bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study on prevalence of minor physical anomalies in mentally retarded children in a tertiary care centre of India
Authors: Konar Mithun C. , Karmakar Kushal , Islam Kamirul , Nayek Kaustav , Sil Archan 
Published: February 2019

Background: Paucity of studies in world literature and lack of any Indian study assessing the frequency, prevalence and severity of minor physical anomalies (MPAs) in children with mental retardation (MR) as well as their importance for prediction and timely recognition of mental insufficiency, if any.Methods: A cross-sectional observational study involving 273 mentally retarded children aged 5-18 years was conducted over a period of one year and were compared with their age and sex matched controls. Waldrop and Halverson (1971) physical anomaly scale was used to assess those MPAs.Results: In the study group, higher percentage (79.85% vs. 40.29%) of children had MPAs with a predominance of multiple MPAs in comparison to healthy children (40.29% and 0%, respectively). Higher average frequency of MPAs per child was noted in the study group (1.42) than control group (0.40). Mean Waldrop weighting score was significantly higher among mentally retarded children than their controls (3.7±0.8 versus 0.8±0.2, P<0.0001). Authors noticed a gradual and significant decrease in Waldrop score with increase in intelligence quotient (IQ) [F=175.72, P<0.001]. A significant strong negative correlation between Waldrop score and IQ level (r=-0.89, P<0.001) was also observed. Out of eighteen variables of Waldrop score, seven were found as significant in binary logistic regression model for MR. Our model can explain 37.6% to 50.1% variability of the MR.Conclusions: MPAs are more prevalent in mentally retarded children than healthy children. A clear-cut demarcation between these two groups is possible by the frequency of anomalies and the increased strength of their expression (i.e. their weighting scores).
Antibiotic resistance pattern of Staphylococcus aureus infections in children
Authors: Kumar K. Senthil , Kumar C. Ajith Brabhu 
Published: February 2019

Background: Methicillin resistant Staphylococcus aureus (MRSA) is endemic in India and is a dangerous pathogen for hospital acquired infections. Analysing antibiotic susceptibility pattern of Staphylococcus helps us to overcome the therapeutic difficulties created by the rising anti-microbial resistant bacteria and guide us in choosing appropriate antibiotics. Hence, this study was conducted.Methods: Children with confirmed S. aureus infection between the age group of 0-12 years were classified into MSSA and MRSA subgroups. Isolates were identified as S. aureus using standard microbiological methodologies at diagnostic bacteriology laboratory, in the Microbiology department. Basic demographic variables and antibiotic resistance patterns were compared between MRSA and MSSA subgroups.Results: Majority of S. aureus were isolated from pus followed by blood culture. Prevalence of community acquired MRSA in present study (80%, with 95% CI from 68.56% to 91.44%) was significantly higher when compared to another studies (p value=0.004). Resistance to gentamicin and ciprofloxacin among the MRSA isolates was more than that in methicillin sensitive S. aureus (MSSA) (P<0.001).Conclusions: It is prudent to include MRSA coverage in empirical antibiotic regimens in settings where a significant proportion of patients hospitalized for S. aureus infection have MRSA.
Intermittent clobazam prophylaxis in simple febrile convulsions: a randomised controlled trial
Authors: Kumar Vinod , Gupta Ashish 
Published: February 2019

Background: Febrile seizure (FS) is the most common type of childhood seizure disorder with a prevalence of 2-5% in children less than 5 years. Although the prognosis of febrile seizure is usually good, however, the possibility of recurrence keeps many parents and families in a state of anxiety and concerned, for years after the first seizure. Thus, intermittent prophylactic treatment might be advised in children with high risk of recurrence.Methods: The study was a prospective randomized, double blind, placebo-controlled trial conducted at Department of Pediatrics, Umaid Hospital, Dr S N Medical College, Jodhpur on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. Subjects were randomly prescribed oral clobazam according to weight of child and placebo when they developed a febrile disease during the first 48 h of the onset of fever. Temperature reduction measures with paracetamol and tepid sponging were also advised. Patients were followed up for the frequency and time of febrile seizure recurrence, febrile episodes and side effects of drugs for 12 months.Results: Ten (3.8%) of 257 episodes in clobazam group and 38 (14.07%) episodes in placebo group had seizure recurrence (p value <0.001). The two groups were not significantly different in terms of side effects. (p >0.05).Conclusions: Intermittent oral clobazam therapy is a very effective measure in preventing recurrence of febrile seizures.
Prevalence of attention deficit hyperactivity disorder, gender difference and its co morbidity among urban school children in a city of southern Rajasthan, India
Authors: Bhardwaj Anubhuti , Mandot Sanjay , Jain Hemant 
Published: February 2019

