Indian pediatricsPub Date : 2025-06-01Epub Date: 2025-04-02DOI: 10.1007/s13312-025-00027-3
Nimisha S Dange, Vaman Khadilkar, Ketan Gondhalekar, Anuradha V Khadilkar
{"title":"Double Burden of Malnutrition in Under-Five Children (NFHS-5 Data) Using Extended CIAF: WHO 2006 Growth Standard Versus 2019 Indian Growth References.","authors":"Nimisha S Dange, Vaman Khadilkar, Ketan Gondhalekar, Anuradha V Khadilkar","doi":"10.1007/s13312-025-00027-3","DOIUrl":"10.1007/s13312-025-00027-3","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the double burden of malnutrition (DBM) in under-five children using extended composite index of anthropometric failure (eCIAF) using WHO 2006 and 2019 Indian standards.</p><p><strong>Methods: </strong>Data of 2,32,920 under-five children as per National Family Health Survey-5 were eligible for inclusion. Incomplete records and extreme z-scores were excluded. eCIAF categories included: A No failure; B Wasted; C Wasted + Underweight; D Wasted + Stunted + Underweight; E Stunted + Underweight; F Stunted; G Stunted + Overweight; H Overweight; Y Underweight; Underfailure (UF): A + B + C + D + E + F + Y; Overfailure (OF): G + H.</p><p><strong>Results: </strong>Records of 1,96,015 under-five children were analyzed. 50.1% versus 74% children were categorized as no failure using WHO and Indian standards, respectively (P < 0.001). Prevalence of DBM, UF and OF using WHO reference was significantly higher than using Indian references [49.9% vs. 26%; 48.4% vs. 24.7%; 3.5% vs. 1.9%, respectively].</p><p><strong>Conclusion: </strong>Using Indian references prevents misclassification of DBM in under-fives.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"428-432"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763385","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}
Indian pediatricsPub Date : 2025-06-01Epub Date: 2025-04-29DOI: 10.1007/s13312-025-00077-7
Jogender Kumar, Praveen Kumar, Vineet Bhandari
{"title":"Noninvasive Ventilation Strategies in Neonates.","authors":"Jogender Kumar, Praveen Kumar, Vineet Bhandari","doi":"10.1007/s13312-025-00077-7","DOIUrl":"10.1007/s13312-025-00077-7","url":null,"abstract":"<p><p>We provide recommendations on neonatal noninvasive ventilation (NIV) strategies used in the delivery room (DR) and neonatal intensive care unit (NICU). A systematic search was performed in the PubMed, Embase, and CENTRAL databases to identify relevant literature from the past 5 years. A critical review of the available literature was conducted to provide context-specific recommendations. In the DR, we recommend using nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV) with a T-piece resuscitator (TPR). Surfactant replacement therapy should be administered early (< 2 h of life) in infants requiring NCPAP of 6-7 cm H<sub>2</sub>O and FiO<sub>2</sub> > 0.3, using less invasive surfactant administration techniques. Infants should be transported to the NICU on positive pressure support using NCPAP or TPR. In extremely preterm infants with severe respiratory distress requiring intubation in the DR, surfactant should be considered during the intubation. If equipment and expertise are available in the NICU, NIPPV is the preferred mode of NIV. Nasal masks or short binasal prongs are the preferred nasal interfaces. A heated, humidified, high flow nasal cannula is not recommended as the primary mode of NIV. Additional clinical trials are needed for nasal high frequency ventilation and noninvasive ventilation neurally adjusted ventilatory assist modes of NIV. Guidelines for the recommended initial and maximal settings for primary, post-extubation, and weaning off NIV in neonates are provided in this article. NIPPV and NCPAP are the preferred modes of NIV in neonates with respiratory distress.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"451-460"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Clinical Risk Index for Babies (CRIB) II Score and Extended Sick Neonatal Score (ESNS) as a Predictor of In-hospital Mortality in Premature Neonates with Gestational Age ≤ 32 Weeks.","authors":"Goolla Akhila, Jasashree Choudhury, Vijay Kumar Krishnegowda, Debasish Nanda","doi":"10.1007/s13312-025-00107-4","DOIUrl":"https://doi.org/10.1007/s13312-025-00107-4","url":null,"abstract":"<p><strong>Objective: </strong>To compare Clinical Risk Index for Babies (CRIB) II score and Extended Sick Neonatal Score (ESNS) for predicting in-hospital mortality in premature neonates with gestational age ≤ 32 weeks.</p><p><strong>Method: </strong>This prospective observational study included 110 preterm neonates less than equal to 32 weeks of gestation. Clinical parameters of CRIB II score and ESNS were documented at time of admission and laboratory parameter were obtained with 24 h. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio of the two scores as a predictor of mortality were compared.</p><p><strong>Result: </strong>The sensitivity, specificity, PPV, NPV and the Area under the Receiver Operating Characteristic (ROC) curve of CRIB II score at a cut-off value of ≥ 10 were 85.2%, 96.4%, 88.5%, 95.2%, ands 0.91 (95%CI 0.83, 0.98) respectively. The corresponding values for ESNS at a cut-off value of ≤ 11, were 77.8%, 71.1%, 46.7%, 90.8% and 0.85 (95%CI 0.78, 0.92) respectively. CRIB II score had better predictive accuracy for in-hospital mortality among premature neonates compared to ESNS (0.93 v 0.73).