bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solid malignant pediatric tumors: a histopathological study
Authors: Gupta Neelu , Choudhary Monika , Pachar Sandeep , Dhaka Jai Prakash , Verma Roshan 
Published: February 2017

Background: In general, the features of malignancies in children differ biologically and histologically from those of adults with respect to incidence, type of tumor, underlying familial or genetic aberration and tendency to regress spontaneously or cytodifferentiation. In recent years, identification of specific genes, oncogenes, tumor markers and other biological and pathological factors have played an important role in staging and classifying risk categorization of specific tumors as low, intermediate and high-risk lesions.Methods: This study is under taken to evaluate the incidence and morphological features of solid malignant tumors in children of fifteen years and below. The material for present study is obtained from S. P. Medical College, Bikaner and referred cases. The histopathology slides and paraffin blocks are reviewed.Results: The sections 3-5 μ thick, are cut and stained by haematoxylin and eosin in all cases and special stains like PAS, MTS, RS done where ever feasible. An analysis of 60 cases of solid malignant tumors of childhood over a period of 5years are made. The early onset and the embryonal nature of the major pediatric tumors, suggest a prenatal origin and role of genetic factors. Infections, exposure to drugs and chemicals during pregnancy are other contributory factors.Conclusions: Accurate incidence of data is important in the planning and evaluation of clinical trials. Documentation of cases, advanced diagnostic methods like IHC, cytogenetic studies and treatment modalities with close follow up is needed to achieve better statistical evaluation of the problem.
Correlation of C-reactive protein and neutrophil counts as early indicators of severe dengue in children
Authors: Atukuri Sandhya Rani , Nayak Praveen 
Published: February 2017

Background: Dengue has broad clinical presentation with unpredictable clinical evolution and outcome while most patients recover following a self-limiting non-severe clinical course, a small proportion progress to severe disease. As early diagnosis of dengue infection remains a challenge around the world in areas of limited resources, laboratory parameters like CRP, Neutrophil counts may serve as predictive markers to promote early diagnosis. The objectives of this study were to stratify the levels of C-reactive protein and Neutrophil counts in children with dengue fever and to determine the correlation of C-reactive protein and Neutrophil counts with the severity of dengueMethods: This was an Observational chart based descriptive study done in all pediatric dengue children (aged 1-15 years) admitted at Father Muller medical college hospital, Mangalore during the period of June 2014 to 2016. Total sample size was 100. Data collection was done by using purposive sampling based on inclusion and exclusion criteria from case records. Controls (n = 20), children with diagnosis of viral fever were considered in the study.Results: Out of the 100 children studied, 16% were <5 years ,33% between 6-10 years and 51% above 10 years of age. Mean CRP levels in NS1, IgM and both are 6.2, 6.9, 6.3. CRP values >5 were considered as positive. Mean CRP values in dengue fever with warning signs (DF1), without warning signs (DF2) and Severe Dengue (DF3) were 6.3, 6.2, 11.4 respectively. Absolute Neutropenia was observed in 52% of the study population of dengue (DF1) of which severe neutropenia was observed in 19% and 15% OF DF2 (with no warning signs) also showed neutropenia. CRP values are significant in the study when compared to controls and absolute neutropenia was observed in 52% of dengue with warning signs. Hence CRP and neutropenia may be helpful as early predictors of severe dengue.Conclusions: Our study was an attempt to correlate CRP and neutropenia for early prediction of severe dengue. Mean CRP values in the population were significant statically but not as markedly elevated in other bacterial illness as the study population have no enrolled cases of severe dengue. But neutropenia (<1,500/cmm) and positive CRP (>5) may serve as predictive markers in a resource limited setting.
Clinical profile, outcome and clinical indicators for poor prognosis in full term babies born with severe birth asphyxia: study from tertiary care hospital from western India
Authors: Thakkar Pareshkumar A. , Valia Paresh , Parmar Niyati , Javadekar Bakul , Thakkar Ukti P. 
Published: February 2017

