Indian pediatrics最新文献

{"title":"Learning Agreements for Teaching Communication Skills to Postgraduate Students in Pediatrics.","authors":"Priyanka Gupta, Jagdish Chandra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study evaluated learning agreements (LA) as a teaching-learning tool when administered to eleven postgraduate students in Pediatrics, with each learner moving at an individual pace. After LA, the median (IQR) Gap-Kalamazoo Communication Skills Assessment Score (GKCSAC) of students increased from 14 (11, 14) to 27 (27, 33); P = 0.003. The scores on all the nine distinct components of the GKCSAC exhibited a statistically significant increase (P < 0.01). Additionally, all students perceived themselves as more competent and confident in their communication skills.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"761-765"},"PeriodicalIF":1.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534362","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":"Understanding and Expanding the Role of Pediatricians in Child Adoption in the Backdrop of Emerging Regulations in India: A Contemporary Review","authors":"Bhavneet Bharti, Prahbhjot Malhi","doi":"10.1007/s13312-024-3280-3","DOIUrl":"https://doi.org/10.1007/s13312-024-3280-3","url":null,"abstract":"<p>Adoption provides a unique opportunity to establish stable family relationships and enhance the social safety net. In India, adoptions are governed by the Hindu Adoption and Maintenance Act, 1956, and the Juvenile Justice (Care and Protection of Children) Act, 2015, each with distinct eligibility criteria. Currently, approximately 33,870 Indian couples are registered as prospective adoptive parents (PAPs), and this number is rising. The Central Adoption Resource Authority (CARA) website lists 2,140 children available for adoption, with 731 being categorized as normal and 1,409 as special needs. CARA, under the Ministry of Women and Child Development, oversees both domestic and international adoptions of legally free orphaned, abandoned, and surrendered children. The scope of adoption has expanded from primarily young infants to include older children, children with special needs, and foster care, in line with the National Child Policy. Pediatricians play a crucial role in the adoption process, understanding medical aspects within the legislative framework and acting in the child’s best interests. This involves collaborating with multiple stakeholders, conducting comprehensive pre-adoption medical examinations, and providing ongoing medical and behavioral support post-adoption. This review emphasizes recent changes in adoption practices in India and highlights the evolving role of pediatricians as champions for these children and their adoptive families.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"84 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260195","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":"Global Initiative for Asthma Guidelines 2024: An Update","authors":"Nikhil Rajvanshi, Prawin Kumar, Jagdish Prasad Goyal","doi":"10.1007/s13312-024-3260-7","DOIUrl":"https://doi.org/10.1007/s13312-024-3260-7","url":null,"abstract":"<p>Asthma poses significant challenges in pediatric care, particularly in resource-limited settings. The Global Initiative for Asthma (GINA) 2024 guidelines represents a crucial step forward in addressing these challenges. This review critically evaluates the guidelines, focusing on their implementation and impact in developing countries like India. There have been certain key updates including a revised diagnostic flow chart and emphasis on alternative tools like peak flow meters. Challenges related to bronchodilator reversibility and interpreting FEV1/FVC are also explored. The article further addresses the implications of bronchial provocation testing in pediatric asthma. Detailed insights into cough-variant asthma highlight its rising recognition and management strategies. The GINA 2024 guidelines reflect updated criteria for commencing a particular step of therapy, aiming to optimize management and outcomes in pediatric asthma care. The guidelines have updated the role of allergen immunotherapy in pediatric asthma based on emerging evidence of efficacy and safety. Overall, the GINA2024 guidelines offer a realistic approach to pediatric asthma care, with a potential for broader applications pending further research and adaptation.