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood (3-5%). The main characteristics of attention deficit hyperactivity disorder are inattention, hyperactivity, and impulsivity. The Objective of this study was to study prevalence of ADHD in school aged children.Methods: A cross sectional descriptive school-based study was conducted in a private school of Udaipur from January 2017 to September 2018. All eligible students were included. Total 1200 students were enrolled. They were assessed for the presence of ADHD using INCLEN diagnostic tool and those found positive were further assessed for the presence of co-morbid conditions using child behavior checklist (CBCL).Results: In present study out of total 1200 students 730(60.83%) were male and 470(39.17%) were female. 76 (6.3%) students out of 1200 were ADHD Positive. ADHD was more common in male students (73.7%), urban locality (57.89%), in age group 6 to 9 years (44.7%) and higher economic class (46.1%). Hyperactivity-Impulsivity type was most common type (51.32%). Male students had predominance of hyperactivity (60.7%) whereas in female student’s inattention type was predominant (45%). Aggressive Behavior (19.6%) and rule breaking behavior (80.4%) was more common in male. Somatic complaints were more common in females (60%). Oppositional defiant disorder was observed in male (21.4%) and female (10%) students. 15.8% of ADHD students had learning disorder.Conclusions: Present study shows 6.3% prevalence of ADHD. Hyperactivity type of ADHD was more common in boys, while Inattention type was more common in girls. Among associated co morbid conditions - aggressive behavior, rule breaking behavior and oppositional defiant disorder (ODD) was found to be more prevalent in boys while anxious behavior, somatic complaints and social problems were more commonly found in girls. Thought problems, learning disorders and conduct disorders are also observed in ADHD students.
A study on clinical profile and outcome of patients in PICU (paediatric intensive care unit) at tertiary care unit
Authors: Jyothi K. Aruna , Ankireddy Korisipati 
Published: February 2019

Background: This study was carried out with the objectives to study the clinical profile and to find the outcome of children admitted to pediatric intensive care unit (PICU) of Kurnool medical college and hospital, Andhra Pradesh.Methods: A retrospective study was carried in children aged more than 28 days to 12 years admitted in PICU from 1st January 2016 to 31st December 2016 when a total of 600 patients were admitted.Results: Out of these, 400 (66.66%) cases were males and 200 (33.33%) cases were females. Maximum numbers of patients were in the age group of more than 28 days to 1 year which constituted 325 (54.16%) cases. This was followed by 1 year to less than 5 years age group which constituted 150 (i.e. 25%) cases. Under 5 years aged children constituted 500 (83.33%) cases. Next most common age group admitted was 5 years to 10 years with 85 (i.e. 14.16%) cases and 10 to 12 years age group constituted 40 (6.66%) cases. In this study, central nervous system was the commonest system involved (n=195, 32.5%). Other systems involved were: respiratory system (n=122, 20.33%), cardiovascular system (n=65, 10.83%), gastro-intestinal system (n=32, 5.33%), hematological (n=35, 5.83%) and renal system (n=23, 3.83%). Other causes include infections (n=97, 16.16%), metabolic (n=17, 2.83%), down syndrome (n=7, 1.16%) and poisoning (n=7, 1.16%) etc.Conclusions: Out of the 600 patients admitted to PICU, 168 (28%) patients died. 315 (52.5%) cases improved. 117 (19.5%) cases constituted those who were shifted to higher centre or another department or were taken against medical advice.
A clinical study of new onset seizures in children aged 3-12 years
Authors: Dwivedi Rinu , Sudha Priya P. , Padmavathi P. 
Published: February 2019