Background: The World Health Organization describes birth asphyxia as failure to initiate and sustain default breathing at birth. The aim of the study was to study the clinical profile and outcome at 3 months of age of full term babies born with severe birth asphyxia and to analyze risk factors associated with adverse outcome.Methods: This was a prospective observational study carried out over period of 12 months in year 2015-16. All full term babies born with severe birth asphyxia (n = 45) during four months period were enrolled and were followed up for 3 months. Severe birth asphyxia was defined as APGAR score 3 or less at 1 minute. Baseline characteristics, clinical profile and outcome were noted. HIE was graded as per Sarnat and Sarnat staging. Neurological Assessment at 7th day and on discharge was done and were assessed by Amiel Tison Scale at 3 months. Multivariate analysis by linear regression was done to find risk factors associated with adverse outcome. Results: Of total 45 babies with SBA, 35 developed HIE, of which 13 (28.8%) were in HIE grade II and 13 (28.8%) were in HIE III. Mortality found was 20% while 28.5% of survivors had abnormal neurological outcome at 3 months. Multivariate analysis of risk factors shows that abnormal neurological finding on 7th day of life, APGAR ≤ 6 at 10 minute and HIE grade II or more where associated with abnormal outcome(p = 0.01). The risk factors associated with mortality were multiorgan dysfunction, difficult to control seizures, APGAR ≤4 at 10 minute (p = 007).Conclusions: Full term neonates with severe birth asphyxia has significant mortality and significant number of survivors has abnormal neurological outcome at 3 months of age. Presence of certain clinical indicators is associated with increased risk of adverse outcome.
Cord blood albumin as a predictor of neonatal hyperbilirubinemia in healthy neonates
Authors: K. C. Gaurav Aiyappa , Shriyan Ashvij , Raj Bharath 
Published: February 2017

Background: Neonatal jaundice or icterus neonatrum has been observed in newborn babies for many centuries. The objective of this study was to determine the correlation between cord albumin levels and development of hyperbilirubinemia in term healthy neonates.Methods: A prospective study was conducted on 165 term healthy neonates. Gender, gestational age, anthropometric measurements were taken into consideration. It was ascertained that there was no other risk factor for hyperbilirubinemia amongst the neonates. The neonates were divided into two groups A and B based on the cord albumin levels of <2.8 gm/dl and >2.8 gm/dl.Results: Of the 165 babies included in the study, 126 babies were under Group 1 and 39 under Group 2. 44 babies (34%) in group 1 and 28 babies (71.7%) in group 2 (p<0.0005) developed clinical icterus of which 16 in group 1 and 19 in group 2 required phototherapy (p<0.05). 1 baby in group required exchange transfusion. The sensitivity and specificity of cord albumin in detecting neonatal hyperbilirubinemia in this study was determined to be 71.8% and 65.1% respectively.Conclusions: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So, routine determination of cord albumin can be advocated to keep a track on at risk neonates.
Cord C-reactive protein as a marker for early onset neonatal sepsis children
Authors: Patrick Reeba , Rajan Aswathy , Shriyan Ashvij 
Published: February 2017

Background: Of the 2.8 million neonatal deaths, worldwide, 0.43 million is contributed by sepsis alone. The objective of this study was to determine the levels of umbilical cord C-reactive protein and assess the suitability of this test in diagnosing early onset sepsis in newborns born to mothers with no risk factors for intrapartum infection. To determine the influence of other factors such as parity, birth weight and mode of delivery on the levels of cord CRP.Methods: CRP levels in cord blood were estimated for 103 consecutive newborns delivered at a tertiary care teaching hospital. These babies were monitored for signs of sepsis for 72 hours and were later followed up with serum CRP and blood cultures.Results: A prospective cohort study of 103 consecutive newborns were taken of which 53.4% were male babies. Comparison of cord CRP levels of baseline characteristics revealed significant elevation in babies born to multipara mothers (p = 0.0028) and in low birth weight babies (p = 0.05), while there were no significant changes in different modes of delivery. The mean cord CRP of the study group was 0.694±0.2979. Out of 104 babies, 16 had elevated cord CRP (above 1.1mg/l) of these, 12 babies were later confirmed to have sepsis. The mean cord CRP level in babies with EOS was 1.3±0.255 (p = 0.001). A sensitivity of 100%, specificity of 90.9%, positive predictive value of 75% and negative predictive value of 100% was determined.Conclusions: This study confirms that cord CRP is an effective marker to predict EONS. An optimal concentration of cord CRP > 1.1 mg/L has maximal sensitivity and specificity to predict EONS.
Immunization status of 24-35 months old children in urban slums of Ahmedabad, Gujarat, India: a cross sectional study
Authors: Chaudhari Chintu C. , Gunjana Geet , Modi Khushboo Kiritbhai , Patel Manali Prashantkumar , Thakker Nisarg Rajivbhai , Thakor Nilesh 
Published: February 2017