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"2 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227004","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":"Monocytic Human Leukocyte Antigen-DR Expression Levels to Predict Outcome in Children With Severe Sepsis","authors":"Nanmaaran Periyannan Thangavel, Narayanan Parameswaran, Prabhu Manivannan, Jaikumar Govindaswamy Ramamoorthy","doi":"10.1007/s13312-024-3278-x","DOIUrl":"https://doi.org/10.1007/s13312-024-3278-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To assess the association between monocytic Human Leukocyte Antigen-DR (mHLA-DR) expression and outcome in children with severe sepsis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Consecutive children, aged 29 days to 15 years, who were admitted with severe sepsis or septic shock in the pediatric intensive care unit (PICU) were enrolled. mHLA-DR expression [antigen bound per cell (ABC)] was assessed on two time points: between 72 to 120 hours (P1) and 121 to 168 hours (P2), of stay in PICU and the difference between the two was calculated as delta mHLA-DR. Outcomes were noted for survival, mortality and secondary infection during the hospital stay.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Forty-seven children with median (IQR) age 24 (10, 96) months and a median (IQR) duration of illness of 3 (3, 5) days, were enrolled consecutively. Pediatric Logistic Organ Dysfunction (PELOD) score &gt;10 was observed in 63.8% children. 18 children succumbed. The median mHLA-DR levels (ABC) at P1 were significantly higher in children who survived as compared with those who expired (7409 vs. 2509, <i>P</i> = 0.004). Similarly, the median mHLA-DR levels (ABC) at P2 were higher in those who survived than the expired group (14728 vs. 2085, <i>P</i> = 0.001). The median delta mHLA-DR levels (ABC) were 4574 and 309 for the survived and expired group, respectively (<i>P</i> = 0.012). mHLA-DR at P1 (<i>P</i> = 0.004), mHLA-DR at P2 (<i>P</i> = 0.001) and delta mHLA-DR (<i>P</i> = 0.012) was significantly associated with mortality but not associated with secondary infection. A negative correlation was observed between PELOD score and mHLA-DR at P1 (<i>r</i> = −0.25, <i>P</i> = 0.46), at P2 (<i>r</i> = −0.425, <i>P</i> = 0.018) and delta mHLA-DR (<i>r</i> = −0.27, <i>P</i> = 0.41). The area under curve (95%CI) of mHLA-DR expression (ABC) at P2 for a cutoff of &lt; 6631 was 0.966 (0.907, 1.0) to predict mortality in severe sepsis.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>mHLA-DR levels were significantly lower in children who succumbed than those who survived at both time points. mHLA-DR levels can be a useful biomarker to diagnose immune-paralysed state.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"19 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260144","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":"Clinical Profile of Children with Adenovirus Infection–A Hospital-based Observational Study","authors":"Poovazhagi Varadarajan, Ramesh Subramanian, Gomathy Srividya, Nisha Rangabashyam, Seenivasan Subramani","doi":"10.1007/s13312-024-3277-y","DOIUrl":"https://doi.org/10.1007/s13312-024-3277-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To describe the clinical profile and determine the factors affecting mortality of children admitted with adenovirus infection in a tertiary care centre in South India.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this observational study, respiratory specimens (nasopharyngeal swab / endotracheal aspirate) were collected from all hospitalized pediatric patients presenting with fever, cough, breathlessness, gastrointestinal symptoms, unexplained encephalopathy or multisystem involvement, between February 2023 and August 2023. Infection with adenovirus was determined by viral pathogen panel based on polymerase chain reaction (PCR) technique. Those referred from elsewhere with positive adenovirus report but nonavailability of treatment details and children with coinfections were excluded. The clinical and laboratory profile of children with adenovirus infection were collected and predictors for in-hospital mortality were determined by logistic regression analysis.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of 527 children who were screened, 130 children with a median (IQR) age of 18 (10, 48) months, had adenovirus infection. 84.5% were aged below 5 years. 62 (41.33%) children required intensive care admission. Abnormal chest radiograph, multisystem involvement and non-respiratory illness were present in 90 (69.2%), 97 (74.62%) and 26 (20%) children. Complications included acute respiratory distress syndrome (<i>n</i> = 8), hemophagocytic lymphohistiocytosis (<i>n</i> = 7), left ventricular dysfunction (<i>n</i> = 11), acute liver cell failure (<i>n</i> = 7), acute kidney injury (<i>n</i> = 13), and multiorgan dysfunction (<i>n</i> = 16). Overall mortality was 13%. Acute kidney injury, left ventricular dysfunction and pancytopenia were identified as factors that may be significantly associated with death.