Background: Seizures are common in pediatric age group and less than 1/3rd of seizures in children are caused by epilepsy. Aim of present study was to analyze the etiological factors and clinical profile of new onset seizures in children aged 3-12 years.Methods: This was a prospective study done at a tertiary care center of south India. Authors analyzed 98 children aged 3-12 years presenting with new onset seizures. Proper history and investigations including EEG, and CT brain were done to confirm the etiology.Results: Out of 98 children 51 were 3-5 yrs of age and 47 were 6-12 years. 66.3% had generalized seizure and 33.6% had partial seizure. Partial seizure were more common in 5-12 years of age. Intracranial infections were the leading cause (73/98) which included neurotuberculosis (26/73), NCC (20), bacterial meningitis (12), cerebral malaria (8) and viral encephalitis (7). Intracranial infections were the leading cause in both age groups. Space occupying lesions were more common in 6-12 years (46.8%) as compared to 3-5 years (19.6%). NCC and Tuberculoma were the leading CT findings in both age groups. There was significantly high incidence of focal EEG changes in partial seizure group compared to generalized seizure group.Conclusions: Intracranial infections were leading cause of new onset seizures especially GTCS. Good clinical evaluation and judicious use of investigations should be ensured. CT brain and EEG are more likely to be informative in partial seizures than in generalized seizures.
A study of echocardiographic changes in patients of thalassemia major
Authors: Chanpura Vaishali R. , Modi Daxay 
Published: February 2019

Background: Thalassemia major is a chronic hematological disorder. Regular blood transfusion is the only modality of long-term survival for these patients. This leads to iron overload, the heart being the most severely affected organ. The gold standard for detecting myocardial iron deposition is cardiac MRI. However, very few patients can afford this investigation. Hence, authors carried out this study to find out whether early iron overload can be detected by echocardiography which is a simple and less expensive tool. The objective of this study was to document echocardiographic changes of cardiac iron overload in patients of thalassemia major even before appearance of symptoms.Methods: A comparative cohort study conducted from January 2018 to October 2018 in the Department of Paediatrics of SSG Hospital, and Government Medical College, Vadodara. The case group consisted of 35 patients of Thalassemia major. 35 age and sex matched normal children were selected as controls. Relevant blood investigations were performed in cases. 2-Dimensional M-Mode Echocardiography was performed in both patients and controls. Thalassemia major patients were compared to normal healthy children for various parameters in echocardiography indicating the systolic and diastolic function. Proportion and percentage were calculated for descriptive analysis. Independent t-Test was applied between two groups to find out significance level.Results: For all parameters except End systolic volume and fractional shortening, p values were less than 0.05 which is significant. 85% (30/35) had increase in interventricular septal dimensions (IVSD), 97%(34/35) had increase in posterior wall dimensions (PWD), 82%(29/35) had increased left ventricular internal diameter diastole(LVIDD), 88%(31/35) had increased left ventricular internal diameter systole (LVIDS), 80%(28/35) had increased E/A RATIO .Ejection fraction was affected in 77%(27/35).This shows that patients of thalassemia major have significant cardiac dysfunction; possibly because of cardiac iron overload.Conclusions: Echocardiography is an effective tool for screening cardiac iron overload in patients of thalassemia major and should be done periodically in all patients.
Aetiological profile of fever in neonatal and paediatric population in hospital setting
Authors: Dwivedi Amitabh 
Published: February 2019

Background: Febrile illness in children is a common cause of admission to hospital globally, with significant associated morbidity and mortality. Dengue, malaria, scrub typhus, typhoid and leptospirosis have been identified as major causes of acute undifferentiated febrile illness in Thailand, Malaysia, and Nepal. Climate variation, over population and urbanization may all contribute to the emergence and reemergence of infections in tropical regions like Tamil Nadu. The objectives of this study were to describe the aetiology of fever in hospitalized neonatal and Pediatric population. A descriptive study was designed.Methods: A prospective observational study was conducted. All children from 0 to 18 years admitted as in-patients. Sample size was calculated to be 650. Basic laboratory tests were done in all cases.Results: Out of a total of 650 children maximum number (40.7% n=265) of patients had short duration of fever between 1 to 3 days. Majority (56%) of patients had temperature between 100.4 to 101F. Only 5 children were confirmed to have malaria. Maximum number of pus cells found was 80 to 100 in 3 children in urine examination. Total Infectious cases were 631 (97.07%).Conclusions: Infectious aetiology was more common than non-infectious aetiology. Among all aetiologies, viral fever particularly dengue was the most common aetiology. Enteric fever was the second most common infectious cause of fever after viral fever. Short febrile illness (1 to 5 days) was the most common type of fever in children admitted in hospital. In neonates, the most common cause of fever was probable sepsis followed by dehydration fever.
Ventilator associated pneumonia: incidence and risk factors in a tertiary care hospital
Authors: Rathor Manish , Sharma Neetu 
Published: February 2019