Background: Immunization is one of the most cost effective methods of preventing childhood diseases and needs to be sustained with higher coverage for desired benefits. Objective of the study was to assess immunization coverage in children of 24-35 months of age group in urban slums of Ahmedabad city, India.Methods: Using the purposive sampling method, a cross sectional community based study was conducted in urban slum area (Vadaj area) of Ahmedabad city during July-November 2014. All 214 children of 24-35 months age group of the area were included after taking verbal informed consent of their parents or guardians. Vaccination status of the children was verified using the Immunization card. In conditions where the Immunization card was not available, the mother/parents were asked about the site of vaccinations to confirm the vaccines being given. Analysis of study was done by using appropriate statistical software. Results: Total 936 households were surveyed. There were 214 children in the 24-35 months age group. Mamta card or immunization record was available with 145 (73.6%) mothers of 24-35 months age group of children. Vaccination coverage in the age group of 24-35 months old children was maximum for BCG and OPV first dose (96.7%) followed by Pentavalent first dose (95.8%) and OPV second dose (95.3%). Overall, 75.7% of the children in the 24-35 months age group were completely immunized while only 6 children were unimmunized. Dropout rate percentage for Pentavalent 1st dose to pentavalent 3rd dose was 3.44% while for BCG to second dose of measles was 19.75%.Conclusions: Complete immunization coverage was 75.7% which was better than the national surveys still the causes for no/ partial vaccinations need to be addressed.
Prevalence of urinary tract infection among preschool febrile children attending the pediatric OPD
Authors: Shetty Pradeep N. , S. Prashanth , Jagadeeshwara Sowmya 
Published: February 2017

Background: Urinary tract infection (UTI) is one of the most common bacterial illness among febrile infants and preschool children with a reported prevalence between 4.1% and 7.5%. The objective of this study was to know the prevalence of urinary tract infection in preschool febrile children.Methods: Cross sectional study conducted in pediatric OPD of a Government teaching hospital with 500 febrile preschool children aged 3 to 6 years. Results: Prevalence of UTI in febrile preschool children aged 3-6 years was 2.9% in males and 5.5% in females with overall prevalence of 4%. 15% had temperature > 39.3 oC. 45% had dysuria, 35% had vomiting. 25% and 20% had increased frequency and burning micturition respectively. 70% patients with UTI and 30% cases without UTI had proteinuria. 95% patients had pus cells > 5 per HPF. 60% patients had bacteria in their urine where as in culture negative cases only 1.04% had bacteria. E coli was the common organism isolated (80%), followed by Klebsiella. Majority were resistant to Ampicillin (55%). 75% of microorganisms were sensitive to ceftriaxone. 70% were sensitive to gentamycin, norfloxacin and cephalexin. 5% UTI cases had RFT. KUB X-ray was normal in all the cases. 20% of cases showed features suggestive of acute pyelonephritis on Ultrasonography. 1 out of 4 Patients who underwent Intravenous pyelography showed hydronephrosis. 2 out of 4 cases showed VUR in MCU.Conclusions: UTI is a potential cause of fever in children below 6 years of age. Urine culture is the gold standard for diagnosis of UTI in children. Parents should be educated about the importance of UTI and its long-term complications.
Clinical, etiological, biochemical, microbiological and neurosonogram factors in related with neonatal seizures in Visakhapatnam, India
Authors: Rao Marpi Suryaprasada , Rao Gavara Chinna , Sultana Ayesha , Karthik Putrevu Jagannadha 
Published: February 2017

