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":"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":"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}

{"title":"Subclinical Origins of Cardiometabolic Risk in Indian Adolescents: A Cross-Sectional Study.","authors":"Shalini G Hegde, Shreyas R Kankara, John Michael Raj, Babu Philip, Pratibha Dwarkanath, Anura V Kurpad","doi":"10.1007/s13312-026-00354-z","DOIUrl":"10.1007/s13312-026-00354-z","url":null,"abstract":"<p><strong>Objective: </strong>To measure and study the associations between body and hepatic fat and cardiometabolic risk (CMR) factors, in apparently healthy Indian adolescents.</p><p><strong>Methods: </strong>In this cross-sectional study, anthropometry and CMR factors (glycosylated hemoglobin, lipid profile, seated blood pressure measurement) were measured in apparently healthy Indian adolescents aged 11-16 years. Hepatic fat was measured by MRI proton density fat fraction (PDFF) using a 3.0 T system (GE Signa Architect). Whole-body fat was measured by dual-energy X-ray absorptiometry (DXA).</p><p><strong>Results: </strong>Forty adolescents (24 boys) with a mean (SD) age of 14.3 (1.5) years were enrolled. At least one CMR factor was seen in 32.5% of all adolescents and in 18% of those who were normal body mass index (BMI). The prevalence of fatty liver was 5%. The waist circumference was significantly different between adolescents with CMR factors and those without (P = 0.003). Fat mass index (OR 2.08, 95% CI 1.17-3.68), total fat mass (OR 1.32, 95% CI 1.06-1.64), and truncal fat mass (OR 1.75, 95% CI 1.12-2.72) were positively associated with CMR and progression of hepatic steatosis. Fat in the android region had the maximum association with CMR (OR 30.54, 95% CI 2.09-445.98).</p><p><strong>Conclusions: </strong>CMR and hepatic steatosis are prevalent in Indian adolescents and can occur even at normal BMI, with android fat distribution being the strongest determinant of CMR.</p><p><strong>Trial registry: </strong>Clinical Trials Registry of India; Ref. No. CTRI/2024/06/068925.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"656-662"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963497","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":"Respiratory Stabilization for Successful Intubation in Neonates: A Randomized Controlled Trial.","authors":"Deeksha Gupta, Poonam Singh, Mayank Priyadarshi, Suman Chaurasia, Sriparna Basu","doi":"10.1007/s13312-026-00321-8","DOIUrl":"10.1007/s13312-026-00321-8","url":null,"abstract":"<p><strong>Objective: </strong>Maintenance of non-invasive respiratory support during endotracheal intubation (ETI) is a feasible intervention to prevent procedure-related physiological instability (PI) in neonates. However, the evidence for its use is conflicting. The present study evaluated the effects of continuing pre-existing respiratory support during ETI in neonates compared to standard care.</p><p><strong>Methods: </strong>Neonates (≥ 26 weeks) requiring ETI in the neonatal intensive care unit (NICU) were randomized to undergo ETI either on respiratory support (intervention; n = 75) or in room air (control; n = 75) using a computer-generated variable block random sequence, stratified according to gestational age (< 32 weeks and ≥ 32 weeks). Neonates with bradycardia (heart rate, HR < 100/minute), life-threatening congenital anomalies and those requiring intubation on emergency basis, were excluded. The primary outcome was first attempt successful intubation without PI (defined as desaturation, absolute fall in peripheral oxygen saturation (SpO₂) by > 20% and/or bradycardia, heart rate (HR) < 100/minute). Secondary outcomes were first attempt successful intubation and its duration, number of attempts, changes in HR, SpO₂ and regional cerebral oxygen saturation (rcSO₂) and incidence of procedure-related adverse events.</p><p><strong>Results: </strong>The baseline maternal and neonatal variables were comparable between both groups. The primary outcome was achieved in 73.3% and 62.7% of the neonates in the intervention and control group, respectively [relative risk (95% confidence interval) 1.3 (0.7-1.7); P = 0.161]. Minimum SpO₂ was significantly lower, and its change from baseline was significantly higher in controls without any difference in the rates of desaturation, bradycardia and change in rcSO₂.</p><p><strong>Conclusion: </strong>Continuation of pre-existing non-invasive respiratory support during ETI in neonates better maintained SpO₂ without any significant improvement in the primary outcome. .</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"642-649"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633353","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":"Continuous Ambulatory Blood Pressure Monitoring of Non-Dialyzed Children and Adolescents with Chronic Kidney Disease.","authors":"Akanksha Mahajan, Cindy Lalramchuani, Mukta Mantan, Vimal Mehta","doi":"10.1007/s13312-026-00346-z","DOIUrl":"10.1007/s13312-026-00346-z","url":null,"abstract":"<p><p>Hypertension is a known complication and modifiable risk factor for chronic kidney disease (CKD). Diurnal variability is better assessed using continuous ambulatory blood pressure monitoring (CABPM). We enrolled 74 adolescents (78.4% boys) aged 10-18 years with CKD, excluding those on dialysis or with hypertensive urgency/emergency. Casual blood pressure and CABPM were measured using Omron oscillometric sphygmomanometer and A&D TM2441, respectively. Using CABPM, 12 (16.2%) had white coat hypertension, 7 (9.5%) had masked hypertension, and 14 (18.9%) had ambulatory hypertension. Twenty-eight (37.8%) children had blunted nocturnal dipping and 6.6% had left ventricular hypertrophy (LVH).</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"674-676"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769842","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":"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":"684-690"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","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":"Finger Dexterity and Pencil Grasp Patterns as Correlates of Handwriting Proficiency: A School-Based Cross-Sectional Analytical Study.","authors":"Aravind Chandrasekaran, Rajkumar Gajendran","doi":"10.1007/s13312-026-00383-8","DOIUrl":"10.1007/s13312-026-00383-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between finger dexterity and handwriting proficiency in schoolchildren, and to describe the distribution of pencil grasp patterns during a standardized copy task.</p><p><strong>Methods: </strong>This school-based cross-sectional analytical study (June-August 2025) used complete enumeration of students in Grades 3-5. After parental consent, teachers completed the Handwriting Proficiency Screening Questionnaire (HPSQ); students performed a 2-3-line copy task in English for pencil-grasp classification and underwent O'Connor finger dexterity testing under standardized classroom conditions.</p><p><strong>Results: </strong>Among 500 students, 170 (34.0%) had poor handwriting (HPSQ ≥ 14). Age, grade, and sex were comparable between the poor and good handwriting groups. Dexterity was markedly worse in the poor handwriting group [O'Connor finger time (s): 388 (71.5) vs. 309.7 (59.9); P < 0.001]. Finger time moderately correlated with HPSQ scores (r = 0.466). Grasp patterns differed between groups (P < 0.001); dynamic tripod was less common in the poor handwriting group (33.5 vs. 50.0%), and non-mature grasps had higher odds of poor handwriting (OR 2.01, 95% CI 1.38-2.93). Poor legibility and performance-time subscores were higher with non-mature grasps and increased with slower finger times. In multivariable analysis, slower finger dexterity and higher grade independently predicted greater difficulty.</p><p><strong>Conclusion: </strong>One-third of students had poor handwriting. Slower O'Connor finger dexterity independently predicted teacher-rated difficulty, while non-mature grasp patterns, though more prevalent in poor handwriting group, were not independently predictive. Findings support school screening that pairs HPSQ with a brief dexterity test, with interventions targeting fine motor control rather than grasp retraining.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"650-655"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294867","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}