Background: The objective of this study is to find the occurrence and contributing risk factor of ventilator associated pneumonia (VAP) in 2 months-5 years age group.Methods: This was a prospective, observational, hospital-based study carried out in a tertiary care setting hospital. All patients between 2 months-5 years age admitted in the ICU who had undergone MV were included in the study. Inclusion criteria includes patients who developed pneumonia after the 48 hours of mechanical ventilation and those patients were excluded who developed pneumonia within 48 hours of mechanical ventilation and having respiratory system findings /involvement prior to the MV. After recruiting patients baseline clinical characteristics (age, sex, diagnosis, duration of MV) were taken, monitored and diagnosed VAP using CDC guidelines until they were discharged or deceased. The parameters such as fever, oxygenation, leucocytosis, other risk factors. chest X-ray and ETA>105CFU/ML or microscopy (grain stain>l bacteria/>10 polymorphonuclear cells) were collected every 48 hours.Results: This study was done in 133 patients while 42 patients (31.58%) developed VAP during their ICU stay. Early onset VAP occurred in 34 (80.9%) while late onset VAP was observed in the remaining 8 (19.1%) patients. In ETA culture CFU>105 Klebsiella (38%) was the predominant isolate followed by Pseudomonas (23%), Acinetobacter (17%), Staphylococcus (13%) and Citrobacter (10%) are offending organism responsible for VAP in MV patient in present study. On analysis (univariate) reintubation, altered sensorium at intubation and use of antacid are found significantly associated risk factors with the development of VAP. Multivariate analysis revealed that reintubation was an important risk factor for the development of the VAP.Conclusions: The various risk factors can be minimized for better outcome of patients undergoing mechanical ventilation. Risk factors such as reintubation, altered sensorium at intubation and use of antacid are associated with VAP and also the physician treating must have knowledge and awareness about prevention of these risk factor to improve the outcome of patients.
Acute kidney injury in paediatric intensive care: need for extended vigil
Authors: P. J. Saritha , M. P. Jayakrishnan , T. P. Ashraf , G. Geeta M. 
Published: February 2019

Background: Acute kidney injury (AKI) is an important contributor towards morbidity and mortality among critically ill children. The objective of this study was to ascertain the etiological factors, categorize the severity and determine the immediate outcome of AKI among children admitted to the pediatric intensive care unit (PICU) of a tertiary referral hospital in south India.Methods: A prospective study was conducted from January to December 2012 in the PICU, Government medical college, kozhikode, a major referral hospital in north Kerala. The institutional ethics committee approved the study. Children in the age group of 1 month to 12 years admitted to the PICU for at least 48 hours were included if they had no previous renal disease/AKI at the time of admission. Serum creatinine levels of the children were measured at the time of admission, at 48 hours, and one month later. Outcome measures included normalization of serum creatinine or persistence of impaired renal function. Mortality was assessed both immediately and after one month.Results: A total of 1716 children were included in the study, of which 107 children developed AKI (6.2%). Among the 107 children, 56 children (52.3%) were boys. Majority of children were infants 75(70.1%). Infection was the commonest underlying condition associated with AKI. Most of the children with acute kidney injury were in the earliest phase (Stage 1). Twenty-six children (24.29%) died. Among the survivors, 10% were found to have impaired renal function when followed up a month later.Conclusions: There is a high incidence of AKI in critically ill infants admitted in PICU. Residual renal impairment can persist even after discharge from hospital and these children need follow up for a longer time.
Partial trisomy 15: a rare occurrence
Authors: Gandhi Prachi , Malik Sushma , Subramanian Sharan , Wade Poonam , Saxena Shruti , Lichade Vinaya 
Published: February 2019