</p><p><strong>Conclusion: </strong>Both CRIB II and ESNS are useful tools to predict the risk of mortality during hospital stay in premature neonates. However, CRIB II score has a better predictive ability for in-hospital mortality in comparison with ESNS.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158255","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":"Prevalence of Vitamin B12, Folate, and Iron Deficiency in Adolescents in the Yadadri-Bhuvanagiri District of Telangana: a Community-based Study.","authors":"Emine A Rahiman, Gomathi Ramaswamy, Rajendra Prasad Anne, Sangeetha Sampath, Patil Parag Parshuram","doi":"10.1007/s13312-025-00096-4","DOIUrl":"https://doi.org/10.1007/s13312-025-00096-4","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of anemia and iron, folate, and vitamin B12 deficiency in the adolescents of Yadadri-Bhuvanagiri district of Telangana.</p><p><strong>Methods: </strong>A cross-sectional community-based study was conducted. Prevalence of anemia and micronutrient deficiencies were calculated and analyzed for age, sex, socio-economic status, diet, menstruation, and growth.</p><p><strong>Results: </strong>The prevalence of anemia and deficiency of iron, vitamin B12 and folate was 34.1%, 29.2%, 77.4%, and 8.7%. Anemia and iron deficiency were higher in girls compared to boys (41.2% vs 20.9%,, P < 0.001; 39.5% vs 9.8%, P < 0.001) and girls in active menstruation (44.6% vs 12.1%; 42.3% vs 21.2%, P < 0.001). Anemia was more in older girls (15-19 years) compared to those aged 10-14 years (50% vs 28.9%; P < 0.001).</p><p><strong>Conclusions: </strong>Anemia is a significant health problem for older girls. Vitamin B12 deficiency is prevalent in nearly three-fourths of adolescents.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150282","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":"Skin Damage Risk and its Severity Caused by Pulse Oximetery Saturation Probe Attachment in Preterm Neonates: A Prospective Observational Study from Western India.","authors":"Aditya Hemendra Bhatt, Dipen Vasudev Patel, Reshma Kushal Pujara, Mayur Kiran Shinde, Somashekhar Marutirao Nimbalkar","doi":"10.1007/s13312-025-00100-x","DOIUrl":"https://doi.org/10.1007/s13312-025-00100-x","url":null,"abstract":"<p><p>A six-month prospective study assessed 94 preterm neonates using neonatal skin condition score (NSCS) at the site of peripheral capillary oxygen saturation (SpO<sub>2</sub>) probe attachment. Skin damage (NSCS > 3) occurred in 70.21% of neonates at least once. The severity of skin injury was associated with lower gestational age, lower birth weight, and poor outcomes.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150365","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}
Indian pediatricsPub Date : 2025-05-22DOI: 10.1007/s13312-025-00091-9
Anuradha Khadilkar, Chirantap Oza, Neha Sanwalka, Neha Kajale, Vivek Patwardhan, Dipali Ladkat, Alex Ireland, Raja Padidela, Vaman Khadilkar
{"title":"Reference Data for Lunar iDXA for the Assessment of Bone Health in Indian Children and Youth: A Cross-Sectional Study.","authors":"Anuradha Khadilkar, Chirantap Oza, Neha Sanwalka, Neha Kajale, Vivek Patwardhan, Dipali Ladkat, Alex Ireland, Raja Padidela, Vaman Khadilkar","doi":"10.1007/s13312-025-00091-9","DOIUrl":"https://doi.org/10.1007/s13312-025-00091-9","url":null,"abstract":"<p><strong>Objective: </strong>Dual energy x-ray absorptiometry (DXA) is the commonest bone densitometry technique in children. As no pediatric reference database for Indian children using a narrow fan beam densitometer is available, the aim of the study was to provide sex- and age-specific reference percentile curves for the assessment of bone health using the Lunar iDXA in 1-19-year-old Indian children.</p><p><strong>Methods: </strong>A cross-sectional study was carried out between November 2017 and July 2022 involving 1247 (607 girls) healthy children from Pune, India. The bone mineral content [BMC (g)], bone area [BA (cm<sup>2</sup>)], and bone mineral density [BMD (g/cm<sup>2</sup>)] were measured using the GE-Lunar iDXA narrow-angle fan beam scanner. Reference percentile curves were generated for total body BMC (TBBMC), total body BA (TBBA), lumbar spine bone mineral apparent density [BMAD (g/cm<sup>3</sup>)], and left femoral neck BMAD. Additionally, we provided percentile curves for TBBA relative to height, TBBMC relative to TBBA, lean body mass (LBM) relative to height, and TBBMC relative to LBM.</p><p><strong>Results: </strong>Mean (SD) bone parameters were expressed by age groups for boys and girls separately. The average annual age-related increase in TBBMD, lumbar spine BMD, and femoral neck BMD was 6.3, 7.2, and 4.5%, respectively, across different age groups. The median TBBA and TBBMC for height were higher in boys than girls by 14.7 and 24.9%, respectively. Similarly, the median TBBMC for LBM was 36.8% higher in boys as compared to girls.</p><p><strong>Conclusion: </strong>The study reports reference curves for DXA parameters (narrow fan beam) for Indian children and youth.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119501","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}
