Indian pediatrics最新文献

{"title":"Intrapleural Fibrinolytic Therapy as the Initial Modality, Compared to no Intrapleural Fibrinolytic Therapy, in Children With Empyema: A Systematic Review and Meta-analysis.","authors":"Meenakshi Sachdeva, Kanchankumar Bhagyawant, Pawan Kalyan, Soumi Kundu, Shetanshu Srivastava, Pranita Pradhan, Joseph L Mathew","doi":"10.1007/s13312-026-00377-6","DOIUrl":"10.1007/s13312-026-00377-6","url":null,"abstract":"<p><strong>Context: </strong>There is a wide variation in the use of intrapleural fibrinolytic therapy (IPFT) in children with empyema. This necessitates an up-to-date evaluation of the evidence, to develop an evidence-based guideline recommendation.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of IPFT versus no IPFT in children with empyema.</p><p><strong>Evidence acquisition: </strong>A systematic search for randomized controlled trials (RCTs) comparing IPFT versus no IPFT in children with empyema, was conducted in databases of published literature (PubMed, Embase, Cochrane Library, Scopus, Web of Science), grey literature, and four clinical trial registries. Multiple a priori outcomes reflecting efficacy and safety were evaluated. The Cochrane Risk-of-Bias 2 tool was used for quality assessment, and the certainty of evidence was evaluated using the GRADE approach.</p><p><strong>Results: </strong>The literature search identified 3,113 citations, and their step-wise screening identified three relevant RCTs. The pooled odds ratio for the critical outcome 'failure of therapy' was 0.15 (95% CI 0.04 - 0.50, I² = 50%) with fixed-effect model, and 0.14 (95% CI 0.02 - 1.12, I² = 50%) with the random-effects model. Serious adverse events were rare but comparable between the groups. Length of hospitalization was reported variably, but one RCT reported a shorter stay with IPFT. There were no data on long-term clinical outcomes, pulmonary function tests, or cost of therapy. The evidence certainty was 'very low'.</p><p><strong>Conclusion: </strong>The available evidence on IPFT as an initial modality for pediatric empyema is limited and of very low certainty. Although pooled estimates suggested a potential reduction in treatment failure with IPFT, the results were sensitive to the statistical model used.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"787-796"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411552","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":"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":"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":"727-733"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","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":"Pediatric Pulmonology.","authors":"Nikhil Rajvanshi","doi":"10.1007/s13312-026-00437-x","DOIUrl":"https://doi.org/10.1007/s13312-026-00437-x","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108937","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":"Impact of Step Stool in the Delivery of CPR by Healthcare Providers: a Simulation-Based Study.","authors":"Mihir Sarkar, Moumita Samanta, Sandipan Sen, Nandini Sinharay, Mahammad Ali, Abhijeet Roy, Geethanjali Ramachandra","doi":"10.1007/s13312-026-00429-x","DOIUrl":"https://doi.org/10.1007/s13312-026-00429-x","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of using a standard height step stool on the quality of pediatric cardiopulmonary resuscitation (CPR) for health care providers (HCP) of different heights in a simulated environment.</p><p><strong>Methods: </strong>A simulation-based prospective cross-sectional study was conducted in a tertiary care referral hospital in Eastern India using a quantitative CPR (QCPR) training manikin (Little Junior QCPR, Laerdal Medical, Norway). A total of 8 min of CPR session was conducted, where 2 compressors performed alternatively in every 2-min segment without a step stool. After a 15-min rest, the session was repeated using a standard step stool (21.5 cm). The quality of chest compression was assessed using Q-CPR Review software v2.0 in three defined height tertiles (short, medium and tall). Compression rate, depth, good release percentage, and app-derived total scores were assessed as the primary outcome. Every compressor provided feedback regarding the level of their comfort, fatigue, and bodyache, graded on a Likert scale.</p><p><strong>Results: </strong>Out of 80 healthcare providers (HCPs) who were screened, 72 participated in 36 CPR sessions; each CPR session had two cycles of CPR, one without and one with step stool. The mean (SD) participant height was 167 (6.5) cm. Overall, mean compression depth increased by 4.5 mm, adequate compression depth improved by 20%, and adequate recoil improved by 13%. In the shortest height tertile, compression depth increased by 10 mm. Additionally, 83.3% of participants reported greater comfort while performing CPR with the step stool.