Indian Journal of Pediatrics最新文献

{"title":"Diagnostic Accuracy of Furosemide Stress Test and Cystatin-C for Predicting Acute Kidney Injury Progression in Children: A Prospective Cohort Study.","authors":"S Dyvik, Nisha Toteja, Aliza Mittal, Bharat Chaudhary, Siyaram Didel, Kuldeep Singh, Purvi Purohit, Daisy Khera","doi":"10.1007/s12098-024-05401-w","DOIUrl":"10.1007/s12098-024-05401-w","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the predictive ability of furosemide stress test (FST), serum and urine cystatin-C in identifying progressive acute kidney injury (AKI) and the need for kidney replacement therapy (KRT).</p><p><strong>Methods: </strong>Children aged one month to 18 y admitted in the pediatric intensive care unit (PICU) with Kidney Diseases Improving Global Outcomes (KDIGO) stage-1/2 AKI were enrolled. FST and serum and urine cystatin-C levels were performed and analyzed. The primary outcome was progression to stage-3 AKI. Secondary outcomes included comparing predictive ability of FST vs. cystatin-C for stage-3 AKI and need for KRT, adverse effects, length of hospital stay and mortality.</p><p><strong>Results: </strong>Of the 41 children enrolled, seven (17.07%) progressed to KDIGO stage-3 AKI. Four children were furosemide non-responders at 2 h and five at 6 h post-FST. The sensitivity, specificity and area under the receiver operating characteristic curve (AUROC) of FST at 2 h were 57.14%, 100% and 0.84 (p = 0.01), and at 6 h were 71.43%, 100% and 0.87 (p < 0.001), respectively. Urine cystatin-C was positive in 20 (48.78%) children, of which seven progressed to stage-3 AKI [sensitivity- 100%, specificity- 61.76%, AUROC- 0.91 (p = 0.003)]. Five of nine children with positive serum cystatin-C progressed to stage-3 AKI [sensitivity- 71.43%, specificity- 88.24%, AUROC- 0.75 (p = 0.08)]. All FST non-responders progressed to undergo KRT showing sensitivity and specificity of 66.67% and 100% at 2 h (AUROC- 0.87) and 85% and 100% at 6 h (AUROC- 0.89) respectively.</p><p><strong>Conclusions: </strong>FST is a simple bedside tool with robust predictive value in detecting kidney impairment progression in children and can be utilized in PICU for assessing tubular dysfunction. The diagnostic accuracy of FST was comparable to that of urine and serum cystatin-C. Further studies can be done on a larger cohort for better generalizability.</p>","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"625-631"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004790","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":"Long-Term Outcomes of Disease Modifying Therapies in Gaucher Disease.","authors":"Rani Manisha, Shubha R Phadke","doi":"10.1007/s12098-023-04986-y","DOIUrl":"10.1007/s12098-023-04986-y","url":null,"abstract":"<p><strong>Objectives: </strong>To study clinical response to treatment with enzyme replacement therapy (ERT) and substrate reduction therapy (SRT) in a cohort of Gaucher disease.</p><p><strong>Methods: </strong>Retrospective data of 8 patients of Gaucher disease was compiled. The treatment included all three currently available enzyme replacement therapies as well as substrate reduction therapy with Eliglustat. The relevant blood investigations were done in follow-up visits. The assessment of the effects of long-term treatment over varying periods up to 13 y was done with various issues related to the course of therapy documented.</p><p><strong>Results: </strong>Improvement in hematological parameters was seen in all patients. Reduction of spleen size occurred in 7 of 8 patients (87.5%). One patient had 2 successful pregnancies while on therapy. A distinct patient with type 3 Gaucher disease developed complication in the form of Gaucheroma within the spleen.</p><p><strong>Conclusions: </strong>Awareness about the disease and the efficacy of the therapies amongst pediatricians will help in early diagnosis and better outcomes. The available therapies have changed the outcome of the patients and improved the quality of life in patients with Gaucher disease. The data of Indian patients is important at this juncture when under Rare Disease Policy, government funding has become available for ERT for Gaucher disease patients in India.</p>","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"585-591"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691689","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":"Diagnostic Accuracy of Pediatrician-performed Digital Retinal Imaging with 3nethra neo for ROP Screening.","authors":"Ashok Garg, Jogender Kumar, Deeksha Katoch, Sourabh Dutta, Praveen Kumar","doi":"10.1007/s12098-024-05042-z","DOIUrl":"10.1007/s12098-024-05042-z","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of pediatrician-performed wide-field digital retinal imaging (WFDRI) for diagnosing Retinopathy of prematurity (ROP), as compared to binocular indirect ophthalmoscopy (BIO) as the reference standard.