bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of acute flaccid paralysis cases reported from a tertiary care hospital in Delhi
Authors: Kumar Ajay 
Published: June 2020

Background: As many countries including India become polio-free, Guillain–Barre syndrome (GBS) becomes the most common cause of the acute flaccid paralysis (AFP). Objective: To describe the socio-epidemiology and causes of AFP cases reported from a tertiary care hospital in Delhi. Materials and Methods: This was a cross-sectional descriptive study based on record review of the case investigation forms of AFP cases reported from January 2011 to December 2013. Results: Total 187 cases of AFP were reported during the study period. Majority (54.01%) of the cases were male. The mean age was 5 years 3 months (range - 1 month to 13 years8 months). The age group most commonly affected was 5-12 years (43.32%) followed by 2-5 years (32.62%). Most (88.24%) of the cases belonged to low socio-economic status, with 79.68% of the cases from an urban area. Investigations were done within 48 h of the date of notification by medical personnel in 94.65% of cases. Two stool specimens were collected within 7 days of onset of weakness in 94.12% of cases and stool condition was good in all collected specimens. None of the stool samples tested positive for wild poliovirusesand vaccine derived poliovirus. Non-polio enterovirus was isolated in 15 cases (8.02%) while results were not mentioned in 12 cases (6.42%). In six cases, vaccine virus was isolated. The most common cause of AFP was GBS (32.08%) followed by isolated facial palsy (8.56%) and viral myalgia (6.95%). Conclusion: GBS was most common cause of AFP followed by isolated facial palsy. The slum area and migratory population need more attention as the majority of AFP cases were from low socio-economic status family.
Clinical profile and outcome of poisoning in children admitted to a tertiary referral center in South India
Authors: Vasanthan Mullai , James Saji , Shuba S , Abhinayaa J , Sivaprakasam Elayaraja 
Published: June 2020

Background: Childhood poisoning covers the entire gamut from accidental ingestion in toddlers and preschool children to intentional overdosage in adolescents. The poisons range from fuel to drugs and other chemicals. Objective: To determine the epidemiology, clinical profile, and outcome of children presenting with acute poisoning in a tertiary care center in south India. Materials and Methods: All patients from the age of 1 month to 18 years, admitted during the 1-year study period with a history of poisoning, were included. Animalbites, snake, and scorpion envenomation were excluded. The data were analyzed using SPSS software, version 16. A multivariate analysis was also done and a p<0.05 was considerer significant. Results: There were 75 cases of poisoning out of the total 4074 admissions. Accidental poisoning constituted 73.3% cases and the remaining 26.7% were suicidal. In most of the cases, poisoning was due to fuel (28%) or drugs (21.3%), and kerosene oil was the most common causative substance (28.0%) followed by camphor (14.7%). The higher incidence of poisoning was found in lower middle socio-economic class (56.0%). An analysis of the outcome showed that92.0% were discharged home, 4.0% with sequelae, and death in 4.0% cases. Conclusion: The highest incidence of poisoning was observed in the lower middle socio-economic group. Most of the poisons were household products, and the most common nature of exposure was accidental. In most of the cases, recovery was complete.
Comparison of World Health Organization body mass index for age Z scores and revised Indian Academy of Pediatrics growth standards for the diagnosis of thinness, overweight, and obesity among adolescent girls
Authors: Venkatesh Soma , Pachaiappan Natarajan , Ramalingam Vanitha 
Published: June 2020