Background: Neonatal seizure is a common neurological problem in the neonatal period. Detection of seizure, its etiology, and clinical types is important for guiding therapy. A varied number of conditions are capable of causing seizures in the neonatal period. The aim was to study biochemical, microbiological and, nurosonogram factors related with neonatal seizures in Visakhapatanam, India.Methods: The study was carried out in the Department of Paediatrics, Andhra medical college, King George Hospital, Visakhapatnam, Andhra Pradesh. The study was done to assess the biochemical changes, nurosonogram factors and microbilogical organisms implicated in neonatal seizures.Results: The present study is descriptive in nature where clinical spectrum of neonatal seizures in neonates was studied. 1500 neonates were admitted in NICU during the study period, among them 200 (13.3%) developed neonatal seizures. Etiology in majority of the cases of neonatal seizures was hypoxic ischemic encephalopathy (45%) followed in frequency by intracranial haemorrhage (14%), meningitis (12%), hypoglycaemia (11%), hypocalcaemia (4%) and others (14%). The most common organism implicated in neonatal seizures was Escherichia coli (36%), followed by Klebsiella (30%), staphylococcus aureus (19%), Streptococci agalactiae (7%) and unknown (8%). Meningitis accounted for 12% of neonatal seizures. Most common biochemical abnormalities noted were hypoglycemia, hypocalcaemia and hyponatremia.Conclusions: Biochemical abnormalities may significantly contribute to seizure activity and possibly correction of these abnormalities may play a significant role in seizure control. A biochemical work up is necessary for all cases of neonatal seizures. Appropriate treatment with antibiotics is essential. Examination of cerebrospinal fluid is essential work up in cases of neonatal seizures. Neurosonogram had good potential in predicting neurological outcome in neonates with perinatal asphyxia. Neurosonogram should be incorporated in the routine evaluation of seizures.
Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India
Authors: Vasundhara Arigela , Sahoo Manas Ranjan , Chowdary Sai Silpa 
Published: February 2017

Background: Shock is a state of impaired tissue perfusion resulting in an imbalance between oxygen demand and supply. This widespread reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients, the end result of which is an altered cellular and sub cellular function leading to anaerobic metabolism and accumulation of lactic acid, and consequently cellular damage, multiple organ dysfunction and finally cardiovascular collapse.Methods: The present study was conducted in the department of Pediatrics at Alluri Sitarama Raju Academy of Medical Sciences hospital, Eluru, between December 2014 and June 2016. It is a prospective study. Children aged 1 month to 12 years with a clinical diagnosis of shock were included after written consent from parents.Results: Out of 75 children admitted with shock, 69.33% had septic shock, 25.33% had hypovolemic shock, 2.66% had distributive shock, 2.66% cardiogenic shock. Most common age group admitted with shock was 1 month-1 year 38.666%. Among 75 children with shock, 74.66% children survived and 25.33% children died. Mortality rate in cardiogenic shock was 100%, in septic shock 28.84%, in hypovolemic shock 10.52%.Conclusions: Septic shock was the most common type of shock. Most common cause for septic shock was pneumonia. Septic shock has got highest mortality in the present study.Need for inotropes and mechanical ventilaton indicates poor prognosis in shock.
Adenosine deaminase activity in cerebrospinal fluid: diagnostic investigation in central nervous system disorders in children
Authors: Rahaman Sk Rafikul , Panda Anshuman , Mandal Pradyut K. , Chatterjee Kripasindhu , Borgaonkar R. V. 
Published: February 2017