Partial trisomy 15q is a very rare entity and most of them are characterized by duplication of regions 15q21-15q26.3. This duplication is frequently associated with deletions in another chromosome resulting in unbalanced translocations. Authors report here, a rare case of partial trisomy 15, with breakpoints between 15q11.1 to q23, probably the first reported case with these breakpoints. Irrespective of the breakpoints, the phenotypic features are consistent in all affected cases and predominantly consist of craniofacial anomalies. In addition, finger abnormalities, very short neck, skeletal malformations and congenital heart disease may be present. Our neonate had typical dysmorphic features of arachnocamptodactyly, narrow face, large prominent, nose with broad nasal bridge, long philtrum, pointed chin, short neck, and low set deformed ears. Neonates’ cytogenetic analysis revealed additional chromosomal material on the long arm of the chromosome 15 from q11.1 to q23.1, which was suggestive of partial trisomy of chromosome 15. Most cases reported have had a stormy clinical course, however, our proband had only mild respiratory distress at birth and she was discharged in a few days.
The impact of ipsilateral central neck dissection on the 2015 American thyroid association risk stratification system and TNM staging in papillary thyroid carcinoma
Authors: Penna Gustavo C. , Corradi Patricia F. , Mendes Henrique G. , Berenstein Cynthia K. , Pires Magda C. , Fonseca Bernardo , M. Moraes Gustavo 
Published: February 2019

<p class="abstract"><strong>Background:</strong> In patients with classic papillary thyroid carcinoma (PTC) and no clinical evidence of lymph node metastasis (cN0), elective central neck dissection remains controversial. This study evaluates whether elective ipsilateral central neck dissection (eICND) along with total thyroidectomy could modify the staging of these patients. Additionally, we aim to assess pN1 risk factors, the incidence of post-operative complications, and the correlation between pN1 and change in tumor classification according to the risk stratification score of the American thyroid association 2015 (ATA 2015-RSS) and the TNM Score.</p><p class="abstract"><strong>Methods:</strong> This is a prospective, observational study, involving 46 patients with cN0 PTC who underwent eICND along with total thyroidectomy. The number of metastatic lymph nodes, the largest lymph node metastasis, and the extra-nodal extension were assessed. </p><p class="abstract"><strong>Results:</strong> 22 out of 46 patients (47.8%; CI 32.9–63.1) presented lymph node metastasis. Seventeen out of the 45 patients initially classified as low or intermediate ATA 2015-RSS upgraded their risk staging (37.8%; CI 23.8–53.5). Fourteen out of these reclassified patients had their initial ATA 2015-RSS changed due to lymph node metastasis larger than 2 mm (mostly between 3 mm and 4 mm). Ten out of 46 (21.7%; CI 10.49–36.4) patients had their TNM staging reviewed. General complication rate was 17.4% (8/46).</p><p class="abstract"><strong>Conclusions:</strong> Elective dissection of levels VI ipsilateral and VII showed the ability to upgrade the initial ATA 2015-RSS and TNM staging in patients with cN0 PTC. However, further studies are necessary to evaluate the clinical impact of lymph node micro-metastasis.</p>
Do eyeglasses and palatal prostheses affect the results of the Weber test?
Authors: Atar Yavuz , Salturk Ziya , Berkiten Guler , Kumral Tolgar Lutfi , Uyar Yavuz , Yildirim Guven , Aydogdu Imran , Dogan Mehmet Onder , Sari Huseyin , Ekincioglu Enis 
Published: February 2019

<p class="abstract"><strong>Background:</strong> The aim of the study was to analyze the possible effects of eyeglasses and palatal prostheses on the results of the Weber tuning fork test.</p><p class="abstract"><strong>Methods:</strong> We enrolled 96 patients diagnosed with unilateral conductive-type hearing loss. All were aged between 18 and 65 years. Group 1 was composed of 48 patients with eyeglasses and group 2 included 48 patients with palatal prostheses. All patients underwent the weber tuning fork test with and without their eyeglasses and prostheses, and the results were compared. Weber tests were performed using 256 Hz and 512 Hz tuning forks. </p><p class="abstract"><strong>Results:</strong> No significant between-group difference was apparent (both p&gt;0.05).</p><p class="abstract"><strong>Conclusions</strong> Neither eyeglasses nor palatal prostheses significantly affected the results of the Weber test.</p>