Background: In spite of the rapid economic growth of India in recent years, the health of our children is being challenged by the troublesome duo of over nutrition and undernutrition. Determination of the magnitude of this problem needs uniform and representative growth standards across the country. Aim: To compare the prevalence of thinness, overweight, and obesity among girls aged 10-15 years belonging to urban Pondicherry using the World Health Organization (WHO) body mass index (BMI) for age Z scores and revised Indian Academy of Pediatrics (IAP) growth standards. Materials and Methods: A total of 287 girls were included in the study. Weight and height were measured for all of them as per standard guidelines and BMI were calculated. Thin, overweight and obese girls were identified based on the WHO Z scores for BMI-for-age as well as revised IAP growth standards 2015. Results: The prevalence of thinness as per WHO BMI for age Z scores was 22.6%. The prevalence of overweight and obesity were 6.6% and 2.1%, respectively. In comparison, the prevalence of thinness according to revised IAP growth standards was 10% and that of overweight and obesity were 6.3% and 1.4% respectively. The prevalence of thinness as per recent IAP growth standards is significantly less compared to the prevalence obtained using WHO Z scores. Conclusion: Using the WHO BMI for age Z scores is likely to overestimate the prevalence of thinness significantly when compared to revised IAP growth standards for Indian children. BMI for age Z scores for Indian children is needed to address this issue in large prospective multicenter studies.
Sizes of induration and nutritional status in children with positive Mantoux test
Authors: Singh Mukesh Vir , Kumar Durgesh , Kumar Dinesh , Lata Kusum , Shukla K M , Varshney Sangeeta 
Published: June 2020

Background: The immune status of children is always affected by nutrition. Sometime severe malnutrition is associated with false negative Mantoux test. There is a need to study to observe the effect of nutritional status on the size of indurations in Mantoux positive children. Study Design: Observational analytical cross-sectional study. Methods: The study population consisted of 310 patients, belonging to both sexes and age of 1-14 years, attending the outpatient department of UP Rural Institute of Medical Sciences and Research, Saifai, Etawah. Only Mantoux positive cases were included in the study. Their sizes of indurations of skin reaction weremeasured and recorded in mm. The nutritional status was calculated as the weight for age and height for age standard (Z-score), using the NCHS charts of for males and females. Results: Out of 800 children screened for tuberculosis, 310 children had positive Mantoux test and were recruited in the study. Mean induration (20 mm) was similar in all the groups. However, the size of indurations ranged from 10-40 mm, 11-33 mm, and 12-24 among normal weight, underweight, and overweight Z-score groups. Mean induration was same (20 mm) in two Z-score height for age groups (normal height, stunting), while it was 20.6 mm in the over-height group. Although, the range of Mantoux positivity ranges from 10-35 mm, 11-40 mm, and 18-22 mm among normal height, stunting, and over height Z-score groups. Conclusion: Although, nutritional status can affect the positivity of Mantoux test; in Mantoux positive children, the size of indurations does not depend on their nutritional status.
Bicycle handlebar injuries in children: Is “ring sign,” an indicator of intra?abdominal organ injuries?
Authors: Deepak J , Aravind K L , Shankar Gowri , Narendrababu M 
Published: June 2020

Background: Children are vulnerable to a wide range of bicycle-related traumatic injuries. Bicycle handlebar injuries often cause diagnostic dilemma and delay in diagnosis due to trivial nature of the incident. Objectives: To study the bicycle handlebar injuries in children and their management. Materials and Methods: A retrospective review of all the children with blunt abdominal injuries secondary to bicycle handlebar injuries at our institution, between April 2011 and March 2015 was done. The patient medical records were examined, and all the data pertaining to the demographic information, clinical history, hematological investigations, imagingstudies, operative technique, post-operative recovery and complications, and duration of hospitalization were obtained. Results: During the study period of 48-month, 26 children with blunt abdominal injuries were treated at our institution. Among these patients, 7 children had bicycle handlebar abdominal injuries. All 7 patients were male. Mean age of the patients was 9.6 years (range 5-12 years). The average time gap between trauma and presentation to our institution was 46 h (range 22-96 h). All the 7 children had circular patternedabrasion of the bicycle handlebar over the abdominal wall. Mean duration of hospital stay was 16.1 (range: 9-28) days, and the average duration of follow-up was 35.6 months (range 7-55 months). Conclusion: “Ring sign” indicates a higher probability of associated intraabdominal injury, and these children should be thoroughly evaluated and managed with close observation, repeated clinical examination, appropriate imaging studies, and surgical or endoscopic intervention as required.
A study of abuse including physical, substance, and sexual abuse among urban adolescent children
Authors: Sanjeeva G N , Patil Alkarani T , Kumar Pragalatha 
Published: June 2020