Indian pediatricsPub Date : 2025-05-12DOI: 10.1007/s13312-025-00066-w
Mahima Gulati, Suneela Garg
{"title":"Lifestyle Medicine and the Role of the Pediatrician.","authors":"Mahima Gulati, Suneela Garg","doi":"10.1007/s13312-025-00066-w","DOIUrl":"10.1007/s13312-025-00066-w","url":null,"abstract":"<p><p>Non-communicable diseases (NCDs) are now the leading causes of human deaths worldwide. The current paradigm of ills, pills, drills and bills does not lend well to optimal management of NCDs. Indeed, what is required is an updated skills set, with the practitioner serving as a coach to the patient. The root cause of NCDs lies in dysregulated lifestyle behaviors and habits. Lifestyle medicine is the fastest growing medical specialty in the house of medicine. It aims to systematically implement the evidence-based science of healthy lifestyle habits. The six pillars of Lifestyle medicine are healthy, wholesome nutrition, regular physical activity, avoiding use of risky substances like tobacco, restorative sleep, stress management and resiliency, and fostering positive social relations (\"forks, feet, fingers, sleep, stress, love\"). This perspective article describes the competencies pediatricians can harness to apply Lifestyle medicine in their daily clinical practice.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008636","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}
Indian pediatricsPub Date : 2025-05-05DOI: 10.1007/s13312-025-00079-5
Sheetal Madalagi, Kalyani Malasane, Deepti Joshi, R Krishnaprasad
{"title":"Clinical Spectrum of Ocular Manifestations of Mumps in Children: A Cross-Sectional Study.","authors":"Sheetal Madalagi, Kalyani Malasane, Deepti Joshi, R Krishnaprasad","doi":"10.1007/s13312-025-00079-5","DOIUrl":"https://doi.org/10.1007/s13312-025-00079-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the ophthalmological and neuro-ophthalmological manifestations of mumps in children.</p><p><strong>Methods: </strong>This cross-sectional study included 41 children aged < 18 years who were clinically diagnosed with mumps by a pediatrician and referred to a tertiary eye hospital. Comprehensive ophthalmic evaluation included visual acuity testing, slit-lamp biomicroscopy, fundus examination, ocular movement assessment, and squint measurement.</p><p><strong>Results: </strong>The mean time from onset of parotitis to ocular symptoms was 7 days. Out of 41 children, 15 (36.85%) had follicular conjunctivitis. Other ophthalmic findings included acute non-granulomatous uveitis (17.07%), acute acquired esotropia (17.07%), optic neuritis (9.75%), sixth nerve palsy (9.75%), encephalitis (4.87%), dacryoadenitis (2.43%), myasthenia gravis (2.43%), and accommodative insufficiency (2.43%).</p><p><strong>Conclusion: </strong>Apart from causing systemic involvement, mumps causes varied ocular manifestations which highlight the importance of a unified role of pediatricians and ophthalmologists in managing children with mumps.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012601","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":"FCGR2A Gene Polymorphism Association in Children with Multisystem Inflammatory Syndrome.","authors":"Esra Yeşiltepe, Derya Duman, Necdet Kuyucu, Sevcan Tuğ Bozdoğan, Lara Çıtırık, Edanur Yeşil, Derya Karpuz","doi":"10.1007/s13312-025-00047-z","DOIUrl":"https://doi.org/10.1007/s13312-025-00047-z","url":null,"abstract":"<p><strong>Objective: </strong>Fc gamma receptor IIa (FCGR2A) gene polymorphism is associated with increased susceptibility to autoimmune and infectious diseases. The aim of the present study was to evaluate the association of FCGR2A rs1801274 polymorphism with the development and severity of multisystem inflammatory syndrome in children (MIS-C).</p><p><strong>Methods: </strong>This case-control study was conducted in a single center with MIS-C patients and healthy children. Clinical and cardiac imaging data of the participants was collected. The association between the clinical severity of the disease and FCGR2A rs1801274 polymorphism were investigated.</p><p><strong>Results: </strong>There was no significant association between FCGR2A rs1801274 polymorphism and cardiovascular complications in MIS-C patients. However, those with homozygous FCGR2A rs1801274 gene polymorphism developed severe cardiac dysfunction and required immunomodulatory agents other than intravenous immunoglobulin. The mean age of the patients with severe MIS-C was significantly higher than those with mild MIS-C, and systolic dysfunction was significant.</p><p><strong>Conclusions: </strong>Further multicenter studies in different ethnic groups are needed to evaluate the association between differences in the FCGR2A rs1801274 gene and severity of MIS-C and/or other inflammatory diseases.</p><p><strong>Trial registry: </strong>Mersin University Clinical Trial Registry, Decision number 2022/280 dated April 20, 2022.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"62 5","pages":"372-377"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}