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Multisystem involvement was observed in majority of children presenting with adenovirus infection. Non-respiratory presentation is seen in a fifth of children with adenovirus infection.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"21 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260147","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 Cardiac Critical Care: A Vital Link in the Chain-of-Survival of Children with Congenital Heart Disease","authors":"Arun Kumar Baranwal, Navpreet Kaur, Shilpa Vellore Govardhan","doi":"10.1007/s13312-024-3236-7","DOIUrl":"https://doi.org/10.1007/s13312-024-3236-7","url":null,"abstract":"<p>Despite significant strides made in childhood survival during the last 75 years, India bears the largest burden of congenital heart disease (CHD) in the world. The care of a child with CHD requires multidisciplinary collaboration and development of distinct training opportunities in developing countries to ensure outcomes similar to those achieved in high-income countries. We present a commentary on the current state of pediatric cardiac critical care in India and propose pathways to fulfil the unmet needs of Indian children. The aim is to achieve self-reliance in pediatric cardiac services and to move towards optimal outcome and intact survival of children with CHD.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"43 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744216","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":"Use of Paracetamol for Treatment of Patent Ductus Arteriosus in Preterm Neonates: A 5-Year Experience From a Tertiary Hospital in India.","authors":"Deepika Kainth, Satya Prakash, Vivek Kumar, R Dhinakaran, Ankit Verma, Ramesh Agarwal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated ductal closure rates in preterm neonates with hemodynamically significant patent ductus arteriosus (hsPDA) who received paracetamol (PCM) as first-line therapy.</p><p><strong>Methods: </strong>In this retrospective chart review, we included inborn preterm (< 37 weeks) neonates (January 2017-December 2021) with hsPDA (ductal diameter > 1.5 mm and left atrium-to-aortic root ratio (La/Ao > 1.4) who were treated with oral or intravenous PCM. Primary outcome was hsPDA closure (defined as small or no PDA) following 3-day treatment. Secondary outcomes were need for retreatment and surgical ligation, pulmonary hypertension (PH), and in-hospital morbidities.</p><p><strong>Results: </strong>Out of 2784 preterm birth, 117 neonates were diagnosed with hsPDA. Out of 96 neonates who received PCM in the first course, 20 died before the completing the first course. The median (IQR) gestation and birth weight of neonates who received PCM were 28 (26, 29) weeks and 841 (714, 1039) g, respectively. Out of 76 neonates who completed treatment with first course of PCM (57 intravenous, 19 oral), 43 (56.6%) achieved successful closure and five (6.6%) developed PH. Out of 14 neonates who received a second course of PCM, 10 achieved closure of hsPDA while one neonate expired.</p><p><strong>Conclusion: </strong>Paracetamol is associated with successful closure of hsPDA in 56.6% of preterm neonates after one course and 70% of premies after two courses.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"656-660"},"PeriodicalIF":1.7,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158394","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":"Recommending Adoption of Revised Growth Charts for Indian Children is Misleading.","authors":"Rakesh Lodha, Pavitra Mohan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":"61 7","pages":"697"},"PeriodicalIF":1.7,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554654","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":"Cobalamin C Deficiency: An Uncommon Cause of Hemolytic Uremic Syndrome.","authors":"Kanika Singh, Mukul Pandey, Rajiv Uttam, Sidharth Kumar Sethi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"691-693"},"PeriodicalIF":1.7,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860907","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":"Revised WHO Guidelines on Hemoglobin Cutoffs to Define Anemia in Individuals and Populations.","authors":"Ritika Khurana, Purva Kanvinde, Sangeeta Mudaliar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 2024, the World Health Organization (WHO) has proposed revised hemoglobin cutoffs for diagnosing anemia in children aged 6-23 months, pregnant women in the second trimester and those residing in elevated areas with the aim of increasing the sensitivity and ensuring uniformity in diagnosis. There are no major changes in other domains.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":"671-674"},"PeriodicalIF":1.7,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442559","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}