Background: Adolescents are the future citizens of a country, and it is imperative to systematically address their needs. The prevalence of abuse including physical and sexual, by these adolescents as well as against them, have been increased. Objective: The study was undertaken to estimate the prevalence of abuse including physical, substance, and sexual abuse in adolescents of Bengaluru urban. Materials and Methods: This was a cross-sectional survey conducted among the adolescents aged 10-19 years in Bengaluru. A pretestedself-designed semi-structured questionnaire which included demographic profile and details of the substance abuse (physical and sexual abuse), juvenile delinquency was used. Data were analyzed using SPSS software. Results: A total of 303 adolescents were enrolled during the study period, out of which 167 adolescents were from school and 136 adolescents from the slum. Most children (54.1%) belonged to the age group of 14-16 years. Smoking (48.5%) was the most common form of abuse among the parents. The most commonsubstance abuse seen among children was smoking (30%). Majority were involved in violence with other adolescents (71%). Sexual abuse was seen more in slum children as compared to school children. Substance abuse among children was mostly influenced by friends in 70 (40.7%) cases. Conclusion: Substance abuse was common in male slum adolescents for which peer pressure and curiosity were the main influences. More than one-quarter of slum adolescents reported physical abuse while sexual abuse was more commonly reported in female slum adolescents.
Awareness among mothers regarding oral rehydration salt solution in management of diarrhea: A cross-sectional study
Authors: Thammanna P S , Sandeep M , Sridhar P V 
Published: June 2020

Background: Diarrhea remains one of the leading global causes of death among children under the age of 5 years; diarrhea and the resultant mortality from it is both preventable and treatable. Proper knowledge regarding the use of oral rehydration salt solution (ORS) helps in preventing morbidity and mortality from diarrhea. Objective: To assess the awareness, knowledge and practice of mothers of under-five children regarding the use of ORS and other alternative solution during diarrheal illness. Methods: A cross-sectionalstudy involving 250 mothers with children of age 6 months - 5 years was carried out. Data were collected using a semi-structured questionnaire; it included data regarding socio-demographic characteristics and questions pertaining to knowledge of mothers about ORS. Results: Out of 250 study participants, 203 (81.2%) mothers were homemakers and 212 (84.8%) were literate. It was seen that 63 (25.2%) mothers did not know about ORS, 146 (58.4%) knew about the role of ORS in diarrhea, 129 (51.6%) had knowledge regarding homemade ORS. Only 119 (47.6%) mothers knew how to prepare ORS properly, and the most common source of informationregarding ORS was a doctor. 84 (33.6%) mothers had a misconception about ORS, and only 51 (20.4%) participants knew about syrup zinc. The higher education level of mother was associated with better knowledge regarding various aspects of oral rehydration therapy. Conclusion: The knowledge regarding the use of ORS in diarrhea is insufficient; hence, there is need to educate mothers regarding the use of ORS as well as homemade ORS substitutes during diarrhea.
Bacterial profiles and risk factors for neonatal sepsis in a rural tertiary care hospital in north India
Authors: Sareen Aarti , Aggarwal Prerna , Mahajan Kusum 
Published: June 2020

Objectives: To study, the bacterial profile in cases of neonatal sepsis admitted to the neonatal nursery or neonatal intensive care unit (NICU) and to identify the risk factors for early-onset neonatal sepsis. Design: Retrospective survey of hospital records from January 2012 to December 2012. Setting: A neonatal unit of a rural medical college hospital. Subjects: All inborn and outborn neonates who either had clinical signs of sepsis or were born to mothers with risk factors for sepsis and underwent a sepsis screen. Neonatal sepsis was defined as positive blood culture in babies younger than 1 month of age who had clinical signs of sepsis or had maternal risk factors for sepsis. Results: 396 neonates were screened for sepsis during the study period, of which 64 (16%) were culture positive. Of these, 42 (65.6%) had early-onset sepsis while 22 (34.3%) had late-onset sepsis (LOS). There were 6 deaths among those who had sepsis (9.3%). The predominant organisms in both early and LOS were Klebsiella and Staphylococcus aureus followed by Escherichia coli. Conclusion: The pattern of isolates is more or less similar to that seen in other NICU across the country. Klebsiella and S. aureus weretwo of the commonest organisms isolated in our study.
Burden of acute infections (except respiratory and diarrheal) and its risk factors among under-five children in India: A systematic review and meta-analysis
Authors: Ganguly Enakshi , Sharma Pawan K , Bunker Clareann H 
Published: June 2020