</p><p><strong>Methods: </strong>Eligible infants undergoing ROP screening were enrolled consecutively. BIO was performed by trained ophthalmologists, followed by WFDRI (using \"3nethra neo\" camera) by a pediatrician. An expert pediatric ophthalmologist reviewed de-identified images for quality, presence, and severity of ROP. She was masked to the findings of BIO and the pediatrician. Diagnostic accuracy for detecting any ROP, ROP requiring treatment (Type 1), and ROP requiring referral (Type 1 or 2) were calculated for WFDRI, considering BIO as the reference standard.</p><p><strong>Results: </strong>The analysis included 427 eyes. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic accuracy, and diagnostic odds ratio of WFDRI were 0.88 (95% CI: 0.81, 0.93), 0.89 (0.85, 0.92), 7.8 (5.7, 10.9), 0.14 (0.09, 0.21), 0.89 (0.85, 0.91), and 58.3 (31, 110) respectively for detection of 'any ROP'. For detecting ROP requiring treatment (Type 1), the sensitivity, specificity, NLR, and diagnostic accuracy were 0.90 (0.75, 0.97), 1.00 (0.99, 1.00), 0.11 (0.04, 0.27), and 0.99 (0.98, 1.00) respectively. For ROP requiring referral, the sensitivity, specificity, NLR, and diagnostic accuracy of pediatrician-performed WFDRI were 0.92 (0.80, 0.98), 1.00 (0.99, 1.00), 0.08 (0.03, 0.21), and 0.99 (0.98, 1.00) respectively. No serious adverse events were noted. The pediatrician and ophthalmologist had a near-perfect (k-1.00) and strong (k-0.88) agreement for ROP requiring treatment and any ROP, respectively.</p><p><strong>Conclusions: </strong>Pediatrician-performed WFDRI is feasible, safe, and has excellent diagnostic accuracy for identifying ROP requiring treatment.</p>","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"605-611"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899665","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":"The Effect of Inhaled Corticosteroids on Bone Mineral Density in Asthmatic Patients: Authors' Reply.","authors":"Rashmi Kapoor, C P Singh, Gaurav Singh, Rajeswari Samal","doi":"10.1007/s12098-025-05536-4","DOIUrl":"10.1007/s12098-025-05536-4","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"680"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970164","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":"Interleukin-8 as a Potential Marker in Severity of Dengue in Children: A Prospective Comparative Observational Study.","authors":"Unnati Achanta, Suresh Rangaraj, Subash Sundar, Leela K V","doi":"10.1007/s12098-025-05538-2","DOIUrl":"10.1007/s12098-025-05538-2","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"656"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981891","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":"How Low is Low Volume of Cerebrospinal Fluid from Suspected Cases of Tuberculous Meningitis to Refuse Acceptance in the TB Laboratory? Authors' Reply.","authors":"Sarman Singh, Mani Muthu Mani Sankar, Jitendra Singh, Syed Beenish Rufai, Parveen Kumar","doi":"10.1007/s12098-025-05504-y","DOIUrl":"10.1007/s12098-025-05504-y","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"686"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669781","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":"Massive Hematemesis due to Gastroepiploic Artery Pseudoaneurysms in a Toddler.","authors":"Lokesh Kumar, Kalyana Prabhakaran, Mahesh S Maddimani, Mugundhakumar Balashanmugam, Siyaram Didel, Daisy Khera, Pushpinder Khera","doi":"10.1007/s12098-025-05545-3","DOIUrl":"10.1007/s12098-025-05545-3","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"673"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984633","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":"Preterm Care Training Through Comprehensive Multimodal Training Packages.","authors":"Chaitra Angadi, Adhisivam Bethou","doi":"10.1007/s12098-025-05550-6","DOIUrl":"10.1007/s12098-025-05550-6","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"577-578"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017717","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":"Unusual Neuroimaging in Atypical Fulminant SSPE.","authors":"Shweta Pandey, Ravindra Kumar Garg, Sneh Jain, Harish Nigam","doi":"10.1007/s12098-025-05499-6","DOIUrl":"10.1007/s12098-025-05499-6","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"664"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752406","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":"FSGS in Kimura Disease - A Rare Cause of Nephrotic Syndrome in an Adolescent.","authors":"Megha Jayachandran, Rohan B C, Abhijit Choudhary, Supriya Kushwah, Urmila Dahake, Meenakshi Girish, Prashant Ramteke, Anand Chellappan","doi":"10.1007/s12098-025-05509-7","DOIUrl":"10.1007/s12098-025-05509-7","url":null,"abstract":"","PeriodicalId":13320,"journal":{"name":"Indian Journal of Pediatrics","volume":" ","pages":"666"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709663","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}