Background: Tubercular meningitis (TBM) is an endemic disease in developing countries. Adenosine deaminase activity (ADA) has been of great importance for many years in TBM diagnosis. The objective of this study was to determine the CSF-ADA levels in different CNS disorders, to compare the CSF-ADA activity in different types of meningitis, to find out the sensitivity and specificity of CSF-ADA in the diagnosis of TBM and to establish the prognostic value of CSF-ADA in TBM in comparison to Control group.Methods: For control group CSF was collected from the patients of simple febrile convulsions and idiopathic epilepsy.Results: The present study was carried out in the 112 cases of different CNS disorders, age ranging from 4 months to 12 years with a mean age of 4.12 years and 38 cases (27+11) of control group (simple febrile convulsion and idiopathic epilepsy). In the present study CSF-ADA level was statistically significantly increased in all types of meningitis (p<0.05). In case of TBM, the mean CSF-ADA level increased statistically significantly with increase in CSF protein level (p<0.05). In case of TBM, there was no significant difference in the mean ADA value according to CSF sugar level (p<0.10). In case of TBM, the mean CSF-ADA level increased significantly with increase in CSF cell count (p< 0.01) mainly lymphocytes.Conclusions: Thus it can be concluded from our study that CSF-ADA estimation is relatively simple and inexpensive procedure in the early diagnosis of tuberculous meningitis with high sensitivity (100%) and specificity (97.5%) at a cut-off level of 5IU/L and can be used in differentiating TBM from other types of meningitis. Along with diagnostic utility of CSF-ADA, it has also prognostic value in the follow-up case of tuberculous meningitis.
Influence of maternal HbA1C on fetal insulin levels
Authors: H. T. Yashoda , B. Swetha , G. Manasa 
Published: February 2017

Background: Gestational diabetes is the most common medical complication during pregnancy. The objective of this study was to study the effect of maternal HbA1C levels on fetal insulin levels.Methods: Study was conducted at KIMS. 57 babies born to eligible diabetic pregnant women aged between19 to 40 years with gestational age between 35 and 42 weeks were recruited. Multiple births, gestational age <34 weeks, steroids given within 24 hours before birth, delay of >20 minutes in cord blood collection, delay of >60 minutes before freezing of plasma were excluded. Maternal investigations (HbA1C) were collected from maternal records. Umbilical cord blood was collected immediately after delivery and insulin levels were measured.Results: In this study, mean cord blood insulin levels were 7.83±3.53 μU/ml, mother’s mean HbA1C levels were 6.47±1.26. Statistically significant association was found between maternal HbA1C levels and fetal insulin levels. (r 0.37; P 0.004).Conclusions: Increased cord blood insulin levels were found in infants of diabetic mothers at birth, more so in large for gestation age babies, suggesting inutero fetal programming and hence strict control of maternal diabetes is recommended to decrease long-term fetal effects.
Vitamin D status in children with cerebral palsy
Authors: Manohar Sowjan , Gangadaran Rajakumar Ponnandai 
Published: February 2017

Background: The aim of the study was to find the prevalence of vitamin D status - vitamin D deficiency and insufficiency in children with cerebral palsy and to compare them with normal children. To identify the risk factors associated with vitamin D deficiency in these children.Methods: A prospective case control study was done in 200 children in Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur, Tamil Nadu, India over a period of one year from December 2014 to December 2015 after obtaining approval from institutional ethical committee. Study group contained 100 children with cerebral palsy. 100 Age and sex matched children were taken as controls. Children included in the study were between 1 to 12 years. All children were subjected to the following investigations: serum calcium-total, serum phosphorus, serum alkaline phosphatase (SAP) levels. These were determined by an automated analyzer. The 25OH vitamin D levels were estimated by CLIA (chemi luminescence immunoassay) method. Results: Vitamin D deficiency was observed in 32 (32%) and insufficiency in 61 (61%) of children with cerebral palsy in case group. Similarly, vitamin D status studied in control children was found that majority of them 49 (49%) was normal. While 38 (38%) were vitamin D insufficient, 13 (13%) showed deficient levels (p <0.0000001).Conclusions: The presence of feeding difficulties, poor sunlight exposure, poor nutritional status, and the use of antiepileptic drugs, type of CP and the functional grade of CP had statistically significant association with Vitamin D deficiency in these children.