Context: Acute infections of eyes, ears, skin, and others are a common cause of morbidity in under-five children. The overall burden of other infections and their risk factors is not known. Evidence Acquisition: Available literature was searched comprehensively using PubMed for acute infections (except acute respiratory and diarrheal diseases) using the relevant medical subject heading terms. Extracted articles were independently reviewed against inclusion/exclusion criteria and rated for quality. 10 articles were abstracted and reviewed to identify the reported prevalence and risk factors for acute infections among children. Results: The pooled prevalence of infections (not including acute respiratory and diarrhea) between 2002 and 2013 was 18.42 (95% confidence interval: 9.30-30.62), with reported range of 3.7-50.8%. The significantly positively associated factors reported in single studies were young age of the child, malnutrition, poor breastfeeding, low socio-economic status, animal rearing near household and mothers’ illiteracy for independent morbidities. Conclusion: The evidence on risk factors including breastfeeding, vaccination, age, and sex that predispose under-fiveIndian children to different infections is inconclusive. There is a need to conduct more studies on acute infections other than acute respiratory and diarrhea, to establish their determinants in Indian children.
Awareness about human immunodeficiency virus/acquired immune deficiency syndrome and risk factors among out of school adolescents in an urban city
Authors: Bisht Supriya , Prajapati N C , Kumar Rajesh , Agarwal Renu 
Published: June 2020

Background: Adolescence is a complex phase of transition from childhood to adulthood. Present education programs usually overlook the needs of adolescents. Among those who are out of school, lack of appropriate level of education regarding human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) make them more vulnerable. Objective: To find the awareness about HIV/AIDS and risk factor among out of school adolescents. Materials and Methods: In this cross-sectional observational study, 211 adolescentspresently not going to school for ?6 months were interviewed. A simple random sampling was done from different areas such as traffic signals, railway station, and slums. Results: Among studied adolescents, 25% had never been to school, while 44.6% had studied <5th class. Half of them worked outside while a quarter was involved in household work. About 44% of total adolescents had heard aboutHIV/AIDS with 16.3% from the age group 10-14 years and 63.2% from 15 to 19 years group. Awareness about sexual relationships was seen in 67% males and 51% females. Among those aware of physical relations, knowledge about condoms was present in 92% males and 82% females. Among sexually active adolescents (67), 74% males and 28% females were involved in physical relations outside marriage, comprising 38 (18%) of all interviewed, putting them at high-risk behavior. Around 25.8% males and none of the females among them had used condoms. 26 (68.4%) of these “at risk” adolescents had a relationship with consent, whereas 24 (63.2%) had multiple sexual partners. Conclusion: Being out of school, these adolescents have poor educational status. Their knowledge about HIV/AIDS is very poor. Adolescents with better education status, higher age and male gender were more aware regarding various aspects of HIV. Significant proportions among these indulge in high-risk sexual behavior, does not use condoms and have multiple sex partners. Their specific needs should be addressed by the ongoing campaigns and programs against HIV to spread more awareness.
A study of modifiable risk factors for acute lower respiratory tract infections among under five children in a tertiary care hospital in Gulbarga, Karnataka
Authors: Mirji Gangadhar , Shashank K J , Shrikant S W 
Published: June 2020