</p><p><strong>Conclusion: </strong>Step stool improved the compression depth, reduced incomplete recoils, and improved CPR quality among HCPs in simulation setting, with a greater advantage among the shorter HCPs.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074309","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":"Transparent Film Versus Microporous Tape for Temperature Probe Fixation: Author's Reply.","authors":"Aditya Hemendra Bhatt, Somashekhar Marutirao Nimbalkar, Dipen Patel","doi":"10.1007/s13312-026-00434-0","DOIUrl":"https://doi.org/10.1007/s13312-026-00434-0","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074333","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":"Systemic Autoinflammatory Diseases: An Evolving Paradigm of Fevers Beyond Autoimmunity and Infections.","authors":"Pavneet Kaur, A V Ramanan, Raphaela Goldbach-Mansky, Narendra Kumar Bagri","doi":"10.1007/s13312-026-00428-y","DOIUrl":"https://doi.org/10.1007/s13312-026-00428-y","url":null,"abstract":"<p><p>Systemic autoinflammatory diseases comprise a diverse group of disorders unified by a state of sterile inflammation. These conditions are poorly recognized and often mistaken for chronic infections, particularly in settings like ours with a high burden of infections. The paradigm of these diseases is evolving. Sixty-five monogenic autoinflammatory diseases have been described to date, with a varied spectrum of clinical features, ranging from recurrent febrile episodes to multisystem manifestations, such as arthralgias, abdominal pain, ocular, and cutaneous symptoms. There is often a delay in the diagnosis of these conditions owing to limited awareness, which leads to disease-related morbidity and mortality. Timely recognition of these disorders can be facilitated by identifying suggestive features on history, examination, and laboratory evaluation.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891590","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":"Teamwork Attitudes and Perceptions Following Team-Based Learning in Undergraduate Medical Students: An Educational Evaluation.","authors":"Priyanka Gupta, Rukmini Mysore Srikantiah, Sanjana Kapoor, Mitasha Singh","doi":"10.1007/s13312-026-00426-0","DOIUrl":"https://doi.org/10.1007/s13312-026-00426-0","url":null,"abstract":"<p><p>Team-based learning (TBL) is a learner-centered instructional strategy that promotes collaboration, accountability, and teamwork skills among students. This educational evaluation among Phase III MBBS students at a public teaching institution in North India assessed teamwork attitudes and perceptions after four TBL sessions using a retrospective pre-post questionnaire adapted from the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ). The questionnaire assessed team structure, leadership, situation monitoring, mutual support, and communication. Of 124 eligible students, 122 responded. TBL significantly improved attitudes and perceptions across all domains (P < 0.001), thereby supporting the development of teamwork during undergraduate medical training.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880172","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":"Strengthening Breastfeeding for Every Newborn: Indian Alliance on Breastfeeding Action.","authors":"Neelam Mohan","doi":"10.1007/s13312-026-00427-z","DOIUrl":"https://doi.org/10.1007/s13312-026-00427-z","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880210","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":"Trends in Child Health Indicators in India: Insights from National Family Health Survey (NFHS)-6.","authors":"Malika Yadav, Varun Kumar","doi":"10.1007/s13312-026-00412-6","DOIUrl":"10.1007/s13312-026-00412-6","url":null,"abstract":"<p><p>The National Family Health Survey-6 fact sheets (NFHS-6, 2023-2024) released by the Ministry of Health and Family Welfare, Government of India, reveal persistent undernutrition, rising urban overweight, widening rural-urban and tribal inequities, and declining exclusive breastfeeding rates, albeit with significant progress in national immunization coverage, antenatal care, and reduction in common childhood illnesses like diarrhea and pneumonia. The absence of mortality indicators limits comprehensive analysis of healthcare utilization and its impact. Persistent regional inequities and gaps in quality of care seen in this data should guide urgent, targeted action.