Rotaviruses by virtue of its segmented genome generate numerous genotypes. G1P8 is the most common genotype reported globally. We intend to identify the evolutionary differences among G1P8 strains ...from the study with vaccine strains. Stool samples collected from children <5 years were screened for rotavirus antigen by enzyme linked immunosorbent assay. The samples that tested positive for rotavirus were subjected to VP7 and VP4 semi‐nested RT‐PCR. Sanger sequencing was performed in randomly chosen VP7 and VP4 rotavirus strains. Phylogenetic analysis showed less homology between study strains and vaccine strains and they were placed in different lineages. The VP7 and VP4 proteins of rotavirus were analyzed by two different platforms to identify the amino acid substitutions in the epitope regions. Nine amino acid substitutions with respect to Rotarix®, RotaTeq® and Rotasiil®—V66A, A/T68S, Q72R, N94S, D100E, T113I, S123N, M217T, and I281T were observed in VP7. There were five amino acid substitutions—S145G, N/D195G, N113D, N/I78T, E150D in VP4 (VP8 portion) with respect to Rotarix® and RotaTeq® vaccine strains. M217T substitution in VP7 (epitope 7‐2) and N113D, D195G substitution in VP4 (epitope 8‐3, 8‐1) confer changes in polarity/electrical charge with respect to vaccine strains, thus indicating the need for continued surveillance.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Feeding practices adopted by parents play a critical role in the development of children's taste preferences, eating habits, nutrition and eventual weight status. Many scales have been ...developed to assess feeding practices among children of various age groups. This paper aimed to construct and validate a robust scale for the comprehensive assessment of sleep‐time feeding practices for children aged 0‐3 years and to establish the risk of developing Early Childhood Caries (ECC).
Methods
There were multiple phases to the development of the scale: (a) formation of a conceptual framework, (b) systematic development of an item pool, (c) refinement of the item pool by focus group discussion, cognitive interviewing and pretesting, (d) validity testing and (e) reliability testing. The conceptual framework was built based on four broad constructs: breastfeeding, bottle‐feeding, other feeding modes and ‘tooth and diet’ constructs. Reviews of existing scales in related areas were instrumental in scale development and helped to generate an initial pool of 45 items, which was finally refined to 28 items.
Results
Cognitive interviews by the ‘think‐aloud protocol’ helped to reduce ambiguity and maximize clarity of the questions. Pretesting the scale aided increased comprehension and specificity. Face and content validity were corroborated by ‘subject matter experts’ who endorsed the suitability and appropriateness of items. Reliability was assessed by test‐retest, and a near‐perfect agreement was obtained in 96% of the items.
Conclusions
This is the first validated scale currently available for recording sleep‐time feeding practices of children less than three years of age. This 28‐item scale can be applied as a potential clinical scale to record sleep‐time feeding history and the risk of developing ECC as well as a research scale to investigate the association of sleep‐time feeding practices with ECC.
Full text
Available for:
BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objective
To determine the case fatality rate and factors for death in community acquired pneumonia among children aged 1 month to 59 months admitted in a referral Hospital.
Design
Hospital based ...retrospective study.
Setting
Institute of Child Health and Hospital for Children, Chennai.
Patients
Case records of children aged 1 month to 59 months of age with pneumonia (clinically diagnosed pneumonia, radiologically diagnosed pneumonia, and clinically and radiologically diagnosed pneumonia), from January 2006 to December 2008.
Outcome measures
Case fatality rate (CFR) was calculated. Risk factors for mortality analyzed were young age of 1 to 6 months old, female sex, wheeze, respiratory rate ≥70/min, chest indrawing, altered level of consciousness, convulsions, shock, associated heart disease, recent measles, weight for age <−2
Z
score and need for assisted ventilation. The association of risk factors to mortality was arrived at for all three categories of pneumonia cases separately.
Results
Case fatality rate was 8.2% (95% CI: 7.37–8.99%). There was no significant difference in the CFR among the three study groups. Need for assisted ventilation alone was found to be an independent risk factor for mortality in children with pneumonia among all the study groups. Other risk factors like young age, weight for age <-2
Z
score, altered level of consciousness, and congenital heart disease were also observed among these groups.
Conclusion
Among 1 month to 59 months old hospitalized children with pneumonia, CFR was 8.2%. Need for assisted ventilation was a significant risk factor associated with mortality.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Introduction
Children with autism spectrum disorders predominantly exhibit social impairment but significant physical features are manifested as motor delays and deficits affecting their daily ...living. Though sensory integration is a basic component required for motor skills, the impact of sensory processing dysfunction on fine motor skills is not clear, which is explored in this study.
Methods
This cross sectional study was carried out in Vidya Sudha – school for children with special needs. Overall, 56 children diagnosed with autism spectrum disorders with the Childhood Autism Rating Scale were included in the study. Peabody Developmental Motor Scale-2 was used to assess the level of their fine motor skill, and the sensory profile served to evaluate their sensory processing dysfunction.
Results
Pearson’s correlation showed a strong positive correlation between the fine motor quotient and auditory, visual, vestibular, and tactile processing, with r > 0.7 and p 0.05. Beta value of logistic regression of tactile, vestibular, and visual processing was 0.554, 0.288, and 0.191, respectively, which conveys that tactile dysfunction has a major impact, followed by vestibular and visual processing deficits.
Conclusions
The study concludes that tactile, vestibular, and visual sensory dysfunctions appear to influence the fine motor skills, with tactile dysfunction exerting a greater impact. The result strongly emphasizes that paediatric therapists should individualize treatment on the basis of sensory dysfunction, which should be considered and simultaneously addressed when training fine motor function and activities of daily living.