Background: Acute respiratory infection includes any infection of the upper or lower respiratory system, as defined by the International Classification of Diseases. Acute respiratory infection is a leading cause of morbidity and mortality in under-five children in developing countries. Objective: This study was undertaken to identify various modifiable risk factors for acute lower respiratory tract infections (ALRI) in children aged from2 months to 5 years. Methodology: This hospital-based case–control study was conducted at Basaveshwarand Sangameshwar general hospital, Gulbarga over 1½. year 200 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 months to 5 years were interrogated for potentially modifiable risk factors as per a predesigned preformed. 200 healthy control children in the same age group were also interrogated. Results: The significant socio-demographic risk factors were incomplete immunization for age, low parental education, low socioeconomic status, and overcrowding (p<0.05 in all). Significant nutritional risk factors includemalnutrition, anemia, and rickets (p<0.05 in all). Significant environmental risk factors were parental smoking, use of biomass fuel, and mud/cow dung flooring (p<0.05 in all). Using multiple logistic regression analysis, the factors which were found to be significantly associated were younger age (p=0.000), anemia (p=0.000), incomplete immunization for age (p=0.002), malnutrition (p=0.00), low literacy level of father (p=0.000), and overcrowding (p=0.000). Conclusion: This study has identified various socio-demographic, nutritional, and environmental modifiable risk factors for ALRI which can be tackled by effective education of the community and appropriate initiatives taken by the government.
A study of prevalence of Mycoplasma pneumoniae pneumonia and validation of Immunoglobulin M for Mycoplasma pneumoniae in the diagnosis of Mycoplasma pneumoniae pneumonia
Authors: Kumar Pragalatha , Patil Alkarani T , Latha F J 
Published: June 2020

Background: Mycoplasma pneumoniae pneumonia (MPP) is one of the most common causes of childhood community-acquired pneumonia (CAP) and common cause of mortality and morbidity in young children. Polymerase chain reaction (PCR) is promising with higher specificity and superior sensitivity to that of culture or single point serology. Objective: This study was conducted to estimate the prevalence of MPP, and to compare the efficacy of PCR and immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) for the diagnosis of MPP among CAP in children. Materials and Methods: This study was conducted in children between 2 months and 12 years of age admitted with clinical and radiological features of pneumonia. The children were presumed clinically to have MP infection as per IAP guidelines when they had a cough and fever for more than 5 days. A predesigned proforma was used to collect history and clinical examination findings. Routine investigations such as complete blood count, C-reactive protein, chest X-ray, and blood culture were done. Those suspected of infection with MP infection were further subjected to PCR and IgM ELISA. Results: MP(27%) was found to be an important cause of CAP in children between 2 and 8 years. The most common clinical symptoms were cough and fever (100%) followed by myalgia (20.8%), arthralgia (16.6%), and rashes (12.5%). PCR is the rapid reliable diagnostic test with a sensitivity of 100% and specificity of 93%. IgM ELISA is equally effective diagnostic test with sensitivity of 83% and specificity of 100%. Conclusion: MP is an emerging cause of CAP in school going as well as preschool children. Although PCR is an alternative test of culture, use of simple test like IgM ELISA will reduce the cost of investigation and help us in arriving at definitive diagnosis of MP.
Clinical characteristics and laboratory profile of childhood systemic lupus erythematosus in a tertiary care center
Authors: Kumar B M Sunil , Rau A T K , Rao Chandrika 
Published: June 2020

Objectives: To study the clinical characteristics and laboratory profile of systemic lupus erythematosus (SLE) in children in a tertiary care center. Methods: Children presenting to our tertiary care center with suspected SLE, fulfilling at least 4 out of 11 American College of Rheumatology (ACR) criteria for the diagnosis of SLE were reviewed retrospectively. The study period was from June 2012 to May 2015. The clinical presentation and laboratory parameters were analyzed. Results: A total of 14 patients fulfilled the ACR criteria; there were 12 girls and 2 boys with a sex ratio of 1:6 favoring girls. The mean age on presentation was 9.8 years with a range of 3-15 years. At presentation, 70% of the children had features not suggestive of SLE. The most common symptom was fever seen in 100% of the patients, followed by hematological abnormalities in 78%, and renal involvement in 57% patients. Arthritis, skin lesions, and pulmonary involvement were seen in 42% of the patients. The gastrointestinal presentation was seen in 21% of the patients. Conclusion: SLE has a varied clinical presentation depending on the predominant organ involved. A high index of suspicion is required for the early diagnosis of SLE in children.