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"691-694"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678611","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":"Diagnosis and Management of Transfusion-Dependent Thalassemia: Evidence-Based Guidelines From the Pediatric Hematology Oncology Chapter of the Indian Academy of Pediatrics.","authors":"Nita Radhakrishnan, Pooja Dewan, Jagdish Chandra, Ratna Sharma, Satyam Arora, Sunil Bhat, Shruti Kakkar, Amit Jain, Anand Prakash, V K Khanna, Tulika Seth, Amita Trehan, Deepak Bansal, Amita Mahajan, Shobha Tuli, J S Arora, Revathi Raj, Roshan Colah, Prateek Bhatia, Prashant Sharma, Reena Das, Ashish Jain, Vinita Srivastava, Hem Chand Pandey, Nidhi Mehta, Nupur Parakh, Sunil Gomber, Manas Kalra, Rajiv Kumar Bansal, Emine A Rahiman, Bhavna Dhingra, Rashmi Dalvi, P Kartik Ganga, Bhavin Jankharia, Anju Seth, Sirisha Rani Siddaiahgari, Santanu Sen, Aashima Dabas, Puneet R Arora, Avantika Sharma, Jyoti Pandey, Neeraj Aggarwal, Purva Kanvinde, A T K Rau, Gaurav Kharya, Satyendra Katewa, Pranoti Kini, Anjali Bedi, Jasmine Kaur Ahuja, Ranjana Mishra, Seema Kapoor, Amita Singh, Neerja Gupta, Madhulika Kabra, Vinay Shetty, Ritika Sud, Nisha Iyer, Nitin Shah, Vineeta Gupta, Sujata Sharma, Satya Prakash Yadav, Shweta Bansal, Upendra Kinjawadekar, Vineet Saxena, Ruchira Gupta, Neelam Mohan, Mamta Manglani","doi":"10.1007/s13312-026-00366-9","DOIUrl":"10.1007/s13312-026-00366-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Justification: &lt;/strong&gt;India bears a high burden of thalassemia, underscoring the need for enhanced awareness, systematic screening, and standardized, high-quality care. In the absence of indigenous guidelines, gaps remain in knowledge and care delivery. To address this, the Pediatric Hematology Oncology Chapter of the Indian Academy of Pediatrics (IAP-PHO) is issuing evidence-based regional guidelines tailored to the Indian context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective of these guidelines is to establish nationally accepted standards for the diagnosis, comprehensive management, and prevention of thalassemia syndromes, incorporating the latest and locally relevant evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Process: &lt;/strong&gt;These evidence-based guidelines were developed through structured deliberations by 67 national experts under the IAP-PHO, incorporating iterative literature review, expert consensus, and context-specific considerations for India. The evidence quality (levels A-D, X) and strength of recommendation (strong, moderate, weak) are graded using the updated American Academy of Pediatrics framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Scope: &lt;/strong&gt;These guidelines provide a comprehensive, evidence-based framework for thalassemia care in India, encompassing prevention, diagnosis, transfusion and chelation, complication management, curative therapies and systems-based care, including day-care services and transition to adult care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendations: &lt;/strong&gt;Regular transfusion therapy with leukodepleted packed red cells to maintain pre-transfusion hemoglobin of 9.5-10.5 g/dL is the cornerstone of management in transfusion-dependent thalassemia (TDT), with individualized adjustment in special situations such as cardiac dysfunction. Iron chelation therapy should be initiated after 10-20 transfusions or when serum ferritin (SF) exceeds 1000 ng/mL; oral deferasirox is the preferred first-line agent. Combination therapy using deferasirox, and/or deferiprone and/or desferrioxamine is recommended when monotherapy with either deferasirox or deferiprone fails to reduce SF to &lt; 2500 ng/mL or in the case of poor tolerance to one agent or when there is evidence of significant organ iron overload on T2*MRI (magnetic resonance imaging); de-escalation of chelation is recommended when SF approaches &lt; 500 ng/mL. Comprehensive multidisciplinary care, incorporating systematic screening and timely interventions for cardiac, hepatic, endocrine, and skeletal complications, is strongly recommended. Early counseling for hematopoietic stem cell transplantation (HSCT) should be offered at diagnosis, with transplantation preferably performed at a younger age. Universal antenatal screening, cascade screening, and access to prenatal diagnosis, are critical to reducing disease burden. Emerging disease-modifying therapies may be considered in selected patients, with evolving pediatric data. Delivery of care through dedicated thalassemia day-care centers and stru","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"612-637"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561369","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}