Objectives To assess the clinical and laboratory features of suspected meningitis to assist in the accurate diagnosis of bacterial meningitis in young Indian children. Study design Children <2 years ...of age with clinical suspicion of meningitis were enrolled. Clinical and laboratory information was collected, and cases were classified based on cerebrospinal fluid findings as clinical, aseptic, or probable and confirmed bacterial meningitis. Results A total of 2564 children with suspected meningitis were enrolled over 45 months; 156 cases of aseptic and 51 cases of bacterial meningitis were identified. Stiff neck and bulging fontanelle were more common in bacterial meningitis ( P < .05), but were present in <15% of patients. The World Health Organization and American Academy of Pediatrics classifications for high suspicion of bacterial meningitis were met in 84% and 88% of cases of bacterial meningitis, respectively, but were also present in 54% and 74% cases of aseptic meningitis. Culture and gram stain were positive in 7 (14%) and 4 (8%) cases of bacterial meningitis. Conclusions Signs of bacterial meningitis and proposed criteria for high suspicion of bacterial meningitis are non-specific in this population. Standard microbiological tests for bacteria are insensitive in this setting, necessitating highly sensitive methods to identify bacterial meningitis.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Early childhood caries (ECC) remains a public health challenge globally, more so in developing countries. The association between sleep-time feeding practices and ECC remains obscure. The study ...evaluated this association using Feeding At Sleep Time (FeAST) scale. A case-control study was planned among 627 toddlers, were cases included children with ECC while controls were children without ECC. Three patterns of feeding associated with sleep were recorded: beginning of sleep, during the course of sleep, and early morning hours sleep. Dental caries was scored using International Caries Detection and Assessment System (ICDAS II). The study participants included 302 (48%) cases and 325 (52%) controls. Adjusted odds ratios (AORs) for breastfeeding at the beginning of sleep, during the course of sleep, and early morning hours sleep were 6.7, 6.5, and 3.7, respectively (p = 0.001), on comparing cases versus controls. Similarly, AORs for bottle-feeding at the beginning of sleep, course of sleep, and early morning hours sleep were 5.1, 8.3, and 3.7, respectively (p = 0.001). Addition of sweeteners yielded an AOR = 2.84, while the intake of solids during sleep yielded an AOR of 6.02(p = 0.001). Other feeding modes like sippers, tumblers, etc., had a statistically significant association (p = 0.001). Sleep-time feeding practices increase the risk for ECC in 12- to 36-month-old children.
Objectives: Traumatic brain injury (TBI) disrupts the developing brain in the pediatric population. This study aims to look at the outcomes of moderate and severe TBI over a five-year follow-up to ...look for the long-term sequelae of head injury in the pediatric population. Materials and Methods: A prospective observational study was conducted after obtaining the permission of the Institutional Ethics Committee with the primary study participants admitted between 2015 and 2017 with follow-up extending up to 2022 in 118 pediatric patients, aged between 1 and 15 years who required admission in the pediatric intensive care unit with moderate and severe TBI. Results: Language impairment was noted in 33.63% ( n = 37) patients during early follow-up, and 12 of them continued to have impaired language skills and communication at the end of five years. With regard to school functioning, children had more difficulty in the arithmetic domain ( n = 33) compared to language domains ( n = 17). While the parents noted improvements in scholastic performances, some degree of difficulty in learning was noted in most of the children, who sustained TBI. Despite these difficulties, 27 out of 41 participants, who gave their higher secondary examinations have gone on to pursue undergraduate courses in colleges. Conclusion: Our study indicates that over the passage of time, children tend to have a reasonable chance at recovery, and with the potential for plasticity, early and aggressive rehabilitative services may enable the child to have a decent quality of life and in selected cases, even an independent life.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
10.
Clinical Profile of Scrub Typhus in Children Palanivel, Sengottaiyan; Nedunchelian, Krishnamoorthi; Poovazhagi, Varadharajan ...
Indian journal of pediatrics,
11/2012, Volume:
79, Issue:
11
Journal Article
Peer reviewed
Objective
To study the clinical profile and outcome of scrub typhus cases admitted in an urban referral centre.
Methods
This descriptive study describes the clinical profile of 67 children with scrub ...typhus, who were admitted in an urban referral centre(ICH & HC,Chennai) during the period between October 2010 and March 2011.The diagnosis was confirmed by IgM ELISA.
Results
All children presented with fever. Eschar and rash were present in 46% and 35% cases, respectively. Cough, vomiting, altered sensorium and oliguria were present in 73%,59%,58% and 43%, respectively. Hepatosplenomegaly and pallor were the commonest findings encountered in more than 80% children. Other findings were edema, lymphadenopathy and icterus.Thrombocytopenia, elevated liver enzymes and leukocytosis were seen in 77%, 64% and 49% cases, respectively. Pleural effusion, ascites, shock and respiratory failure were seen in 61%, 47%,45%,34% cases, respectively. Acute renal failure, hepatic failure, multiorgan dysfunction syndrome (MODS), meningoencephalitis and acute respiratory distress syndrome(ARDS) were seen in 10%,10%,7%,6% and 4% cases, respectively. Doxycycline and azithromycin were the antibiotics used. The overall mortality rate was 11.94%. Causes of death were shock, ARDS, acute renal failure(ARF), MODS and disseminated intravascular coagulation(DIVC).
Conclusions
When a child presents with acute febrile illness, maculopapular or erythematous rash, hepatosplenomegaly, lymphadenopathy, thrombocytopenia and features suggestive of capillary leak, diagnosis of Scrub typhus must be considered and the child should be started on empirical therapy with doxycycline or azithromycin which is life saving.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
PDF
