needed to enhance childhood cancer care outcomes and quality of life.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198962","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 Shorter (3-4 Days) Antibiotic Therapy Adequate Compared to Standard (5-7 Days) Duration in Neonates with Suspected (Culture Negative) Sepsis? Yes.","authors":"Shiv Sajan Saini","doi":"10.1007/s13312-025-00103-8","DOIUrl":"https://doi.org/10.1007/s13312-025-00103-8","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198961","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":"Arthritis in Children: A Diagnostic Conundrum.","authors":"Dhaarani Jayaraman, Julius Xavier Scott","doi":"10.1007/s13312-025-00106-5","DOIUrl":"https://doi.org/10.1007/s13312-025-00106-5","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198908","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":"Efficacy of Biweekly Iron Supplementation on Iron Status in Under-Five Children: A Prospective Cohort Study.","authors":"Krishna Nesara, Dhandapany Gunasekaran, Sharbari Basu","doi":"10.1007/s13312-025-00099-1","DOIUrl":"https://doi.org/10.1007/s13312-025-00099-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of prophylactic biweekly Iron and Folic acid (IFA) supplementation (National Iron Plus Initiative) in maintaining iron status in under-five children with iron sufficiency.</p><p><strong>Methods: </strong>Consecutive healthy children screened for normal iron status (normal hemoglobin and serum ferritin) were started on iron prophylaxis as one mL syrup containing 20 mg elemental iron and 100 µg folic acid biweekly for six months. The pre- and post-supplementation hemoglobin and serum ferritin levels were compared.</p><p><strong>Results: </strong>Out of 573 children screened, none were receiving IFA prophylaxis routinely. A total of 173 out of 200 eligible children completed the intervention with a significant increase in the mean (SD) hemoglobin [11.7 (0.5)-11.9 (0.5) g/dL] and serum ferritin [54.5 (23.5)- 63.6 (21.1) µg/L] at six months (P < 0.001).</p><p><strong>Conclusions: </strong>Biweekly iron and folic acid supplementation improved iron status in children aged 1 to 5 years with iron sufficiency.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198960","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}